EYE MOVEMENT DESENSITISATION AND REPROCESSING (EMDR)
WHAT IS EMDR?
EMDR was discovered in 1987 by American psychologist, Francine Shapiro, when she noticed that eye movements influence the way we react to emotions, memories and behaviours. This process can identify the root of the underlying psychopathology. This treatment involves the therapist administering bilateral stimulation – while “watching” a certain image or concentrating on a specific thought, the patient looks at the therapist’s finger, or listens to a bilaterally administered sound or tapping. The patient’s brain subconsciously does all the work. The end result can mean different things for different people, but usually the patient is no longer troubled by traumatic memories. EMDR can alleviate the symptoms of PTSD (Post Traumatic Stress Disorder) or other unresolved trauma experiences.
It has the following goals;
- Process disturbing memories (trauma is released and worked through)
- Reduces lingering effects of traumatic experiences (trauma does not affect the patient emotionally anymore)
- Develop adaptive coping mechanisms (new skills are developed and the patient can cope in the future without feeling distressed)
IS IT EVIDENCED BASED?
Yes. There is a lot of research (over 30 randomized controlled trials) that supports the use of EMDR. It is recommended by the World Health Organization, the American Psychiatric Association and the United States Department of Veterans Affairs. EMDR is also one of the techniques Bessel van der Kolk describes in his well-known book about traumatic stress, The Body Keeps the Score.
IS IT SAFE?
Yes, it is very safe in the hands of a qualified therapist. In the first weeks the patient might feel more “upset” and have more nightmares, but this will subside.
FOR WHICH PROBLEMS CAN IT BE USED?
EMDR is typically used for trauma – whether it be in the past or recent, severe or mild (small-t trauma). However, its applications are broad, including depression, addiction, low self-esteem, procrastination and chronic pain.
WHAT HAPPENS DURING THE PROCESS?
There are eight phases in EMDR therapy:
- History taking
The therapist takes down a comprehensive history. This includes identifying how the past has influenced current symptoms, and identifying the inadequately processed memories and negative beliefs and memories to be targeted during EMDR. - Preparation
The therapist obtains informed consent from the patient. They explain the process to the patient (e.g. what they must do) and the patient learns calming techniques (safe place). - Assessment
The therapist identifies the target memory, including negative and positive cognitions, and does the baseline assessments. - Desensitisation
Next, the therapist applies bilateral stimulation until certain outcomes are reached. - Installation
The positive cognition gained is installed until certain outcomes are reached. - Body scan
The body scan technique is used to check whether processing is complete. - Closure
Once the memory work is done, the focus shifts to the “here and now”, and the patient is stabilised. - Re-evaluation
After each session the patient’s progress is checked. If there are remaining problems they are identified.
The first three phases focus on diagnosis. The treatment begins in phases 4 and 5. During this time, the therapist follows a regime of bilateral gestures and the patient follows with his/her eyes.
HOW LONG IS THE DURATION OF TREATMENT?
Often only as few as three sessions are necessary. Some patients may take much longer, depending on individual factors, such as how many problems they want to work on.
HOW EFFECTIVE IS EMDR?
Typically, the equivalent of three 90-minute sessions produces 85-100% remission of PTSD with single trauma (see studies by Wilson, Becker, & Tinker;1995 & 1997). Visit Emdria at https://www.emdria.org for more information.
Dr Melane Van Zyl