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EMDR Eye Movement Desensitisation and Reprocessing
EMDR Trauma-Focused Therapy.
Don Charnock doncharnock1@gmail.com
EMDR Europe Accredited Consultant
Masters Degree Counselling & Psychotherapy (Supervision)
Post Grad Dip Cognitive Behavioural Psychotherapist
EMDR or Eye Movement Desensitisation and Reprocessing, is a trauma focused
psychotherapy. EMDR is recommended by the World Health Organisation, as a first-line
psychological treatment for Post Traumatic Stress Disorder (PTSD). In the UK, the National
Institute for Clinical Excellence, has identified both EMDR and trauma-focused Cognitive
Behavioural Therapy TF-CBT, as evidenced based treatments in the NHS, for the treatment
of chronic PTSD. Chronic PTSD is diagnosed if symptoms persist for three months or longer.
EMDR therapy was developed for the treatment of post-traumatic stress disorder (PTSD) on
the basis that traumatic experiences are not always 'processed' or 'stored' correctly by the
brain because of the impact and severity of the trauma.
Referral Guidelines
 Both EMDR and TF-CBT are effective and evidenced based recommended
psychological treatments for PTSD.
 Referrals for EMDR Therapy may be appropriate, for individuals who have
experienced traumatic or distressing life experiences. Disorders include PTSD, acute
stress, phobias, anxiety, depression.
 EMDR may be a therapeutic option for individuals who have difficulties tolerating
“reliving”, imaginal exposure with TF-CBT.
2
Post Traumatic Stress Disorder (PTSD)
Post Traumatic Stress Disorder (PTSD) refers to psychological symptoms that may develop in
the aftermath of traumatic events or distressing life experiences. According to the DSM-5,
‘the essential feature of post-traumatic stress disorder’ (PTSD) is the ‘development of
characteristic symptoms following exposure to one or more traumatic events’.
Psychological trauma is common in the general population. Trauma survivors, with or
without a formal diagnosis of PTSD, often develop chronic symptoms.
Typical PTSD symptoms include, but are not limited to, intrusive memories, distressing
dreams, dissociative ‘flashbacks’, heightened physiological stress reactions to trauma
related ‘triggers’, avoidance of trauma-related stimuli, memory deficits and changes in
mood. In PTSD there is a considerable risk of co-morbid or other conditions, such as
depression, anxiety and alcohol misuse.
Post Traumatic Stress Disorder (PTSD) has a strong relationship with somatisation or body
sensations and particularly with medically unexplained symptoms (MUS). Physical pain,
body sensations and other somatic complaints have consistently been linked to traumatic
experiences or exposure.
EMDR Adaptive Information Processing
The EMDR, Adaptive Information Processing (AIP) theoretical paradigm or model, views
psychopathology or psychological disturbance, as based on memories of traumatic life
events, that have been incompletely processed by the brain’s information processing system.
Traumatic events and distressing experiences, may overwhelm the cognitive functions of the
brain and are not processed properly, creating dysfunctional memory systems that reveal
themselves as symptoms of psychological disturbance, including Post Traumatic Stress
Disorder (PTSD).
According to the AIP theory, incomplete processing of life experiences, means that a
disturbing event has been stored in memory as it was originally experienced with the
emotions, physical sensations and beliefs fundamentally unchanged.
3
EMDR Eight-Phase Protocol
EMDR therapy is conducted in the context of a therapeutic alliance between the EMDR
practitioner and the client/patient. EMDR is an eight-phase protocol treatment developed
to access the dysfunctional experiences or memories, stored in the mind/brain.
Research studies relating to efficacy, found that EMDR therapy significantly reduces the
symptoms of PTSD, depression and anxiety.
The eye movement component of EMDR adds to its effects in the processing of emotional
memories. A core feature of EMDR therapy is that the patient is asked to hold a disturbing
memory in mind while engaging in sets of eye movements or other dual attention, bilateral
stimuli (BLS), including sounds or bilateral tapping. The EMDR process, involves focusing on
a traumatic image, thought, emotion and bodily sensations. Research into the eye
movement component of EMDR has found that eye movements promote changes in
memory vividness and emotionality.
The EMDR ‘desensitisation’ reprocessing procedure, involves the client processing memories
by shifting their awareness between the past and a safer present. The EMDR protocol also
includes a structure to explore and process positive experiences. EMDR therapy aims to
identify current situations that are triggering the disturbance, the experiences that have laid
the groundwork for the dysfunction and positive experiences that are needed to overcome
any lack of knowledge or build personal skills, resources and resilience.
Don Charnock
EMDR Europe Accredited Consultant / Practitioner. doncharnock1@gmail.com
EMDR Supervision by SKYPE available
Shapiro, F., (2014) The role of Eye Movement Desensitisation and Reprocessing (EMDR)
therapy in medicine: Addressing the psychological and physical symptoms stemming from
adverse life experiences. The Permanente Journal Winter 2014/Vol. 18 No. 1.
4
EMDR Eight Phase Protocol
Phase 1. Client History - Purpose - Obtain background information. Identify suitability for
EMDR treatment. Identify processing targets from positive and negative events in the
client’s life. Procedures – Standard history-taking questionnaires and diagnostic
psychometrics. Review of criteria and resources. Questions regarding (1) past events that
have laid the groundwork for pathology, (2) current triggers, (3) future needs.
Phase 2. Preparation - Purpose – Prepare appropriate clients for EMDR processing of
targets. Stabalise mood and increase access to positive affects. Procedures – Education
regarding the symptom picture. Metaphors and techniques that foster stabalisation and a
sense of personal self-mastery and control.
Phase 3. Assessment - Purpose – Assess the target memory for EMDR processing by
stimulating primary aspects of the memory. Procedures – Elicit the image, negative belief
currently held, desired positive belief, current emotion, physical sensations and baseline
measures.
Phase 4. Desensitisation - Purpose - Process experiences and triggers, toward an adaptive
resolution (subjective units of distress SUD level 0). Fully process all channels of memory
networks, to allow for a complete assimilation of memories. Incorporate templates for
positive experiences. Procedures – Process past, present and future. Standardised EMDR
processes that allow for the spontaneous emergence of insights, emotions, physical
sensations and other memories. “Cognitive Interweave” to open blocked processing by
elicitation of more adaptive information.
Phase 5. Installation - Purpose – Increase connections to positive cognitive networks.
Increase generalisation effects within associated memories. Procedures – Identify the best
positive cognition (initial or emergent). Enhance the validity of the desired positive belief to
a validity of cognition VOC level 7.
Phase 6. Body Scan – Purpose - Complete processing of any residual disturbance associated
with the target. Procedures – Concentration on and processing of any residual physical
sensations.
Phase 7. Closure – Purpose - Ensure client stability at the completion of an EMDR session
and between sessions. Procedures – use of guided imagery or self-control techniques if
needed. Briefing regarding expectations and behavioural reports between sessions.
Phase 8. Re-evaluation – Purpose - Evaluation of treatment effects. Ensure comprehensive
processing over time. Procedures – Explore what has happened since the last session.
Re-access memory (target) from last session. Evaluation of integration within larger social
system (Shapiro, 2005).
doncharnock1@gmail.com EMDR Europe Accredited Consultant
5

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EMDRreferal2016

  • 1. 1 EMDR Eye Movement Desensitisation and Reprocessing EMDR Trauma-Focused Therapy. Don Charnock doncharnock1@gmail.com EMDR Europe Accredited Consultant Masters Degree Counselling & Psychotherapy (Supervision) Post Grad Dip Cognitive Behavioural Psychotherapist EMDR or Eye Movement Desensitisation and Reprocessing, is a trauma focused psychotherapy. EMDR is recommended by the World Health Organisation, as a first-line psychological treatment for Post Traumatic Stress Disorder (PTSD). In the UK, the National Institute for Clinical Excellence, has identified both EMDR and trauma-focused Cognitive Behavioural Therapy TF-CBT, as evidenced based treatments in the NHS, for the treatment of chronic PTSD. Chronic PTSD is diagnosed if symptoms persist for three months or longer. EMDR therapy was developed for the treatment of post-traumatic stress disorder (PTSD) on the basis that traumatic experiences are not always 'processed' or 'stored' correctly by the brain because of the impact and severity of the trauma. Referral Guidelines  Both EMDR and TF-CBT are effective and evidenced based recommended psychological treatments for PTSD.  Referrals for EMDR Therapy may be appropriate, for individuals who have experienced traumatic or distressing life experiences. Disorders include PTSD, acute stress, phobias, anxiety, depression.  EMDR may be a therapeutic option for individuals who have difficulties tolerating “reliving”, imaginal exposure with TF-CBT.
  • 2. 2 Post Traumatic Stress Disorder (PTSD) Post Traumatic Stress Disorder (PTSD) refers to psychological symptoms that may develop in the aftermath of traumatic events or distressing life experiences. According to the DSM-5, ‘the essential feature of post-traumatic stress disorder’ (PTSD) is the ‘development of characteristic symptoms following exposure to one or more traumatic events’. Psychological trauma is common in the general population. Trauma survivors, with or without a formal diagnosis of PTSD, often develop chronic symptoms. Typical PTSD symptoms include, but are not limited to, intrusive memories, distressing dreams, dissociative ‘flashbacks’, heightened physiological stress reactions to trauma related ‘triggers’, avoidance of trauma-related stimuli, memory deficits and changes in mood. In PTSD there is a considerable risk of co-morbid or other conditions, such as depression, anxiety and alcohol misuse. Post Traumatic Stress Disorder (PTSD) has a strong relationship with somatisation or body sensations and particularly with medically unexplained symptoms (MUS). Physical pain, body sensations and other somatic complaints have consistently been linked to traumatic experiences or exposure. EMDR Adaptive Information Processing The EMDR, Adaptive Information Processing (AIP) theoretical paradigm or model, views psychopathology or psychological disturbance, as based on memories of traumatic life events, that have been incompletely processed by the brain’s information processing system. Traumatic events and distressing experiences, may overwhelm the cognitive functions of the brain and are not processed properly, creating dysfunctional memory systems that reveal themselves as symptoms of psychological disturbance, including Post Traumatic Stress Disorder (PTSD). According to the AIP theory, incomplete processing of life experiences, means that a disturbing event has been stored in memory as it was originally experienced with the emotions, physical sensations and beliefs fundamentally unchanged.
  • 3. 3 EMDR Eight-Phase Protocol EMDR therapy is conducted in the context of a therapeutic alliance between the EMDR practitioner and the client/patient. EMDR is an eight-phase protocol treatment developed to access the dysfunctional experiences or memories, stored in the mind/brain. Research studies relating to efficacy, found that EMDR therapy significantly reduces the symptoms of PTSD, depression and anxiety. The eye movement component of EMDR adds to its effects in the processing of emotional memories. A core feature of EMDR therapy is that the patient is asked to hold a disturbing memory in mind while engaging in sets of eye movements or other dual attention, bilateral stimuli (BLS), including sounds or bilateral tapping. The EMDR process, involves focusing on a traumatic image, thought, emotion and bodily sensations. Research into the eye movement component of EMDR has found that eye movements promote changes in memory vividness and emotionality. The EMDR ‘desensitisation’ reprocessing procedure, involves the client processing memories by shifting their awareness between the past and a safer present. The EMDR protocol also includes a structure to explore and process positive experiences. EMDR therapy aims to identify current situations that are triggering the disturbance, the experiences that have laid the groundwork for the dysfunction and positive experiences that are needed to overcome any lack of knowledge or build personal skills, resources and resilience. Don Charnock EMDR Europe Accredited Consultant / Practitioner. doncharnock1@gmail.com EMDR Supervision by SKYPE available Shapiro, F., (2014) The role of Eye Movement Desensitisation and Reprocessing (EMDR) therapy in medicine: Addressing the psychological and physical symptoms stemming from adverse life experiences. The Permanente Journal Winter 2014/Vol. 18 No. 1.
  • 4. 4 EMDR Eight Phase Protocol Phase 1. Client History - Purpose - Obtain background information. Identify suitability for EMDR treatment. Identify processing targets from positive and negative events in the client’s life. Procedures – Standard history-taking questionnaires and diagnostic psychometrics. Review of criteria and resources. Questions regarding (1) past events that have laid the groundwork for pathology, (2) current triggers, (3) future needs. Phase 2. Preparation - Purpose – Prepare appropriate clients for EMDR processing of targets. Stabalise mood and increase access to positive affects. Procedures – Education regarding the symptom picture. Metaphors and techniques that foster stabalisation and a sense of personal self-mastery and control. Phase 3. Assessment - Purpose – Assess the target memory for EMDR processing by stimulating primary aspects of the memory. Procedures – Elicit the image, negative belief currently held, desired positive belief, current emotion, physical sensations and baseline measures. Phase 4. Desensitisation - Purpose - Process experiences and triggers, toward an adaptive resolution (subjective units of distress SUD level 0). Fully process all channels of memory networks, to allow for a complete assimilation of memories. Incorporate templates for positive experiences. Procedures – Process past, present and future. Standardised EMDR processes that allow for the spontaneous emergence of insights, emotions, physical sensations and other memories. “Cognitive Interweave” to open blocked processing by elicitation of more adaptive information. Phase 5. Installation - Purpose – Increase connections to positive cognitive networks. Increase generalisation effects within associated memories. Procedures – Identify the best positive cognition (initial or emergent). Enhance the validity of the desired positive belief to a validity of cognition VOC level 7. Phase 6. Body Scan – Purpose - Complete processing of any residual disturbance associated with the target. Procedures – Concentration on and processing of any residual physical sensations. Phase 7. Closure – Purpose - Ensure client stability at the completion of an EMDR session and between sessions. Procedures – use of guided imagery or self-control techniques if needed. Briefing regarding expectations and behavioural reports between sessions. Phase 8. Re-evaluation – Purpose - Evaluation of treatment effects. Ensure comprehensive processing over time. Procedures – Explore what has happened since the last session. Re-access memory (target) from last session. Evaluation of integration within larger social system (Shapiro, 2005). doncharnock1@gmail.com EMDR Europe Accredited Consultant
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