Jana Deardorff MA, LPC, NCC, MAC
EMDR is a method of psychotherapy that has been extensively researched and proven effective for the treatment of trauma. Discovered in 1987 by a research psychologist, Francine Shapiro PhD., it has revolutionized psychotherapy. And the research is there to show it!
EMDR has helped millions of people of all ages around the world relieve many types of psychological distress. EMDR compared to traditional talk therapy is fast, comprehensive and lasting!
All patterns of thinking, feeling, doing are an accumulations of experiences stored in your body and nervous system. Helpful and non-helpful patterns guide us to relationship, communication, careers, substance abuse, self-injury or self help. We learn early on from our care taker (usually parents) what we are about. We learn to believe good and bad things about ourselves, others and our future. Adaptive Information Processing model of EMDR was developed to explain the rapidity in of patterns of change in clients. The continued influence of early life experiences is due to the present-day stimuli eliciting a negative affect of belief. For example, a child may scared and lacking control when threatened by an adult, but to continue to respond to all adults would be unhealthy in many ways. If the abuser of a child is the parent the child could easily learn, "the world is not safe, I have not control and its my fault". Same is true for adults. If you experienced the destruction of Hurricane Ike a few years back, maybe witnessed the horror or had loss, but to continue to react the same as you did then because its hurricane season could get in your way of living your life. Some people are not safe as with the child and some hurricane's the same, but not all. I believe these patterns we develop are rooted in survival.
What is an EMDR session like?
When EMDR was first it was by Shapiro, she had notice she felt calmer when her eyes would move from left to right while thinking of her stressful life situation she would feel calmer. Over the years its been refined and now this back and forth with eyes "bilateral stimulation" can also be done with auditory or tactile back and forth from one side of the body to the other. It is believe that this bilateral stimulation mimics REM sleep when you are processing your day. Somehow this opens memory networks and allows one to reprocess the past with today's brain. EMDR has a standard set of protocols listed below.
Eight Phases of Treatment
The amount of time to complete treatment will depend upon the history of the client. Complete treatment of targets involves a three pronged protocol: Past memories, present disturbance and future action. Processing does not mean "talking about what happened" as with "talk therapy". Processing means setting up a learned state that will allow experiences that are causing problems to be "digested" and stored appropriately in your brain. That means that what is useful to you from your experience will be learned, and stored with appropriate emotions in your brain,m and be able to guide you in a positive ways in the future. The unhelpful emotions, beliefs, and body sensations will be discarded. Negative emotions, feelings and behaviors are generally caused by unresolved earlier experiences that are pushing you in the wrong direction. The goal of EMDR Therapy is to leave you with the emotions, understanding, and perspective that will lead to healthy interaction with yourself, others and the world in general.
Phase 1: History & Treatment Planning
Generally takes 1-2 session. This phase includes a discussion on specific problems, what has brought you into therapy. With this information a treatment plan is developed. I like to think of people like a puzzle. Are there pieces that do not fit? Are there missing pieces? how about pieces put together that do not belong together. How about extra pieces?
Phase 2: Preparation
For most clients this will take a session, for other's with severe trauma it may take much longer. Basically, you will be educated about EMDR and perhaps taught some skills. Skills such as identifying feeling or developing ways to cope with stress. The happiest people on the planet have ways of relaxing themselves and decompressing from life's inevitable and often unsuspected stress.
Phase 3: Assessment
During this phase targets are developed for processing. The first step is for the person to select a specific picture or scene from the target event that best represents the memory. Then chose a statement that expresses a negative self-belief associated with the event. Even if the the client intellectually knows the statement is false, it is important that he focus on it. These negative beliefs are actually verbalizations of the disturbing emotions that still exist. Common statements are: "I am helpless","I am dirty", "I am bad", "I'm in danger".
Phase 4: Desensitization
This phase focuses on the client's disturbing emotions and sensations. With the target at hand for processing. For example, I had a client that was robbed at gun point and then hit in the head with the gun and fell unconscious. Her belief was "I am not safe". The emotion that goes with that belief was "fear". We rated the fear from 0-10 and rated the belief from being completely true to completely false. She reported the belief was mostly true. I asked her to float back in her life to the earliest time she remembered feeling unsafe and fearful. While processing it was revealed that when she was six years old she was playing with friends and got stuck in old refrigerator and could not escape for several minutes. She feared she would die. We processed from that time until the present and in the end she reported "I'm safe now". EMDR has a way of connecting past learned situations with the present. After EMDR she was finally able to sleep though the night.
Phase 5: Installation
These are statements that increase the strength of the positive belief. While they are called installations, I belief they are not truly installed, but enhancing a belief that was in you all along. Just as the case above she believed she "was not safe", intellectually she knew she was safe now. Installations could also be remember a time she she felt powerful and then using bilateral stimulation.
Phase 6: Body Scan
After the positive cognition has been strengthened and installed, the therapist will ask the person to bring the original target even to mind to see if she notices any residual tension in the body. If there is then the body sensations are targeted and processed.
Phase 7: Closure
Ends every treatment session, The Closure ensure that the person leaves at the end of the session feeling better. If the processing of the target event is not complete in a single session, the therapist will assist the person in using self-calming techniques or containing the trauma so it can be processed as the next session.
Phase 8: Reevaluation
Opens every new session when the therapist checks on the work that was done at the prior session. This guides the clinician through the treatment plan. As with any form of good therapy, the Revaluation Phase is vital to determine the success of the treatment over time. Although, clients may feel relief almost immediately with EMDR, it is as important to complete the eight phases just as it is to complete an entire course of antibiotics.
For further information:
Trauma Recovery - EMDR humanitarian assistance programs