A time-efficient, comprehensive methodology for the treatment of the disturbing experiences that underlie many pathologies, EMDR is an integrated model that incorporates aspects of psychodynamic, experiential, behavioral, cognitive, body-based, and systems therapies.  It comprises an eight-phase treatment that includes the use of eye movements or other left-right stimulation.  EMDR helps trauma survivors reprocess disturbing thoughts and memories, providing profound and stable treatment effects in a short period of time.  Although neurobiological investigators still have not provided a definitive explanation, a number of physiological studies are being carried out and theoretical suggestion have been put forth that link the effects of EMDR to REM sleep, dual attention, and/or bihemispheric involvement. 

Eye Movement Desensitization and Reprocessing, Second Edition by Francine Shapiro (front flap, book jacket)

Is EMDR only useful for trauma? What else can it do?

EMDR drastically mitigates the symptoms of a major trauma, such as a threat to life or well being. But it can help with less traumatic events as well, such as phobias, and even generalized states like anxiety and complicated grief reactions. Some therapists use it as a performance enhancing tool, to target limiting beliefs.

Here is a list of some other conditions that therapists are treating with EMDR:

• Panic attacks
  
• Dissociative disorders
  
• Pain disorders
  
• Stress reduction
  
• Addictions
  
• Sexual and/or Physical abuse
  
• Body dysmorphic disorders
  
• Personality Disorders

Does EMDR Really Work?

The American Psychiatric Association and the International Society for Traumatic Stress studies have designated EMDR as an effective post traumatic stress disorder treatment. There have been approximately 20 studies conducted in which EMDR was found to rapidly and efficiently decrease or even eliminate post traumatic stress disorder symptoms and to significantly decrease anxiety. Studies have been carried out in agencies such as:

• US Department of Veterans Affairs and Department of Defense
• The United Kingdom Department of Health
• The Israeli National Council for Mental Health
• and many others.

How Does EMDR work?

There have been no definitive explanations for how EMDR works. It appears that when a traumatic event occurs, not only is the memory retained, but also the visceral experience and emotion (e.g. fear, shame, panic) as well. EMDR seems to provide a mechanism for getting at the somatic components of a trauma. EMDR introduces bilateral stimulation (BLS) into the therapy. Through BLS we may be introducing an increased capacity to pay attention—an orienting response—and thus able to integrate new, helpful associations. It may be that EMDR simulates REM sleep or other healing activities our ancestors engaged in that most of us no longer regularly do (primitive dance, long pilgrimages or treks, etc.)

Here is how I sometimes explain how EMDR may be working: The brain has two halves, left and right. The left brain is more associated with cognition, linear thought, and rationality. The right brain is more associated with feelings, has no sense of past and future, and has no capacity for analysis. So for example, if you have a phobia of needles, one part of your brain (the left) may logically understand that the phobia you have isn’t warranted, while the other part of your brain (the right) is on high alert. The two aspects of the brain aren’t communicating with one another. Thoughts don’t feel and feelings don’t think. EMDR is a process that provides an opportunity for the brain hemispheres to “learn” what the other side of the brain “knows.” EMDR helps people to process the distressing tension between what is thought and what is felt. They no longer feel as distressed by triggers or compelled to avoid certain stimuli in such reactive ways.

What actually happens in the course of treatment?
EMDR is an 8-phase treatment.

Phase 1: I learn about you, your history, assess whether EMDR might be useful to you, identify targets for future work, and talk with you about the pivotal events (both high and low) in your life.

Phase 2: I prepare you and help you stabilize prior to treatment, and point out ways you already have of self soothing, or bring in new ways to do so.

Phase 3: I ask you to identify the particular disturbance, the image you have of it, the negative belief about yourself that is associated with it, the emotions, the physical sensations and the belief you would rather be able to access.

Phase 4: We then move into standardized EMDR procedures to allow the spontaneous insights, thoughts and body sensations to emerge from you. You will access your own adaptive thoughts and associations.

Phase 5: The installation phase allows for an increase in positive associations, and new ways of thinking about the scenario. In phases 4 and 5, I will add “bilateral stimulation,” or BLS which can be accomplished with a light bar, theta-tappers and/or ear-phones. In each device, there is a repetitive left/right/left component that you will see, feel and/or hear. This BLS seems to help people access thoughts, memories, associations that are enormously helpful, illuminating or healing. After a brief interval of BLS I then ask people to associate to the original image and we continue to work with limiting beliefs or cognitive distortions until they dissipate.

Phase 6: Residual physical sensations are identified through a body scan as a way to complete the processing more fully.

Phase 7: Session Closure, usually with a guided imagery or some form of psychological containment.

Phase 8: We then evaluation whether future treatment is necessary or if symptoms have been eliminated.

Research tells us that the best way to treat trauma is to include both cognition and somatic experience. Somatic therapy involves not only talking about feelings, but examining how you know you’re experiencing feelings. For example, fear may be experienced as ice water in the belly; joy as an expansion in the chest, and so on. I find that EMDR allows me to do meaningful work with a patient in a much shorter span of time than traditional “talk therapy.” After successful EMDR treatment, you will remember the events that traumatized you, but perhaps not as vividly. Successful reprocessing allows you to stop reliving the images, sounds and feelings associated with the trauma, and from that less distressed state, you will be able to respond to triggers with more resilience and presence.