Eye Movement Desensitization and Reprocessing (EMDR)

Eye Movement Desensitization and Reprocessing (EMDR) is a therapeutic approach developed by Francine Shapiro. Originally EMDR was used for processing traumatic memories in PTSD, and this is the application for which is supported by most evidence. There is increasing evidence that it can also be applied helpfully in other conditions where intrusive memories are problematic.

EMDR draws upon Shapiro’s model of ‘Adaptive Information Processing’ (AIP). This model proposes human beings process information, and that this information is stored in memory networks containing nodes for events, thoughts, feelings, body sensations, and so on. The AIP model proposes that following trauma memories can be stored in a dysfunctional ‘unprocessed’ way – in networks that are not connected with the bigger network. According to the AIP model the EMDR protocol is said to access the dysfunctionally stored information and to stimulate the adaptive processing of this information. The rationale is sometimes given that “human beings have the ability to overcome trauma and to process difficult events – EMDR facilitates this natural process”.

EMDR is an 8-phased approach. These phases are:

  1. Client history (including trauma(s) identification, risk assessment, dissociation, client goals)
  2. Preparation (including psychoeducation, safe place)
  3. Assessment (cross-sectional breakdown of the specific trauma memory on which you have chosen to work)
    • Image
    • Negative cognition
    • Positive cognition
    • Validity of cognition (VoC)
    • Emotions
    • Subjective units of distress (SUDS)
    • Physical location of disturbance
  4. Desensitization (memory reprocessing)
  5. Installation (installation of positive cognition)
  6. Body scan (hold preferred belief in mind and scan the body “the body keeps the score”)
  7. Closure (of a complete or incomplete session)
  8. Re-evaluation

EMDR is a 3-pronged approach. It involves processing details of the past events that set the groundwork for the disturbance, processing the current situations that trigger distress, and processing what is needed for the future (future template / future rehearsal).

Protocols / Procedures / Techniques

Recent Traumatic Event Protocol (R-TEP) - Shapiro & Laub (2014)