The Effectiveness of EMDR

Eye Movement Desensitization and Reprocessing (EMDR) has been shown to be an effective method in treating those exposed to traumatic events.  Discovered unintentionally by Psychologist Francine Shapiro in 1987, she observed that as her eyes moved rapidly, it “produced a dramatic relief from her distress” (Van Der Kolk, p. 253).  Through the use of EMDR, patients are able to revisit past traumatic experiences without painful re-creations which could otherwise result in re-traumatization.  EMDR consists of eight phases:  history taking, preparation, assessment, desensitization, body scan, closure, and reevaluation (Rousseau, 2018).  EDMR treatment is minimally invasive to the patient as it does not require them to talk about their traumatic experience.  Instead, EMDR focuses on stimulating and opening up the associative process as “therapists ask their clients to hold the memories of anxiety-provoking stimuli—for example, the painful memories of a frightening accident—in their minds. While doing so, clients track the therapist’s back-and-forth finger movements with their eyes” (Arkowitz, 2012).  This process helps take loosely associated memories and images from a patient’s past and piece them together to a more comprehensive perspective of the traumatic experience.  Through studies, it has been shown that rapid eye movement (REM) sleep “reshapes memory by increasing the imprint of emotionally relevant information while helping irrelevant material fade away” and “make(s) sense out of information whose relevance is unclear while we are awake and integrate it into the larger memory system” (Van Der Kolk, p. 262).  By large, those affected by PTSD have difficulty getting to and remaining in REM sleep.  Because EMDR mimics REM sleep through the moving of the eyes back and forth in a rapid manner, “EMDR should be able to take advantage of sleep-dependent processes, which may be blocked or ineffective in PTSD sufferers, to allow effective memory processing and trauma resolution” (Van Der Kolk, p. 263).  By becoming in-tune with the context of the emotions and sensations related to traumatic events, patients can learn to overcome physical reactions that were previously dictated by the imprint of the past.

Many who experience traumatic events attempt to suppress their memories by shutting down “the brain areas that transmit the visceral feelings  and emotions that accompany and define terror” (Van Der Kolk, p. 94).  In an attempt to protect themselves from the hurtful past,  trauma victims can unintentionally prevent themselves from feeling fully alive in the present.  As a result, the traumatic memory remains stuck in the patient’s mind, “undigested and raw” (Van Der Kolk, p. 258).  To be able to recover from trauma, its crucial that patients are able to feel present and be aware of what is going on within them.  “The core of our self-awareness rests on the physical sensations that convey the inner states of the body” (Van Der Kolk, p. 95).  EMDR helps to restore a trauma victim’s broken “self-sensing system” and reactive it by integrating the traumatic material into a “coherent event in the past, instead of experiencing sensations and images divorced from any context” (Van Der Kolk, p. 257).  EMDR allows the brain to activate new images, feelings, and thoughts from seemingly unrelated events while simultaneously restoring the patients sense of agency, engagement, and ownership of mind and body.

EMDR therapy can also be used to help those who are grieving over the loss of a loved one and those suffering from debilitating medical conditions.  Family members are “often unable to retrieve positive memories of the deceased, which further exacerbates and complicates the grieving process” (Shapiro, 2014). Similarly, those who experience a tragic medical condition such as a burn victims or amputees may benefit from EMDR.  In both examples, EMDR treatment helps the individual to focus on pleasant past experiences rather than the emotional present.  The individual can then mark their grief as a specific point in time and begin to understand that their tragic event is not what defines them as a person and start to heal emotionally.

Patients showed dramatic improvements with very few EMDR treatments.  In a study of twelve individuals, Dr. Van Der Kolk found that after only three EMDR sessions, “eight of the twelve had shown a significant decrease in their PTSD scores” (Van Der Kolk, p. 256).  It was also found that patient’s PTSD scores improved substantially better than those who used pharmaceuticals (Prozac) for treatment.  After several EMDR treatments, patients were able to integrate their traumatic memories and continue to improve to the point where many were cured of their ailments and remained cured months after treatment, unlike those who relapsed once off the medication.  Further, Dr. Francine Shapiro found, “Twenty-four randomized controlled trials support the positive effects of EMDR therapy in the treatment of emotional trauma and other adverse life experiences relevant to clinical practice. Seven of 10 studies reported EMDR therapy to be more rapid and/or more effective than trauma-focused cognitive behavioral therapy. Twelve randomized studies of the eye movement component noted rapid decreases in negative emotions and/or vividness of disturbing images, with an additional 8 reporting a variety of other memory effects. Numerous other evaluations document that EMDR therapy provides relief from a variety of somatic complaints” (Shaprio, 2014). EMDR has proven to be an effective, minimally invasive, and long lasting treatment option for victims of trauma.  This holistic approach may prove to be more beneficial to trauma victims than other more invasive or pharmaceutical dependent treatments that may not have as long lasting results.

Although much EMDR  treatment research has shown “that processing memories of such (adverse life) experiences results in the rapid amelioration of negative emotions, beliefs, and physical sensations (Shapiro, 2014), there is one glaring limitation to EMDR.  It has been found to be not as effective in patients who have experience childhood trauma.  Dr. Van Der Kolk suggests EMDR doesn’t work as well in children because of the mental and biological changes that occur in children who experience chronic child abuse.  Because an abused child’s life can have a variety of “triggers”, they may not be able to distinguish their trauma as being a past isolated event that they can move on from, as EMDR attempts to do.  Abused children often lack a secure base and secure attachment with loving caregivers. “A secure attachment combined with the cultivation of competency builds an internal locus of control” (Van Der Kolk, p. 115). Without these primitive skills, the physiological changes in children after experiencing a traumatic event can make it harder from them to break free from the past as it could be harder from them to look within and realize they’re not the cause of their own trauma.  Nevertheless, EMDR is an extremely useful tool that can be used in the medical field for both patients and family members alike.  This treatment can help mental health professionals pinpoint what adverse experiences are effecting an individual so psychological and physical resolution can occur.

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