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EMDR: Eye Movement Desensitization & Reprocessing

What is EMDR?
EMDR is a psychotherapy used to treat troubling symptoms, such as anxiety, guilt, anger, depression, panic, sleep disturbance, and flashbacks, that are the result of traumatic experiences. Not only has EMDR therapy been proven effective in reducing the chronic symptoms which follow trauma, the therapy benefits appear to be permanent.

What does EMDR stand for?
Eye Movement. Much has been learned about this therapy since the day it was named for eye movements. Now it appears that the beneficial effects are facilitated by an alternating stimulation of the right and left hemispheres of the brain. Eye movements accomplish this, as do bilateral alternating taps or tones.
Desensitization refers to the removal of the emotional disturbance associated with a traumatic memory.
Reprocessing refers to the replacement of the unhealthy, negative beliefs associated with traumatic memories, with more healthy, positive beliefs.

When is EMDR appropriate?
There are two types of trauma, big "T" trauma and little "t" trauma. Big "T" traumas are the major horrific events, like combat, rape, or the loss of a child. Little "t" traumas are the smaller everyday chronic horrors, like daily negative childhood messages leading a girl to grow up believing she will never be good enough. EMDR can help heal both types of trauma. EMDR therapy can be a very intense emotional experience, temporarily. It is not appropriate for those who are unwilling or unable to tolerate highly disturbing emotions. An EMDR therapist must take a thorough history to determine if and how EMDR can be used as part of an overall treatment plan. EMDR has been successfully used to treat many problems. Some of them include: PTSD, Complicated grief, Phantom Limb Pain, Anxiety, Sexual abuse, Peak performance, Depression, Panic attacks, Performance anxiety, Phobias, Dissociative disorders, Addictions

EMDR: Frequently Asked Questions
What is EMDR? Eye Movement Desensitization and Reprocessing (EMDR) is a non-drug, non-hypnosis psychotherapy procedure. The therapist guides the client in concentrating on a troubling memory or emotion while moving the eyes rapidly back and forth (by following the therapist's fingers). This rapid eye movement, which occurs naturally during dreaming, seems to speed the client's movement through the healing process.

What is it used for? EMDR is used to treat troubling symptoms such as anxiety, depression, guilt, anger, and post-traumatic reactions. It can also be used to enhance emotional resources such as confidence and self-esteem.

What happens in a session? EMDR is different for everyone, because the healing process is guided from within. Sometimes past issues or memories come up, which are related to the current concern. Sometimes a painful memory brings up unpleasant emotions or body sensations. This is normal and generally passes within a few minutes, as long as the EMDR is not stopped. The upsetting emotion or memory often seems to fade into the past and lose its power.

Why bring up a painful memory? When painful memories are avoided, they keep their disturbing power. However, a flashback or nightmare can feel as upsetting and overwhelming as the original experience, yet not be helpful. In therapy, and with EMDR, you can face the memory in a safe setting, so that you do not feel overwhelmed. Then you can get through it and move on.

Will I be in control? It is hard to predict the thoughts, feelings, or memories that might come up during EMDR. It depends upon each individual's natural healing process. You are always in charge of whether to continue or stop. You can also decide how much to tell the therapist about the experience.

Are there any precautions? Yes. There are specific procedures to be followed depending on your presenting problem, emotional stability, medical condition, and other factors. It is very important that the therapist be formally trained in EMDR. Otherwise, there is a risk that EMDR would be incomplete, ineffective, or even harmful.

What happens afterwards? You may continue to process the material for days or even weeks after the session, perhaps having new insights, vivid dreams, strong feelings, or memory recall. This may feel confusing, but it is just a continuation of the healing process, and should simply be reported to the therapist at the next session. (However, if you become concerned or depressed, you should call your therapist immediately.) As the distressing symptoms fade, you can work with the therapist on developing new skills and ways of coping. .

How can I get EMDR treatment? EMDR Canada maintains a listing of EMDR therapists. You can also contact local EMDR Therapists for referrals.

How long does EMDR therapy take? This depends on several factors including the nature of the problem being treated, the client's history, and the client's ability to tolerate high levels of disturbance. In some cases, one EMDR treatment session is enough. Usually it takes weeks to months, but sometimes years of treatment are required. When EMDR therapy is used appropriately, it can significantly shorten the overall length of time in therapy.

What is an EMDR session like?
First, client and therapist work together to collect basic information about the traumatic experience. The most disturbing part of the incident is identified and becomes the processing target. Example: Image of the rapist's face. The negative belief connected to the trauma is identified. Example: I will never get over this. And a preferred, positive belief is named. Example: It's over, I can move on with my life now. Next, client is asked to rate (on a 1-7 scale) how true the positive belief feels when paired with the target. Usually it does not feel very true at this point. Client is asked to name the emotions the target elicits, to rate the associated distress level (on a 0-10 scale), and to locate the disturbance in the body. Example: Fear and shame, with disturbance level 10, in belly and chest. Then, client is asked to hold in awareness the target, the negative belief, and the disturbing body sensations. At the same time, the therapist guides the client's eyes to move rapidly back and forth. This is done in sets, which may last from a few seconds to a few minutes. During each set the client is instructed to just notice whatever changes occur in mind and body, without controlling the experience in any way. Very often, in the first few sets there is an increase in the disturbance level. After a while, with each new set, the target becomes less and less disturbing and the positive belief feels more and more true. The target is completely processed when recall of the image no longer brings up disturbing emotions, and the preferred positive belief feels totally true. Example: Client recalls that the rapist's face was threatening then but does not feel threatened by the image anymore.

How does EMDR work? Research to answer this question is now in progress at The Human Resource Institute's Trauma Center in Brookline, MA. Researchers there are using SPECT brain-scan imaging to map the changes that occur after EMDR treatments. It is known that the brain has a natural mechanism for processing disturbing events, however, when a traumatic experience is overwhelming the brain may not be able to process it in the usual way. That is why severely traumatized people often find themselves stuck in disturbing memories long after the traumatic event. Research suggests that an important part of the natural trauma processing happens during REM (rapid eye movement) sleep, which provides alternating stimulation of the right and left hemispheres of the brain. This may help explain why EMDR therapy seems to jump-start the brain's natural healing ability, allowing the traumatic memory to become less and less disturbing.