emdrs  2 Jan 2004 - 23:31   

EMDR is a relatively new therapy developed originally by Francine Shapiro (in the USA) in the late 1980s to deal with trauma. EMDR appears to allow emotional and cognitive material to be reprocessed and resolved much more quickly than by using the traditional therapies alone. Intense fears and anxieties (including panic, phobias, the consequences of abuse, rape, miscarriage and bereavement) are likely to be assisted by the use of EMDR, sometimes in combination with traditional therapies. Fortunately, many conditions seem to respond much more quickly when EMDR is used. It is not fully understood why the method works so well but research data are being evaluated continuously. EMDR should only be used by clinicians skilled in both EMDR and the longer established therapies for any given condition.

Models and theories have been proposed, consistent with a number of therapies. It is thought that during the extreme stress of a traumatic incident the brain quickly stores information to enable the subject to survive and act in an emergency. Normally, for those who do not need assistance later, the brain appears to reprocess this information over time (perhaps during sleep) so that it is coded more efficiently into normal memory, so that it does not provoke stress when accessed. Those who need help are people who we think are unable to reprocess (without assistance) the emotional and logical memories and beliefs into a more efficient and less painful, coded information memory. Some sufferers tend to keep their minds occupied, so as not to be overwhelmed by painful thoughts or images. EMDR appears to allow the brain to lift its ‘emotional barriers’ so that adaptive information processing takes place allowing integration of the logical and emotional understanding of the events. EMDR tends not erase memories; on the contrary, more memories are likely to be accessed than with traditional methods. However, as with any therapy, factual accuracy is not assured in accessed personal memories. Interpretation of human memory varies with time, and distorted perceptions can occur even without therapy.

The clinician carefully prepares the patient and obtains informed consent before treatment. It is important to screen for pre-existing contraindications but there few known exceptions as to who might be helped. During therapy, the clinician helps the patient to locate ‘faulty cognitions’ (as in cognitive therapy) and assists appropriate beliefs to re-establish during reprocessing. In this way, patients no longer fear their thoughts or re-live past events and emotions. It is believed that EMDR appears to activate the brain’s natural healing processes. As the name EMDR suggests, eye movements are most commonly used to stimulate the processing in EMDR therapy but, increasingly, other forms of stimuli to direct the patients' attention are used in EMDR. Dual Attention Stimuli including bilaterally presented sounds and touch are now commonly used. After the EMDR sessions, processing of new material and memories might naturally continue at home for some time as part of the healing process. Patients are usually asked to keep a log of any worrying thoughts or vivid dreams between sessions, and bring these to the next appointment.

For many patients, benefits can occur far more quickly than with other therapies but feelings during therapy might also be intense. However, using EMDR can also be a more gentle way of accessing painful memories because patients remain aware of the ‘present’ context (Dual Attention) and experience their memories camparatively briefly. Therapy sessions are usually scheduled for 2 hours so that good resolution (or closure) can be achieved on each occasion. It is anticipated that fewer sessions will be required (but not guaranteed) compared to when using traditional therapies.

Having used the more traditional therapies since 1979, I am impressed by the way EMDR has considerably reduced the overall time in treatment for my patients. However, as with any treatment, guarantees cannot be given because all individuals respond differently. These statements represent my personal understanding about EMDR. If you have enquiries about EMDR or its outcome data, please feel free to contact me: pdutton@synapse2000.co.uk

Additional Information about EMDR plus links to research studies comparing the effectiveness of EMDR with other treatments are available on this site. www.emdrs.org.uk

P V Dutton - June 2000