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INFORMATION & INFORMED CONSENT FOR EMDR,
Eye-Movement Desensitization & Reprocessing
Updated: 3/25/04
What is EMDR?
Eye Movement Desensitization and Reprocessing, or EMDR, is a powerful new psychotherapy technique which has been successful in helping people suffering many forms of emotional distress, including trauma, anxiety and panic, fears and phobias, loss, disturbing memories, etc. EMDR is considered a breakthrough therapy because of its simplicity and the fact that it can bring quick and lasting relief.
EMDR therapy uses bilateral stimulation—including right/left eye movement and tactile or auditory stimulation—which repeatedly activates the opposite sides of the brain, releasing emotional experiences that are “trapped” in the nervous system. This assists the neurophysiological system, the basis of the mind/body connection, to free itself of blockages and reconnect itself.
Who discovered EMDR?
In the late 1980’s, psychologist Francine Shapiro, Ph.D., observed that particular eye movements reduced the intensity of disturbing thoughts in some clients. Dr. Shapiro decided to study this effect scientifically, and in 1989, reported in the Journal of Traumatic Stress her success using a method she called EMDR to treat victims of trauma.
How does EMDR work?
Currently, there is not enough known about brain function to be able to explain with certainty how EMDR or any other therapy produces its effects. It is believed, however, that negative life experiences or traumas may upset the biochemical balance of the brain’s physical information processing system, thereby preventing the information from being processed and resolved in a healthy, adaptive way. The result is that the thoughts, feelings, beliefs, and memories (smells, sights and sounds, etc.) associated with the disturbing experience are, in effect, stored or “trapped” in the nervous system and are often suppressed from consciousness. The distress, however, lives on in the nervous system where it causes disturbances in the emotional functioning of the person.
EMDR is considered an effective technique for “unlocking” the negative memories and emotions stored in the nervous system, thereby helping the brain to successfully process the experience. EMDR unblocks the brain’s information processing system in three possible ways: 1) it may tap into the same mechanisms used in learning and memory now identified with REM sleep, 2) the rhythmic intervention of EMDR improves communication between the brain hemispheres, unblocking the processing that is manifested as phase discrepancies between equivalent areas in the brain’s hemispheres, or 3) EMDR may initiate an orienting reflex change in neurophysiological functioning leading directly to desensitization.
In an EMDR session, the therapist works gently in guiding the client to revisit the traumatic incident. When the memory is brought to mind, the feelings are re-experienced in a new way. EMDR makes it possible to gain the self-knowledge and perspective that will enable the client to choose their actions, rather than feeling powerless over their re-actions. This process can be complex if there are many experiences connected to the negative feelings. The EMDR therapy sessions continue until the disturbing memories and emotions are relieved.
What are the advantages of EMDR Therapy?
When used in conjunction with other traditional methods of therapy, EMDR can help move people more effectively and quickly from emotional distress to peaceful resolution of the issues or events involved. Treatment with EMDR helps in eliminating even the most difficult emotions—the memory remains but the negative response is neutralized. The positive, long-term results of EMDR therapy affect all levels of the client’s well-being—mental, emotional and physical, so that their responses return to normalcy and health. To date, more than half a million people have benefited from EMDR therapy.
What problems are helped by EMDR?
Studies to date show a high degree of effectiveness with the following conditions:
Depression Loss/injury of a loved one
Anxiety/panic attacks Car/work accidents
Phobias/Fears Fire
Post-traumatic Stress Assault/violent crimes
Physical abuse Robbery
Sexual abuse Rape
Bad Temper Natural Disasters
Low Self-Esteem Injury
Relationship problems Illness
Worrying/brooding Witness to violence/trauma
Trouble Sleeping Childhood trauma
Who can be helped by EMDR?
EMDR can help many different people suffering from many types of experience or disturbance, such as those listed above. Research has shown EMDR to be effective for children, adolescents, and adults of many different backgrounds and nationalities. EMDR may also be helpful for people in specific professions, such as police, emergency workers and firefighters, and can be used to enhance performance or reduce performance anxiety of athletes, actors, musicians, students, public speakers and executives.
Are there studies that show that EMDR is effective?
Research studies show that EMDR is very effective in helping people process emotionally painful and traumatic experiences. In fact, EMDR is the most thoroughly researched method in the treatment of Post-traumatic Stress Disorder and trauma. Studies consistently show that treatment with EMDR results in elimination of the targeted emotion—the memory remains, but the negative response is neutralized. Several important research studies conducted on EMDR include the following:
Chemtob, C.M., Nakashima, J., Hamada, R.S. & Carlson, J.G. (2002). Brief
Treatment for Elementary School Children with Disaster-Related Posttraumatic
Stress Disorder: A Field Study. Journal of Clinical Psychology, 58, 99-112.
Shapiro, F. (1999). Eye movement desensitization and reprocessing (EMDR) and
the anxiety disorders: Clinical and research implications of an integrated
psychotherapy treatment. Journal of Anxiety Disorder, 13, 35-67.
Wilson, S.A., Becker, L.A. & Tinker, R.H. (1995). Eye movement desensitization
and reprocessing (EMDR) treatment for psychologically traumatized individuals.
Journal of Consulting and Clinical Psychology, 63, 923-937.
Wilson, S.A., Becker, L.A. & Tinker, R.H. (1997). Fifteen-month follow-up of
eye movement desensitization and reprocessing (EMDR) treatment for PTSD and
psychological trauma. Journal of Consulting and Clinical Psychology, 65,
1047-1056.
What preparation is needed for an EMDR session?
Most of the preparation for EMDR occurs in 1-3 sessions prior to the actual beginning of the EMDR sessions. The therapist will need some time to obtain background and history, determine the appropriateness of using EMDR, explain about EMDR, assess and test the best methods for bilateral stimulation, and help to establish skills and techniques to decrease distress, if needed. EMDR is most effective when used in conjunction with other modes of therapy, and the therapist should discuss a plan of treatment ahead of time.
The only preparation necessary for the client to begin EMDR is to read any information provided and sign an Informed Consent form. It may be useful, however, for the client to do some additional research on his/her own (other resources are suggested below) and to begin to think about what issues s/he would like to work on.
What happens during an EMDR session?
Just as EMDR assists the brain with its natural processing of emotional information, the EMDR therapist assists the client in the healing process by becoming a partner on a journey to release past trauma from the client’s nervous system.
A typical EMDR session begins with the therapist guiding the client to pinpoint a problem or event that will be the target of the session. As the thoughts and feelings come to the surface, the therapist and client work together to create patterns of bilateral stimulation, directing eye movements, tactile sensations and/or sounds through hand movements, light bars, hand-held pulsers, and/or a CD with headphones. This stimulation may bring up conscious thoughts or feelings that can be shared with the therapist, as well as enhance unconscious processing of the experience, thereby helping to release the disturbing emotions associated with the problem or event. The patterns of bilateral stimulation continue until the emotions are neutralized and the event is re-associated with positive thoughts and feelings about oneself (such as “I realize now that it wasn’t my fault”).
Some clients experience dramatic responses in a short period of time while others progress more slowly. The results, however, are equally effective and long-lasting.
How often would I need EMDR treatments?
Typically, an EMDR session lasts from 60 to 90 minutes. The length of the session depends upon a number of factors, including the nature and history of the problem, the degree of trauma, the specific circumstances of that particular day, etc. While in some cases, only a single session of EMDR is needed, more typically a course of treatment is somewhere between 5 and 15 sessions, usually on a weekly basis. For individuals with a history of multiple painful experiences that have remained unresolved for years, a number of additional EMDR sessions may be needed.
Is there any discomfort involved in the EMDR process?
The EMDR treatment can evoke strong emotions or sensations during a session. This is perfectly normal and desirable, since the technique works on the negative feelings when they are brought into the client’s awareness. However, the re-experiencing of these unpleasant feelings is usually brief and will generally leave when the process is completed. If the client will stay with the process through the upsetting memories for a short time, s/he will likely be pleased and satisfied with the outcome of the therapy. Relief, for many, occurs rapidly and permanently.
What happens between EMDR sessions?
After an EMDR session, some clients experience a strong sense of relief, a feeling of openness or even euphoria. Since information may continue to be processed after the bilateral stimulation stops, however, new and unexpected material might also surface after the session. Some clients may even experience unusual thoughts or vivid dreams that may or may not have significant meaning. These are all normal reactions and part of the releasing process, and should not cause undue concern. In fact, some unusual experiences during the time of the EMDR therapy indicates that it is working.
It is a good idea to keep notes, perhaps in the form of a daily log, of any distressing, unusual or noteworthy thoughts or feelings. The client can then bring these notes to the next EMDR session. This log will help the therapist to know if any adjustments in the therapy are warranted.
Is EMDR Hypnosis?
No. During the EMDR session, the client is awake and alert and in control at all times. The healing that takes place with EMDR is generally much faster than with hypnotherapy. Like hypnosis, however, EMDR seems to work with the unconscious mind, bringing into consciousness the repressed thoughts and feelings that must be experienced again in order to release their energetic hold on the person.
What type of training does a therapist need to use EMDR?
The EMDR Institute offers two levels of training: Level I is the Introductory Training and Level II is the Advanced Training. EMDR Therapists are well-qualified to perform EMDR after both levels of training. Only practicing, licensed therapists may receive EMDR training, since they are the only mental health professionals qualified to use EMDR therapy with clients. A clinical background is necessary for proper application of the EMDR technique. This is a highly specialized method that requires supervised training for therapeutic effectiveness and client safety. Clients may wish to ask for the therapist’s EMDR Certificate of Training.
How do I know if EMDR is right for me?
There are a number of factors to consider when evaluating the appropriateness of EMDR therapy for a client’s particular situation and history. During the client’s initial consultation with a trained EMDR therapist, all relevant factors will be discussed in full to help both the therapist and client to make an informed decision about the appropriateness of moving forward with EMDR.
In general, though, people are excellent candidates for EMDR therapy if they have . . .
…difficulty trusting people
…fear of being alone
…lack of motivation
…anxiety or panic
…frequent feelings of guilt or shame
…poor concentration or memory
…explosive or irrational anger/bad temper
…trouble sleeping
…nightmares
…worrying or brooding
…poor self-image
…relationship problems
…stage fright or performance anxiety
…obsessive or compulsive behavior
…chronic feelings of detachment/not fitting in
…extreme, unexplainable fears
…depression
…disturbing thoughts
…a history of abuse
…been a victim of a crime or serious accident
…witnessed a crime or serious accident
…been through/witnessed a natural disaster
…ever experience a traumatic event or series or events
Some objectives of EMDR Therapy
Thanks to the on-going success of EMDR therapy for hundreds of thousands of people, it is not difficult to have high expectations for a therapy program that includes the EMDR technique. The short-term benefits of EMDR are simple and straight-forward—the immediate relief of emotional distress and the elimination of the debilitating effect of unresolved past trauma.
The long-term benefits of EMDR therapy include the restoration of each client’s natural state of healthy, emotional functioning. This return o normalcy brings with it a greater sense of personal power, more rewarding relationships and a more peaceful life.
How can I find out more about EMDR?
Several excellent books about EMDR are available, including the following recommended reading:
Emotional Healing at Warp Speed: The Power of EMDR by David
Grand, PhD
Eye Movement Desensitization and Reprocessing: Basic Principles,
Protocols and Procedures by Francine Shapiro, PhD
Small Wonders by Joan Lovett, MD
Transforming Trauma: The Revolutionary new therapy for freeing the
mind, clearing the body, and opening the heart by Laurel Parnell
PhD
In addition, the Internet can provide a wealth of information, including the following useful websites:
emdr.com (EMDR Institute)
emdrportal.com (EMDR Resource Cooperative)
psychotherapy-center.com (site for Steve Reed)
ACKNOWLEDGMENT AND CONSENT FOR EMDR,
Eye-Movement Desensitization and Reprocessing, TREATMENT
Client #: ____________
Updated: 11/11/02
I have been advised and understand that Eye Movement Desensitization and Reprocessing, EMDR, is a treatment approach that has been widely validated by research only with civilian Post-traumatic Stress Disorder. Research on other applications of EMDR is now in progress.
I have also been specifically advised of the following:
1) Distressing, unresolved memories may surface through the use of
the EMDR procedure.
2) Some clients have experienced reactions during the treatment
sessions that neither they nor the administering clinician may
have anticipated, including a high level of emotion or physical
sensations.
3) Subsequent to the treatment session, the processing incidents/
material may continue, and other dreams, memories, flashbacks,
feelings, etc., may surface.
Before starting EMDR treatment, I have thoroughly considered the above information and have obtained whatever additional information and/or professional advice I deemed necessary or appropriate to having EMDR treatment. My signature below represents a statement that I have read and understood the information in this Informed Consent form and as outlined by my therapist, have received a copy of this Informed Consent form, agree to comply with fees and policies, and consent to receiving the EMDR treatment as described above.
My signature on this Acknowledgement and Consent is free from pressure or influence from any person or entity, and I understand that I have the right to withdraw my consent for EMDR treatment at any time.
____________________________________________ __________
Client Signature Date
____________________________________________ __________
Client Signature Date
____________________________________________ __________
Parent/Guardian Signature Date
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