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Pondering of a therapist’s mind: Demystifying EMDR

It seems to me that there is a lot of mystery about EMDR in the community. Not only that but there seems to be a bit of ‘contempt prior to investigation, a phrase I read in a self-help book. Why the confusion? Well, it seems that many people have heard of it, or maybe even heard stories that made them leery, although I haven’t heard any really scary stories about it myself.

So what is EMDR?

EMDR is a psychotherapeutic treatment approach developed by Francine Shapiro, when she was studying to become a psychologist. One day, she was running through a park, and wasn’t feeling well, but she happened to notice that moving her eyes left to right seemed to reduce disturbing thoughts and feelings she was having at the time. She decided to experiment to see if this was a valid observation, first with herself, then with peers at the university, and eventually completed the research for her dissertation on the subject. 70 volunteers signed up, allowing her to fully develop the  protocols that formed the foundation for EMDR as we know it today. EMDR is currently recommended by the American Psychological Association, and by the US Department of Défense, as a suitable treatment for PTSD, and since 1989, when Francine completed and published her doctoral research on EMDR, this psychotherapy has in fact been developed further to address all sorts of mental health issues.

So what does EMDR involve?

First, EMDR involves 8 phases which include the following:

  1. History taking, assessment and treatment planning
  2. Preparation – the client has an opportunity to learn about EMDR as a treatment, what the procedures are, what to expect during and after sessions, and also learns techniques such as grounding, and relaxation, in order to ensure they have healthy ways to manage disturbing emotions or stress.
  3. Identifying target events or issues which will be addressed in treatment, which includes determining any negative cognitions, desired positive cognitions, emotions and their intensity regarding the target, and associated body sensations.
  4. Desensitization of the disturbing memory or issue using bi-lateral stimulation such as eye movements(visual), buzzers in the hands or tapping (kinesthetic), bi-lateral sounds heard with earphones(auditory), or light board. The purpose in his phase is to reduce the intensity of the disturbance.
  5. Installation involves guiding the client, also with bilateral stimulation to replace negative cognitions and feelings, sensations with positive ones.
  6. Body scan is used to ensure any remnants of discomfort are removed, even when they think of the negative event or issue.
  7. Closure involves grounding or relaxation techniques, and discussion on what to be aware of after the session, as well as ways to monitor effects of treatment.
  8. Reevaluation involves reviewing the issues the client wanted to address, to ensure everything has been covered.

In the case of single incident trauma, this process can often move along fairly quickly. In cases of multiple or complex trauma, the process needs to ensure client comfort, and it is the case that some issues require more attention, as client progress may be affected by how long it takes that client to trust the process, and to develop the ability and confidence to proceed, as well as the tools necessary to take care of themselves if anything comes up in between sessions. A good therapist will work collaboratively with the client, at the pace that works best for that individual. It’s helpful to actually keep a journal, so any insights, reflections, concerns can be shared with the therapist, during treatment. It also helps the client to be able to notice the progress being made. An excellent book for anyone wanting to learn about EMDR is called “Getting past your past” by Francine Shapiro. I highly recommend the book to anyone interested in EMDR, particularly because of all the wonderful people who kindly agreed to let their stories be told.

Sources: Big Book of Alcoholics Anonymous, Wikipedia (on Francine Shapiro), www.emdria.org

I look forward to hearing from you.
harris-sig
Dr Barbara Harris, PhD, MSW, RSW

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Dr. Barbara now offers Skype sessions for EMDR Intensives, Consultations and Trauma Counselling.

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