EMDR
What is EMDR?
The EMDR International Association, or EMDRIA, describes EMDR as an empirically-supported, therapist-guided psychotherapy for Posttraumatic Stress Disorder, also known as PTSD, alongside a wide array of disorders, symptoms, and mental health-related issues.
The EMDR model posits that our disorders or pathological conditions stem from our failure to connect traumatic or adverse experiences to healthier, more adaptive memory networks-failing to make this connection leads to a dysfunction in our adaptive information processing system. Our adaptive information processing, or AIP, is proposed to be an innate mechanism within us that aims to process
new information adaptively in relation to our environment. Take this scenario as an example: I am assaulted by a dog during my morning run, resulting in a severe cut on my arm, a surge of adrenaline and other chemicals in my body, and a terror-driven emotional response. Most people would categorize such an event as traumatic or negative. If I can interpret this event as an infrequent, isolated incident and subsequently link it to my numerous positive and affectionate encounters with dogs, it’s likely to be accommodated within that network as an adaptive memory. This isn’t to imply that it won’t stir up negative emotions or elicit an emotional reaction when recalled, but it would form part of a broader or adaptive viewpoint regarding dogs. We process the information in a manner that doesn’t lead to traumatization.
On the other hand, if a memory fails to establish connections with a more adaptive memory network, it may end up being stored in a segregated memory network. This is a common occurrence for individuals who are dealing with the effects of Posttraumatic Stress Disorder. Within this segregated network, the experiences that are stored are not properly processed. This network contains a mix of emotions, thoughts, physical sensations, and temporal structures that are all associated with the distorted and new information that is being stored. As a result, the memory is at risk of being recalled dysfunctionally, leading to confusion about the time, place, and context of the memory. Additionally, when traumatic memories are stored in this way, they often resurface in a fragmented manner rather than as a coherent, sequential narrative. Because the memory is kept separate from the rest of the individual’s experiences, there is a lack of connection between new positive experiences and the distressing memory.
How long does EMDR therapy last?
EMDR is a structured model that encompasses eight stages and a three-pronged approach. The eight stages encompass Phase 1: History Taking, Phase 2: Preparation, Phase 3: Assessment, Phase 4: Desensitization, Phase 5: Installation, Phase 6: Body Scan, Phase 7: Closure, Phase 8: Reevaluation. The three-pronged approach relates to the concept of time, specifically past, present, and future. This model aims to maximize stabilization throughout the therapy process.
The length of each stage of treatment in EMDR therapy may vary from person to person, with some stages potentially being skipped altogether depending on the specific problem being addressed, the level of stabilization the individual has, and the symptoms they are displaying. For example, in the case of a dog attack, a person with a strong support network, effective coping strategies, and a history of resilience might find that their symptoms can be effectively treated in just a few sessions of EMDR therapy. However, for someone who has experienced multiple traumatic events that have not been fully processed, these unresolved traumas could be activated during the EMDR therapy process. The extent to which the individual has compartmentalized their traumatic memories, experienced dissociation, and suffered from resulting psychological fragmentation will greatly influence the length of the treatment and determine whether additional therapeutic interventions may be necessary for a successful recovery.
In the scenario of a dog attack, the efficacy of EMDR therapy in addressing and alleviating symptoms can also be impacted by the individual’s level of psychological resilience, the quality of their support system, and the presence of any unresolved traumatic experiences that may surface during the course of treatment. An individual who possesses a strong sense of self and effective coping mechanisms may find that their symptoms improve rapidly with the use of EMDR. However, for someone who has experienced multiple traumas that have not been fully processed or integrated, the treatment process may be more complex and prolonged. The severity of any dissociative tendencies, tendencies to compartmentalize traumatic memories, and resulting fragmentation of one’s psychological state will play a significant role in determining the duration and success of EMDR treatment, as well as whether additional therapeutic modalities will be required to facilitate a comprehensive recovery process.
It is within the realm of possibility that during a therapy session, I could potentially reach a point where I am able to fully process the traumatic experience of a dog attack. Once this milestone is achieved, the therapist may choose to shift focus towards addressing other current triggers that may be affecting me. Additionally, the therapist could assist me in creating a personalized plan or template for how to effectively handle encounters with dogs in the future. It is important to note that the three-pronged approach of addressing past traumas, dealing with present triggers, and preparing for future situations may be adapted and tailored depending on the specific circumstances and needs of the individual.
What Happens During a standard reprocessing EMDR Session?
Phase 3: Assessment and Phase 4: Desensitization encompasses the establishment of the target and utilizing dual attention bilateral stimuli for reprocessing the content. During the evaluation phase, the memory and its most disturbing image are identified along with the linked negative belief. Also in this phase, the positive belief that the individual would rather adhere to is determined. The individual is requested to recognize emotions and bodily sensations, as well as to rank the level of disturbance on a scale. Afterward, processing commences using dual attention combined with visual, tactile, or auditory bilateral stimuli.
Let’s revisit the incident of the dog attack. The most traumatic image might be the moment the dog began to charge at me. The negative belief could be that I am about to die, accompanied by a feeling of my heart pounding and pain in my arm. I would prefer to believe that I am safe. Once the memory is triggered, bilateral movements start, and I am requested to simply observe whatever may surface. The role of the therapist is to support the inherent adaptive information processing system within the individual, rather than acting as the expert of the experience. Ideally, after several sets, the memory starts to become less disturbing.
Upon completion, the positive belief is installed using dual attention bilateral stimuli. During the processing, I might have found a new positive belief or used the initial one identified. Once determined, I will be asked to sustain the original memory along with the new positive belief while partaking in dual attention bilateral stimuli. This procedure connects the segregated memory network of the dog attack with the positive, adaptive memory networks that already exist within me, leading to the memory being assimilated into a broader perspective.
What happens after the session?
After a therapy session, there are a variety of potential reactions that individuals may experience. One common response is feelings of fatigue or exhaustion, which may be due to the emotional energy expended during the session. Some individuals may also find that they form new connections between different aspects of their thoughts and emotions, leading to more vivid and intense dreams. Despite these possible challenges, the majority of individuals report feeling a sense of relief and hopefulness after therapy, as they have been able to address and process difficult emotions or experiences. However, if symptoms such as anxiety or distress intensify after a session, it is important to reach out to the counselor for support and guidance, although this situation is not common and should not be a cause for alarm.
Is EMDR Right for Me?
If you are considering EMDR therapy, it is essential to first seek out a licensed therapist who has experience and expertise in this particular type of treatment. By consulting with a qualified professional, you can discuss your individual circumstances, concerns, and goals in order to determine if EMDR is the most appropriate approach for you. The therapist will conduct an assessment of your specific needs and mental health history to determine if EMDR therapy aligns with your treatment goals and objectives. Ultimately, working with a therapist who is knowledgeable in EMDR will ensure that you receive the most effective and personalized care tailored to your unique needs and circumstances.
Conclusion
Eye Movement Desensitization and Reprocessing, EMDR, is a psychotherapy technique that has gained recognition for its effectiveness in addressing a wide range of mental health issues, with a particular focus on trauma-related symptoms. The core principle of EMDR is to activate the brain’s innate healing mechanisms, facilitating the reprocessing and restructuring of distressing memories that contribute to psychological distress. While EMDR may not yield positive results for every individual, it has shown promise as a valuable therapeutic approach for individuals struggling with trauma-related symptoms. If you are considering embarking on EMDR therapy, it is crucial to ensure that you collaborate with a trained and licensed therapist who possesses the necessary expertise to guide you through the process and maximize the therapeutic benefits.
Contact us today to see if EMDR might help you release what no longer serves you.
Tina Motley, LCSW and Misty Tafao, LSATP, are approved consultants for therapists who have completed Basic Training in EMDR. They provides both individual and group consultation for EMDR certification.