Trauma, sexual abuse, anxieties, and unresolved issues can haunt people for years. However, a person does not have to feel trapped because an innovative treatment called EMDR can help. EMDR is an acronym for Eye Movement Desensitization and Reprocessing. It is an informational processing therapy that assists individuals in resolving past issues. It is a non-invasive treatment which does not utilize drugs or hypnosis. It mimics the processing which individuals go through when they dream in the REM state of sleep with bilateral stimulation of the brain. However EMDR is more focused and a patient is guided through the reprocessing with the assistance of a licensed therapist.
How EMDR Was Developed
One day Francine Shapiro Ph.D. was walking through the park trying to process an unpleasant experience. She realized that as she was scanning the surroundings looking left and right, she began to feel better. Thinking there was a correlation between her improved mood and eye movements, she began to research this phenomenon and EMDR was born. (Shapiro, F. (2001). Eye Movement Desensitization and Reprocessing: Basic Principals, Protocols and Procedures. (2nd ed.). New York: Guilford Press.)
Multiple research studies have been conducted on the efficacy of EMDR and it is now approved for treatment of PTSD by both the International Society for Traumatic Stress Studies and The American Psychiatric Association Practice Guideline. Additionally The Department of Defense/Department of Veterans Affairs Practice Guidelines recommends EMDR for the treatment of all trauma survivors. (EMDR Institute, Inc. The Efficacy of EMDR. From the EMDR Official Website, http://www.emdr.com.)
What Does it Treat?
EMDR is most widely known for its effectiveness in treating PTSD. However, protocols have been established for anxiety, phobias, unresolved grief, addictions, performance anxiety, chronic pain, panic attacks, depression, and traumatic events. (EMDR Institute, Inc. Clinical Applications. From the EMDR Official Website, http://www.emdr.com.
How Does it Work?
When a person experiences a traumatic experience, the images, sounds, smells, thoughts, feelings, and sensations are lodged in a part of the brain and can become stuck there. Oftentimes the pathway that allows a person to make sense of these experiences is blocked. It literally becomes a moment frozen in time within the brain. EMDR helps to dislodge the blockage and reprocess the thoughts, feelings, and memories. (EMDR International Association. How Does EMDR Work? From the EMDRIA Official Website, http://www.emdria.org.)
Research utilizing Single Photon Emission Computed Tomography (SPECT) scans have actually documented the movement of these blockages. Images of the brain pre-EMDR and post-EMDR show activation of the higher cognitive centers after the person has undergone EMDR, thus allowing a healthier integration of the experience. In other words, after EMDR, the trauma survivor is able to feel calmer and doesn’t feel the need to constantly search for imagined signs of danger. (Levin, P., Lazrove, S., & van der Kolk, B. A. (1999). What psychological testing and neuroimaging tell us about the treatment of posttraumatic stress disorder (PTSD) by eye movement desensitization and reprocessing (EMDR). Journal of Anxiety Disorders, 13, 159-172.)
During EMDR, a trained therapist gently guides the person through an eight phase process to identify and revisit the issue. The experience is then reprocessed by using either visual, auditory, or tactile methods to stimulate both sides of the brain back and forth from left to right until the issue is no longer bothersome. Simple issues can be resolved in as quickly as one session, however complex traumas or long-standing, unresolved issues may have multifaceted layers which need to be processed. In these cases multiple sessions are required.
Phases of Treatment
There are eight phases of treatment in EMDR. (Shapiro, F. & Forrest, M. (1997). EMDR The Breakthrough Therapy for Overcoming Anxiety, Stress and Trauma. New York: Basic Books.)
The first phase involves a complete assessment and development of a treatment plan. In the second phase, the therapist works with the patient to assure that he or she has adequate coping mechanisms to deal with any emotional disturbance which might surface during treatment. These include various relaxation tools and stress management strategies. It is also during this phase that any questions are answered about the procedure and treatment protocols.
The third phase of treatment assesses the specific issue and the effect it has on the person. During this phase, the patient comes up with the picture or image that best represents the issue to be reprocessed and with the therapist’s help identifies what negative beliefs are currently held as a consequence of that issue. Then emotions related to the issue are identified along with areas in the body which are affected by it. The level of distress is gauged using a SUDS rating scale (subjective units of distress). The SUDS scale is a 1 to 10 rating scale where 1 equals no distress and 10 equals the most distress a person can imagine. It is a useful way for a person to determine their progress with reprocessing. After the negative effects of the issue are assessed, the patient is asked to identify what he/she would like to believe about themself instead. This is called the positive cognition. The validity of that belief is then measured using a 7 point rating scale where 1 is completely untrue and 7 is completely accurate.
In the forth phase of treatment, the reprocessing begins. The patient holds onto the image, negative belief, emotions, and body sensations as the therapist stimulates the bilateral reprocessing. The original mode of reprocessing in the establishment of EMDR was eye movements however auditory and tactile modes may also be utilized. As the issue is reprocessed, the SUDS level is assessed until there is no further distress.
Installation of the Positive Cognition occurs in the fifth phase. EMDR is utilized to strengthen and cement the positive belief. In the sixth phase, a body scan takes place where the person is asked to focus on any uncomfortable sensations within their body and any residual body distress is removed allowing the patient to have an overall positive feeling.
The seventh phase is the closure phase. The session wraps up and the patient is encouraged to monitor any images, thoughts, or feelings that occur until the next session and is reminded that sometimes people will continue to process the issue afterward. Should any disconcerting experiences occur, the patient is encouraged to contact the therapist immediately. The eighth phase of treatment involves re-evaluation. At the next session, the patient and therapist review the patient’s log and symptoms experienced. The presenting issue is reassessed and a plan is developed for any additional work.
Sometimes a patient is unable to complete all phases within one session. In these cases, the session closes with a relaxation exercise and the session is closed as in the seventh phase of treatment. At the next session, the treatment will resume with more reprocessing until the layers of issues can be integrated.
Benefits
EMDR significantly affects the brain’s ability to reprocess issues. The bilateral stimulation appears to enhance the brain’s ability to rewire the synaptic connections to a more balanced state. When combined with traditional therapy, EMDR can help a person to move beyond old issues in a significantly shorter time period. Benefits can be seen not only in the short-term but also long-term. The short term benefits naturally include the relief of troubling symptoms. However the long term benefits are even greater as a person regains a sense of peacefulness and centeredness and finds more balance in their life.
Additional Considerations
EMDR is a highly specialized treatment process which has undergone extensive research. Shapiro warns that it needs to be facilitated by a trained and licensed mental health professional. Many hours of training by an EMDRIA approved professional are required before a therapist is certified to provide EMDR treatment and there are two levels of certification. If you are seeking EMDR treatment, ask the therapist what training they have received, what level of certification they have, and what their success rate has been with people who have similar issues.
In Conclusion
EMDR can offer a fairly rapid treatment to help resolve a variety of distressing issues. People have reported significant progress after completing EMDR treatments and research continues to prove the efficacy of its use. Distressing issues are able to dissolve away with EMDR leaving a person feeling more peaceful and calm, sometimes for the first time in years.
