EMDR Case Study

What is an EMDR® session like?

emdr session havocaFirst, client and therapist work together to collect basic information about the traumatic experience. The most disturbing part of the incident is identified and becomes the processing target.

Example: Image of the rapist’s face. The negative belief connected to the trauma is identified. Example: I’ll never get over this. And a preferred, positive belief is named.
Example: It’s over, I can move on with my life now.

Next, client is asked to rate (on a 1-7 scale) how true the positive belief feels when paired with the target. Usually it does not feel very true at this point. Client is asked to name the emotions the target elicits, to rate the associated distress level (on a 0-10 scale), and to locate the disturbance in the body.

Example: Fear and shame, with disturbance level 10, in belly and chest.

Then, client is asked to hold in awareness the target, the negative belief, and the disturbing body sensations. At the same time, the therapist guides the client’s eyes to move rapidly back and forth. This is done in sets, which may last from a few seconds to a few minutes. During each set the client is instructed to just notice whatever changes occur in mind and body, without controlling the experience in any way. Very often, in the first few sets there is an increase in the disturbance level. After awhile, with each new set, the target becomes less and less disturbing and the positive belief feels more and more true. The target is completely processed when recall of the image no longer brings up disturbing emotions, and the preferred positive belief feels totally true.

Example: Client recalls that the rapist’s face was threatening then but does not feel threatened by the image anymore.

(Bilateral audio tones are an alternative to eye movements)

How does EMDR® work?

Research to answer this question is now in progress at The Human Resource Institute’s Trauma Center in Brookline, MA. Researchers there are using SPECT brain-scan imaging to map the changes that occur after EMDR ® treatments. It is known that the brain has a natural mechanism for processing disturbing events, however, when a traumatic experience is overwhelming the brain may not be able to process it in the usual way. That is why severely traumatized people often find themselves stuck in disturbing memories long after the traumatic event. Research suggests that an important part of the natural trauma processing happens during REM (rapid eye movement) sleep, which provides alternating stimulation of the right and left hemispheres of the brain. This may help explain why EMDR therapy seems to jump-start the brain’s natural healing ability, allowing the traumatic memory to become less and less disturbing.

Has EMDR ® been researched?

EMDR ® is now the most researched treatment for post-traumatic stress disorder (PTSD). Many scientific studies have shown it is effective and long-lasting. For example, in December 1995 a study by Wilson, Becker, and Tinker was published in the prestigious Journal of Consulting and Clinical Psychology. The study showed that 80 subjects diagnosed with PTSD showed significant improvement after EMDR therapy. At a 15-month follow-up, treatment benefits were unchanged.

An EMDR® Story . . .

Summarized from Chapter 9 in EMDR: The Breakthrough Therapy for Overcoming Anxiety Stress & Trauma (Shapiro & Forrest).

Mia was a single mother whose 12-year-old son and only child was killed by a train when his shoe became stuck in the track. For a year after his death she had obsessive thoughts and nightmares about the accident. Her depression was intense and she often thought of suicide. Mia took a disability leave from work because she couldn’t concentrate or function well. She was treated with Prozac, Ativan, and weekly “talk” therapy, but 13 months after her son’s death she felt even more hopeless and distressed. Running out of money, her doctor suggested she enroll in a free PTSD research study at Yale Psychiatric Institute. There she was seen by psychiatrist Steve Lazrove for three sessions of EMDR. In the first treatment session she described the worst part of the story and rated it a “10” on a 0-10 disturbance rating scale. Mia reported the emotion was a terrible pain in her chest, and a sense that “my heart was stolen from me.” She said, “I feel guilt. He was my responsibility.” Lazrove elicited a more positive belief, that it was an accident and not her fault. Then he had her focus on the most disturbing images and thoughts and guided her eyes to move back and forth. Gradually, over the course of about an hour, and after 23 sets of eye movements, the details of the memory became less disturbing. By the end of the first session she reported she could think about the accident scene and it no longer felt distressing. “I feel relieved. I feel more comfortable, like a weight has lifted off me. When I think about that the way I did before, it was really hard, it was really painful. But I don’t see it like that anymore. The painful part is gone out of that.” By the end of the three sessions she came to feel that it had neither been her fault nor her son’s fault. At the 8-month follow-up visit Mia reported she had returned to work. She was sleeping well and was no longer having obsessive thoughts about the accident.

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