Eye Movement Desensitization and Reprocessing (EMDR)
What is EMDR?
EMDR stands for Eye Movement Desensitization and Reprocessing. It was developed by Francine Shapiro, Ph.D. and has been used for treatment of negative thoughts and feelings. The goal of EMDR treatment is to reduce and eliminate negative thoughts and feelings, to increase and strengthen positive thoughts and feelings, and to enable you to really be at your best in your everyday life.
Is EMDR used only for treating Post-Traumatic Stress Disorder?
According to the December, 2005 Harvard Mental Health Letter (“Post-traumatic Stress Without Trauma”): Experiences not usually regarded as traumatic can cause the characteristic symptoms of post traumatic stress disorder.
Surprisingly, life events (such as relationship problems, work problems, financial problems, school problems, health problems, significant losses or life changes) are as likely as traumatic events to cause symptoms typical of post-traumatic stress disorder. In fact, people whose worst event are not traumatic have more post-traumatic stress symptoms for a longer time than those whose worst event are traumatic.
The authors suggest that life events may increase overall psychological stress and distress, bringing on symptoms related to an earlier trauma. Traumatic events may reduce the ability to cope with other kinds of stress. Both traumatic experiences and overall distress may increase the risk of developing post-traumatic symptoms after either a traumatic experience or a non-traumatic life event.
What are the key elements of EMDR?
There are two key elements of EMDR treatment. The first is something called “bilateral stimulation”--which means “two-sided stimulation.” You probably know that your brain has a right hemisphere and a left hemisphere and that each side of your body is “hard-wired” to a specific side of your brain. Creating a rhythmic, back and forth stimulation of each hemisphere of the brain seems to stimulate something we call the “information processing system” to go into a highly accelerated mode of functioning--which is exactly the treatment effect we have to create to get the results we’re after. There are several different methods that have been developed for creating the “bilateral stimulation” effect. The original technique is the one for which this model is named, eye movement. Another is a “tactile” method--that is, using your sense of touch. This is generally accomplished using two finger knee taps (you get a real strong sensory impulse from the outside corner of the kneecap). We often use the tactile method with younger children because they have some difficulty holding their head still and just moving their eyes. There are other methods of bilateral stimulation, but these are the ones generally used.
The second key element of EMDR treatment is sort of the “art and science” of how we have to prompt and guide your thoughts while we’re doing the bilateral stimulation. This is explained in more detail during the session, but in a nutshell how we do this will be determined by a number of factors individual to your unique situation.
Is EMDR something like hypnosis?
EMDR is very different than hypnosis in three important ways:
In EMDR you don’t go into any kind of “altered state”--you’re totally aware of what’s going on, you’re totally in control of the process, and it’s nothing that somebody is doing to you--it’s your brain that’s doing the work; the EMDR is simply a catalyst for speeding up the benefits you get from psychotherapy.
EMDR does not have the capacity to create false memories.
EMDR is not at all dependent on the placebo effect--in other words, somebody can be totally convinced that it’s not going to work and it still works just as well, because it’s purely a biophysical process.
Could our EMDR work accidentally change something I don’t really want to change?
No. The really interesting thing about your brain is that it came “pre-programmed” to automatically do what you want it to do--it just has to be stimulated correctly! EMDR seems to help your brain get rid of what you don’t want and need, and actually strengthen what you do want and need. It will not take away anything useful for you, and it will not change anything you don’t want to change. Parents bringing their teenagers to therapy may ask us to use EMDR to change this or that, and sadly we have to break the news to them that unless their son or daughter wants to change, it doesn’t really work like that.
Are there any possible negative side effects of EMDR treatment?
Only two that anybody’s been able to identify:
1) EMDR has a tendency to make bad memories seem very distant or unclear, so if we’re dealing with something you’re going to have to testify about in court, we’re going to want to talk to your attorney about the possible implications of your treatment. (You may end up being a lousy witness!).
2) EMDR has the ability to bring back a memory strongly enough so that you may momentarily have the same intensity of emotion that you had at the time the event was occurring. Because of the way we use EMDR very strategically, this happens very rarely with clients--the vast majority of them find our work to be very gentle, calming, and relaxing. If it were to occur, we would always take the time to help you get to a better place with it before you leave the office--our goal is to always leave people walking out feeling better than when they walked in! The possibility, though, does bring up three important issues:
- It’s extremely important that during our history-taking that you tell us about any significant traumas you’ve experienced.
- If you are in recovery for any form of addiction and “strong feelings” are one of your triggers, we would encourage you to be very aggressive about “working your program” and make sure you have a good relapse prevention plan in place.
- If you have any fears or concerns about getting “overwhelmed” by feelings, please let us know about this and before we even start our EMDR work we'll give you some “emotional management” tools so you don’t have to be afraid of feeling your feelings anymore.
So how quickly can I expect to reach my treatment goals?
That depends on a number of variables unique to your own personal situation, but here are some generalities:
One of the variables is the amount of trauma. Obviously, a single incident trauma would tend to clear more quickly than someone who has multiple traumas. The official EMDR website indicates that a single trauma can be processed within three sessions for 80-90% of clients.
We will spend the first and second session in preparation for EMDR. Sometimes this may take a third session before we actually start the EMDR. During this phase, we’ll do a careful history, identify targets that we will address in EMDR, and answer any questions about the process.
After our first actual EMDR session, we’ll know better about how long it will take, because we should have a pretty clear indication of how rapidly your body and nervous system are responding. Most people start noticing positive benefits right from the very first EMDR session.
We will also talk about lifestyle guidelines--getting on a consistent sleep schedule, using the abdominal breathing, getting a little exercise everyday, drinking lots of water, controlling carbohydrate intake, avoiding use of chemical depressants (like alcohol and marijuana), and restricting use of chemical stimulants (like caffeine & nicotine). These lifestyle changes are beneficial whether you are in an EMDR treatment program or not.