A Treatment Approach for Traumatic Events

Many people experience trauma during their lifetime that affects their quality of life. Trauma is an emotional response to an event that is perceived to be life-threatening, like an accident, mental or physical abuse, or a natural disaster.  Immediately after the event, shock and denial are typical.  Longer-term reactions can include unpredictable emotions, flashbacks and even physical symptoms like headaches or nausea.  While these feelings are normal, some people have difficulty managing these emotions in constructive ways and may need to turn to psychologists, social workers, certified mental health counselors and trained behavioral health clinicians for help.

For those who live with memories of trauma, Eye Movement Desensitization & Reprocessing (EMDR) can be an effective choice for treatment.  While providing counseling for individuals, couples, children and adults, I offer this remarkable treatment that uses eye movement to help patients decrease the intensity of their memories and rebuild self-esteem and confidence.

How was EMDR developed?

In 1987, psychologist Dr. Francine Shapiro made the chance observation that eye movements can reduce the intensity of disturbing thoughts under certain conditions.  Dr. Shapiro studied this effect scientifically and, in 1989, she reported success using EMDR to treat victims of trauma in the Journal of Traumatic Stress.  Since then, EMDR has developed and evolved through the contributions of therapists and researchers all over the world. Today, EMDR is a set of standardized protocols that incorporates elements from many different treatment approaches.

How does EMDR work?

No one really knows exactly how any form of psychotherapy works in the brain.  However, we do know that when a person is very upset, their brain cannot process information as it ordinarily does.  One moment becomes “frozen in time,” and remembering a trauma may feel as bad as going through it the first time, because the images, sounds, smells, and feelings haven’t changed.  Such memories have a lasting negative effect that interferes with the way a person sees the world and the way they relate to other people.

EMDR seems to have a direct effect on the way the brain processes information,  allowing normal information processing to resume.  Following a successful EMDR session, a person no longer relives the images, sounds, and feelings when the event is brought to mind. That person may still remember what happened, but it is less upsetting.  Many types of therapy have similar goals; however, EMDR appears to be similar to what occurs naturally during dreaming or REM (rapid eye movement) sleep.  Therefore, EMDR can be thought of as a physiologically-based therapy that helps a person see disturbing material in a new and less distressing way.

What kind of problems can EMDR treat?

Scientific research has established EMDR as effective for post-traumatic stress disorder (PTSD).  Clinicians also have reported success using EMDR in treatment of the following conditions:

  • Panic attacks
  • Complicated grief
  • Dissociative disorders
  • Disturbing memories
  • Phobias
  • Pain disorders
  • Performance anxiety
  • Stress reduction
  • Addictions
  • Sexual and/or physical abuse
  • Body dysmorphic disorders
  • Personality disorders

What is the actual EMDR session like?

There are 8 phases of EMDR treatment:

1)      Patient History and Treatment Planning: The first session involves the patient talking with the therapist who will take down some history including the reason why the patient is seeking help.

2)      Preparation: During preparation, the therapist will help teach self-care techniques, such as relaxation and visualization.  These techniques will help the patient as they go through the 8 step process.  The therapist will also explain EMDR in more detail and talk about what can be expected in the coming sessions.

3)      Assessment: During the assessment, the therapist will work on determining a target memory (specific scene or picture) that best represents the traumatic event.  The patient and therapist also work on determining negative and positive beliefs.  A negative belief associated with the trauma could be “I’m in danger.”  A positive belief to replace the negative belief would be “I’m safe now.”

4)      Desensitization: The patient learns to reprocess the negative beliefs and upsetting emotions while the therapist begins the eye movement process.

5)      Installation: The patient works on replacing negative beliefs with positive thoughts while the therapist performs the eye movement process.

6)      Body Scan: The patient will work on focusing on any lingering physical sensations so they can discuss the emotional event without feeling uncomfortable or tense.

7)      Closure:  The therapist will discuss the progress with the patient and goals for the next visit.

8)      Reevaluation: Each new session begins with a reevaluation of progress.  Based on this reevaluation, the therapist will determine whether the patient can move on to a new target memory or if additional treatment is needed for the previous target memory.

Past, Present and Future

Although EMDR may produce results more rapidly than previous forms of therapy, speed is not the issue and it is important to remember that every person has different needs.  For instance, one person may take weeks to establish sufficient feelings of trust (Phase Two), while another may proceed quickly through the first six phases of treatment only to reveal something even more important that needs treatment.  Also, treatment is not complete until EMDR therapy has focused on the past memories that are contributing to the problem, the present situations that are disturbing or trigger the traumatic event, and what skills the person may need for the future.

Besides using EMDR for treatment of patients with trauma, I have also had success in using EMDR as an addition to cognitive therapy for those patients who want to change their “stuck thinking.”  These patients have not experienced trauma, but have come to therapy with the hopes of changing patterns of negative and self-defeating thinking.  EMDR has been successful in helping patients ”remove the baggage” that has accumulated and created their state of mind, while adding strength to a patient’s natural progression of positive cognitions, i.e. “life can be difficult, but I can be strong.”

It is important to find a mental health professional that is experienced in EMDR therapy and has the most up to date training.  Because this process requires processing difficult memories, the therapist must ensure the patient has the coping skills to work through emotions during and in between sessions.  Like any self-improvement therapy, the patient will need to be committed and persistent to get the best results.

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About Terrel Fenn, LICSW

Terrel Fenn, LICSW, joined the Concord practice of Harvard Vanguard Medical Associates in 2004. He provides counseling to adults and children and has additional training in the areas of substance abuse treatment and hypnotherapy. He is certified in EMDR treatment by the EMDR International Association.
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