A “Rapid” End to the Cycle of Distress
Cynthia, age 32, is a survivor of childhood abuse. She has experienced depression, anxiety, and low self-esteem since her abuse. Logically, she knows she is safe now. Emotionally, she feels out of control. The emotional distress continues to negatively affect her daily life and her relationships. In the counselor’s office, Cynthia’s eyes follow a light moving back and forth across a bar as she focuses on an image that represents the abuse. She briefly re-experiences the emotions she felt then - and then they are gone. She remembers events she had forgotten – and things begin to make sense. Positive thoughts come to mind – and she realizes new things about herself. After several sessions, Cynthia still remembers what happened, but she no longer feels the emotional pain that she has struggled with for years. She feels like “a burden has been lifted” and her symptoms have significantly reduced. Cynthia’s story is typical of EMDR therapy.
Ask people if they know about EMDR and a good percentage will say “well…I’ve heard of it…” What is this new therapy that has gained both media attention and popularity among therapists? Well…it’s not simply the latest fad. EMDR is supported by a growing body of research for treating trauma, depression, anxiety, anger, grief, and pain. It is also endorsed by significant organizations, such as the Department of Defense, the VA, the FBI, the Red Cross, the American Psychological Association, and the Menninger Clinic (to name a few…).
So, back to the question: What is it? EMDR stands for Eye Movement Desensitization and Reprocessing and was developed by psychologist Francine Shapiro in the mid 1980’s. Shapiro’s theory is that the brain processes disturbing experiences differently than normal events. When a distressing event occurs, the images, sounds, and sensations of the event become “frozen in time.” They are frequently re-experienced and continue to negatively influence a person’s mental well-being. This brings to mind the returning veteran who repeatedly relives combat experiences, the adult victim of childhood bullying who is still fearful and defensive, or the survivor of domestic violence who seems to be perpetually angry. But trauma doesn’t always include physical harm: any situation that makes you feel helpless, overwhelmed, afraid, or alone can be traumatic and can lead to posttraumatic stress disorder, anxiety, depression, stress, or other mental health problems. EMDR was developed for these types of problems.
So…how does it work? Similar to other techniques, EMDR addresses the cognitive, affective, and sensory aspects of memory and uses imagery, mindfulness, free association, and exposure to distressing material. However, a feature unique to EMDR is bilateral stimulation. Bilateral stimulation basically activates the “whole” brain by moving the eyes, tapping, or using audio or sensory pulses that alternate attention from the left to the right and so on. Although the exact mechanism is unknown, the stimulation is thought to mirror eye movements during REM sleep when the brain is processing information. As stimulation is applied, the client focuses on an image of the troubling event, along with related negative self-statements. Ultimately, the “frozen” memory becomes integrated into the brain in a natural and healthier way and the distressing emotions associated with the trauma are released. Frequently, symptoms that have been present since the trauma occurred are reduced or cease altogether.
What happens during an EMDR session? The client is awake, conscious, and in total control of continuing or stopping the process. Basically, the brain does the processing and the client is simply the observer and reporter of what comes to mind. If there is a high level of distress during an EMDR session, it typically lasts a few minutes and then decreases rapidly. Specific techniques are used by the therapist if the distress does not dissipate naturally.
EMDR has eight phases that address the past, present, and future manifestation of memories, cognitions, and symptoms. The phases include history taking, self-soothing, bilateral processing and targeting the image, identifying and rating thoughts, awareness of body sensations and emotions, logging reactions, and developing healthier future responses.
The number of sessions depends upon the client’s history, the problem, and the length of time that the distressing situation was endured. Several studies report positive results in as few as 3 to 6 sessions and outcomes are typically maintained over time.
Like any type of psychotherapy, EMDR is not a panacea - it can’t “cure” everything. However, ongoing research continues to support its effectiveness for severing the emotional ties associated with painful memories and reducing the symptoms that compromise mental health.