Eye Movement Desensitization
and Reprocessing (EMDR)
Eye Movement Desensitization and Reprocessing (EMDR) therapy is an extensively researched, effective psychotherapy method proven to help people recover from trauma and other distressing life experiences, including PTSD, anxiety, depression, and panic disorders. EMDR enables people to heal from the symptoms and emotional distress that are the result of disturbing life experiences. Repeated studies show that by using EMDR therapy people can experience the benefits of psychotherapy that once took years to make a difference. Through EMDR, individuals safely reprocess traumatic information until it is no longer psychologically disruptive to their lives. Over time, exposure to traumatic memories will no longer induce negative feelings and distressing symptoms.
Types of Trauma
Many people are hestitant to identify their experiences as “trauma”. Trauma is simply your mind and body’s response to a deeply distressing or disturbing event that overwhelms your ability to cope. What counts as trauma is a wide range of events or experiences… “Big T” trauma as we call it can be deeply disturbing, life-threatening events or situations including a violent attack, serious car accident, or the death of a parent. We can also experience some types of trauma that don’t involve violence, death, or disaster, yet they can still have significant negative effects…this is what we call “little t” trauma. “Little t” trauma can be any event or ongoing situation that causes distress, fear, and a sense of helplessness including the loss of a relationship, chronic invalidation, negative family patterns taught throughout childhood or adulthood, or bullying. Trauma work can be immensely helpful in changing beliefs about self and the world regardless what type of trauma you have experienced.
Trauma Symptoms
Emotional & psychological symptoms:
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Shock, denial, or disbelief
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Confusion, difficulty concentrating
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Anger, irritability, mood swings
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Anxiety and fear
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Guilt, shame, self-blame
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Withdrawing from others
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Feeling sad or hopeless
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Feeling disconnected or numb
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Insomnia or nightmares
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Fatigue
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Being startled easily
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Difficulty concentrating
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Racing heartbeat
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Edginess and agitation
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Aches and pains
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Muscle tension
What is EMDR?
EMDR therapy involves attention to three time periods: the past, present, and future. Focus is given to past disturbing memories and related events. Also, it is given to current situations that cause distress, and to developing the skills and attitudes needed for positive future actions. With EMDR therapy, these items are addressed using an eight-phase treatment approach.
Phase 1: The first phase is a history-taking session(s). The therapist assesses the client’s readiness and develops a treatment plan. Client and therapist identify possible targets for EMDR processing. These include distressing memories and current situations that cause emotional distress. Other targets may include related incidents in the past. Emphasis is placed on the development of specific skills and behaviors that will be needed by the client in future situations.
Initial EMDR processing may be directed to childhood events rather than to adult onset stressors or the identified critical incident if the client had a problematic childhood. Clients generally gain insight on their situations, the emotional distress resolves and they start to change their behaviors. The length of treatment depends upon the number of traumas and the age of PTSD onset. Generally, those with single event adult onset trauma can be successfully treated in under 5 hours. Multiple trauma victims may require a longer treatment time.
Phase 2: During the second phase of treatment, the therapist ensures that the client has several different ways of handling emotional distress. The therapist may teach the client a variety of imagery and stress reduction techniques the client can use during and between sessions. A goal of EMDR therapy is to produce rapid and effective change while the client maintains equilibrium during and between sessions.
Phases 3-6: In phases three to six, a target is identified and processed using EMDR therapy procedures. These involve the client identifying three things:
1. The vivid visual image related to the memory
2. A negative belief about self
3. Related emotions and body sensations.
In addition, the client identifies a positive belief. The therapist helps the client rate the positive belief as well as the intensity of the negative emotions. After this, the client is instructed to focus on the image, negative thought, and body sensations while simultaneously engaging in EMDR processing using sets of bilateral stimulation. These sets may include eye movements, taps, or tones. The type and length of these sets is different for each client. At this point, the EMDR client is instructed to just notice whatever spontaneously happens.
After each set of stimulation, 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 choose the next focus of attention. These repeated sets with directed focused attention occur numerous times throughout the session. If the client becomes distressed or has difficulty in progressing, the therapist follows established procedures to help the client get back on track.
When the client reports no distress related to the targeted memory, (s)he is asked to think of the preferred positive belief that was identified at the beginning of the session. At this time, the client may adjust the positive belief if necessary, and then focus on it during the next set of distressing events.
Phase 7: In phase seven, closure, the therapist asks the client to keep a log during the week. The log should document any related material that may arise. It serves to remind the client of the self-calming activities that were mastered in phase two.
Phase 8: The next session begins with phase eight. Phase eight consists of examining the progress made thus far. The EMDR treatment processes all related historical events, current incidents that elicit distress, and future events that will require different responses