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One of the many supplemental scientific services options offered at Transformations Drug & Alcohol Treatment Center is Eye Movement and Desensitization and Reprocessing (EMDR). It is a type of psychotherapy based on the belief that disturbing memories are at the root of many mental disorders. Its goal is to reduce the effects of upsetting memories by teaching clients better ways of coping.
At Transformations, it is utilized to treat clients who have experienced events that continue to disturb them to such an extent that it is affecting their ability to function normally.
The client’s primary therapist does the initial assessment in order to identify whether or not EMDR would be beneficial. Next, the EMDR therapist attempts to identify if the client possesses necessary coping strategies to regulate their emotions both during the process and after.
A Harvard researcher believes the reason EMDR works is connected with the biological mechanisms involved in Rapid Eye Movement (REM) sleep, causing internal associations as the clients begin to process the memory and disturbing feelings. In successful EMDR therapy, the meaning of painful events is transformed on an emotional level. For instance, a rape victim shifts from feeling horror and self-disgust to holding the firm belief that “I survived it and I am strong.”
Unlike talk therapy, in EMDR the insights that clients gain come from their own accelerated intellectual and emotional processes instead of clinician interpretation. The outcome is that clients feel empowered by the very experiences that once troubled them. Their wounds have closed and been transformed. As a natural outcome of the EMDR therapeutic process, the clients’ thoughts, feelings and behavior show strong indicators of emotional health and resolution. All of this is accomplished without a lot of talking or doing homework as in other therapies.
EMDR focuses on the past, present and future, particularly past disturbing memories and related events. It uses bilateral stimulation (BLS), which consists of having the client think of a disturbing image and leading the client through some eye-tracking movements or other bilateral stimulation. The goal is to have the client make new, less stressful associations to the image, gain insight into themselves so they can change their behavior, and to develop specific skills that will help them handle situations better in the future.
Phase 1: The therapist assesses the client’s readiness and develops a treatment plan after a history-taking session. Possible targets for EMDR processing are determined, such as disturbing memories and current situations that are causing emotional distress. The first EMDR processing may involve childhood events instead of adult-onset stressors if the client had a problematic childhood.
The length of treatment depends upon the number of traumas and the age of PTSD onset. Generally, those with single-event adult-onset trauma can be successfully treated in less than five hours. Multiple trauma victims may require a longer treatment time.
Phase 2: During this phase, the therapist ensures that the client can handle emotional distress in a number of ways. Emphasis is on having the client learn a variety of imagery and stress reduction techniques that they can use outside of the sessions.
Phases 3-6: Using EMDR procedures the client identifies a target and:
The client also identifies a positive belief and the therapist aids the client in rating it and the negative emotions. The client then focuses on the image, negative thought and body sensations at the same time while engaging in EMDR processing using sets of bilateral stimulation, which may include eye movements, taps or tones.
For example, the client may use his eyes to track the therapist’s hand as it moves back and forth across the client’s field of vision. The client is encouraged to spontaneously notice whatever happens. The length of these sets varies from client to client.
The clinician tells the client to let his/her mind go blank and to notice whatever thought, feeling, image, memory or sensation comes to mind after each set of stimulation. The clinician will choose the next focus of attention based on what the client reports, and sets will be repeated throughout the session. The therapist will help the client get back on task if the client gets too upset or has trouble continuing.
When clients get to the point where they are no longer feeling distressed about the targeted memory, the are reminded to think of the positive belief identified when the session began. Clients may now be directed to focus on the positive belief during the next set of distressing events.
Phase 7: This phase involves closure and the keeping of a log by the clients for a week, documenting a related material that arises. This serves to remind the client of self-calming activities learned in Phase Two.
Phase 8: Now that progress that has been achieved, it is examined. All related historical events, current incidents that cause distress, and future events that will require different responses, are noted.
