Eye Movement Desensitization Reprocessing (EMDR)
Eye Movement Desensitization Reprocessing (EMDR) is an eight-phase psychotherapy approach developed by Dr. Francine Shapiro in 1989 to address trauma in adults. There are now more studies on EMDR for Post-Traumatic Stress Disorders (PTSD) than any other psychotherapeutic approach. EMDR has been approved by APA, WHO, the Department of Defense, and SAMHSA (emdria.org and emdr.com) as one of the treatment of choices for PTSD. EMDR has since been expanded for use with children and adolescents and is used for anxiety, depression, phobias, smaller life disturbances, as well as for performance enhancement.
Dr. Shapiro conceived the Adaptive Information Processing model to explain the mechanisms by which EMDR assists clients in moving a disturbing event to a more adaptive and helpful response. The therapist helps the client determine current disturbing triggers with the associated image, thoughts, and feelings about it and traces the triggers back to the foundational event. The client then is instructed to think of the distressing event. Then the therapist has the client move his eyes back and forth by following their fingers, or listen to alternating sounds or taps on their hands. EMDR therapists often have technological devices such as a light bar, audio or a tactile/buzzie device to provide the alternating bilateral stimulation.
The therapist asks the client what he or she is experiencing, after the client responds, the therapist continues with the alternating stimulation. The majority of an EMDR reprocessing session focuses on the alternating stimulation and the clients reports of what they are experiencing between intervals. The goal of reprocessing is to eliminate the distress and symptoms related to the disturbing event. A baseline measure is taken at the beginning of the session and is used to assess the client’s reprocessing. The reprocessing is not complete until the client reports the disturbance is at a “0”.
As with most therapies the mechanism for EMDR is not yet understood. One hypothesis is the dual attention aspect of EMDR. The therapist has the client focus on the alternating stimulation while the client thinks of the upsetting incident which may allow the brain to reprocess and have a more adaptive response.
EMDR is now used for adults, adolescents and children in other diagnostic and life challenges, such as depression, anxiety, OCD and phobias. It is also used with stressors, such as divorce, grief, job loss, bullying and medical traumas.