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EMDR and how it can resolve stress and PTSD

Thursday, June 19, 2014  
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EMDR is the abbreviation for "eye movement desensitization and reprocessing". It is quite a mouthful for something that looks, at least on the surface, very simple. Used appropriately the approach can be very helpful as a tool in counseling and psychotherapy to resolve post traumatic symptoms and to unblock trapped emotions and thoughts.

There is a substantial and growing body of research and authentication for the efficacy of EMDR when compared with CBT and 'eclectic therapies'. For example to quote the World Health Organization's (2013) guidelines for the management of conditions that are specifically related to stress: "Trauma-focused CBT and EMDR are the only psychotherapies recommended for children, adolescents and adults with PTSD. Like CBT with a trauma focus, EMDR therapy aims to reduce subjective distress and strengthen adaptive cognitions related to the traumatic event. Unlike CBT with a trauma focus, EMDR does not involve (a) detailed descriptions of the event, (b) direct challenging of beliefs, (c) extended exposure, or (d) homework." 

When effective, the person may find themselves freed of the nightmares, fears, grieving and seemingly out-of-control symptoms and reactions that they have suffered from for years. The results are shown to be permanent over time. In the face of triggering events that previously set off an avalanche, they are able at last to feel back in the driving seat of their reactions. Instead they are responding - having a sense of distance from the past event, and a calmer sense of choice about their position in the here and now.

To a fly on the wall EMDR looks pretty odd - the client and therapist are sitting quite close face to face or side by side, while the client's eyes track the therapist's hand or pen as it waves quite quickly side to side in front of them. This is the 'eye movement' referred to in the title. Alternatively, the therapist might be tapping alternately on the back of the client's hands for brief periods, as the client sits with their eyes open or closed, possibly showing emotion, but not saying anything.

'Desensitization' refers to those overwhelming physical and emotional reactions which can trouble a person long after the original event took place - covered by the term 'post traumatic stress'. For example, after an accident some people find that for no reason they can rationally explain, at times they are vulnerable to being overwhelmed by the original physiological reactions of the past event - a rush of adrenaline, gasping for breath, panic, the contraction of blood to key organs that makes the skin feel clammy or cold, or with goose pimples, perhaps tearfulness and inability to think straight.

'Reprocessing' refers to the way in which the technique enables the person to work through their thoughts and feelings that are related directly or indirectly to the experience they are choosing to work on. In counseling and psychotherapy this is intrinsic to the process of talking therapies and the complex exploration and unfolding that can happen. With EMDR this relational and exploratory aspect is not replaced but it concentrates some of the rational and emotional processing so that results can be achieved more quickly.

A trusting therapeutic relationship is still an essential factor when working with EMDR, and so initially time needs to be invested in establishing that trust. In addition, the therapist will need to assess that the client is psychologically stable and resilient enough and can calm themselves, with no psychotic or dissociative symptoms.

In an EMDR session there is less exploration - the therapist does not need to understand or know everything with the client. The therapist is facilitating and supporting the client's accessing of memories, associations and feelings within a carefully researched psychological framework. There is no interpretation at that point, and in many cases the client will not feel the need for it. Somehow the processing taps into the deeper experience of the person in a way that feels satisfying and true. Later it may be appropriate to explore the outcome together, but essentially, if EMDR is successfully carried out, the work is done.

There is an increasing body of credible research on how and why EMDR is so effective. The results speak for themselves - liberation from debilitating, stuck reaction patterns, the ability to move on in life, and a sense of relaxation and empowerment.


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