Eye Movement Desensitization and Reprocessing therapy, (EMDR) is a comprehensive, integrative psychotherapy approach. The goal of EMDR is to elevate human suffering and assist individuals to strive for healthy lifestyle. EMDR treatment focuses on desensitizing and processing related historical events, current incidents that elicit distress, and future scenarios that will require different responses. The overall goal is to produce the most comprehensive and profound treatment effects in the shortest period of time, while at the same time ensuring client’s safety, stability, and growth.
In a controlled study, 80 percent of multiple civilian trauma victims are no longer reporting Post-Traumatic Stress Disorder (PTSD) after approximately six hours of treatment. More than 20 controlled studies have assessed the effects of EMDR, and all of them consistently found that EMDR effectively decreased or eliminated symptoms of PTSD for the majority of the clients. Even though researchers concentrated on the effects of EMDR on PTSD, clinicians have reported success using EMDR in the treatment of personality disorders, panic attacks, grief, pain disorders, eating disorders, addiction, performance anxiety, sexual and physical abuse, as well as body dysmorphic disorders.
A typical EMDR treatment therapy for children and for adults consists of 12 sessions; each session lasts between 60 to 90 minutes. The number of sessions will be determined by the therapist and depends upon client’s history.
A successful outcome of EMDR therapy is that normal information process is resumed; the client will still remember the event, but in a less upsetting way, and will therefore no longer relive the images, sounds, smells, and feelings as he or she experienced them prior to treatment. After successful treatment of EMDR, affective distress is relieved, negative beliefs are reformulated and physiological arousal is reduced.
EMDR uses an eight-phase approach. In the first phase, the therapist obtains history, assesses the client’s readiness for EMDR and develops a treatment plan. Both the client and therapist identify possible targets for EMDR processing; these include recent distressing events, current situations that elicit emotional disturbances, related historical incidents, and the development of specific skills and behaviors that will be needed by the client in future situations.
During the second phase of treatment, the therapist ensures that the client has adequate methods of handling emotional distress and good coping skills, and that the client is in a relatively stable state. If further stabilization is required, or if additional skills are needed, therapy focuses on providing these. The client is then able to use stress-reducing techniques whenever necessary, during or between sessions.
In phases three through six, a target is identified and processed using EMDR procedures.
This involves the client identifying the most vivid visual image related to the memory (if available), a negative belief about self, related emotions, and body sensations. The client also identifies a preferred positive belief. After this, the client is instructed to focus on the image, negative thought, and body sensations while
simultaneously moving the eyes back and forth (bi-lateral movement) following the therapist’s fingers as they move across the client’s field of vision for 20 to 30 seconds. In addition to bi-lateral eye movement technique used during EMDR session, therapists often use auditory tones, tapping, or other types of tactile stimulation. The client is instructed to just notice whatever happens. After this, the clinician instructs the client to let the mind go blank and to notice whatever thoughts, feelings, images, memories, or sensations come to mind.
Depending upon the client’s report, the clinician will facilitate the next stage of attention. In most cases, a client-directed association process is encouraged. This is repeated numerous times throughout the session. If the client becomes distressed or has difficulty with the process, the therapist follows established procedures to help the client resume processing. When the client reports no distress related to the targeted memory, the clinician asks the client to think of the preferred positive belief that was identified at the beginning of the session, or a better one if it has emerged, and to focus on the incident, while simultaneously engaging in the eye movements.
After several sets, clients generally report increased confidence in their positive belief regarding the event. The therapist checks with the client regarding body sensations as a tool to assess client’s progress.
In phase seven closure the therapist asks the client to keep a journal during the week to document any related issues that may arise and reminds the client of the self-calming activities that were mastered in phase two. Phase eight is a re-evaluation of previous sessions, and of the client’s progress since the last session.
After EMDR processing, clients generally report that the emotional distress related to the memory has been greatly decreased or even eliminated.
It is important to keep in mind that EMDR should be administered by a trained clinician who successfully completed EMDR training.
References:
- Eye Movement Desensitization Reprocess Institute. (2004). Retrieved on December 21, 2008, from http://www.emdr.com/index.htm
- Shapiro, F. (1989). Efficacy of the Eye Movement Desensitization Procedure in the Treatment of Traumatic Memories. Journal of Traumatic Stress, 2, 199-223.
- Shapiro, F. & Forrest, M. (1997). EMDR the breakthrough therapy for overcoming anxiety, stress and trauma. New York: Basic Books.
- Shapiro, F. (1989). Eye Movement Desensitization: A new treatment for post-traumatic stress disorder. Journal of Behavior Therapy and Experimental Psychiatry, 20, 211-217.
- Shapiro, F. (1990). The EMDR approach for psychotherapy (Rev. ed.). Watsonville, CA: Author.
- What is EMDR? (2005). [Brochure]. EMDRIA, TX: Author.
