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.
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.
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.
