Trauma causes the mind to go into overdrive. The mind tries to block out the wreckage of an accident: the smell of smoke, the spray of broken glass when one car crashes into another. People who have Post-traumatic stress disorder Sometimes they limit their lives, making them think of streets or smells or songs they’ve encountered. But memories make themselves known – through nightmares, flashbacks and intrusive thoughts.
PTSD was first included in the Diagnostic and Statistical Manual of Mental Disorders in 1980. He identified a few treatment methods Helping people Dealing with traumatic memories. Over the past decade, a seemingly unconventional treatment has made its way into mainstream medicine.
Eye movement disorder and reprocessing therapy, better known as EMDR, may seem strange to an observer. The practice involves encouraging people to process traumatic memories while simultaneously interacting with images, sounds or feelings that stimulate both parts of the brain. Patients can move their eyes back and forth, follow the therapist’s finger, or see flashes of light on alternating sides of the screen. The idea is to bind the brain to the present while a patient remembers the past.
In recent years, EMDR has attracted more attention, thanks in part to the whole epidemic and the interest in celebrity trauma treatment who have shared their experiences. Prince Harry Recorded EMDR session For a documentary with Oprah. Sandra Bullock said. He turned to EMDR In the year After a stalker broke into her home in 2014. “The Good Place” actress Jamila Jamil He wrote in a 2019 Instagram post EPRDF “saved my life”
Patients seeking EMDR may be inspired by another source: “The Body Expects Results,” the seminal book on trauma that spent more than 200 weeks on the New York Times bestseller list. Bessel van der Kolk, the book’s author, says the treatment is one of the most effective ways to deal with PTSD symptoms. “It’s not a new treatment anymore,” he said. “It’s a very well established thing.”
What is EMDR?
Psychologist Francine Shapiro She founded EMDR in 1987 as she struggled with her own disturbing memories—first, Experimenting on herselfAs she walks through a park, she rolls her eyes back and forth and then slowly extends the treat to other people.
Therapists perform EMDR in eight stages that typically span six to 12 sessions, although this number varies from person to person. Each session lasts 60 to 90 minutes. First, the therapist discusses the patient’s current challenges, gathers information about their history, and then develops a treatment plan, says Dr. Deborah Korn, “every memory deserves respect.”
The patient may need to “float” back from their current symptoms, she said, to identify triggers for a recent emotional outburst or panic attack. The goal is to identify the traumatic memory that a patient can process in the later stages of EMDR.
“You don’t see a lot of people saying, ‘I want to work on my traumatic memories from ages 5 to 11,'” says Dr. Korn. “They say I’m miserable.”
Understand post-traumatic stress disorder
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The patient and physician then design coping strategies, such as breathing exercises or meditation to combat dissociation, that a patient can use if they feel anxious during or between sessions.
Once these strategies are established, typically after a session or two, the therapist instructs the patient to recall the most difficult aspect of the traumatic event. It may be an image, sound or smell that often enters their mind; For some patients, the most vivid memories associated with trauma occurred shortly before an event occurred, says Sanne Huben, a researcher at Maastricht University who studies EMDR.
When patients engage in activities such as moving their eyes, tapping their body, or hearing a faint buzzing sound that alternates between their ears, they focus on the feelings and sensations they experience while thinking about this aspect. Each set of these binaural stimuli lasted between 30 and 60 seconds.
Occasionally, the therapist will ask the patient what they are noticing or feeling, encouraging them to think about the memory from today’s perspective. “If you say, ‘It’s my fault,’ a therapist might ask how old you were. When you were young, did you think you could take care of yourself?” said Vail Wright, senior director of healthcare innovation at the American Psychological Association. “You don’t just sit there and think about the memories.”
How does EMDR work?
It is not unique to EMDR to force a patient to deliberately look into the past; Most treatments for PTSD, including prolonged exposure and cognitive processing therapy, encourage patients to “actively approach the trauma,” says Dr. Shaylee Jain, a PTSD expert at Stanford University.
Revisiting the wound can trigger the body’s stress response—a spike in cortisol and a jump in heart rate. But over time, the process can slowly cause you to lose your memory, allowing your body to adapt to stress and anxiety.
“That fight-or-flight response goes down several levels, so you’re back in the driver’s seat of your life,” says Dr. Jain. Instead of avoiding triggers.
With EMDR, the additional component of dyadic stimulation is theoretically the patient’s current experience of trauma. “Nowadays we use the phrase one foot and one foot,” says Marianne Silva, a clinical social worker and EMDR specialist at the VA New England Health Care System.
The binaural stimulus must be compelling enough to distract patients, but not so frightening that they fully focus on it. For example, multiplication tables require a lot of effort, says Richard McNally, a professor of psychology at Harvard University.
Our brains are incapable of fully focusing on both binary stimuli and traumatic memories, says Dr. Huben. The theory behind EMDR is that memories become more vivid and emotional when a patient is unable to fully concentrate.
“At the end of the treatment session, they put it back in storage,” Dr. McNally said. “It is in a degraded form. It’s not that sensational,” he said.
Is EMDR Effective?
Today, clinicians generally consider EMDR effective for trauma treatment. of World Health Organization And American Psychological Association They have recommended and developed guidelines for administering treatment to people with PTSD. In England National Institute of Health and Care ExcellenceA firm authority in the field of psychology lists EMDR as a tool for adults struggling with trauma and for children who have not responded to trauma-focused cognitive behavioral therapy.
But scientists are debating whether EMDR is more effective than other trauma treatment methods. Pim Kuypers, Professor of Clinical Psychology at the Vrije Universiteit Amsterdam; He analyzed about 80 studies On EMDR and as it has proven, although the research shows the positive effects of the treatment, “the quality of the research is very bad,” he said.
He said many psychotherapies lack rigorous studies, but the evidence for EMDR is particularly thin, with small sample sizes and potential bias among the clinicians conducting the studies.
While EMDR can be very effective, Dr. Kuipers cautioned against wholeheartedly supporting the evidence behind the treatment.
And there are very few studies showing that EMDR works in the long term, says Henri Ottgar, professor of forensic psychology at Maastricht University in the Netherlands.
Dr. Ottgar, Dr. Huben, and other researchers are investigating whether EMDR increases patient sensitivity. False memories. While the creation of false memories is a concern in many treatments, Dr. Huben says, “This is different from EMR.
When EMDR became popular in the late 90s and early 2000s, Dr. McNally, a trauma researcher at the time, was one of the most outspoken opponents of the treatment—writing that EMDR was “.It is one of the many medical fuzz balls that litter the landscape of psychology today.” in the Journal of Anxiety Disorders. He admits that EMDR can cause people to lose their memory, but he doesn’t think there’s convincing evidence that the treatment’s most specific eye movement–is of any additional benefit. Today, whether processing trauma with a therapist leads to similar results remains up for debate. Dr. Jain calls it the “million dollar question.”
Still, there are patients and clinicians who swear by the treatment — and enough “robust data” to back it up, Dr. Jain said. Patients report fewer PTSD symptoms after the sessions, Dr. Wright said, with fewer flashbacks and intrusive thoughts.
Who can EMDR work for?
“Anyone who has experienced trauma” can benefit from EMDR, says Trisha Miller, a psychotherapist at the Cleveland Clinic. People with mental health problems such as depression, eating disorders, phobias and addictions can benefit from EMDR, she said, although there has not yet been strong research proving the treatment is effective for these conditions.
People looking for EMDR practitioners should make sure they find a certified specialist, Ms. Miller emphasized. The EMDR International Association, which conducts certification and training for the treatment, a Directory Professionals trained and certified by the company.
“From a medical perspective, I like ‘everything that works,'” says Dr. Jain. “If EMDR works for you, do it.”