EMDR
EMDR is an integrative memory-based approach to psychotherapy that focuses on reprocessing of experience developed by Francine Shapiro. It looks at a client’s past memories, present triggers and their desired outcomes (future outcomes). It is guided by the Adaptive Information Processing (AIP) Model and has 8 phases of treatment.
Adaptive information Processing (AIP) Model
…When a trauma occurs, it appears to get locked in the brain in an isolated memory network with the original picture, sounds, thoughts, feelings, and so on. Since the experience is locked there, it continues to be triggered whenever a reminder comes up and is responsible for the frequent feelings of helplessness, hopelessness, fear, and so forth that we can’t seem to control. This prevents learning from taking place. The old material just keeps getting triggered over and over again. In another part of your brain, in a separate network, is most of the information you need to resolve it. It’s just prevented from linking up to the old stuff… Francine Shapiro
Bilateral Stimulation
…The eye movements or alternative bilateral stimulation (BLS) such as auditory and tactile stimuli we use in EMDR seem to unlock the system and allow your brain to process the experience. As a client moves through the sets of BLS, the information moves; the changing picture corresponds to shifts of affect and self-assessment, which become a part of the way the experience is now stored. It is just like a train travelling along its route…. Francine Shapiro
Unlocking Trauma and Adverse Experiences
…When the disturbing material is unlocked and allowed to process, the reservoir of negative emotion is drained along with it. Thus, persistence and courage are important. REGARDLESS of how disturbing the emotions might be ….NOTHING NEGATIVE IS BEING PUT IN. INSTEAD, IT IS BEING LET OUT… Francine Shapiro
Treatment Goal
…At the end of EMDR treatment, the target information is fully processed, and the client reaches an adaptive resolution. Metaphorically speaking, the train has arrived at the end of the line… Francine Shapiro
8 Phases
EMDR is a structured 8 Phase clinical treatment modality. It is commonly used to treat posttraumatic stress symptoms, depression, anxiety, phobias and any symptom related to memories of experiences in the past.
Phase 1
Trauma Case Conceptualisation: Identify what to target in EMDR and to ensure the appropriateness of EMDR. Administration of Measures.
Phase 2
Resourcing, Stabilisation and Preparation: Focus on creating safety and preparing for phases 3-6 by establishing stabilisation and resourcing. Increase access to positive affects, and body awareness.
Phase 3
Jointly identify the target memory: Finding the wound(s). Then activate the client’s trauma network in the brain before immediately moving into Phase 4.
Phase 4
Desensitisation: The therapist conducts Bilateral Stimulation (BLS), i.e., eye movements, tactile or auditory stimulation. The client is asked to attend to both the target image and to the Bilateral Stimulation (BLS) simultaneously.
Phase 5
Installation: The therapist attempts to increase the strength/validity of the Positive Cognition (PC) with the intention of replacing the Negative Cognition (NC) during Bilateral Stimulation (BLS).
Phase 6
Body Scan: Concentration on and processing of any residual physical sensations. Bilateral Stimulation (BLS) is undertaken if discomfort is reported.
Phase 7
Closure: The therapist helps the client end the session by debriefing, reviewing gains made, setting expectations, reviewing coping techniques and planning for the next session.
Phase 8
Evaluation: In this phase, gains made during the last session are reviewed, and the therapist may re-conduct earlier phases to ensure that the gains have been maintained since the last session.