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EMDR
TREATMENT: Eye
Movement Desensitization and Reprocessing
What
is EMDR?
During
EMDR1 the client attends to past and present experiences in brief
sequential doses while simultaneously focusing on an external stimulus.
Then the client is instructed to let new material become the focus of
the next set of dual
attention. This sequence of dual attention and personal association
is repeated many times in the session. Eight
Phases of Treatment The
first phase is a history taking session during which the therapist
assesses the client's readiness for EMDR and develops a treatment plan.
Client and therapist identify possible targets for EMDR processing.
These include recent distressing events, current situations that elicit
emotional disturbance, related historical incidents, and the development
of specific skills and behaviors that will be needed by the client in
future situations. During
the second phase of treatment, the therapist ensures that the client has
adequate methods of handling emotional distress and good coping skills,
and that the client is in a relatively stable state. If further
stabilization is required, or if additional skills are needed, therapy
focuses on providing these. The client is then able to use stress
reducing techniques whenever necessary, during or between sessions.
However, one goal is not to need these techniques once therapy is
complete. In
phase three through six, a target is identified and processed using EMDR
procedures. These involve the client identifying the most vivid visual
image related to the memory (if available), a negative belief about
self, related emotions and body sensations. The client also identifies a
preferred positive belief. The validity of the positive belief is rated,
as is the intensity of the negative emotions. After
this, the client is instructed to focus on the image, negative thought,
and body sensations while simultaneously moving his/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. Athough eye
movements are the most commonly used external stimulus, therapists
often use auditory tones, tapping, or other types of tactile
stimulation. The kind of dual attention and the length of each set is
customized to the need of the client. The client is instructed to just
notice whatever happens. After this, the clinician instructs the client
to let his/her mind go blank and to notice whatever thought, feeling,
image, memory, or sensation comes to mind. Depending upon the client's
report the clinician will facilitate the next focus of attention. In
most cases a client-directed association process is encouraged. This is
repeated numerous times throughout the session. If the client becomes
distressed or has difficulty with the process, the therapist follows
established procedures to help the client resume processing. When the
client reports no distress related to the targeted memory, the clinician
asks him/her to think of the preferred positive belief that was
identified at the beginning of the session, or a better one if it has
emerged, and to focus on the incident, while simultaneously engaging in
the eye movements. After several sets, clients generally report
increased confidence in this positive belief. The therapist checks with
the client regarding body sensations. If there are negative sensations,
these are processed as above. If there are positive sensations, they are
further enhanced. In
phase seven, closure, the therapist asks the client to keep a journal
during the week to document any related material that may arise and
reminds the client of the self-calming activities that were mastered in
phase two. The
next session begins with phase eight, re-evaluation of the previous
work, and of progress since the previous session. EMDR treatment ensures
processing of all related historical events, current incidents that
elicit distress, and future scenarios that will require different
responses. The overall goal is produce the most comprehensive and
profound treatment effects in the shortest period of time, while
simultaneously maintaining a stable client within a balanced system. After
EMDR processing, clients generally report that the emotional distress
related to the memory has been eliminated, or greatly decreased, and
that they have gained important cognitive insights. Importantly, these
emotional and cognitive changes usually result in spontaneous behavioral
and personal change, which are further enhanced with standard EMDR
procedures. Books Eye
Movement Desensitization and Reprocessing: Basic Principles, Protocols
and Procedures EMDR:
The Breakthrough Therapy for Overcoming Anxiety, Stress and Trauma EMDR
as an Integrative Psychotherapy Approach EMDR
and Psychotherapy Integration EMDR
in the Treatment of Adults Abused as Children Small
Wonders: Healing Childhood Trauma with EMDR Through
The Eyes of a Child EMDR
in Children and Adolescent Psychotherapy EMDR
and the Relational Imperative: The Therapeutic Relationship in EMDR
Treatment EMDR
Solutions: Pathways to Healing |
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