Eye Movement Desensitization and Reprocessing, commonly known as EMDR, has been accepted by the American Psychiatric Association, the American Psychological Association and the Veteran’s Administration as an effective and recommended treatment for trauma. It is one of the most well researched therapies available for helping individuals who have experienced traumatic events. EMDR is used in a variety of therapeutic settings worldwide for the treatment of trauma.
EMDR as Therapy
A well respected form of psychotherapy, EMDR is an information processing technique used to diminish distress caused by exposure to traumatic events. EMDR focuses on retrieving, processing and resolving past experiences that continue to negatively affect an individual’s life. Symptoms such as overwhelming emotion, intrusive thoughts, flashbacks, anxiety and the physiological symptoms of fear are reduced or eliminated by this treatment. EMDR accesses past trauma, the triggers that cause distress in the present and the thoughts and emotions that accompany and cause distress to continue. It helps an individual understand and gain control over the ways in which past traumatic experiences impact everyday functioning. Most who are treated with EMDR experience significant and lasting relief from trauma symptoms.
Clinicians and EMDR Practice
EMDR is a structured protocol of interventions used by an EMDR specialist who has received intensive training in the use of the technique. Clinicians that practice EMDR typically have a background in other psychological and therapeutic techniques as well. Their education, licensing and certifications include a wide range of approaches and they come from all disciplines that prepare therapists for a mental health practice. These can include psychiatry, psychology, expressive therapies and other related fields that specialize in the treatment of children, adolescents and adults who have experienced trauma. Whatever the overall educational background of a clinician that uses EMDR, each licensed practitioner has completed specialized training in the use of this therapy and continues to receive ongoing education to keep abreast of new developments in the use of this technique.
Course of Treatment
Due to its effectiveness in the treatment of trauma, many clinicians who treat individuals with PTSD and other trauma-related conditions practice this technique. Those trauma specialists who do not are commonly familiar with EMDR and are supportive of its use. Referrals may be done in order to supplement ongoing therapy or, in some instances, may become the primary treatment used to address trauma reactions.
EMDR treatment occurs in a series of sessions that progress through distinct phases facilitated by the therapist. This process begins with an interview done by the EMDR practitioner in order to prepare for the sessions that follow. The therapist will gather information about the symptoms of distress experienced currently, the history of related difficulties, one’s current support system, coping skills and any other problems that may be affecting the quality of life. Next, the therapist and client will identify goals for treatment and collaborate to create an individualized treatment plan tailored to meet an individual’s specific needs. The goals of EMDR that are established in the treatment plan target physiological and psychological reactions to trauma that are currently causing distress. Experiential techniques are then used over a series of sessions in which the underlying causes of distress are elicited and resolved.
Trauma symptoms are manifestations of distress. They may be physical, psychological, emotional, mental and behavioral. Underlying trauma-based beliefs about self, others, situations and events cause symptoms to continue even when traumatic events have passed. EMDR targets these underlying negative beliefs and helps replace them with more appropriate and positive ones. In the case of past trauma, for example, the once accurate belief that one is in danger could be replaced with the appropriate and positive belief that one is safe. EMDR sessions help clients identify beliefs that support their distress and practice replacing them so that distress is diminished.
EMDR practitioners use experiential techniques to engage their clients in dual attention. Clients focus on a negative mental image, belief, feeling or bodily sensation associated with trauma while also attending to some sort of additional stimulus. The additional stimulus is provided by the therapist or the participant is taught to create one. Its purpose is to establish a more neutral experience so that the trauma can be experienced with less distress and successfully reprocessed.
A type of bodily sensation is used to create the second attention. This may involve visual tracking of the therapist’s finger movements, listening to an auditory tone, tapping or another type of sensory cue used to attract and hold attention. As this attention to two simultaneous experiences occurs, the therapist guides the participant through experiencing and reprocessing distressful memories, thoughts, feelings and beliefs. This type of experiential process takes place over a series of sessions and results in decreased trauma symptoms or their elimination.
Closure and Review
The final phases of EMDR therapy typically involve journaling and a review of the entire course of treatment. Participants will have increased their awareness of triggers, stress responses and beliefs that have contributed to their distress. Additionally, they will have learned ways to self-soothe and calm themselves when experiencing trauma symptoms. In closure, clients are usually asked to journal about any remaining discomfort or related issues and to be aware of the management techniques they have learned to use successfully in sessions. Finally, a review of therapy is done so that progress is noted in detail and coping strategies for any future need are reinforced.