Eye Movement Desensitization and Reprocessing (EMDR) Therapy: Basic Principles, Protocols, and Procedures

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EMDR therapy emphasizes working with imagery, cognitions, emotions, somatic sensations, and behavior linked to a disturbing memory, as well as attending to past, current, and future-oriented experiential contributors. Unlike many psychotherapeutic treatments, EMDR does not require prolonged exposure, the direct challenging of beliefs, or numerous sessions to achieve results.

Baldwin, M. & Korn, D. (2021). Every memory deserves respect: EMDR, the proven trauma therapy with the power to heal. New York: Workman Publishing Company.

Marich, J. (2014). Trauma Made Simple: Competencies in assessment, treatment, and working with survivors. PESI Publishing: Eau Claire, WI. Marich, J. & Dansiger, S. (2021). Healing addiction with EMDR therapy: a trauma-focused guide. New York: Springer Publishing Company. The fifth phase of EMDR is installation, which strengthens the preferred positive cognition. Body Scan

Those little buzzers had worked some kind of Robin Williams magic. I didn't just understand the weight of my abuse logically. I felt it, like a blade through flesh, a bone popping out of place. I felt it like a lover saying it's not going to work: sharp, immediate, and terrifying. I actually felt, with searing clarity, the horror of what happened to me -- maybe for the first time ever. I felt how tremendously sad it was that I was forced to make my parents feel loved at such a young age. I felt how courageous I must have been to endure that torture, day after day for so many years, by the people I trusted most in this world. I felt a sense of love and adoration for my childhood self that I'd never been able to summon before. Archer, D. (2021). Anti-racist psychotherapy: Confronting systemic racism and healing racial trauma. Montreal: Each One Teach One Publications.The therapist offers an explanation for the treatment, and introduces the client to the procedures, practicing the eye movement and/or other BLS components. The therapist ensures that the client has adequate resources for affect management, leading the client through the Safe/Calm Place exercise. Assessment Van Der Kolk, B. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. New York: Viking. Mark C. Russell, PhD, ABPP, is a core faculty member at Antioch University, Seattle, and the establishing director of the Institute of War Stress Injury, Recovery, and Social Justice. As a graduate student, Dr. Russell became Francine Shapiro's research assistant and was primarily responsible for developing the theory underlying EMDR. Two measures are used during EMDR therapy sessions to evaluate changes in emotion and cognition: the Subjective Units of Disturbance (SUD) scale and the Validity of Cognition (VOC) scale. Both measures are used again during the treatment process, in accordance with the standardized procedures: Validity of Cognition (VOC) scale

During EMDR therapy, clinical observations suggest that an accelerated learning process is stimulated by EMDR’s standardized procedures, which incorporate the use of eye movements and other forms of rhythmic left-right (bilateral) stimulation (e.g., tones or taps). While clients briefly focus on the trauma memory and simultaneously experience bilateral stimulation (BLS), the vividness and emotion of the memory are reduced. Appendices with session transcripts, clinical aids, and tools for assessing treatment fidelity and outcomes.Marich, J. & Dansiger, S. (2018). EMDR Therapy and Mindfulness for Trauma-focused Care. New York: Springer Publishing Company Closure is used to end the session. If the targeted memory was not fully processed in the session, specific instructions and techniques are used to provide containment and ensure safety until the next session. Re-evaluation In addition to getting a full history and conducting appropriate assessment, the therapist and client work together to identify targets for treatment. Targets include past memories, current triggers and future goals. Preparation

Marich, J. (2011). EMDR Made Simple: Four Approaches to Using EMDR with Every Client. Eau Claire, WI: PESI Publishing (Premiere) Dr. Russell has authored more than 13 articles and 6 book chapters on EMDR. He was awarded the Distinguished Psychologist Award by the Washington State Psychological Association for his sustained effort to transform military mental healthcare including advocating for EMDR trainings and treatment access, as well as the 2018 Outstanding Service in the Field of Trauma Psychology by APA Division 56 Trauma Psychology. Bannit, S.P. (2012). The Trauma Toolkit: Healing trauma from the inside out. Wheaton, IL: Quest Books. The third phase of EMDR, assessment, activates the memory that is being targeted in the session, by identifying and assessing each of the memory components: image, cognition, affect and body sensation.The sixth phase of EMDR is the body scan, in which clients are asked to observe their physical response while thinking of the incident and the positive cognition, and identify any residual somatic distress. If the client reports any disturbance, standardized procedures involving the BLS are used to process it. Closure Francine Shapiro, PhD, the originator and developer of EMDR therapy, was senior research fellow emeritus at the Mental Research Institute in Palo Alto, California, and executive director of the EMDR Institute in Watsonville, California. She founded and was president emeritus of the Trauma Recovery/EMDR Humanitarian Assistance Programs, a non-profit organization that coordinates disaster response and pro bono trainings worldwide. An excellent resource on an important evidence-based treatment for traumatic stress. This book is relevant for all practitioners interested in EMDR therapy, including novices as well as those who already use the approach. The third edition offers a wealth of detail to guide the reader in applying EMDR across a range of clinical presentations. Highly recommended."--David Forbes, PhD, Professor, Department of Psychiatry, University of Melbourne; Director, Phoenix Australia--Centre for Posttraumatic Mental Health During this phase, the client focuses on the memory, while engaging in eye movements or other BLS. Then the client reports whatever new thoughts have emerged. The therapist determines the focus of each set of BLS using standardized procedures. Usually the associated material becomes the focus of the next set of brief BLS. This process continues until the client reports that the memory is no longer distressing. Installation Dworkin, M. (2005). EMDR and the Relational Imperative: The Therapeutic Relationship in EMDR Treatment. New York: Brunner-Routledge.