Eye Movement Reprocessing

Eye movement desensitization and reprogramming, or EMDR, therapy is a controversial treatment forcing on people with post-traumatic stress disorder. In order to treat the trauma related problems, this method of therapy focuses on having the patient reliving the distressing event in order to think it is in a more logical and structured way. In Bruce Bower’s article EMDR: promise and dissent: new research enters debate over a highly touted trauma therapy – eye movement desensitization and reprogramming, he takes the readers through a typical therapy session by explaining that, “ A session of EMDR usually lasts about 90 minutes. The client first thinks about the earlier trauma and comes up with an image from the incident. He or she then chooses a current negative belief that goes with the image and a desired positive attitude toward it. A sexual abuse survivor, for instance, might come up with “I am damaged for life” and “I’m safe now,” respectively.” One unique aspect of EMDR is how this technique incorporates the use of body through rapid side to side eye movements and alternating sounds or taps on a series of body points. As the participant imagines the trauma and discussing the emotions and stress levels, the therapist simultaneously conducts the particular sensation to body such as holding up two fingers and moving them back and forth.

William Harrar went into private practice in 1991 and continues to maintain a private practice. He provides professional consultations to other therapists and consults at local psychiatric units as well. He also provides psychotherapy to individuals, couples, and families. Dr. Harrar’s emphasis is brief treatments, especially treatments utilizing EMDR. His expertise in EMDR has afforded him as an approved consultant and certified therapist with the Eye Movement Desensitization and Reprocessing International Association (EMDRIA). Dr. Harrar also facilitates at national EMDR Institute trainings.

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.

I. Theoretical and Research Basis for Treatment While working with Precious it has become clear that she has gone through a number of traumas as a child and up until her young adulthood. Precious, dealing with both sexual and physical abuse, has come a long way in wanting to seek treatment and actually wanting to move past her previous traumas. Relevant treatment choices for Precious would be Eye Movement Desensitization and Reprocessing (EMDR) Trauma focused cognitive behavior therapy Exposure therapy Cognitive Processing Therapy Integrative treatment of complex trauma for adolescents.

Treatment of posttraumatic stress disorder is possible. The current treatment of PTSD encompasses several types of psychotherapy combined with a medication regimen. Cognitive therapy is one type of therapy used to combat PTSD. The goal of cognitive therapy is to allow the patient to slowly experience feelings, thoughts, and events associated with the trauma in a controlled setting. This allows the PTSD sufferer, to categorize the traumatic feelings associated with the event and assign a more positive meaning to them. Thus providing a coping mechanism. Another school of thought places the therapeutic focus on gradually exposing the PTSD sufferer to elements of the trauma. The goal is to desensitize the patient to the traumatic event. This allows the patient to resume a normal life. One other form of therapy used in treatment of PTSD is EMDR. EMDR or Eye Movement Desensitization and Reprocessing is a form of exposure therapy that places the emphasis on guided eye movements. The theory is that the movements help retrain how the brain reacts to memories of the traumatic event. Success has

Foa and her colleagues (2011) created prolonged Exposure (PE) for clients trying to overcome with PTSD that is based on the emotional processing therapy (Foa, 2011). PE treatment plan includes collecting of information associated to both the traumatic experience and the trauma survivor's responses to it, the teaching of breathing retraining techniques, education, the re-experiencing of the trauma in imagination, and in vivo exposure (Foa, 2011). When compared with CPT, PE is a 10-session treatment (60-90 minutes) that is centered on both in-vivo and imaginal exposure to the trauma memory and ensuing adaptation. PE reports that repetitive stimulation of the trauma memory allows the clients to integrate new, counteractive information about themself and their world. Additionally, homework assignments in PE allow the client to face safe situations, which were formerly resolute to be threatening based upon inaccurate post-traumatic beliefs (Foa,

The symptoms that are being treated through this individualized treatment plan related to post traumatic stress disorder are: dissociative reactions, irritable and aggressive behavior, concentration problems, and trauma-related external reminders. The first goal is in place to assist Precious in learning to eliminate intrusive memories, a “notable feature of memory in PTSD is the reliving experiences or “flashbacks” to the trauma” (Berwin, 2003, p. 340), and addressing causes of these memories through the intervention of prolonged exposure. In addition, the second goal that is being implemented, preventing and addressing distortions, is being addressed through prolonged exposure. This technique is “a general treatment strategy for reducing anxiety that involves confronting situations, activities, thoughts, and memories that are feared and avoided even though they are not inherently harmful.” (Foa, 1998, p. 65). The flashbacks and distortions that Precious experiences are being addressed through prolonged exposure, due the fact that it

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

From this assignment, I learned that the immediate crisis based interventions for trauma are vastly different than a treatment plan which may incorporate long-term goals and strategies, such as cognitive behavioral therapy and/or Eye Movement Desensitization and Reprocessing (EMDR). I have to shift my thinking towards strategies as immediate as eye-contact and tone of voice, as well as make adjustments in how I searched for resources and

I would also utilize eye movement desensitization and reprocessing (EMDR) therapy, which is commonly used for individuals suffering from post traumatic

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

This annotated bibliography looked at 6 different journal articles on the effectiveness of Cognitive Behavior Therapy (CBT) in treating Post-Traumatic Stress Disorder (PTSD) versus other methods and variations of CBT. Historically speaking, it is common knowledge in the field of psychology for CBT to have a 50% success rate for patients with PTSD in that it either works or it doesn’t work, which is traceable to the patients commitment to the therapy. These articles review abstract ideas that have been ventured upon by researchers to corroborate the preconceived notions of CBT and PTSD and find a

According to Sharf, (2008) the eye movement desensitization and reprocessing (EMDR) was designed to treat posttraumatic stress disorder. EMDR requires that the clients visualize an upsetting memory and accompanying physical sensations. The clients repeat negative self-statements that they associate with the scene. The procedure is repeated again and again until the client’s anxiety is reduced. EMDR focuses on desensitizing strong emotional reasons in clients and help them to reframe their belief systems to accommodate new emotional states (Sharf, 2008).

[When applying this type of therapy to treating a client with post traumatic stress disorder, EMDR is a reasonable choice because… ]

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.