Eye Movement Desensitization and Reprocessing (EMDR) is an evidenced based treatment for addressing unresolved trauma or Post-traumatic Stress Disorder (PTSD).
How does a person become traumatized?
Individuals are traumatized when they become overwhelmed by a disturbing event or experience and are therefore unable to process what happened. In addition to being overwhelmed they may develop negative beliefs about themselves associated with the traumatic memory.
Although it may not make sense, logically, it often feels safer to blame oneself for the traumatic experience because the alternative seems worse (e.g., If it wasn’t my fault, what happened was out of my control and that means the world is not safe).
Common negative beliefs that individuals develop after a traumatic experience:
· I’m a bad person
· I’m permanently damaged
· I deserve only bad things
· I should have done something or I should have known better
· I can’t trust/protect myself
· I’m a failure
The body and mind are incredibly resilient and are able to heal most wounds (both physical and psychological) UNLESS the healing process is somehow blocked; for example with a physical trauma dirt or other debris may get in the way and cause infection. When a person experiences tissue damage, they generally clean the wound so that the body can do its job and heal itself. EMDR therapy works the same way with the psyche. By identifying the negative beliefs associated with the disturbing event and applying the bilateral stimulation in EMDR (i.e., cleaning out the dirt and debris from the wound), the mind is able to re-process the experience and heal itself. So instead of adhering to a negative belief (e.g., "I’m a bad person") the individual can finally conceptualize the reality of the situation (e.g., "Wait a minute, that WASN'T my fault; this painful thing happened to me, but that doesn't mean I'm a bad person. I did the best I could.").
What makes EMDR so effective?
Bilateral stimulation (BLS) is what makes EMDR such a unique and powerful therapeutic technique. BLS is any alternating movement from the left and right sides of the body (e.g., moving the eyes from side to side, hearing a sound alternating between the left and right ear, tapping or feeling a sensation alternating between the left and right hands… etc.). One of the reasons it’s believed that BLS works for trauma is because it mimics REM sleep, in which individuals process the events of their day while resting, therefore allowing subconscious memories to be more easily accessed. It promotes balanced reprocessing of traumatic memories by stimulating both the left (more factual, pragmatic) and right (more emotional) sides of the brain; this allows the individual to conceptualize the memory from a holistic or “wise mind” perspective.
Another reason why EMDR is so effective is because of the dual-attention process created by the BLS. When processing trauma without bilateral stimulation clients can often become overwhelmed (i.e., flooded) by unwanted emotions which can lead to dissociation; this interferes with the person’s ability to process the traumatic memory. Dual attention (i.e., simultaneously focusing both on the bilateral stimulation and the traumatic memory) creates a sort of buffer so that the person is less likely to become overwhelmed and shut down or dissociate.
EMDR Treatment Structure
Phase #1 – History Taking and Treatment Planning
Phase #2 – Preparation / Resourcing: Container, safe/calm place, nurturing/protective figure, etc.
Phase #3 Assessment – Involves choosing the memory to focus on and identifying the following: the worst part, the negative cognition associated, the positive cognition associated as well as the validity of the positive cognition, the intensity of the disturbance when recalling the memory (using SUD scale), the emotion and the physical sensations.
Phase #4 Desensitization (using BLS) – Involves “running the memory” with both sides of the brain engaged. This part of the process can take 1 to multiple sessions, depending on the memory and person.
Phase #5 Installation (reprocessing) – Once there is no more disturbing information surfacing and the SUDs are between a 0 and a 2/10 (whatever feels ecologically sound or appropriate), the validity of the positive (more adaptive) cognition will be reassessed and established.
Phase #6 Body Scan – This involves checking that there are no residual unresolved and unwanted physical sensations (emotions) associated with the memory.
Phase #7 Closure
Phase #8 Re-evaluation (i.e., Check-in at the start of each subsequent session to see if anything came up between sessions.)
More information on EMDR can be found through the following resources:
· EMDR: The Breakthrough Therapy for Overcoming Anxiety, Stress and Trauma by Francine Shapiro, PhD and Margot Silk Forrest
Comments