Robin Richardson, LCSW-C

Certified EMDR Therapist

EMDR
 

What is EMDR?

EMDR, or Eye Movement Desensitization and Reprocessing, is known for its efficacy and is the most researched psychotherapeutic treatment for Post Traumatic Stress Disorder (PTSD). EMDR is also used in treating depression, anxiety, obsessive–compulsive disorders and more. In addition, EMDR can also be an effective enhancement tool to assist with performance in areas such as sports or public speaking. EMDR may be an appropriate treatment for anyone experiencing post-traumatic stress disorder, anxiety, depression, obsessive compulsive disorders or for those who wish to enhance their performance. A certified EMDR therapist collects both a thorough client history and utilizes an eight-stage protocol to determine, along with the client, EMDR’s appropriateness and a client’s readiness for EMDR treatment.

Like many other important discoveries, EMDR was developed serendipitously. Dr. Francine Shapiro, Ph.D., recognized that she and others expressed relief from disturbing thoughts and experiences after engaging in repetitive eye movements.

As Dr. Shapiro further investigated her theory, she realized that EMDR’s effectiveness did not occur only because of eye movements. Rather, it was the “dual attention stimuli,” or bi–lateral stimulation, that functioned to engage a client’s attention to an external stimulus while the client simultaneously focused on internal thoughts and feelings that led to the relief from disturbing thoughts and feelings.

To summarize, EMDR is an information processing therapy and uses an eight-phase approach. The goal of EMDR is to greatly decrease or eliminate emotional distress related to a memory while gaining important cognitive insights. These emotional and cognitive changes usually result in spontaneous behavioral and personal change, which are further enhanced with standard EMDR procedures.

What is dual attention or bi-lateral stimulation?

Dual attention means focusing on two things at one time. During an EMDR session, the client is instructed by a Certified EMDR clinician to focus on external stimuli such as:

  1. Eye movements — by following a moving light, right to left and back again while focusing on a thought or feeling, or
  2. Auditory stim — by listening through ear phones to a sound alternately in the right ear and the left, while focusing on a thought or feeling, or
  3. Hand-tapping — a hand tap in the palm of each hand, right and then left and repeating while focusing a thought or feeling, or
  4. A combination of both light and palm or palm and sound, whichever a client chooses while focusing on a thought or feeling.

The eye movements, sound, hand tap or any combination is the external stimuli. The internal stimulus is the thought or feeling the client thinks about at the same time… dual attention stimuli. Bi–lateral stimulation means that because you are paying attention to two different forms of stimulation, your brain is busy managing stimulation.

Sound difficult? It isn’t at all for most people. Imagine doing this: While you’re watching a tennis match (eyes moving right to left) you’re focused on thoughts and feelings related to a significant experience. Thus, the sport event is one focus, external stimulus, while the focus on thoughts or feelings is the other, internal stimuli. There you have it, an example of dual attention stimuli or bi-lateral simulation. However, this is not an example of an EMDR session.

EMDR is not a form of hypnosis. Clients are fully in charge, awake and alert during EMDR. Before EMDR begins, a Certified EMDR clinician collects a thorough history from each client and evaluates appropriateness for EMDR along with the client.

EMDR Theory

The theory supporting EMDR states that if information related to a distressing or traumatic experience is not fully processed, the initial emotions, thoughts and perceptions could be stored in the brain as they were remembered. This unprocessed information then colors the way we see our world and may contribute to further distress.

In other words, if someone has a traumatic event in which the brain does not process fully, the unprocessed information gets stored as a “sensorial or actual picture.” As we move forward in life, this “sensorial picture” influences how our brain processes a new experience that may have nothing to do with the actual traumatic event. Instead, the brain or neural pathways “read” the new experience as similar to the past-unprocessed event, thus coloring our current experience.

For example, if you have been in a significant car accident, your body may respond to driving conditions similar to the accident’s conditions in a startled, automatic manner. If you were hit on the right side of your car, you may react differently to cars coming from that direction. Clinically, it is thought that the brain is responding to stored short-term information. As the brain fully processes the trauma event and time passes and you remember this painful accident, you may feel a tinge of fear or sadness AND see the whole situation in the larger context of your entire life. You see both the good and painful experiences from the event and even identify ways you might have grown from the experience. It is believed that a fully processed event is stored in long–term memory.

When an event is stored in short-term memory, no matter how long ago the actual event happened, it is thought to cause PTSD symptoms such as sweats, flashbacks, intense startle reactions, anxiety, nightmares, anger and guilt. You may be unable to think of driving without fear of another accident occurring. Traumatic memory is different from other forms of memory in that the brain processes it differently. Thoughts, images, feelings, body sensations, and the meaning of the event tend to get disconnected from the verbal processing centers of the brain. It is thought that EMDR and other forms of bi-lateral stimulation help to shift the processing of the traumatic issue from short-term to long-term memory. This shift changes how the trauma is experienced in the body and allows for the development of a meaningful, coherent narrative.

Currently EMDR is the most researched psychotherapeutic treatment for PTSD. Having twenty controlled outcome studies investigate the efficacy of EMDR, the productiveness of EMDR in the treatment of PTSD is now well recognized. In fact, Dr. Daniel G. Amen, a nationally recognized Psychiatrist and brain imaging expert in the fields of brain and behavior and brain imaging states that. “EMDR helps to rebalance the brain and is one of the quickest treatments to help people heal from emotional trauma.” (www.amenclinics.com)

What can I expect in an EMDR session?

There is a standard eight–phase approach or protocol that certified EMDR clinicians use. This includes taking a complete history, preparing the client, identifying targets and their components, actively processing the past, present and future aspects, and on–going evaluation. The processing of a target includes the use of dual stimulation while the client concentrates on various aspects. After each set of movements the client briefly describes to the clinician what s/he experienced. At the end of each session, the client should use the techniques s/he has been taught by the clinician in order to leave the session feeling in control and empowered. At the end of EMDR therapy, previously disturbing memories and present situations should no longer be problematic, and new healthy responses should be the norm.

For more information about EMDR and its efficacy, please contact www.EMDR.com.