EMDRIA’S DEFINITION OF EYE MOVEMENT DESENSITIZATION AND REPROCESSING (EMDR)
I. Purpose of Definition
The purpose of this definition is to serve as the foundation for the development and implementation of policies in all EMDRIA’s programs in the service of its mission. This definition is intended to support consistency in EMDR training, standards, credentialing, continuing education, and clinical application while fostering the further evolution of EMDR through a judicious balance of innovation and research. This definition also provides a clear and common frame of reference for EMDR clinicians, consumers, researchers, the media and the general public.
II. Foundational Sources and Principles for Evolution
Francine Shapiro, Ph.D. developed EMDR based on clinical observation, controlled research, feedback from clinicians whom she had trained and previous scholarly and scientific studies of information processing. The original source of EMDR is derived from the work of Shapiro as it is described in her writings (Shapiro, 2001). Shapiro made clear that she is committed to the development of EMDR in a way that balances clinical observations and proposed innovations with independent empirical validation in well designed and executed scientific studies. Previously held and newly proposed elements of EMDR procedure or theory that cannot be validated must give way to those that can.
III. Aim of EMDR
In the broadest sense, EMDR is intended to alleviate human suffering and assist individuals and human society to fulfill their potential for development while minimizing risks of harm in its application. For the client, the aim of EMDR treatment is to achieve the most profound and comprehensive treatment effects in the shortest period of time, while maintaining client stability within a balanced family and social system.
IV. Framework
EMDR is an approach to psychotherapy that is comprised of principles, procedures and protocols. It is not a simple technique characterized primarily by the use of eye movements. EMDR is founded on the premise that each person has both an innate tendency to move toward health and wholeness, and the inner capacity to achieve it. EMDR is grounded in psychological science and is informed by both psychological theory and research on the brain.
EMDR integrates elements from both psychological theories (e.g. affect, attachment, behavior, bioinformational processing, cognitive, humanistic, family systems, psychodynamic and somatic) and psychotherapies (e.g., body-based, cognitive-behavioral, interpersonal, person-centered, and psychodynamic) into a standardized set of procedures and clinical protocols. Research on how the brain processes information and generates consciousness also informs the evolution of EMDR theory and procedure.
V. Hypotheses of the EMDR Model
The Adaptive Information Processing model is the theoretical foundation of the EMDR approach. It is based on the following hypotheses:
1. Within each person is a physiological information processing system through which new experiences and information are normally processed to an adaptive state.
2. Information is stored in memory networks that contain related thoughts, images, audio or olfactory memories, emotions, and bodily sensations .
3. Memory networks are organized around the earliest related event.
4. Traumatic experiences and persistent unmet interpersonal needs during crucial periods in development can produce blockages in the capacity of the adaptive information processing system to resolve distressing or traumatic events.
5. When information stored in memory networks related to a distressing or traumatic experience is not fully processed, it gives rise to dysfunctional reactions.
6. The result of adaptive processing is learning, relief of emotional and somatic distress, and the availability of adaptive responses and understanding.
7. Information processing is facilitated by specific types of bilateral sensory stimulation. Based on observational and experimental data, Shapiro has referred to this stimulation as bilateral stimulation (Shapiro, 1995) and dual attention stimulation (Shapiro, 2001).
8. Alternating, left-right, visual, audio and tactile stimulation when combined with the other specific procedural steps used in EMDR enhance information processing .
9. Specific, focused strategies for sufficiently stimulating access to dysfunctionally stored information (and in some cases, adaptive information) generally need to be combined with bilateral stimulation in order to produce adaptive information processing.
10. EMDR procedures foster a state of balanced or dual attention between internally accessed information and external bilateralstimulation. In this state the client experiences simultaneously the distressing memory and the present context.
11. The combination of EMDR procedures and bilateral stimulation results in decreasing the vividness of disturbing memory images and related affect, facilitating access to more adaptive information and forging new associations within and between memory networks.
VI. Method
EMDR uses specific psychotherapeutic procedures to 1) access existing information, 2) introduce new information, 3) facilitate information processing and 4) inhibit accessing of information (Lipke, 1999). Unique to EMDR are both the specific procedural steps used to access and process information, and the ways in which sensory stimulation is incorporated into well-defined treatment procedures and protocols, which are intended to create states of balanced or dual attention to facilitate information processing. EMDR is used within an 8-phase approach to trauma treatment (Shapiro, 1995, 2001) in order to insure sufficient client stabilization and reevaluation before, during and after the processing of distressing and traumatic memories and associated stimuli. In Phases 3 – 6, standardized steps must be followed to achieve fidelity to the method. In the other 4 phases there is more than one way to achieve the objectives of each phase. However, as it is a process, not a technique, it unfolds according to the needs and resources of the individual client in the context of the therapeutic relationship. Therefore, different elements may be emphasized or utilized differently depending on the unique needs of the particular client.
To achieve comprehensive treatment effects a three-pronged basic treatment protocol is used to first address past events. After adaptive resolution of past events, current stimuli still capable of evoking distress are processed. Finally future situations are processed to prepare for possible or likely circumstances. VII. Fidelity in application through training and observation
It is central to EMDR that positive results from its application derive from the interaction between clinician, method and client. Therefore graduate education in a mental health field (e.g., clinical psychology, psychiatry, social work, counseling, or marriage and family therapy) leading to eligibility for licensure, certification or registration, along with supervised training, are considered essential to achieve optimal results. Meta-analytic research (Maxfield & Hyer, 2002) indicates that degree of fidelity to the published EMDR procedures is highly correlated with the outcome of EMDR procedures. Evidence of fidelity in procedure and appropriateness of protocol is considered central to both research and clinical application of EMDR.
References
Lipke, H. (1999). EMDR and psychotherapy integration: theoretical and clinical suggestions with focus on traumatic stress . Boca Raton: CRC Press.
Maxfield, L., & Hyer, L. (2002). The relationship between efficacy and methodology in the treatment of PTSD with EMDR. Journal of Clinical Psychology .
Shapiro, F. (1995). Eye Movement Desensitization and Reprocessing, Basic Principles, Protocols and Procedures. (1st ed.) New York: The Guilford Press.
Shapiro, F. (2001). Eye Movement Desensitization and Reprocessing, Basic Principles, Protocols and Procedures. (2nd ed.) New York: The Guilford Press.
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