A EMDR Methodology for Working with Trauma

EMDR is a form of psychotherapy originally designed for trauma therapy. EMDR provides a here-and-now stimulus as the client recounts his/her traumatic memories. Tapping or eye movements keeps the client in the present and in the observer position. This keeps the client stable, so that he/she can remember stressful experiences without being re-traumatized.

EMDR is very much a relational-therapy application which I find very useful for integrating into my work.

EMDR is founded by Francine Shapiro. Here are 2 lectures of EMDR by Shapiro herself.

About Shapiro’s Way with EMDR

History and research history on EMDR

Commonly administered EMDR Process

EMDR process has a structure. The actual procedure administered is unique to each individual. The therapist, during the session, has to remain focus on the phenomenology of the patient. Keep in mind that simply following the steps alone is not therapy.

1. EMDR therapy begins with a clarification of a trauma-specific case history. The client reveals a traumatic event(s), it’s symptoms and these are to be worked on. The treatment process is also explained to the client.

2. The effectiveness depends on the choice of the outcome situation, and the unveiling of the cause of the traumatic situation.

3. Stabilization of the current situation of the client is important. The client is also prepared internally for the exercise. e.g. the client is asked to use a stop signal if he/she feels too uncomfortable. The client also gets to describe a safe place.  In other words, the client is asked to consider the resources he/she has.

4. Estimation of the degree of severity of the experience. The client is ask to rate the degree of feeling felt at the moment about an event. The client is asked to describe and rate a negative aspect of the event (e.g. feelings of fear or guilt). The client is also asked to describe and rate a positive outcome of the event (e.g. feeling of freedom from guilt).

5. The client is asked to estimate how strong the feelings of stress at the moment is.

6. The client is asked to describe how he/she feels in the body.

7. Pre-processing step: to ask the client to relax and recount the event. Allowing the client to creatively enter into the scene. The therapists begins to lightly tap on the client’s wrists or knees, or guides the client with eye-movements, and encourages the client to describe the situation(s) as they arise to consciousness.

8. The weaving in of the here-and-now situation with past situation.  The client gets to see the traumatic experience as a more mature person (as opposed to a child when he/she suffered a trauma).  The client also gets to view the situation from a vantage point of a safer present.

9. Re-evaluation of the feelings of the traumatic events.

10. Anchoring: the client is asked to recite what he/she has learnt from the experience (the positive experience) as the therapists taps the client’s wrist a little more.

11. Body scan test: to check how the feelings in the body. And to find out what else  that is stressful that is felt in the body.

12. Closing conversation and dialogue: something light hearted, breathing, relaying.

13. Next session, the previous treatment is rated again to see how the treatment is integrated. If the stress is still there, therapy can be repeated, if it is successful, anchoring work can be done.

Sometimes the client does stabilize after the therapeutic work. It is useful to be patient and listen to the patient’s current experience. The goal of the therapy is not to completely resolve every stress in one sitting, but to bring stability week to week, until the client learns to integrate the treatment.

Often the client feels permanent relief of a certain degree of stress.

Own work experience

I decided to use the tapping technique with a client who mentioned a car accident in which she was a driver that happened 20 years before. She is a successful businesswoman in her 50s, and had never mentioned this incident prior. This incident came to light as a result of  a dream recollection.

The client had left a going-away party with some friends, had some drinks. It was also midnight, which was the day of her birthday. As she drove home, she collided with a drunk pedestrian, who got severely injured and died.

During the therapy, the client expressed fear and guilt which she had shut off all the years. She never had a chance to talk about her trauma to anyone and felt lonely.

The tapping allowed the client to see the event as if it were a movie. She could experience the emotions and was able (with hesitation) to vocalize the feelings. Her arms began to sweat.  She began to remember more details of the night after the accident when she went home, and the morning after, how she felt like it was a nightmare, but it was for real.

At the end of the session, the client felt her loneliness, but was relieved about being able to share. Her fear level regarding the event went from a high 10 to 0.  She still processes sadness and guilt about the event, which was later our work-in-progress.

Bibliography

Schubbe, O. (2004). Traumatherapie mit EMDR. Order, 22, 99.

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