WHAT IS EMDR?

Sara Gilman, M.F.T., F.A.A.E.T.S.
Marriage & Family Therapist

Category: EMDR
Lifeforce Services, Inc.

EMDR is an acronym for Eye Movement Desensitization and Reprocessing, a method of psychotherapy that has been extensively researched (See EMDR Resources) and proven effective for the treatment of trauma, specifically for Posttraumatic Stress Disorder (PTSD). PTSD is a psychological disorder that sometimes develops after a person experiences an event so disturbing to them, that the brain, body and mind are unable to process what has happened in a way that allows the person to integrate the experience and heal from it. The person is often left with symptoms such as depression, nightmares, intrusive thoughts, and flashbacks (which brings back all the fear and detail of the original experience).

One of the most difficult aspects of PTSD is that present day experiences which have nothing to do with the originally traumatizing event, have the power to 'activate' the networks in the brain that 'froze' the disturbing aftereffects. Thus, the person ends up being 'triggered' by such ordinary daily events as smells, sounds and sights reminiscent off the original event, leaving them in a state of discomfort similar to that experienced during the trauma. This makes everyday life a minefield of potential triggers, never knowing when one will be set off. An example would be the smell of the cologne worn by a child's abuser, once the child was grown. Can you imagine the potential horror of this? This is typical of the type of 'somatic clearing' that can be expected with EMDR. Once treated successfully, the smell would no longer have the power to 'trigger' the same visceral response.

In the past, PTSD has been considered a chronic stress disorder that's difficult to treat and that to some extent, people simply learn to live with. With the appearance of EMDR, many sufferers of PTSD found relief when nothing else brought it. The first series of research studies was actually done with combat veterans diagnosed with PTSD, traditionally one of the most difficult populations to treat. The only diagnosis at least as common with this population is substance abuse. They are found similarly joined in the civilian and criminal justice world as well. Hence the current focus on the treatment of this co-occurring disorder with EMDR. The belief is that many people use substances to medicate the psychological pain often left as a result of old, untreated trauma. Therefore, "treat the underlying trauma, diminish the person's urge to use substances to numb it". In addition, the use of substances increases the chances of being in seriously traumatizing life circumstances, thus perpetuating the cycle.

Since it's development in 1989 (by Francine Shapiro, PhD), it has continued to be extensively researched and is now used to treat many other forms of emotional distress such as anxiety, panic, substance abuse, phobias and the aftereffects of childhood abuse (sexual, emotional and physical). EMDR uses rhythmic, bilateral (side to side) eye movements, sounds or tactile stimulation along with a very specific 8-phase treatment protocol, designed to target the disturbing material and help to process it until it is no longer physically or emotionally disturbing to the person. ONLY psychotherapists and M.D.s specifically trained in EMDR should provide this treatment.

HOW DOES IT WORK?

At the present time, no one is certain how EMDR works. There is still much to be learned from neuroscience about how the human brain works, but in the last 10 years more has been researched and written about trauma and PTSD than in the last 50 years! Brain researchers such as Daniel Siegel, Bessel Van der Kolk and Allan Schore (among others), have been keenly focused on trying to understand what happens in the brain, body and emotional system during and after a traumatic experience.

It is thought that when a person becomes extremely upset, the brain is unable to process information in the way it usually does, thereby leaving the experience "frozen in time" and stuck in the nervous system. This is what is believed to cause the kinds of symptoms seen in PTSD. EMDR appears to activate the brain's natural processing abilities with great efficiency, thereby helping to process the disturbing material through the nervous system, allowing the person to heal more completely. Following is a more detailed description of how the phases of the EMDR protocol are set up for treatment.

When EMDR is used to treat an identified trauma (e.g. sexual abuse), the "target" is the entire bio-psychological package including: 1) The worst part of the image of the event; 2) The negative cognition one now holds about oneself, e.g. "It's my fault", 3) The emotions evoked by the event, e.g.: terror, guilt, shame, etc; and 4) The disturbing somatic sensations experienced when focusing on this targeted event (stomach churning, chest tightening, etc.) By activating the event in this manner, the brain stem (visceral) and neural memory networks seem to be able to communicate more freely, thereby allowing previously "frozen" material to move toward a more adaptive state. The ability of our brain/body/mind to accomplish this type of resolution is referred to as "Adaptive Information Processing " or AIP (Shapiro, 2001). AIP presumes that the brain and nervous system, just like the body, has an innate capacity to heal itself after being traumatized, and that EMDR appears to be an effective intervention for activating that natural healing process. (Shapiro; 1995,2001)