Eye Movement Desensitization and Reprocessing Therapy or EMDR therapy for short is a kind of psychotherapeutic intervention technique that makes use of lateral eye movements as its primary component. Lateral eye movements are made up of horizontal eye movements from right to left or left to right within one’s visual pane. Dr. Francine Shapiro first came up with this technique in the 1980s. This was after observing that patients who were being treated for problems associated with stressful events or traumatic events seemed more relieved from their stress when discussing memories of these events as they performed lateral eye movements.
Dr Shapiro then fine-tuned the technique by including additional aspects of Cognitive Behavioral Therapy within the process. This gave rise to a therapeutic intervention that the doctor felt was more effective than other techniques for treating people who had been exposed to traumatic stress in the past. EMDR therapy started to gain popularity among numerous therapists who underwent training by Shapiro and her colleagues. Currently, EMDR is quite popular as an effective and potential intervention that can be used in various contexts.
Uses of EMDR Therapy and Its Principles
Originally, EMDR was used in treating people who had gone through some form of stressful or traumatic experience causing emotional adjustment issues. The method was first used for treating Acute Stress Disorder, Adjustment Disorders, and Post Traumatic Stress Disorder. Once it started becoming popular, supporters of the treatment claimed that it could also be used to treat other health problems including anxiety disorders, depression, and substance abuse disorders. PTSD and trauma are commonly co-occurring disorders in people suffering from addiction. The main goals of EMDR therapy are to aid with the recovery process, alleviate symptoms, and treat trauma specifically when used for addiction recovery.
Interestingly, although EMDR is meant to use eye movements or EM, there are therapists who avoid using this component. Typically, eye movements will involve the therapist moving his or her fingers laterally or back and forth within the client’s visual field while the patient’s eyes follow the movement. On the other hand, relevant literature on the treatment shows that the treatment can be just as effective even with the replacement of the eye movement component with other techniques. Some of these alternative techniques include attention-focusing techniques like finger taps or the use of sounds.
EMDR therapy also incorporates the following aspects:
- Techniques found within the Cognitive Paradigm of Psychology focuses on any problems associated with one’s thinking or cognition. This cognitive paradigm is also concerned with the connection between behaviors and attitudes, the correlation between change in one’s belief systems and behavioral changes, the formation of beliefs, and the correlation between people's behavior and their belief systems
- Techniques found within behaviorism or the behavioral paradigm of psychology: EMDR heavily borrows from this paradigm but they are not exclusive to this treatment as they are also used in other modes of therapy. They were merely applied to EMDR.
- Assigned homework and In-Session Activities: EMDR borrows a leaf from most types of psychotherapy, more so Cognitive Behavioral Therapy, during which the therapist works hand in hand with the client to develop skills during their sessions. Afterward, the Therapist will assign “homework” to the client to complete. This homework will involve applying the skills that have been practiced during therapy sessions in real-life situations.
- The Development of a Stable Therapeutic Relationship: This is the working bond that exists between the client and the therapist and it includes the aspects of understanding, trust, and mutual respect. According to research, this therapeutic relationship plays a significant role in the positive results in any type of psychotherapy. If this alliance is weak then the outcomes of the treatment will also be poor.
The Eye Movements in EMDR are based on the theory that the use of saccadic eye movements or jerky/fast eye movements occurring naturally when one focuses on an object incorporates the person’s ability to reduce emotional stress and reprocess experiences. The aspect of eye movement within EMDR treatment is just a single component of the whole method. EMDR borrows from other elements of psychotherapy procedures that were already proven and established such as Cognitive Behavioral Therapy.
How EMDR Therapy Works
EMDR takes a therapeutic approach that is more action-oriented. Although the therapist takes an interest in the history of the client, the primary focus of the treatment is on how the person typically functions in their environment. Although the delivery of the method varies with different therapists, the traditional EMDR approach works in eight primary stages during treatment delivery.
- Collection of the Patient’s History and Planning the treatment: The therapist will take a detailed history of the patient and come up with a proper treatment plan
- Treatment Preparation: The Therapist will set several expectations for the treatment and help the patient establish techniques for self-control that can be used during sessions. The Therapist also discusses the patient’s trauma and its relation to their addiction to develop a better understanding of the entire treatment process to be carried out during the client’s addiction rehabilitation program
- The Assessment: The client and the therapist find a memory to focus on for each session with the patient picking a scene that represents the memory ideally. The patient will then make a statement to express a negative self-belief that is associated with this event. Afterward, the therapist urges the patient to make a positive statement associated with an internal feeling of control contradicting the aforementioned negative belief.
- Desensitization: The therapist will guide the patient through various eye movements or alternative modes of stimulation as he or she concentrates on the scene of the session and encourages the patient to be open to any outcomes. The therapist tells the patient to blank out any scene he or she was focusing on following each eye-movement series.
- The Installation: This stage aims to reinforce the positive belief that the client now associates with the scene selected by coupling the previous negative belief with the positive belief.
- Scanning the Body- The therapist requests the patient to visualize the scene again while observing for any remaining tension in the body. If there is any, the therapist helps the patient target and reprocess these individual sensations to eliminate and reduce any negative emotions and body sensations connected with the said scene.
- Closure- The patient makes use of the newly learned self-control techniques from phases one and two to restore an internal equilibrium. This phase is most efficient when there is incomplete reprocessing. The client will need to keep a journal or notes of any disturbances experienced in-between sessions.
- The Reevaluation- Prior to each follow-up session, the therapist will check to ensure there is a maintenance of progress while identifying any new areas that will need to be treated all through the patient’s substance addiction rehabilitation program.
All through the EMDR treatment phases, the therapist will work with the clients to help them process traumatic experiences via a state of learning that enables traumatic and disturbing experiences to be stored in the brain with healthy perspectives, understanding, and emotions.
When using EMDR therapy to treat addiction and trauma, the therapist will approach each situation for each client through a more informed perspective. This enables the patients to address the contributing factors and root causes of the addiction appropriately.