Ariana K. Goswick

Psychotherapist, LMHC

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What is EMDR?


Eye Movement Desensitization and Reprocessing (EMDR) therapy is an interactive, evidenced-based psychotherapy technique, originally developed in 1989 by Francine Shapiro, to treat distress associated with traumatic experiences. Since then, the scope of use has broadened beyond severe trauma, to include a wide variety of overwhelming life experiences. While there are many therapeutic approaches that compare to the effectiveness of EMDR, research has shown that EMDR therapy can exhibit improvement in symptoms in less sessions than other treatment modalities.

Who can benefit from EMDR?
EMDR has been extensively researched and proven effective for the treatment of PTSD. However, experiencing severe trauma (i.e, active combat in war or childhood physical abuse) is not a prerequisite to benefit from EMDR. Painful or overwhelming experiences, such as being teased in elementary school, experiencing the death of a pet, or severe anxiety with public speaking, can also be addressed through this treatment modality.

How does EMDR work?
Using an 8-Phase protocol, EMDR integrates elements of many effective psychotherapies including psychodynamic, Mindfulness-Based Cognitive Behavioral (MBCBT), interpersonal, experiential, and body-centered. It is the bilateral stimulation (BLS) core component of EMDR, however, that distinguishes it from any other method.

BLS is visual, tactile or auditory stimuli occurring in a rhythmic pattern from the left hemisphere of the brain to the right. For example, visual BLS could involve watching a hand (as demonstrated here) or a moving light alternating from left to right and back again. Tactile BLS could involve experiencing alternating taps on each hand. Auditory BLS could involve hearing alternating tones.

BLS was discovered accidentally by Francine Shapiro, Phd, as she was walking in a park in the late 1980’s. While walking, Shapiro noticed that some distressing feelings about a particular situation suddenly subsided. When she reflected back on what happened, she remembered that she had experienced some spontaneous saccadic eye movements (rapid blinking). This led her to experiment further and discover that when a person deliberately focuses on a distressing memory, and then concentrates on bilateral stimulation, their distress is reduced both in the short and long-term.


What does bilateral stimulation (BLS) do? 
While there is still a lot to learn about BLS, it can be said that it produces four main effects:

  1. Relaxation including decreased physiological disturbance.
  2. Thoughts become less focused on what had been causing the distress.
  3. The problem seems further away and less intense.
  4. Decreased worry

These effects are first experienced in the lower areas of the brain as a physiological response (i.e, decreased heart rate, tension), progressing ‘up’ the brain leading to changes in thoughts (e.g, shift from previously held self-blame to “It’s not my fault”).
What BLS & EMDR is not:
EMDR and the use of BLS is not a form of hypnosis. EMDR requires a client to be awake and fully present in the room.  When processing distressing memories using BLS, clients recall challenging memories as if they are watching a movie or looking out of the window of a moving train.  EMDR therapy does not erase the memory or event.  Rather, it desensitizes the emotional impact the memory has on our emotional well-being, and reprocesses it so when we recall the memory, it can be viewed as merely an event that occurred in our lives without the accompaniment of emotional and physiological disturbance.
Is BLS safe?
For most people, BLS is relaxing and perfectly safe. However, because it involves direct sensory stimulation of the nervous system, bilateral stimulation can trigger unexpected responses in people with conditions which involve hypersensitivity to sensory stimuli, e.g, people with acquired brain injury (where the condition involves sensitivity to complex visual or auditory stimuli), migraine sufferers (usually when they have the migraine), people with Dissociative Identity Disorder (where different ego states may be activated by sensory changes). People with these kinds of conditions should only engage in BLS with the guidance of a trained EMDR therapist.
More information:
For more information on the history, use, and evaluation of EMDR, please visit the Frequently Asked Questions Section of the EMDR Institute™ website:
www.emdr.com/frequent-questions



References:
1. Shapiro, F., (1995). Eye Movement Desensitization and Reprocessing: Basic Principles, Protocols and Procedures (1st edition). New York: Guilford Press.

2. Shapiro, F., (2001). Eye Movement Desensitization and Reprocessing: Basic Principles, Protocols and Procedures (2nd edition). New York: Guilford Press.

3. Shapiro, F., (2002). Paradigms, Processing, and Personality Development. In F. Shapiro [Ed.]. EMDR as an Integrative Psychotherapy Approach; Experts of Diverse Orientations Explore the Paradigm Prism. Washington, D.C.: American Psychological Association Books.

4. Shapiro, F. & Maxfield, L. (2002). EMDR: Information processing in the treatment of trauma. In Session: Journal of Clinical Psychology, 58, 933-946. Special Issue: Treatment of PTSD.

5. Stickgold, R. (2002). EMDR: A putative neurobiological mechanism of action. Journal of Clinical Psychology, 58, 61-7
6. van der Kolk, B.A. (2002). Beyond the talking cure: Somatic experience and subcortical imprints in the treatment of trauma. In F. Shapiro (Ed.), EMDR as an integrative treatment approach: Experts of diverse orientations explore the paradigm prism, Washington, D.C.: American Psychological Association Books.
7. Siegel, D. (2002). The Developing Mind and the Resolution of Trauma: Some Ideas About Information Processing and an Interpersonal Neurobiology of Psychotherapy. In F. Shapiro (Ed.), EMDR as an integrative treatment approach: Experts of diverse orientations explore the paradigm prism, Washington, D.C.: American Psychological Association Books.

8. MacCulloch, M.J., & Feldman, P. (1996). Eye movement desensitization treatment utilizes the positive visceral element of the investigatory reflex to inhibit the memories of post-traumatic stress disorder: A theoretical analysis. British Journal of Psychiatry, 169, 571-579.
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