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| What is EMDR
and how can it help control pain? |
by Mark Grant MA
Eye Movement Desensitization and Reprocessing
(EMDR) is a powerful new method of psychotherapy. To date, EMDR has helped
over one million people of all ages recover from many different types of
psychological distress.
In 1987, psychologist Dr Francine Shapiro
made the chance observation that eye movements can reduce the intensity
of disturbing thoughts under certain conditions. Dr Shapiro studied this
effect scientifically and, in 1989, she reported success using EMDR to
treat victims of trauma in the Journal of Traumatic Stress. Since then,
EMDR has developed and evolved through the contributions of therapists
and researchers all over the world. Today, EMDR is a set of protocols that
incorporate elements from many different treatment approaches.
No one knows exactly how EMDR works. However,
we do know that when a person is very upset, such as with a trauma or chronic
pain, their brain cannot process information as it does ordinarily. Experiences
become "frozen in time" and distressing feelings and memories
may be re-lived day after day, without ever seeming to get better. Such
memories can have a lasting negative effect on the way a person sees the
world and relates to other people, as well as interfering significantly
with his or her ability to live life.
EMDR seems to have a direct effect on the
way that the brain functions. It has been suggested that the bilateral
stimulation stimulates brain activity normally associated with information
processing, such as occurs during REM sleep. Following successful EMDR
treatment, normal information processing is resumed, as indicated by changes
in the pain sensations, and the way the client experiences the pain. Its
almost as thought the way the pain is 'remembered' physically has changed.
Therefore, EMDR can be thought of as a physiologically based therapy that
helps a person see disturbing material in a new and less distressing way.
| But does EMDR really work? |
A number of scientific studies have shown
that EMDR is effective, for example, the prestigious Journal of Consulting
and Clinical Psychology published research by Wilson, Becker and Tinker
in December, 1995. This study of 80 subjects with post-traumatic stress
demonstrated that clients improved significantly with EMDR treatment, and
further study showed that this beneficial effect was maintained for at
least 15 months. In 1997 EMDR was recognized by the American Psychological
Association as "probably efficacious" as a treatment for trauma.
Although EMDR is still too new for there
to have been much research regarding its use as a treatment for pain, two
pilot studies have found it to be effective. In addition, since chronic
pain involves numerous neurological similarities to trauma, including disruption
of REM sleep EMDR ought to work with pain. Just as EMDR is thought to "push
start" REM-type information processing of traumatic feelings, it is
also thought to facilitate reprocessing of distressing sensations and thoughts
associated with chronic pain.
| What is the actual EMDR session like? |
During EMDR, the therapist works with the
client to identify a specific problem to be the focus of a treatment session.
With chronic pain this might be the pain itself, or some aspect of how
the pain has affected the sufferer's life. The client focuses on the pain,
and any relevant thoughts and feelings while the therapist performs sets
of eye movements. Then the client just notices whatever comes to mind without
making any effort to control direction or content.
Many people find this aspect the most difficult,
that they literally don't have to do anything other than pay attention
to their experience. Each person will process information uniquely, based
on personal experience and values. It is important to understand that there
is no way to do EMDR incorrectly! Sets of eye movements are continued until
the sensations become less disturbing and positive thoughts and beliefs
begin to emerge; for example, "I can control my pain." During
EMDR the client may experience different sensations, even increased pain,
but by the end of the session most people report a great reduction in the
level of disturbance.
One or more sessions are required for the
therapist to understand the nature of the problem and to decide whether
EMDR is an appropriate treatment. The therapist also will discuss EMDR
more fully and provide an opportunity to answer any questions about the
method. Once therapist and client have agreed that EMDR is appropriate
for a specific problem, the actual EMDR therapy can begin.
A typical EMDR session lasts about 90 minutes.
The type of problem, life circumstances, and the amount of previous trauma
will determine how many treatment sessions are necessary. Although success
has been achieved in as little as three sessions with trauma, with chronic
pain a more typical course of treatment is 6 to 10 sessions, performed
weekly, or every other week. When there are other problems associated with
the pain (e.g., trauma, litigation,) the treatment period may be lengthier.
EMDR may be used within a standard "talking" therapy, as an adjunctive
therapy with a separate therapist, or as a treatment all by itself.
Prior to EMDR treatment of pain, or any other
psychological treatment, the therapist should ensure previous medical investigations
and treatments have been completed to the satisfaction of the client. Or
that the client is willing to proceed if they haven't, bearing in mind
that the pain may be signaling some unknown pathology. Fortunately, EMDR
cannot take away pain that is necessary, so there is no danger of the client
feeling "too good" following treatment and then doing too much
physically and injuring themselves. Medical mismanagement such as inappropriate
use of medication, lack of adequate information etc should also be addressed
prior to commencing EMDR treatment of pain.
Adapted from 'What is EMDR' by EMDRIA
(EMDR International Association)
These materials are provided by Mark Grant to assist you to participate actively in your treatment and cope with chronic pain in the best way possible.
Mark Grant is a psychologist, specializing in the management of chronic pain and trauma. His advice is based on many years of clinical experience working with persons affected by chronic pain and trauma.
Mark has also conducted research regarding a multi-modal approach to pain management. He is the author of the self-help tapes and CDs listed above, which use accelerated learning principles for sufferers of chronic pain and stress. He has also spoken at numerous international conferences and workshops about pain management.