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January 2009

EMDR FAQ - Frequently Asked Question
EMDR - Eye Movement Desensitization and Reprocessing
By Carol Boulware, Ph.D

WHAT IS EMDR?
Eye Movement Desensitization and Reprocessing, or EMDR, is a powerful new psychotherapy technique which has been very successful in helping people who suffer from trauma, anxiety, panic, disturbing memories, post-traumatic stress and many other emotional problems. Until recently, these conditions were difficult and time-consuming to treat. EMDR is considered a breakthrough therapy because of its simplicity and the fact that it can bring quick and lasting relief for most types of emotional distress.

The EMDR technique uses a natural function of the body, rapid eye movement, or REM, as its basis. The human mind uses REM during sleep time to help it process daily emotional experiences. When trauma is extreme, this process breaks down and REM sleep doesn't bring the usual relief from distress. This is where EMDR comes in. It is the next step or, you might say, an advanced stage of the REM processing.

As troubling images and feelings are processed by the brain via the eye-movement patterns of EMDR, resolution of the issues and a more peaceful state are soon at hand.

WHO DISCOVERED EMDR?
In the late 80's, psychologist Francine Shapiro, Ph.D., observed that particular eye movements reduced the intensity of disturbing thoughts in some clients. Dr. Shapiro decided to study this effect scientifically. In 1989, she published an article in the Journal of Traumatic Stress, describing her success using a method she called EMDR. Since that time, other therapists around the world have contributed to its development. EMDR has evolved into a highly effective technique that incorporates elements from other various treatment modalities.

HOW DOES EMDR WORK?
When disturbing experiences happen, they are stored in the brain with all the sights, sounds, thoughts and feelings that accompany them. When a person is very upset, the brain seems to be unable to process the experience as it would normally. Therefore, the negative thoughts and feelings of the traumatic event get "trapped" in the nervous system. Since the brain cannot process these emotions, the experience and/or their accompanying feelings, are often suppressed from consciousness. However, the distress lives on in the nervous system where it causes disturbances in the normal emotional functioning of the person.

The EMDR Technique does two very important things. First, it "unlocks" the negative memories and emotions stored in the nervous system, and second, it helps the brain successfully process the experience.

The therapist works gently with the client, guiding him or her to revisit the traumatic incident. As images and feelings arise, the client's eye movements are "matched" with the remembered events and then re-directed into particular movements that cause the release of the memories.

When the memory is brought to mind, the feelings are re-experienced in a new way. EMDR makes it possible to gain the self-knowledge and perspective that will enable the client to choose their actions, rather than feeling powerless over their re-actions. This process can be a complex if there are many experiences connected to the negative feelings. The EMDR therapy sessions continue until the traumatic memories and emotions are relieved.

WHAT ARE THE ADVANTAGES OF EMDR THERAPY?
Research studies show that EMDR is very effective in helping people process emotionally painful and traumatic experiences. When used in conjunction with other therapy modalities, EMDR helps move the client quickly from emotional distress to peaceful resolution of the issues or events involved.

EMDR sessions work amazingly fast. Processing even the most difficult memories can be achieved in a fraction of the time it previously would have taken with traditional therapy alone. It also enables the more efficient use of conventional psychotherapies, bringing greater results in much less time.

The positive, long-term results of EMDR therapy affects all levels of the client's well-being -- mental, emotional and physical, so that their responses return to normalcy and health.

Traditional therapies often focus on memories from the unconscious mind, and then analyzing their meaning to gain insight into the problem. EMDR clients also acquire valuable insights during therapy, but EMDR can short-cut the process and go right to the releasing stage.

Studies consistently show that treatments with EMDR result in elimination of the targeted emotion or memory. The memory remains, but the negative response is neutralized.

WHAT PROBLEMS ARE HELPED BY EMDR?
Studies to date show a high degree of effectiveness with the following conditions:

  • Trauma
  • fears
  • anxiety
  • childhood trauma
  • phobias
  • physical abuse
  • sexual abuse
  • rape
  • victims of violent crimes
  • post-traumatic stress
  • depression
  • overwhelming fears
  • panic attacks
  • low self-esteem
  • performance and test anxiety

The EMDR technique is most effective when used in conjunction with other traditional methods of therapy in treating these and many other emotional disorders.

EMDR therapy can help clients replace their anxiety and fear with positive images, emotions and thoughts.

WHO CAN BE HELPED BY EMDR?
People who have experienced or witnessed violence, disasters, crimes, sexual assault and other traumas, victims of crime and professionals such as police, emergency workers and firefighters; accident victims and anyone who has experienced a serious loss (such as the death of a close friend of family member, divorce, etc.). EMDR is also very effective treatment for people suffering from phobias--extreme fear of flying, water, spiders, etc.

Because EMDR has the power to relieve any type of emotional block or fear, It can also be used to enhance the performance of athletes, actors, musicians, students, public speakers and executives.

ARE THERE STUDIES THAT SHOW THAT EMDR IS EFFECTIVE?
Fourteen controlled studies of EMDR make it the most thoroughly researched method ever used in the treatment of trauma! A recent study of individuals who experienced rape, military combat, loss of loved ones, disasters and serious accidents, found that 84-90% had relief of their emotional distress after only three EMDR sessions. Another study showed that EMDR was twice as effective in half the amount of time of standard traditional psychotherapeutic care.

Another study of subjects with post-traumatic stress revealed that the significant improvement they gained with the EMDR treatments were maintained for at least 15 months.

Although some people have dramatic responses in a short period of time, others will progress more slowly. However, the results will be equally effective and long lasting.

Since the initial medical study in 1989, world-wide research has helped develop and evolve EMDR. To date, more than half a million people have benefited from EMDR therapy.

WHAT HAPPENS DURING AN EMDR SESSION?
Just as EMDR assists the brain with its natural processing of emotional information, the EMDR therapist assists the client in their healing process by becoming a partner on a journey to release past trauma from the client's nervous system.

A typical EMDR session begins with the therapist gently guiding the client to pinpoint a problem emotion or event that will be the target of the treatment. As the thoughts and feelings come to the surface, the therapist and client work together to re-direct the eye movements that accompany the briefly recalled experience. As the eye movements are re-directed, the negative emotions are released.

The patterns of eye movements continue until the unwanted emotions are neutralized and the troubling event is re-associated with positive thoughts and feelings about oneself, such as "I realize now that it wasn't my fault."

HOW OFTEN WOULD I NEED EMDR TREATMENTS?
Typically, an EMDR session lasts from 60 to 90 minutes. The length of the session depends upon a number of factors, including the nature and history of the problem, the degree of trauma, the specific circumstances on that particular day, etc.

In cases where a single recent traumatic event is involved, a single session of EMDR may be all that is required. However, a more typical course of treatment is somewhere between 5 and 15 sessions, either weekly or every two weeks. For individuals with a history of painful experiences and years of feeling bad about them, a number of EMDR sessions may be needed.

EMDR is most effective when used in conjunction with other modes of therapy. Your therapist will discuss a plan of treatment with you ahead of time so you will generally know what to expect. Usually, at least one session is necessary for the therapist to evaluate whether or not EMDR is the appropriate choice of therapy.

IS THERE ANY DISCOMFORT INVOLVED IN THE PROCESS?
The EMDR treatment can evoke strong emotions or sensations during a session. This is perfectly normal and desirable, since the technique can only work on the negative feelings when they are brought into the client's awareness. However, the re-experiencing of these unpleasant feelings is brief and they will soon leave you when the process is completed.

If the client will persevere through the upsetting memories for a short time, he or she will likely be thrilled with the outcome of the therapy. Relief occurs rapidly, and for many, permanently.

WHAT HAPPENS BETWEEN EMDR SESSIONS?
Between EMDR sessions, it is a good idea for the client to keep a daily log in which to record any unusual or noteworthy thoughts or feelings. He or she can then bring their notes to the next EMDR session. This log will help the therapist to know if any adjustments in therapy are warranted.

After an EMDR session, there may be a strong sense of relief, a feeling of openness or even euphoria. This is a normal reaction to the release that has, and is, taken place.

From time to time, some clients experience unusual thoughts or vivid dreams that may or may not have any meaning. This is part of the releasing process and should not cause undue concern. Actually, unusual experiences during the time period of the EMDR therapy indicates that it is working.

IS EMDR HYPNOSIS?
No. During the EMDR session, the client is awake and alert and in control at all times. The healing that takes place with EMDR is much faster than with hypnotherapy. Like hypnosis, EMDR seems to work with the unconscious mind, bringing into consciousness the repressed thoughts and feelings that must be experienced again in order to release their energetic hold on the person.

WHAT TYPE OF TRAINING DOES A THERAPIST NEED TO USE EMDR?
The EMDR Institute offers two levels of training: Level I, an Introductory training and Level II, the Advanced Training.

Only practicing, licensed psychotherapists, psychiatrists, social workers and counselors may receive EMDR training. These are the only mental health professionals qualified to use EMDR therapy with clients. A clinical background is necessary for proper application of the EMDR technique. This highly specialized method requires supervised training for effectiveness and client safety. In the words of the Behavior Therapist Journal, "Clients are at risk if untrained clinicians attempts to use EMDR." It may be wise to request the therapist to provide you with their EMDR certificate of training.

HOW DO I KNOW IF EMDR IS RIGHT FOR ME?
There are a number of factors to consider when evaluating the appropriateness of EMDR therapy for a client's particular situation and history. During your initial consultation with a trained EMDR therapist, all the relevant factors will be discussed to help you come to a decision and to move ahead with EMDR.

In general though, you are an excellent candidate for the EMDR technique if you have...

...depression or disturbing thoughts
...a history of abuse, or sexual abuse
...been the victim of a crime or serious accident
...witnessed a crime or serious accident
...severe anxiety
...frequent feelings of guilt or shame
...poor concentration or memory
...explosive or irrational anger
...trouble sleeping
...been through a natural disaster
...obsessive or compulsive behavior
...chronic feelings of detachment
...extreme, unexplainable fears
...difficulty trusting people
...fear of being alone
...lack of motivation
...serious relationship problems

SOME OBJECTIVES OF EMDR THERAPY
Thanks to the on-going success of EMDR therapy for hundreds of thousands of people, it is not difficult to have high expectations for a therapy program that includes the EMDR technique.

The short-term benefits of EMDR is simple and straightforward -- the immediate relief of emotional distress and the elimination of the debilitating effect of unresolved past trauma.

Longer-term benefits of EMDR therapy include the restoration of each client's natural state of emotional functioning. This return to normalcy brings with it a greater sense of personal power, more rewarding relationships and a more peaceful life.

These are some of my objectives as I work with my clients and EMDR.

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Dr. Carol Boulware is a Psychotherapist and a Certified EMDR Therapist practicing in Santa Monica and Redondo Beach. She is a member of the Independent Psychotherapy Network. Contact Dr. Boulware at (310) 395-3351 or carolphd@psychotherapist.net. Her website is http://www.EMDR-Therapy.com

© Copyright 2009 by Carol Boulware, Ph.D.

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