What Is Eye Movement Desensitization And Reprocessing?

Eye Movement Desensitization and Reprocessing: Created by Francine Shapiro in 1987 and developed into eye movement desensitization and reprocessing in 1991, it constructs a model of accelerated information processing, helps patients to quickly reduce anxiety, and induces positive Emotions, arouse internal insights, changes in attitudes and behavior changes, and strengthen internal resources to enable patients to achieve desired changes in behavior and relationships.

Eye Movement Desensitization and Reprocessing: Created by Francine Shapiro in 1987 and developed into eye movement desensitization and reprocessing in 1991, it constructs a model of accelerated information processing, helps patients to quickly reduce anxiety, and induces positive Emotions, arouse internal insights, changes in attitudes and behavior changes, and strengthen internal resources to enable patients to achieve desired changes in behavior and relationships.

Chinese name

Eye movement desensitization and reprocessing

Applied discipline

psychology

Application range

Clinical and Counseling Psychology

Eye movement desensitization and reprocessing concept

Eye movement desensitization and reprocessing (EMDR) was created by Francine Shapiro in 1987. It was originally only for eye movement desensitization (EMD) and developed into eye movement desensitization and reprocessing in 1991. Eye movement desensitization is only one type of bilateral stimulation in EMDR, and bilateral stimulation is part of many components in EMDR operation.

EMDR is an integrated psychotherapy. It draws on the essence of cybernetics, psychoanalysis, behavior, cognition, physiology and other schools to construct a model to accelerate information processing, help patients to quickly reduce anxiety, and induce Positive emotions, arouse internal insights, changes in attitudes and behavior changes, and strengthen internal resources to enable patients to achieve desired changes in behavior and relationships. ^[1]

Eye movement desensitization and reprocessing indications

EMDR treatment is mainly to alleviate the distressing emotions caused by the painful traumatic childhood experience and to help the psychological rehabilitation of the victims of crisis events. The target of this psychotherapy is mainly the victims of traumatic events, such as victims of traffic accidents, loved ones' deaths, violent attacks, sexual assaults, natural disasters, man-made disasters, production accidents, conflicts or war trauma. Because these traumatic events often cause adult and child victims (participants and eyewitnesses) to experience issues such as phobias, panic attacks, nightmares, insomnia, inattention, increased alertness, traumatic flashbacks, avoidance, substance abuse and Wetting the bed, fighting behaviors, sleep disturbances.

In addition, EMDR is also used to treat personality disorders and psychological disorders caused by childhood traumatic traumatic experiences, and the suffering of children and adolescents (such as being abused).

Theoretical basis of eye movement desensitization and reprocessing

EMDR theorists characterize EMDR as an integrated treatment method, full of a variety of essentials, such as: emotional network theory, PTSD network theory, dissociation, emotion dominates learning, assimilation and adaptation, non-verbal trauma memory representation, and incorporate correction information And Horowitz (1976) 's "completion trend" in the initial analysis of trauma information processing. EMDR theorists believe that their treatments incorporate a dynamic view of information processing, which is consistent with new learning / cognitive models including the theorists' conclusions.

Shapiro (1995) has proposed a "message processing" model to illustrate the analysis of traumatic memory. The main arguments included in the model are as follows:

1. Traumaization interferes with psychological and physiological processes, and those processes usually improve the adaptation to event memory. Traumatic memory is at least partially dissociated from the broader semantic and emotional network and in the form of "state dependence" Presentation, which leads to distortions in perception, feeling and response.

2. When people's internal self-healing mechanism is stimulated, trauma memories will be integrated into the normal form again. Conjugate eye movements (or other stimuli, such as vocalizations or taps) engaged in the context of the EMDR procedure, will stimulate this self-healing mechanism. Several hypotheses have been proposed to illustrate the possible contribution of these stimuli.

3. Information about self-other attribution, as well as cognitive, emotional, and physiological response elements are coded. Self-representation plays a key role in preserving distorted traumatic memories.

4. For multiple trauma, the dose of EMDR treatment depends on the number of trauma memories that can be touched and resolved. Sometimes, but not all, memory can be categorized by topic.

Eye movement desensitization and reprocessing mechanism

Human beings have an inherent adaptive information processing system. This information processing system exists as part of the self-regulating function of human thinking and emotion. Research suggests that when a person feels upset and distressed, his brain cannot process information as normal. When some people experience traumatic events, those traumatic events that can stimulate a strong emotional response and recurring scenes during traumatic events cause the parties' intrinsic adaptive information processing system to "condense" and "block". Subsequently, the inner and outer symbols or signs of those traumatic experiences constantly trigger repeated re-experiences of vision, hearing, taste, thinking, physical sensation (physical) or emotion that are as intense as when the person first experienced the trauma, leading to Appearance of PTSD symptoms. Such traumatic memories that have not been adaptively processed by the parties may have a very profound negative impact on how the parties view the world and the relationship to others. Under the influence of these traumatic experiences that cannot be adaptively handled, the behavior of the parties often becomes very inflexible and limited in order to avoid the recurrence of the pain and re-experience phenomenon. This is the psychopathological basis of PTSD symptoms.

EMDR can have a direct effect on the process of painful material information in the brain of a traumatic event party. Under the guidance of the therapist, the client's focus on eye movements, ear tones, or hand tapping can trigger an internal neurophysiological mechanism known as an inquiry response. It is this internal neurophysiological mechanism-inquiry response that restores the function of the client's adaptive information processing process to normal, which leads to a reduction of the client's PTSD symptom response. This "adaptive information processing process" is originally the client's own inherent ability, and it is not the healer's interpretation or thought that has led to the client's adaptive changes in thinking and emotion. The true role of EMDR is to help the parties restore their ability to adjust internally and adapt to changes.

Eye movement desensitization and reprocessing treatment steps

EMDR sees people as a whole. Throughout the treatment process, EMDR has always focused on the emotional and physiological changes that are taking place. ^[1]

1. Psychological diagnosis interview: Establish a sincere and trusting therapeutic relationship with the visitor, understand the visitor's personal information and psychological pain data, and the pain and significance of the traumatic event. Assess the suitability of the client for EMDR, introduce the client to the nature and process of EMDR treatment, and enable the visitor to understand the significance of trauma events and trauma during the interview.

2. Preparation of therapist and visitor: It mainly includes determining the position of therapist and visitor and demonstrating the eye movement process. Generally, the therapist sits to the right of the visitor with the chair at a 45-degree angle. Ask the patient to look up with both eyes,

The therapist uses the forefinger and middle finger that are close together to make a regular left, right, up, down, oblique down, or circle motion interval of about 60 cm in the patient's line of sight. The frequency of motion is about once every second. , The eyeball follows the finger to the left and right. The distance between the therapist and the patient, the distance and frequency of finger shaking can be adjusted accordingly, so that the patient does not feel unwell.

3. Evaluation: At this step, the visitor selects a specific memory he wants to process, and selects the visual image related to the event that causes the visitor to feel the most pain. The therapist discusses and evaluates the level of the subjective discomfort unit with the client and the extent of their cognitive accuracy. The former refers to the degree of psychological distress caused by intrusive appearances, impressions, thoughts, emotions, ideas, sounds, feelings, flashbacks, numbness and unresponsiveness to surroundings caused by incidents. 0-11 levels. The latter refers to the extent to which negative beliefs and values have occurred to the visitor as a result of the occurrence of the event, or to the extent to which the beliefs and values of the visitor have undergone a negative change.

4. Eye movement desensitization: It is mainly aimed at the "trigger information" state (including: images, hallucinations, situations, thinking and beliefs, emotions, physical activities of the body, etc.) that induce traumatic pain in visitors, and generally induces intrusiveness. Or re-experiencing negative information), allowing the visitor to focus on the visual image and the negative beliefs, emotions, and accompanying physical sensations identified, and at the same time do eye movements driven by the therapist's fingers (10-20 times) ). After that, he was completely relaxed, and the patient was rested with his eyes closed to eliminate all kinds of thoughts in his head. After about 2 to 3 minutes of rest, the patient is prompted to experience and evaluate any physical discomfort (such as head swelling, chest tightness, shoulder pain, etc.). And re-evaluate SUD as described above. If the score is high or the pain is severe (both physical and emotional), repeat the above eye movements with "current status". This negative state gradually fades or disappears during eye movements. The number of eye movements required depends on the degree of pain relief. If SUD drops to level 1-2, "positive cognition and emotional introduction" can be performed. Under the guidance of the therapist, the patient was brought into positive cognition and emotion "state", and then the eye movement, experience and re-evaluation process were the same as above, and the evaluation index was VOC.

5. Reconstruction of empirical meaning and cognition: discuss and negotiate with the client on the main pain experience and the trigger information that induces the pain experience, in order to promote the visitor's performance and significance to events, traumas, and traumatic reactions As well as understanding the negative beliefs and values and adaptive coping styles brought by trauma, it encourages visitors to reconstruct negative beliefs in order to develop adaptive coping styles. The effect of positive or positive cognitive reconstruction can be assessed with VOCs until the patient's score for cognitive accuracy (VOC) rises to 7 points.

6. Somatosensory examination: The therapist asks the visitor to close the eyes and "examine" the feelings of various parts of the body while imagining the visual impression and positive cognition, and pay attention to whether there are other feelings of physical tension or discomfort. Because emotional pain often manifests as physical discomfort, treatment is considered complete only when traumatic memory appears in the visitor's consciousness and the visitor does not experience emotional and physical tension. If the visitor reports physical discomfort, eye movements can be continued for these discomforts until the discomfort decreases or disappears.

7. Re-experience and evaluation of curative effect: The therapist and the visitor will discuss and discuss the content, experience, harvest, and remaining issues of both parties in the whole treatment process together. Self-reported assessments of SUD, VOC, and somatosensory can be used, with a focus on enhancing the effect and impact of the intervention subject on this treatment.

8. End of treatment: Tell the patient that the treatment will end, answer the patient's questions, and ask the patient to make a post-treatment record. Then work out the next goals and treatment plan and end the treatment.