EMDR for Trauma:
accidents, suicide or death of loved ones, war, rape, muggings, etc.
trauma: abuse such as neglect, emotional and physical abuse, etc.
What is EMDR?
EMDR: Eye Movement Desensitization & Reprocessing
In 1987, while walking in a park, Dr. Francine Shapiro
made a chance observation. She noticed that the intensity of her disturbing thoughts and feelings reduced after her eyes had
been moving rapidly back and forth. Being a student of psychology and a naturally curious person she decided to research this
for her doctoral thesis. She found a way to use rapid eye movements in a special psychotherapy protocol, and discovered it
was very successful in relieving chronic distress in victims of trauma. By 1989, Shapiro had developed a totally new kind
of psychotherapy: EMDR therapy.
What is EMDR?
is a psychotherapy used to treat troubling symptoms, such as anxiety, guilt, anger, depression, panic, sleep disturbance,
and flashbacks, that are the result of traumatic experiences. Traditional therapies have met with limited success in treating
victims of trauma. Not only has EMDR therapy been proven effective in reducing the chronic symptoms which follow trauma, the
therapy benefits appear to be permanent. To date, it has helped an estimated two million people of all ages receive relief
from many different kinds of psychological distress.
What does EMDR stand for?
Eye Movement. Much has been learned about this therapy since the
day it was named for eye movements. Now it appears that the beneficial effects are facilitated by an alternating stimulation
of the right and left hemispheres of the brain. Eye movements accomplish this, as do bilateral alternating taps or tones.
to the removal of the emotional disturbance associated with a traumatic memory.
Reprocessing refers to the replacement of the unhealthy, negative
beliefs associated with traumatic memories, with more healthy, positive beliefs.
When is EMDR
There are two types of trauma, big "T" trauma
and little "t" trauma. Big "T" traumas are the major horrific events, like combat, rape, or the Ioss of
a child. Little "t" traumas are the smaller everyday chronic horrors, like daily negative childhood messages leading
a girl to grow up believing she will never be good enough. EMDR can help heal both types of trauma. EMDR therapy can be a
very intense emotional experience, temporarily. It is not appropriate for those who are unwilling or unable to tolerate highly
disturbing emotions. An EMDR therapist must take a thorough history to determine if and how EMDR can be used as part of an
overall treatment plan. EMDR has been successfully used to treat many problems. Some of them include:
Complicated grief Phantom Limb Pain
Anxiety Sexual abuse Peak performance
Depression Panic attacks
Phobias Dissociative disorders Addictions
What is EMDR? Eye Movement Desensitization and Reprocessing (EMDR) is a non-drug, non-hypnosis
psychotherapy procedure. The therapist guides the client in concentrating on a troubling memory or emotion while moving the
eyes rapidly back and forth (by following the therapist's fingers). This rapid eye movement, which occurs naturally during
dreaming, seems to speed the client's movement through the healing process.
What is it
used for? EMDR is used to treat
troubling symptoms such as anxiety, depression, guilt, anger, and post-traumatic reactions. It can also be used to enhance
emotional resources such as confidence and self-esteem.
What happens in a session? EMDR is different for everyone, because the healing
process is guided from within. Sometimes past issues or memories come up, which are related to the current concern. Sometimes
a painful memory brings up unpleasant emotions or body sensations. This is normal and generally passes within a few minutes,
as long as the EMDR is not stopped. The upsetting emotion or memory often seems to fade into the past and lose its power.
Why bring up a painful memory? When painful memories are avoided, they keep their disturbing power. However,
a flashback or nightmare can feel as upsetting and overwhelming as the original experience, yet not be helpful. In therapy,
and with EMDR, you can face the memory in a safe setting, so that you do not feel overwhelmed. Then you can get through it
and move on.
Will I be in control? It is hard to predict the thoughts, feelings, or memories that might come up during EM DR.
It depends upon each individual's natural healing process. You are always in charge of whether to continue or stop. You can
also decide how much to tell the therapist about the experience.
Are there any precautions? Yes. There are specific procedures to be followed depending
on your presenting problem, emotional stability, medical condition, and other factors. It is very important that the therapist
be formally trained in EMDR. Otherwise, there is a risk that EMDR would be incomplete, ineffective, or even harmful.
What happens afterwards?
You may continue to process the material for days or even weeks after the session, perhaps having new insights, vivid dreams,
strong feelings, or memory recall. This may feel confusing, but it is just a continuation of the healing process, and should
simply be reported to the therapist at the next session. (However, if you become concerned or depressed, you should call your
therapist immediately.) As the distressing symptoms fade, you can work with the therapist on developing new skills and ways
of coping. .
How long does EMDR therapy take? This depends on several factors including the nature of the problem being
treated, the client's history, and the client's ability to tolerate high levels of disturbance. In some cases, one EMDR treatment
session is enough. Usually it takes weeks to months, but sometimes years of treatment are required. When EMDR therapy is used
appropriately, it can significantly shorten the overall length of time in therapy.
What is an EMDR session like?
First, client and therapist work together to collect basic information
about the traumatic experience. The most disturbing part of the incident is identified and becomes the processing target.
Example: Image of the rapist's face. The negative belief connected to the trauma is identified. Example:  never get over
this. And a preferred, positive belief is named. Example: It's over, I can move on with my life now. Next, client is asked
to rate (on a 1-7 scale) how true the positive belief feels when paired with the target. Usually it does not feel very true
at this point. Client is asked to name the emotions the target elicits, to rate the associated distress level (on a 0-10 scale),
and to locate the disturbance in the body. Example: Fear and shame, with disturbance level to, in belly and chest. Then, client
is asked to hold in awareness the target, the negative belief, and the disturbing body sensations. At the same time, the therapist
guides the client's eyes to move rapidly back and forth. This is done in sets, which may last from a "few seconds to
a few minutes. During each set the client is instructed to just notice whatever changes occur in mind and body, without controlling
the experience in any way. Very often, in the first few sets there is an increase in the disturbance level. After awhile,
with each new set, the target becomes less and less disturbing and the positive belief feels more and more true. The target
is completely processed when recall of the image no longer brings up disturbing emotions, and the preferred positive belief
feels totally true. Example: Client recalls that the rapist's face was threatening then but does not feel threatened by the
How does EMDR work?
Research to answer this question
is now in progress at The Human Resource Institute's Trauma Center in Brookline, MA. Researchers there are using SPECT brain-scan
imaging to map the changes that occur after EMDR treatments. It is known that the brain has a natural mechanism for processing
disturbing events, however, when a traumatic experience is overwhelming the brain may not be able to process it in the usual
way. That is why severely traumatized people often find themselves stuck in disturbing memories long after the traumatic event.
Research suggests that an important part of the natural trauma processing happens during REM (rapid eye movement) sleep, which
provides alternating stimulation of the right and left hemispheres of the brain. This may help explain why EMDR therapy seems
to jump-start the brain's natural healing ability, allowing the traumatic memory to become less and less disturbing.
Has EMDR been researched?
EMDR is now the most researched treatment for post-traumatic stress disorder
Google: Francine Shapiro Library
Research Demonstrating EMDR
International Research Findings
EMDR is endorsed as a therapy for traumas, internationally,
by government and professional organizations.
· American Psychiatric Association. (2004). Practice guideline
for the treatment of patients with acute stress disorder and posttraumatic stress disorder. Arlington, VA: Author. (Practice
· Bleich, A., Kotler, M., Kutz, I., & Shalev, A. (2002). Guidelines for the assessment
and professional intervention with terror victims in the hospital and in the community. Jerusalem, Israel: National Council
for Mental Health.
· Chambless, D.L., et al. (1998). Update of empirically validated therapies, II. The
Clinical Psychologist, 51, 3-16. (Australia)
· Foa, E.B., Keane, T.M., & Friedman, M.J. (2009). Effective
treatments for PTSD: Practice Guidelines of the International Society for Traumatic Stress Studies. New York: Guilford Press.
· Institut national de la santé et de la recherche médicale (INSERM). (2004). Psychotherapy:
An evaluation of three approaches. Paris, France: French National Institute of Health and Medical Research.
Northern Ireland Department of Health. (2003). The management of post traumatic stress disorder in adults. Belfast, Ireland:
Department of Health, Social Services and Public Safety Clinical Resource Efficiency Support Team (CREST).
Quality Institute Heath Care CBO/Trimbos Intitute. (2003). Multidisciplinary guideline anxiety disorders. Utrecht, Netherlands:
Author. (Dutch National Steering Committee on Mental Health Care)
· Sjöblom, P.O., Andréewitch, S.
Bejerot, S., Mörtberg, E., Brinck, U., Ruck, C., & Körlin, D. (2003). Regional treatment recommendation for
anxiety disorders. Stockholm, Sweden: Stockholm City Council, Medical Program Committee.
· United Kingdom
Department of Health. (2001). Treatment choice in psychological therapies and counselling evidence based clinical practice
guideline. London, England: Department of Health.
· United States Department of Veterans Affairs
& Department of Defense. (2004). VA/DoD clinical practice guideline for the management of post-traumatic stress. Washington,
DC: Department of Veterans Affairs & Department of Defense.
· World Health Organization guidelines for Treatment
of Traumatic Stress (2013)