EMDR Answer

Q & A Corner

Question: What is EMDR?

Answer:

EMDR was founded by accident in 1987 by a psychology graduate student by the name of Francine Shapiro. Basically she had noticed that some distressing thoughts that were bothering her had come and gone, and was able to finally link the "disappearance of the distress" to the rapid movement of her eyes. Shapiro then tested the process further on herself and then with others. Since then many research studies have been done to confirm the efficacy (see below) of EMDR. Studies have shown EMDR to be highly effective in the treatment of PTSD (Post-Traumatic Stress Disorder), including long-standing, unresolved traumatic memories. It has helped to relieve the flashbacks and intrusive thoughts experienced by rape victims, victims of sexual abuse, and war veterans. EMDR may also be used in treating victims of natural disasters, automobile accidents, phobias, severe anxieties, and so forth. There is also now an EMDR Institute , founded by now Executive Director, Dr. Francine Shapiro, for the training of professionals to properly administer and develop these procedures

What does EMDR stand for and how does it work?

EMDR stands for Eye Movement Desensitization and Reprocessing, and originally Shapiro called the treatment simply Eye Movement Desensitization. Reprocessing was later added when Shapiro realized that the movements (similar to REM movements of sleep) helped in some way to reprocess material that was " unresolved and locked " in the brain. No one completely knows how EMDR works, but research studies show in fact that it does work. It is known that we have verbal and nonverbal memories, and it is believed that in trauma, the nonverbal memories (emotional, sensory [touch, smell]) become frozen in time and are fragmented memories that are not integrated and processed. If one is raped, then any reminder of the rape can trigger a response and the rape can be re-experienced all over again (flashbacks). The "trigger" could be a smell (cologne of the attacker), a touch (beard similar to attacker), a color (of attacker's shirt or room of the attack). There is a sensory memory that is frozen and then generalizes (spreads) to anything similar -- now a " trigger." With the use of EMDR it is believed that somehow the right and left brain are now able to communicate with one another and old distressful material can be processed. Essentially, the negative, strong emotion linked to the memory dissipates and the person can move on, so to speak. The memory may still be there, but without the incapacitating intense emotions.

How is EMDR done?

Although the procedure itself may appear simple, EMDR must be done by experienced professionals trained in EMDR. As in any therapy situation, there must be trust in the therapist, and a sense of safety (since this is a basic element that has been lost because of a trauma). During the reprocessing, intense emotions will be raised along with possible abreactions ( screaming/sobbing). Assuming the therapist is EMDR trained and skilled, the sessions will be based on the kind of problem and its longevity ( e.g., one-time rape or mugging versus years of sexual abuse that began at age four). A thorough history will be taken and a therapeutic relationship needs to form at this point. At the beginning of a session, instructions are given and the client must always be in control. The therapist will then move an idex finger back and forth in front of the eyes creating a rapid eye movement (saccadic movement), while the individual thinks about a past traumatic memory. Sound and tapping of the hands may also be used if preferred or if someone is blind. A signal to stop the treatment or simply take a break is agreed upon so the client is in control at all times. No one should proceed with EMDR without a sense of trust in the therapist or a feeling of safety.

Important parts of a session include rating an emotion on a scale of one to ten (10 being the worst terror) and then bringing to mind the various memories that have caused the trauma or years of emotional disability. A session can (and often does) take up to 90 minutes to provide the needed time to deal with difficult memories and then return to the everyday world. The EMDR therapist may ask the client to focus on the worst incident in all the years of abuse, a typical incident, the most recent incident or a body sensation. (This may be viewed as taking different snapshots of the abuse, using different lenses to focus in on the traumatic memories.) This requires good assessment/evaluative skills on the part of the therapist and skill in administering the treatments. It also requires that the client understand and agree to the procedures -- that the client is ready and willing to go through the process of desentization and reprocessing.

The number of sessions could be one (one-time trauma) to twenty or more (long-time sexual abuse). Sometimes a one-time trauma will actually unleash another unresolved trauma that also requires resolution. The number of sessions and the pace will depend upon the client working with the therapist. But, the control of the sessions (timing, etc.) rests with the client.

Is EMDR effective?

Initial studies (Shapiro, 1989) and others that have followed ( case and controlled studies) and have replicated Shapiro's initial study (Wilson et al., 1995) have shown EMDR to be highly effective in treating the incapacitating memories and intense emotions associated with psychological trauma. Many other therapies/techniques can also be helpful with PTSD (art, movement, and journaling) and can be integrated into the overall treatments offered. But EMDR seems to have shown itself to be a very effective tool in the treatment of traumatic, unresolved memories. (See References below.)

Although EMDR has been shown to be effective and safe, you would not want to put yourself in a situation that created more stress or premature ending of a treatment because of a poorly trained or untrained therapist.

Where can I learn more about EMDR or find a practitioner?

You can go to the EMDR Institute's website at www.emdr.com or e-mail the Institute at: inst@emdr.com . Be sure to only embark on a course of EMDR treatments with a therapist who has been trained in the EMDR techniques and has received supervision in EMDR.

Remember no one discussion or overview such as this can fully explain EMDR and is meant to provide information only for those who may be interested in EMDR and would possibly like to learn more about EMDR. No one treatment or therapy is suggested or recommended and all decisions around the kinds of treatments, help or support you might need or agree to, should rest with (you) the one seeking treatment. If you have any questions about EMDR or the possibility of traumatic symptoms, do log onto the EMDR home page for further information. If you would like to seek some general advice/clarification around traumatic experiences you may also refer to Pysch Options™ Rates/Types of Services and/or go to the Registration Site. Treatment of PTSD or traumatic symptoms cannot be done on-line and requires face-to-face therapy with a skilled therapist. (For some texts on PTSD, please see our Bibliotherapy section.) (Also see the section on PTSD within this site for more information on PTSD.)

References/Bibliography

Parnell L: EMDR in the Treatment of Adults Abused as Children. W. W. Norton, New York, 1999.

Shapiro F (1989): Efficacy of eye movement desensitization procedure in the treatment of traumatic memories. Journal of Traumatic Stress Studies, 2, pp 199--223.

Shapiro F. Eye Movement Desensitization and Reprocessing: Basic Principles, Protocols, and Procedures. The Guilford Press, 1995

Wilson SA, Becker LA, & Tinker RH (1995): Eye movement desensitization and reprocessing (EMDR) method treatment for psychologically traumatized individuals. Journal of Consulting and Clinical Psychology, 63, pp 928 -- 937.

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