EMDR - Eye Movement Desensitization and Reprocessing - is a psychological method for treating experientially based disorders and emotional difficulties that are caused by disturbing life experiences, ranging from traumatic events such as combat stress, assaults, and natural disaster, to upsetting childhood events. EMDR is a complex method that brings together elements from well-established clinical theoretical orientations including psychodynamic, cognitive, behavioral, and client-centered (Shapiro, 2001).
EMDR entails an eight-phase approach guided by an information processing model that views pathology as based upon perceptual information that has been maladaptively stored. Consequently, EMDR treatment focuses on the perceptual components of the memory (affective, cognitive, and somatic) in order to expedite the accessing and processing of disturbing events and facilitate an attendant learning process. More specifically, EMDR aims to (i) facilitate resolution of memories of earlier life experiences (e.g., elicitation of insight, cognitive reorganization, adaptive affects, and physiological responses), (ii) desensitize stimuli that trigger present distress as a result of second-order conditioning, and (iii) incorporate adaptive attitudes, skills, and desired behaviors for enhanced future functioning.
During EMDR, the clinician works with the client to identify the specific problem that will be the focus of treatment. Utilizing a structured protocol, the practitioner guides the client through the description of the disturbing event or issue, helping the client select important aspects that are upsetting. While the client is engaged in the eye movements, he or she is experiencing various parts of the initial memory or other memories. The practitioner pauses with the eye movements at regular intervals to insure that the client is processing adequately on his or her own. The practitioner facilitates the process, making clinical decisions about the direction of the intervention. The goal is the client's rapid processing of information about the negative experience, bringing it to an "adaptive resolution." In Shapiro's words, this means a reduction in symptoms, a shift from the negative belief to the client's new positive belief, and the prospect of functioning more optimally. EMDR treatment may last from 1 - 4 sessions for a single trauma to 1 year or longer for more complex problems.
What is the actual EMDR session like?
During EMDR, the therapist works with the client to identify a specific problem as the focus of the treatment session. The client calls to mind the disturbing issue or event, what was seen, felt, heard, thought, etc., and what thoughts and beliefs are currently held about the event. The therapist facilitates the directional movement of the eyes or other dual attention stimulation of the brain, while the client focuses on the disturbing material, and the client just notices whatever comes to mind without making any effort to control direction or content. Each person will process information uniquely, based on personal experiences and values. Sets of eye movements are continued until the memory becomes less disturbing and is associated with positive thoughts and beliefs about one's self; for example, "I did the best I could." During EMDR, the client may experience intense emotions, but by the end of the session, most people report a great reduction in the level of disturbance.
One or more sessions are required for the therapist to understand the nature of the problem and to decide whether EMDR is an appropriate treatment. The therapist will also discuss EMDR more fully and provide an opportuntiy to answer questions about the method. Once therapist and client have agreed that EMDR is appropriate for a specific problem, the actual EMDR therapy may begin.
A typical EMDR session lasts from 60 - 90 minutes. The type of problem, life circumstances, and the amount of previous trauma will determine how many treatment sessions are necessary. EMDR may be used withing a standard "talking" therapy, as an adjunctive therapy with a separate therapist, or as a treatment all by itself.
What kind of problems can EMDR treat?
Scientific research has established EMDR as effective for post traumatic stress disorder. However, clinicians have reported success using EMDR and psychotherapy in treatment of the following conditions:
|
|