by Wendy Gibbs
Therapist, Sarkis Family Psychiatry
EMDR (Eye Movement Desensitization and Reprocessing) is a distinct, comprehensive, integrative psychotherapy approach that is compatible with all major therapy orientations. The EMDR approach defines non-organic pathology as unresolved memory networks that develop dissonant emotional and somatic stress from negative self-cognitions developed in response to trauma. Negative self-cognitions such as “I’m worthless”, “I don’t belong”, and “I’m powerless" are examples of the faulty self-perceptions that define, attract, and skew the perceived human experience and trigger symptomology. In short, the goal of EMDR is to empower a patient to have the freedom to self-actualize by choice.
The eye movement in EMDR is intended to stimulate the eyes in a lateral back-and-forth motion for measured sets of 10-30 passes akin to the occipital lobe’s stimulation during REM sleep. A clinician uses visual or tactile cues to initiate the bilateral eye-movement while the patient processes a targeted present-life experience that causes distress. A clinician will take frequent breaks in movement, noting discomfort and dissociation, and request feedback from the patient as emotional and somatic distress resolves. As processing allows neurotransmission to follow present distress to prior distress of similar nature, the links in memory allow the patient to discover the originating trauma(s) that produced negative cognition(s). A session patterned with several sets of bilateral stimulation and clinician-prompted cognitive interweave gives the patient the insight necessary to realize a new, positive belief that is intrinsic to the identity of the person.
EMDR treatment is structured to protect the patient’s vulnerability and limit the stress of exposure to traumatizing events. EMDR protocol includes a full bio-psycho-social-sexual-trauma history with screening for highly-dissociative patients, psychoeducation about the risks and benefits of EMDR therapy and grounding techniques, the development of a targeted treatment plan, bilateral processing, identification of adaptive positive cognitions and available resources, somatic processing, and integration of new positive cognitions into larger systems. Continued supportive therapy sessions reinforce and template future positive cognition integration.
To date, there has been over 18 randomized controlled treatment outcome studies of EMDR in the treatment of single trauma PTSD with a 77-100% remission rate using 3-6 sessions. Similar remission outcomes in complex trauma cases typically consist of 12 sessions lasting 50-90 minutes per visit. The current body of research also indicates EMDR efficacy for the treatment of panic disorder, dissociative disorders, somatoform disorders, anxiety disorders, body dysmorphic disorder, addictions, resolution of sexual and physical abuse, stress reduction, and relief from disturbing memories and cognitions. Current research is addressing the efficacy of EMDR with depressive symptoms and personality disorder clusters.