What is EMDR?
EMDR (Eye Movement Desensitization and Reprocessing), as with most therapy approaches, focuses on the individual’s present concerns. EMDR’s approach, however, considers past experiences are being activated by present or future anticipated experiences.
What is different about EMDR?
- EMDR’s focus is on the brain’s ability to constantly learn, taking past experiences and updating them with the present situation.
- This is referred to as “The Adaptive Information Processing Hypothesis.”
- Adaptive learning is constantly updating memory network systems (reconsolidating).
- EMDR’s focus is the person’s inability to update experiences.
- EMDR therapy uses a set of procedures to organize these negative and positive networks and then uses bilateral stimulation, i.e., eye movements, alternative tapping, etc. as the catalyst to effectively integrate the past experiences with the present adaptive learning. Much like eating, we digest food, keeping the nutrients necessary of health, letting go of the waste, we keep what is necessary for adaptive learning. And let go of unnecessary information..
When was EMDR developed?
- EMDR was a Ph.D. dissertation treating PTSD, written by Francine Shapiro that was published in 1989.
- After publishing her findings, numerous clinicians treating clients with PTSD sought training in the procedures outlined.
- Shapiro began teaching others her procedures, and over the course of time, 1990-1995, she refined and expanded her procedures.
- EMDR became an official treatment approach in 1995 when she published her training manual: EMDR, Eye Movement Desensitization and Reprocessing, Protocol and Procedures.
How was EMDR developed?
- Shapiro, as part of her Ph.D. program and other environments, had knowledge of the use of eye positioning and movements related to a person accessing various components of memory.
- Shapiro combined various forms of psychotherapy into a structured set of procedures then applied rapid eye movements as a way to process the client’s disturbing memories.
- Shapiro speculated that rapid eye movements would replicate the processing that occurs during the REM (Rapid Eye Movement) phase of sleep.
- Shapiro viewed the rapid eye movements as activating the client’s Adaptive Information Processing system, thereby allowing the negative memory networks to be updated to present, known adaptive responses and beliefs.
What does EMDR look like in treatment?
- Overall Treatment Planning
- Clients come to treatment expressing concerns.
- The clinician will help the client understand the dynamics of the present concerns and how to adaptively manage them.
- An overall treatment plan will be developed that will accomplish the client goals.
- Within that treatment plan, EMDR therapy, along with other therapy approaches, will be used to accomplish treatment goals.
- EMDR Procedures
- The client will be instructed, through a set of questions, to access and activate the negative experience and the desired adaptive resolution.
- Sets of rapid eye movement (or other forms of bilateral stimulation) will be applied.
- The client is encouraged to just “free associate” and allow the brain to work through the experience.
- Sets of eye movements will be alternated with brief client reports of what is being experienced.
- EMDR processing will continue until the past experience has been updated to an adaptive present perspective.
- With long standing issues, this process may take multiple sessions.
- Once the disturbing experiences have been processed, the client and clinician work together to integrate these new insights and perspectives into their daily life.
Is it necessary to tell the clinician all the details of an experience in order for it to be processed?
No, full disclosure of the experience is not necessary for the experience to be processed.
Will emotions and sensations be experienced?
Yes – emotions and sensations may come up during processing, although the client will be prepared and safely managed by the clinician during processing.
Is EMDR like hypnosis?
No, during EMDR processing, the client is present and fully in control of the experience.
Is EMDR a brief treatment?
EMDR therapy , as with all treatment approaches, will help clients accomplish their treatment goals.
- The length of time that it takes is dependent upon the client’s complexity.
- Frequently EMDR therapy is only one of several treatment interventions used to accomplish the client’s treatment goals.
One of the first things we ask clients is what is the level of distress you are experiencing. 1-10, 10 being the most distress. Look at this graph below to help you determine the level of distress that something is bothering you.
Here is what happens before EMDR:
Designed by Ayan Mukherjee
The 8 phases of EMDR outlined here to help your clients understand the process.
1~The first phase is a history-taking session during which the therapist assesses the client's readiness for EMDR and develops a treatment plan. Client and therapist identify possible targets for EMDR processing. These include recent distressing events, current situations that elicit emotional disturbance, related historical incidents, and the development of specific skills and behaviors that will be needed by the client In future situations
2~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. However, one goal is not to need these techniques once therapy is complete.
3~In phase three through six, a target is identified and processed using EMDR procedures. These involve 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. The validity of the positive belief is rated, as is the intensity of the negative emotions.
4~After this, the client is instructed to focus on the image, negative thought, and body sensations while simultaneously moving his/her eyes back and forth following the therapist's fingers as they move across his/her field of vision for 20-30 seconds or more, depending upon the need of the client. Although eye movements are the most commonly used external stimulus, therapists often use auditory tones, tapping, or other types of tactile stimulation. The kind of dual attention and the length of each set is customized to the need of the client. The client is instructed to just notice whatever happens. After this, the clinician instructs the client to let his/her mind go blank and to notice whatever thought, feeling, image, memory, or sensation comes to mind. Depending upon the client's report the clinician will facilitate the next focus 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.
5~ When the client reports no distress related to the targeted memory, the clinician asks him/her 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 this positive belief.
6~The therapist checks with the client regarding body sensations. If there are negative sensations, these are processed as above. If there are positive sensations, they are further enhanced.
7~In phase seven, closure, the therapist asks the client to keep a journal during the week to document any related material that may arise and reminds the client of the self-calming activities that were mastered in phase two.
8~The next session begins with phase eight, re-evaluation of the previous work, and of progress since the previous session. EMDR treatment ensures the processing of all 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 simultaneously maintaining a stable client within a balanced system.
The information written above is from Jocelyn Ftzgerald