# Any successes with exposure therapy or EMDR?



## asittingducky (Apr 23, 2013)

I'm considering either exposure therapy or eye movement desensitization and reprocessing. I feel that talking about your thoughts and feelings like in CBT is one thing, but to actually make a habit of altering your reactions and forming appropriate behaviors is a whole other thing that takes time and practice. I'm curious if anybody has experience with either and whether it proved successful and after how long?


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## asittingducky (Apr 23, 2013)

bump


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## drpjl (Jul 28, 2012)

EMDR (Eye Movement Desensitization and Reprocessing) is a psychotherapy that has been empirically validated in over 24 randomized studies of trauma victims. It is considered one of the three treatments of choice for trauma (along with CBT and Prolonged Exposure) by organizations such as ISTSS (International Society for Traumatic Stress Studies), American Psychiatric Assn, American Psychological Assn, Dept of Veteran Affairs, Dept of Defense, Depts of Health in Northern Ireland, UK, Israel, the Netherlands, France, and other countries and organizations.

The World Health Organization recently published "Guidelines for the management of conditions that are specifically related to stress: "Trauma-focused CBT and EMDR are the only therapies recommended for children, adolescents and adults with PTSD. Like CBT with a trauma focus, EMDR therapy aims to reduce subjective distress and strengthen adaptive cognitions related to the traumatic event. Unlike CBT with a trauma focus, EMDR does not involve (a) detailed descriptions of the event, (b) direct challenging of beliefs, (c) extended exposure, or (d) homework." (Geneva, WHO, 2013)

I'm a psychologist who uses EMDR as my primary treatment psychotherapy and I've also personally had EMDR therapy for anxiety, panic, grief, and “small t” trauma. As a client, EMDR worked extremely well and also really fast. As an EMDR therapist, and in my role as a facilitator who trains other therapists in EMDR (certified by the EMDR International Assoc. and trained by the EMDR Institute) I have used EMDR successfully with panic disorders, childhood sexual/physical/emotional abuse and neglect, single incident trauma and complex/chronic PTSD, anxiety, depression, grief, body image, phobias, distressing memories, bad dreams and more...

To understand more about EMDR therapy, it's really crucial that the therapist spends enough time in one of the initial phases (Phase 2) in EMDR that involves preparing for memory processing or desensitization (memory processing or desensitization - phases 3-6 - is often referred to as "EMDR" which is actually an 8-phase psychotherapy). In this phase resources are "front-loaded" so that you have a "floor" or "container" to help with processing the really hard stuff. In Phase 2 you learn a lot of great coping strategies and self-soothing techniques which you can use during EMDR processing or anytime you feel the need. You learn how to access a “Safe or Calm Place” which you can use at ANY TIME during EMDR processing (or on your own) if it feels scary, or too emotional, too intense. So if you start feeling overwhelmed or that it's too intense, you can ground yourself (with your therapist's help in session, and on your own between sessions) and feel safe enough to continue the work. In my practice, after the Phase 2 work lets us know that my patient is safe enough and able to cope with any emotion and/or physical sensation both during and between EMDR processing sessions, I often suggest we try a much less intense memory first if there is one that happened BEFORE the trauma(s). If there isn't one, then I suggest we start developmentally with the least disturbing memory and work our way "up" to the most disturbing event(s).

Grounding exercises are indispensable in everyday life, and really essential in stressful times. Anyone can use some of the techniques in Dr. Shapiro's new book "Getting Past Your Past: Take Control of Your Life with Self-Help Techniques from EMDR." Dr. Shapiro is the founder/creator of EMDR but all the proceeds from the book go to two charities: the EMDR Humanitarian Assistance Program and the EMDR Research Foundation). Anyway, the book is terrific. It's an easy read, helps you understand what's "pushing" your feelings and behavior, helps you connect the dots from past experiences to current life. Also teaches readers lots of helpful techniques that can be used immediately and that are also used during EMDR therapy to calm disturbing thoughts and feelings.

One of the key assets of EMDR is that YOU, the client, are in control NOW, even though you likely were not during past events. You NEVER need re-live an experience or go into great detail, ever! You NEVER need to go through the entire memory. YOU can decide to keep the lights (or the alternating sounds and/or tactile pulsars, or the waving hand, or hand/knee tapping - all forms of bilateral stimulation that should be decided by the client for the client's comfort) going, or stop them, whichever helps titrate – measure and adjust the balance or “dose“ of the processing. During EMDR processing there are regular “breaks” and you can control when and how many but the therapist should be stopping the bilateral stimulation every 25-50 or so passes of the lights to ask you to take a deep breath and to say just a bit of what you’re noticing. The breaks help keep a “foot in the present” while you’re processing the past. Again, and I can’t say this enough, YOU ARE IN CHARGE so YOU can make the process tolerable. And having a therapist who is experienced in the EMDR techniques helps make it the gentlest and safest way to neutralize bad life experiences and build resources.

Pacing and dosing are critically important. So if you ever feel that EMDR processing is too intense then it might be time to go back over all the resources that should be used both IN session and BETWEEN sessions. Your therapist can use a variety of techniques to make painful processing less painful, like suggesting you turn the scene in your mind to black and white, lower the volume, or, erect a bullet-proof glass wall between you and the painful scene, and so forth. There are a lot of these kinds of "interventions" that ease the processing. They are called "cognitive interweaves" that your therapist can use, and that also can help bring your adult self's perspective into the work (or even an imaginary Adult Perspective). Such interweaves are based around issues of Safety, Responsibility, and Choice. So therapist questions like "are you safe now?" or "who was responsible? and "do you have more choices now?" are all very helpful in moving the processing along.

In addition to my therapy practice, I roam the web looking for EMDR discussions, try to answer questions about it posted by clients/patients, and respond to the critics out there. It's not a cure-all therapy. However, it really is an extraordinary psychotherapy and its results last. In the hands of a really experienced EMDR therapist, it's the most gentle way of working through disturbing experiences.


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## asittingducky (Apr 23, 2013)

^Thank you for the informative response. That gave me a much better idea of what the therapy focuses on. The thing is my anxiety is more rooted in obsessive thoughts and compulsions. For a while my social anxiety and low self-esteem became unmanageable because of roommates and coworkers bullying me nonstop for a year over compulsive issues I have. Since EMDR seems to be so focused on PSTD, I was wondering if you would still support EMDR for obsessive OCD thoughts or deeply ingrained habits in response to stress? Or would something like CBT or exposure therapy seem more appropriate? I'm just stuck in a situation where I'm constantly surrounded by triggers and I don't have support for it.


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## asittingducky (Apr 23, 2013)

bump


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## Ichigo91 (Feb 21, 2012)

I did EMDR for a couple of months, I didn't see any change.


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