Emdr Toolbox A Powerful StrategyOf Self Through Eye Movement Desensitization and Reprocessing Therapy

Chapter 1: Introduction

In the late 1980s new psychotherapy, called Eye Movement Desensitization and Reprocessing (EMDR) therapy was presented as a treatment of post-traumatic stress disorder (PTSD). This psychotherapy has situated itself within, as well as generate much debate on the genesis and nature of traumatic memories, treatment strategies, and the production, reproduction, validation, and reliability of scientific knowledge in the mental health disciplines.

It is a useful starting point to speak of psychotherapy by its relation to suffering. The relief and easing of suffering, whether physical or existential, is most often the implicit motive driving the production and engagement of myriad psychotherapeutic interventions. Suffering has no intrinsic, timeless meaning. It is provided meaning by systems and institutions, most prominently biomedicine. The common explanation provides us with an etiological event, leading ta alterations in brain chemistry, which the scientific community is slowly unraveling in its attempts to end this scourge of pain. It is a moral argument in which suffering is the evil against which can rally our resources together in opposition. Less often, however, are the historical, political, legal, economic, and philosophical dimensions brought into this discourse.

When considering the manifold ways in which science and technology make up people, the very diversity of human life means that a general theory bent on explanations and predictions will make little headway. Consequently, historians, philosophers, sociologists, and anthropologists alike must attend carefully to the origin of our ideas and their evolution.

In this introduction, l will provide a brief internal account of EMDR therapy, using language consistent with the prescribed treatment theory and practice, quoting heavily to minimize interpretive distortion. I will further outline the implications for such a genealogy.

Background

In 1979, Francine Shapiro was undertaking a Ph.D. program in English literature at New York University when she was diagnosed with cancer. Unsatisfied with biomedical approaches to treatment, she left New York in search of workshops and seminars on the mind, body, and psychological methods to enhance physical and mental well-being.

Shapiro's new-age investigative odyssey eventually led her to enroll in a doctoral program in clinical psychology at the Professional School for Psychological Studies in San Diego. It was in 1987, at age 39, while strolling through a park, that she noticed that her disturbing thoughts began to dissipate, as she instinctively moved her eyes from side to side. For her dissertation she put together a study of 22 people diagnosed with PTSD (both sexual abuse and combat-related), to be treated with what was then called Eye Movement Desensitization therapy.

A comprehensive account of its practice and theory can be found in the book Eye Movement Desensitization and Reprocessing: Basic Principles. Protocols. and Procedures, written by its inventor Francine Shapiro. She proposes a conceptual framework in which psychological trauma is located in the brain, through a mechanism of dysfunctional memory storage.

What follows is an internal account of the relationship between the characterization of various mental ailments, the professionals privileged to treat these conditions, and their arsenal of psychotherapeutic techniques. This description is crucial to keep in mind while reading the second (historical) section of this paper; it provides the necessary reference-frame of EMDR.

Afterward, l will unpack many of the implicit assumptions of EMDR as presented by Shapiro, focusing on the unproblematized nature of traumatic memory, dissociation, objectivity, suggestion, and patient-therapist relationship.

Francine Shapiro's EMDR: An Internal Account

In Principles, EMDR is divided into eight phases. Phases One and Two involve history taking and client preparation. The former is described as an evaluation of the client's dysfunctional behaviors, stimulating triggers, and the determination of the traumatic memories which are directly responsible for the present dysfunction and therefore should he processed with EMDR, and which are incidental to the crisis, and can be set aside...to be remediated by education, problem-solving, or stress management techniques. The second phase, entitled preparation, outlines goals toward explaining the EMDR process and putative effects to the client addressing concerns, familiarizing the client with safety and relaxation procedures, and establishing a therapeutic alliance". This term is used interchangeably with rapport to indicate a general sense of bonding and trust between the therapist and patient.

Phase Three, the assessment phase, produces positive and negative statements (cognitions) that will be used in the EMDR sessions, and provide baseline values for subjective reporting of emotional states. While the image of a specific past event is held 'in mind' with a negative statement such as I'm powerless or I cannot succeed, the client is asked to name an emotion, and choose a number from 0-10 indicating their Subjective Units of Distress (SUD) level, and to then locate this distress in some bodily sensation. Following, a positive cognition such as I can control my actions or I can succeed is rated by the client as to its perceived truthfulness on a 1-7 Validity of Cognition (VoC) scale. It is assumed that this convergence of the image and negative cognition will generally stimulate the dysfunctional material to a greater intensity than either of the two alone. For the initial event, the client is instructed to locate the earliest available memory to which the negative cognition applies...Clinical skill is necessary, however, because the original negative cognition designated by the client May not be the one linked to the earlier memory.

The first three phases are carried out in 50-minute sessions and are not completed until an appropriate rapport has been established, even if this takes months. Subsequent sessions are 90 minutes in duration.

Phases Four to Six are named Desensitization, Installation, and Body Scan, and are described as operating under the principle of Accelerated Information Processing. Shapiro's sample phrase for this phase is ''Bring up the picture and the words [clinician repeats the negative cognition] and notice where you feel it in your body. Now, follow my fingers with your eyes. Sets of saccadic eye movement approximately 24 forward and backward motions of the therapist's fingers, tracked by the client across his or her field of vision, is the most unique aspect of this EMDR therapy. it’s purpose is to merely serve as an initial focal point for entering the memory network". Organized around terms like neuro network, Shapiro has developed a new language with which to identify and explain traumatic memory. In her words:

For desensitization to occur. it is necessary to process the dysfunctional material that is stored in all of the channels associated with the target event When an