Eye Movement Desensitization and Reprocessing (EMDR)

First, the client and therapist work together to collect basic information about the traumatic experience, the nagging beliefs that persist and cloud day-to-day experiences, or symptoms associated with possible trauma (even if we have no memory of the trauma) such as hypervigilance, nightmares, etc.

 

Here is a snippet of what such a session might look like for a single incident trauma of a car accident:

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Together, the client and the therapist identify a starting target, by respecting a set of conditions for effectiveness. In this case, they opted for the moment the other car struck them. Other options may have been seeing the other car approach, the look on one of the victim’s faces, the sight of the blood, the smell of engine fuel, the sound of sirens, the sensation of being stuck in the vehicle, etc.

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Therapist: Bring back the image of the car hitting you.

 

The therapist helps the client identify the negative belief associated with it.

 

Client: I’ll never get over this.

 

Then, a preferred, positive belief, one that the client would like to believe and integrate but does not yet believe, is named.

 

Client: It’s over; I can move on with my life now.

 

Next, the client is asked to rate, on a scale (called the VOC scale) of 1 (not true at all) to 7 (completely true), how true the positive belief feels when connected to the target. At this stage, it usually doesn't feel very true. The client is then asked to identify the emotions that the target brings up, rate the level of distress associated with it on a scale (called the SUDs scale) of 0 to 10, and identify where in the body the disturbance is experienced.

 

Client: Fear and shame, with disturbance level 10, in belly and chest.

 

Then, the client is asked to hold in awareness the target, the negative belief, and the disturbing body sensations associated with the feelings. At the same time, the therapist guides the client’s eyes to move rapidly back and forth (or other bilateral stimulation used). This is done in sets, which may last from a few seconds to a few minutes. During each set the client is instructed to just notice whatever changes occur in mind and body, without attempting to control the experience in any way.

 

Occasionally, in the first few sets (first few minutes), there is an increase in the disturbance level. After a few sets of bilateral stimulations, with each new set, the target becomes less and less disturbing, and the positive belief feels increasingly true. The target is completely processed when recall of the image no longer brings up disturbing emotions, and the preferred positive belief feels completely true.

 

Client: Recalls the event accurately but no longer feels threatened by the image. It now feels like a distant memory rather than something that is happening right now.