Current research on Eye Movement Desensitisation & Reprocessing (EMDR) Robin Logie Derek Farrell Melanie Temple David van den Berg DCP Oxford 7 th Dec 2013

History of EMDR Francine Shapiro 1987 – walk in the park 1989 – Journal of Traumatic Stress RCT PTSD

Trauma based therapy trauma or other unresolved life events that cause psychological disorders addresses trauma/life event directly PTSD obvious starting point – specifically relates to trauma Most psychological disorders relate to trauma/life event

Differs from other trauma based therapies Integrates memory/image of ‘worst moment’ current negative cognition eg ‘I’m not safe’ bodily sensation Combined with bilateral stimulation

Procedure: The 8 phases of EMDR 1. History-taking 2. Preparation(eg relaxation, ‘safe place’) 3. Assessment

Assessment Specific image Current negative belief (Negative Cognition) e.g. ‘I am helpless’ Desired positive belief (Positive Cognition) e.g. ‘I am in control’ Validity of Cognition (VOC) Emotion Current level of disturbance (SUD) Location of emotion

Procedure: The 8 phases of EMDR 1. History-taking 2. Preparation(relaxation, ‘safe place’) 3. Assessment 4. Desensitisation 5. Installation 6. Body scan 7. Closure 8. Re-evaluation

Theoretical rationale Adaptive Information Processing (Solomon & Shapiro 2008) Inadequate processing of info re distressing experiences EMDR achieves integration

Training & accreditatation Europe EMDR Association Standardises training courses (7 days) Accreditation

Further information EMDR Association UK & Ireland Humanitarian Assistance Programme Robin Logie

Active ingredients of EMDR Eye movements: interfere with working memory processes (van den Hout et al, 2011)van den Hout et al, 2011 Makes memory less vivid, less emotional Enhances processing because less overwhelmed link into the same processes that occur during REM sleep (Stickgold, 2002)Stickgold, 2002 EMs induced relaxation and/or orienting response

Which disorders? EMDR focuses on trauma Post Traumatic Stress Disorder (PTSD) Any disorder related to trauma Accident Bereavement Survivor of abuse Trauma may not be initially apparent Not neuro/organic disorders eg psychosis, manic depression

EMDR with children Simpler than other forms of therapy Less abreaction Involves parents Same as adult protocol ‘minimal creativity’ Simplified as necessary for child eg omit cognitions (child < 5) Alternatives to eye movements eg auditory ‘clicks’, hand taps, drumming Narrative approach

Training Need to be fully trained & experienced therapist before EMDR training Basic, Part 1:3 days Intermediate, Part 2:1 day Advanced, Part 3:3 days Children: Levels 1 and 2 Accreditation Consultant - supervision