Wednesday, November 30, 2022

What Is Emdr Treatment For Ptsd

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What To Expect From Emdr Session

Eye Movement Desensitization and Reprocessing (EMDR) for PTSD

Typically, during an EMDR session, the therapist guides a person through the structured eight-step process. This process can help them discover insights and form new thoughts while focusing on the targeted memory and engaging in the eye movement or other exercises.

As the memory is processed, the person may begin to feel less overwhelmed or distressed when thinking about the different aspects of the memory. They potentially will begin to think about other painful or distressing memories related to the one being targeted in the session. This is a sign of the memory being processed and the brain beginning to heal.

After the session, a person should feel more empowered over their memories and their present situation. They also should be better able to handle future situations.

Emdr Phase : Reevaluation

Each new session begins with a reevaluation of your progress. First, you will be asked to focus on any targets youve already reprocessed. Your therapist will review your responses, checking to see if youve maintained the positive results.

Your therapist may also ask how you feel about the previously-treated targets and review any disturbances that came up between sessions. Based on this reevaluation, your therapist will decide whether to move on to new targets or to revisit old targets for additional reprocessing and integration.

How Did Emdr Therapy Start

In the late 1980s, Francine Shapiro, Ph.D., discovered a connection between eye movement and persistent upsetting memories. With this personal insight, she began what became a lifelong study and development of Eye Movement Desensitization and Reprocessing therapy.

Over the years, and in the face of initial skepticism, Dr. Shapiros work developed from a hypothesis to a formal therapy process. EMDR therapy has been demonstrated to be effective for treating trauma in randomized clinical trials, case studies, and millions of clinical hours treating trauma and trauma-related disorders across the globe. From the American Psychiatric Association, the U.S. Department of Veterans Affairs and Department of Defense , the United Kingdoms National Institute for Health Care and Excellence , and the World Health Organization , multiple global organizations now recognize the effectiveness of EMDR therapy that Dr. Shapiro developed.

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Will I Lose Control Of Myself Or My Emotions

The nature of EMDR can be very activating. An appropriately trained EMDR provider will walk you through every specific concern including experiencing strong emotions. The protocol has safety measures in place to prevent anyone from losing control, and the client is in charge of the entire process from beginning to end. Therefore you can stop or take a break at any time.

Who Is Emdr Appropriate For

EMDR Therapy for Trauma Recovery

EMDR therapy has been endorsed by the American Psychiatric Association and the International Society for Traumatic Stress Studies. The United States Department of Veterans Affairs , the Department of Defense, and overseas organizations, including the United Kingdom Department of Health and the Israeli National Council for Mental Health have also endorsed this treatment.

According to the EMDR Research Foundation, over 30 studies have documented the effectiveness of EMDR therapy over the past 30 years for problems such as rape and sexual abuse, combat trauma, childhood trauma and neglect, life-threatening accidents, and symptoms such as anxiety, depression, and substance abuse.¹

Edy Nathan, MA, LCSW, is a licensed psychotherapist with over 20 years of experience as a certified EMDR practitioner. Nathan believes that this type of therapy has the ability to heal people who are suffering from all types of trauma.

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Using Emdr To Treat Ptsd

EMDR therapy uses a structured eight-phase approach that includes:

  • Phase 1: History-taking
  • Phase 2: Preparing the client
  • Phase 3: Assessing the target memory
  • Phases 4-7: Processing the memory to adaptive resolution
  • Phase 8: Evaluating treatment results

Processing of a specific memory is generally completed within one to three sessions. EMDR therapy differs from other trauma-focused treatments in that it does not include extended exposure to the distressing memory, detailed descriptions of the trauma, challenging of dysfunctional beliefs or homework assignments.

How Do I Still Honor Those Who I Lost During These Events Or Am I Betraying Those Who Lost Their Lives

When traumatic memories become normal memories we are better able to serve those who we wish to remember well. Healing from these events provides the space and ability to celebrate them.

When the memories are stuck in the emergency center of the brain, it is much harder to honor them because it is too triggering. Again, traumatic memories are not erased, just changed into healthier more adaptive memories.

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How Does Emdr Therapy Affect The Brain

Our brains have a natural way to recover from traumatic memories and events. This process involves communication between the amygdala , the hippocampus , and the prefrontal cortex . While many times traumatic experiences can be managed and resolved spontaneously, they may not be processed without help.

Stress responses are part of our natural fight, flight, or freeze instincts. When distress from a disturbing event remains, the upsetting images, thoughts, and emotions may create an overwhelming feeling of being back in that moment, or of being frozen in time. EMDR therapy helps the brain process these memories, and allows normal healing to resume. The experience is still remembered, but the fight, flight, or freeze response from the original event is resolved.

Emdr Phase : Desensitization

EMDR | The impact of EMDR on my PTSD 18 months later

During the desensitization phase, youll pay attention to all the negative beliefs and disturbing emotions and bodily sensations that come up as you focus on your target image while following your therapists finger back and forth with your eyes.

Youll be asked to take note of all your reactions to the processinggood, bad, or neutralincluding any new insights, associations, or emotions you experience.

After each set of rapid eye movements, the therapist will check in with you and assess your level of disturbance regarding the target image. During this process, you will continue to digest or process the feelings, images, and beliefs that occur in relation to the trauma target.

The desensitization phase continues until your distress level, as measured by the SUD scale, is reduced to 0 or 1.

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Who Can Benefit From Emdr Therapy

EMDR therapy helps children and adults of all ages. Therapists use EMDR therapy to address a wide range of challenges:

  • Anxiety, panic attacks, and phobias
  • Chronic Illness and medical issues
  • Depression and bipolar disorders
  • Post-Traumatic Stress Disorder and other trauma and stress-related issues
  • Violence and abuse

What Type Of Treatment Is This

Eye Movement Desensitization and Reprocessing is a psychotherapyor talk therapyfor PTSD. EMDR can help you process upsetting memories, thoughts, and feelings related to the trauma. By processing these experiences, you can get relief from PTSD symptoms.

Video

Dr. Melissa Beason-Smith describes the Eye Movement Desensitization and Reprocessing treatment under a minute.

Dr. Melissa Beason-Smith describes the Eye Movement Desensitization and Reprocessing treatment under a minute.

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Research With Military Personnel And Veterans

Most research on EMDR has been conducted in non-Veteran civilian samples. A recent review identified four randomized controlled trials examining EMDR in military or Veteran populations . All of these studies were published before the year 2000 and only one study included a full course of treatment . The others were short duration studies . EMDR improved PTSD symptoms comparably to comparison conditions EMDR without eye movement usual care and, biofeedback ). Given the limitations of these studies, more research with Veterans and military Service members is needed.

Is Emdr Therapy Applied To Every Clinical Disorder

EMDR Therapy

No. EMDR therapy was developed as a treatment for traumatic memories and research has demonstrated its effectiveness in the treatment of PTSD . Shapiro states that it should be helpful in reducing or eliminating other disorders that originate following a distressing experience. For example, Brown, McGoldrick, and Buchanan found successful remission in five of seven consecutive cases of Body Dysmorphic Disorder cases after 1-3 EMDR therapy sessions that processed the etiological memory. Similarly there have been reports of elimination of phantom limb pain following EMDR treatment of the etiological memory and the pain sensations . It is not anticipated that EMDR therapy will be able to alleviate fully the symptoms arising from physiologically based disorders, such as schizophrenia or bipolar disorder. However, experiential contributors may play a major role in some symptoms, and there are anecdotal reports of persons with such disorders being treated successfully with EMDR therapy for distress related to traumatic events.

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Can The Effects Of Emdr Therapy Be Attributed To Placebo Or Non

No. A number of studies have found EMDR therapy superior in outcome to placebo treatments, and to treatments not specifically validated for PTSD. EMDR has outperformed active listening , standard outpatient care consisting of individual cognitive, psychodynamic, or behavioural therapy in a Kaiser Permanente Hospital , relaxation training with biofeedback . EMDR therapy as been found to be relatively equivalent to CBT therapies in seven randomized clinical trials that compared the two approaches. Because the treatment effects are large and clinically meaningful, it can be concluded that EMDR therapy is not a placebo treatment. For example, in a meta-analysis of PTSD treatments, Van Etten and Taylor , calculated the mean effect sizes on self-report measures for placebo and control conditions as 0. 43, for EMDR as 1.24, and for CBT as 1.27 . Several studies have measured the credibility of the treatments being provided, as a way to determine if EMDR therapy elicited more confidence from clients, thereby producing larger effects no study found EMDR more or less credible. Because EMDR therapy is not more credible than these other therapies, it appears that the effects cannot be attributed to suggestion or a heightened placebo effect.

What Does Emdr Therapy Feel Like

Typically, in EMDR, you will make spontaneous new insights and begin to notice that you feel less overwhelmed recollecting aspects of your chosen target, and you could potentially start to think about related memories that are painful or unpleasant. That is how EMDR therapy will make you feel like, and that means your mind is beginning to heal.

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Effectiveness And Theoretical Basis

Concerns have included questions about its effectiveness and the importance of the eye movement component of EMDR. In 2012, Hal Arkowitz, and Scott Lilienfeld summed up the state of the research at the time, saying that while EMDR is better than no treatment and probably better than merely talking to a supportive listener,

Yet not a shred of good evidence exists that EMDR is superior to exposure-based treatments that behavior and cognitive-behavior therapists have been administering routinely for decades. Paraphrasing British writer and critic Samuel Johnson, Harvard University psychologist Richard McNally nicely summed up the case for EMDR: “What is effective in EMDR is not new, and what is new is not effective.”

Client perceptions of effectiveness are also mixed.

Finding An Emdr Therapist

EMDR and C-PTSD Treatment

EMDR is a highly specialized therapy that should be conducted by a licensed mental health professional who has specific training in this complex approach. Some therapists are EMDR trained, meaning they have completed EMDR basic training. Others are EMDR certified, meaning they have conducted at least 50 EMDR sessions with patients and continue to further their education.

In addition to ensuring a therapist is certified to provide EMDR therapy, there are specific questions you may want to ask a potential therapist.

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Phase : History Taking

First, youll work with your therapist to develop a treatment plan and treatment goals. This might include talking about your history, what emotional triggers and symptoms you experience, and what youd like to achieve from therapy.

Your therapist might also determine whether youd benefit from therapies or treatments alongside EMDR.

Is Emdr Therapy Effective With Schizophrenia

Two studies have indicated that EMDR therapy has provided positive treatment effects to traumatized psychotic patients . In the second study, treatment of PTSD has a positive effect on auditory verbal hallucinations, delusions, anxiety symptoms, depression symptoms, and self-esteem. Individuals with schizophrenia may have experienced distressing life experiences or traumas that exacerbate their symptoms. Using EMDR therapy to process memories of such events may be helpful in alleviating stress and reducing symptoms. In such cases, it would be assumed that treatment would be provided only after appropriate stabilization, and in the hands of an expert in this specialty area. Anecdotal reports have given preliminary support for this. However, more research needs to be conducted.

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Is Emdr Therapy A One

No. When Shapiro first introduced EMDR therapy into the professional literature, she included the following caveat: It must be emphasized that the EMD procedure, as presented here, serves to desensitize the anxiety related to traumatic memories, not to eliminate all PTSD-symptomology and complications, nor to provide coping strategies to victims . In this first study, the focus was on one memory, with effects measured by changes in the Subjective Units of Disturbance scale. The literature consistently reports similar effects for EMDR with SUD measures of in-session anxiety. Since that time, EMDR therapy has evolved into an integrative approach that addresses the full clinical picture. Two studies have indicated an elimination of diagnosis of posttraumatic stress disorder in 83-90% of civilian participants after four to seven sessions. Other studies using participants with PTSD have found significant decreases in a wide range of symptoms after three-four sessions. The only randomized study of combat veterans to address the multiple traumas of this population reported that 12 sessions of treatment resulted in a 77% elimination of PTSD. Clients with multiple traumas and/or complex histories of childhood abuse, neglect, and poor attachment may require more extensive therapy, including substantial preparatory work in phase two of EMDR .

What Do People Who Have Tried Emdr Say About It

EMDR

that I have taken some control of my life back. Freedoms I didnt realize Id lost have been returned to me through EMDR in ways that psychotherapy couldnt quite manage I can say that I have let something shapeless, but every day terrifying, go.

Steph

Long story short, my experience receiving EMDR completely changed my life past experiences don’t bother me at all anymore In fact, I know how much wiser and stronger I’ve grown from these past struggles. It was intensely cathartic, emotionally draining, challenging, yet relieving and empowering.

Jason N. Linder

I worked with my EMDR therapist to resolve those traumas and the issues that had arised. In that process I really became liberated. During each and every session I experienced revelations. Everything just made sense.

Vivian Kulaga

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What Do The Guidelines Recommend

Guidelines issued by more than one professional organization have recently boosted the credibility of EMDR. These guidelines define who may benefit from the treatment. For example:

  • The American Psychiatric Association has noted that EMDR is effective for treating symptoms of acute and chronic PTSD. According to the APA, EMDR may be particularly useful for people who have trouble talking about the traumatic events they’ve experienced. The APA guidelines note that other research is needed to tell whether improvements from EMDR can be sustained over time.
  • The Department of Veterans Affairs and the Department of Defense have jointly issued clinical practice guidelines. These guidelines “strongly recommended” EMDR for the treatment of PTSD in both military and non-military populations. They also note that this approach has been as effective as other psychological treatments in some studies, and less effective in others.

What Is Emdr Therapy

Eye movement desensitization and reprocessing therapy is a mental health treatment technique. This method involves moving your eyes a specific way while you process traumatic memories. EMDRs goal is to help you heal from trauma or other distressing life experiences. Compared to other therapy methods, EMDR is relatively new. The first clinical trial investigating EMDR was in 1989. Dozens of clinical trials since EMDRs development show this technique is effective and can help a person faster than many other methods.

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What Does Emdr Therapy Involve

EMDR therapy consists of eight phases. These phases occur over multiple sessions, with one session sometimes using parts of several phases. An example of this would be how phases 1 and 2 typically happen only in early sessions, while phases 3 through 8 are part of multiple sessions later.

For a single disturbing event or memory, it usually takes between three and six sessions. More complex or longer-term traumas may take eight to 12 sessions . Sessions usually last between an hour and 90 minutes. The eight phases are:

  • Patient history and information gathering. This part of the process involves your healthcare provider gathering information about you and your past. This helps them determine if EMDR is likely to help you. It also includes asking about upsetting or disturbing events and memories that you want your therapy to focus on, as well as your goals for this therapy.
  • Preparation and education. During this phase, your healthcare provider will talk to you about what will happen during EMDR sessions and what you can expect. Theyll also talk to you about things to focus on to help you feel more stable and safe during sessions. Theyll provide you with tools to help you manage your emotions.
  • Installation. During this phase, your healthcare provider will have you focus on the positive belief you want to build in as you process a memory. This positive belief can be what you said in phase 3 or something new you think of during phase 4.
  • Sense activation during phase 4

    What If I Need To Keep The Memory In Order To Protect Myself

    PTSD Treatment: EMDR Therapy The VA

    It is a common concern that by desensitizing memory content, one might be disarmed or feel they are without protection since the memory triggers us to be cautious and possibly take certain actions or safety measures. It is important to remember that the body is supposed to return to homeostasis, or rest and digest once a traumatic or dangerous event has passed.

    Desensitizing this content does not put us in danger, in fact, it equips us to respond more effectively because the body and brain is free to respond to the current situation or danger right in front of us without these past traumatic events interfering.

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