The fifth phase of EMDR is installation, which strengthens the preferred positive cognition. This process continues until the client reports that the memory is no longer distressing. Usually the associated material becomes the focus of the next set of brief BLS. The therapist determines the focus of each set of BLS using standardized procedures. Then the client reports whatever new thoughts have emerged. Subjective Units of Disturbance (SUD) scaleĪfter the client has named the emotion he or she is feeling, the clinician asks, "On a scale of 0-10, where 0 is no disturbance or neutral and 10 is the highest disturbance you can imagine, how disturbing does it feel now?"ĭuring this phase, the client focuses on the memory, while engaging in eye movements or other BLS. The clinician asks, "When you think of the incident, how true do those words (repeat the positive cognition) feel to you now on a scale of 1-7, where 1 feels completely false and 7 feels totally true?" Both measures are used again during the treatment process, in accordance with the standardized procedures: Validity of Cognition (VOC) scale 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. 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 therapist ensures that the client has adequate resources for affect management, leading the client through the Safe/Calm Place exercise. The therapist offers an explanation for the treatment, and introduces the client to the procedures, practicing the eye movement and/or other BLS components. Targets include past memories, current triggers and future goals. In addition to getting a full history and conducting appropriate assessment, the therapist and client work together to identify targets for treatment. The treatment is conditionally recommended for the treatment of PTSD. While clients briefly focus on the trauma memory and simultaneously experience bilateral stimulation (BLS), the vividness and emotion of the memory are reduced. Unlike other treatments that focus on directly altering the emotions, thoughts and responses resulting from traumatic experiences, EMDR therapy focuses directly on the memory, and is intended to change the way that the memory is stored in the brain, thus reducing and eliminating the problematic symptoms.ĭuring 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). When the memories are triggered these stored disturbing elements are experienced and cause the symptoms of PTSD and/or other disorders. These unprocessed memories are understood to contain the emotions, thoughts, beliefs and physical sensations that occurred at the time of the event. The Adaptive Information Processing model considers symptoms of PTSD and other disorders (unless physically or chemically based) to result from past disturbing experiences that continue to cause distress because the memory was not adequately processed. Sessions can be conducted on consecutive days. Eye Movement Desensitization and Reprocessing (EMDR) therapy (Shapiro, 2001) was initially developed in 1987 for the treatment of posttraumatic stress disorder (PTSD) and is guided by the Adaptive Information Processing model (Shapiro 2007). EMDR is an individual therapy typically delivered one to two times per week for a total of 6-12 sessions, although some people benefit from fewer sessions.
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