Eye Movement Desensitization and Reprocessing

Eye Movement Desensitization and Reprocessing (EMDR; also called Adaptive Information Processing / AIP) is a form of psychotherapy developed in the late 1980s by Dr Francine Shapiro, Ph.D. It involves thinking about traumatic events while engaging one or more of the senses (taste, touch, sight, sound, and/or smell). This might involve moving the eyes back and forth, hearing certain sounds, tasting certain things, being touched, or using pleasant scents.

According to Shapiro, this method can help people address unprocessed emotional trauma that is hurting them physically or emotionally. The process is intended to 'un-embed' traumatic memories from the brain and help a person move on from the emotional or physical pain they are feeling.

Use

EMDR has been used to treat survivors of rape, family violence, physical or verbal abuse, first-responder shock, chronic pain, combat, hurtful memories, select health issues, and unresolved, hurtful life experiences. It has been tested and researched in a large number of organizations since it was first published in 1987.

Today, there are EMDR trainers and trainings internationally. Over 10,000 psychologists and therapists in the United States are qualified to practice EMDR.

Treatment process

EMDR therapy combines different elements to maximize treatment effects. Shapiro describes the theory behind EMDR, research, and the treatment process in detail in her 2001 book Eye movement desensitization and reprocessing: Basic principles, protocols and procedures. (2nd edition) New York: Guilford Press.

EMDR therapy involves attention to three time periods: the past, present, and future.  It addresses past traumatic events and disturbing memories of them. It also addresses current situations that cause distress. Finally, it aims to teach skills and attitudes that will help build future success.

The EMDR model addresses these items are addressed using an eight-phase treatment approach.

Phase 1

The first phase is one or more history-taking session(s).  The therapist assesses the client’s readiness and develops a treatment plan.  Client and therapist identify possible targets for EMDR processing.  These include distressing memories and current situations that cause emotional distress.  Other targets may include related incidents in the past.  Emphasis is placed on the development of specific skills and behaviors that will be needed by the client in future situations.

Initial EMDR processing may be directed to childhood events rather than to adult-onset stressors or the identified critical incident if the client had a problematic childhood.  Clients generally gain insight on their situations, the emotional distress resolves and they start to change their behaviors.  The length of treatment depends upon the number of traumas and the age of PTSD onset.  Generally, those with single event adult onset trauma can be successfully treated in under 5 hours.  Multiple trauma victims may require a longer treatment time.

Phase 2

During the second phase of treatment, the therapist ensures that the client has several different ways of handling emotional distress.  The therapist may teach the client a variety of imagery and stress reduction techniques the client can use during and between sessions. A goal of EMDR therapy is to produce rapid and effective change while the client maintains equilibrium during and between sessions.

Phases 3-6 

In phases three to six, a target is identified and processed using EMDR therapy procedures.  These involve the client identifying three things:

1.  The vivid visual image related to the memory

2.  A negative belief about self

3.  Related emotions and body sensations.

In addition, the client identifies a positive belief.  The therapist helps the client rate the positive belief as well as the intensity of the negative emotions.  After this, the client is instructed to focus on the image, negative thought, and body sensations while simultaneously engaging in EMDR processing using sets of bilateral stimulation.  These sets may include eye movements, taps, or tones.  The type and length of these sets is different for each client.  At this point, the EMDR client is instructed to just notice whatever spontaneously happens.

After each set of stimulation, the clinician instructs the client to let his/her mind go blank and to notice whatever thought, feeling, image, memory, or sensation comes to mind.  Depending upon the client’s report, the clinician will choose the next focus of attention.  These repeated sets with directed focused attention occur numerous times throughout the session.  If the client becomes distressed or has difficulty in progressing, the therapist follows established procedures to help the client get back on track.

When the client reports no distress related to the targeted memory, (s)he is asked to think of the preferred positive belief that was identified at the beginning of the session.  At this time, the client may adjust the positive belief if necessary, and then focus on it during the next set of distressing events.

Phase 7 

In phase seven, closure, the therapist asks the client to keep a log during the week.  The log should document any related material that may arise.  It serves to remind the client of the self-calming activities that were mastered in phase two.

Phase 8

The next session begins with phase eight.  Phase eight consists of examining the progress made thus far.  The EMDR treatment processes all related historical events, current incidents that elicit distress, and future events that will require different responses.

Other websites

• EMDR International Association(EMDRIA)
• EMDR European Association, Inc.
• National Institute for Health & Clinical Excellence UK
• EMDR Scotland Archived 2008-12-01 at the Wayback Machine