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Practice for Psychotherapy & Counseling
Dr. Phil Stöckli , ph.D.
Gemeindestr. 26 | 8032 Zürich
Tel. 076 282 8885
Practice for Psychotherapy
Dr. Phil Stöckli, PhD
EMDR - eye movement desensitization &
reprocessing
What is EMDR?
EMDR stands for "Eye Movement Desensitization
and Reprocessing" and was discovered between
1987 and 1989 by the American
Psychologist Dr. Francine Shapiro
developed for the treatment of
trauma. She found out that rapid
(horizontal) eye movement
triggers the processing of
memory in the brain. What
sounds simple at first is a complex and
comprehensive Psychotherapy method, which
requires several years of training, and to which
currently only recognized Psychotherapists are
admitted.
When I first heard of the incredible healing effects
of EMDR (example #1, #2) I became suspicious and
thought it was unserious and unscientific.
Meanwhile, I am convinced that EMDR is a very
effective therapy method
and a powerful tool to
speed up
Psychotherapeutic
processes. It works with
most people.
History
In 1987, Shapiro accidentally discovered the effects
of eye movements. She had just received a difficult
diagnosis herself and went for a walk in the
hospital park to digest the news. She moved her
eyes (randomly) quickly back and forth and ten
minutes later, her distress suddenly had
disappeared. Shapiro was so fascinated by this
event, that she developed EMDR in the following
years. Later, Shapiro and colleagues found that the
effect can not be caused solely by eye movements,
but rather by bilateral stimulation. But by that
time, the name EMDR has already been
established and so that they decided to keep it.
When you do EMDR today, you have a choice to do
it using eye movements, alternating sounds (with
headphones) or with a vibrating device ("EMDR
Buzzies"with alternating vibrations, see picture).
How does it work?
Interestingly, the efficacy is well documented, but
it is not completely understood how and why
EMDR works. There are, however, some
hypotheses:
•
The bilateral stimulation boosts the
processing of memories, similar to REM sleep
•
EMDR triggers an orientation reaction, leading
directly to desensitization and processing of
traumatic memory
•
EMDR promotes bilateral data exchange
between the two sides of the brain so that
"stuck" memories can be processed.
•
EMDR “deblocks” the Information processing
system in the central nervous system (CNS).
Due to the sensory overload during a
traumatic situation, this system is thought to
be partially blocked with PTSD patients.
Slow vs. fast stimulation
With slow stimulation, existing phenomena are
intensified or anchored. Note that these effects are
only temporary. This technique will be used during
a first ‘trial session’ (so called absorption technique)
or at the conclusion of a successful EMDR session.
Fast stimulation, however, is used for the actual
EMDR treatment. Memories are processd deeply
and the effects are permanent.
Effectiveness
The EMDR method has been accepted as an
effective and time-efficient treatment for post-
traumatic stress disorder. By now, almost every
civilized country has its own EMDR training center.
Furthermore, EMDR is being adapted successfully
for other Psychiatric disorders. In the 30 years of
its existence, EMDR has become the therapeutic
method with the most controlled and uncontrolled
therapeutic trials for the treatment of PTSD.
[Current state of EMDR research] The effects are
persistent and stand out clearly from placebo
effects. A person with a single trauma (and no
other preconditions) might only need a few
sessions (10 or so) of EMDR treatment until they
feel significantly better. For a person suffering
from early or repeated traumatization, it will take
takes substantially longer. The period of
stabilization (before you can confront any trauma
at all) might take weeks to years.
Which problems can EMDR be used for?
•
Monotrauma (single traumatic event) such as
accidents, catastrophic events
•
Complex trauma (early or repeated
traumatization) such as physical, emotional
and sexual abuse, war experiences, etc.
•
Attachment issues / Developmental Trauma
•
Depression
•
Anxiety, panic attacks, phobia
•
ADHD
•
Asperger syndrome
•
Obsessive-compulsive disorder
•
Mourning processes
What does an EMDR treatment look like?
The treatement can be divided in 8 phases. In the
best case scenario, you can start processing the
difficult memories after a few sessions. These are
the 8 phases which every EMDR treatment should
contain:
1. Thorough medical history
- Especially stressful or traumatic events
- Diagnosis, possibly trauma assessment
- Indication und treatment plan
2. Preparation - this phase might take between
a few sessions and years!
- In-depth information about the treatment
- Checking / acquiring strategies for emotion
regulation
- Acquiring stabilizing techniques, getting in touch
with
your body an feelings
- Trial session with positive memories (so called
Absorption-technique), with slow bilateral
stmulation
3. Assessment of one chosen memory (image,
thoughts, feelings, distress level, body sensations)
4. Desensitization / Reprossessing with fast
bilateral stimulation, until distress is gone
5. Installation of positive thoughts / body
sensations with slow bilateral stimulation
6. Body scan
7. Closure - The patient must be returned to a
state of equilibrium at the end of each session,
regardless of whether reprocessing is complete.
8. Reevaluation and treatment planning in the
following session
The actual processing of the memories takes place
in a 60-90 minute session (phases 3-7).
Note: Instead of the tiring eye movements, EMDR
can be performed using a vibrating device (EMDR
”buzzies”, see picture above).
Preconditions for a EMDR treatment
•
Patient should ideally be in a relatively stable
phase of life, meaning: currently no profound
life events such as change of residence, final
exam, separation / divorce, pregnancy, child
birth, withdrawal treatment, etc.
•
Sufficient self-regulation strategies (since
treatment is performed on an outpatient
basis)
•
No ongoing abusive relationship
•
For ADHD patients, it is recommended to be
on their medication that day
•
Exclusion criteria: psychosis, epilepsy, acute
suicidality, permanent drug use, permanent
use of benzodiazepines
Links and literature
•
Great animation by the National Center for
PTSD - Video (2.54)
•
Dr. Leeds explains how EMDR works Video
(4.43)
•
Interview with Dr. Francine Shapiro Video
(8.20)
•
Dr. Francine Shapiro explains EMDR Video
(3.59)
•
Historic document of Dr. Francine Shapiro
talking about her discovery Old video (2.54)
Old video (2.51)
•
Good article pdf
•
FAQ, more scientific Text
•
FAQ, less scientific Text
•
Overview current research
•
Even Prince Harry is doing EMDR!