Introduction to EMDR Therapy

Eye Movement Desensitisation and Reprocessing (EMDR) is a scientifically supported, integrative psychotherapy approach based on the Adaptive Information Processing (AIP) model. Developed in the 1980s by Francine Shapiro, EMDR therapy is shown to be effective and is endorsed by the World Health Organization (WHO). It was initially designed as a treatment procedure for posttraumatic stress disorder (PTSD) but is presently used for the treatment of many disorders, including anxiety disorders and depression. EMDR is compatible with every main orientation in psychotherapy. EMDR online clinic would like to present a brief introduction to the topic which was written in Melbourne. 

            Unprocessed memories caused by traumatic and painful events are the main focus of EMDR therapy. According to Shapiro, traumatic memories generate pathological modifications within the neural element (the brain). These modifications prevent the brain from fully processing information and experiences, allowing unprocessed memories to generate negative emotions, sensations and cognitions felt when the event was first experienced. Unprocessed traumatic memories usually determine an escape or avoidance behavior which ceases the recalling of those negative emotions. The manner in which the brain stores and responds to traumatic and painful experiences is better understood through the AIP model.  

            As opposed to other forms of therapy, the focus of EMDR is not a talk-based therapy. EMDR involves working with a distressing memory with the aim of adaptive processing of traumatic event/s. This ultimately results in the elimination or alleviation of the symptoms associated with the distressing memory.

            While focusing on particular aspects of the unpleasant memory, the client is provided bilateral (left-right) stimulation. This involves eye movement in most cases, but it can also involve alternating physical taps, sounds, or hand-held pulsars. Bilateral stimulation possible generates a REM like state in which both sides of the brain are activated. This reduces the vividness of the trauma and facilitates the establishment of reprocessing.  

            EMDR therapy is a systematic approach that includes eight steps which address the treatment of multiple disorders:

            Step 1: Client History

            The negative and positive life experiences of the client need to be acknowledged by the therapist within the AIP model. This allows the therapist to understand whether the client is ready for memory reprocessing or not. Some clients manage to develop healthy emotional and cognitive connections, as well as adaptive behaviors and positive self-concepts simply by reprocessing the memory. However, those who have had on-going, complex trauma, may need to develop or enhance certain resources during EMDR therapy. Positive resources can be created during the sessions, consequently being stored in memory and intensified through specific procedures.

            Step 2: Preparation

            During preparation, the therapeutic relationship is a central focus. The therapist explains the EMDR model and treatment plan, provides clarifications and addresses concerns, and establishes the mechanics of the treatment administration. This is the phase in which the client learns about the procedures and is taught how to use stop signals in case they need to take a break during the session. It is also important for the client to understand their own symptoms and how the reprocessing of traumatic memories works.

            Step 3: Assessment

            Together, the client and the therapist identify the target memory which causes emotional distress. The sensory components of the traumatic or painful experience are then established; the most relevant image, the body sensation, the negative and positive beliefs associated with the experience, and the dominant emotions. The therapist uses the Subjective Units of Disturbance (SUD) scale and the Validity of Cognition (VOC) scale in order to assess how true the client considers a particular belief to be and how disturbing a certain emotion is.

            Step 4: Desensitisation

            The desensitisation phase begins with a rational evaluation of the disturbing event. The target memory and the associations start being reprocessed. While the client focuses on the traumatic or painful memory, they also engage in multiple sets of bilateral stimulation. After each set of bilateral stimulation, the client is asked to communicate the insights that emerge. The client’s response dictates factors such as the type of bilateral stimulation used and the length of each set. The purpose is to lower the level of distress that occurs when the client focuses on their memory.

            Step 5: Installation

            The therapist works on strengthening the preferred positive cognition, in order to replace the original negative cognition. How deeply the client believes the positive one will be measured on the VOC scale, with the goal being a rating of 7.

            Step 6: Body scan

            The client is asked to focus again on the disturbing memory, but this time to also pay attention to their physical response and positive cognition. If the therapist learns about any residual somatic tension, they can target it for reprocessing. Standardised procedures for bilateral stimulation are used.

            Step 7: Closure

            This step is particularly important, as it is essential for the client to return to a state of calmness and equilibrium at the end of the EMDR session. There are several self-calming techniques which can be used, and some of them involve guided imagery.

            Step 8: Re-evaluation

            During re-evaluation, the therapist checks the level of distress with the last processed memory and makes sure that their positive treatment results have maintained. At the same time, the therapist checks for additional targets to reprocess.

            EMDR therapy is a relatively new approach, but the research and clinical trials conducted to date show its strong efficacy. As it does not require extended exposure to the traumatic or painful memory, it is sometimes preferred by individuals with severe trauma. Sexual abuse, childhood trauma, and substance abuse are some of the problems which can be processed through EMDR therapy.

             Clients who choose this form of psychotherapy may encounter positive changes after an EMDR session. Being more sensitive to external stimuli, having vivid dreams, sleeping differently, and feeling lightheaded are all possible side effects. However, such post-processing symptoms normally disappear as they continue treatment. Although mental health professionals who are trained in EMDR therapy typically follow standard procedures and protocols to obtain positive results, their approach is tailored to the needs of each individual client.

EMDR online clinic was started in Melbourne, Australia.