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Introduction of EMDR

There is a shared dream in all trauma therapy professions, which is to find a faster way to shorten the days our clients spend in agony.  It is with Dr. Francine Shapiro’s creation of the Eye Movement Desensitization Reprocessing (EMDR) that our dream has come true.

Since the American Psychology Association (APA) approved EMDR, there have been amazing stories shared throughout America.  We have heard from not only the victims but also the rescuers involved in the Oklahoma City Bombing; how they were all saved by EMDR.

EMDR has evolved from a simple skill to a well-developed, integrated psychotherapy.  This psychotherapy has proven to alleviate client’s pain and pay close attention to the importance of the integration of inner self-growth and outer social system at the same time.

I . Origin of the Theory

In 1987, Shapiro realized how eye movements had psychological effects on people.  This can be traced back to 1979 while Shapiro was writing her dissertation in English Literature in New York University (NYU).  During that period of time, she developed an interest in the relation of causal effect in human psychological phenomenon and physical well being.  It was at that same time she was diagnosed with breast cancer, and it made her treasure her life even more.  It became more meaningful at this point of her life when she first had an interest in the viewpoints that behaviorism carries on the physiological causal effect.  Later on, she studied the neuropsychoimmunological research that Norman Cousins and some others were doing and this made her strongly believe in the correlation between illness and pressure.

When she was told that the cancerous cells in her body had been completely removed, but uncertain if she would relapse, Shapiro started going to many mental health, physiological and psychological workshops to ensure her well being as a whole person.  Then she went on to pursue her PhD in clinical psychology.  The topic of her dissertation was on the relationship between mental and physical health and pressure.  This was when Eye Movement Desensitization and Reprocessing was first established and developed.

II . Meaning of the Eye Movement

Eye movement refers to the fingers of the therapist moving back and forth in front of the client or in the form of tapping so the client’s vision can be led from one end to the other in order to elicit the client’s neurotransmission system.  The distance that needs to be kept between the therapist and the client mainly depends on the comfort zone of the client.

From her clinical experiences, Shapiro pointed out that other than the eyes moving horizontally, there are vertical or diagonal movements as well.  Every type of movement has a unique effect, the therapist needs to discuss which type of movement most comfortably suits the client, and the speed of the eye movements needs to be taken into account too.

This theory originated from Shapiro’s personal experience.  Therefore, when she established this theory, she emphasized on the psychological state and needs of a client.  She pointed out that clients are often the best teachers for therapists.  Therapists need to treat the cognition, thought, feeling, behavior and belief of their clients’ with delicacy.  In other words, the professional attitude in EMDR is to focus on the client as the center of therapeutic process.

III . Adaptive Information Processing

According to the reference, if we can establish a good attachment with the caregiver during our childhood, our cortex will be well developed for us to develop self comforting and self integration ability.  In EMDR, by using eye movements, clients will be able to build a higher level of cognitive processing and for the cortex to function so the original cognitions will change.

After many clinical experiments, Shapiro realized that information theory could explain the effect brought by eye movements for clients better than the desensitization hypothesis.  Therefore, after changing the name, Adaptive Information Processing became the core of this therapy.  She also emphasized that the terms used in EMDR are from the neurophysiological information processing of G.H. Bower and P.J. Lang in the 1980s.

The reason for the term “adaptive” is to point out the fine connection that will take place in the process.  These experiences are unique in their own ways and are able to integrate into positive affect and cognitive schema.  She also emphasizes that the negative memories stored in the brain need to be processed no matter how long they have been there or else clients will not be able to attain real freedom within oneself.

Shapiro believes that this therapy forces the clients to face these stored traumatic memories directly which initiates the nerotransmitting system in the client, and the direction of the transmission will naturally turn to the self adaptive processing which assists the client.  This is known as the adaptive information processing.  The bilateral movement includes the horizontal movements of the eyes, the taps on the knees, light bar, hearing bilateral stimuli and others; they are all adjusted to the special needs of each individual client.

IV . Therapy Results

In 1995, S.A. Wilson, Lee A. Becker and Robert H. Tinker conducted therapeutic assessments on eighteen clients with traumatic experiences and had undergone three sessions of EMDR.  The initial result showed EMDR had remarkable effects.  This finding brought about the value of EMDR in psychotherapy by clinical practitioners.  Later on, Wilson, Becker and Tinker did a fifteen-month follow-up with same clients, the result pointed out that 84% of them have not presented any Post Traumatic Stress Disorder (PTSD) syndrome (Wilson, Becker & Tinker, 1997).  Many researches have also shown the therapeutic effect from EMDR.  APA also gave high recognition to EMDR in 2004.

EMDR assists clients to face their past life experience, let them sort out the negative emotions and memories in order to gain a new conception of the past events, for the clients to gain control over their life, set them free from past disturbances.  Therefore, EMDR is believed to have integrated the etiology of psychodynamic, behavioral, cognitive, experiential, hypnosis and systematic theories.

Furthermore, it is like what Shapiro has once stated, “it is hard to discern which theory that EMDR can be categorized in, the most important thing is not the different therapies, but to threat the client as a whole being.

V. Research Development

The EMDR theory on information processing is still in development, therefore the hypothesis on the physiological reaction of neurotransmitter and adaptive information processing.The research results made Shapiro point to basic components in EMDR treatment, including some very important aspects:  interrupted exposure, perceived mastery, attention to physical sensation, cognitive reframing, alignment of memory components, free association, mindfulness, eye movements and alternative dual attention stimuli.Other important concepts include orienting response, disturbed, hypnosis, cellular and brain-level changes.

Since 1989, there have been fifteen research results from clinical observation and experiment of PTSD clients, most of the results came out positive.  However, researchers should still take note on issues like the appropriateness of treatment, assessment appropriateness, and secondary gain.

In order to spread this therapy worldwide, EMDR has established international associations and a website www.emdria.org.  It also encourages helping professionals to make local adjustments when practicing, to add to the abundance of EMDR.  TEMDRIA was established under this belief and is supported by TEMDRA to gather and train practitioners in Taiwan.

臺灣眼動減敏與歷程更新治療學會 Taiwan Eye Movement Desensitization & Reprocessing Association
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