Most experts agree that one way to get "unstuck" and free
from the symptoms is through exposure to the traumatic experience. This
means to face the memories or troubling events until they are no longer
disturbing. EMDR combines elements of several well-established clinical
theoretical orientations (e.g., psychodynamic, cognitive, behavioral,
client-centered) together with "bilateral stimulation" in a unique
and novel way to dissipate the upset associated with the experience. Bilateral
stimulation refers to the use of alternating right-left tracking that may
take the form of eye movements, tones or music delivered to each ear, or
tactile stimulation, such as alternating hand taps. Creative alternatives have
been developed for children that incorporate the bilateral stimulation, using
puppets, stories, dance, art, and even swimming.
EMDR helps
process the troubling thoughts, feelings, and memories so that children can
return to their normal developmental tasks and prior levels of coping. EMDR is
being used with other childhood problems that are not caused by trauma, such
as attention deficits (AD/HD), anxiety and depressive disorders. EMDR can also
help to strengthen feelings of confidence, calmness and mastery.
How Was EMDR Developed?
... Does EMDR Really Work?
In 1987,
psychologist Francine Shapiro made the chance observation that under certain
conditions eye movements can reduce the intensity of negative, disturbing
thoughts. Dr. Shapiro studied this effect scientifically, and in 1989, she
published a study reporting success using EMDR to treat adult victims of
trauma. Since then, EMDR has developed through the contributions of therapists
and researchers all over the world. There are now more scientific studies
proving the efficacy of using EMDR to resolve trauma and posttraumatic stress
disorder (PTSD) than any other psychotherapy method.
This
revolutionary therapy has been adapted and modified for children. Over
the last 10 years, EMDR has been used world wide to help children. There are
hundreds of case study reports on the positive effects of EMDR with children.
Positive outcomes in the Oklahoma bombing, Hurricane Andrew, Hurricane Iniki,
the shootings in Jonesboro, Arkansas are just a few case examples of EMDR
being successfully used with children. Case reports with children have been
consistent with research findings using EMDR with adults. As with many other
treatment modalities, scientific controlled outcome studies on child therapy
have lagged behind clinical case reports. To date, the research studies
conducted on using EMDR with children, have showed positive results, including
achieving a positive outcome where previous treatment had failed (Chemtob
& Nakashima, 1996).
How is EMDR Used
with Children?
EMDR is
part of an integrated treatment approach and is often used in conjunction with
other therapy practices such as play therapy, talk therapy, behavior therapy,
and family therapy. EMDR will be explained and used when agreed upon by the
family and child. Children and parents are always in control of the process.
A typical
EMDR treatment session begins in a positive way by having children use their
imagination to strengthen their sense of confidence and well-being. For
example, children may be asked to imagine a safe or protected place where they
feel relaxed and comfortable or to remember a time when they felt strong and
confident. These positive images, thoughts and feelings, are then combined
with the "bilateral stimulation." These beginning experiences with
EMDR typically give children increased positive feelings and demystify the
process of EMDR, so that children know what to expect.
When agreed
upon between the parent, child, and therapist, the child is asked to bring up
an upsetting memory or event that is related to the focal problem. Bilateral
stimulation is used again while the child focuses on the upsetting experience.
When an upsetting memory or event is "desensitized" that means that
the child can face the past events or memories and no longer feel disturbed,
frightened, or avoidant of the thoughts and feelings attached to the event.
The result of "reprocessing" simply means that the child has a more
healthy perspective on the upsetting memories or events. The meaning attached
to the event is no longer distorted nor interferes with the child's
functioning or development. When the event is reprocessed, children can more
comfortably believe and trust, "It's over." "I'm safe
now." "I did the best I could." " I have other choices
now."
What are Children’s
Reactions to EMDR?
It is most
helpful if parents support the use of EMDR with their children. Parents
and professionals can explain that EMDR is a way to get over troubling
thoughts, feelings, and behaviors.
The EMDR
process is different for each person, because the healing process is
guided from within. Some children report that EMDR is relaxing and have an
immediate positive response. Other children may feel tired at the end of an
EMDR session, and the benefit from the treatment comes in the days to follow.
After some children have experienced EMDR, they will specifically request
EMDR
in other sessions. And then there may be times when the child tries EMDR but
will ask to discontinue the procedure, because he or she is not really ready.
One ten-year-old had been injured in an accident. She wore a body cast for a
year and was preoccupied with injury, illness, and death. After EMDR, she
began crying tears of joy and stated, "I'm so happy, it really is over
and I am strong." Another five-year-old boy who had behavioral
problems and had worked with the therapist using other kinds of therapy, tried
EMDR and stated, "Why didn't you do this with me before?"
Another eight-year-old boy who kept having nightmares stated,
"It just popped out of my head, the monsters are gone." Other
children say little at all, but their behavior changes and parents state:
"Things are back on track."
How Does EMDR
Work?
While it is
not clear how EMDR works, there are ongoing investigations of the possible
mechanisms by which EMDR facilitates a reprocessing of human experience. We do
know that EMDR is not hypnosis. It may be that EMDR works similarly to what
occurs naturally during dreaming or REM (rapid eye movement) sleep, where
certain information is processed. It may be that the bilateral stimulation
produces a compelled relaxation response or a distraction that helps children
and adults relax rather than avoid facing disturbing events and memories.
Others think that the bilateral stimulation may help both hemispheres of the
brain communicate to one another, and therefore may allow for accessing the
body's natural healing mechanisms. In EMDR, all the information, across
all modalities (images, sounds, emotions, sensations, and thoughts/beliefs
coded in words) is accessed together and metabolized.
Helpful
Resources
Chemtob,
C., Naskashima, J., & Carlson, J. (2002). Brief treatment for
elementary school children with disaster-related posttraumatic
stress disorder: A field study. Journal of Clinical Psychology, 58, 99-112.
Greenwald,
R. (1999). Eye movement desensitization and reprocessing (EMDR) in child and
adolescent psychotherapy. Northvale, NJ:Jason Aronson Inc.
Lovett, J.
(1999). Small wonders: Healing childhood trauma with EMDR. New York: The
Free Press.
Shapiro,
F., (2001). Eye Movement Desensitization and Reprocessing, 2nd Ed. New York:
Guilford Press.
Tinker, R.
& Wilson, S. (1999). Through the eyes of a child: EMDR with
children. New York: W.W. Norton & Co.
For more information on EMDR:
*EMDR
Institute (Francine Shapiro): http://www.emdr.com
*EMDRIA (EMDR
International Association): http://www.emdria.org.
This
Brochure was created by: Marsha Heiman, Ph.D., Susan Packwood, LMSW-ACP, Terry
Becker-Fritz, MS, RN, CS, Suzie Carson, LISW, Laurie Donovan, LMSW-ACP, Mary
Froning, Psy.D., Gary Peterson, MD
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