What is EMDR and what kinds of problems can it
treat?
Eye Movement Desensitization and Reprocessing (EMDR) is a proven
method of psychotherapy developed in 1987 by a psychologist, Dr. Francine
Shapiro. It has developed and evolved through contributions of therapists and
researchers worldwide. Today, EMDR is a standardized protocol that incorporates
elements of many different treatment approaches. Proven effective for
post-traumatic stress, EMDR therapy can help clients replace their anxiety and
fear with positive images, emotions and thoughts. Symptoms that can be helped
by EMDR include:
- High anxiety and lack of motivation
- Depression
- Memories of a traumatic experience
- Fear of being alone
- Unrealistic feelings of guilt and shame
- Difficulty in trusting others
- Relationship problems
How does EMDR work?
How any psychotherapy actually works
in the brain remains largely unknown. When someone is very upset, however,
their brain is unable to process information in its ordinary way. A moment of
extreme upset can become 'frozen in time' - and, when remembered, feel as bad
as the first time because the original images, sounds, smells and feelings
haven't changed. Such memories can have a lasting negative impact and interfere
with the way a person experiences life. EMDR seems to help normal information
processing resume - freeing a person to no longer relive the painful details
each time the original event comes to mind. Disturbing material can be
processed, and then experienced in a less distressing way. What happened is not
forgotten, but is less upsetting. While other types of therapy have similar
goals, EMDR seems similar to what happens during dreaming or REM (rapid eye
movement) sleep.
Is there evidence of EMDR's effectiveness*?
EMDR is an
evidence-based intervention in the treatment of PTSD according to at least 20
controlled outcome studies and many reputable organizations and national health
guidelines including: the Cochrane Database of Systematic Reviews (2007) and
The American Psychiatric Association Practice Guideline for the Treatment of
Patients with Acute Stress Disorder and Posttraumatic Stress Disorder (PTSD)
(2004) that has given EMDR the same status as Cognitive Behavior Therapy as an
effective treatment for ameliorating symptoms of PTSD. The U.S. Department of
Veterans Affairs and Department of Defense has placed EMDR in its highest
category of therapies recommended for treatment of PTSD (Clinical Practice
Guidelines, 2004). In addition, the International Society for Traumatic Stress
Studies (ISTSS) gave EMDR an “A” rating for treatment of adult PTSD
(Foa et al., 2009). EMDR has been determined to be efficacious in the treatment
of trauma by several international health and governmental agencies including
the United Kingdom Department of Health (2001), the Israeli National Council
for Mental Health (2002), the Dutch National Steering Committee Guidelines
Mental Health Care (2003), French National Institute of Health and Medical
Research (2004), (UK) National Institute for Clinical Excellence (2005), and
the Medical Program Committee/Stockholm City Council, Sweden (2003).
*A bibliography of research on EMDR may be found at
www.emdria.org
What happens in a session?
The therapist and client
first identify a specific problem as the focus for treatment. The client brings
to mind a disturbing issue/event and what was seen, heard, felt, and thought -
as well as what thoughts and beliefs are currently held about that event. The
therapist facilitates directional movement of the client's eyes or other dual
attentional stimulation of the brain, while the client focuses on the
disturbing material and simply notices whatever comes to mind. The client
observes whatever comes to mind without making any effort to control direction
or content. Each person processes information in a unique way based on values
and personal experiences. Eye movements continue until the memory becomes less
disturbing and is associated with positive thoughts about one's self (for
example, "I did the best I could.") Intense emotions may arise during EMDR, but
most people report a great reduction in the level of disturbance by the end of
the session.
How long does EMDR take?
One or more sessions are
required for the therapist to understand the problem and determine that EMDR is
appropriate. The therapist will discuss EMDR and answer questions. Once the
therapist and client decide that EMDR is appropriate, therapy may begin. A
typical session lasts 60-90 minutes. The kind of problem, life circumstances
and trauma history will determine the number of treatment sessions needed.
Adapted from 'What is EMDR?' EMDRIA, 2005