WHAT IS EMDR AND HOW DOES IT WORK?
There are a number of theories about how EMDR works. EMDR causes bilateral stimulation of the two hemispheres of the brain via the rapid, back-and-forth movement of the eyes; some practitioners may use alternating sounds or vibrations. This bilateral stimulation seems to accelerate the brain’s ability to process the trauma.It is the patient’s inability to effectively do this processing which is the main cause of the symptoms of PTSD. A decoupling of the sense of threat and the trauma is facilitated by the EMDR. This leads to positive changes in both emotional reactions and negative thought patterns in relation to the trauma. Excess anxiety and sleep problems begin to resolve. Improved function and more constructive thinking patterns then result.
WHAT HAPPENS IN AN EMDR SESSION?
The therapist works with the patient, asking them to start talking about the traumatic event- recalling feelings, thoughts and perceptions. Periodically, the patient is asked to focus on the therapist’s finger movements (side-to-side, to cause bilateral stimulation of the cerebral hemispheres), while focussing on a given aspect of the event. Some additional aspects include working on body sensations related to the trauma and instilling more positive statements re the event.
IS EMDR A TYPE OF HYPNOSIS?
EMDR is not hypnosis. Patients are fully awake and in control during the EMDR sessions.
IS EMDR SUPPORTED BY RESEARCH?
EMDR is the most extensively researched method of treatment for PTSD. Twenty controlled-outcome studies have investigated EMDR for the treatment of PTSD. It has been found to be more rapid, efficient and comprehensive in treating the trauma of PTSD than behavioural therapy and standard cognitive and psychotherapy treatments. Follow-up studies have found that patients who have undergone EMDR have maintained a high level of benefit at five years.
EMDR was discovered in 1987 by Francine Shapiro, a professor of psychology at UCLA. More than a dozen randomly controlled trials have shown its efficacy, including a 2007 study by Van der Kolk which found that EMDR was more effective for PTSD patients than Prozac, an antidepressant & anti-anxiety medication.
(For more research information www.EMDR.com)
HOW LONG WILL TREATMENT TAKE?
Studies show that PTSD symptoms from a single traumatic event can often be resolved in three to six sessions of EMDR. With survivors of multiple traumas, treatment usually takes longer.
The aim of EMDR treatment is to achieve the most profound and comprehensive treatment effects in the shortest period of time (The EMDR International Association). This has benefits to you in terms of suffering and cost.
IS THE TREATMENT DIFFICULT?
Many PTSD patients find it easier to gain benefit from EMDR than traditional psychotherapy and counselling, perhaps as it is more therapist-directed and actively targets the traumatic experience.
WHAT ARE THE SIDE-EFFECTS OF EMDR?
EMDR is normally very well tolerated and has minimal side-effects, the main being that you may be more emotional in the period immediately after the session; this is usually only in the very early treatment sessions for a traumatic event.
Memories of the traumatic event become more faint. This is a benefit, not a side-effect, however, if you are required to testify in a court of law regarding the event, this may be of relevance.
Flashbacks are now thought to be recurrent perceptions, not memories. PTSD patients need help to form memories from these perceptions and EMDR seems to facilitate this.
Nightmares in PTSD are believed to be an attempt by the brain to turn the perception into a memory.
The eye movement used in EMDR therapy seems to act a substitute for the REM (Rapid Eye Movement) sleep phase in which dreams occur and which is often disrupted in PTSD. EMDR enables processing to occur during waking hours to bypass the blockage.
Medication helps with the symptoms of PTSD, however it does not fundamentally resolve the disorder, as opposed to a course of treatment with EMDR.
During a traumatic event, patients affected by PTSD seem to have lost their ability to ‘make meaning’ from the situation. This is caused by a process called “dissociation” leading to thoughts, emotions and perceptions being stored without being processed.
EMDR makes use of the brain’s neuroplasticity. When a memory is activated, the chemistry of that neuronal circuit enters a malleable state. This presents an opportunity to decouple the patient’s feeling of threat from the traumatic memory.
The bilateral stimulation which occurs with EMDR leads to :
1) Reduced sympathetic nervous system arousal ( with less of the fear & stress response mediated by adrenaline etc); sleep & anxiety improve.
2) Reduced distress
3) Reduced mental avoidance
4) Increased distancing from the trauma
5) Activates the orienting response
