Eye Movement Desensitization and Reprocessing (EMDR) is a psychotherapeutic approach developed by Francine Shapiro to resolve symptoms resulting from exposure to a traumatic or distressing event, such as sexual assault. Clinical trials have demonstrated EMDR's efficacy in the treatment of post traumatic stress disorder (PTSD). It has shown to be more effective than some alternative treatments and equivalent to cognitive behavioral and exposure therapies.

     The theoretical model underlying EMDR treatment hypothesizes that EMDR works by processing distressing memories. EMDR is based on a theoretical information processing model which suggests that symptoms arise when events are inadequately processed, and can be eradicated when the memory is fully processed. It is an integrative therapy, synthesizing elements of many traditional psychological orientations, such as psychodynamic, cognitive behavioral, experiential, physiological, and interpersonal therapies.

What should I expect during a session using EMDR?

     EMDR's most controversial aspect is an unusual component of dual attention stimulation, such as eye movements, bilateral sound, or bilateral tactile stimulation. The founder of EMDR, Francine Shapiro, while walking in the park in 1987, discovered that side to side eye movements appeared to decrease the negative emotion associated with her own distressing memories. She decided to incorporate this new component into cognitive restructuring therapy for traumatic memories.

     In an EMDR session, a specific traumatic memory is identified for the focus of the session. The client is instructed to focus on an image, a corresponding negative thought, and body sensations associated with the traumatic memory 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. Although 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.

     See www.EMDR.com or the Handbook of EMDR and Family Therapy Processes by Francine Shapiro for more information.