Eye Movement Desensitization Regulation (EMDR)

This paper will examine, compare and contrast Eye Movement Desensitization Reprocessing (EMDR) and Cognitive Processing Therapy (CPT) in the case of Joe, a fictional client with post-traumatic stress disorder from two tours of combat duty as a Marine Corps sniper in the Middle East, without the use of psychotropic medications. EMDR uses side-to-side eye movements in a one-on-one session with a clinician while the client focuses on a distressing memory until he or she reports reduced symptomology or no psychological distress; the clinician then has the client think of positive thoughts while continuing the exercises. EMDR has been the target of debate over its effectiveness, with some scholars suggesting that it is the “rewiring” of the brain that is most beneficial. CPT is often used when other processes of recovery fail. Therapy, administered individually or in a group, initially focuses on misconstrued beliefs of denial and self-blame for the traumatic incident and then addresses beliefs the client has about himself and the world in general. CPT uses talk therapy and worksheets with the goal of the client learning to make sense of what happened and fit it in with the beliefs about themselves and others. Findings suggest that each therapy has its advantages and which is best depends on how responsive the client is to each mode and the therapeutic alliance between the client and therapist.

Observations are completed by senior therapists of the new therapists or therapists who are beginning a new type of intervention after recent certification. This would include a certification for Eye Movement Desensitization and Reprocessing (EMDR). The intervention is used in trauma. After the therapist completes the required training they will need to receive case supervision by a credentialed EMDR therapist as well as group supervision to discuss the cases. There

EMDR consist of 12-15 sessions and information is gotten about the client history, establish rapport, and explain the treatment. The therapist then asks the client questions about visual images of the trauma, the client’s emotional and physiologic reactions to the trauma, unhelpful self-representations, and helpful self-representations (Briere & Scott, 2013). More so, the purpose of EMDR is to reduce the effect of negative emotions or disturbing memories. EMDR engages the client in a two-sided stimulation (i.e. hand taps, eye stimulation by following the movement of an object or audible voices (Briere & Scott, 2013; Eka,

EMDR therapy, EMDR uses an eight-phase approach, referring to the past, present, and future aspects of the traumatic experience, and dysfunctional stress stored memories. The first Phase calls History and Treatment Planning. In this phase the therapist listens the patient's history and develops a treatment plan. In Phase II, the preparation, the therapist teaches the patient how to calm down him/herself with the help of relaxation techniques. The phase III is Assessment in which the therapist asks the patient to visualize the image of the disturbing event, then asks him/her to develop a positive cognition associating with that image. In Phase IV, Desensitization, the patient  focuses on the disturbing memories during short sessions of 15-30 seconds. At the same time, he/she also focuses on the alternative stimulation such as directed eye movements, slapping hands, or voices. This process repeats  many times until the patient's reaction to the target memory becomes less distressed. In Phase V, Installation, the therapist again with the use of bilateral stimulation asks the patient to remember the event about which the positive cognition is developed in the phase III, and makes sure that

PE is built on the assumption that retelling an account of a traumatic experience repeatedly will allow the brain to fully process the memory of that experience, which makes it less painful and something that no longer dominates their life. Additionally, PE is based in Emotional Processing Theory, which posits that PTSD symptoms arise as a result of cognitive and behavioral avoidance of trauma-related thoughts, reminders, activities and situations. PE helps the client interrupt and reverse this process by blocking cognitive and behavioral avoidance, by introducing corrective information. Finally, PE facilitates in organizing and processing of the trauma memory and associated thoughts and

Post traumatic stress disorder (PTSD) is a mental health condition that presents in form of anxiety disorder, and it usually develops following exposure to an event or incident that is terrifying and mostly associated with an increased risk or actual occurrence of severe body harm. These events exceed the coping capabilities of the individual, resulting into psychological trauma. As a result of the trauma, the affected individual develops fear conditioning in their brain, possibly because of certain brain chemicals that are released. Some structures in the brain are also thought to undergo atrophy. The risk of developing post traumatic stress disorder

During this treatment, the patient enter a 60 to 90 minute session, depending on the nature, history, degree or trauma, specific circumstances on the particular day, etcetera. EDMR helps the brain with the natural processing of information. The therapist becomes a partner for the patient in an attempt to help them release past trauma from their nervous system. The session will begin with gentle guidance from the doctor, while they ask them to pinpoint a problem or event that will be the main focus of the treatment. As those thoughts and feelings surface, the patient and therapist work together to redirect the eye movements that accompany the briefly recalled memory. Once the eye movement is redirected, the accompanying feelings are released, and this will continue until the emotions are neutralized and the event is re-associated with positive thoughts and feelings about oneself, such as the realization that the incident was not the patients fault. History and evaluation are typically done in one session, and in some cases when the incident is a singular event, only one session may be required. The more typical course is anywhere between 5 and 15 sessions usually on a weekly basis. For those with a longer history with traumatic events and with years of negative feelings about them are likely to require multiple sessions (source it up). Author Scott Lilienfeld offers his criticism of the practice on the web site Quackwatch.org, stating,

One insight I have gained from this week lesson is that after the six phase in the EMDR Therapy, The client is asked to focus on the image, negative thought, and body sensations while simultaneously moving his or her eyes back and forth following the therapist's fingers as they move across his/her field of vision for 20-30 seconds or more, depending upon the need of the client.

Compared to both pharmaceuticals and other forms of psychotherapy, EMDR has proven to be effective in the treatment of PTSD (Shapiro, 2002). There have been approximately twenty controlled studies that proved this (Shapiro, & Laliotis, 2010). EMDR has been recommended as a first line of treatment including by the American Psychiatric Association (Shapiro, & Laliotis, 2010). EMDR uses bilateral stimulation such as auditory tones, tactile taps and

One always hear the saying, “The mind is a terrible thing to waste” but does society know what the mind really is? Post-Traumatic Stress disorder commonly known as PTSD is a mental illness that affects the mind. Throughout one’s lifetime, one must have heard or even experienced PTSD at some point. This disorder can develop after a traumatic event or even after an overwhelming period in one’s life. This study was developed to illustrate the causes of PTSD, how it affects the mind and the treatments and issues associated with this mental illness.

Alternatively, the individual has to acknowledge that the trauma is real, undeserved, and important. Through therapy sessions, the patient is made to acknowledge that the nature of the disorder may have led to the additional and undeserved trauma in addition to admitting that the process of recovery is not at all trivial and requires a substantial amount of time and effort to go through. Moreover, the therapist works to separate the residual problems into bits that are resolvable, for instance, personal improvement goals and those that are irresolvable, such as the behavior of another disordered member of the

EPR consists of exposing the patient to situations or thoughts they may fear. The prevention in participating in rituals or compulsions, whether physical or mental, are crucial to maximising the effect of the treatment. Approximately 50% of patients benefit from EPR without the involvement of medication. In formal applications of this type of treatment these steps are often followed:

EMDR has weaknesses and debated for being controversial due to it being difficult to support the signature aspect of the therapy, namely alternating eye movements as actually necessary to the treatment (McLay et al., 2016, p. 702). Eye movements and cognitive reprocessing which are deemed by EMDR as essential failed to make a unique contribution to the outcome of therapy (Rubin, 2002, p. 14). According to the Prochaska & Norcross, “The eye movements are only one form of bilateral stimulation and may not be required for the therapeutic effect” (2014, p. 211). Hand taps and repetition of auditory cues are other alternate stimuli which can be used instead of eye movements. Early claims were made about EMDR having almost magical results that only one session of EMDR could provide treatment for clients (McLay et al., 2016, p. 702; Prochaska & Norcross, 2014, p. 210). Furthermore, EMDR could be viewed as a simple variant of exposure therapy with a gimmick in marketing the therapy as something new (Rubin, 2002, p. 12). According to Perkins & Rouanzoin (2002), “EMDR is best explained by learning processes that subsume exposure and cognitive-behavioral treatments” (p. 80). EMDR has not been proven effective outside of PSTD.

This paper looks at the treatment of Eye Movement Desensitization and Reprocessing in treating individuals with PTSD. This is a very controversial treatment and more recently there has been quite a lot of research done on this treatment. The paper with indentify, the criteria for diagnosising an individual with PTSD, the specific treatment, other treatments for PTSD and the limitations of the research.

After finishing weekend one for almost a month now, it's dawned on me how effective EMDR Therapy can be. I've been testing it with about 4 clients so far, and most of them have reported remarkable changes.