{"id":4813,"date":"2021-02-18T09:37:20","date_gmt":"2021-02-17T23:37:20","guid":{"rendered":"https:\/\/www.counsellingconnection.com\/?p=4813"},"modified":"2021-03-01T13:36:28","modified_gmt":"2021-03-01T03:36:28","slug":"emdr-background-structure-and-applications","status":"publish","type":"post","link":"https:\/\/www.counsellingconnection.com\/index.php\/2021\/02\/18\/emdr-background-structure-and-applications\/","title":{"rendered":"Eye Movement Desensitisation and Reprocessing (EMDR): Background, Structure and Applications"},"content":{"rendered":"\n

In this article, we explore what Eye Movement Desensitisation and Reprocessing (EMDR) is, how it works, which conditions are being treated with it, and what\u2019s involved in each of its eight phases. A companion piece<\/a> offers a snapshot of research conducted so far, outlines the main effects the therapy induces, and notes the requirements for EMDR certification, should you decide that it would be a useful tool in your therapist\u2019s arsenal of techniques.\u00a0<\/p>\n\n\n\n

What is EMDR?<\/strong><\/h2>\n\n\n\n

The creator and developer of EMDR, Francine Shapiro, defines it as \u201can empirically validated treatment for trauma, including such negative life experiences as commonly present in medical practice\u201d (Shapiro, 2014). It is a fairly new, non-traditional type of psychotherapy which is growing in popularity and, as Shapiro noted, already has some randomised, controlled trials under its belt to bolster its claims to therapeutic effectiveness. If you\u2019ve heard anything about it, though \u2013 or even registered its name of \u2018eye movement reprocessing\u2019 \u2013 you are probably wondering how, or why, it works, especially given that it doesn\u2019t rely on talk therapy or medications. It doesn\u2019t focus on changing the thoughts, emotions, or behaviours resulting from a traumatic event or distressing issue. Rather, EMDR uses a patient\u2019s own rapid, rhythmic eye movements to allow the brain to resume its natural healing process (EMDRIA, 2021).

Like some other therapies, EMDR came into existence as a result of serendipity. One day in 1987, Shapiro, a California psychologist in private practice, took a walk in the woods, absorbed in distressing thoughts. Yet, as her walk concluded, she realised that her mood had lifted after moving her eyes back and forth while observing her environment. Curious, Shapiro tried different ways of bringing about the same experience for her clients and found that they, too, felt better afterwards. EMDR was born. After an initial study was published in 1989, numerous investigations and conference presentations focused on it as a surprisingly effective means of helping clients overcome the anxiety associated with PTSD and other anxiety disorders. It quickly became a go-to therapy for military veterans struggling with combat-related trauma (Arkowitz & Lilienfeld, 2012; Tejcek, 2016). <\/p>\n\n\n\n

How does it work?<\/strong><\/h2>\n\n\n\n

We don\u2019t actually know the answer to this! Shapiro\u2019s Adaptive Information Processing model proposes that EMDR therapy facilitates the accessing and processing of traumatic memories and other adverse life experiences, bringing them to an adaptive resolution. Our brains have an inbuilt mechanism for recovering from traumatic memories and events. It involves communication between the amygdala (our alarm signal for stressful events), the hippocampus (which helps us with learning \u2013 especially memories about safety and danger), and the prefrontal cortex (which analyses behaviour and emotion, working to control it). While it\u2019s often true that traumatic experiences can be managed and resolved spontaneously, sometimes the system is overwhelmed and people need help. 

Stress responses are part of our natural instincts of fight, flight, or freeze, but when distress remains with us after a traumatic \u2013 or at least disturbing \u2013 event, the upsetting images, thoughts, and emotions can create feelings of overwhelm. In these cases, it is like being back in that moment, or of being \u201cfrozen in time\u201d. EMDR therapy helps the brain to process the memories, allowing normal healing to resume. The person still remembers the experience, but the fight\/flight\/freeze response from the original event is resolved (EMDRIA, 2021; EMDR Institute, 2020).

Upon the completion of successful treatment, emotional distress is decreased, negative beliefs are reformulated, and physiological arousal is reduced. During the therapy, the client concentrates on emotionally disturbing material in short sequential \u201cdoses\u201d while simultaneously focusing on an external stimulus. Typically, the external stimulus is lateral eye movements directed by the therapist, but other stimuli, such as hand tapping and audio stimulation, are also used. Shapiro hypothesises that EMDR therapy helps clients access the traumatic memory network, so that information processing is enhanced, with new associations forged between the traumatic memory and more adaptive memories or information. The new memories are thought to result in complete information processing, new learning, elimination of emotional distress, and development of cognitive insights. <\/p>\n\n\n\n

EMDR\u2019s three-headed protocol focuses on, in turn:<\/p>\n\n\n\n

  1. The past events that have laid the groundwork for dysfunction, processing them and forging new associative links with adaptive information;
     <\/li>
  2. The current circumstances that evoke distress, with both internal and external triggers desensitised;
     <\/li>
  3. Imaginal templates of future events, incorporated to assist the client in acquiring the skills needed for adaptive functioning (EMDR Institute, 2020).<\/li><\/ol>\n\n\n\n

    What EMDR is used for<\/strong><\/h2>\n\n\n\n

    As we noted, the therapy started out as a way to relieve the anxiety, intense emotion, and physiological arousal of trauma. Seeing how it helped traumatised clients, therapists began to extend its use, coming to employ EMDR for all of the following (although EMDR has not been empirically validated as effective with all of these):<\/p>\n\n\n\n