What is EMDR?

EMDR stands for Eye Movement Desensitization and Reprocessing. This evidenced based practice is a treatment modality which has a high success rate when treating Post-Traumatic Stress Disorder (PTSD). An abbreviated description of PTSD according the Diagnostic and Statistical Manual IV’s indicates that the person experiences a traumatic event, the event is persistently re-experienced by the individual through multiple ways such as intrusive thoughts or flashbacks, there is an avoidance of trauma related reminders, negative thoughts and arousal/reactivity worsen following the traumatic experience, these symptoms last longer than one month, and they impair one’s ability to function in some important area of their life(Force, DSM-IV, Frances, & Association, 2000). More than half of women and men report experiencing at least one traumatic event in their lifetime, meaning an experience that exceeds the person’s present ability to cope. One way to conceptualize trauma is what we might call big “T” traumas  like sexual assault, natural disaster, traumatic loss of a loved one and little “T” like the recurring mis-attunements between caregiver and child, loss of a relationship, repeated experiences of neglect, or being embarrassed at work. The experience of trauma is very subjective based on each individual. It is estimated that approximately 12% of adult women have experienced completed rape and that twice as many women have experienced childhood sexual abuse than adult rape. Sexual abuse is a strong predictor of PSTD for both men and women. (Van Der Kolk et al, 2007).

            In a ground breaking study by Bessel Van Der Kolk et al. in 2007 they found EMDR to be significantly more effective at treating Post-Traumatic Stress Disorder (PTSD) than medication or the control group and had longer lasting positive effects. After only three sessions of EMDR 58% of the participants were symptom free six months later compared to zero of the participants who had received the medication, Fluoxetine (Van Der Kolk et al, 2007). According to the EMDR Institute’s Website, more than 30 positive controlled outcome studies have been done on EMDR therapy.  Some of the studies show that 84%-90% of single-trauma victims no longer have post-traumatic stress disorder after only three 90-minute sessions.  Another study, funded by the HMO Kaiser Permanente, found that 100% of the single-trauma victims and 77% of multiple trauma victims no longer were diagnosed with PTSD after only six 50-minute sessions. In another study, 77% of combat veterans were free of PTSD in 12 sessions.

As quoted from the EMDR Institute’s Website, 

“There has been so much research on EMDR therapy that it is now recognized as an effective form of treatment for trauma and other disturbing experiences by organizations such as the American Psychiatric Association, the World Health Organization and the Department of Defense. Given the worldwide recognition as an effective treatment of trauma, you can easily see how EMDR therapy would be effective in treating the “everyday” memories that are the reason people have low self-esteem, feelings of powerlessness, and all the myriad problems that bring them in for therapy. Over 100,000 clinicians throughout the world use the therapy and millions of people have been treated successfully over the past 25 years.” (www.emdr.com)

We know that EMDR is helpful for many people experiencing PTSD symptomology which may include symptoms of anxiety, depression, anger, grief and low self-worth, but what is it exactly? Dr. Francine Shapiro, the creator of EMDR, reports walking through the park one day and observing that some disturbing thoughts and stress reactions she was having seemed to suddenly dissipate while her eyes inadvertently swept back and forth. This experience led her to coin the term bilateral stimulation. On a basic level bilateral stimulation means alternating activation between the two hemispheres of the brain. This can be done through eye movement as well as tactile or auditory stimulation. Through the combination of bilateral stimulation and elements of cognitive behavioral therapy, EMDR can often help individuals process their trauma to resolution and release the overwhelming negative emotions, sensations, and cognitions attached to the memory. 

According to the EMDR Institute,

“After the clinician has determined which memory to target first, he or she asks the client to hold different aspects of that event or thought in mind and to use his or her eyes to track the therapist’s hand as it moves back and forth across the client’s field of vision.  As this happens, for reasons believed by a Harvard researcher to be connected with the biological mechanisms involved in Rapid Eye Movement (REM) sleep, internal associations arise and the clients begin to process the memory and disturbing feelings and likely moving the memory into a different part of the brain by activating channels of associations between memories. In successful EMDR therapy, the meaning of painful events are transformed on an emotional, cognitive, and somatic level.  For instance, a rape victim shifts from feeling horror and self-disgust to holding the firm belief that, “I survived it and I am strong” and when they scan their body the body agrees with that statement. Unlike talk therapy, the insights clients gain in EMDR therapy result not so much from clinician interpretation, but from the client’s own accelerated intellectual and emotional processes.  The net effect is that clients conclude EMDR therapy feeling empowered by the very experiences that once debased them.  Their wounds have not just closed, they have transformed. As a natural outcome of the EMDR therapeutic process, the clients’ thoughts, feelings and behavior are all robust indicators of emotional health and resolution—all without speaking in detail or doing homework used in other therapies.” (www.emdr.com)

This does not mean that the individuals forget their trauma, but by being able to process the trauma in a safe environment, individuals often feel as if the trauma has less power over them and that the traumatic experience feels more securely placed in the past. This can allow the person to live more in the present moment unburdened by pervasive negative cognitions relating to the self.  

Before any type of trauma processing, be it through EMDR or through the creation of a trauma narrative, it is important to make sure that the individual feels regulated and resourced enough to tolerate this exposure. For this reason EMDR protocol also includes many resourcing strategies such as safe place instillation, grounding exercises, and resource enhancement techniques. This can also incorporate other forms of resourcing and coping skills training such as diaphragmatic breathing, progressive muscle relaxation, mindfulness techniques, essential oils, biofeedback, and expressive arts to meet each individual client’s need.

If you are interested in learning more about EMDR or receiving EMDR therapy for yourself or a loved one please contact Jill Terhune, Ed.S., L.P.C.C. at Compass Counseling at 270-777-4490.

References

Van Der Kolk et al., B. (2007). A Randomized Clinical Trial of Eye Movement Desensitization and Reprocessing (EMDR), Fluoxetine, and Pill Placebo in the Treatment of Posttraumatic Stress Disorder: Treatment Effects and Long-Term Maintenance. Journal of Clinical Psychiatry68,

Force, the T., DSM-IV, Frances, A., & Association, the A. P. (2000). Diagnostic and statistical manual of mental disorders DSM-IV-TR                                                          (4th ed.). Washington, DC: American Psychiatric Association.

www.emdr.com