The EMDR (Rapid Eye Movement Desensitization and Reprocessing] is a psychotherapeutic approach. It was designed around the 1990s to deal with PTSD or the stress associated with past traumatic events. EMDR therapy focuses on assessing and processing past traumatic memories and other adverse experiences. The aim here is to change the outlook of the patient. Suppose the brain starts to see positives instead of negatives when the traumatic experiences resurface. It will be much easier for the patient to handle them without experiencing panic attacks.
If EMDR therapy is successful:
- the distress of the past trauma is relieved
- the negative beliefs reformulate
- the physiological effects like panic attacks, rapid breathing, etc., reduce.
Why use EMDR therapy for handling PTSD?
EMDR therapy does not require the patient to discuss the entire traumatic event in one sitting. The patient reflects on his past emotional traumas or incidences step-by-step. The patient then dives into the emotionally disturbing material while focusing on external stimuli. These external stimuli include directed eye movements, audio stimulation, and hand tapping.
The therapeutic process of EMDR therapy focuses on accessing the traumatic memory while enhancing the information processing centers of the brain. When the brain’s information processing capabilities enhance, the brain automatically starts to forge new and positive connections in the specific traumatic memory and between different traumatic memories. This allows for better judgment and understanding of the past trauma.
Doug is a patient with repressed childhood trauma. The patient was the victim of a psychopathic mother and has lost confidence in himself. The therapist uses EMDR therapy add to discuss the traumatic memories with the patient. After conducting the EMDR therapy successfully, the patient starts to view the past in a different light. Instead of feeling that he was emotionally abused, violated, constantly manipulated, and turned into a slave for his mother, etc., he feels that he survived through a trauma. He is a strong person who can handle any situation since he has already handled the worst. Finally, the patient realizes that he is not in his mother’s clutches anymore, and he is free to move on with his life. These factors will boost the patient’s self-confidence and help him understand himself in a better manner.
The three-pronged protocol of EMDR therapy
EMDR therapy works based on a 3-pronged protocol
First, the therapist and the patient discuss the past trauma. This helps to lay down the groundwork for therapy and understand where the dysfunction stems from. Next, new associations form via the use of adaptive information.
The situations that cause distress to the patient in the current scenario are the targets of focus. The therapist works to desensitize the patient toward the external and internal triggers.
In the final stage, the therapist presents the patient with new scenarios that may or may not occur in the future. It allows the patient to adapt and process the trigger. Thus, reducing the chances of getting triggered by the events.
Effect of EMDR therapy on the brain
As I mentioned before, EMDR therapy primarily focuses on forging new bridges between the past trauma and the patient’s feelings. If you injure the same place repeatedly, the wound will start to fester and lead to heightened pain. Once you stop injuring that specific region, the healing will automatically resume.
EMDR therapy works on a similar principle. The mind prefers to be in a happy and contented environment. However, when there are past traumas lurking in the shadows, this blocks the progress towards contentment. This causes an imbalance in the mental health of a person. The wound of the past trauma and emotional abuse stays and starts to cause an intense level of mental suffering. Once the block of the past trauma formed is removed, the brain moves in the direction of better mental health.
What is PTSD?
PTSD or post-traumatic stress disorder is when you suffer through a traumatic event in the past, and the traumatic event keeps resurfacing when certain triggers are presented. You may either have experienced a traumatic event visually or suffered through it. The most common symptoms of PTSD are:
- Reliving the event as if it’s happening again and again.
- Distressing memories of the event that you cannot shake off.
- Nightmares and upsetting dreams about the event.
- Physical reactions and high emotional distress in reaction to something that reminds you of the traumatic event.
How to identify if you are suffering from PTSD?
Besides the above-mentioned symptoms, there are other ways to identify if you or your loved one is suffering from PTSD. They may either start to exhibit avoidance symptoms, or they may show negative changes in mood and thinking. The symptoms of avoidance would be:
- Avoiding any types of events related to the traumatic past.
- Avoiding people, activities, or places that can remotely remind the person of past events.
Symptoms of changes in the thinking process and mood due to PTSD would be:
- Showing hopelessness toward the future
- Pushing everyone away
- Negative thoughts about self, others, and the world.
- Difficulty in remembering aspects of the traumatic event
- Feeling dissociated from friends and family
- emotional numbness
- Difficulty feeling happy, content, or any kind of positive emotion.
Physical symptoms of PTSD
- Getting frightened or startled easily and quickly
- Difficulty concentrating
- Constantly on guard for any kind of danger
- Angry outbursts, irritability, and aggressive behavior
- Overwhelming levels of shame or guilt
- Difficulty sleeping
If a child is suffering from PTSD, the symptoms may also include the following:
- Reenacting parts or aspects of the traumatic event via play
- Nightmares that may or may not involve aspects of the traumatic event.
EMDR therapy for the treatment of PTSD
When treating PTSD, EMDR therapy works alongside the adaptive information processing model. The therapy generally takes place in two sessions per week. The sessions move on for 6 to 12 weeks. This depends on the intensity of the traumatic event and how well the patient is responding to therapy.
The adaptive information processing model is specifically used to treat patients with PTSD and other disorders that have their origination rooted in a traumatic past. The traumatic memories are expected to contain the beliefs, thoughts, emotions, and physical sensations that occurred when that traumatic event occurred. When the patient’s fears are triggered, these disturbing events are experienced. They may appear as the same physical sensations, thoughts, beliefs, and emotions.
Newest psychotherapeutic treatments involve altering the past emotions, responses, and thoughts that have resulted from the traumatic experience. However, EMDR takes a different route. EMDR therapy directly focuses on traumatic memory. This changes the way the brain processes specific memory.
EMDR therapy is effective because it incorporates bilateral stimulation like eye movements, taps, tones, etc. The patient focuses on the traumatic memory and the associated sensation. The patient also experiences bilateral stimulation simultaneously. This allows the associated emotions and vividness of the traumatic memory to reduce.
Phases of EMDR therapy for the treatment of post-traumatic stress disorder.
EMDR therapy comprises eight different phases. The phases of EMDR therapy are as follows:
First phase: The therapist records the patient’s history and triggers
Phase two: The therapist prepares the patient for the therapy.
Phase three: The target memory assessment begins
Phases four to seven: Adaptive information processing method is used to assess the memory.
Phase eight: In this phase, the therapist evaluates the treatment outcome.
If it is one specific memory that is traumatic, the patient may complete treatment within 1-3 sessions. However, if there are multiple traumatic events in the patient’s past, the therapy may take longer.
EMDR therapy is more effective than the other forms of psychotherapy because, in EMDR, the psychologist does not ask the patient to discuss the traumatic event in detail. The therapist does not ask the patient to do any homework either. Thus, all the treatment takes place only in the clinic.
The first phase: history and treatment planning
The therapist will take the complete history of the traumatic event/events. He will then conduct appropriate assessments to identify the specific memory targets for the treatment process. The targets may include current triggers and memories regarding the trauma. The future goals of the patient are also taken into consideration.
During this phase, the therapist will explain the treatment procedure to the patient. The therapist introduces the patient to the different accessory procedures. These will be utilized during the therapeutic process. The therapist will explain and teach bilateral stimulation to the patient like eye movement, tapping, etc. The therapist also introduces breathing exercises and relaxation techniques so that the patient can control the response if it trigger induces memories or emotions related to PTSD.
The third phase of the EMDR therapy is assessment. During this phase, the therapist asks the patient to focus on the memory that is to be targeted. The following memory components are assessed:
- Body sensation
- How the memory affects the patient
During this phase, the therapist will also conduct two psychological measurements to evaluate specific changes in the cognition and emotions of the patient and the emotions. These are:
- Validity of cognition [VOC] scale
- Subjective units of disturbance [Sud] scale
These measures help judge the patient’s response and therapeutic outcome completed before moving to the next phase. It is imperative that you understand what is the validity of cognition and subjective units of disturbance before you enroll in EMDR therapy.
Validity of cognition scale
To measure this, though therapist asks the patient to focus on a positive cognition when focusing on a specific memory. In the next step, the patient marks the positive cognition on a scale of 1 to 7. Here, one means completely false, and 7 means completely true.
The patient says that he feels 2 regarding a specific positive cognition like a survivalist attitude. This indicates that the patient does not see himself as a person who was strong and survived the trauma.
Subjective units of disturbance scale
Once the patient identifies a specific emotion regarding a past memory, the clinician will ask the patient to mark said emotion on a scale of 0 to 10. On this scale, zero is neutral or absence of disturbance, while 10 will be the highest level of disturbance that the patient can feel. This, too, is recorded at different intervals during the treatment process. It helps measure the patient’s response to the treatment.
Once the therapist reaches this state, he asks the patient to focus on the traumatic memory while engaging in bilateral stimulation. As I have mentioned before, bilateral stimulation can either be eye movement, tapping, or any other physical activity. When the patient is using the bilateral stimulation, the therapist will determine their focus. During this phase, the patient will report whatever new thoughts may appear regarding the incident. The primary objective of this phase is to enable the patient to stop seeing the traumatic memory as distressing.
This is the fifth phase of EMDR therapy. Here, the positive cognition that the patient has started to identify is further strengthened by using different relaxation techniques. The bilateral stimulation techniques help during this phase.
The body scan is the sixth phase of the treatment process. During this phase, the therapist asks the patient to be mindful of the bodily sensations when the patient focuses on the past trauma. The patient focuses on the incident and the positive responses. While doing this, the patient identifies if there is any residual stress. The bilateral stimulation is again employed to process the memory if the patient reports any disturbance.
The closure ends the therapeutic session. The focus of closure is to provide specific techniques and instructions to the patients and send the patient home with actionable steps that can be taken if the past trauma resurfaces before the next session. This allows the patient to be safe in the absence of the therapist.
This is the final phase of EMDR therapy. During the re-evaluation phase, the therapist will use the different psychological tests to measure the patient’s responsiveness towards the therapeutic process. The patient’s present psychological state is monitored. The therapist identifies whether the treatment has taken effect or if it requires more therapy. If there is more than one traumatic memory, the therapist decides if it is safe to move on to the next memory or if the current memory requires more sessions.
Now you know how EMDR therapy works for PTSD. However, there are certain things that you must know before you start the therapy.
Other therapeutic options for past traumas:
What must you know before starting the EMDR therapy?
Even though the procedure of EMDR therapy is effective and safe, there are certain side effects that the patient may experience. These are:
- Realistic and vivid dreams
- A heightened response to emotions or physical sensations.
- Lightheadedness, dizziness, or vertigo.
Even though EMDR takes multiple sessions to take effect, you may start seeing visible improvement right after the first session itself.
A few other points to keep in mind when you start EMDR therapy
The beginning of the therapeutic sessions may bring discomfort, emotional distress, and unexpected bodily sensations, especially if you are dealing with a traumatic past.
EMDR may also seem less overwhelming than all the other psychotherapeutic techniques since it does not involve the patient talking about their traumas in vivid detail or at length.
This is why relaxation and mindfulness techniques are important parts of EMDR therapy. These techniques can come in very handy if you are experiencing unwanted emotions or feel distressed. In case you feel distressed during the therapeutic process, your therapist will guide you to the present using relaxation techniques, breathing exercises, etc.
EMDR therapy has not only been successful in treating past traumas related to war, accidents, or CBD. It can also target panic attacks, anxiety disorders, childhood traumas, etc. EMDR for anxiety has proven to be extremely beneficial for various anxiety disorders.
EMDR therapy involves eight different phases. It starts with the identification of the traumatic events. It ends with the patient viewing the traumatic events in a different light. Even after the therapy completion, patients should continue the relaxation techniques to successfully keep all of the past traumas or triggers at bay.
Have you tried EMDR therapy? How has your experience been? Would you suggest EMDR as a therapeutic approach for others suffering from PTSD? If yes, why? If not, why not? Your experiences may encourage someone else to go into therapy. If you think you are a good candidate for EMDR therapy, discuss the same with your psychologist. The psychotherapists who work with EMDR therapy are specifically trained in assessment methods, bilateral stimulation, and various other techniques to help the therapy be successful. Therefore, make sure that the therapist you consult for EMDR has the right certifications.
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We all must accept that we have skeletons in our closets. The sooner we start to deal with them, the better our mental health will be. Please subscribe to the Guilt Free Mind if you have found this post insightful. I will send you notifications about the release of new blog posts. This way, you will never miss out on available therapeutic approaches, tips, and tricks for boosting your mental health, improving confidence, and leading a better life. If you have any queries about this blog post or any other article on Guilt Free Mind, please reach out to me on any of my social media channels. You can also mention your queries in the comment section or email me the same. I will be happy to help.