EMDR

Eye Movement Desensitization and Reprocessing Therapy

 Founder: Francine Shapiro
● 1987: Walking through park when she realized her eye movements decreased negative
emotions associated with distressing memories
● Found others had same response, but realized eye movements alone didn’t create
therapeutic effects and added other elements
● Developed Eye Movement Desensitization
● Tested her theory: case study and controlled study
○ EMD resulted in decreased subjective distress and increased confidence in a positive
belief; participants in EMD reported significant changes compared to other
participants
● Executive Direction of EMDR Institute in CA
● Founder and President of Trauma Recovery EMDR Humanitarian Assistance Programs
● Recipient of International Sigmund Freud Award
What is EMDR?
❖ Eye Movement Desensitization and Reprocessing (EMDR) is a cognitive behavioral
therapy developed in 1987 to desensitize clients to distressing memories, feelings,
cognitions, and to replace negative cognitions with positive ones
➢ Key component in EMDR is the use of bilateral stimulation
➢ Therapist will stimulate a rapid back and forth eye movement, or alternates left and
right hand taps/sounds in each ear, while the client visualizes the distressful
scene/disturbing memory
■ Eye movement similar to REM sleep will be recreated during the bilateral
stimulation; Difference is client is awake during this process
❖ Up to 8 sessions
❖ EMDR stems from AIP Model (adaptive information processing)
➢ Suggests that neural pathways in amygdala and hippocampus store traumatic
memories that become trapped and not integrated into the wider adaptive memory
network
What is EMDR?
Clip: What is EMDR and Why it is Used:

https://www.youtube.com/watch?v=hKrfH43srg8
Where is this used?
❖ Primarily by psychotherapists in a
clinical setting, and mainly for the
treatment of PTSD, however can be
utilized in other mental health settings ➢ Treatment for:
such as hospitals. Primarily for adults, ■ Dissociative disorders
however some research supports this ■ Performance anxiety
method for children. ■ Eating disorders
■ Attachment disorders
■ Body dysmorphic disorders
■ Pain disorder, Personality disorders
■ Depression, Anxiety
■ Addictions
■ Couples Therapy
 The Therapeutic Process
Phase 1: History and Treatment Plan Client’s readiness is assessed and treatment plan
developed; possible targets are identified for EMDR processing
Phase 2: Preparation Therapist teaches client relaxation and stress reduction techniques; client
needs to “buy in” to process; build relationship
Phase 3: Assessment Client identifies negative and positive beliefs; uses subjective units of
discomfort (SUD) scale to rate discomfort
Phase 4: Desensitization Client focuses on event, image, or beliefs during stimulation; asked to
“blank it out”; may be repeated several times
Phase 5: Installation Use validity of cognition scale to strengthen positive beliefs; pair positive
beliefs with trauma
 The Therapeutic Process
Phase 6: Body Scan Clients scan their bodies while remembering event, image, negative belief;
additional processing if tension remains
Phase 7: Closure Clients focus on psychological stability; therapist encourages the client to keep
a log during the week or employ other self-management techniques outside therapy
Phase 8: Reevaluation Therapist reviews journal; examination of progress made; therapist and
client process related historical events, current distressing incidents , and potential future events;
treatment may change as new issues are identified
Is EMDR Effective?
❖ Research supports this method is effective; can rapidly solve simultaneously multiple
aspects of an experience
➢ EMDR encourages the resolution of disturbances manifested physically, emotionally, and cognitively, and does
so even when the disturbance is generated from several different experiences;
➢ For war veterans whose traumatic events are usually multiple, this is an effective tool (Silver, 2008).
❖ Maxfield (1999)
➢ The results of six of the civilian studies and one of the combat veteran studies suggest that
EMDR is an effective therapy for PTSD.
➢ Suggests to be more effective than active listening, standard Kaiser care*, relaxation therapy and
no treatment.
➢ Indications that it may be equivalent in effectiveness to CBT exposure therapies.
❖ Utilization for children
➢ Using the EMDR for children offers a possibility to explore the child’s thoughts and feelings.
➢ Research suggests this can be an effective technique, however suggests it should be adjusted specifically for
children (Ahmad, 2008)
Considerations with this technique..
❖ Training for this type of technique is extremely specific, it is imperative that the therapist is
thoroughly trained to utilize this type of method on a client
➢ Children, consider the sensitivities developmental age and appropriateness of timing

❖ Consider the possible medical history of a client with the use of lights, and other
sensitivities with the “tapping” portion of this technique; or links to trauma by utilizing
this technique
➢ Example: if a client was in a severe motor vehicle accident, lights may be extremely
triggering ; client who has epilepsy (possibility of seizures)

❖ Client motivation for change, current suicidal or homicidal ideation, ongoing substance
abuse, and similar problems need to be taken into account and worked with.
 EMDR in Action
Private therapy session led by Dr. Becky Spelman
https://www.youtube.com/watch?v=KpRQvcW2kUM
 3 Sentences to Take Away
● EMDR is a highly specific form of therapy and requires extensive training
● View of human nature: components of psychodynamic, cognitive,
cognitive-behavioral
○ Trauma is embedded in the psyche; core beliefs influence cognition; people
can change by developing new cognitions and behaviors
● It is not just about the eye movements! Changing the client’s core beliefs is another aspect
of therapy
 Practicing EMDR
● Get into pairs
● Decide who will play the “therapist” and the “client”
● Therapist: choose your method (fingers; tapping)
● Client choose a distressing memory you’re comfortable sharing with your partner
● Practice EMDR as client remembers event/memory; therapist use eye movements to
process event
 Final thoughts...Your thoughts?
● Necessary the client “buys in” to the therapy-- a trusting therapeutic relationship is
essential; educating the client is another component
○ How much do you include on an informed consent document?
○ If you want to work with children, is this a therapy you could use?
● Important the therapist is passionate about this technique-- the counselor needs to “buy
in” to it also
● Teaching relaxation techniques and coping skills is just as important as stimulation and
processing; client must be willing to engage in homework

Is EMDR something you could use?

Any criticism?
 References
Ahmad, A., & Sundelin-Wahlsten, V. (2008). Applying EMDR on children with PTSD. European Child & Adolescent Psychiatry, 17(3),
127-132. doi:10.1007/s00787-007-0646-8

Neukrug, E.S. (2011). Counseling Theory and Practice. Belmont, CA; Brooks/Cole.

Maxfield, L. (1999). Eye movement desensitization and reprocessing: A review of the efficacy of EMDR in the treatment of PTSD.
Traumatology, 5(4),

Rubin, A. (2003). Unanswered questions about the empirical support for EMDR in the treatment of PTSD: A review of
research.Traumatology,12(4),302-313.doi:10.1177/1534765606297821

Silver, S. M., Rogers, S., & Russell, M. (2008). Eye movement desensitization and reprocessing (EMDR) in the treatment of war veterans.
Journal Of Clinical Psychology, 64(8), 947-957. doi:10.1002/jclp.20510

Spelman, Becky. (2013, June 24) Private Therapy Clinic/EMDR Therapy Session (Break Up). Retrieved from
https://www.youtube.com/watch?v=KpRQvcW2kUM

[VEN EMDR] . (2016,June 30) How EMDR works? Look at this animation (English).Retrieved from:
https://www.youtube.com/watch?v=hKrfH43srg8

“History of EMDR.” EMDR Institute – EYE MOVEMENT DESENSITIZATION AND REPROCESSING THERAPY, EMDR
Institute, Inc, 2018, www.emdr.com/history-of-emdr/.

“What is EMDR?” EMDR Institute – EYE MOVEMENT DESENSITIZATION AND REPROCESSING THERAPY, EMDR Institute,
Inc, 2018, http://www.emdr.com/what-is-emdr/