EMDR therapy uses a three pronged protocol: 1 the past events that have laid the groundwork for dysfunction are processed, forging new associative links with adaptive information; 2 the current circumstances that elicit distress are targeted, and internal and external triggers are desensitized; 3 imaginal templates of future events are incorporated, to assist the client in acquiring the skills needed for adaptive functioning.
EMDR Eye Movement Desensitization and Reprocessing is a psychotherapy that 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.
It is widely assumed that severe emotional pain requires a long time to heal. EMDR therapy shows that the mind can in fact heal from psychological trauma much as the body recovers from physical trauma.
When you cut your hand, your body works to close the wound. If a foreign object or repeated injury irritates the wound, it festers and causes pain. Once the block is removed, healing resumes. EMDR therapy demonstrates that a similar sequence of events occurs with mental processes. If the system is blocked or imbalanced by the impact of a disturbing event, the emotional wound festers and can cause intense suffering.
Using the detailed protocols and procedures learned in EMDR therapy training sessions, clinicians help clients activate their natural healing processes. More than 30 positive controlled outcome studies have been done on EMDR therapy. There has been so much research on EMDR therapy that it is now recognized as an effective form of treatment for trauma and other disturbing experiences by organizations such as the American Psychiatric Association, the World Health Organization and the Department of Defense.
Over , clinicians throughout the world use the therapy. Millions of people have been treated successfully over the past 25 years. EMDR therapy is an eight-phase treatment. Eye movements or other bilateral stimulation are used during one part of the session. As this happens, for reasons believed by a Harvard researcher to be connected with the biological mechanisms involved in Rapid Eye Movement REM sleep, internal associations arise and the clients begin to process the memory and disturbing feelings.
In successful EMDR therapy, the meaning of painful events is transformed on an emotional level. The net effect is that clients conclude EMDR therapy feeling empowered by the very experiences that once debased them. Their wounds have not just closed, they have transformed.
EMDR therapy combines different elements to maximize treatment effects. A full description of the theory, sequence of treatment, and research on protocols and active mechanisms can be found in F. Although some clinicians may use EMDR for various problems, its research support is primarily for disorders stemming from distressing life experiences.
EMDR is based on a theoretical information processing model which posits that symptoms arise when events are inadequately processed, and can be eradicated when the memory is fully processed.
It is an integrative therapy, synthesizing elements of many traditional psychological orientations, such as psychodynamic , cognitive behavioral, experiential, physiological, and interpersonal therapies. EMDR's most unique aspect is an unusual component of bilateral stimulation of the brain, such as eye movements, bilateral sound, or bilateral tactile stimulation coupled with cognitions, visualized images and body sensation. EMDR also utilizes dual attention awareness to allow the individual to vacillate between the traumatic material and the safety of the present moment.
This prevents retraumatization from exposure to the disturbing memory. As EMDR is an integrative therapy which combines elements of cognitive behavioral and psychodynamic therapies to desensitize traumatic memories, some individuals have criticized EMDR and consider the use of eye movements to be an unnecessary component of treatment. Also recent studies that have removed eye movement from the method have found the procedure less effective [16]. There are two perspectives on EMDR therapy.
One was advanced by the method's creator, with a theory that eye movements provide some neurological and psychological effects that enhance the processing of traumatic memories.
The other perspective is that eye movements are an epiphenomenon , unnecessary, and that EMDR is simply a form of desensitization. It integrates elements of imaginal exposure, cognitive therapy, psychodynamic and somatic therapies. It also uses the unique and somewhat controversial element of bilateral stimulation e. According to Francine Shapiro's theory, when a traumatic or distressing experience occurs, it may overwhelm usual ways of coping and the memory of the event is inadequately processed; the memory is dysfunctionally stored in an isolated memory network.
When this memory network is activated, the individual may re-experience aspects of the original event, often resulting in inappropriate overreactions. This explains why people who have experienced or witnessed a traumatic incident may have recurring sensory flashbacks, thoughts, beliefs, or dreams.
An unprocessed memory of a traumatic event can retain high levels of sensory and emotional intensity, even though many years may have passed. EMDR uses a structured eight-phase approach and addresses the past, present, and future aspects of the dysfunctionally stored memory. During the processing phases of EMDR, the client attends to the disturbing memory in multiple brief sets of about seconds, while simultaneously focusing on the dual attention stimulus e. Following each set of such dual attention, the client is asked what associative information was elicited during the procedure.
This new material usually becomes the focus of the next set. This process of alternating dual attention and personal association is repeated many times during the session. The theory is that EMDR works directly with memory networks and enhances information processing by forging associations between the distressing memory and more adaptive information contained in other semantic memory networks. It is thought that the distressing memory is transformed when new connections are forged with more positive and realistic information.
This results in a transformation of the emotional, sensory, and cognitive components of the memory so that, when it is accessed, the individual is no longer distressed. When the distressing or traumatic event is an isolated incident, the symptoms can often be cleared with one to three EMDR sessions.
But when multiple traumatic events contribute to a health problem - such as physical, sexual, or emotional abuse, parental neglect, severe illness, accident, injury, or health-related trauma that result in chronic impairment to health and well-being - the time to heal may be longer.
Eye Movement Desensitisation and Reprocessing EMDR is a rapdily developing treatment method that is being applied to an increasingly wide range of clinical conditions. The founder of the approach is Francine Shapiro.
Shapiro claims that the discovery of EMDR was serrendipitous; she claims that she was out walking and was feeling upset when she noticed that if she induced rapid saccadic eye movements , this had an immediate calming effect that elminated her traumatic feelings. She expermimented with her discovery and developed a clinical technique that has aroused extensive interest around the world.
Initially, the technique was developed for the treatment of psychological trauma. However, the protocol has been developed over the past decade to deal with a wide variety of usually anxiety-based disorders. Essentially the technique involves exposing the patient to his traumatic memories whilst simultaneously inducing rapid eye movements by asking the patient to track an oscillating stimulus such as a finger or light. The patient is also required to hold in mind a cognitive statement about himself that is derived during the assessment process.
There is considerable debate and controversy regarding how and why EMDR works. When it is successful, the technique can eliminate the intrusive symptoms associated with psychological trauma within a session or two. Lohr et al chose to adhere to the popular name for the treatment protocol, EMDR, because it is now the most commonly used term.
However, it is suggested that incorrect labelling of the technique perpetuates a myth which implies the establishment of a mechanism for the phenomenon. It should be noted that while EMDR requires specialist training available from the EMDR Institute which offers courses around the world, it is a technique and not a therapy in and of itself and is most effectively employed by broadly trained and experienced therapists who use it when in their clinical judgement it fits the situation.
The technique can induce powerful emotional reactions. Thus, if it is applied without sufficient understanding and experience to a patient for whom the treatment is contraindicated, it can induce a psychotic reaction.
The following basic terms are described in Shapiro's text [1]. The evidence about whether EMDR is effective will be first considered on the basis of what scientific committees from around the world have concluded, then EMDR will be compared to typical treatments, medication and traditional exposure based treatments. Although, as discussed below, EMDR is generally considered an efficacious treatment for the treatment of trauma, and its effectiviness is considered to be eqivalent to that of traditional exposure therapy, the working mechanisms that underlie the effectiveness of EMDR, and whether the eye movement component in EMDR contributes to its clinical effectiveness it still a point of uncertainty and contentious debate.
Effectiveness: Conclusions from international scientific committees Based on the evidence of controlled research both the practice guidelines of the American Psychiatric Association [19] and the Department of Veterans Affairs and Defense [20] have placed EMDR in the highest category of effectiveness and research support in the treatment of trauma.
This status is reflected in a number of international guidelines where EMDR is a recommended treatment for trauma [21] [22] [23] [24] [25] [26].
Van der Kolk et al. The study also suggests a role for SSRIs as a reliable first-line intervention. Effectiveness: EMDR versus traditional exposure treatments studies in the last 5 years EMDR proved significantly better than stress inoculation training with prolonged exposure in a study with 24 participants diagnosed with post traumatic stress disorder. EMDR was also found to work more quickly than exposure based treatments in a larger trial with participants. The only significant difference at follow-up was an improvement in depression according to an independent observer in favour of EMDR.
EMDR and Prolonged Exposure PE were found to be equivalently efficacious and both superior to a waitlist control in a controlled trial of 74 female rape victims. Unlike other studies noted above, there was no difference between the active treatments in rate of improvement. However EMDR seemed to do adequately well despite utilising no homework tasks and less exposure. The study met the highest criteria for methodological rigour proposed by Foa and Meadows. However there were no differences between the two treatments in the intent to treat analysis and no differences between the two treatments on percentage of people with PTSD diagnosis at follow-up.
Two recent meta-analyses concluded that traditional exposure therapy and EMDR have equivalent effects both immediately after treatment and at follow-up.
However, controlled research is needed to evaluate the efficacy of these applications. In designing the research the entire EMDR protocol should be evaluated within the context of the potential special needs of the particular population. For instance, Brown et al. In contrast, Brown et al. Now all the readers of this Wiki page will not be surprised that treating the underlying trauma made such a significant difference in her illness. But the way we worked together may be new to you. EMDR was discovered 20 years ago by Dr.
Francine Shapiro who very methodically and scientifically realized that bilateral stimulation to the brain helps to reduce trauma and its aftermath.
I have been doing EMDR for 9 years and am constantly amazed by how it can help people. EMDR appears to allow the brain to take the trauma that has not been stored effectively and allow it to hook up with adaptive information. Therefore, as Dr. Sarno would say, the brain no longer needs to be distracted from the trauma.
It can be processed and the physical sensations are reduced or completely eradicated. Often in one session. This can be done even if you do not have a specific trauma that appears to be connected to the pain. I had one client who woke up one morning paralyzed. Even though she got most of her movement back, she remained in a great deal of pain and had to stop working at a job she loved.
Within 20 minutes, her pain was down to a zero and she had more range of motion than she had had in years!
Her pain level remained at a three or lower as long as her stress level was managed.
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