Shootings, Attacks, and Disasters: How EMDR Therapy Can Help

Times Square is reflected in a green eyeEach time a mass shooting, terrorist attack, or natural disaster occurs, it becomes increasingly important to raise awareness of counseling options to help in dealing with the emotional trauma people can feel as a result. Incidents like these can cause symptoms of posttraumatic stress, including a hyperaroused state, nightmares, avoidance of trauma-related emotions or reminders, and flashbacks to the event (American Psychiatric Association, 2013). Early intervention can assist in healing (Shalev, 2002).

People who experience trauma may benefit from counseling approaches such as cognitive behavioral therapy, group therapy, or eye movement desensitization and reprocessing (EMDR) (U.S. Department of Veterans Affairs, 2016). While some argue pros and cons of the various treatments, EMDR has been used by more than 100,000 therapists to treat millions of people in the past 25 years (EMDR Institute, Inc., 2016). It has been approved as a treatment for trauma by the World Health Organization, American Psychiatric Association, and the U.S. Department of Veterans Affairs (Doherty, 2016).

EMDR uses back-and-forth horizontal eye movements paired with unique therapeutic protocols to produce a desensitizing effect on disturbing memories. While standard EMDR protocols are used for processing troubling memories that have already become embedded, the recent traumatic episode protocol (R-TEP) can be used to process a recent trauma. R-TEP may promote positive coping and resilience before the memory has had time to cause issues (Shapiro and Laub, 2009).

When a person interested in EMDR meets with a counselor, assessments are first performed to determine if EMDR is appropriate. If suitable, EMDR protocols generally follow the same eight phases as shared by the EMDR Institute (2016):

  1. History taking and treatment planning
  2. Preparing
  3. Identifying targets for desensitization and reprocessing. Targets can be memories, beliefs, or images related to a disturbing event.
  4. Desensitizing targets using specific scripts and alternating sensations such as eye movements
  5. Installing a positive belief about the person in the context of the disturbing event
  6. Internally performing a body scan for any lingering distress
  7. Concluding the session
  8. In the next session, reassessing targets processed in the previous session to learn if any changes have occurred

Shapiro and Laub (2009) offer modifications to the standard EMDR protocols when using R-TEP. One is the use of a “Google search” in phase 3, the target identification phase. The person in therapy is asked to scan internally for disturbing targets specific to the incident as if scanning the internet for a phrase or an image (Shapiro and Laub, 2009).

Treating a recent trauma may require only a few sessions. However, it is important for those seeking treatment to maintain realistic expectations about the number of sessions necessary for a history of complex trauma, which can require many sessions.

In phase 4 of R-TEP, the person in therapy tells their story of the incident while experiencing back-and-forth eye movements. The person may be asked to imagine watching the incident on television or from a seat on a train as images of the incident pass by outside the train. This is to increase a person’s sense of safety during the desensitizing phase (Shapiro and Laub, 2009).

If during R-TEP processing a person does not feel less disturbed by the incident, Shapiro and Laub (2009) suggest widening the focus to all associations with the incident. If the felt disturbance still does not reduce, the person may be encouraged to expand focus to unlimited associations, not just those of the incident. This expansion can be used whenever a person becomes stuck in a too-narrow focus (Shapiro and Laub, 2009).

Treating a recent trauma may require only a few sessions (EMDR Institute, Inc., 2016). However, it is important for those seeking treatment to maintain realistic expectations about the number of sessions necessary for a history of complex trauma, which can require many sessions. Factors such as a person’s current coping skills and support system also influence the number of sessions needed.

To learn if EMDR and the R-TEP may be helpful for a recent incident, consult a licensed mental health professional trained in EMDR through a program approved by the EMDR International Association.

References:

  1. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  2. Doherty, M. G. (2016). EMDR International Association. Retrieved from http://www.emdria.org/
  3. EMDR Institute, Inc. (2016). What is EMDR? Retrieved from http://www.emdr.com/what-is-emdr/
  4. EMDR International Association. (2016). EMDRIA approved EMDR training. Retrieved from http://www.emdria.org/?page=22
  5. Shalev, A. Y. (2002). Treating survivors in the immediate aftermath of traumatic events. In R. Yehuda (Ed.), Treating Trauma Survivors with PTSD (157-188). Washington DC: American Psychiatric Publishing, Inc. Retrieved from http://www.traumacenter.org/resources/pdf_files/Shalev_Early_Treatment.pdf
  6. Shapiro, E., & Laub, B. (2009). The recent traumatic episode protocol (R-TEP): An Integrative Protocol for Early EMDR Intervention. In M. Luber (Ed.), Eye movement desensitization and reprocessing scripted protocols: Basics and special situations (251-269). New York, NY: Springer Publishing Company.
  7. U.S. Department of Veterans Affairs. (2016). Treatment of PTSD. National Center for PTSD. Retrieved from http://www.ptsd.va.gov/public/treatment/therapy-med/treatment-ptsd.asp

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  • MaryJo

    MaryJo

    July 7th, 2016 at 12:06 PM

    My daughter has worked with her counselor on EMDR for about 6 months now. Very effective and helpful in her case!

  • Tate

    Tate

    July 8th, 2016 at 10:40 AM

    In light of all of the recent attacks and murders that we have all been witness to, I think that it could be a very good idea for anyone who has been impacted in any way to seek out someone who is professional that you can talk to. Friends and family are great but sometimes the hurt that we have experienced will go far deeper than what the average person can touch. If you are given tools like CBT or EMDR this can help you cope in ways that might not have been possible without them.

  • heather a.

    heather a.

    July 9th, 2016 at 1:29 AM

    I have no issue with people wanting to use emdr but dont understand why the article doesnt approve of straightforward one to one psychotherapy/counselling…

  • Camille Larsen

    Camille Larsen

    July 11th, 2016 at 9:44 AM

    Heather,
    Thank you for your comment. While EMDR and Cognitive Behavior Therapy are two one to one options, there are also other approaches within the individual talk therapy model. Your comment makes for a great suggestion to write about some of the other approaches used with individuals in future articles.

  • Cole

    Cole

    July 10th, 2016 at 1:53 PM

    Are there many therapists trained to offer this \

  • Camille Larsen

    Camille Larsen

    July 11th, 2016 at 9:39 AM

    Cole,
    It is tough to speculate the number of EMDR therapists who have specific training on R-TEP, but EMDR therapists have resources available to learn about it. If someone is interested in R-TEP, they can ask their therapist about it and for someone already trained in EMDR, it is generally a matter of learning just the R-TEP specific nuances for a recent trauma. Great question.

  • Irina

    Irina

    July 11th, 2016 at 4:58 PM

    so helpful with anxiety and stress related issues you would say?

  • Camille L

    Camille L

    July 12th, 2016 at 10:53 AM

    Irina,
    R-TEP, as I understand it, is designed for the treatment of recent trauma. There are other applications for EMDR, though, and research continues to be done to expand on what EMDR can be helpful for. In the preparation phase of EMDR, counselors work with people to build internal resources, and those resources may be helpful for coping with anxiety and stress. Your comment also makes for a great suggestion for future articles about resources such as Calm Place, or Safe Place, a guided imagery resource people can use to bring themselves to a calm state when they feel the need.

  • William S.

    William S.

    June 8th, 2017 at 3:17 PM

    I am a therapist and I don’t do EMDR but I have been through it. It helped me to clear some things that years of therapy had not. Certain things clicked in a way that they had not previously. It’s also evidence-based and backed by the VA as one of the few ways that help veterans with PTSD.

  • William

    William

    September 10th, 2017 at 8:54 PM

    One other thing I should add is if you want to see what an EMDR session is like, take a look at this documentary by The Mental Health Channel showing an EMDR session with a therapist and client. justmind.org/emdr-therapy

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