Relief without “rehashing the past”
Eye Movement Desensitization and Reprocessing (EMDR) Counseling Technique
Relief from many types of psychological distress for over two million people ages 2 and up
Research over the past 20 years has shown that this non-invasive method has worked more efficiently and rapidly, than some other forms of counseling. For more than two million people ages 2 and up, EMDR has allowed the resynchronization of the brain’s hemispheres resulting in healing of: stress, anxiety, ADHD, grief, addictions, eating disorders, disturbing memories, sexual and/or physical abuse, post traumatic stress (PTSD), panic attacks, phobias, dissociative disorders, pain disorders, and other challenges.
Clients report relief at needing to only remember a small part of an event or issue as they are guided through the EMDR process. Part of the process involves the counselor facilitating dual attention stimulation. EMDR can help to strengthen feelings of confidence, calmness and mastery. EMDR can be part of an integrated treatment approach used with other techniques such as play therapy, talk therapy, behavior therapy and family therapy; as an adjunctive therapy with a separate counselor; or as a treatment all by itself.
Eye Movement Desensitization and Reprocessing (EMDR) allows both hemispheres of the brain to work together to allow the “frozen” memory to be processed thus effectively resolving difficulties caused by disturbing, difficult, or frightening life experiences. After successful EMDR a person still remembers what happened, however, now the event is less upsetting since normal information processing has resumed allowing the event to be put into its proper context.
We know that events such as accidents, abuse, violence, death, and natural disasters are traumatic but we do not always recognize the ways they affect and influence our everyday lives. Even common upsetting events such as divorce, school problems, peer difficulties, failures, and family problems can deeply affect a person’s sense of security, self-esteem, and development. When we have upsetting experiences, repeated failures, or are traumatized, we lose a sense of control over our lives. This can result in symptoms of anxiety, depression, irritability, anger, guilt, and/or behavioral problems. When an upsetting, scary, or painful experience occurs a person’s brain cannot process information as it would ordinarily. That fragmented moment becomes “frozen” in the body and the right hemisphere of the brain, unable to be interpreted and processed. The left side of the brain, where speech and logic reside, is shut down not allowing the verbalization and logical processing of the event; this is why traditional talk therapy alone cannot resolve it. When a memory of the event occurs it may feel as bad as going through it the first time because the unprocessed images/ sounds/ smells/ feelings haven’t changed. As a result that “frozen” moment may have lasting negative effects that interfere with the way a person sees the world, regulates emotions, relates to other people (misreading of facial expressions or tones of voice), overreacts, and has difficulty with impulse control, has low tolerance for stress or frustration, and their ability to self-calm due to impairment of the right hemisphere causing difficulty regulating the processing of new social and emotional information.
EMDR is an information processing therapy that uses an eight phase approach to address the contributors of a wide range of pathologies. It attends to the past experiences that have set the groundwork for pathology, the current situations that trigger dysfunctional emotions, beliefs and sensations, and the positive experience needed to enhance future adaptive behaviors and mental health.
During treatment various procedures and protocols are used to address the entire clinical picture. One of the procedural elements is "dual stimulation" using bilateral eye movements, tones, pulses, or taps. During the reprocessing phases the client attends momentarily to past memories, present triggers, or anticipated future experiences while simultaneously focusing on a set of external stimulus. During that time, clients generally experience the emergence of insight, changes in memories, or new associations. The clinician assists the client to focus on appropriate material before initiation of each subsequent set.
Eight Phases of Treatment
The first phase is a history taking session during which the therapist assesses the client's readiness for EMDR. The client and therapist identify possible targets for EMDR processing. These include recent distressing events, current situations that elicit emotional disturbance, related historical incidents, and the development of specific skills and behaviors that will be needed by the client in future situations.
During the second phase of treatment, the therapist ensures that the client has adequate methods of handling emotional distress and good coping skills, and that the client is in a relatively stable state. If further stabilization is required, or if additional skills are needed, therapy focuses on providing these. The client is then able to use stress reducing techniques whenever necessary, during or between sessions. However, one goal is not to need these techniques once therapy is complete.
In phase three through six, a target is identified and processed using EMDR procedures. These involve the client identifying the most vivid visual image related to the memory (if available), a negative belief about self, related emotions and body sensations. The client also identifies a preferred positive belief.
After this, the client is instructed to focus on the image, negative thought, and body sensations while simultaneously attending to the dual attention stimulus. The kind of dual attention and the length of each set is customized to the need of the client. The client is instructed to just notice whatever happens. After this, 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 facilitate the next focus of attention. In most cases a client-directed association process is encouraged. This is repeated numerous times throughout the session. If the client becomes distressed or has difficulty with the process, the therapist follows established procedures to help the client resume processing. When the client reports no distress related to the targeted memory, the clinician asks him/her to think of the preferred positive belief that was identified at the beginning of the session, or a better one if it has emerged, and to focus on the incident, while simultaneously engaging in the dual attention stimulus. After several sets, clients generally report increased confidence in this positive belief. The therapist checks with the client regarding body sensations. If there are negative sensations, these are processed as above. If there are positive sensations, they are further enhanced.
In phase seven, closure, the therapist asks the client to keep a journal during the week to document any related material that may arise and reminds the client of the self-calming activities that were mastered in phase two.
The next session begins with phase eight, re-evaluation of the previous work, and of progress since the previous session. EMDR treatment ensures processing of all related historical events, current incidents that elicit distress and future scenarios that will require different responses. The overall goal is produce the most comprehensive and profound treatment effects in the shortest period of time, while simultaneously maintaining a stable client within a balanced system.
After EMDR processing, clients generally report that the emotional distress related to the memory has been eliminated, or greatly decreased, and that they have gained important cognitive insights. Importantly, these emotional and cognitive changes usually result in spontaneous behavioral and personal change, which are further enhanced with standard EMDR procedures.
