EMDR Therapy – Eye Movement Desensitization and Reprocessing
What is EMDR? – A Guide for Consumers
EMDR stands for “eye movement desensitization and reprocessing.” It is a procedure used in psychotherapy to help you reduce the impact of experiences from the past that intrude on your present-day life. Often, these experiences from the past involve a trauma such as assault, abuse, an accident, or a natural disaster. Even though the trauma may have happened many months or even years ago, you still feel its impact in your daily life through post-traumatic symptoms such as intrusive memories, emotional flooding or numbing, nightmares, anxiety, low self-esteem, and difficulty getting on with your life. EMDR has also been used to help people deal with anxiety and panic problems, grief issues, reactions to physical illness, and many other conditions where strong emotions are associated with life experiences. EMDR has proven effective in the treatment of post-traumatic symptoms in several research studies.
The Problem with Trauma
In daily life, we all use our minds to figure things out, cope with predictable stresses, and regulate our emotions and our self-esteem. The experience of trauma overwhelms our capacity to cope, and the trauma experience often gets stored in our minds in ways that make it very difficult to use our usual ways of coping. For example, even though we know that a traumatic event happened in the past, it becomes impossible for us to think about it without starting to feel emotions and other sensations that occurred at the time of the original experience.
We also typically develop a negative way of thinking about ourselves in relation to trauma, such as “It’s my fault” or “I’m a bad person.” These negative thoughts often influence how we think and feel about ourselves in other situations. EMDR attempts to activate your coping skills to deal with the present-day impact of the trauma. The EMDR procedure can help desensitize the images and feelings associated with the trauma. It can help you to recognize and work on feelings and thoughts that come up with the trauma. And it can help you think differently about yourself in relation to the trauma.
The EMDR Procedure
The therapist will talk with you about yourself in an effort to understand the history of your difficulties and how they are affecting your current life. This may take one or two sessions. If EMDR is recommended, your therapist will explain the procedure. If you decide to go ahead with it, you and the therapist will construct a description of your problem that includes: an image or picture that represents the past event, your negative beliefs about yourself in relationship to the event, how you would prefer to think about yourself in relation to the event (positive belief), your emotions associated with the event; and your physical sensations associated with the event. You will also be asked to give numerical ratings to your degree of upset and the credibility of the positive belief so your progress can be monitored during the session.
After the protocol described above is established, you will begin the processing phase of the procedure using the eye movements (or other kinds of bi-lateral, rhythmic attentional stimulation, if eye movements are not appropriate in your case). A typical EMDR processing session lasts from 50-90 minutes. During this part of the treatment the therapist will be sitting beside and facing you. The therapist will ask you to bring to mind the picture of the experience that is bothering you along with the negative self-thought, the emotions, and the physical sensations. You will be asked to hold this in mind as best you can while following with your eyes the therapist’s fingers, which are moving back and forth. After a series of about 30-50 eye movements (or more), the therapist will ask you to stop, let go of the image (or thought) for a second, take a deep breath and then notice and describe briefly what thoughts, feelings, images and body sensations arise for you. Usually, the therapist will ask you to go on with those thoughts, feelings, images and sensations and will do another set of eye movements.
You will go through this process of moving your eyes, pausing, and reflecting several times during the session. Typically, the images, emotions, and sensations you experience change as you go through this process. Assuming that your thoughts, feelings, images, and physical sensations become less distressing, the therapist will ask you to bring up the positive self-statement and will use EMDR to help you begin to associate this new way of thinking about yourself with the original troubling image. If your level of upset continues to be high toward the end of the session the therapist will work with you to help you to calm down and prepare you to continue your work at your next session.
You and your therapist will often know if EMDR is going to be useful to you in one or two sessions. It’s hard to predict, in general, how long EMDR treatment will take. You may experience sufficient relief from your symptoms in as few as two to six sessions or EMDR may be a procedure that you and your therapist use as part of a longer-term therapy process for several months to deal with certain problems and issues.
EMDR processing can be upsetting. There are many safety procedures built into the EMDR process, but it can still be an intense experience. The aim of each EMDR session is to help you feel less upset at the end of the session. But sometimes it’s hard to work through a difficult issue even in a 90-minute session. If staying upset or becoming upset after a session becomes a pattern for you, you should tell your therapist that this is happening. In EMDR, you might remember events or parts of events you either hadn’t thought about before or hadn’t associated with the problem being worked on. Memories coming up in EMDR are no more or less accurate than any other memories that our mind constructs when reflecting on the past. Regardless of the absolute truth of the memories that emerge, they usually bring up important psychological issues that can be processed in EMDR.
You shouldn’t undertake any course of treatment, EMDR included, where your life circumstances and financial resources will not allow you to work safely and bring the therapy to a reasonable conclusion. Even though EMDR can tield results in a short time, you need to be prepared to follow through with a course of treatment.
You should only undertake EMDR treatment with a therapist who is credentialed to do psychotherapy and who has special training approved by the EMDR International Association (EMDRIA). As with any psychotherapy, you should feel comfortable with your therapist. You should feel free to ask about your therapist’s EMDR training and his or her general experience in working with difficulties such as yours.