What is EMDR?
EMDR stands for Eye Movement Desensitization and Reprocessing. EMDR was developed by Francine Shapiro, Ph.D. who wrote, "I noticed that when disturbing thoughts came into my mind, my eyes spontaneously started moving very rapidly back and forth in an upward diagonal. Again the thoughts disappeared, and when I brought them back to mind, their negative charge was greatly reduced. At that point I started making the eye movements deliberately while concentrating on a variety of disturbing thoughts and memories, and I found that these thoughts also disappeared and lost their charge" (Shapiro, 1995, p. 3).
EMDR appears to work well in alleviating many psychological symptoms. For example, EMDR is recommended as treatment for the symptoms of trauma (flashbacks, intrusive memories, nightmares), phobias (including the fear of medical procedures), agoraphobia, unremitting grief reactions, and anxiety reactions. Research is currently underway to test EMDR's efficacy in the treatment to eating disorders and addictions.
What does the procedure of EMDR entail?
The client must spend some time with the clinician in order for a complete assessment of the nature of the current symptoms (be they flashbacks, nightmares, or intrusive thoughts or images) and for the clinician to ascertain the client's current level of overall functioning, including both resources and current coping skill needs. It may take a number of sessions to gather information and establish a safe baseline to work together from before EMDR is initiated.
Often it is helpful to learn some additional skills for coping with intense emotions and/or providing good self-care prior to starting EMDR. We may need to first work on developing tools to help make the client more able to function at home, school, or work.
Before EMDR is begun, the client and clinician develop a hierarchy of problem symptoms or memories to target with EMDR. The client is asked a number of questions to elucidate a specific issue and other pertinent things, such as the thoughts, beliefs, feelings, sensations, and meanings of a particular incident.
EMDR is carried out using eye movements, bilateral tones, or tactile stimulus (or all three) while the client initially focuses attention on unwanted symptoms and the negative self statements that help maintain the symptoms. Processing continues, with periodic breaks to verbally check in with the client, until there is a sense of relief about the original issue or incident that is being processed.
What is the theory behind how EMDR works?
The human brain acts as a type of information processing system. That is, information perceived in the world through our senses (eyes, ears, etc.) is coded and stored in the brain for future retrieval, appraisal, and problem-solving. When the information that is taken in is traumatic in nature, the central nervous system is overly stimulated and this results in brain changes that can have a negative impact on learning and the future ability to discriminate threatening from non-threatening events. Some traumatic events are easily recalled by the client (flashbacks, memories); some are not. Just because you do not have a specific memory, does not mean you do not have symptoms of post-traumatic stress, such as sleep and eating disturbances, panic, or anxiety symptoms. A common explanation given to clients about the process is the following:
"Often, when something traumatic happens, it seems to get locked in the nervous system with the original picture, sounds, thoughts, feelings, and so on. Since the experience is locked there, it continues to be triggered whenever a reminder comes up. It can be the basis for a lot of discomfort and sometimes a lot of negative emotions, such as fear and helplessness, that we can't seem to control. These are really the emotions connected with the old experience that are being triggered.
The eye movements we use in EMDR seem to unlock the nervous system and allow your brain to process the experience. That may be what is happening in REM, or dream, sleep: The eye movements may be involved in processing the unconscious material. The important thing to remember is that it is your own brain that will be doing the healing and that you are the one in control." (Shapiro, 1995, p. 120)
It is thought to be the bilateral (both sides) stimulation of the brain in EMDR that allows your brain to process the upsetting events or symptoms in a new way. Theoretically, this allows the thinking brain (cortex) to assist the emotional brain (limbic system) to shut down the stress response that has gotten "stuck" in the brain. Once unstuck, you can release the memories and symptoms are alleviated or reduced.
Your therapist will assist you in the processing. You may feel free to stop at any time. You are also encouraged to ask any questions you have.
EMDR at Tropos
Dr. Hammon-Paulson is a level II trained practitioner of EMDR and has attended additional advanced trainings in the use of EMDR in the treatment of trauma, anxiety, addictions, and peak performance issues.
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