Eye Movement Desensitization and Reprocessing Essay

There are many events in a person’s life that can be considered traumatic. Trauma can be easily described as a distressing experience caused by an event or physical injury. The symptoms that follow a traumatic event can include disassociation, hyperarousal, and avoidance. Some people choose to cope with their symptoms in many different ways such as substance abuse, medication, and/or therapy. When working with trauma there are many diverse forms of treatment. Eye Movement Desensitization and Reprocessing [EMDR] is one form of treatment that appears to be effective. Eye movement desensitization and reprocessing is a treatment used in psychotherapy to alleviate distress associated with trauma (Shapiro, 1991). During EMDR clients reprocess information while focusing on external stimuli such as, lateral eye movements, hand tapping, and audio stimulation. Francine Shapiro developed EMDR in 1987 after discovering that eye movements had a desensitizing effect on herslef, and also after experimenting she found that others also had the same response to eye movements. In 1987, Shapiro named this approach to treatment Eye Movement Desensitization. A case study was conducted to test the effectiveness of eye movement desensitization. The results indicated there was a significant decrease in distress and increase in confidence in positivity (EMDR Institute, 2012). When this treatment was first discovered it was reported it serves to decrease anxiety and did not claim to eliminate all posttraumatic stress disorder symptoms. Gaining feedback from clients and clinicians this treatment continued to develop. In 1991 reprocessing was added to eye movement desensitization creating EMDR. Adding reprocessing was to reflect the insights and cognitive changes that occurred during treatment and to identify the information processing theory (that Shapiro developed) to explain the treatment effects (2012). In 1995 the EMDR International Association was founded to establish standards for training and practice (Shapiro, 2001). There have been many studies published in regards to posttraumatic stress disorder and demonstrating the effectiveness of EMDR. EMDR therapy happens in eight stages. EMDR requires clients to think about the past, present, and future. The first phase is designed to obtain history and also to develop treatment planning. Obtaining history information can take one to two sessions or it is something that is continuous throughout therapy. Clinicians will discuss with the client the specific problem and symptoms resulting from the problem. The client does not have to give much detail in regards to history. Some people will share and give great information and specifics and there are others who are only comfortable sharing limited information. With the background information and history collected, the therapist will be able to develop a treatment plan that will identify targets on which to use EMDR (Shapiro, 1991). Targets are the events from the past that created the problem, situations that cause distress, and skills client needs to learn for future well being (1991). The second phase is preparation, it is important to explain the theory of EMDR and how it works. Establishing rapport to ensure clients are reporting accurate feelings and changes that are experienced during eye movements is helpful (Shapiro, 2001). The second phase of treatment the therapist will also ensure the client has several ways to cope with difficult situations. The therapist is able to teach different techniques of imagery and stress reduction techniques that clients can use during sessions. The techniques are used to rapidly produce change in emotional disturbances (2001). The client at this point is learning self care. The third phase is assessment, in this phase the client will select a specific memory/picture from the target event. At that time a statement is chosen that expresses a negative self belief associated with the event (Shapiro, 2001). The negative beliefs are verbalizations of negative and disturbing emotions that still exist. The common statements include I am bad, I am worthless, I am nothing, etc. The client then picks a positive statement to replace the negative belief. The positive statement should reflect what is appropriate in the present (2001). The client is then asked to estimate how true they feel the positive statement is using the one to seen Validity of Cognition scale; one equals completely false and seven equals completely true (Maxfield, 1999). Also, during the Assessment Phase, the person identifies the negative emotions along with physical sensations associated with the memory. The client is asked to rate disturbance on the Subjective Units of Disturbance (SUD) scale, with zero reflecting no disturbance and ten reflecting the worst feeling ever had (1999). The next phase focuses on the client’s emotions and sensations as they are measured using the SUDs rating (Shapiro, 2001). The desensitization phase people reprocess past events while focusing on an external stimulus. This phase allows a chance to identify and resolve similar events that may have happened and are associated with the specified event/memory. During desensitization, the therapist will lead the person in sets of eye movement with appropriate changes of focus until his SUDs levels are reduced to zero or a low number. Another phase is the installation phase. The goal is to increase the positive belief that the person has identified previously to replace the negative belief. The goal is for people to identify and believe in their positive statement and scoring it high on the Validity of Cognition scale. After the positive belief statements and installation the next phase which is the body scan phase, the client is ask to think about the past target and asked to notice and focus on changes in body. The seventh phase is closure. In this phase the client is asked to keep a log during the week of anything related to the memory that may arise. The goal is to ensure that the client leaves feeling better than the beginning of treatment (Shapiro, 1989). It is reported if the processing of the traumatic target event is not complete in a single session, the therapist will assist the person in using a variety of self-calming techniques in order to regain a sense of stability. The last phase examines the progress made thus far. The therapist makes sure positive results on scales have been maintained. The reevaluation phase is vital in order to determine the success of the treatment over time (Maxfield, 1999). Clients may feel relief almost immediately with EMDR; however it is as important to complete the eight phases of treatment. The goal of EMDR is to produce the most comprehensive and profound treatment effects in the shortest period of time, while simultaneously maintaining a stable client. The beginning of EMDR appears to be similar to exposure therapy. There are several studies and reviews that have been completed to test the effectiveness of EMDR in treating trauma. EMDR has been found to be an effective treatment for trauma. It has also been found to work faster than other therapies (Cahill, 1999). A study done by Davidson and Parker compared EMDR to no treatment and compared it to other exposure therapies such as prolonged exposure (2001). This study explored thirty four studies on the effectiveness of EMDR in treating trauma. It was discovered that among the thirty four studies, EMDR was found to be effective with an effect size of . 83 when compared to no treatment. It was also found to be a better choice of treatment than other non-exposure therapies such as CBT which only had an effect size of . 55. Controlled efficacy studies report a decrease in PTSD diagnosis of 70-90% after three to six sessions (Chemtob et al. , 2000). EMDR has been compared with cognitive behavior therapy in past clinical trials. EMDR has also been compared with and found superior to a wide range of other treatments, such as relaxation therapy, biofeedback, standard mental health treatment in a managed care facility, and active listening (Maxfield, 1999). Evidence based support has led to EMDR being acknowledged as effective in the treatment of PTSD. Independent reviewers for the American Psychological Association reports EMDR and exposure therapy as empirically validated treatments (Chambless et al. , 1998). Also the International Society for Traumatic Stress Studies designated EMDR as effective for PTSD (Shalev et al. , 2000). They noted that EMDR is more efficient than other treatments as it used significantly fewer sessions than behavior therapy and took less time (2000). Cahill found similar results in a literature review conducted. They found that as a whole EMDR is effective in treating trauma, but that it is equally as effective when compared to other exposure therapies (1999). Some studies also indicate that EMDR may be more easily tolerated by clients than other exposure therapies. In a study by Schubert, it was discovered the use of eye-movements in the EMDR process reduced the pulse and heart rate in clients (2010). This suggests a calming experience as the process progresses. EMDR has been extensively researched in the treatment of trauma survivors. EMDR has been tested with survivors of a wide range of traumatic events, using a variety of control conditions, in multiple types of settings, by numerous researchers (Maxfield, 2002). Research has also investigated the use of EMDR with victims of rape, physical assault, childhood abuse, natural disasters, accidents, and other traumas (2002). EMDR is a therapeutic technique in which the patient moves his or her eyes back and forth, while concentrating on the target event or memory causing distress. The therapist waves a stick or light in front of the patient and the patient is supposed to follow the moving stick or light with his or her eyes. EMDR is fast and rapid approach to therapy. While there are many supporters of this type of therapy there are many critics that believe EMDR is pseudoscience. It is suggested, wit evidence based information EMDR is an effective treatment. It is important to note that only clinicians who have received specialized training in EMDR are able to conduct it.