Eye Movement Desensitization and Reprocessing (EMDR)
Trauma can show up in our lives in many different ways. It can show up where we do not always expect it to. Trauma can result in: feelings of isolation, difficulty trusting people, feeling numb or disconnected, having difficulty concentrating, experiencing mood swings, having an easy startle, being easily reactive, having difficulty setting boundaries, sensory concerns, feeling the need to find control.
ICC counsellors practice in a trauma-informed way. We are committed to bringing safety, trust and transparency, choice, collaboration, empowerment, and an understanding of culture into our work with clients.
What is EMDR therapy?
EMDR is a structured therapy that is well researched for trauma and Post Traumatic Stress Disorder (PTSD) symptoms. When engaging in this therapy, the client will focus briefly on the trauma memory and experience bilateral stimulation (eye movements, feet or hand tapping), which research demonstrates can reduce the vividness and emotional reaction connected to the trauma memories. Research has demonstrated that EMDR also helps with the following conditions, to name a few:
- Obsessive Compulsive Disorder (OCD)
- Anxiety, panic, phobias, test anxiety
- Mood Disorders
- Eating Disorders
- Substance Use
- Dissociative Disorders
- Stress
- Pain, Chronic Illness, Medical Trauma
- Grief and Loss
- Sports Anxiety
- Experience of Trauma, Abuse, and Neglect
- Post Traumatic Stress Disorder
- Sleep Problems
- Addictions
- Impulse Control Behaviours
There is no need to walk through your traumatic story in detail. When we recall or are reminded of a stressful or traumatic event, we often react with a stress response (such as fight, flight, freeze, appease). We may feel overwhelmed or like we are back in the same situation again. Although we will still likely remember our traumatic events, EMDR helps reduce or eliminate the need for our brains to re-enter the stress cycle. Our brain learns to heal from the events of the past.
EMDR Sessions
There are eight phases and three prongs in EMDR therapy. The three prongs of EMDR therapy are: past, present, and future. EMDR seeks to identify how events or experiences from people’s pasts are “showing up” or creating dysfunction in their present, process those past experiences so they have less impact on the present, and help people react differently in the future.
Phase One: History. During this phase, the counsellor and client will begin building a therapeutic relationship; the client will communicate their reasons for seeking therapy; and the therapist will gather any important and relevant information including identifying existing strengths and resources (coping strategies) and conducting informal assessments. This knowledge will inform the preparation phase.
Phase Two: Preparation. In this phase, the therapist will provide psychoeducation to ensure the client knows what to expect; help the client strengthen existing resources and build additional resources; and identify the specific targets (goals) for therapy.
Phases One and Two are typically done simultaneously. Depending on the nature of the client’s goals and existing resources, this phase may take as little as one session. But it as long as it takes for the client to be able to successfully utilize resources to self-sooth and cope. It is critical that the client have sufficient resources to be able to safely experience the neural activation occurring during the processing phases.
Phases Three through Seven: Assessment, Desensitization, Installation, Body Scan, and Closure. Phases Three through Seven must be done in conjunction with each other. This is where the bilateral stimulation and processing takes place. It is important to activate the neural pathways in order to facilitate processing, which means the client is likely to experience some distress, but it is equally important that sufficient time is given each session to ensure the client feels safe and contained. During this time, it is not uncommon for clients to experience emotions, dreams, or distress outside of session, and it is important clients remember to employ the resources practiced in previous phases.
Phase Eight: Re-evaluation. This is a continual process throughout therapy during which the therapist and client notice any changes or effects the client may be experiencing and identify changes or additional resources the client may need.
References
Shapiro, F. (2018). Eye movement desensitization and reprocessing (EMDR) therapy: Basic principles, protocols, and procedures (3rd ed.). The Guilford Press.
Kennard, D. (2019). S.A.F.E. approach to EMDR therapy. Safety and attachment focused EMDR. Personal Transformation Institute.
Learn more in our EMDR blog post!
If you are interested in trying EMDR feel free to book now.
Accelerated Resolution Therapy (ART)
Accelerated Resolution Therapy (ART) is an evidence based form of psychotherapy that utilizes back and forth eye movements that are combined with a technique called voluntary memory/image replacement. This is used to help clients address anxiety, depression, trauma, relationship issues, grief, addiction and many other mental and physical conditions. Together they work to re-program the way in which the destressing images and memories are stored in the brain so that they no longer trigger strong physical and emotional reactions in your body.
Accelerated Resolution Therapy (ART) uses a combination of eye movements and rescripting of traumatic imagery in order to separate physiological sensations (think nervous system reactions) associated with a traumatic experience. ART is also used to support sports and performance enhancement, relationship issues, grief, and job-related stress. Some others who use ART use it for situations such as: physical and sexual abuse, depression, anxiety, smoking and substance use, eating disorders, fibromyalgia, chronic pain, personality disorders, anxiety, and phobias.
This is a short term therapy that research has demonstrated as an evidence based practice, ART demonstrates significant clinical results in one to five sessions. Sessions are typically 80 to 90 minutes. There is no required homework between sessions and clients are not required to disclose details of their past traumatic experiences. ART uses exposure through visualization, visualized in-vivo exposure, relaxation and stress inoculation that is facilitated by eye movements (similar to EMDR), re-scripting of negative images, and cognitive restructuring. Clients can attend other types of therapy while engaging with an ART therapist. This is a very specific therapy and the approach is far more direct that other therapies.
How is ART Different from EMDR?
- Images: ART uses a technique called Voluntary Image Replacement, which aims to change the recall of images (such as from negative to positive) rather than the EMDR technique of cognitively desensitizing clients about their trauma
- Sensation Processing: ART therapists spend more time helping clients process physiological sensations (like somatic processing therapies) than EMDR does. Eye movements are used to process physiological sensations as well as traumatic memories.
- Standardization: ART uses a fixed number (40) of eye movements to help a client process, not be flooded by distressing information. EMDR has different sets of eye movements each time.
If you are interested in trying ACT feel free to book now.
Trauma Focused Cognitive Behaviour Therapy (TF-CBT)
This type of therapy is an option you can ask for when you book an individual session with a clinical counsellor or intern at Island Clinical Counselling. This treatment is most often used with children and youth, but can be adapted easily for adults. Trauma Focused CBT is an evidence-based psychotherapy model that utilizes individual and caregiver sessions to address difficult emotions and behaviour related to traumatic events. The goals of TF-CBT are to enable clients and their loved ones to cope with trauma related emotions and behaviours. It also aims to provide a safe, therapeutic method for facing and resolving issues related to traumatic events. The treatment hopes to effectively integrate trauma lived experiences and helps clients move on with life in more positive and safe ways. When we work with children, part of the treatment plan is to help caregivers support their children and youth through improving parental skills and increasing communication. Part of the work in TF-CBT also involves creating a “trauma narrative.” This narrative helps to place the traumatic experience within the larger context of a client’s life story. When an individual can express what happened, they can get a sense of mastery over their traumatic memories, feelings, and reminders. Trauma narratives come in many forms and can be tailored to the age and personal interests of the child, youth, or adult client.
If you are interested in trying TF CBT feel free to book now.