EMDR in Lexington, Richmond & Frankfort KY

EMDR-Eye Movement Desensitization and Reprocessing or sometimes called 

Rapid Eye Movement Therapy

Have you experienced a traumatic event in your life that has impacted your daily living? Do you suffer from PTSD and often feel a sense of anxiety, panic, experience flashbacks, or memories that flood you and you feel vulnerable to that traumatic event again? If so, there is help for you.

EMDR (Eye Movement Desensitization and Reprocessing) is a psychotherapy that enables people to heal from the symptoms and emotional distress that are the result of disturbing life experiences. Repeated studies show that by using EMDR therapy people can experience the benefits of psychotherapy that once took years to make a difference. It is widely assumed that severe emotional pain requires a long time to heal. EMDR therapy shows that the mind can in fact heal from psychological trauma much as the body recovers from physical trauma. When you cut your hand, your body works to close the wound. If a foreign object or repeated injury irritates the wound, it festers and causes pain. Once the block is removed, healing resumes. EMDR therapy demonstrates that a similar sequence of events occurs with mental processes. The brain’s information processing system naturally moves toward mental health. If the system is blocked or imbalanced by the impact of a disturbing event, the emotional wound festers and can cause intense suffering. Once the block is removed, healing resumes. Using the detailed protocols and procedures learned in EMDR therapy training sessions, clinicians help clients activate their natural healing processes.

More than 30 positive controlled outcome studies have been done on EMDR therapy. Some of the studies show that 84%-90% of single-trauma victims no longer have post-traumatic stress disorder after only three 90-minute sessions. Another study, funded by the HMO Kaiser Permanente, found that 100% of the single-trauma victims and 77% of multiple trauma victims no longer were diagnosed with PTSD after only six 50-minute sessions. In another study, 77% of combat veterans were free of PTSD in 12 sessions. There has been so much research on EMDR therapy that it is now recognized as an effective form of treatment for trauma and other disturbing experiences by organizations such as the American Psychiatric Association, the World Health Organization and the Department of Defense. Given the worldwide recognition as an effective treatment of trauma, you can easily see how EMDR therapy would be effective in treating the “everyday” memories that are the reason people have low self-esteem, feelings of powerlessness, and all the myriad problems that bring them in for therapy. Over 100,000 clinicians throughout the world use the therapy. Millions of people have been treated successfully over the past 25 years.

EMDR therapy is an eight-phase treatment. Eye movements (or other bilateral stimulation) are used during one part of the session. After the clinician has determined which memory to target first, he asks the client to hold different aspects of that event or thought in mind and to use his eyes to track the therapist’s hand as it moves back and forth across the client’s field of vision. As this happens, for reasons believed by a Harvard researcher to be connected with the biological mechanisms involved in Rapid Eye Movement (REM) sleep, internal associations arise and the clients begin to process the memory and disturbing feelings. In successful EMDR therapy, the meaning of painful events is transformed on an emotional level. For instance, a rape victim shifts from feeling horror and self-disgust to holding the firm belief that, “I survived it and I am strong.” Unlike talk therapy, the insights clients gain in EMDR therapy result not so much from clinician interpretation, but from the client’s own accelerated intellectual and emotional processes. The net effect is that clients conclude EMDR therapy feeling empowered by the very experiences that once debased them. Their wounds have not just closed, they have transformed. As a natural outcome of the EMDR therapeutic process, the clients’ thoughts, feelings and behavior are all robust indicators of emotional health and resolution—all without speaking in detail or doing homework used in other therapies.

Treatment Description:

EMDR therapy combines different elements to maximize treatment effects. A full description of the theory, sequence of treatment, and research on protocols and active mechanisms can be found in F. Shapiro (2001) Eye movement desensitization and reprocessing: Basic principles, protocols and procedures (2nd edition) New York: Guilford Press.

EMDR therapy involves attention to three time periods: the past, present, and future. Focus is given to past disturbing memories and related events. Also, it is given to current situations that cause distress, and to developing the skills and attitudes needed for positive future actions. With EMDR therapy, these items are addressed using an eight-phase treatment approach.

Phase 1: The first phase is a history-taking session(s). The therapist assesses the client’s readiness and develops a treatment plan. Client and therapist identify possible targets for EMDR processing. These include distressing memories and current situations that cause emotional distress. Other targets may include related incidents in the past. Emphasis is placed on the development of specific skills and behaviors that will be needed by the client in future situations.

Initial EMDR processing may be directed to childhood events rather than to adult onset stressors or the identified critical incident if the client had a problematic childhood. Clients generally gain insight on their situations, the emotional distress resolves and they start to change their behaviors. The length of treatment depends upon the number of traumas and the age of PTSD onset. Generally, those with single event adult onset trauma can be successfully treated in under 5 hours. Multiple trauma victims may require a longer treatment time.

Phase 2: During the second phase of treatment, the therapist ensures that the client has several different ways of handling emotional distress. The therapist may teach the client a variety of imagery and stress reduction techniques the client can use during and between sessions. A goal of EMDR therapy is to produce rapid and effective change while the client maintains equilibrium during and between sessions.

Phases 3-6: In phases three to six, a target is identified and processed using EMDR therapy procedures. These involve the client identifying three things:

1. The vivid visual image related to the memory

2. A negative belief about self

3. Related emotions and body sensations.

In addition, the client identifies a positive belief. The therapist helps the client rate the positive belief as well as the intensity of the negative emotions. After this, the client is instructed to focus on the image, negative thought, and body sensations while simultaneously engaging in EMDR processing using sets of bilateral stimulation. These sets may include eye movements, taps, or tones. The type and length of these sets is different for each client. At this point, the EMDR client is instructed to just notice whatever spontaneously happens.

After each set of stimulation, the clinician instructs the client to let his/her mind go blank and to notice whatever thought, feeling, image, memory, or sensation comes to mind. Depending upon the client’s report, the clinician will choose the next focus of attention. These repeated sets with directed focused attention occur numerous times throughout the session. If the client becomes distressed or has difficulty in progressing, the therapist follows established procedures to help the client get back on track.

When the client reports no distress related to the targeted memory, (s)he is asked to think of the preferred positive belief that was identified at the beginning of the session. At this time, the client may adjust the positive belief if necessary, and then focus on it during the next set of distressing events.

Phase 7: In phase seven, closure, the therapist asks the client to keep a log during the week. The log should document any related material that may arise. It serves to remind the client of the self-calming activities that were mastered in phase two.

Phase 8: The next session begins with phase eight. Phase eight consists of examining the progress made thus far. The EMDR treatment processes all related historical events, current incidents that elicit distress, and future events that will require different responses

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More information related to Trauma

Signs and Symptoms of Trauma

A trauma is the result of someone being exposed to an actual or real threat of death, serious injury, or sexual violence. This may entail experiencing the event themselves, witnessing a traumatic event occurring with another person, learning about a traumatic event happening to a close family member or friend, or repeatedly being exposed to disastrous traumatic events (e.g., social workers repeatedly investigating and witnessing child abuse, soldiers in combat, police officers repeatedly exposed to murders, violence, etc., first responders repeatedly collecting human remains.

Many great resources can be found at the National Institute of Mental Health at: http://www.nimh.nih.gov/health/publications/post-traumatic-stress-disorder-research-fact-sheet/index.shtml

Child Trauma

The National Child Traumatic Stress Network (NCTSN) at http://nctsn.org/trauma-types/early-childhood-trauma/Symptoms-and-Behaviors-Associated-with-Exposure-to-Trauma lists various symptoms that may  be shown in children, who have been exposed to a traumatic event. A child may experience a trauma through physical, sexual, or emotional abuse, witnessing domestic violence, experiencing neighborhood violence (gangs), being involved or knowing another person has been in a near-fatal or fatal car accident, and many other instances. A child may exhibit symptoms, such as the following: Cognitive (has memory problems, demonstrates poor verbal skills, Behavioral (excessive temper, act out in social situations, startles easily, screams or cries excessively, fears being separated from parent/caregiver), and Physiological (may regress with potty training, wet the bed, experience headaches and stomachaches, poor sleep patterns). 

http://www.childtrauma.com/

Posttraumatic Stress Disorder (PTSD)

PTSD is a mental health diagnosis categorized in the Trauma and Stressor-Related Disorders. It often resembles anxiety, depression, panic attacks, helplessness, worry, fear, problems with memory, exaggerated startle response, sleep disturbances, flashbacks, nightmares, angry outbursts, intense emotions, or avoidance strategies. These symptoms have to be present for longer than a month to meet the criteria for PTSD.

http://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml

Treatments that can make a difference

The person experiencing PTSD would benefit from seeing a qualified mental health therapist. A Licensed Professional Counselor (LPCC), a Licensed Clinical Social Worker (LCSW), a Licensed Marriage and Family Therapist (LMFT), or a Psychologist are all trained mental health professionals that provide counseling to both children and adults, who are experiencing PTSD. An individual would work with their therapist on establishing a treatment plan that works best for the client.

The following are treatment interventions, as described by http://www.childtrauma.com/treatment/trauma-therapies/ . Adult and/or child treatments for  PTSD are listed below:

Prolonged Exposure (PE) involves having the client tell the story of the trauma memory in detail, along with thoughts and emotions, from beginning to end. And then tell it again, and again... The theory is that as avoidance of the memory is prevented, the client has a chance to learn that it can no longer hurt, and desensitization occurs. This is an effective, well-researched treatment, mainly for adults.

Cognitive Processing Therapy (CPT) is an exposure variant that involves having the client  write down the trauma memory rather than speak it; the writing may provide some distance, making the procedure more tolerable. Most of the research on CPT has been with adult victims of rape, but one study of incarcerated teens with PTSD also showed CPT's effectiveness.

Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) is a treatment for children that  involves having the child create a book of the trauma memory, in which each page of the book represents one significant part of the event. The drawing helps to hold the child's interest, while going only a page at a time breaks down the memory into small parts, so that facing it is more tolerable. This method is well tolerated by children and well researched. The goal is for the child to create a narrative (through drawings, writings, other creative measures), which is sometimes in the form of a book, after learning coping skills to process their story with their therapist.

Narrative Exposure Therapy (NET) begins by creating a graphic time line of the client's life,  marking all of the best and worst events along the way. Then the worst events are addressed sequentially using narrative exposure (basically PE). NET has been found to be rather efficient with children as well as adults, perhaps because the broader life perspective from the time line has been structured in.

Traumatic Incident Reduction (TIR) involves having the client imaginally view a "movie" of  the trauma memory, and then discuss it with the therapist. This is repeated until no further distress is reported. TIR could use more research but appears to be efficient and well tolerated by children as well as adults.

Eye Movement Desensitization & Reprocessing (EMDR) involves having the client concentrate  on the worst part of the memory for perhaps half a minute at a time, while moving his or her eyes back and forth by following the therapist's moving fingers. This is done again and again until all distressing aspects of the memory have been worked through. The brief burst of exposure, combined with the distraction of the eye movements, may help to make the procedure more tolerable. This web site features a lot of information on EMDR, because it is well researched, effective, well tolerated, and has been found to be more efficient than the traditional exposure methods (such as PE, TF-CBT).

Counting Method (CM) involves having the client visualize a "movie" of the trauma memory,  from beginning to end, while the therapist counts out loud from one to one hundred. The visualization, time limit, and distraction of the counting may help to make the procedure more tolerable. In the one controlled study completed so far, CM appeared to work as well and as quickly as EMDR (PE took about 50% longer for the same results). It has so far been used only with adults.

Progressive Counting (PC) is a variant of the counting method, developed by Dr. Greenwald,  designed to make the treatment more efficient and better tolerated by clients. PC involves having the client visualize a series of progressively longer "movies" of the trauma memory while the therapist counts out loud first from one to 10, then to 20, then 30, etc. PC appears to be at least as effective as EMDR, well tolerated by clients, more efficient, and relatively easy for therapists to learn. PC is now featured in many of our training programs.

Structured Play Therapy is a structured, directive style of play therapy that guides the child to  repeatedly go through the trauma memory, in symbolic form. This is not a manualized treatment approach like the others on this page, and the research supporting this approach is not as strong as for most of the others listed. Even so, it is a legitimate and potentially effective way of conducting "exposure" with a child.

Long Term Successes and Ways to Get Help

If you have experienced a traumatic event and are experiencing the symptoms of PTSD, there is help for you. Working alongside a qualified mental health professional and focusing on traumatic triggers, coping skills, cognitive (thinking) distortions, telling your story via a narrative, and building a relationship with a therapist can significantly reduce and even end the intrusive feelings and flashbacks associated with PTSD. Instead of avoiding the thoughts and feelings associated with the traumatic event(s), a therapist will encourage you to remember the event, process it, address your feelings when the event occurred, and begin to incorporate purposeful coping skills to decrease the intense emotions and thoughts of PTSD.

Here are tips and suggestions to help with your own healing or the healing of a loved one with  PTSD: http://www.helpguide.org/articles/ptsd-trauma/post-traumatic-stress-disorder.htm

Seeking treatment for PTSD or Trauma is easy. Select a professional , we recommend a psychologist, LPCC  or LCSW first, and have an assessment performed. They may refer you to a psychiatric ARNP or a psychiatrist for a medication evaluation and or prescribe a course of treatment. 

If you need  help, call us at 859-338-0466 or contact us today!

Make an appointment with a dedicated staff member in order to start your healing process. 

Please see the Counseling Process section for more details on scheduling your visit.