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Last updated on 1 August 2019

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Eye Movement Desensitisation and Reprocessing therapy (EMDR therapy)

EMDR therapy is a trauma-informed and phased approach to psychotherapy, based on an adaptive information processing (AIP) model of learning and development. It integrates the use of physical bi-lateral stimulation (BLS) with a range of cognitive, behavioural and psychodynamic (psychoanalytic) concepts and strategies.

 

Essentially, the 'repetitive re-orienting' associated with BLS in EMDR treatment appears to accelerate 'free association' and to promote the re-consolidation of 'traumatic' memories, physiologically. This refers to memories associated with adverse life events and stressful experiences of having been challenged (least disturbing), threatened, or overwhelmed (most disturbing). Such experiences are associated with activation of specific stress responses (the 'startle' response, the 'fight-flight' response and the 'fright-faint' response). The memories of these events may be held in memory in 'state-specific' (episodic) form, with their associated stress responses waiting to be 'activated' (triggered) in the present. 

The 'reprocessing' of these memories seems to occur through stimulation of an orienting response (OR). The outcome is a physiological 're-calibration' of how easily stress responses (startle, fight-flight, fright-faint) are triggered in the present. It should be noted, however, that considerable care must be taken in the application of EMDR treatment, which is really what EMDR therapy is all about. Vulnerable clients (as many as 15% of the general population), may have had many or early experiences of being overwhelmed and may require considerable stabilisation before, during and after treatment.

History

Eye Movement Desensitisation (EMD) was discovered by Dr Francine Shapiro in 1987, as an effective treatment for post traumatic stress disorder (PTSD). The word Reprocessing (R) was added in 1991 and thus was 'EMDR' born.

 

Later, in 2001, Dr Shapiro wrote that if she had her time over again, she would simply have called it 'Reprocessing therapy', as using the abbreviation 'EMDR' leads to considerable confusion as to whether one is talking about:

- EMDR treatment    Phases 3-6 of EMDR therapy (the procedures for 'reprocessing' a disturbing memory);
- EMDR therapy        Phases 1-8 of EMDR therapy (a structured approach to, or 'system' of, psychotherapy).
The term 'EMDR therapy' signifies the evolution of Eye Movement Desensitisation (EMD) into Reprocessing therapy (R) and is Dr Shapiro's preferred term. This writer will avoid using the abbreviation 'EMDR' as consistently as possible.
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