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EMDR for Professionals Hospice of Volusia/Flagler Lynda Majure Ruf, EdS, LMFT, LMHC August 3, 2007. What is EMDR?. EMDR is a psychological method for treating emotional difficulties caused by disturbing events.
Hospice of Volusia/Flagler
Lynda Majure Ruf, EdS, LMFT, LMHC
August 3, 2007
Under normal circumstances, this information processing may occur during thinking, talking, expressive/artistic activities, and/or dreaming.
In trauma, however, a malfunction of this natural information processing system occurs such that the experience of the trauma remains “frozen”, manifesting in persistent intrusive thoughts, negative emotions and self-referenced beliefs, and unpleasant body sensations.EMDR: An Adaptive Information Processing Model
When a traumatic or very negative event occurs, information processing may be incomplete, perhaps because strong negative feelings or dissociation interfere with information processing. This prevents the forging of connections with more adaptive information that is held in other memory networks. For example, a rape survivor may “know” that rapists are responsible for their crimes, but this information does not connect with her feeling that she is to blame for the attack. The memory is then dysfunctionally stored without appropriate associative connections and with many elements still unprocessed. When the individual thinks about the trauma, or when the memory is triggered by similar situations, the person may feel like s/he is reliving it, or may experience strong emotions and physical sensations. A prime example is the intrusive thoughts, emotional disturbance, and negative self-referencing beliefs of posttraumatic stress disorder (PTSD).
During EMDR, the clinician works with the client to identify the specific problem that will be the focus of treatment.
Utilizing a structured protocol, the practitioner guides the client through a description of a disturbing event related to his or her presenting problem(s). The practitioner asks the client to identify and focus on the image, cognitions, emotions, and somatic distress associated with the traumatic memory.
While the client is engaged in eye movements or some other form of bilateral stimulation, s/he is experiencing various aspects of the initial memory or other related memories.
The practitioner pauses with the eye movements or bilateral stimulation at regular intervals to ensure that the client is processing adequately on his or her own.
The practitioner guides the process, making clinical decisions about the direction of the intervention. The client may process at cognitive, affective, and/or somatic levels over the course of a given session. The goal is the client's rapid processing of information about the negative experience, bringing it to an "adaptive resolution."
In Shapiro's words, this means a reduction in the symptomatology, a shift in the negative belief to the client's new positive belief, and the prospect of functioning more optimally.
The comprehensive "three-pronged approach" employed in the EMDR method addresses:
1) earlier life experience;
2) present-day stressors; and
3) desired thoughts and actions for the future.
EMDR treatment may last from 1-3 sessions to 1 year or longer for complex problems.
"Several lines of evidence suggest that EMDR may help in the treatment of PTSD by turning on memory processing systems normally activated during Rapid Eye Movement (REM) sleep but dysfunctional in the PTSD patient. Two separate memory systems store information in the brain. One, located in the hippocampus, stores 'episodic' memories, the memories of actual events in our lives. The second, located in the neocortex, stores general information and associations.”
Stickgold proposed that recovery from trauma depends the processing of traumatic memories in their episodic form into general semantic memories. Literature that suggests that this normally occurs during REM sleep but is prevented from occurring for people who have PTSD. In particular the arousal associated with PTSD results in associations between the trauma event and other related events failing to develop.
“In a recent EMDR study, in collaboration with the New England Deaconess/Beth Israel Neuroimaging Laboratory, brain scans were used to measure how brain activity changes after effective treatment.”
The eight phases of the EMDR protocol represent a
comprehensive treatment approach incorporating many well-established elements of psychotherapy and the novel element of bilateral stimulation.
1. Client History and Treatment Planning
2. Client Preparation
6. Body Scan
I am a bad person.
I am worthless (inadequate).
I am shameful.
I deserve only bad things.
I cannot trust my judgment.
I cannot succeed.
I am not in control.
I am powerless.
I am weak.
I cannot protect myself.
I am stupid.
I am Insignificant (unimportant).
I am a disappointment.
I deserve to die.
I deserve to be miserable.
I cannot get what I want.
I am a failure (will fail).
I have to be perfect (please everyone).
I am permanently damaged.
I am a good person.
I am worthy; I am worthwhile.
I am honorable.
I deserve good things.
I can trust my judgment.
I can succeed.
I am now In control.
I now have choices.
I am strong.
I can (learn to) take care of myself.
I have intelligence.
I am significant (important).
I am okay just the way I am.
I deserve to live.
I deserve to be happy.
I can get what I want.
I can succeed.
I can be myself (make mistakes).
I am (can be) healthy.
Reprinted with permission of the EMDR Institute, Inc.
Sexual Abuse by
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BEING LAID OFF
AT HIS COMPANY
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Nausea, tightness in chest, tingling in arms.
International Treatment Guidelines