What is EMDR?

"The aim of EMDR treatment is to achieve the most profound and comprehensive treatment effects in the shortest period of time."

–from the EMDR International Association's Definition of EMDR

"The speed at which change occurs during EMDR contradicts the traditional notion of time as essential for psychological healing. EMDR has integrated elements from many different schools of psychotherapy into its protocols, making EMDR applicable to a variety of clinical populations."

–Bessel A. van der Kolk, MD, Boston University School of Medicine

My goal for my clients is simple: to help you achieve the results you want as quickly, easily, and safely as possible, and to make sure that those results "stick" permanently. EMDR is based on the most recent developments in neuroscience, which is continuously and rapidly expanding our understanding of psychological performance. The easiest way to explain EMDR is to answer some of the most frequently asked questions.

 

How are the patterns in my brain shaped?

All patterns, good and bad, (brain activity, thinking patterns, emotional patterns, behavior patterns, communication patterns, and relationship patterns) are simply the result of an accumulation of experiences stored in your brain and nervous system. Most of the negative "patterns" people come to me wanting to change have been caused by one of two things (sometimes both).

The first is called imprinting. From the time of fetal development and then after birth, your brain starts developing very rapidly, and how it develops is shaped tremendously by everything being pulled in through your five senses. This process creates an "imprint" on your developing brain, which becomes sort of a "default mode"-the conditioned way you will naturally tend to think, feel, and act, unless other forces have somehow reshaped this imprinting later on. So early life experiences (even ones you can't consciously remember)-especially experiences with caregivers and others close around you-have a massive influence on personality development.

The second major shaping influence for these patterns is stress. From conception onward, anytime you're under any type of stress, your brain triggers certain glands in your body to produce a large amount of hormones we call "stress hormones"-things like adrenaline, cortisol, and some others. During these periods of time, your brain does not process the information coming in through your five senses the way it normally does. This interruption of the normal processing leads to a chain reaction of effects in the nervous system: it's a little hard to explain, but it's like "undigested" sensory data that creates "blockages" in the nervous system, alterations to pathways within the nervous system, and alterations to brain chemistry where the neurotransmitters (serotonin, dopamine, chetacholamine, epinephrine, nor-epinephrine, etc.) get thrown out of balance.

The bottom line is, it's the build up of the effects of this "stress response" in the body, brain, and nervous system that we believe to be the culprit behind most of the emotional difficulties that people experience. Basically, the person reaches a point where certain things are triggering a pattern of neurological impulses in the body to fire over and over again. The most challenging thing is that over time all these patterns get stronger and stronger. It's like working out a muscle, the more you work it, the stronger it gets. On a neurological level, it's actually more like water running through a trench. The more water that runs through it, the deeper it gets carved out until it gets to the point where it seems like everything wants to flow into that groove much too easily.

 

So what are the options?

One option is taking pharmaceuticals. Sometimes people benefit from pharmaceuticals and psychotherapy.

Another option is EMDR. EMDR changes emotional reactions, negative thought patterns, and entrenched habits (and often even physical discomfort) that people can't just "think themselves out of." EMDR has given us the ability to essentially reverse all those negative patterns that have developed in the brain, body, and nervous system.

There are actually two key elements of EMDR treatment. The first is something called "bilateral stimulation"-which just means two-sided stimulation. The brain has a right hemisphere and a left hemisphere and each side of the body is "hard-wired" to a specific side of the brain. Creating a rhythmic, back and forth stimulation of each hemisphere of the brain seems to stimulate something we call the "information processing system" to go into a highly accelerated mode of functioning-which is exactly the treatment effect we have to create to get the results we're after. There are several different methods that have been developed for creating the "bilateral stimulation" effect: visual, auditory, and tactile.

The second key element of EMDR treatment is sort of the "art and science" of how I have to prompt and guide your thoughts while we're doing the bilateral stimulation. I'll explain the instructions in more detail, but how I do this will be determined by a number of factors individual to your unique situation.

The end result of EMDR treatment is to reduce and eliminate negative thoughts and feelings, to increase and strengthen positive thoughts and feelings, and to enable you to really be at your best in your everyday life.

 

If EMDR was designed for treating Post Traumatic Stress Disorder, and I've never been through anything particularly traumatic, how will it help me with my issues?

According to the December, 2005 Harvard Mental Health Letter ("Post-traumatic Stress Without Trauma"): Experiences not usually regarded as traumatic can cause the characteristic symptoms of post traumatic stress disorder.

Surprisingly, life events (such as relationship problems, work problems, financial problems, school problems, health problems, significant losses or life changes) were as likely as traumatic events to cause symptoms typical of post-traumatic stress disorder. In fact, people whose worst event was not traumatic had more post-traumatic stress symptoms for a longer time than those whose worst event was traumatic.

The authors suggest that life events may increase overall psychological stress and distress, bringing on symptoms related to an earlier trauma.

Traumatic events may reduce the ability to cope with other kinds of stress. Both traumatic experiences and overall distress may increase the risk of developing post-traumatic symptoms after either a traumatic experience or a non-traumatic life event.

 

Is EMDR something like hypnosis?

EMDR is very different from hypnosis in three important ways:

In EMDR you don't go into any kind of "altered state"-you're totally aware of what's going on, you're totally in control of the process, and it's nothing that somebody is doing to you. It's your brain that's doing the work. The EMDR is simply a catalyst for speeding up the benefits you get from psychotherapy.

EMDR does not have the capacity to create false memories.

EMDR is not at all dependent on the placebo effect. In other words, somebody can be totally convinced that it's not going to work, and it still works just as well because it's purely a biophysical process.

 

How well researched and scientifically proven is EMDR?

For detailed answers to that question, I would encourage you to go to www.emdr.com/studies.htm, but here are a few quick answers.

EMDR has been judged as empirically validated and given a rating of "highest level of effectiveness" in numerous international practice guidelines including The American Psychiatric Association Practice Guidelines.

In September of 2000, EMDR was accepted by the management of the Vanderbilt Mental Health Center in Nashville (a division of the Vanderbilt University Medical Center) as one of only three acceptable treatment methods for their seriously and consistently mentally ill patients. This acceptance was influenced by one clinician, Jan Stadtlander, LCSW, who had been using EMDR with her patients for seven years and achieving remarkable results with them.

EMDR is the most researched psychotherapy method for PTSD.

There are more controlled studies that have evaluated the effectiveness of EMDR in the treatment of PTSD than any other method.

As of 2002, more than 20 controlled outcome studies of EMDR have already been published and/or presented. These studies all found EMDR superior to the control condition on measures of PTSD, with EMDR using fewer treatment sessions to achieve effects. Follow up studies at intervals up to 5 years after treatment have indicated a high level of maintenance of treatment effects.

EMDR is on the American Psychological Association Division of Clinical Psychology's list of empirically validated methods. Only two other methods are even on this list for the treatment of PTSD.

The International Society for Traumatic Stress Studies has stated that EMDR is an "effective treatment".

The United Kingdom Department of Health has listed EMDR as an effective treatment.

EMDR is endorsed by the American Red Cross, the FBI, the International Critical Incident Stress Management Foundation, and major HMO's such as Kaiser and Value Options.

EMDR courses are being taught in over 30 colleges and universities, and it is part of the standard treatment in many VA hospitals.

David V. Baldwin, Ph.D., a licensed psychologist in Eugene, Oregon has compiled a current list of published journal articles on EMDR. As of 2001, he already had 238 articles on his list.

EMDR was used extensively to treat survivors in the aftermath of the Oklahoma City bombing and in New York after 9-11.

Research presented in the Fall 2003 in Chicago by Dr. Bessel A. Van der Kolk, MD, is showing EMDR to be more effective than SSRI's. Dr. Van der Kolk is Professor of Psychiatry at Boston University Medical School, Clinical Director of the Trauma Center at HRI Hospital in Brookline, MA, and past President of the International Society for Traumatic Stress Studies (ISTSS). He has taught at universities and hospitals across the United States and around the world, including Europe, Africa, Russia, Australia, Israel, and China. He has been active as a clinician, researcher, and teacher in the area of stress since the 1970's. He has published extensively on the impact of stress on human development, and his book, Psychological Trauma, was the first integrative text on the subject. His latest book explores what we have learned in the past 20 years about the role of stress in psychiatric illness, and his current research is on brain imaging and how stress affects memory processes.

 

If EMDR is so great, why have I never heard of it before?

EMDR has actually received a great deal of media attention the last few years. Segments have been run on shows like Dateline and 20/20 spotlighting the extraordinary speed and effectiveness of EMDR.

 

How quickly can I expect to reach my treatment goals?

That depends on a number of variables unique to your own personal situation, but here are some generalities:

People seem to progress about four times as fast with EMDR than with any other form of treatment.

After our first actual EMDR session, I'll be able to answer that question a lot more specifically, because I should have a better indication of how rapidly your body and nervous system are responding.

You can speed up the pace of our progress by paying more attention to your health: getting on a consistent sleep schedule, getting a little exercise everyday, drinking lots of water, eating "clean", controlling carbohydrate intake, avoiding the use of chemical depressants (like alcohol and marijuana), and restricting the use of chemical stimulants (like caffeine and nicotine).

 

Can you get me off my meds?

People use medications for many different reasons. Regardless of whether a person needs to continue the use of medication, EMDR helps to give relief from the stressors that everyone encounters in life.

 

Could our EMDR work accidentally change something I don't really want to change?

No. The really interesting thing about the brain is that it comes "pre-programmed" to automatically do what you want it to do. It just has to be stimulated correctly. EMDR seems to help the brain get rid of what you don't want or need, and actually strengthen what you do want or need. It will not take away anything useful for you, and it will not change anything you don't want to change.

 

Are there any possible negative side effects of EMDR treatment?

Only two that anybody's been able to identify:

1. EMDR has a tendency to make bad memories seem very distant or unclear, so if we're dealing with something you're going to have to testify about in court, you will have to talk to your attorney about the possible implications of your treatment. You may end up being an ineffective witness!

2. EMDR has the ability to bring back a memory strongly enough so that you may momentarily have the same intensity of emotion that you had at the time the event was occurring. Because of the way I use EMDR very strategically, this situation happens very rarely with my clients. The vast majority of them find our work to be very gentle, calming, and relaxing. If it were to occur, I would always take the time to help you get to a better place with it before you leave my office. My goal is to leave people walking out feeling better than when they walked in! The possibility, though, does bring up three important issues:

  • It's extremely important that during our history-taking you tell me about any significant traumas you've experienced.

  • If you are in recovery from any form of addiction and "strong feelings" are one your triggers, I would encourage you to be very aggressive about "working your program" and making sure you have a good relapse prevention plan in place.

  • If you have any fears or concerns about getting "overwhelmed" by feelings, please let me know about this fear. Even before we start our EMDR work, I'll give you some "emotional management" tools so you don't have to be afraid of feeling your feelings anymore.
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