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What is EMDR?

EMDR stands for eye movement desensitization and reprocessing. It's a very popular therapy modality right now and a lot of people kind of understand it but not really; so today I'm going to try to explain it as simply as I can. EMDR is a way to process trauma. It doesn't have to be like big “T” trauma like PTSD or being a veteran or having a car accident or something like that. EMDR is meant for that or it was developed for that but you can see huge benefits from it just to reduce some really significant anxiety. If you've had a tough childhood, maybe you were fired recently and you're having an emotional reaction to that. Maybe you have made some choices where you've had bad relationships and that keeps happening. Maybe there's bullying or teasing there are a number of little “t” traumas that EMDR is also really great for.


How Does EMDR Work?

Let me explain a little bit how it works. EMDR is based on REM sleep. During sleep there are kind of three sleep phases. The first phase is light sleep and that's where you're settling down in your bodies starting to relax into sleep. And then you have deep sleep. Deep sleep is where your body is being kind of fixed; that’s where kids do all their growing. That's where our body makes repairs to itself. Then we have REM sleep or rapid eye movement, In REM sleep that is where we process our emotions and feelings. Oftentimes it's when we're dreaming that our brains are trying to manage through and process our experiences and the feelings that are left from those experiences. In REM sleep your eyes move back and forth. By moving back and forth that's what we call bilateral stimulation. If your eyes are moving back and forth that's activating the right side and the left side of your brain. When both sides of your brain are working at the same time it's a lot more efficient in the processing of emotions.


What To Expect in an EMDR Session

When you're coming into EMDR you may find your therapist using a long light bar with a light that literally goes back and forth and your eyes are going to be watching this light through the whole session. Your EMDR therapist may also use devices called tappers; they are little electronic devices that you hold in your hand and it vibrates right left right left. You get to determine the speed of the intensity whatever feels most comfortable to you. And that is going to activate your right and left side of your brain. In many cases that therapist can see your eyes moving back and forth while you're holding these tappers. Another way that a therapist might use EMDR is by tapping on your knees. They'll sit across from you and they will tap right left right left and again to stimulate the right and left side of your brain.


When you are processing something in EMDR it can happen really quickly so it's important to work with an EMDR therapist that is very experienced and trained because it's very easy to dive into an old feeling or  trauma and it's not always that easy to learn how to resource for yourself. Resourcing is a way that you can calm your nervous system. You can calm your body and kind of come back to present so you're not stuck or traumatized by whatever it is that you're trying to process. Oftentimes people will start with something that's a smaller target, something that's not too emotionally triggering and then lead up to bigger issue.

What To Look For in an EMDR Therapist?

If you want to participate in EMDR therapy you have to find someone that specializes in it. Not everyone does EMDR and those that do are of varying experience so please do your homework check in and see if they've been fully certified or credentialed how long they have been practicing EMDR and ask them a little bit about their method and their protocol because there are more traditional ways of doing EMDR and then there are little more flexible ways of doing EMDR that might incorporate more somatic experiencing or other somatic based modalities especially for the resourcing


Once you go into EMDR you will feel significantly better. It is fast-acting and very specific. Think about your brain as a shelving unit; your brain is storage. And by going through EMDR your brain is going to this emotion/trauma/incident that you're usually not able to place correctly in the storage of your mind. The experience was so traumatic or made such an impression your brain doesn't exactly know where to place it in this storage unit. EMDR takes that memory or that feeling or experience and repackages it in a way that the brain can put it on the proper shelf. It takes this thing, opens it up and then says okay that's where it goes and then it places it on the shelf and from that point on it will not be as triggering as it used to be. I myself have done EMDR and it's pretty amazing. so if you're interested in finding out more about EMDR we at Pacific Marriage and Family Therapy Network have a couple of therapists that practice EMDR in Santa Monica and we're very happy to talk to you about it and we're very happy to schedule appointments for you when convenient.


Below we have a little more clinical explanation.

EMDR (Eye Movement Desensitization and Reprocessing) is a psychotherapy that enables people to heal from the symptoms and emotional distress that are the result of disturbing life experiences.  Repeated studies show that by using EMDR therapy people can experience the benefits of psychotherapy that once took years to make a difference. It is widely assumed that severe emotional pain requires a long time to heal.  EMDR therapy shows that the mind can in fact heal from psychological trauma much as the body recovers from physical trauma.  When you cut your hand, your body works to close the wound.  If a foreign object or repeated injury irritates the wound, it festers and causes pain.  Once the block is removed, healing resumes.  EMDR therapy demonstrates that a similar sequence of events occurs with mental processes.  The brain’s information processing system naturally moves toward mental health.  If the system is blocked or imbalanced by the impact of a disturbing event, the emotional wound festers and can cause intense suffering.  Once the block is removed, healing resumes.  Using the detailed protocols and procedures learned in EMDR therapy training sessions, clinicians help clients activate their natural healing processes.

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. 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.  Millions of people have been treated successfully over the past 25 years.

EMDR therapy is an eight-phase treatment.  Eye movements (or other bilateral stimulation) are used during one part of the session.  After the clinician has determined which memory to target first, he asks the client to hold different aspects of that event or thought in mind and to use his 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. In successful EMDR therapy, the meaning of painful events is transformed on an emotional 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.”  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.

EMDR therapy combines different elements to maximize treatment effects.  A full description of the theory, sequence of treatment, and research on protocols and active mechanisms can be found in F. Shapiro (2001) Eye movement desensitization and reprocessing:  Basic principles, protocols and procedures (2nd edition) New York: Guilford Press.

EMDR therapy involves attention to three time periods:  the past, present, and future.  Focus is given to past disturbing memories and related events.  Also, it is given to current situations that cause distress, and to developing the skills and attitudes needed for positive future actions.  With EMDR therapy, these items are addressed using an eight-phase treatment approach.


Phase 1:  The first phase is a history-taking session(s).  The therapist assesses the client’s readiness and develops a treatment plan.  Client and therapist identify possible targets for EMDR processing.  These include distressing memories and current situations that cause emotional distress.  Other targets may include related incidents in the past.  Emphasis is placed on the development of specific skills and behaviors that will be needed by the client in future situations.

Initial EMDR processing may be directed to childhood events rather than to adult onset stressors or the identified critical incident if the client had a problematic childhood.  Clients generally gain insight on their situations, the emotional distress resolves and they start to change their behaviors.  The length of treatment depends upon the number of traumas and the age of PTSD onset.  Generally, those with single event adult onset trauma can be successfully treated in under 5 hours.  Multiple trauma victims may require a longer treatment time.


Phase 2:  During the second phase of treatment, the therapist ensures that the client has several different ways of handling emotional distress.  The therapist may teach the client a variety of imagery and stress reduction techniques the client can use during and between sessions. A goal of EMDR therapy is to produce rapid and effective change while the client maintains equilibrium during and between sessions.

Phases 3-6:  In phases three to six, a target is identified and processed using EMDR therapy procedures.  These involve the client identifying three things:
1.  The vivid visual image related to the memory
2.  A negative belief about self
3.  Related emotions and body sensations.

In addition, the client identifies a positive belief.  The therapist helps the client rate the positive belief as well as the intensity of the negative emotions.  After this, the client is instructed to focus on the image, negative thought, and body sensations while simultaneously engaging in EMDR processing using sets of bilateral stimulation.  These sets may include eye movements, taps, or tones.  The type and length of these sets is different for each client.  At this point, the EMDR client is instructed to just notice whatever spontaneously happens.

After each set of stimulation, the clinician instructs the client to let his/her mind go blank and to notice whatever thought, feeling, image, memory, or sensation comes to mind.  Depending upon the client’s report, the clinician will choose the next focus of attention.  These repeated sets with directed focused attention occur numerous times throughout the session.  If the client becomes distressed or has difficulty in progressing, the therapist follows established procedures to help the client get back on track.

When the client reports no distress related to the targeted memory, (s)he is asked to think of the preferred positive belief that was identified at the beginning of the session.  At this time, the client may adjust the positive belief if necessary, and then focus on it during the next set of distressing events.

Phase 7:  In phase seven, closure, the therapist asks the client to keep a log during the week.  The log should document any related material that may arise.  It serves to remind the client of the self-calming activities that were mastered in phase two.


Phase 8:  The next session begins with phase eight.  Phase eight consists of examining the progress made thus far.  The EMDR treatment processes all related historical events, current incidents that elicit distress, and future events that will require different responses

Republished from EMDR Institute,

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