| Where
did EMDR come from?
Does it really work?
How does it work?
What kind of problems
can EMDR treat?
What happens in a
typical EMDR session?
How
long would the treatment take?
What's the next step?
Tell me more about
how EMDR works
Tell
me more about the scientific evidence for EMDR
Where did EMDR come from?
EMDR was developed by psychologist Dr. Francine Shapiro
who discovered that eye movements can reduce the intensity
of disturbing thoughts under certain circumstances.
Dr. Shapiro studied this effect scientifically
and in 1989 she reported success using EMDR to treat
victims of trauma in the Journal of Traumatic Stress.
Since then EMDR has developed and evolved through the
contributions of therapists and researchers all over
the world. Today EMDR is a set of protocols that incorporate
elements from many different treatment approaches.
PTSD Treatment consultant Edward Sim
is one of the only accredited EMDR specialists in the
UK to be trained by Dr. Shapiro.
Does it really work?
EMDR has been shown
to be effective for the majority of patients. In fact,
over 80% of people who have experienced a single disturbing
accident are free of symptoms after five hours treatment
carried out over a six week period.
There are many scientific
studies that have shown that EMDR is effective - click
here to read more about them.
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How does it work?
When a person is under a great deal
of stress, their brain cannot process information as
it does under normal circumstances. The traumatic moment
becomes 'frozen in time' , which is why remembering
a traumatic moment often feels as bad as going through
the experience for the first time. Such memories have
a lasting negative effect on the way a person sees the
world and can interfere with his or her life.
EMDR seems to have a direct effect on
the way these traumatic memories are stored, so following
a successful EMDR session, the images, sounds and feelings
of the incident are still remembered, but are less upsetting.
EMDR appears to be similar to what occurs
naturally during dreaming or REM (Rapid Eye Movement)
sleep. Therefore, EMDR can be thought of as a physiologically
based therapy that helps people see disturbing material
in a new and less distressing way.
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What kind of problems can EMDR treat?
Scientific research
has established EMDR as effective for Post Traumatic
Stress Disorder. It has also been used successfully
to treat panic attacks, phobias, performance anxiety,
stress, addictions, dissociative disorders, disturbing
memories and anxiety disorder.
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What happens in a typical EMDR session?
During EMDR, the
therapist works with the patient to identify the specific
disturbing issue or event, what was seen, felt, heard,
thought, etc; and what thoughts and beliefs are currently
held about that event.
The therapist facilitates by directional
movements of the eyes or other bilateral stimulation
of the brain while the client focuses on the disturbing
material, and the client just notices whatever comes
to mind without making any effort to control direction
or content.
Each person will process information
uniquely, based on personal experiences and values.
It is important to understand that there is no way for
the client to do EMDR incorrectly. Sets of eye movements
are continued until the memory becomes less disturbing
and is associated with positive thoughts and beliefs
about oneself.
During EMDR the client may experience
intense emotions, but by the end of the session, most
people report a great reduction in the level of disturbance.
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How long would the treatment take?
One session is
needed for the therapist to decide whether EMDR is an
appropriate treatment. The therapist will also discuss
EMDR more fully and provide an opportunity to answer
any questions about the method. Once therapist and patient
have agreed that EMDR is appropriate, the actual EMDR
therapy may begin.
A typical EMDR session lasts between
60 and 90 minutes. A single session of EMDR is sufficient
in some cases. However, a typical course of treatment
is four sessions. EMDR may be used within a standard
'talking' therapy or a as treatment all by itself.
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What's the next step?
Either call us or
send us your phone number using the contact
form or by email. A therapist
will be in touch to have an initial chat to ascertain
if you need therapy. If so, depending on availability,
we'll do our best to get you fixed up with a therapist
as soon as possible.
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Tell me more about how EMDR works
The originator of EMDR, Francine Shapiro:
"The adaptive information processing
(AIP) model guides EMDR treatment. This theory posits
that many disorders are based, at least in part, on
the inadequate processing of information relating to
distressing experiences. It is proposed that this information
is stored, with the emotions and physical sensations,
in a state-independent fashion. Essentially, the memory
becomes isolated, without adequate integration with
semantic knowledge or assimilation into other memory
networks. During effective treatment, traumatic material
is linked to more adaptive material and new associations
are made, resulting in complete information processing
and adaptive resolution. What is useful is learned,
stored with appropriate emotion, and is able to effectively
guide one in the future. What is useless (such as high
arousal, disturbing emotions, irrational beliefs, sensations)
is discarded. (Shapiro 2002).
There have been many other studies looking
into the way that the brain processes traumatic memories
compared to those of normal incidents.
Van der Kolk* calls the process that
prevents traumatic memories being integrated into autobiographical
memories 'disassociation'. He says that the memories
lead a 'relatively independent existence from the remainder
of the person's conscious experience'.
He continues: 'If a person's problem
with PTSD are being caused by disassociation treatment
needs to consist of association.
'However, traumatic memories that need
to be associated are not primarily represented by a
person's verbal account of the past but by the fragmented
sensory or emotional elements related to the trauma.
When these elements are activated, the entire neural
net in which the memory is stored is stimulated, causing
the person to relive the old but terrifying event.'
This is the stage at which EMDR can begin
to reconcile the traumatic memories into a coherent
whole with the autobiographical memories.
Van der Kolk goes on to describe the
subcortical area of the brain that stores the traumatic
memories which are not under any conscious control as
distinct from higher levels of the brain in the prefrontal
cortex.
A useful way to picture this distinction
is to think of the lower subcortical area area as 'mechanical',
whereas the higher level cortical area is 'emotional'.
Traditional therapy relies on 'top-down'
techniques to manage disruptive emotions and sensations,
whereas EMDR tackles the 'mechanical' upset in the subcortical
area.
So, with the knowledge that traumatic
memories are treated in a different way to normal memories,
let's turn to something called the 'amygdala'. A part
of the limbic system, van der Kolk describes the amygdala
as the 'smoke detector' that interprets whether incoming
sensory information is a threat. The challenge of effective
psychotherapy he says is to 'decondition the amygdala
from interpreting innocuous reminders of the trauma'.
When people experience triggers that
cause them to relive their traumatic experience, they
have increased activation of the limbic system.
Van der Kolk goes on to describe how
EMDR serves to 'loosen up the free associative processes,
giving people very rapid access to memories and images
of their past... allowing them, in some way, to associate
current painful life experiences with previous life
events that have been successfully mastered.'
Another difference from traditional counseling
is that EMDR seems to be able to accomplish its therapeutic
action without forcing people to articulate in words
the source of their distress. In other words, it seems
to be possible for EMDR to be effective even when people
don't speak.
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Tell me more about the scientific
evidence for EMDR
EMDR has received intense scientific scrutiny and has
been found to be a very effective treatment for PTSD
(eg Chentob, Tolin, Van der Kolk & Pitman). It has
also been acknowledged as an effective treatment for
PTSD by the UK Department
of
Health
and by the International Society for Traumatic Stress
Studies (Shalev 2000).
The Journal of Consulting and Clinical
Psychology published research by Wilson, Becker, and
Tinker in December 1995. This study of 80 subjects with
post traumatic stress demonstrated that clients improved
significantly with EMDR treatment, and further study
showed that this beneficial was maintained for at least
15 months. The findings from this and other studies
indicate that EMDR is highly effective and that results
are long lasting.
Other controlled studies that support
the efficacy of EMDR include Kleinknecht, 1992; Carlson
et al, 1998; Marcus Marquis & Sakai, 1997; Rothbaum,
1997; Scheck, Schaeffer & Gillette, 1998; Wilson,
Becker & Tinker, 1995; Wilson, Becker & Tinker,
1997) have been conducted, and results demonstrate that
EMDR is one of the most efficient treatments available
for PTSD. Studies indicate that EMDR may also be effective
in treating phobias (Kleinknecht, 1993), panic attacks
(Goldstein & Feske, 1994; Nadler, 1996), performance
anxiety in the workplace (Foster & Lendl, 1996),
body dysmorphic disorder (Brown, McGoldrick & Buchanan,
1997), trauma in children (Greenwald, 1994), and the
reduction of chronic pain (Hekmat, Groth & Rogers,
1994).
*Beyond the Talking Cure: Somatic
experience and subcortical imprints in the treatment
of trauma by Bessel A. van der Kolk
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