The EMDR therapy

The "Eye Movement Desensitization and Reprocessing"

is a psychotherapy developed by Francine Shapiro, which emphasizes disturbing memories as the cause of psychopathology and alleviates the symptoms of post-traumatic stress disorder . EMDR is used for individuals who have experienced severe trauma which remains unresolved.According to Shapiro, when a traumatic or distressing experience occurs, it may overwhelm normal cognitive and neurological coping mechanisms. The memory and associated stimuli are inadequately processed, and stored in an isolated memory network. The goal of EMDR therapy is to process these distressing memories, reducing their lingering effects and allowing clients to develop more adaptive coping mechanisms. This is done in an 8 step protocol that includes having clients recall distressing images while receiving one of several types of bilateral sensory input including side to side eye movements. The use of EMDR was originally developed to treat adults suffering from PTSD, however, it is also used to treat other conditions and children.

Advocates of EMDR have a lot of trouble explaining, just like me, the rational functional mechanism underlying its effectiveness. However, the main justification for its action is essentially based on its combination of psychological and neurological processes. Recovery occurs after making eye movements as well as other components of EMDR, which releases one from the pathological condition following a system of information processing (Lohr, Kleinknecht, Tolin & Barrett, 1995). Generally, the treatment consists of a number of sessions and the number of sessions devoted to each phase of treatment is strongly dependent on the condition of each individual patient (Hurst & Milkewicz, 2000).

The initial phase is devoted to personal evaluation where the goal is to determine if the patient is suitable for treatment. The initial evaluation takes into consideration, the capacity of the client to get to the bottom of his problems, external tension factors, his physical condition, etc. The second phase acquaints the client with the goals and procedures of EMDR. At this point, imagery and relaxation techniques are often added to reinforce the capacity of the patient to come face to face with the series of traumatic memories which trouble him (Hurst & Milkewicz, 2000)

Francine Shapiro interview's on EMDR technique.

This is followed by the identification of a traumatic memory and an image which most closely represents it (Shapiro, 1989). At first, the patient chooses a poor appraisal of the self (for example, “I am nothing, useless”) relative to this traumatic event and in similarly, chooses thereafter, something which imparts value to him (“I am someone good”) to replace the wrong estimation. The patient evaluates the extent, the force with which he believes his positive estimation, using a graduated scale from 1 to 7. The image and the negative emotion are also linked and the patient’s level of disease is evaluated with the help of another scale (Lohr, Kleinknecht, Conley, Dal Cerro, Schmidt, & Sonntag, 1992).

The patient must then focus on the negative emotions that he encountered, and at the same time, move his eyes from left to right. This process of desensitization is repeated till the scale measuring the level of disease shows significant reduction. The process of cognitive restructuration generally follows the procedure of desensitization. At this point, positive emotion is consolidated so that it replaces the negative idea associated with the traumatic memory. The patient should retain positive belief and image in his spirit, till the continuing eye movements are able to re-attach the positive sentiment to the traumatic memory.

Ocular movements

Practically, jerky eye movements remove the block in the information processing system thereby re-conditioning positive emotions in place of negative ones. It is like doing a “reset” as we do with our computers! Ocular movements used in EMDR are stable, of equal duration and voluntary. The therapist plays the key role of an accompanist and a guide sensitive to any emotion from the patient.