In 1989,
an American psychologist.
Named Francine Shapiro was walking in the park when she
first noticed her eyes making spontaneous saccadic eye movements towards the
upper,
right
when she was thinking disturbing thoughts.
She proposed that the saccadic eye movements were linked to
the alterations in information processing that she perceived within
her mind and led to what is now known as
EMDR or eye movement desensitization and reprocessing therapy.
In early EMDR treatments, Shapiro
intentionally reproduced
these saccadic eye movements with patients instructed to shift their
gaze back and forth.
Between two fingers held up in front of the patient
on either side of the midline or with extremely rapid
contralateral movements.
Saccades are rapid ballistic movements that abruptly change the eye's
point of fixation,
these movement can different in amplitude ranging from smaller movements like
the ones you make when reading a book to larger
movement like the ones made when you look around the room.
This form of therapy is often used to treat post-traumatic
stress disorder and complex.
Post-traumatic stress disorder,
also known as PTSD or c-ptsd.
You may be thinking what's the point, and why does
it help?
Well,
the repetitive redirecting of attention in EMDR induces the neurobiological state,
like that of REM sleep.
REM sleep, or rapid eye movement sleep,
plays an important role in dreaming memory and emotional processing.
This REM state is optimal to support the integration of
memories into General semantic Networks.
We have two types of memory networks: episodic and semantic.
The semantic memory focuses more on factual and conceptual knowledge
about the world.
Mostly through language.
The episodic memory focuses on one's life.
Events a person has experienced throughout the phases of
their life,
when we perceive an event in our conscious awareness,
the initial formation of the episodic memory occurs in the
hippocampus and our brain extracts and stores the emotional information
of the event in our amygdala.
The integration of the episodic and semantic memories is facilitated
By REM sleep.
This emotional processing,
however,
which again happens in REM
sleep fails in people with PTSD.
During an EMDR session.
The current procedure is to ask the patient to recall
a distressing part of the traumatic event that they wish
to work through the therapist helps the patients focus on
the visual representation of the trauma.
Most strongly associated with negative feelings and distress the
patient then gives a negative self statement,
they feel because of that event,
for example,
these statements could be I'm helpless,
I'm weak.
I can't take care of myself or I'm not good
enough.
The patient.
Also,
identifies the effect evoked by the image in their
head,
Whether it be fear,
anger sadness or something else,
the patient rates its
intensity from 0 to 10 on the subjective units
of distress scale,
which is commonly used in exposure therapy where individuals estimate
the severity of their fear in a situation with zero
being,
no fear and 10 being the most the severe
fear and distress that they've ever experienced.
At the same time,
the therapist help the patient become aware of and describe
in detail physical Sensations.
And thoughts that arise when thinking about these images. Together,
the therapist and the patient also established a direction to
the therapy by developing a positive cognition.
This answers,
the question: "When you see yourself in that situation
what would you rather believe about yourself than the negative
self statement that you just mentioned?
The patient is asked to rate the degree to which they
believed this statement at a "gut level". Together with the
distress rating, this assessment helps,
the therapist gauge the progress towards a more emotionally improved
interpretation of the traumatic event.
Following
this initial phase.
However,
patients been holding the image,
their thoughts,
feelings,
and physical Sensations in mind,
and move their eyes back and forth by following the
therapist's hand
These sets
of alternating stimulation.
Last from 20 seconds to several minutes depending on the
patient's emotional reaction.
The patient's emotional reaction is associated and correlated with physiological
signs of relaxation such as reduction of blood pressure and
heart rate.
After each pause the patient reports on what came to
mind.
This may be a new image thought,
emotion or at times, a change in physical sensation,
the patient.
Then focuses on this new information and another set of
stimulations
via eye movements
follow. The process continues,
until the associations are no longer changing,
or until only positive Associations and Sensations are reported. Depending
on the remaining levels of stress and strength of the
positive cognition.
The therapist may then decide to initiate further processing of
the initial image or to start processing other aspects of
the trauma. Patients
Often express new beliefs about the traumatic event such as,
it wasn't my fault,
with a puzzled expression on their face or with a
smile of relief or they find themselves.
Almost disbelievingly accepting a painful past mistake that has
haunted them for decades.
Using statements like I really didn't have any other
choice at the time or I did the best I
could under the circumstances.
In between
eye movement sets,
patients engage in normal conversation with the therapist.
Typically reporting on what occurred during the simulation,
they do not appear to be in a trance State.
They typically describe their flow of Consciousness during eye movements
as resembling focused daydreaming. EMDR has been shown in several
controlled studies,
to reduce PTSD symptoms
to the level of non patient-controls and the results of EMDR
Were seen in three sessions are less for more than 80%
of patients with a dropout rate of less than 10%
and no noticeable.
Side effects,
amazingly controlled trials of EMDR for civilian PTSD,
report 77 to 90% remission rate.
Thanks to walk in the park.
The psychological association's committee on verified treatments now proclaims
EMDR as efficacious for civilian PTSD and
multiple randomized.
controlled trials have supported the efficacy of brief
EMDR treatments to reduce PTSD in most victims of adult
onset.
Trauma,
future research,
should assess the impact of lengthier intervention, combination
treatments of EMDR and medications,
like antidepressants and treatments on the resolution of PTSD in
adults with childhood related
traumas. For more videos like this one,
please visit the demystifying medicine McMaster YouTube channel.
Thank you for watching.