Letting Go of the Past: EMDR from The Body Keeps the Score Part of the Lunch with Lois Series Lois A. Pessolano Ehrmann PhD, LPC, NCC Certified EMDR Clinician and Approved Consultant Executive Director and Found of The Individual and Family CHOICES Program 2214 North Atherton Street, Suite 4 State College, PA 16803 814-237-0567 www.individualandfamilychoices.com
Training Objectives By the end of this presentation participants will: Describe at least two hypothesis about why positive outcomes occur for traumatized clients who receive EMDR. Identify at least three components of the EMDR Basic Protocol for trauma resolution and why this is so essential to healing.
EMDR: What is It? EMDR is a psychological method for treating emotional difficulties caused by disturbing events. EMDR brings together elements from wellestablished clinical theoretical orientations. 1987 psychologist Francine Shapiro found that voluntary eye movements reduced the intensity of disturbing thoughts. 1989 Shapiro initiated the research study examining efficacy of EMDR in Vietnam combat veterans and victims of sexual assault. There are many studies that have documented the efficacy of EMDR in traumatized individuals when the basic protocol has been followed by the clinician. 3
EMDR: What is it used for? Discrete traumas such as 911, sunami, earthquake, rape experience Chronic abuse such as childhood sexual abuse, childhood physical abuse and neglect War or combat related traumatic stress/ PTSD Anxiety and other mood issues especially when fed by traumatic material 4
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EMDR: How does it work? EMDR is postulated to be an accelerated information processing model. Traumatization is a disruption of the inherent information processing system that normally leads to integration and adaptive resolution following upsetting experiences (van der Kolk & Fisler, 1995) 6
EMDR: How does it work? continued Components of Traumatic Memory Triggers Pictures Emotions TRAUMA Sensations Beliefs 7
EMDR: An Accelerated Information Processing Model EMDR specifically targets traumatic material and appears to restart stalled information processing, facilitating the resolution of the traumatic memories. Helps both parts of the brain work at the same time so that traumatic material stuck in the limbic area of the brain can move across the synapses into the frontal lobe area where perspective and rationality exits. 8
EMDR: Some Other Hypothesized Mechanisms Stickhold (2002): EMDR helps REM to restart in traumatized persons. Van der Kolk (1999): after EMDR left frontal lobe and cingulate gyrus were changed and participants had increased ability to differentiate between exposure to a real traumatic event and confrontation with a mere reminder of an event that happened many years ago. 9
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Bessel s Fascination with EMDR Page 253 EMDR loosens up something in the mind/brain that gives people rapid access to loosely associated memories and images from their past. This seems to help them put the traumatic experience into a larger context or perspective. People may be able to heal from trauma without talking about it. EMDR enables them to observe their experiences in a new way, without verbal give and take with another person. EMDR can help even if the patient and the therapist do not have a trusting relationship. This was particularly intriguing because trauma understandably, rarely leaves people with an open trusting heart.
Is EMDR a Type of Exposure Therapy? Repeated Exposure Therapy desensitizes clients to the trauma. EMDR does some desensitization but also then helps the client to integrate or digest the trauma. When trauma is integrated and digested the client s sense of agency, engagement and commitment through ownership of body and mind is restored.
What Happens During EMDR? Before any trauma processing evaluation of client resources and resource development occurs. Tapping In Clinician works with the client to identify the specific problem that will be the focus of treatment There is a structured protocol (review the Basic Protocol Template) Eye movements or some other bilateral stimulation is done while the person experiences various aspects of the initial memory or other related memories. Practitioner pauses with the bilateral stimulation at regular intervals to ensure that the client is processing adequately on his or her own. Clinician guides the process and direction. The client may process at cognitive, affective, and or somatic levels over the course of a session and the goal is the client s rapid processing of information about the negative experience bringing it to an adaptive resolution. It is a three-pronged approach that addresses Earlier life experience Present-day stressors Desired thoughts and actions for the future 13
The Structured Basic Protocol
Why Do Clients Seem to Respond Well to EMDR? It is a client centered approach that allows the clinician to facilitate the mobilization of the client s own inherent healing mechanisms. The EMDR model acknowledges the physiological component in emotional difficulties. The basic protocol directly targets these physical sensations, along with negative beliefs, emotional states and other disturbing symptoms. Thus it is very comprehensive treatment of trauma material. 15
EMDR: Where to find more Information www.emdria.org www.emdr.com www.individualandfamilychoices.com Go to the EMDR Regional Meeting page for articles 16