We continue to recognize Mental Illness Awareness Week in Canada with information about an important approach to treating individuals who have experienced trauma. Eye Movement Desensitization and Reprocessing is an effective way to support clients who have experience significant trauma.
What is EMDR?
Eye Movement Desensitization and Reprocessing (EMDR) is a treatment for psychological trauma. It is currently one of the fastest and most effective therapies for post-traumatic stress disorder (PTSD) with 85% of those treated no longer meeting the diagnostic criteria post-treatment.
The procedure involves remembering aspects of the stressful event while the right and left hemispheres of the brain are activated through eye movements, taps or sounds in repeated sequence for short periods of time. In this way, parts of the memory are reaccessed, reprocessed by the nervous system, and released, to the effect that they are no longer bothersome when recalled.
The effect of trauma
According to one theory, when the nervous system is overwhelmed by a stressful event, aspects of the experience become tied to the emotions of the event. For example, features of experiencing a car accident: the body’s jolt from impact, the sound of crumpling metal, the smell of burning rubber, etc., combined with emotional shock, become locked in the memory of the event. A similar sound or smell can trigger re-experience of the emotional shock and fear. Neurons activated during the traumatic event are now wired together such that reactivation of only part of this new circuit (the scent of burning rubber) can trigger the activation of other aspects of the system (fear). This may be how flashbacks, nightmares, and intrusive thoughts related to the memory are triggered and persist long after the event. Other symptoms of trauma include panic attacks, anxiety, phobias, and mysterious physical symptoms.
Because the consequence of triggering this trauma circuit is so severe, the brain or subconscious mind attempts to cordon this circuit off from the rest of the brain. This is revealed in avoidance behaviours intended to prevent unpleasant emotions, and unfortunately tend to be extreme such as the avoidance of certain people or places. Inevitably an encounter with someone with features similar to the perpetrator or a scent reminiscent of the scene triggers the circuit and the nervous system activates for “fight or flight,” or deactivates in a “freeze” response. Negative, rigid, and overly broad beliefs about the self are constructed from these events such as “I can’t trust anyone” or “I am powerless.”
Avoiding thoughts of the trauma prevent the ability to think of the event objectively. Additionally, it may be difficult to remember aspects of the event or the event in its entirety. In this way, a negative belief system develops and persists despite experiential evidence to the contrary.
EMDR appears to reconnect the traumatic event to positive self-beliefs and memories. After treatment, the negative self-beliefs arising from the trauma no longer seem relevant. Events that had triggered the fight, flight, or freeze response no longer have that effect. It is theorized that EMDR facilitates the linking of neurons of the trauma network into larger networks associated with healthy self-esteem.
Healing Memory Networks
Memories of traumatic events can be thought of as being linked by association to other kinds of psychological material including other memories, images, thoughts, emotions, and physical sensations. The memory of one event can spark the memory of another seemingly unrelated event. For example, recalling a recent car accident can elicit the memory of another time a person felt powerless such as having been bullied in elementary school. The link between these two events includes the aspects of feeling powerless to protect oneself from danger. When the memories of the accident and bullying become linked, the fear from these events is amplified and newly connected to activities that were previously neutral. Because of this “rewiring,” innocuous events are now perceived by the nervous system as “dangerous.” Reactions meant to enable safety-seeking behaviour, like fear and anger erupt in situations in which danger is not real but merely perceived. The resultant physiological stress responses contribute to numerous health and relationship problems, if the trauma is not treated.
EMDR seems to link traumatic memories to healthy psychological material, which refutes the negative self-concept. Again, using our example, the memories of bullying and the accident might be newly connected to memories of defensive, adroit driving and standing up to the aggressive coworker. The result is that the felt need to constantly be on high alert for danger while driving or in social situations relaxes and the fight, flight, or freeze reaction becomes absent when there is no real danger.
Who can benefit?
EMDR was developed as a method for recovery from post-traumatic stress and has been shown to help individuals who have experienced natural disasters, serious illness, invasive medical procedures, neglect or abuse as a child, combat veterans, rape victims, witnesses to violence, victims of motor vehicle and other accidents, to name a few. It has also been successfully applied to other situations in which people feel stuck in thoughts, feelings, and memories from past events. This method of processing psychological “stuck points” has helped people with phobias of things like flying, public speaking, and socializing. EMDR has helped others change long-standing unhealthy behaviours like binge-eating, purging, substance abuse, and gambling.
Peter Levine, in his seminal work on trauma entitled “Waking the Tiger” says, “If you are experiencing strange symptoms that no one seems to be able to explain, they could be arising from a traumatic reaction to a past event that you may not even remember. You are not alone. You are not crazy. There is a rational explanation for what is happening to you. You have not been irreversibly damaged, and it is possible to diminish or even eliminate your symptoms” (1997).
People involved with the Insurance Corporation of British Columbia (ICBC) or a personal injury lawyer are often referred to resolve the psychological fallout from a motor vehicle accident. EMDR has shown itself to be a quick and effective way of healing from such an injury.
How long does it take to treat trauma with EMDR?
This is a difficult question to answer as it depends on the number of traumas suffered and whether one has a history of child abuse or neglect. In general, we can say that it will take as few as three sessions, and sometimes as many as 12 or more. This information comes from research summarized below:
Studies have shown that 83-90% of those diagnosed with PTSD no longer met the criteria for the diagnosis after 4-7 sessions of EMDR (Lee et. al, 2002; Rothbaum, 1997).
Others have found significant decrease of a variety of PTSD-related symptoms after only 3-4 sessions (Ironson et. al, 2002; Scheck et. al, 1998; Wilson et. al, 1995).
One study has shown that 77% of sufferers of multiple traumas no longer meet PTSD diagnostic criteria after 12 sessions (Carlson et. al, 1998).
People with histories of childhood abuse or neglect may require more than 12 sessions (Korn & Leeds, 2002; Mayfield & Hyder, 2002; Shapiro, 2001).
For more information check the following links:
Jonathan Wieser, Registered Clinical Counsellor