Eye movement desensitization and reprocessing

Eye movement desensitization and reprocessing (EMDR) is a form of psychotherapy developed by Francine Shapiro in the 1990s in which the person being treated is asked to recall distressing images; the therapist then directs the client in one type of bilateral sensory input, such as side-to-side eye movements or hand tapping. It is included in several evidence-based guidelines for the treatment of post-traumatic stress disorder (PTSD).

It has been controversial; critics have argued that the eye movements in EMDR do not add to its effectiveness and lack a falsifiable theory. While multiple meta-analyses have found it to be just as effective as trauma focused cognitive behavioral therapy for the treatment of PTSD, these findings are tentative given the low numbers in the studies, high risk rates of researcher bias and high dropout rates.

The person being treated is asked to recall distressing images while generating one of several types of bilateral sensory input, such as side-to-side eye movements or hand tapping. The 2013 World Health Organization practice guideline says that “Like cognitive behavioral therapy (CBT) with a trauma focus, EMDR aims to reduce subjective distress and strengthen adaptive beliefs related to the traumatic event. Unlike CBT with a trauma focus, EMDR does not involve (a) detailed descriptions of the event, (b) direct challenging of beliefs, (c) extended exposure, or (d) homework.”

A 1998 meta-analysis found that EMDR was as effective as exposure therapy and SSRIs.

A 2002 meta-analysis concluded that EMDR is not as effective, or as long lasting, as traditional exposure therapy.

A 2005 and a 2006 meta-analysis each suggested that traditional exposure therapy and EMDR have equivalent effects immediately after treatment and at follow-up.

Two meta-analyses in 2006 found EMDR to be at least equivalent in effect size to specific exposure therapies.

A 2009 review of rape treatment outcomes concluded that EMDR had some efficacy. Another 2009 review concluded EMDR to be of similar efficacy to other exposure therapies and more effective than SSRIs, problem-centered therapy, or “treatment as usual”.

A 2010 meta-analysis concluded that all “bona fide” treatments were equally effective, but there was some debate regarding the study’s selection of which treatments were “bona fide”.

A Cochrane systematic review comparing EMDR with other psychotherapies in the treatment of Chronic PTSD, found EMDR to be just as effective as Trauma-Focused Cognitive Behavior Therapy (TFCBT) and more effective than the other non-TFCBT psychotherapies. Caution was urged interpreting the results due to low numbers in included studies, risk of researcher bias, high drop out rates, and overall “very low” quality of evidence for the comparisons with other psychotherapies.

Another systematic review examined 15 clinical trials of EMDR with and without the eye movements, finding that the effect size was larger when eye movements were used. Again, interpretation of this meta-analysis was tentative. Lee and Cuijpers (2013) stated that “the quality of included studies was not optimal. This may have distorted the outcomes of the studies and our meta-analysis. Apart from ensuring adequate checks on treatment quality, there were other serious methodological problems with the studies in the therapy context.”

The 2009 International Society for Traumatic Stress Studies practice guidelines categorized EMDR as an evidence-based level A treatment for PTSD in adults. Other guidelines recommending EMDR therapy – as well as CBT and exposure therapy – for treating trauma have included NICE starting in 2005, Australian Centre for Posttraumatic Mental Health in 2007, the Dutch National Steering Committee Guidelines Mental Health and Care in 2003, the American Psychiatric Association in 2004, the Departments of Veterans Affairs and Defense in 2010, SAMHSA in 2011, the International Society for Traumatic Stress Studies in 2009, and the World Health Organization in 2013.

EMDR is included in a 2009 practice guideline for helping children who have experienced trauma. EMDR is often cited as a component in the treatment of complex post-traumatic stress disorder.

A 2017 meta-analysis of randomized controlled trials in children and adolescents with PTSD found that EMDR was at least as efficacious as cognitive behavior therapy (CBT), and superior to waitlist or placebo.

The proposed mechanisms that underlie eye movements in EMDR therapy are still under investigation and there is as yet no definitive finding. The consensus regarding the underlying biological mechanisms involve the two that have received the most attention and research support: (1) taxing working memory and (2) orienting response/REM sleep.

There have been a number of proposed mechanisms including the Adaptive Information Processing (AIP) model.[unreliable medical source] In addition, brain waves during EMDR treatment shows changes in brain activity, specifically the limbic system showed its highest level of activity prior to commencing EMDR treatment.[unreliable medical source] A slowing of brain waves during the bilateral stimulation (eye movement) is somewhat similar to what occurs during sleep.[unreliable medical source]

According to the 2013 World Health Organization practice guideline: “This therapy [EMDR] is based on the idea that negative thoughts, feelings and behaviours are the result of unprocessed memories. The treatment involves standardized procedures that include focusing simultaneously on (a) spontaneous associations of traumatic images, thoughts, emotions and bodily sensations and (b) bilateral stimulation that is most commonly in the form of repeated eye movements.”

Salkovskis in 2002 reported that the eye movement is irrelevant, and that the effectiveness of EMDR was solely due to its having properties similar to CBT, such as desensitization and exposure.

EMDR therapy was first developed by Francine Shapiro upon noticing that certain eye movements reduced the intensity of disturbing thought. She then conducted a scientific study with trauma victims in 1988 and the research was published in the Journal of Traumatic Stress in 1989. Her hypothesis was that when a traumatic or distressing experience occurs, it may overwhelm normal coping mechanisms, with the memory and associated stimuli being inadequately processed and stored in an isolated memory network.

Shapiro noted that, when she was experiencing a disturbing thought, her eyes were involuntarily moving rapidly. She noticed further that, when she brought her eye movements under voluntary control while thinking a traumatic thought, anxiety was reduced. Shapiro developed EMDR therapy for post-traumatic stress disorder. She speculated that traumatic events “upset the excitatory/inhibitory balance in the brain, causing a pathological change in the neural elements”.

As early as 1999, EMDR was controversial within the psychological community, and Shapiro was criticized for repeatedly increasing the length and expense of training and certification, allegedly in response to the results of controlled trials that cast doubt on EMDR’s efficacy. This included requiring the completion of an EMDR training program in order to be qualified to administer EMDR properly, after researchers using the initial written instructions found no difference between no-eye-movement control groups and EMDR-as-written experimental groups. Further changes in training requirements and/or the definition of EMDR included requiring level II training when researchers with level I training still found no difference between eye-movement experimental groups and no-eye-movement controls and deeming “alternate forms of bilateral stimulation” (such as finger-tapping) as variants of EMDR by the time a study found no difference between EMDR and a finger-tapping control group. Such changes in definition and training for EMDR have been described as “ad hoc moves [made] when confronted by embarrassing data”.

A 2000 review argued that the eye movements did not play a central role, that the mechanisms of eye movements were speculative, and that the theory leading to the practice was not falsifiable and therefore not amenable to scientific inquiry. It went on to refer to EMDR as “pseudoscience”, citing non-falsifiability as one of several hallmarks of pseudoscience that EMDR met. As discussed in 2013 by Richard McNally, one of the earliest and foremost critics: “Shapiro’s (1995) Eye Movement Desensitization and Reprocessing (EMDR) provoked lively debate when it first appeared on the scene in the late 1980s…. Skeptics questioned whether the defining ingredient, bilateral eye movement, possessed any therapeutic efficacy beyond the imaginal exposure component of EMDR…. A 2001 meta-analysis suggested that EMDR with the eye movements was no more efficacious than EMDR without the eye movements (Davidson & Parker, 2001), implying that “what is effective in EMDR is not new, and what is new is not effective” (McNally, 1999, p. 619).

Although controlled research has concentrated on the application of EMDR to PTSD, a number of studies have investigated EMDR therapy’s efficacy with other disorders, such as borderline personality disorder, and somatic disorders such as phantom limb pain.

What Can Go Wrong With Self-EMDR?

What Can Go Wrong?

    Although the most important consideration with Self-EMDR is safety, safety, safety – several reports have come in about problems.  Every one has been evaluated and removed.

Mary was a teenage mother, estranged from her family and living in a flat with her baby.  The child’s father did not like babies (“Dirty things”) and so departed with another lady.  Bravely, Mary battled on until, unexpectedly, the baby died of SIDS (Sudden Infant Death Syndrome).

Mary procured a copy of my book but reportedly was “unable to eliminate or substantially reduce the guilt and depression” within the suggested three or four one-hourly sessions.  She had allowed the grief process to run its course for two months, after moving back with her parents, before attempting self-EMDR.  Why the delay?  I recommend this because grief is part of a natural and necessary healing process.  To grieve is to heal, but unusually protracted grieving is unnecessary and undesirable.

Self-EMDR-sad_woman A brief E-mail conversation with the youngster and her mother was sufficient to establish the cause of Mary’s failure.  Once entranced and reliving the shock and desperate pain she had experienced when finding the baby’s body, Mary “bailed out”.  “I don’t like pain,” she said. “I’ve already had my share.”  I explained that, “If you are able to tolerate as little as 40 minutes of severe discomfort, once or even twice, you will be free of the tragedy for the rest of your life.  I promise.”  And so it was!  Mary rode the trauma down (from 10 out of 10 in terms of its intensity, to 9, to 9, to 9, to 6, to 5, to 3) over a period of 60 minutes.  At that point she was aware of a huge relief, but was feeling tired and called it off until the following day.

Accompanied by her fascinated – and hugely grateful – mother, the youngster did two more five-minute sets and called a halt when she could discern no further discomfort.  She could remember Baby’s death, and funeral, and the black hole she had carried in her heart for weeks afterwards, but the memory itself carried no pain. Self-EMDR-hope-despair

But, but… what if the trauma went down to only five out of 10 in intensity, and stayed there?  No problem.  Mary would simply do more five-minute sets during the next few  days until the discomfort did disappear.  Failure is not possible. 

    What other problems can we encounter?  I have had several complaints that were traced to people failing to focus, while in trance, on a single trauma.  Perhaps John is over-tired when starting his Self-EMDR.  His entranced mind drifts from the fact a junior member of the company has been promoted over his head (the principal trauma);  to the fact he feels jealous because his wife would rather spend time with the baby than with him;  to that awful noise in the car’s engine.  John is supposed to hold his focus on a single trauma or area of discomfort, and keep it there, set after set, as  the level of conflict falls away.  If he allows his attention to drift, it simply won’t happen.

In the rare event a Self-EMDR session is completely halted, possibly because… the smoke alarm starts screaming, or the power supply fails, a potentially unfortunate situation can unfold. Hours later, or on the following day, the painful emotions that were in the process of being drained, abruptly come bursting to the surface.  Although they, in turn, will recede without additional sets it can be a startling phenomenon. The obvious solution, of course, is to have another Self-EMDR session and finish draining the emotions once and for all.

Unfortunately the one problem area which is likely to capture every counselling and therapeutic modality in the world, also affects EMDR and Self-EMDR.

Because of their primal role, males tend to become aggressive when challenged (admittedly with plenty of exceptions).  As a result there is an inclination for John JoSelf-EMDR-sad_boynes to blame somebody else no matter what goes wrong;  even when he is obviously at  fault.  If he climbs out of bed on the wrong side, and you get in his face, he won’t even listen to your considered argument.  He’ll be too busy searching his mind for the last word, the coup de grace. 

But the woman is different, because the human coin has two sides.  She may lose an argument, because her emotions tell her that is better than damaging a relationship.  He is the warrior.  She is the nurturer.  The Israeli Defence Force tells us their female soldiers must not be exposed to certain pivotal combat situations.  She will seldom throw away her life because if she does her baby dies (again in primal terms) and there is no mother to look after the children.  On the other hand, John Jones can give himself the luxury of taking a bullet and simply rolling over and dying.  He has proved himself.  Nothing is more important.

Now for the focus:  The archetypal female will blame herself, because her role with the children demands nothing less.  A male will blame the child for keeping him awake night after night.  Eventually the youngster will occupy an unsafe environment.  In the same situation the mother will blame herself, and frequently walk away.  The child will always be in safe hands.

In the case of a severe conflict the male will defend himself by attacking.  The female (especially an adolescent girl) will attack herself, sometimes by cutting.  She blames herself.

It follows that a distraught women receiving EMDR or Self-EMDR is capable of holding so much self-loathing that she will (subconsciously/unconsciously/emotionally) inhibit the therapy from working without being aware of it;  irrespective of the modality or technique involved.

Heads up!

(1)  The above remarks are by definition a generalization, but I am convinced they are a robust generalization;

(2)  EMDR and Self-EMDR enable the woman’s self-loathing to be eliminated with a small handful of sessions, in a manner that is quite impossible with any other approach.


Strategies To Follow When Dealing With Stress

It has been claimed that modern civilization has merely moved pain and discomfort from the physical world to the emotional.  Hello stress!

Again, many strategies used to control anxiety and depression are useful when dancing with the modern nemesis called stress.  One is music.  Immerse yourself in its magic as a means to escape from negative emotions, and therefore exercise some control over them.

Share your aspirations and concerns, and never, never forget that the most effective healing remedy in the world is to help another person.  Almost without exception we will be offered our own Lazarus.  Many fellow travellers will die emotionally of anxiety, depression and stress years before they physically take their leave.  On the back of my professional card I have two little quotations:  “All you have to decide is what to do with the time that is given to you”- J.R.R. Tolkien  and  “You have not lived the perfect day unless you have done something for someone who will never be able to repay you” – anon

   Self-EMDR-relax It must be acknowledged that most people prefer a more pragmatic approach to the exhaustive, corrosive, overwhelming discomfort we call stress.  Try the following:  A quiet,  meditative stroll.  Feel your footfalls.  Calm your breathing.  Look at the trees or gardens.  Make a point of reminding yourself of how lucky you are, compared with many others.  Meditation is a medically proven way of lowering blood pressure, breaking negative endocrinal cycles, and creating positive expectation which plays itself out.  There are many different methods and techniques, and therefore many options available.

Perhaps the most popular stress-busting method in certain warm parts of the world is the early afternoon nap, although it shows no sign of spreading – beyond the much favoured “nana nap”. But the ultimate remedy for me has always been traveling, I remember last year when I felt like I needed to get away from everything that was causing me stress, I remember one day I got up and decided to contact the
best outer banks rentals out there, went I got back from my little vacation I felt better than ever.

A psychotherapeutic approach used for many years is progressive relaxation, in which groups of muscles are tightened and then abruptly relaxed.  Inescapably the muscular relaxation flows on as mental-emotional relaxation.  Of course stress and relaxation cannot exist side by side.

Reframing a stressful situation so it sits more comfortably with the person involved is a further possibility.  In other words, if Mary’s diagnosis with cancer coincides with her compelling need to demonstrate her trust, her spiritual faith, and her courage to the children as an inspiration, she might welcome the diagnosis as a God-given opportunity.  Stress is reduced.  Mary feels she has been touched, not by chance, by the hand of God.  Her prayers have been answered.

Finally, a long-term solution is offered for an entire spectrum of stressors and their resolution.  CLICK HERE to check out the self-help guide, Self-EMDR, by Desmond Long.

Don’t Let Depression Take Over Your Life

Depression is a terrifying, complex phenomenon that affects most people in every community at some time in their life.  In simplistic terms we encounter various types of depression.  (a) Chronic depression typically comes and goes, often varying in intensity, sometimes for a lifetime.  (b) Reactive depression may appear for a particular and recognisable reason.  For example, a grief situation typically causes depression, accompanied by a spectrum of other negative emotions such as anger, denial (in the case of illness or death), exhaustion, anxiety, and reduced self-esteem and self-confidence, which needed to be treated intermediately, you have to find ways of distracting yourself, anything is better than just thinking about your problems even going online to get royalty free images, who knows, it is worth noting that grief is caused by any loss situation – not only a death.  (c)  Clinical depression.   This is the term generally denoting an episode so severe it debilitates the victim.

Not surprisingly depression accompanies many other illnesses, simply because the loss of one’s health must be grieved like any other loss, if healing is to take place.  Pain, hopelessness, fear, the need to recreate oneself, and even suicidality, cause a compounding misery. I recommend you to check out Lumitea Bloating relief for any digestive problems you might have.
Measures used to combat anxiety disorder are often effective with depression.  For example, traumas of the past which have caused “bad” emotional symptoms, are likely to be triggered or resurrected if present-day circumstances are similar.  Take the case of John, a chubby kid who was never able to understand maths or English.  Poor John was bullied by both the sporty kids and the clever kids.  In his first job, stacking shelves at the supermarket, he was mercilessly bullied and ridiculed by an assistant manager.  The emotions of the youngster came flooding back, especially the depression, the shyness and the conviction he was inferior.  The felt like hiding in the wardrobe.  He hated himself.  He was too embarrassed to allow anyone to see the tears.  He’d be better off dead!

The young man had reverted to a child again.  The victimised kid’s emotions had replaced those of the adult, because the assistant manager “felt” so much like the bullies at school.

What can John do about it?  In any number of ways he can introduce techniques into his life that he knew nothing about as a youngster.  That is, John can gather to himself methods of giving himself empowerment, a sense of structure and being in control.  In the process John becomes less and less like the schoolboy.  (I would endeavour to empower my client, move him in the direction of independence, and certainly not tell him what to do.) You can´t let depression take over your life, I always recommend taking some time off to better yourself, maybe going to the beach and checking out a cooler resource to get a cooler, fill it up with food and just go and relax, let the depression disapear.

Self-EMDRbeingaloneAs well, I would discuss the advantages of his using positive affirmations before sleep every night, such as “I now own my life.  Respectfully I defer to no-one, although I will always listen and learn.  Bullies, of whatever age, feel so inferior they need to put on a show of how big and strong and clever they are.  It’s just an act.  In fact they are pathetic idiots.  I feel sorry for them.”

Other techniques?  Assertiveness training is an incredibly powerful approach.  Enquire about neighbourhood classes, or obtain a pamphlet or DVD on the subject.

It is not helpful to overload oneself.  Do one chore or project at a time, and take satisfaction from doing it well.  Also make time for rest and recreation (re-creation).

With depression the inclination frequently exists to isolate yourself from other people.  This is the worst thing you can do.  Seek out a friendly listener.  Confide.  Even ask for help, never an easy task for the male of the species.  Seek out the courage.  You will surprise yourself.  A primal need exists to express the pain existing within, for that process encourages healing.  Another method is to write, write, write out the problem.  Start a diary.  Write to yourself or an imaginary friend.  Tell it like it is.  Then either keep it or discard it.

Yes, words are only words, and depression is an emotion and not words.  The most effective method of combining the two can be found in a modality that is exploding in popularity among mental healthcare professionals in over 130 countries – called EMDR.  A very recent development to this technique is Self-EMDR, whose reach and protocols were researched and developed by Desmond Long and his team.  Check it out.  CLICK HERE.

What Is Anxiety Disorder?

What is anxiety?  It is a normal, healthy and necessary part of our day-to-day life.  For example, we should be anxious and therefore vigilant to an appropriate degree when standing on the edge of a cliff in a blustery wind;  unless we’re a bird, of course.  Again, anxiety is an entirely understandable response for Mary as she awaits the results of her cancer biopsy.

But anxiety disorder is different.  By definition it is typically marked by vulnerable emotions, a feeling of dread, extreme nervousness or the impression of being unsafe – when there is no objective reason for these reactions.  Debilitating panic attacks are an extreme example of anxiety disorder. sad_eyes_Woman_EMDR_therapy

Mental healthcare specialists have claimed that, worldwide, 30 percent of the  population suffer from emotional problems every year, sufficiently severe to require professional intervention.  Whether or not such a blanket claim is meaningful and provable, it must be acknowledged that anxiety, depression, anger management problems, an inappropriate response to stress, and a general dissatisfaction with life, afflict virtually all Western countries.  Perhaps strangely, some statistics claim that the poorer the community the happier are its members!

So… what causes anxiety disorder?  Simplifying the old “nature versus nurture” approach, the question of genetics must be looked at.  If an unusually high incidence of anxiety runs in the family, its members downstream tend to have a higher incidence of anxiety.  A predisposition is said to exist in the bloodline.  But if Granddad were a manic depressive (bipolar), perhaps a bully who screamed and ranted at his children, they are likely to grow up in a fraught environment – unsafe, unloving, intimidating.  In turn this learnt behaviour can be passed from generation to generation.  Children are very, very sensitive and impressionable, and not only model the responses of the authority figures in their own life, but also develop sometimes unfortunate coping mechanisms;  such as anxiety disorder.  In an extreme case, “If he scares me too much I’ll get a migraine or asthma, then he won’t be allowed to hurt me.”  Of course the migraine or asthma is purely a subconscious psychosomatic reaction.

There are various strategies used to combat anxiety disorder.  In terms of this book, Self-EMDR:  The Complete Therapeutic Approach, we tell people that instead of taking a pill so it doesn’t hurt so much, why not remove what is causing the pain.  This approach also makes a reader independent and self-contained, all for the price of several cups of coffee.

(1)  Needless to say, both Complementary/Alternative and Allopathic (orthodox) medication is available to treat anxiety disorder.

(2)  Some sufferers are able to move the emotional stress to the physical level by resorting to a programme of physical exercise.  It is much easier to drain physical stress than emotional stress, simply by resting up for a while.

(3)  Talking to a friend or family member enables you to express the conflict causing anxiety disorder within a supportive environment, and often in the process create more of a sense of balance, control and structure.  This is what counselling is all about.  Seldom is a person destroyed by a trauma.  Rather, it is the lack of support which does the damage.

(4)  Mindfulness exercises.  A meditating technique involves the individual focussing acutely on that point in time called “the present” to the exclusion of the past and the future.  Significantly, stress and anxiety flow when one remembers past conflicts and pain;  and also when one looks into the future, anticipating further conflicts and pain.  The present is a fraction of a second which we  travel – locked in – that is free from both.

(5)  Set goals for yourself daily, and keep to them.  This establishes the impression of structure and control, the very qualities missing when anxiety disorder is encountered.

(6)  Practise deep breathing.  While anxiety can cause the victim to  hyperventilate, measured diaphragm breathing can actually “fool” the autonomic nervous system into emerging from its “fight or flight” response – that is part of anxiety disorder.

(7)  Diet.  Informed nutritional advice, available from a dietician or the pharmacy, has been credited with reducing or eliminating anxiety disorder.  In fact a healthy diet is essential for many areas of well being.  Complementary/alternative practitioners with access to dietary supplements may also prove helpful.

(8)  Check out the book by Desmond Long : Self-EMDR:  The Complete Therapeutic ApproachCLICK HERE.

Self-EMDR – Is It Safe?

Self EMDR The Breakthrough New TherapyIs it safe?

Just how safe?

Although EMDR (sometimes called “processing”) has captured, in fact revolutionized, psychological practice in over 90 countries during a mere 15 years, its birth can be traced back to the dawn of modern civilization.  Indigenous American Indians stamping their feet as they dance around a campfire are entrancing themselves, inspiring themselves, with the same process.

Grandma gently moving backwards and forwards in her rocking chair is in a similar neurological trance.  As with little Mary on the swing in her backyard, and her baby brother who is being rocked to and fro in Mother’s arms or in the cradle.

But therapeutic self-EMDR, is that just as safe?  Yes.  As safe as Grandma and Mary.  In all cases their brain is gently being pulsed by the physical movements.  The resulting trance makes them delightfully relaxed and comfortable – and profoundly receptive.  In my practice I regularly work with fretful and uncomfortable babies (showing Mother how) and with children and teenagers.

Question:  How long will it take me to remove a terrifying experience that has given me nightmares and panic attacks for years or even decades?

Answer:  Often one hour for a single trauma.  Sometimes two or three hours.

If years of severe trauma have accumulated and reinforced, it will take much longer.  In this case a person will practise Self-EMDR (completely unsupervised and independently) on a regular basis for as long as necessary. Self-EMDR-hope-despair

What is the success rate?  In my specialist clinical practice, it is 100 percent for months at a time in the case of a single trauma.  With Self-EMDR, by a person lacking any experience, it is probably 80 – 90 percent depending on motivation.

It is your life.  Self-EMDR is free.  It represents a window of opportunity which has only recently swung open onto the world.

Download Self-EMDR now and start your journey of dicovery and healing within minutes from now. Click the BUY NOW button below to order NOW!