Eye Movement Desensitization and Reprocessing (EMDR) Therapy

Biography

Francine Shapiro

Academic interest shift Participated in

B.A. (1968) M.A. (1974) Brooklyn College Ph.D. (1979) NYU English Literature

Diagnosed with Cancer

workshops Enrolled in a Ph.D. Clinical Psychology Program

History and Theory of EMDR

Francine Shapiro (1987) Therapeutic effect

EMD with added cognitive components

Physiologically-based information

processing system

This system processes multiple elements Stores memories in an accessible and useful form Memories are dysfunctionally processed and stored.

Psychopathology

Three Pronged Protocol

1.

Past events
Groundwork for dysfunctional processing

2. Present events Distress memories targeted Internal and external stimuli desensitized 3. Future events Imagined templates formed Acquired adaptive skills

Understanding Dysfunctional Memories

Memories networks Thoughts, images, sensations, emotions, etc. Trauma Incomplete processing

Prevents the forging of connections with more adaptive information in memory networks

Rape Victim example Large T Traumas sexual trauma, combat trauma, etc.

Small T Traumas being teased by peers

Who can it help?

PTSD Anxiety Depression Phobias Addictions Panic Attacks EMDR therapy is

recognized as a an effective treatment APA (American Psychiatric Association) Department of Defense Veterans Administration (recommended) APA (American Psycological Association) (recommended)

Phases of EMDR
8 Phases Phase 1: History and Treatment Planning Phase 2: Preparation Phase 3: Assessment Phase 4: Desensitization Phase 5: Installation Phase 6: Body Scan Phase 7: Closure Phase 8: Reevaluation

Phases do not equal the number of sessions

Never skip a phase, but you can go back to one

EMDR Phases
Phase 1 Phase 2

History and Treatment

Planning

What brought you to therapy?

Past trauma

Preparation Establishing a trusting relationship Techniques for future coping

Present distressing situation(s) Discuss skills needed for future coping

Relaxation

Explanation of theory and expectations

EMDR Phases
Phase 3 Phase 4

Assessment Choose a specific mental image from the target trauma as well as a negative belief associated with it Choose a desire positive self-belief Rate both situations using SUDS and VOC

Desensitization Focus on negative target

Memories, associations, bodily reactions

20-30 second intervals of eye movement

Tones, taping, etc.

SUDS reevaluation Reprocessing of traumatic associations

EMDR Phases
Phase 5 Phase 6

Installation Focus on positive selfbelief 20-30 second intervals of eye movement VOC reevaluation Installation of positive association

Body Scan Focus on target trauma again

What sensations are you feeling? If so, go back to phase 4

Residual tension?

Goal: your whole body believes the new association

EMDR Phases
Phase 7 Phase 8

Closure Self-calming skills from Phase 2 Expectations for the week after the session Homework: keeping a journal of emotions and further processing

Reevaluation Are results being maintained?

Low SUDS rating, high VOC rating, without body tension

New targets identified to work on Continue reprocessing

Research
Power et al. (2002) Compared EMDR to cognitive restructuring and exposure therapies This study found both CBT and EMDR to be effective at reducing PTSD symptoms however EMDR was more efficacious at reducing PTSD depression related symptoms. This study also stated that participants needed fewer sessions of therapy than those in the other treatment group. de Roos et al. (2010) Compared CBT Vs. EMDR with disaster exposed children after being involved in explosion at a fireworks factory. This study found that both CBT and EMDR lowered post-traumatic stress symptoms questionnaire, but EMDR reached symptom reduction in fewer sessions.

Research cont.
Tarquinio et al. (2012) Compared EMDR, Eclectic Psychotherapy, and a control group for treating PTSD related to domestic violence This study found that Women in the EMDR condition showed significantly reduced PTSD and anxiety and to a greater degree in comparison to the eclectic. These effects were maintained at the 6-month follow-up. Kemp, Drummond, & Dcdermot (2010) Compared PTSD symptoms in children with motor vehicle accident related PTSD after four EMDR sessions or a wait-list control group.

All participants initially met two or more PTSD criteria. After EMDR treatment, this decreased to 25% in the EMDR group but remained at 100% in the wait-list group. Treatment gains were maintained at three and 12 month follow-up.

Research cont.
Jaberghaderi et al. (2004)

Compared CBT vs. EMDR in treating sexually abused Iranian girls with PTSD. Both CBT and EMDR showed significant reductions in posttraumatic symptoms, and moderate reduction in trauma related behavior problems. EMDR was able to attain same treatment gains in nearly half the amount of sessions required for CBT condition.
van der Kolk et al. (2007) Examined the short-term efficacy and long term effects of EMDR vs. Fluoxetine (SSRI) in treating PTSD. Found that EMDR was more effective than Fluoxetine in achieving sustained reductions in PTSD and depression symptoms for adult onset PTSD trauma survivors. Neither treatment produced full remission of PTSD symptoms in child-onset PTSD trauma.

Video
https://www.youtube.com/watch?v=bqbFIj5vwmA

https://www.youtube.com/watch?v=gZ5MLn1Cc94

References

http://www.emdr.com/ http://www.emdrinaction.com/ http://www.emdrnetwork.org/ Centre for Reviews and, D. (2009). Empirically supported psychological treatments for adult acute stress disorder and posttraumatic stress disorder: a review (Structured abstract). Depression And Anxiety, 26(12), 1086-1109. de Roos, C., Greenwald, R., Hollander-Gijsman, M., Noorthoorn, E., Buuren, S., & Jongh, A. (2010). A randomized comparison of cognitive behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR) in disaster exposed children. European Journal Of Psychotraumatology, 11-11 Jaberghaderi, N., Greenwald, R., Rubin, A., Zand, S. H., &Dolatabadi, S. (2004). A comparison of CBF-BT and EMDR for sexually-abused Iranian girls. Clinical Psychology and Psychotherapy, 11, 358_368 Kemp, M., Drummond, P., & Mcdermott, B. (2010). A wait-list controlled pilot study of eye movement desensitization and reprocessing (EMDR) for children with post-traumatic stress disorder (PTSD) symptoms from motor vehicle accidents (English). Clinical Child Psychology And Psychiatry, 15(1), 5-25.

References cont.
Power, K., McGoldrick, T., Brown, K., Buchanan, R., Sharp, D., Swanson, V., et al. (2002). A controlled comparison of eye movement desensitization and reprocessing versus exposure plus cognitive restructuring versus waiting list in the treatment of posttraumatic stress disorder. Clinical Psychology and Psychotherapy, 9, 299_318. Schottenbauer, M. A., Glass, C. R., Arnkoff, D. B., & Gray, S. (2008). Contributions of psychodynamic approaches to treatment of PTSD and trauma: A review of the empirical treatment and psychopathology literature. Psychiatry: Interpersonal And Biological Processes, 71(1), 13-34. doi:10.1521/psyc.2008.71.1.13 Tarquinio, C. C., Brennstuhl, M. J., Rydberg, J. A., Schmitt, A. A., Mouda, F. F., Lourel, M. M., & Tarquinio, P. P. (2012). Eye movement desensitization and reprocessing (EMDR) therapy in the treatment of victims of domestic violence: A pilot study. European Review Of Applied Psychology, 62(4), 205. van der Kolk, B., Spinazzola, J., Blaustein, M., Hopper, J., Hopper, E., Korn, D., & Simpson, W. (2001). A randomized clinical trial of eye movement desensitization and reprocessing (EMDR), fluoxetine, and pill placebo in the treatment of posttraumatic stress disorder : Treatment effects and long-term maintenance (English). The Journal Of Clinical Psychiatry, 68(1), 37-46.