Patients involved in EMDR therapy focus on their past, present and future by addressing disturbing memories that occurred in the past, are currently occurring and “future” memories that patients think will eventually happen to them. Eye movement desensitization and reprocessing therapy is comprised of eight stages:
Stage 1: The patient’s therapist will assess the nature and extent of trauma affecting the patient and develop the most effective treatment plan that emphasizes refinement of coping behaviors and skills. Patients suffering from multiple traumatic events in their life may need to remain in therapy for a longer time than those disturbed by one or two memories
Stage 2: In this stage, the patient learns there are different methods to use between sessions when coping with severe emotional distress. The fundamental goal of eye movement desensitization and reprocessing therapy is for patients to experience a sense of managed equilibrium by using bilateral stimulation (eye movements) and stress reduction techniques.
Bilateral stimulation involves the therapist targeting a specific memory and instructing the patient to think about the event. As the patient is concentrating on the worst aspects of the traumatic memory, the therapist moves his or her hand back and forth in from the patient’s eyes, wiggling and moving the fingers in order to keep the eyes busy.
The theory behind the ability of this unorthodox action to eliminate PTSD symptoms concerns rapid eye movement and the biological mechanisms responsible for REM sleep. As we process and store memories during the “dreaming” stage of sleep, our eyes move rapidly back and forth even though they are closed underneath our eyelids.
Researchers specializing in the psychology of sleeping and dreaming posit the idea that having patients perform this rapid-eye movement procedure while awake and thinking about a traumatic memory may allow patients to safely absorb and store these memories in the manner the brain processes and “packs” away memories in the hippocampus and pre-frontal cortex.
Stages 3 through 6—Continuation of the EMDR process is further expanded by having patients think about a particularly vivid image associated with the bad memory, identifying one negative belief concerning the memory and the self and fully experiencing emotions and any physical sensations evoked by the memory. Patients are then instructed to rate the severity of negative emotions as well state a positive belief they hold about themselves.
After engaging in eye movement desensitization and reprocessing therapy, patients are asked to empty their mind and describe how they are feeling. If the patient is not overstressed and feels strong enough, the therapist may move on to the next disturbing memory. Prior to each EMDR session, the therapist will ask a patient to rate his or her distress level to determine whether the intensity of PTSD symptoms are diminishing.
Phase 7 and 8—Therapists will ask that patients keep a diary when attending EMDR sessions. In addition to benefiting patients, these self-reports also provide therapists with special insights into the ability of patients to use self-calming techniques learned during EMDR therapy.
Acceptance of EMDR therapy has steadily increased over the past decade due to documented efficacy of the therapy as well as professional organizations like the Department of Defense, The Department of Veterans Affairs and the American Psychiatric Association issuing guidelines concerning the use of EMDR. Guidelines published by the VA highly recommend eye movement desensitization and reprocessing therapy for treating PTSD symptoms in both non-military and military populations.