PSYCHE WHAT IS EMDR, HOW IT WORKS AND WHAT THE THERAPY CONSISTS OF

Discovered in the late 1990s, EMDR is often used to treat disorders related to stressful or traumatic events. But when is it appropriate to resort to it and how does the therapy work?

What is EMDR?

EMDR ( Eye Movement Desensitization and Reprocessing ) is a type of psychotherapy treatment approach used to treat traumatic and stressful events. Notably, it is an evidence-based treatment for PTSD, as revealed in 2011 by the Substance Abuse and Mental Health Services Administration (SAMHSA). EMDR therapists help patients with therapy sessions either in-house sessions or online sessions that are held over the video call on zoom or skype and term cloud emdr is used for them. 

This approach was studied by Francine Shapiro between 1987 and 1990 and is currently a standardized tool empirically supported by numerous studies.

According to Shapiro’s Adaptive Information Processing (AIP) model, humans have an intrinsic and adaptive system that allows them to process memories. When they are traumatic it is possible that the elaboration does not take place correctly and a pathology develops.

EMDR, focusing on the recall of the traumatic event, aims to have this memory reworked adequately with a consequent reduction in symptoms.

The EMDR therapist helps the patient through specific stimulation involving both hemispheres of the brain: this can be done with alternating eye movements or other right/left stimulation.

How EMDR works

Bilateral brain stimulation makes it possible to desensitize the memory and to modify the beliefs that the subject has about the event.

This allows the subject to perceive the memory with more detachment, to feel the emotions less intensely, with less disturbing physical sensations and finally to modify the negative beliefs about oneself.

The role of the therapist is to make the patient re-elaborate, guiding him in the alternating ocular movement or with a right/left tactile stimulation, without intervening directly in order not to interrupt the elaboration.

What ailments it is used with is it used

The term trauma can refer to different experiences. Traumas with a capital “T” and traumas with a small “t” are divided:

• Capital T: life events in which the subject – or someone very close to him – has the perception of risking physical integrity or life. The most common examples are accidents, deaths, sexual abuse, natural disasters;
• lowercase t: relational trauma caused by attachment figures who repeatedly fail to meet the child’s emotional and relational needs (trauma by omission).

Given this distinction, EMDR is used with trauma or stressful events of varying intensity

• Pathological and non-pathological mourning;
• Trauma from natural disasters;
• Traffic accident injuries;
• Traumas from abuses of various kinds;
• Traumas following violence;
• Lived in humiliation;
• Childhood trauma

The effectiveness of this treatment is particularly evident with the following complaints:

• post-traumatic stress disorder (PTSD);
• acute stress disorder;
• complex PTSD;
• dissociative disorders;
• adjustment disorders;
• reactive attachment disorder.

Furthermore, EMDR is used extensively in the treatment of children, given their inability to cognitively process a memory.

What is EMDR therapy?

EMDR therapy follows a standard protocol, it is generally used in individual therapies but sometimes it is also used in groups.

The duration of the therapeutic process varies according to the patient’s response and the type of trauma reported.

The protocol includes several phases:

• • A patient history is taken and the treatment plan is established. The problem and the target memories on which to work are defined;
  • The patient is prepared for the therapy: the principles and functioning of the protocol are explained in detail. Furthermore, the first relaxation techniques are introduced;
  • We proceed with a detailed evaluation of the various aspects necessary for the therapy, for example identification of the memory to desensitize and its imaginative, emotional, cognitive and physical component;
  • Desensitization of the memory is initiated thanks to bilateral stimulation until the image of the event is no longer perceived as disturbing;
  • A positive cognitive restructuring of the event is carried out;
  • Attention is paid to the bodily aspects , evaluating any changes in the physical sensations linked to the traumatic event;
  •  We proceed with the closure of the elaboration of the memory;
  • Finally, a re-evaluation of the event takes place to analyze any new aspects.

Side effects 

The sessions can be emotionally intense: the patient may cry or be tired at the end of the session. This depends on the intensity of emotional, cognitive and physical processing.

If the elaboration has not been completed during the session, it is possible that in the following hours the patient will relive part of the memory or unpleasant sensations.

The therapist makes this aspect explicit and makes himself available to be contacted or to anticipate the next appointment.

Effectiveness of EMDR treatment and controversies

To date, there are numerous scientific studies that confirm the effectiveness of this treatment. In 2013, the World Health Organization recognized EMDR as an effective therapeutic approach for the treatment of trauma and related disorders.

Research has not only demonstrated its effectiveness but has also highlighted physiological and structural changes in patients undergoing EMDR. 

A normalization of basal levels of cortisol, a hormone that is produced following stress, has been demonstrated after EMDR treatment (Heber et al., 2002). Changes also emerged at the level of brain structure – hippocampus, medial temporal lobe – brain areas responsible for memory (Pagani et al., 2007; Bossini et al. 2007).

Numerous scientific studies are reported on the EMDR Italia website that support this type of therapeutic approach .