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What
is EMDR?
Eye
Movement Desensitization and Reprocessing (EMDR) is a psychological method for
treating
emotional difficulties that are caused by disturbing life
experiences, ranging from
traumatic events
such as accidents, assaults, illness, natural disasters to upsetting
childhood experiences that have had a lasting effect on one's life.
EMDR is a complex
method that brings together elements from well-established
theoretical orientations,
including
psychodynamic,
cognitive, behavioral and client centered approaches. For
many
clients, EMDR provides more rapid relief than conventional
therapies.
How
Was EMDR Developed?
Psychologist
Francine Shapiro made the chance observation in 1987 that eye movements
reduced
the intensity of her
disturbing thoughts. Dr. Shapiro subsequently tested her
discovery
under a variety of clinical conditions and reported the results of her first study
in
1989 in the Journal of Traumatic Stress.
What
is it Used For?
While
EMDR is best known for its treatment of post-traumatic stress
reactions, it is also
used
to treat anxiety, depression, and other clinical presentations such
as complicated
grief
reactions, phobias, and self-esteem issues. EMDR is also used to
help alleviate
performance
anxiety and to enhance the functioning of people at work, on the
playing
field,
and in the performing arts.
What
Happens in EMDR?
During
an EMDR Session, the clinician works with the client to identify a
specific
problem
or issue that will become the focus of the treatment session.
Utilizing a
structured
protocol, the practitioner helps the client identify an experience
that relates to
the
problem, focusing on aspects of the experience that continue to be
disturbing to the
client
in the present. As the client focuses their attention on the
targeted event, the
clinician
initiates eye movements. Once the client is engaged in the
experience, he or she
is
likely to experience various aspects of the initial memory or other
memories that are
associated
with the targeted event. The clinician pauses with the eye movements
at
regular
intervals to insure that the client is processing adequately on
their own. The
practitioner
acts as a facilitator, making clinical decisions about the direction
of the
client's
processing during EMDR, in an effort to reach an "adaptive
resolution" to the
problem
that was initially identified.
Why
Do So Many Clients Respond Well to EMDR?
EMDR
is a client-centered approach that appears to activate an inherent
healing
mechanism
in the brain that stimulates an information processing system. It
allows the
client
to access a disturbing experience that has been a source of
discomfort, and have the
experience
reprocessed in EMDR in a way that it is no longer a source of
distress to the
client.
These experiences that were once stored in the brain in their
original state are
altered
with EMDR.
The clinician uses EMDR
to activate that experience with all the
thoughts,
feelings and body sensations that are still associated with the
experience.
Through
the adaptive information processing system in the brain, EMDR is
able to
stimulate
a desensitization
and a reprocessing of that initial experience, thereby bringing
it
to a more adaptive resolution.
What
is the Mechanism That Makes EMDR So Effective?
While
it is not clear how EMDR works, there are ongoing investigations of
the possible
mechanisms
involved. What is clear is that present day occurrences can
reactivate
negative
thoughts, emotions, and physical sensations that arise from earlier
experiences
that
are disturbing. It appears that EMDR can change the association of
those
experiences,
greatly decreasing the current distress about past and present
events.
Several
hypotheses have been proposed to explain how EMDR works. The process
of reciprocal inhibition, that is, pairing emotional distress with a
"compelling relaxation response." Bessel van der Kilk,
M.D. of Boston University School of Medicine, postulates that EMDR
helps the client differentiate between explosure to a real traumatic
event and an associated memory of an old traumatic event by
increasing the activity of the anterior cingulate gyrus adn the left
front lobe of the brain.
Another
hypothesis proposed by Harvard researcher Robert Stickgold, Ph.D. is
that EMDR turns on memory processing systems normally activaetd by
REM sleep. The two systems involved in that process, the hippocampus
and the neocortex are being stimulated to "communicate"
with each other, and that the bilateral stimulation activates that
communication. Dr. Stickgold is currently conducting research to
test his hypothesis.
How
Long Does EMDR Therapy Take?
Once
the client and clinician have agreed that EMDR is the treatment of
choice, the
therapy
can take anywhere from 1-3 sessions for a single event trauma to a
year or more
for
more complex problems. A "typical" course of EMDR
treatment is generally 3-15
sessions,
performed at regular intervals. EMDR therapy can be applied as an adjunctive
treatment
for a client who is already in psychotherapy, or it can be a therapy
unto itself.
Ideally,
most clients and clinicians prefer EMDR treatment as part of a
comprehensive
psychotherapeutic
approach.
Are
Eve Movements
Needed to Make EMDR Effective?
Anecdotal
evidence from clients and clinicians alike suggest that bilateral
stimulation
appears
to activate an information processing system in the brain. The
bilateral
stimulation
can be eye movements that are similar to the movements of the eyes
in REM
sleep,
or tapping on one side of the body and then the other in an ongoing
pattern, or
tones
that alternate in the left and right ears.
What
is the Research That Supports EMDR?
Since
1989, several controlled studies have been conducted, and results
demonstrate that
EMDR
is one of the most efficacious
treatments available for posttraumatic
stress
disorder,
or PTSD.
In 1995, Wilson, Decker
and Tinker, in the Journal of Consulting and
Clinical
Psychology
studied the effects of three 90-minute
EMDR treatment sessions on
traumatic
memories of 80 participants. The results suggest that EMDR was
effective in
decreasing
symptoms and anxiety associated with traumatic memory and in
increasing
positive
cognition. Other studies indicate that EMDR may be effective in
treating
phobias,
performance anxiety in the workplace, trauma in children, and the
reduction of
chronic
pain.
Are
There Any Precautions?
Yes.
It is important that clients are thoroughly screened for EMDR
treatment. There are
many
variables that are taken into account when considering EMDR
treatment: the
nature
of the problem, the emotional stability of the client, the client's
history, the
medical
as well as clinical situation. It is also important that the
clinician administering
EMDR
has been formally trained by an EMDRIA-approved
program, and is certified
as a
practitioner
of EMDR by EMDRIA.
How
Do You Get More Information on EMDR?
Further
information can be obtained by calling the EMDR International
Association at
512-451-5200
or by contacting the website
at www.emdria.org.
The
EMDR International Association is a non-profit, professional
organization whose
mission
is to establish, maintain and promote the highest standards of
excellence and
integrity
in EMDR practice, research and education. EMDRIA provides
information to mental health providers and to the public about EMDR.
It has established guidelines for
certification
of EMDR practitioners, consultants and training programs. It
supports
further
research on EMDR's
efficacy,
recent innovations of EMDR treatment, and
applications
of EMDR with different client populations and diagnoses. It
maintains a
register
of certified clinicians, consultants, instructors and training
programs.
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