EMDR

EMDR: Eye Movement Desensitization and Reprocessing

Eye movement desensitization and reprocessing (EMDR): EMDR was developed by Dr. Francine Shapiro and is a research-supported, integrative therapeutic approach designed to treat symptoms of trauma and post-traumatic stress disorder (PTSD). EMDR sessions use bilateral stimulation, such as eye movements, auditory sounds or hand tappers to help client process unresolved memories from adverse experiences such as trauma. EMDR has also been found to be effective in addressing a number of other concerns and it is compatible with other types of therapy. 

Theoretical Foundations for EMDR

The adaptive information processing (AIP) model—the theoretical framework for EMDR therapy—explains that some memories associated with adverse life experiences may remain unprocessed due to the high level of anxiety or disturbance experienced at the time of the event. The stored memory may be linked to emotions, negative thoughts, and physical sensations experienced during the event and the unprocessed memory can affect the way a person responds to subsequent similar negative experiences in life. Through EMDR therapy, these fragmented memories can be reprocessed so that they become more coherent and less disruptive to everyday life.

EMDR Effectiveness:

EMDR has been accepted as an effective form of treatment by several major health organizations including the World Health Organization (WHO), the American Psychiatric Association (APA), and the Department of Defense. Studies show that it is possible to alleviate distressing symptoms more rapidly with EMDR than with talk therapy alone (Shapiro, 2001). One of the reasons EMDR is effective is our brain is designed to hold difficult emotions/sensations/images from our life experiences in our right hemisphere while most of our language processing is in our left hemisphere. Traditional talk therapy is largely limited to your left brain hemisphere. Adding the stimulation of hand tappers, sounds or eye movements helps to access the memories, images or emotions that are biologically stored in the right hemisphere of the brain. Because discussing the details of a traumatic experience is not necessarily required in EMDR sessions, the anxiety associated with confronting and revealing those details may be alleviated. 

EMDR Therapists:

Therapists offering EMDR are licensed mental health professionals who have received specialized training through the EMDR Institute or the EMDR International Association. At a minimum, medical and mental health professionals must have participated in a basic EMDR training course to become EMDR practitioners. Some practitioners choose to seek further training in order to achieve EMDR Certification or to become an EMDR Approved Consultant. 

Therapists at Firefly Counseling Services, P.C. providing EMDR treatment for clients have completed their specialized training in full and have been supervised by approved EMDR Institute supervisors. We also believe that the use of EMDR can be utilized from an attachment principle often cited as AF-EMDR (Parnell, 2013). These principles include:

Fostering client safety
Developing and nurturing the therapeutic relationship to facilitate healing
Using a client-centered approach
Repairing neural networks through the use of the AIP model and Resource Tapping.
Using modified EMDR whenever the client needs or indicates a need to do so

EMDR Sessions:

Although EMDR was originally designed to treat posttraumatic stress, it can be used to address other adverse life experiences or negative beliefs. For example, many clients report feeling relief from symptoms of anxiety, depression, phobias, relationship struggles and early childhood distress, attachment or grief and loss including experiences such as divorce During sessions, the counselor and client may identify a distressing event or negative belief that would benefit from EMDR. The practitioner will spend at least one therapy session describing EMDR and preparing the person for the process, and specific EMDR sessions will be scheduled. It is important to keep in mind that a therapist at Firefly Counseling Services, P.C. will not adhere to a ‘cookie cutter’ model and expect client to fit a ridged or specific protocol. The standard tools and protocol are listed below, but again we believe in a client centered approach and modifying the procedure when needed to meet client needs.

EMDR identifies and processes memories of negative and traumatic events that contribute to present problems. After the person in therapy briefly accesses an unresolved memory, he or she will focus on external stimulus delivered by the therapist. These cues can include eye movement, taps, or tones. During each set of bilateral stimulus, or dual attention, new associations emerge in the form of insights, other memories, and new emotions. After each set, the client briefly reports what emerged in consciousness and the next focus of attention is identified for processing. The processing targets during EMDR therapy include past events, current triggers, and future needs.

 The Eight Phases of EMDR Therapy Include:

History taking: The therapist and client review past events, current concerns and future needs, and identify target events for processing.
Preparation and development of coping skills: To prepare for coping with any distress that may arise during the desensitization phase.
Assessment: With the distressing event in mind, the client’s negative beliefs about himself or herself are discovered e.g. ‘I should have done something’ –or- ‘I am in danger’. In contrast, a desirable positive belief is selected, and this belief is measured to determine how true it feels to the client. Physical symptoms or sensations are recorded as well.
Desensitization: Bilateral stimulation, in the form of eye movements, tones, or taps are used to reprocess the distressing event. The therapist will break periodically to check in on the client or ask questions if needed.
Installation: The client and therapist work together to incorporate positive beliefs into the memory network e.g. ‘I did the best I could’ –or- ‘It’s over now, I am safe’.
Client Self-Evaluation of Emotions and Sensations: Any residual physical tension or distress indicates that the event is not fully processed, and the reprocessing through tapping, sounds or eye movements continues, if necessary.
Closure: This phase will occur at the end of a session, regardless of whether or not the memory is fully processed. A complete sequence of EMDR therapy can take several sessions, and it is important to reach stabilization before the session ends. Closure can include guided imagery, grounding or discussion of the session.
Reevaluation: The next session begins here, in order to evaluate and measure the level of disturbance and the accuracy of the targeted positive belief. If the target remains unresolved, the session will resume with desensitization, phase 4. 
The two key elements of EMDR therapy are identified as the belief that bilateral stimulation (eye movements, tapping, auditory sounds) enhance the efficacy of therapeutic treatment through the development of physiological and neurological transformations, and that these changes actually assist the client in healing and recovering from the negative memories (Shapiro, 2001). Any questions about EMDR or what to expect when pursuing EMDR treatment can be answered by your therapist.

How is EMDR used with children?

EMDR is part of an integrated treatment approach and is often used in conjunction with other therapy practices such as play therapy, talk therapy, behavior therapy and family therapy. EMDR will be explained in child friendly terms and used when agreed upon by the family and child. Children and parents are always in control of the process. A typical EMDR treatment session begins in a positive way by having children use their imagination to strengthen their sense of confidence and well-being. For example, children may be asked to imagine a safe or protected place where they feel relaxed and comfortable or to remember a time when they felt strong and confident. Sometimes children will utilize props or play therapy materials to develop resources such as a calm place through art or sandtray. These positive images, thoughts and feelings, are then combined with the bilateral stimulation which can be tappers, finger puppets to promote eye movements or even skipping or marching in place. These beginning experiences with EMDR typically give children increased positive feelings and demystify the process of EMDR, so that children know what to expect. Therapists at Firefly Counseling Services, P.C. are play therapists at heart and believe in providing a playful, emotionally safe approach to any treatment with children including EMDR.

When agreed upon between the parent, child, and therapist, the child is asked to bring up an upsetting memory or event that is related to the focal problem. Bilateral stimulation is used again while the child focuses on the upsetting experience. When an upsetting memory or event is "desensitized" that means that the child can face the past events or memories and no longer feels disturbed, frightened, or avoidance of the thoughts and feelings attached to the event. The result of "reprocessing" simply means that the child has a more healthy perspective on the upsetting memories or events. The meaning attached to the event is no longer distorted nor interferes with the child's functioning or development. When the event is reprocessed, children can more comfortably believe and trust, "It's over." "I'm safe now." "I did the best I could." "I have other choices now."

Many children will continue to utilize their imagination throughout the process, which does not negatively impact the treatment. A child can choose a toy or prop from the play room to provide a resource while facing difficult memories. These resources may come in the form of nurturing figures, protector figures or wisdom figures (Parnell, 2013). The resources children choose become important to their story and assist in providing a safe space for reprocessing of the trauma, anxiety or attachment disruption. The therapist will provide feedback to parents in the form of a parent consultation bridging the information learned in session with support and coping at home.
Firefly Institute
Phone: 503-560-5822
Fax: 888-503-2864
Location: 
4950 NE Belknap Ct. Ste 205
Hillsboro, OR 97124
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