Trauma Technique: Eye Movement Desensitization Reprocessing (EMDR)
EMDR is used by qualified therapists in a number of our Restorative Justice programs.
Please contact the Director of Restorative Justice Programs if you are interested
in this modality.
What Is EMDR?
Eye Movement Desensitization and Reprocessing (EMDR) is a psychotherapeutic technique
discovered by Francine Shapiro, Ph.D., and was developed in 1987. Although EMDR
was developed originally as a treatment for psychological trauma, it later was broadened
to treat, in selected individuals, a wide variety of psychological symptoms and
dysfunctional beliefs.
A controlled treatment outcome study, published in 1989 in the Journal of Behavior
Therapy and Experimental Psychiatry (Vol. 20, No.3, pgs. 211-217), revealed that
EMDR was effective in reducing the negative emotion associated with traumatic events.
Several, methodologically well done studies of EMDR have since been completed indicating
it’s effectiveness with resolving emotions and symptoms resulting from trauma. In
addition, the International Society for Traumatic Stress Studies has determined
that EMDR is effective for treating trauma, and qualifies for an A/B rating.
How Does EMDR Work?
During EMDR the psychotherapist typically moves a hand back and forth in front of
the patients’ eyes at a distance of about one foot. This back-and-forth movement
is rhythmic and smooth, at the speed of about once cycle per second. The patient’s
eyes follow the therapist’s hand. A set of eye movements typically consists of 30-50
cycles. Other variants of the procedure can include listening to alternating tones
or experiencing alternating hand taps. A psychotherapy session includes a few to
many dozens of sets, with discussion between sets. There are many variations on
the physical aspects of the procedure, and these variations are introduced as necessary
for the success of the treatment.
Much more significant than the physical procedure is the preparation of specific
thoughts, images, feelings, and body sensations which will be focused on just prior
to each set of eye movements. The typical starting point for the procedure is a
specific memory of an upsetting experience, including a pictorial image of the experience,
and the thoughts, feelings, body sensations (and possibly smells, tastes, and sounds)
that go with the experience. As a result of using the eye movement from this starting
point, the patient typically experiences changing pictures, thoughts, and feelings
as the sets continue.
It is the therapist’s responsibility to guide the patient through the procedure.
The patient’s responsibility is to report what is experienced. During the eye movements
the patient is asked to adopt an observing attitude and to make no conscious effort
to modify what is being experienced.
There are enormous variations in the thoughts, images, feelings, and body sensations
that emerge during the procedure. In general, the alternation of sets and discussion
continues across sessions until psychological symptoms are resolved and maladaptive
beliefs modified.
Why EMDR works is not clearly understood. One hypothesis is that EMDR is related
to rapid eye movement (REM) sleep, and REM sleep’s ability to help individuals cope
with their daily stresses.
Who Is Eligible for EMDR?
EMDR has been used with virtually all ages. The standard eye movement technique
is not suitable for patients who have various eye disorders, especially disorders
of the retina. A patient with an eye disorder should not proceed with EMDR unless
medically cleared. Individuals with contacts or spectacles may wish to remove them.
In any event, any discomfort should be reported immediately to the psychotherapist.
The psychotherapist may also solicit feedback about how the procedure is being experienced
(e.g., the comfort level of various distances, ranges of movement, speeds, etc.).
EMDR often works rapidly. Many patients are likely to have made substantial improvement
in ten visits or less. Those with extensive histories of trauma may require much
longer treatment. Once trauma has been resolved there may yet be many areas in which
skills need to be developed, and traditional cognitive behavior therapy or other
forms of therapy may be indicated.
Note: If you would like to begin EMDR, it is advisable to commit
to several sessions before making a final decision about whether the treatment is
appropriate for you. If you decide to continue with EMDR, you should do so until
your psychotherapist indicates you have completed it. By comparison, sometimes the
good effects of a medication take time to occur. Similarly, even if good effects
occur rapidly, the medication may still need to be used for a time thereafter to
insure the stability of treatment success.
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