EMDR, or Eye Movement Desensitization Therapy, is a relatively new and non-traditional clinical practice in which a therapist helps a patient process trauma and mitigate adverse emotional responses to specific painful memories. During EMDR, a therapist will move an object or their fingers in a rapid and repetitive motion to guide the eyes of a patient.
EMDR advocates contend that patients who simultaneously experience these kinds of eye movements while they remember past traumas will have an easier time reprocessing painful experiences. Other principles from well-established behavioral therapies may be employed throughout EMDR therapy.
Some therapists exclude the eye movement component of this therapy altogether. Instead, they may use a repetitive sound or some other method in place of the eye movement.
Principles from Other Established Models in EMDR
EMDR was first intended to help treat patients with acute stress disorder, post-traumatic stress disorder (PTSD), and adjustment disorders. Still, proponents of this therapy claim that it can also be used to treat depression, anxiety, maladjustment, panic attacks, eating disorders, and addiction.
The Elements of EMDR Therapy
Any comprehensive EMDR treatment plan generally includes the following, scientifically-proven elements:
Behavioral therapists typically task patients with completing assignments during treatment as well as at home. Homework has long been seen as a fundamental tool in helping patients develop new skills that are needed to address the psychological issues they face.
Fostering a Strong Therapeutic Relationship
For therapists who regularly practice EMDR, the primary contributor to successful treatment with this therapy is the collaborative relationship between the patient and the therapist.
Patients undergoing EMDR are guided by the therapist to reflect on the especially stressful aspects of their traumatic experiences. This guided reflection is a technique borrowed from a therapeutic modality called exposure therapy.
The central idea in exposure therapy is that anxiety, fear, depression, and other negative emotions result from certain psychological stimuli. When a patient is guided through a re-experiencing process, the negative feelings associated with these stimuli gradually goes away.
Through repeated exposure to specific mental images, an individual should benefit from a reduction in anxiety. Ideally, there comes the point in which reflecting on the experience fails to elicit significant distress in the person. During exposure, participants can also learn breathing and relaxation exercises that will aid in the process.
Cognitive restructuring is a technique adopted from cognitive-behavioral therapy (CBT)—one of the most common and effective therapeutic approaches used by mental health professionals today. Cognitive restructuring consists of re-conceptualizing an individual’s thoughts, emotions, and beliefs in a healthier, more functional, and pragmatic way.
CBT is based on the philosophical notion that dysfunctional behaviors, including substance abuse, are founded in and driven by a dysfunctional belief system. CBT seeks to identify these irrational thoughts and feelings by using a therapeutic process and in doping. Hence, it helps the person reframe them in a manner that is closer to reality.
The Process of EMDR
The delivery of EMDR will vary somewhat between treatment providers, but the standard practice is performed using eight primary steps or phases. These phases include the following:
Phase I: History and Background of the Individual and Preparation for a Treatment Plan
Most relevant information is collected in the first one or two sessions. Still, therapists will often gather information about the person’s background and history throughout the therapeutic process. During this phase, the therapist and client will collaborate to identify specific targets to be addressed in therapy and other areas of a recovery program. These typically include childhood traumatic events, grief, and other problematic emotional disturbances.
Phase II: Treatment Preparation
A treatment alliance is developed during this phase, and the therapist describes the process of EMDR to the client. The therapist will then guide the client through specific techniques to help them cope better with the effects of trauma and adverse emotions. These practices typically include breathing, relaxation, and alternate methods of dealing with distress.
Phase III: Assessment
This phase can be prolonged and includes significant interaction between the client and the therapist. Several targets are identified, and their emotional impact on the patient is examined.
The therapist and client will continue to collaborate to develop healthier, more useful approaches to these emotional responses. Next, the client and therapist will work together to identify ways of measuring current feelings of stress and alternative approaches to handling them.
Phase IV: Desensitization
During desensitization, the actual practice of EMDR is combined with the experience of both the traumatic event(s) and the corresponding emotional reactions. Also, positive emotions are implanted alongside the remembrance of past experience(s) that resulted in distress.
Phase V: Installation
During this time, additional reprocessing is conducted to insert positive feelings regarding the person’s perception of past trauma and his or her ability to cope with everyday events.
Phase VI: Body Scan
Here, the therapist and client aim to reveal any remaining tension being associated with the targets and reprocess it during the course of treatment. Analyses of thousands of EMDR sessions have shown that there is an actual physical reaction related to unresolved thoughts and feelings.
This contention is further supported by research that suggests when an individual is traumatized, the event (surprisingly) is stored in body memory, and not so much in the narrative memory. Therefore, the body retains the unwanted emotions and physical sensations of the initial traumatic event(s). When that information is processed healthily, it can, however, be transferred to narrative memory. As such, bodily sensations and adverse thoughts and feelings linked to the memory lessen and perhaps even disappear.
Phase VII: Closure
During closure, the patient’s responses are reevaluated to ensure they have responded to treatment and feel better as a result. This process ends every treatment session.
Closure ensures that the person leaves the session feeling better than he or she did when they arrived. If the processing of the targeted trauma was not accomplished in a single session, the therapist will teach the client how to use self-calming strategies to regain a sense of balance.
Phase VIII: Reevaluation
In the final phase, the client and therapist work together to reevaluate the entire process. This is done to ensure that the goals of treatment have been reached and that the techniques the person is using for coping are effective.
If any issues still need to be addressed, the therapist returns to the relevant stage and helps the individual work through them again. If the goals of the therapy have been achieved, the EMDR treatment is complete.
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