by Nancy Jennings

EMDR - Eye Movement Desensitization and Reprocessing - is a relatively new and unique therapeutic approach used in helping individuals with a variety of disorders and emotional stresses.

Purely by chance in 1987, psychologist Francine Shapiro discovered that voluntary eye movements eased the intensity of her anxieties and negative thoughts. Later, she went on to study the impact of these voluntary eye movements on Vietnam veterans suffering from post-traumatic stress disorder (PTSD). Over the years, trained clinicians and researchers all over the world have helped refine the techniques used in treating patients.

What Is EMDR?

EMDR is a complex method of psychotherapy that integrates many of the successful elements of a range oftherapeutic approaches in combination with eye movements or other forms of rhythmical stimulation in ways to stimulate the brain's information processing system. The therapist may use a visual approach, often achieved by waving their fingers or some other object back and forth in front of the client's eyes, at a comfortable but fairly quick pace, for short periods of time (hence the "eye movement"). However, some clients - for whatever reasons - are unable to follow the eye movements. In this case, the therapist may tap lightly on the client's knees or hands (placed palm-down on the knees), alternating back and forth between each knee or hand, again at a comfortable but quick pace. This technique may be used several times during a typical therapy session, and is combined with visualization, cognition, and observing body sensations.

How Does It Work?

No one seems to know exactly why or how EMDR actually works. According to the EMDR International Association, "What research has suggested so far is that when a person is very upset, the brain cannot process information as it normally does. The event that provoked the upset becomes 'frozen in time,' and 'stuck' in the information processing system. When a person remembers this event, the recalling of sights, sounds, smells, thoughts and emotions can feel as intense as when it actually occurred. Such upsetting memories may have a profoundly negative impact on the way a person sees the world and relates to other people. Present-day incidents and interactions re-stimulate the experience of this upsetting event." Theorics suggest EMDR works very much like REM sleep, when the brain dreams. Often, during dreams, individuals are able to "work through" issues they may be dealing with, and upon waking, find themselves feeling things have been "resolved."

EMDR appears to produce a direct effect on the way the brain processes upsetting material Researchers have suggested that the eye movements (or being tapped on alternating knees, hands, etc) and the specific targeting of information about the upsetting events may permit direct access to the stored pathology in the brain and more rapid working-through of disturbances than more conventional forms of therapy.

What Happens During an EMDR Session?

A typical EMDR session may start out just as any other therapy session - identifying the specific problem or problems that will be the focus of treatment. With EMDR, no trauma is considered too insignificant - it could be something as simple as always being chosen last for sports teams as a child at summer camp - because every trauma impacts individuals in different ways, and shapes our lives for years to come.

Following a defined protocol, the therapist helps the client identify the images, self-referenced negative belief, emotions and body sensations associated with the targeted problem or event. The client is then asked to develop a new positive belief about him or her self to replace the negative belief.

Once an event or memory is being focused on, the therapist may ask the client to visualize the trauma. Once the client has that picture in his or her mind, the therapist usually begins using EMDR. This is repeated several times over during a session, while working through the trauma at different levels. Clients are encouraged to face and leel their emotions - often a frightening, painful or unhappy experience. When painful memories are avoided, they keep their disturbing power, and may make everyday life difficult. Therapy using EMDR provides a safe place where past traumas can be explored and worked through, so individuals may move forward in their lives.

EMDR is not meant to make someone "forget" an experience they may have had, but rather to learn to process the event in a way that is less emotional and not as threatening.

EMDR and Children

EMDR has been shown to be effective in children, as well, helping them to overcome traumas such as surviving natural disasters, automobile accidents, abuse, neglect, and other emotional experiences.

Some aspects of using EMDR with children are typical of any child in therapy the need for parental (or caregiver) cooperation and support for treatment; the problem of motivating a child who did not request, nor wants, treatment, and the tendency of many children to be uninterested in therapy, have short attention spans, not be verbally oriented, etc.

Because of the emotional aspects associated with EMDR, there must be a strong bond of trust between the child and the therapist, and therefore it should not be undertaken lightly or early in the child/therapist relationship.

EMDR can be used with very young children (under the age of five), but there are special problems. At young ages, children may not have the capacity to concentrate long enough to cooperate with the procedure. If the trauma is painful to recall, children may not be willing to continue. They also may not have the ability to realize EMDR is part of a "healing process."

Using EMDR with pre-adolescents and teens has its own set of challenges, including non-compliance, inability to maintain the commitment, and inability to work towards a goal. They may feel they are "cured" shortly into treatment, and as with younger children, re-experiencing painful traumas may be too difficult for them to handle.

As always, a trusting relationship with the therapist is key to overcoming these and other obstacles.
EMDR expert Rick Greenwald, Psy.D., notes, "Many abused children, particularly those exposed to sexual abuse, have been pressured, lied to, and tricked in a variety of ways. Add to this the child's own adaptive responses, including assumption of guilt, dissociation, distortion, and denial, and there is a high likelihood that the child's memory, cognitive processes, and sense of reality will be seriously compromised." For such children, a major treatment focus may be the recovery of history and validation of their experience, with the therapist as a witness and co-investigator.

As with any form of therapy, using EMDR with abused and neglected children can often be an arduous and emotionally difficult process. Studies have shown, however, that positive results can be achieved fairly quickly (ranging anywhere from "some" relief during the initial session, to complete relief in several sessions), and while the technique is still new, positive rcsults appear to be long-term.

In order to practice EMDR, a therapist must have a graduate (minimum Masters) degree in a human-services or counseling related field, and attend two separate, week-long trainings which include rigorous clinical application.

You can find more information about EMDR, including a list of licensed practitioners, on the world-wide web at www.emdria.org, or by calling (5l2) 45l-5200.