EMDR in my Practice
EMDR (Eye Movement, Desensitization and Reprocessing) is a powerful form of psychotherapy. It is used to reduce and sometimes completely resolve the negative effects that past events have on present experience. EMDR is used primarily to treat people who have suffered “big-T traumas,” major events like rape or a car accident, or a series of related events, often in childhood, like sexual or physical abuse. Often these clients have PTSD (Post Traumatic Stress Disorder). EMDR is also used for those who have suffered “small-T traumas,” events like bullying and parental neglect, which, while not so obviously traumatic, often leave ongoing distress and negatively affect people’s reactions to others.
I often use EMDR to treat clients who have come to me for help with big-T traumas And I occasionally use EMDR to support my work with clients who are dealing with other issues, such as addiction, anger, depression, or anxiety. These clients are often affected by big-T or small-T traumas. I also use EMDR to treat phobias and complicated grief.
Development of EMDR
EMDR was created by Francine Shapiro approximately 30 years ago. While thinking about a disturbing subject, Shapiro, a psychologist, noticed that moving her eyes back and forth significantly reduced her distress. With colleagues she conducted clinical studies, formulated a treatment protocol involving eye movements (and other forms of bilateral stimulation), built an EMDR Institute, and 30 years later EMDR is one of just two treatment modalities recently recommended by the Word Health Organization for PTSD (Post Traumatic Stress Disorder). http://www.who.int/mediacentre/news/releases/2013/trauma_mental_health_20130806/en/ .
How is it done and What Happens in the Session?
In a standard EMDR session, a client brings up a traumatic memory while the therapist has them follow something (a light or hand) moving back and forth. Focusing on the memory combined with the eye movement activates a vivid remembering and deep processing of the traumatic event. What was disturbing– the locked emotions, thoughts and body sensations linked to the event—gradually becomes discharged, enabling the client to think of the event in a new way. The memory of the event now integrates with the more adaptive networks in the brain so the client can interpret the event more rationally and self-lovingly. Not only did I not deserve that beating from my step-father when I was eight but I was courageous in the quiet ways I tried to resist him.
Why does it Work?
It is not known for certain why EMDR works the way it does in unlocking locked reactions in the brain, but it is likely that its therapeutic effect mirrors the effect we experience from R.E.M. sleep. This deep rejuvenating sleep is named for the rapid eye movements that occur during it. It has been scientifically demonstrated that the eye movements in EMDR and REM sleep both facilitate better integration of an event into the brain’s existing bank of knowledge and experience, “increasing episodic association, decreasing physiological arousal, and increasing the recognition of truthful information”. http://consults.blogs.nytimes.com/2012/03/02/the-evidence-on-e-m-d-r/ (page 3). If we understand an event more contextually we’re better able to respond and adapt to it rather than simply react to it.
EMDR is ideally suited to treat people suffering from big- T traumas because a big-T trauma is precisely the kind of event, overwhelming and memorable, that the brain does not fully process. An event like a car accident or a rape disrupts normal brain processes, preventing the brain from integrating the event into its store of information. Instead the memory of the event, including the body’s disturbed reaction to it at the time, becomes locked in the brain, ready to be re-triggered by anything that “reminds” it of the event. The eye movements work to discharge this locked memory. The result: the remembered event, no longer triggering disturbance (or now triggering less disturbance), is integrated into the brain’s store of information. I know I can drive safely through this intersection now because I know there’s no good reason to think I’ll get hit again.
EMDR on small-T Traumas
As mentioned above, EMDR can also be helpful in working through what is sometimes called small- T traumas: these include sibling or parental mistreatment, grief, bullying, humiliation and alienation. While these events generally don’t have the same highly charged after-effects that big-T traumas do, they can, if left unprocessed, generate ongoing disturbance, particularly if these events were recurring in childhood.
A client, for instance, who regularly reacts angrily to his mother, can, through processing his early negative experiences with her, reduce his reactivity not only to her but also to those who similarly provoke him.
Feeling State Addiction Protocol
While EMDR is usually used to discharge negatively-experienced states (trauma-states), it can also be helpful in breaking up the recurring positive feeling states central to most addictions (the immediate pleasure or relief a person gets from, say, alcohol or porn). Dr. Robert Miller has developed an EMDR addiction treatment that, in processing the locked positive state integral to an addiction, helps to reduce the pleasure—and linked urges—of that addiction. I occasionally use this treatment to aid my work with addiction clients.
Organizations that Recommend EMDR for PTSD
The World Health Organization recently recommended EMDR as a treatment for PTSD (Post-Traumatic Stress Disorder). The following organizations have also recommended EMDR as a trauma treatment: American Psychiatric Association, International Society for Traumatic Stress Studies, National Institute for Clinical Excellence (U.K.), (U.S.) Department of Veterans Affairs and Department of Defense, Australian Centre for Posttraumatic Mental Health, and Dutch National Steering Committee Guidelines Mental Health Care.
I am a member of EMDR Canada.