EMDR Eye Movement Desensitization & Reprocessing

Background First discovery of the effects of spontaneous eye movement in 1987 First discovery of the effects of spontaneous eye movement in 1987 First controlled study published in the Journal of Traumatic Stress in 1989 First controlled study published in the Journal of Traumatic Stress in 1989 Discovery of other forms of bilateral stimulation in 1990, leading to the creation of EMDR Discovery of other forms of bilateral stimulation in 1990, leading to the creation of EMDR

Adaptive Informational Processing Model

About EMDR An integrative psychotherapy approach found to effectively treat trauma-related disorders An integrative psychotherapy approach found to effectively treat trauma-related disorders Such as PTSD, dissociative identity disorder, and trauma-related borderline personality disorder Such as PTSD, dissociative identity disorder, and trauma-related borderline personality disorder Amount of time for complete treatment depends on the client’s history Amount of time for complete treatment depends on the client’s history Addresses the issues that contribute to clinical problems Addresses the issues that contribute to clinical problems

Goals of EMDR “To achieve the most effective and efficient treatment effects while maintaining client safety” “To achieve the most effective and efficient treatment effects while maintaining client safety” “To achieve appropriate, adaptive and ecological resolution of presenting problems” “To achieve appropriate, adaptive and ecological resolution of presenting problems” “To incorporate new skills, behaviors and beliefs about self, optimizing clients’ capacity to respond adaptively in the current context of their lives” “To incorporate new skills, behaviors and beliefs about self, optimizing clients’ capacity to respond adaptively in the current context of their lives”

Three-Pronged Reprocessing Approach Past Events Past Events First root causal experience First root causal experience Worst experience Worst experience Any additional experiences Any additional experiences Present Triggers Present Triggers Future- Desired Outcomes Future- Desired Outcomes

8 Phase Treatment Approach

Phase One: Client History Obtain background information to identify appropriate use of EMDR treatment Obtain background information to identify appropriate use of EMDR treatment Identify the presenting issues and related past experiences Identify the presenting issues and related past experiences Develop a treatment plan targeting specific events for memory reprocessing Develop a treatment plan targeting specific events for memory reprocessing Pregnant women and those with cardiac, respiratory or ocular problems should consult their healthcare providers prior to treatment Pregnant women and those with cardiac, respiratory or ocular problems should consult their healthcare providers prior to treatment

Phase Two: Preparation Goal: establish a relationship of trust between therapist and client Goal: establish a relationship of trust between therapist and client Education to client of EMDR practice Education to client of EMDR practice Informed Consent Informed Consent Client is taught affect management skills to cope with any emotional disturbance that may arise Client is taught affect management skills to cope with any emotional disturbance that may arise

Phase Three: Assessment Processing of targeted event (chosen during Phase One) begins Processing of targeted event (chosen during Phase One) begins Identify cognitive distortion “I am worthless” and a positive self-statement that is desirable “I am worthwhile” Identify cognitive distortion “I am worthless” and a positive self-statement that is desirable “I am worthwhile” Therapist takes baseline measurement of target event Therapist takes baseline measurement of target event Client will be able to identify the emotions and physical sensations associated with the event Client will be able to identify the emotions and physical sensations associated with the event

Phase Four: Desensitization Process the experience toward a desirable SUD level Process the experience toward a desirable SUD level Identify and resolve similar events associated with trigger Identify and resolve similar events associated with trigger Therapist leads client in a set of eye movements with appropriate shifts and changes of focus Therapist leads client in a set of eye movements with appropriate shifts and changes of focus Client to be guided through complete resolution of targeted event Client to be guided through complete resolution of targeted event

Phase Five: Installation Strengthen association of positive cognition Strengthen association of positive cognition Goal is for client to accept positive self-statement at a level 7 on the Validity of Cognition scale Goal is for client to accept positive self-statement at a level 7 on the Validity of Cognition scale

Phase Six: Body Scan Original targeted event will be assessed again to check if physical sensations still present Original targeted event will be assessed again to check if physical sensations still present If negative physical response present, reprocessing will be repeated until it disipates If negative physical response present, reprocessing will be repeated until it disipates

Phase Seven: Closure Client needs help to stabilize and orient them to the present Client needs help to stabilize and orient them to the present Close of session with plan for between session techniques, such as keeping a daily journal in case processing continues to take place Close of session with plan for between session techniques, such as keeping a daily journal in case processing continues to take place This is extremely important in cases when complete processing cannot be done in one session This is extremely important in cases when complete processing cannot be done in one session

Phase Eight: Reevaluation This phase guides the therapist through proper protocol This phase guides the therapist through proper protocol Reassess GAF score Reassess GAF score Client report on progress between sessions Client report on progress between sessions Re-access the targeted event and emotions to continue treatment plan Re-access the targeted event and emotions to continue treatment plan Evaluate treatment efficacy Evaluate treatment efficacy

References Van der Hart, O., Nijenhuis, E., and Solomon, R. Dissociation of the Personality in Complex Trauma-Related Disorders and EMDR: Theoretical Considerations. Journal of EMDR Practice and Research, Volume 4, Number 2, DOI: / pages Van der Hart, O., Nijenhuis, E., and Solomon, R. Dissociation of the Personality in Complex Trauma-Related Disorders and EMDR: Theoretical Considerations. Journal of EMDR Practice and Research, Volume 4, Number 2, DOI: / pages EMDR The breakthrough “Eye movement” therapy for overcoming anxiety, stress, and trauma by Francine Shapiro, Margot Silk Forrest. April 11, Published by Basic Books:New York. EMDR The breakthrough “Eye movement” therapy for overcoming anxiety, stress, and trauma by Francine Shapiro, Margot Silk Forrest. April 11, Published by Basic Books:New York.