Counselor Jenn’s Guide to EMDR

What is EMDR?

EDMR, otherwise known as Eye Movement Desensitization and Reprocessing, is a powerful type of psychotherapy used to help millions of people all over the world. Created in the late 1980s by Francine Shapiro, it is a holistic, evidence-based form of treatment that incorporates aspects of several other models. These include cognitive, behavioral and interpersonal. Although originally developed as method to treat PTSD, it has been found to be successful treating many other disorders, like anxiety, phobias, PTSD and grief.

“Holistic, evidence-based treatment that incorporates

aspects of several other models”

EMDR works by enabling an individual to heal from major emotional distress through reprocessing memory. When we experience trauma, we often hold onto that pain and it can cause us to issues long into our lives. These can manifest in the form of symptoms like depression, feelings of worthlessness, sleep problems, phobias…the list goes on. It’s often believed that if we suffer from these types of symptoms, it can take a long period to recover. EMDR indicates this doesn’t have to be the case. If we can learn to reprocess a painful memory, we allow ourselves to heal much faster.

Reprocessing basically involves teaching yourself to treat the memory differently. This is done by encouraging an individual to recall the painful image and describe the emotions trigged by it – all in a safe space with a professional. This is when the most important part of the treatment happens; the clinician asks the individual to focus on a movement, usually their finger moving side to side. This makes the eyes move as if watching a game of tennis. This movement stimulates both sides of the brain and starts to reprocess the memory, whilst imitating REM sleep. Eventually after enough sessions, the memory does not cause the same reaction in the individual as they have learnt a ‘new’ way to think about it.

“tends to be more effective over a shorter period of time”

There are many positives to this type of treatment. In comparison to more traditional forms of therapy, it tends to be more effective over a shorter period of time. This has been proven by many studies undertaken since its development; so much so it’s now fully recognized as a legitimate method to treat emotional trauma by organizations such as the WHO, American Psychiatric Association and the Department of Defense. In one study 83-90% of trauma victims claimed it to be effective in treating their PTSD (Rothbaum, 1997) and many others mirror this high rate of success. Thanks to its accomplishment in this field, professionals began using it to help with other disorders finding it just as successful.

The great thing about EMDR is how fast it can help you while also addressing the core issue and treating it directly. You still remember all that happened but your brain has transformed it, so it doesn’t have the debilitating effect. It works best when used in conjunction with other traditional therapy.

How Does EMDR Work?

When a traumatic incident happens to us, we understandably want to avoid thinking about it as it causes stress; but by choosing to evade this memory we are unable to process it fully. This is because our brain is constructed to protect us. We have our human, conscious brain, our mammal, emotional brain, and finally our reptilian brain. When presented with trauma our brain switches off the first two as a safety mechanism, leaving the latter in fight or flight mode to protect us. This works at the time to keep up safe, but what happens to the memory that we didn’t process?

Unprocessed emotions can lead to the symptoms we talked about earlier: depression, anxiety, sleep problems, phobias, and addiction to name a few. The issue is that the initial distressing memory is still intact and every time we recall it, it causes immediate pain. Imagine if we hurt ourselves physically and the wound was not allowed to heal. This is what happens to our mind and it can affect how we interact with people and our opinions of ourselves.

“the initial memory is still intact, and every time

we recall it, it causes us pain”

EMDR works by encouraging the individual to recall a traumatic memory in a controlled environment. The purpose of this is to reprocess and ultimately reach a peaceful resolution. Long-held negative emotions, like the feeling of shame a rape victim may feel, are subject to new insight. Reprocessing doesn’t mean to simply talk about the event. Instead, it means to set up a learning state that will allow past experiences that previously caused problems to be stored in your brain in a healthy way.

This is done through an 8-step process which needs to be administered by a professional. The clinician in this situation asks the individual to picture the first traumatic event in their past, discuss their emotions, and how their body is responding to the stressor. The individual is then subject to external stimulus, usually in the form of clinician moving their finger from left to right.

“You’re giving your brain the opportunity

 to reprocess this memory”

By focusing on this motion, the eyes are imitating bilateral movement, causing both sides of the brain to be stimulated – something commonly found in REM sleep.  REM sleep is believed to be the time during which we process all external stimuli we receive in a day, so you’re basically giving your brain the opportunity to reprocess this memory, but in a different way. This causes the vividness of the trauma to decrease and gradually the individual becomes desensitized.

Throughout this process, the individual is encouraged to express their emotions in order to eventually move to a peaceful resolution by expelling negative beliefs about themselves/the incident. Once this obstacle has been overcome, the individual can begin to heal properly and normal brain processing can resume. It’s not that you forget what happened to you, you just remember it in a less distressing way.

What Kinds of Problems Does EMDR Treat?

EMDR was originally devised as a method to treat Post Traumatic Stress Disorder, but it has since been found to be just as effective in treating numerous other conditions. These include:

• Panic Attacks

• Insomnia

• Addiction

• Depression

• Phobias

• Anxiety

• Performance Anxiety

• Test Anxiety

• Sleep Disorders

• BDD

• Pain Disorder

• Dissociative Disorders

• Extreme Anger

• Stress

• Grief

• Low self-esteem/feelings of guilt and shame

• Relationship Problems

• Trust Issues

There are many root issues which cause difficulties in our life. EDMR can help reprocess the following problems we may have experienced in the past:

• Sexual Abuse

• Physical Abuse

• Mental Abuse

• Witness to Violent Acts

• Assault

• Natural Disasters

• Childhood trauma

• Chronic Illness/Injury

EMDR is found to be most effective when it is used in partnership with other traditional forms of therapy, with the goal being for the recipient to return to their pre-trauma state.

The reason for its success in such a varied field is as follows:

1. It generally decreases stress levels over a period of time, improving overall mental and physical heath.
2. It helps to overcome numerous mental blocks in an individual’s life, putting painful memories to rest.
3. It assists an individual in attaining achievements in their life, thanks to an increased self-worth
4. In terms of addiction, it can help to alleviate the physical and mental pain one feels during withdrawal.
5. It builds up a person’s resistance, helping them to overcome situations which may have caused a relapse into negative thinking patterns. Now a person can deal with stressful events in a calmer, quicker, stronger way.
6. EMDR allows a person to move away from old habits by eradicating the blocks that cause negativity. For example, an addict can stay clean and those with anger issues are able to control their outbursts.

What Kind of People Can Be Treated By EMDR?

There are numerous things to think about when considering if EMDR is the right path to take for you. Having an initial consultation with an EMDR specialist will help to make you understand the therapy more fully and see if it will work for your situation. Remember, it works best alongside other forms of therapy.

In terms of children, studies have shown they are even more responsive to EMDR treatment. This is probably because children are generally quick to learn and adapt, so reprocessing can be easier for them. They’ve also had less time to settle into negative thinking patterns. Another good reason to use EMDR with children is that it can be presented as a game – and it can be very effective with less verbally confident children.

The History of EMDR

It might surprise you to know that EMDR was discovered by accident. Dr. Francis Shapiro was strolling through a park when she began having upsetting thoughts, which then seemed to disappear. She wanted to know the reason why, and as a graduate studying psychology she was in a perfect position to do so. She began experimenting with the notion of EMDR; finding when speedily moved her eyes from side to side whilst remembering something distressing, the emotional disturbance seemed to lessen. After experimenting on others using the same technique, she found similar results.

Shapiro then continued her research, discovering that bilateral movements had the potential to reduce anxiety-provoking thoughts. It became apparent to her that in order to make the therapy more effective other elements, such as a cognitive component, would have to be added. These became the building blocks which created the standardized form we use today.

“significantly less distress and more

confidence and positivity in comparison”

The next step was to conduct case studies to further ensure the effectiveness of EMDR. In a controlled study Shapiro chose 22 participants, all of whom had tragic events in their past. Half of the group received EMD (Eye Movement Desensitization) whereas the other received similar treatment but with imagery and description in place of eye movement. It was reported that those who experienced the EMD felt significantly less distress and more confidence than those in the other group.

In the year of 1989, Shapiro’s and three other studies were published addressing EMDR. These included The Brom et al, in which 60% of participants expressed a lowering of trauma-related symptoms. During this time, Shapiro stated that a “single session of the procedure was sufficient to desensitize traumatic memories”. This did not mean that EMDR can ‘cure’ PTSD in one session; however, it can serve to help with the anxiety. She also stated that it takes an average of five sessions to treat PTSD comprehensively – although this is of course dependent on the individual.

“controlled studies were completed (…) literature detailing the procedure was published and additional training set up”

Throughout the following years, Shapiro developed and evolved the treatment based on feedback from both clients and practitioners. It was during this time she changed the name to EDMR, to represent the cognitive additions and information processing theory that became a part of the treatment. Due to its strong success rate over such a short period of time, Shapiro began to teach this technique to other licensed professionals. When other controlled studies were completed to support EMDR, literature detailing the procedure was published and additional training set up. Since then the American Psychology Association named it as one of three treatments suitable and effective for PTSD. Since then there have been hundreds of studies and thousands of people who have been treated using EMDR. In 1995 an independent organization, the EMDRIA , was set up to assist with the training and practice of the procedure. EMDR is a safe and effective way to heal, find comfort ad move forward with your life.

What to Expect in an EMDR Therapy Session

It is important to realize that EMDR is a complicated procedure that must be carried out correctly by a professional in order to for it to be safe and effective. It consists of 8 steps and combines many different elements, focusing on the past (the traumatic events), the present (how that effects our emotions and body now) and the future (learning skills to help moving forward).

Phase 1

The very first phase is used to explore the individual’s history. It’s the clinician’s job to ensure the client is ready for the procedure and to create a plan for treatment. The person may discuss traumatic memories, as well as current issues and symptoms. Targets can be made, with the aim of developing new skills and learning behaviors for the future. One of the positives of this treatment is that an individual can be as specific or as vague as they want, making it less intrusive. This phase is generally only used in the first few sessions, however if additional memories are uncovered it can be used again.

Phase 2

This phase involves the clinician preparing the client for the emotional pain they’ll be going through in future phases. This is done by teaching them rapid stress reduction and calming techniques. These can be used both during sessions and in their day-to-day life. Once you’re able to able to apply these techniques, you’ll move to the next phase. This phase also builds a relationship of trust. It generally lasts 4 sessions, but again this depends on the extent of the trauma.

Phases 3-6

In these phases a target memory is identified then reprocessed using EDMR. The first step is for the person to think about a scene or image from the target memory – the one(s) discussed in phase one. The person then expresses a negative self-belief about that event, for example “I am worthless”, which verbalizes their emotions. Next the person picks a positive statement they would prefer to believe, which should be empowering. The clinician then assists with estimating how true they feel about the positive statement on the Validity of Cognition (VOC) scale. They’re also asked about the distress they feel based on the Subjective Units of Disturbance scale (SUD).

The individual then focuses on the image, how their body reacts, and the emotions they feel – whilst at the same time engaging in the reprocessing stimulation. This tends to be in the form of the practitioner moving their finger from left to right with the client’s eyes following, but it could be hand movements or auditory stimulation. Following this, the individual is instructed to clear their mind and take note of the feeling or image. The practitioner may then choose to focus on another event and repeat the process. If the individual becomes too distraught, the practitioner adheres to additional steps to assist them.

The final part of this stage aims for the participant not to feel any physical response in relation to the traumatic event. A session is only considered successful if there is no physical response, as unprocessed memories are stored in our body physically. Once they are reprocessed they move into our narrative memory. The individual is finally asked to recall the positive belief detailed earlier.

Phase 7

This part is the closure of the session. The practitioner requests the individual to keep a log of their week until the next meeting, and encourages the learnt relaxation techniques. The aim is for the individual to feel better leaving the session than when they came in.

Phase 8

This phase begins at the start of the next session. It’s when progress is discussed and reviewed, with the aim of positive results and behaviors being maintained. New targets may also be considered.

On average sessions tend to last 60-90 minutes. In terms of how many sessions EMDR needs, most research studies are based on 3-10, but that is often due to funding/time constraints etc. The amount of time and how many sessions you need are dependent on your unique situation and will be determined by your clinician. This is because it’s contingent on the type of trauma, how many times it is experienced, how complex it is, and finally what resources you have to assist with it.

EMDR in Western New York

EMDR is a well-researched, proven and clinical method of therapy. In comparison to other forms of treatment the period of recovery is much shorter, making it both less expensive and more convenient. The phases and techniques used to ensure the effectiveness of it are complex and intricate – especially due to the stress involved in recalling traumatic memories. In order to guarantee the safety of the individual, the clinician must be properly trained in the intricacies of the process. Certification is provided by the EMDRIA, who regulate and keep the training up-to-date.

When choosing a clinician to work with, you need to ensure they have sufficient qualifications and experience, not just in EMDR but also in other fields of therapy that may be beneficial. You may want to consider their specializations; for example, perhaps they concentrate on working with those with anxiety or with children.

If you live in the Western New York and are looking for a qualified clinician who will be able to provide you with current, professional EMDR therapy and more, then contact Jennifer Nahrebeski. Jennifer works with children, families and adults, and offers a variety of treatments that partner well with EMDR including the following for children:

• Talk Therapy

• Play Therapy

• Sand Therapy

• Therapeutic Games

She has a wealth of experience helping children with anxiety, PTSD and trauma, dual diagnosis and autism. For adults, Jennifer uses a positive and comforting style to help address and give individual’s the tools to manage disorders such as anxiety, depression, trauma and PTSD.  She also assists with family conflict and parenting issues.

Jennifer’s Experience

Jennifer’s has a wealth of experience in counseling, including 15 years at a school facilitating both individual and group counseling. She has worked with the Child and Family Services, providing assistance to those in crisis.  She also spent time with the Forensic Mental Health Department at Erie County Holding Center, treating those with mental illness and aiding with detox and recovery.

One of the main reasons for Jennifer’s success is her approach. She treats every individual with care and is truly passionate about making a change for their life in any way she can. She does this by working with clients to create a unique treatment plan and targets that will provide them with the best possible, professional and personal care.

If you want to start your journey towards healing in the most effective way possible, EMDR may be the path for you. If you have any questions about how EMDR works and how it can be partnered with traditional therapy, contact Jennifer for further information.