EMDR (Eye Movement Desensitization and Reprocessing) has been around for 30 years, but seems to be gaining a lot recognition lately. What is EMDR? Why is it so effective? Can any therapist do EMDR with me? Is it hypnosis?…What exactly is EMDR?
One day in 1987, a psychologist Francine Shapiro, was walking in the park and realized that what she was thinking about didn’t bother her as much as it did a few minutes earlier. Thinking about what just happened, she realized she had been moving her eyes back and forth very quickly. She did this again and noticed the same result. She practiced on friends and family, noticing similar results. Thinking she just stumbled upon an excellent way to help people with traumatic memories, she conducted scientific studies and determined it is effective in decreasing the effects of traumatic memories. Since then, more than 20 randomized research studies have concluded the same thing: EMDR is an effective modality of trauma therapy. Today, EMDR is approved by the Veterans Administration (VA), the Department of Defense, the World Health Organization (WHO), the Department of Health and Human Services (HSS), and many other health agencies around the world. www.emdria.org
As effective as EMDR is, nobody knows exactly how it works. There are several theories at this time, one of them being EMDR works a lot like a proposed theory of REM (Rapid Eye Movement) sleep. That is, during REM sleep, the brain is proposed to be processing and making sense of events that happened during the day; essentially putting them to rest. https://www.ncbi.nlm.nih.gov/books/NBK11121/(https://www.ncbi.nlm.nih.gov/books/NBK11121/). During EMDR therapy, the client is rapidly moving their eyes back and forth, similar to REM sleep. Thus one hypothesis is rapid eye movements, for some still mysterious reason, seem to quickly process memories, attempting to make sense of them and file them away in the proper “filing box” of the memory bank. Take a look at this youtube video explaining how EMDR works: https://www.youtube.com/watch?v=sWyDWvMEl1E. For now, the workings of the brain remain a mystery!
EMDR is a non-physically invasive procedure that utilizes a standardized protocol and should only be done by a therapist who is trained by an EMDRIA approved program. Although the risk of physical harm is incredibly slim, the body and brain are so very connected that a therapist will first determine you are appropriate for EMDR therapy. Certain medical conditions would alert the therapist to contact your doctor first to ensure it is a safe modality to use with you. Additionally, as the body stores memories as well, there is the potential for your body to physically react to the traumatic memory as if it is happening now. Although there is no physical danger to this, it can be very scary for you and the untrained therapist. Furthermore, EMDR should never be done on yourself. Even if you’ve had several sessions with a therapist and think you know what you are doing, even EMDR trained therapists are encouraged not to do it on themselves. First of all, you went through the trauma alone; why make yourself heal alone? Support is so important to successful healing. Second, there may be times you get stuck. You may not notice that you got stuck, but it is more obvious from an outside person. The therapist will help you get unstuck. Even if you know you are stuck, it often takes an outside person to know what to say or do to get you unstuck.
EMDR is NOT hypnosis, although it can share properties. Often when people undergo hypnosis, they feel tired afterward; somewhat lethargic. During EMDR, your brain is doing a great deal of work. This can make you feel tired and lethargic. However, during the treatment, you are fully aware of what is happening. You keep one foot here in the therapist’s office and one foot in the past memory. The therapist will help you learn skills to not put both feet in the past during the treatment.
So what does EMDR look like? During EMDR, the therapist starts by gaining a complete history of you and what brings you to therapy. The therapist will do a couple trauma assessments to ensure proper treatment. Then you and the therapist will make a treatment plan defining what you are going to work on with EMDR. After that, the therapist will teach you skills to handle stressful emotions that may come up. It is important to know that you can remain calm(ish) during stressful memories. You will feel the emotion, but the therapist will teach you skills so they don’t overwhelm you. It often makes the both therapist and client feel better to know that you have skills to avoid overwhelm. Next, the therapist will select with you what “target” you are working on first, tease out the negative belief that goes along with that memory, identify what you’d rather believe, rate how strongly you believe that positive belief (usually this is a very low number), what emotions come up and how strongly, and where you feel any disturbance in your body (remember the body and brain are very connected and the body holds memories as well). Now we get into the active reprocessing of the target memory using eye movements. Once you strongly believe the positive cognition, you have no sensation or disturbance in your body, and you don’t have any strong emotion attached to the memory, the therapist will increase the strength of the positive belief, still using eye movements. Once the positive cognition is strong, the therapist will ask you to bring the original target memory to mind and identify if there are any other sensations or disturbances in the body. “An EMDR session is not considered successful until the client can bring up the original target without feeling any body tension.” http://www.emdria.org. At the end of each session, the therapist will close the session by using self-regulation techniques in order to leave the session feeling some sense of equilibrium. Finally, the therapist will reevaluate at each session to make sure progress has been maintained and identify where to go next. Upon completion of the past target(s), the therapist will go through the protocol again with any situations that are happening now, and then again with any potential situations you can think of in the future that may cause this same distress.
Although EMDR is traditionally a faster and more complete trauma therapy than traditional cognitive therapies, speed is not what you should be looking for. Everyone heals at their own time. Think about the grief process. Some people grieve quickly, while for others it may take years to fully heal from a loss. The important thing is after EMDR therapy, you will regain a sense of safety and stability that you may not have felt in years.
Some therapists will become certified, which means they met additional criteria and obtained several hours of EMDR supervision after basic training. Some therapists will specialize in specific traumatic reactions such as dissociation and consistently seek additional training in those areas to learn best techniques for those specialized needs. You can find an EMDR trained therapist at www.emdria.org among several other websites, or feel free to contact me at megberrylcsw@fastmail.com, 860-501-9767, or 941-462-4807 and I will help you find someone near you.
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