What is EMDR?
Eye Movement Desensitzation and Reprocessing (EMDR), is a therapy for people who are continuously burdened by the consequences of traumatic experiences. This can be a shocking experience, such as an automobile accident or a violent crime. However, it can also be applicable to other experiences that have had a lot of influence on the development of one’s life; and still affect their here and now, such as bullying or injuries/abuses experienced in childhood.
What is the purpose of EMDR?
Certain events can deeply interfere with the lives of people. For the most part, many victims are able to cope with these experiences on their own. However others can develop psychological complaints. This most often involves intrusive memories of the shocking event, in which frightening images (re-experiencing or “flashbacks”) and nightmares occur. Other complaints that often surface are fear and avoidance responses. If certain criteria are met, this is referred to as ” post-traumatic stress syndrome” or PTSS.
EMDR can also be useful for a variety of mental disorders and complaints that are associated with avoidance behavior, sorrow, and/or feelings of fear, shame, sadness, guilt or anger. However, the starting point is always that these symptoms originate as a consequence of one or more damaging experiences. Examples of such are: emotional neglect, negative medical experiences, work- related events, and other shocking, shameful, or otherwise extreme experiences.
The main approach of the EMDR therapist is to help the client process the memories of these events, with the intention of reducing or eliminating the accompanying complaints.
Which types of events can lead to problems with coping?
- Car Accident
- Accident, injury or sickness
- Victim of an attack
- Rape or assault
- Loss of a job
- Natural disaster
- Diagnosis of a serious illness
- Witness of violence
- Loss of a loved one
- Loss of a child
Experiences that occurred earlier in life or more recently, persisting over a longer period of time:
- (sexual) abuse or assault
- persistent neglect and loneliness
- serious illness or diagnosis of a terminal illness
- fertility problems or childlessness.
Which types of complaints can occur following a shocking experience?
People can be faced with various complaints following a shocking experience or after having been exposed to disruptive experiences for a long period of time.
- Re-experiencing the event (s)
- Avoidance behaviour regarding the event (s)
- A constant feeling of being in a high state of alertness
- Persistent stress
- Shame or guilt
- Bad temper/irritability
- Worrying or milling over thoughts
- Feelings of fear and panic
- A negative view of self and low self- esteem
- Sleeping, sexual and eating problems
- Relationship problems
- Physical problems which have no explicable cause.
How does EMDR work?
The therapist will ask you to remember the event, including the associated images, thoughts and feelings. This will take place first, in order to collect more information about the traumatic experience. After that, the coping process is started.
The therapist will ask you to bring up the event in your mind. However, this will now be in combination with a distracting stimulus, for instance through the use of headphones, in which the sounds will alternate from left to right.
The EMDR procedure usually brings forth a stream of thoughts and images, but sometimes feelings and bodily sensations as well. After a few “sets” of sounds have been presented, the experience of the unpleasant event changes, and the negative feelings that are associated with the memory of the event begin to slowly fade. Sometimes multiple sessions are necessary in order to cope with an unpleasant event. Each session will always be concluded in a positive manner.
What are the anticipated effects?
The presented sets of sounds will gradually lead to the memory losing its power and emotional charge. So it will become easier to reflect back on the original event because there is less room in your mind for the unpleasant aspects of the same situation.
Another possibility is that spontaneous new thoughts or insights are generated, which give the event an alternative and less threatening significance. These effects contribute to the person being able to find an appropriate place for the shocking event in the history of their life.
Are there also disadvantages?
After completing EMDR therapy, the effects can continue to work, which is a positive and intended result of the therapy. However, in some cases, it can give the client the idea that they have lost control; for instance, if new images or feelings arise. Therefore it’s reassuring to know that this usually lasts no longer than three days. Afterwards, a new balance should occur.
It is typically advised that a journal be kept, in order to write down what comes up during this time. These things can then be addressed in the sessions that follow.
Does EMDR work and what is the scientific status of this method of treatment?
Much research has been done into the effectiveness of EMDR. Results show that clients react well to EMDR. In the case of a trauma being caused by a single traumatic experience, a few sessions appear to be sufficient for people to be able to go back to their normal daily life activities.
How does one know whether EMDR is appropriate? At the start of the therapy your EMDR therapist will focus extensively on the cause and the background of the complaints. In addition, an evaluation will be made of a number of individual characteristics including personal strength and level of suffering caused by the complaints. This will indicate whether targeted trauma treatment is necessary or called for at that moment and whether EMDR is appropriate for this treatment.
Currently, several studies have been done on the effectiveness of EMDR. This makes EMDR the most evaluated treatment in the area of psychological trauma. According to the most recent guidelines of the International Society for Traumatic Stress Studies (ISTSS), the American Psychiatric Association (APA), and the UK government (NICE), EMDR together with imaginaire exposure, is the “treatment of choice “ for psycho trauma.
The Dutch guidelines commission under the auspices of the Trimbos Institute gave similar advice (www.ggzrichtlijnen.nl)(Dutch only).