EMDR (Eye Movement Desensitization and Reprocessing)
EMDR (Eye Movement Desensitization and Reprocessing), a therapeutic approach discovered in 1987 by Francine Shapiro, has grown from controversial upstart to a scientifically validated form of psychotherapy used by millions worldwide. I first heard about it in 1989 from one of my teachers, then a professor of neuropsychiatry at the University of Toronto, who urged my class of psychotherapists-in-training to pay attention. We were skeptical: the purported brevity of treatment, eight-phase protocol, and following lights back and forth with your eyes were far from the less directive norms of psychodynamic psychotherapy, not to mention the painstaking work with transference and counter-transference.
But even then, studies of EMDR were showing promising results, particularly for the relatively new diagnosis of post-traumatic stress disorder (added in 1980 to the Diagnostic and Statistical Manual of Mental Disorders). With the official recognition of PSTD came a new awareness: the cause of a mental “disorder” could be something outside the individual (i.e., a traumatic event) rather than an inherent individual weakness (i.e., a traumatic neurosis). It’s not you, it’s the way your brain stores overwhelming events.
Today, EMDR is used to treat many conditions, from panic disorders, addictions, and PTSD to fear of public speaking and overcoming creative blocks. It has been endorsed by the US Department of Veterans Affairs and Department of Defence and the International Society for Stress Studies and is used by health professionals trained in a variety of approaches, from psychodynamic and body-oriented to cognitive behavioural. Many of its elements include aspects of these familiar approaches to working with psychological distress.
EMDR focuses on memories stored in a maladaptive form that are causing some kind of disturbance in the present. The assumption is that we have an adaptive information processing system designed to overcome traumatic events.
What happens in an EMDR session?
Once it has been determined that EMDR is appropriate and you are ready for treatment, the memory of the distressing event must be accessed. You are directed to focus on the most disturbing aspect, rate it on a scale of 0 – 10 (with “0” being not at all distressing and “10” being the most distressing imaginable), and identify the irrational negative belief or added meaning you gave the event. Common negative beliefs are, “I’m helpless,” “I don’t deserve love,” “It’s not safe unless I’m in charge,” “I have to be perfect,” and “I’m permanently damaged.”
You will then be asked what you would rather believe about yourself, how true that feels in relation to the disturbing event, what emotions you feel, and where you notice them in your body.
Next comes the bilateral stimulation, either in the form of eye movements (following the therapists fingers or a light bar); sound (music recorded to sound in one ear and then the other), or tapping (on the back of your hands, your knees, or even your feet). The bilateral stimulation keeps you in touch with the present while you think about the past, and is thought to help the brain process events in a way similar to rapid-eye-movement sleep. It is also possible that the bilateral stimulation activates the brain’s orienting response.
Between sets of bilateral stimulation, the EMDR practitioner will check in with you. What do you notice now? It is important to answer as honestly as you can. Sometimes nothing seems to happen and then a new thought or image arises. It may or may not be accompanied by emotion. My clients have described the experience as “a Rolodex of memories,” as if different files are opening and closing in their brain. They often experience surprising insights and a sense of peace.
A typical EMDR session lasts from 60 to 90 minutes. The type of problem, life circumstances, and the amount of previous trauma will determine how many treatment sessions are necessary.
The goal of treatment is to get the disturbance level down to a “0”, where you can think about the memory, but it no longer brings up strong emotions or body sensations, and you can think about it in a new, more adaptive way. I have choices. I deserve to be loved. I can let someone else be in charge and it’s okay. I can make mistakes. I am (can be) healthy.
Thank goodness for curiosity! After ten years of using this evidence-based therapy to relieve clients’ psychological distress, my initial skepticism has been replaced with gratitude.
For more information, go to http://www.emdria.org
Getting Past Your Past, Take Control of Your Life with Self-Help Techniques fro EMDR Therapy, by Francine Shapiro (Rodale, 2012).
Tapping In, A Step-by-Step Guide to Activating Your Healing Resources with Bilateral Stimulation, by Laurie Parnell (Sounds True, Inc., 2008)