Eye Movement Desensitization & Reprocessing

EMDR is an approach to therapy that has become popular in recent years thanks to the research showing it can be very effective in treating trauma / PTSD.

Eye Movement Desensitization and Reprocessing is an evidenced based therapy for the treatment of trauma, anxiety, depression, PTSD, and other counseling issues.

It was created out of the Adaptive Information Processing Model for the treatment of trauma, disturbing life events, mental health & emotional issues, and somatic symptoms.

AIP holds that much psychopathology is the result of the faulty encoding or incomplete processing of information by the brain. In particular, trauma events (both Big”T” & Little “t”) are stored in an isolated, highly reactive from.

In this static state, the trauma is easily stimulated in daily life, becoming highly disruptive to the person’s emotional state. An example would be a former soldier who has returned to civilian life. He hears a car backfire similar to a gunshot and has an instant fight or flight response.

The goal of treatment is to facilitate the problematic information to integrate with the mind. EMDR utilizes an 8 stage, three prong therapeutic intervention aimed at assisting the client’s mind to process/digest difficult emotions and experiences.

The 8 phases of EMDR

Phase 1: History and Treatment Planning.
Phase 2: Preparation.
Phase 3: Assessment & Reprocessing.
Phase 4: Desensitization.
Phase 5: Installation.
Phase 6: Body Scan.
Phase 7: Closure.
Phase 8: Reevaluation.

This modality uses a three prong (past -> present -> future) approach to assist in targeting past experience, present trigger, and future challenges.

Patients move through processing difficult past events, current manifestations of difficulty, and install new resources to cope effectively with the issue in future. Focus on trauma or difficult experience is paired with bilateral stimulation, directed by the therapist, to facilitate the brain’s ability to heal itself. The information is effectively reprocessed, leading to a decrease in troubling symptoms.

Research has demonstrated that EMDR is rapid, safe, and effective. The majority of patients can expect an increase in healthy functioning and a decrease in dysfunctional emotional, cognitive, somatic, and temporal symptoms.

Many patients who have made slow progress in the past or who have not benefited from more traditional therapies say that with EMDR they have finally found something that works for them!

What is EMDR effective in treating?

Though often utilized to great effect in working through trauma, EMDR has been shown to be effective in dealing with a wide range of issues. These include:

Abuse/Neglect: Abandonment Experiences, Rape & Assault Recovery, Shame, Emotional/Psychological/Physical Abuse, Neglect, Betrayals
Anger: Chronic, Uncontrollable Anger Outbursts, Misdirected Anger, Overreaction, Obsession
Anxiety: Indecisiveness, Phobias, Performance Anxiety, Panic Attacks, Shyness, Social Anxiety, Performance Anxiety PTSD, Obsession, Stress Management
Blocks: Performance Anxiety, Phobias & Fears (Examples: Fear of Public Speaking, Heights, Stage Fright, Etc)
Trauma: Post Traumatic Stress Disorder, Combat Recovery, Rape & Assault Recovery, Accidents
Destructive Behavior Choosing Unsafe/Unhealthy Relationships, Attraction to Destructive Individuals, Poor Work Behavior,
Depression Excessive Guilt/Shame, Sadness, Lack of Motivation, Emotional Overeating, Isolation.

Types of Trauma

Big “T” These are major, life altering events which threaten the physical and emotional health of an individual. Examples would include sexual assaults, combat experience, or accidents.

Little “t” These are essentially toxic themes, or beliefs created over time by repeated life experience. They work to create a faulty understanding of oneself and the surrounding environment. Examples would include ongoing teasing by peers growing-up, lack of parental involvement, and destructive relationships.

Past. Present. Future.

EMDR recognizes the damage past life experience can do not only in moments of remembering, but continued dysfunctional behavior in the present.

If left unchecked, a cycle continues into the future, ensuring the individual perpetually lives in a destructive or unsatisfying manner. In a sense, if nothing changes, the past continues to effect the present and dictate one’s future.

It is a kind of trauma cycle. The process facilitated by EMDR assists the individual in gaining a healthy perspective in regards to the past.

It also works to dislodge faulty beliefs. The present situation is targeted as well, leading to more positive beliefs and behavior.

Finally, focus is placed on the future, allowing the person to install how they will effectively incorporate their new skills, beliefs, and information in such a way as to end the destructive cycle. The result is a more effective handling of the past, better functioning in the present, and a healthier future.

What is the “Trauma Cycle?

The Trauma Cycle is a construct utilized to understand and describe the long-term impact of both big “T” and little “t” events. Trauma hinders a person’s ability to function fully not only at the time it occurs, but in the way they perceive the past and what path they take in the future.

Negative impacts are felt emotionally, cognitively, relationally, somatically, and temporally. The individual essentially experiences trauma, responds by using the means necessary to “survive”, and acts according to this new trauma information and skills in place in the future.

Thus, the person will, perhaps unconsciously, seek out the same type of trauma situation over and over again. The goal is a corrective experience. The person seeks to go through the trauma and “get it right” this time. Perhaps the easiest way to fully explain this construct is with an example.

We will use the example of Susan, a 38-year-old wife and mother of three children. Susan was largely ignored growing-up at home by her father, who was a workaholic. Career trumped all concern over family.

When her father was home, he was distant and dismissive, seeming annoyed by her desire for attention. The one area which seemed to catch his attention was her academic performance. She invested heavily in this, as her father saw the “value” of grades in regards to her future career.

Susan’s mother never confronted or contradicted her husband’s priorities. He invested very little in the marriage leaving her in a very needy place. Mother got her needs met by being emotionally enmeshed and dependent on her children.

Father belittled mother as being weak. Susan took her father’s view and emotions on, combining them with her own frustration with mother to needing support from her daughter, rather than taking care of her children.

Susan was always attracted to and dated emotionally aloof, unavailable men, more interested in appearance and success than her. She eventually married one of these men. They both worked a great deal, investing heavily in careers.

What is Bilateral Stimulation?

Bilateral Stimulation takes the form of eye movements directed by the therapist. The eyes move across the center or dividing line running down the middle of the body.

This movement is done while the patient focuses on the issue in question, dual attention stimulation. The combination assists the brain to begin to effectively process the difficult information.

Does EMDR involve Hypnosis or Medications?

EMDR is not hypnosis and does not involve the use of medications. It is non-invasive, facilitating a patient-therapist collaboration in which healing can happen effectively.

What takes place in sessions?

The therapist will guide you through as series of steps, to include defining targets for change, verbal processing, bilateral stimulation, and needed assistance with blocks, as they arise.

Patients are fully conscious and in control throughout sessions, able to end them at any point they feel overwhelmed. Patients are not suggestible or able to be influenced as in hypnosis.

At The Relationship Center, we follow the researched and recommended 8 treatment steps, as outlined by Dr. Francine Shapiro (the psychologist who developed EMDR). This allows us to offer the maximum benefit to our patients and maintain professional integrity.

How long are sessions?

EMDR session durations are 90 minutes. At The Relationship Center, we schedule 2 hour blocks of time with patients to allow for check-in and check-out procedures. An example of an appointment would be to schedule 1-3pm, while the actual procedure is 90 minutes.

How many sessions are typical?

EMDR is much briefer than a traditional talk therapy. It is typical that work is accomplished within 3-6 sessions in many cases. However, there is no guarantee this will be the case for all patients. Those patients with more extensive trauma, especially repeated trauma experienced in childhood should expect their work to go beyond 6 sessions.

Who developed EMDR?<

EMDR was discovered by Dr. Francine Shapiro in 1987. Dr. Shapiro observed the connection between eye movement and difficult emotions.

She found that specific eye movements could aid in lessening these troubling experiences. Since that point, EMDR has been thoroughly researched and developed. She has written books and continues to teach on the subject.

Her text Eye Movement Desensitization and Reprocessing, The Second Edition, is an excellent source of information on the subject.

Shapiro, F. (2001). Eye Movement Desensitization and Reprocessing, 2nd edition, N.Y.

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