LINDA TEPPER, L.C.S.W.
psychotherapy
Eye Movement Desensitization and Reprocessing
...is the name given to a powerful type of psychotherapy developed by Francine Shapiro in 1987. Considered a "power" therapy because it works much quicker than traditional "talk therapy" it has been acknowledged and accepted by the professional community and the general public. While "talk therapy" focuses mainly on the conscious mind and relies on insight to effect change, EMDR works by tapping into the subconscious in order to bring about change. As such, EMDR brings together cognitive, emotional and felt senses that are stored as memories in our brains. The way we act and react is based on prevous learning and experiences. In EMDR, the stored memory of an experience is in the brain and becomes the target of the treatment. As such, EMDR is a treatment that deals with the experiential contributors of present day discomfort. With EMDR treatment, what's useful from an experience becomes learned and what's useless is able to be let go.
EMDR is an eight phase process. The number of sessions devoted to each phase varies on an individual basis.
Phase 1: The therapist takes a complete history of the patient and a treatment plan is designed.
Phase 2: Clients are taught relaxation and self-calming techniques.
Phase 3: The client is asked to describe a disturbing memory. He then is instructed to bring up the visual image of the memory as well as the associated feelings and negative thoughts, such as "I'm a failure." The client is then asked to identify a desired positive thought, such as "I can really succeed." This positive thought is rated against the negative thought on a scale of 1-7, with 1 being "completely false" and 7 being "completely true." This process helps create a goal for treatment. The client then combines the visual image of the trauma with the negative belief, usually evoking strong feelings, which are then rated on the Subjective Unit of Disturbance (SUD) scale. While focusing on the combination of the traumatic image and negative thought, the client either follows the therapist's hand move in a bilateral pattern or experiences bilateral stimulation by tapping or auditory tones. The purpose of the eye movements, tapping or auditory tones is to induce a state of "dual awareness." After each set of bilateral stimulation the client is asked to clear his mind and relax. This is repeated several times during a session.
Phase 4: This phase involves desensitization to the negative thoughts and images. The client is instructed to focus on the visual image of the trauma, the negative belief he has of himself, and the bodily sensations caused by the memory, while at the same time following the therapist's finger/hand with his eyes (or other bilateral stimuation). The client is asked to relax again and report what comes up (or what he notices). These new images, thoughts, or sensations are the focus for the next eye movement set. This is continued until the client can think of the original trauma without significant distress.
Phase 5: This phase focuses on cognitive restructuring, or learning new ways to think. Once the original memory is desensitized (the SUDS level is down to "0"), the client is asked to think about the trauma and a positive thought about himself (e.g., "I can succeed") while completing another couple of eye movement sets. This point of this phase is to bring the client to link the positive statement about himself to the original memory.
Phase 6: The client focuses on the traumatic image and the positive thought, and is once again asked to report any unusual body sensations. The sensations are then targeted with another set of eye movements. The theory behind this is that improperly stored memories are experienced through bodily sensation. EMDR is not considered complete until the client can think of the traumatic event without experiencing any bodily sensations.
Phase 7: The therapist determines whether the memory has been adequately processed. If it hasn't been, the relaxation techniques learned in phase 2 are employed. Memory processing is thought to continue even after the session has concluded, so clients are asked to keep a journal and record dreams, intrusive thoughts, memories and emotions.
Phase 8: This is a reevaluation phase and is repeated at the beginning of each EMDR session after the initial session. The client is asked to review the progress made in the previous session and the journal is reviewed for areas that may need further work.
The eight phases may be completed in a few sessions, or over a period of months, depending on the needs of the client.