Eye Movement Desensitisation and Reprocessing (EMDR)
Eye Movement Desensitisation and Reprocessing (EMDR) Therapy is usually considered when individuals have not responded to Trauma-Focused CBT and other treatments. EMDR can be delivered to children and adults. EMDR is an evidence-based psychological therapy that can be used to treat PTSD. It is delivered usually by psychologists and some psychiatrists who are specifically trained in EMDR. It can be used independently or in combination with medication.
EMDR is based on the premise that the brain stores memories in an organised or ‘processed’ manner. However, in some people when a traumatic event occurs, it can be so overwhelming that the memory of the event is not stored in the usual way and so can be considered ‘unprocessed’. This means that the memory is unusually ‘accessible’ and as a result, can replay in an unplanned manner, or as a result of a trigger, often as a flashback. This can then cause distress to the individual.
In general, the brain processes daily experiences during sleep, especially during a particular phase of sleep known as REM or Rapid Eye Movement sleep. It is thought that in some people, when a traumatic event occurs, the usual daily processing of that memory during REM sleep does not occur. The main aim of EMDR therapy is therefore to help the brain process distressing memories allowing individuals to manage them more effectively.
Sessions are usually held weekly and last up to 90 minutes. For some people, the therapy intervention is relatively short; however, for others who may have experienced multiple traumas, treatment may need to be delivered over a longer time period. EMDR therapy can be considered as having eight phases (Menon and Jayan, 2010).
‘The Eight Phases of EMDR Therapy’.
| 1. Treatment planning and assessment: During this stage, the therapist takes a detailed history allowing the treatment to be planned. |
2. The reparatory phase: This phase of treatment is variable in length and is tailored to the individual. During this phase, a therapeutic relationship between the therapist and the patient is established. A range of techniques which aim to stabilise emotions is developed. Completion of the preparatory phase is essential before the next phases of therapy can begin. |
| 3. Memory assessment: During this phase, the individual will be asked to identify an image of the most distressing part of the memory. In addition to the image identified, the individual will be asked to identify a negative belief associated with the memory and the emotions and sensations associated with it. |
4. The desensitisation or processing phase: During this phase, the distressing memory is evaluated with the aim to change the trauma-related beliefs and emotions associated with it. The individual is asked to hold the belief, image, emotion and sensation in their mind while attending to a series of eye movements. After each series of eye movements, the individual is asked to ‘blank out’ the memory. |
| 5. Installation phase: During this phase, the therapist aims to consolidate the positive cognitions now associated with the image. |
6. Body scan phase: During this phase, the individual is asked to scan the body to determine if any sensations associated with the traumatic memory remain. If sensations are identified, the therapist targets this for further processing. |
| 7. Closure: During this phase the stabilising techniques developed in the preparatory phase are used to bring the individual ‘back to equilibrium’ before the reprocessing is complete. |
8. Re-evaluation: This is the final phase during which an assessment is made of the benefit of the treatment. |
References
Menon, S. B., & Jayan, C. (2010). Eye movement desensitization and reprocessing: A conceptual framework. Indian Journal of Psychological Medicine, 32(2), 136-140. https://doi.org/10.4103/0253-7176.78512
Post-Traumatic Stress Disorder (PTSD) in the Global Context
Post-Traumatic Stress Disorder (PTSD) in the Global Context
