By: Janette Dingee, ATR, LCPC
In 1987, Dr. Francine Shapiro developed a powerful method of psychotherapy called Eye Movement Desensitization and Reprocessing (EMDR). Since that time, EMDR has helped an estimated 2 million people of all ages to recover from trauma and experience relief from many types of psychological distress. Although EMDR was originally developed for the treatment of trauma, is has also been found to be effective in the treatment of:
- attachment related childhood issues
- panic attacks
- complicated grief
- disturbing memories
- stress and anxiety reduction
- performance anxiety
- eating disorders
HOW DOES EMDR WORK?
When a person experiences a very upsetting event, or trauma, their brain has great difficulty processing information. Later on, after the upsetting event, memories, emotions and sensory experiences from that event may feel neurologically and emotionally “stuck” within a person. The moment is remembered vividly and remembering may feel similar to going through the experience for the first time. Individuals may find themselves returning to those memories repeatedly, even though they would rather forget them. They may also overreact to situations that remind them of the original event in some way, however minimal.
Although it is unclear how any psychotherapy method affects the brain, EMDR seems to impact the way in which the brain processes painful, frightening, and traumatic memories. It harnesses the brain’s natural ability to heal, helps to desensitize individuals to trauma and other difficult experiences, and to associate positive beliefs about themselves; for example, “I am a worthwhile person.” When a memory has been successfully cleared, you still remember the event, but it is less upsetting.
WHAT IS AN EMDR SESSION LIKE?
EMDR uses horizontal eye movements, similar to what occurs naturally during dreaming, or REM (rapid eye movement) sleep. This horizontal movement is thought to cause the alternating bilateral stimulation of the brain that facilitates the healing process. Other forms of bilateral stimulation can also be used, include alternating hand tapping or alternating tones heard through a headset.
The client recalls an upsetting issue or event, the feelings associated with the event, and a negative belief about the self. A set (or round) of bilateral stimulation is introduced. The sets of bilateral stimulation may last from 24 seconds to several minutes, depending on the client’s response. After the completion of each set, the client is asked to take a deep breath, let it go and notice what comes to awareness. After attending to what comes to mind spontaneously, and giving a short description, another set of bilateral stimulation is applied. Sets of eye movements or bilateral tapping, continues until the memory or issue is less disturbing. When the processing of an event is complete, and the client feels no disturbance, sets of bilateral stimulation are used to integrate a positive belief about the self, regarding the incident or issue.
When the desensitization phase is complete, the client is once again asked to bring the original incident to awareness and scan the body for any residual tension, etc. If disturbing sensations are noticed, sets of bilateral stimulation are applied until the sensation subsides and a positive feeling or emotion is experienced.
An EMDR session will often end with the visualization of a pre-determined comfortable place that the client has chosen. The comfortable place protocol eases the transition between EMDR processing and session closure. The comfortable place visualization is accompanied by short sets of bilateral stimulation that enhance feelings of safety and calm. Several sets are applied until the client is feeling relaxed and peaceful.
HOW DO I KNOW IF EMDR IS RIGHT FOR ME?
One or more sessions are needed for the therapist to understand the nature of the issues, take a client history and assess whether EMDR would be an appropriate treatment. The decision to pursue EMDR is a collaborative process between the therapist and client. The therapist can also discuss EMDR, trauma or other issues more fully and answer questions about how EMDR can be used as a treatment method. Once the therapist and client have both agreed that EMDR is appropriate for a problem, decisions can be made about when to begin EMDR within the therapy format.
Several criteria are used when assessing readiness for EMDR treatment. EMDR treatment can only begin when a client,
- is committed to treatment
- has a basic level of emotional and physical safety and stability
- is free from active addiction and self-harming behavior
- has some form of consistent support system outside of therapy
- is able to tolerate relatively high levels of emotion
- is able to use guided visualization for safety, protection and nurturing.
HOW LONG DOES AN EMDR SESSION TAKE?
Typical EMDR sessions last from 60 to 90 minutes. Single event traumas, such as a car accident, may require a minimal number of sessions. Long-term trauma and multiple traumatic events require a longer time commitment and an extensive focus on strengths, resources and coping skills. Childhood attachment issues can be treated with EMDR as well. An example of this issue might be an adult who was neglected by unavailable parents, and as a result currently struggles to connect with others, and suffers from feelings of unworthiness and anxiety. This type of EMDR treatment also requires a longer time commitment and a focus on strengths. The type of problem, life circumstances, and the amount of previous trauma will determine how many treatment sessions are necessary and when EMDR should be applied. EMDR may be used within a standard therapy format, as an adjunctive with a separate therapist, or as a treatment all by itself.