EMDR Information & Worksheets

EMDR Information & Worksheets More information can be found at www.cbtplus.ie

Table of Contents INFORMATION ON EMDR THERAPY WHAT IS EMDR? WHAT DOES EMDR LOOK LIKE? WHAT TO EXPECT DURING AN EMDR SESSION HOW LONG DOES IT TAKE? EMDR WORKSHEETS LIST OF EXPERIENCES OR MEMORIES THAT MAY BE ASSOCIATED WITH YOUR PROBLEM .

LIST OF TRIGGERS LIST OF NEGATIVE CORE BELIEFS AND ALTERNATIVE POSITIVE BELIEFS LIST OF COPING SKILLS KEEPING A LOG IN BETWEEN SESSIONS CAN HELP US KEEP TRACK OF YOUR PROGRESS

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Information on EMDR Therapy What is EMDR? EMDR (Eye Movement Desensitization and Reprocessing) is a psychotherapy that helps people heal from the effects of overwhelming life experiences. It was originally developed to treat PTSD among Vietnam veterans but has since been shown to be effective in treating a range of psychological and physical symptoms stemming from adverse life experiences. More often than not we recover from these disturbing events but sometimes we can’t. The traumatic memory gets stored as raw, unprocessed information in the limbic system. Here they are suspended in an isolated memory network that is associated with emotions and physical sensations, and which are disconnected from the brain's cortex where we use language to store memories. (this may explain why we can rationally know something is not true but still don’t believe it on a gut level).

Cues in the environment activate these networks, and trigger all of the sensory and emotional content trapped in the brain. These heightened emotional spikes in the brain tell the autonomic nervous system that you are in danger, as though that experience is happening right now. Nerves throughout your body react as though you need to run or defend yourself.

It is not exactly clear how EMDR works but the prominent theory, adaptive information processing or AIP, suggests that human beings process information, and that this information is stored in memory networks encapsulating events, thoughts, feelings, body sensations, and so on. According to the AIP model the EMDR protocol is said to access the stored dysfunctional information and to stimulate the adaptive processing of this information. The rationale is sometimes given that “human beings have the ability to overcome trauma and to process difficult events – EMDR facilitates this natural process” One way of understanding it is to think about how our body responds to physical trauma. If you fall and cut your hand, the wound won’t close correctly if you have stone or dirt lodged in the cut. The mind is similar in its healing process. The brain naturally takes steps toward healing, but if the processing system has a block from the impact of a traumatic event, the emotional wound can’t heal correctly either. Intense suffering occurs, just like with an infection. EMDR removes this block and allows the brain to perform its natural healing processes so that recovery can continue.

After successful treatment with EMDR therapy, emotional distress is relieved, negative beliefs are updated, and physiological arousal is reduced. Repeated studies show that by using EMDR people can experience benefits that once would have taken years of psychotherapy.

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What does EMDR look like?

EMDR has eight phases of treatment which are briefly described.

Phase 1: History Taking Discuss why you are coming for treatment, the beliefs, behaviours and symptoms related to this problem and what you would like to be able to do differently in the future.

With this information, your therapist will develop a treatment plan that defines the specific targets on which to use EMDR. One of the unusual features of EMDR is that the person seeking treatment does not have to discuss any disturbing memories in detail. If you were to be asked, for example, "What event do you remember that made you feel worthless and useless?" the person may say, "It was something my brother did to me." That is all the information the therapist needs to identify and target the event with EMDR. Phase 2: Preparation You will learn about the theory of EMDR, how it is done, and what the person can expect during and after treatment. You will also learn specific techniques so you can deal with any emotional disturbance that may arise. Learning these tools is an important aid for anyone.

The happiest people in the world have ways of relaxing themselves and decompressing from life's stress. One goal of EMDR therapy is to make sure that you can take care of yourself.

This gives you the opportunity to establish trust with your therapist. If you do not trust your therapist, you may not accurately report what you feel and what changes you are (or are not) experiencing during desensitisation. If you try to please your therapist you will be doing yourself a disservice.

Phase 3: Target Assessment This is used to access each target in a controlled and standardised way so it can be effectively processed. This includes a specific image from the target event, a negative selfbelief associated with the event, a preferable positive self-statement, how true this positive statement feels, negative emotions, physical sensations and how disturbing this memory is out of 10.

Phase 4: Desensitisation Your therapist will lead you in sets of eye movements, sounds, or taps with appropriate shifts and changes of focus. Starting with the main target, the different

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associations to the memory are followed. Your therapist will guide you to a complete resolution of the target.

Phase 5: Installation You will concentrate on and increase the strength of the positive belief that you have identified to replace your original negative belief.

Phase 6: Body Scan

After the positive cognition has been strengthened and installed, your therapist will ask you to bring the original target event to mind and see if any residual tension is noticed in the body. If so, these physical sensations are then targeted for reprocessing.

Phase 7: Closure Ends every treatment session. Closure ensures that you leave at the end of each session feeling better than at the beginning. If the processing of the traumatic target event is not complete in a single session, your therapist will assist you in using a variety of self-calming techniques in order to regain a sense of equilibrium. You will also briefed on what to expect between sessions (some processing may continue, some new material may arise) and what calming techniques could be used to self-soothe in your life outside of the therapy session.

Phase 8: Re-evaluation Once you have completed phase six, your therapist will check in the next session if the positive results (low distress, positive beliefs, no body tension) have been maintained. New disturbing memories may have been identified that need treatment. The Re-evaluation Phase is vital in order to determine the success of the treatment over time. Although you may feel relief almost immediately with EMDR, it is as important to complete the eight phase treatment, just as you would with a course of antibiotics.

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What to Expect During an EMDR Session You will start a processing session by activating the memory as described in phase three. You will then focus on both this target and an external stimulus. Instead of getting fully pulled into a memory, the gentle buzzing in your hands, eye movements, and auditory tones orient the mind and body to the present while simultaneously remembering the distressing experience.

People have different experiences of EMDR. Some say it is like rapid daydreaming; some describe it as watching scenery go by from the window of a train, others liken it to watching a video or snapshots in a slide show. Sometimes people cry, releasing strong emotions, and sometimes people experience physical sensations as their body releases its sensory experiences. You always remain in control and be able to stop, ask questions, or have my help in figuring out and getting what you need. As with all trauma work, EMDR can be emotionally intense. At all times your therapist will be there to help you know you are safe and will gently guide you through any difficult parts of the process EMDR does not make people forget their painful experiences or stop being sometimes upset about them. However, the memories will become just that: memories. They will become less upsetting because they will be filed in the brain as something that happened in the past, instead of manifesting in the present.

The image on the left shows the brain of someone with PTSD. The red areas indicate over-activity in the brain. The image on the right is the same person after four 90-minute sessions of EMDR.

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How long does it take?

The short answer is, you can’t be sure. Every single individual is different, with their own experiences, perceptions, and needs. You can get a more accurate answer to this question once history taking is under way, so you and your therapist have a better understanding of the amount of work that needs to be done. For a single event trauma, the treatment can be quicker. For complex trauma, such as a history of emotional neglect or childhood trauma, it can take longer. For most clients, you will begin to notice a shift in 4-6 sessions, once the reprocessing stage begins.

It is important to make sure to discuss your full history with your therapist. If you have experienced complex trauma and/or dissociation, it’s helpful to work with a therapist with advanced training in EMDR. Complex trauma and dissociation typically require more individualised preparation and specialised interventions to make the treatment a success

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EMDR Worksheets

The following worksheets can be used in preparation for starting your EMDR therapy or used as part of the ongoing process.

List of experiences or memories that may be associated with your problem.

Age

Stressful Experience/Memory

Relevant Information connected to this memory

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List of triggers

List all the images, sounds, smells, physical sensations, people, places, activities or dreams that cause an intenseemotional response

What emotion do you feel?

Bodily sensation?

Urge?

What thoughts pop into your mind whenthis happens?

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List of Negative Core Beliefs and Alternative Positive Beliefs

Negative beliefs

Positive beliefs

RESPONSIBILITY/ I AM SOMETHING “WRONG” I don’t deserve love.

I am a bad person.

I am terrible.

I am worthless (inadequate).

I am shameful.

I am not lovable.

I am not good enough.

I am permanently damaged.

I am ugly (my body is hateful).

I do not deserve . . .

I am stupid (not smart enough).

I am insignificant (unimportant).

I am a disappointment.

I deserve to be miserable.

I am different (don’t belong).

I deserve love; I can have love.

I am a good (loving) person.

I am fine as I am.

I am worthy; I am worthwhile.

I am honorable.

I am lovable.

I am deserving (fine/okay).

I am (can be) healthy.

I am fine (attractive/ lovable).

I can have (deserve) . . .

I am intelligent (able to learn).

I am significant (important).

I am okay just the way I am.

I deserve to be happy.

I am okay as I am.

RESPONSIBILITY/ I DID SOMETHING “WRONG” I should have done something.

I did something wrong.

I should have known better.

I did the best I could.

I learned (can learn) from it.

I do the best I can (I can learn).

SAFETY/ VULNERABILITY I cannot be trusted.

I cannot trust myself.

I cannot trust my judgment.

I cannot trust anyone.

I cannot protect myself.

I am in danger.

It’s not okay to feel (show) my emotions.

I cannot stand up for myself.

I cannot let it out.

I can be trusted.

I can (learn to) trust myself.

I can trust my judgment.

I can choose whom to trust.

I can (learn to) take care of myself.

It’s over; I am safe now.

I can safely feel (show) my emotions.

I can make my needs known.

I can choose to let it out.

CONTROL/ CHOICE I am not in control.

I am powerless (helpless).

I am weak.

I cannot get what I want.

I am a failure (will fail).

I have to be perfect (please everyone).

I am inadequate.

I cannot trust anyone.

I am now in control.

I not have choices.

I am strong.

I can get what I want.

I can succeed.

I can be myself (make mistakes).

I am capable.

I can choose whom to trust.

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List of Coping Skills

What are your current ways of feeling calm or coping with stressful experiences?

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Keeping a Log in Between Sessions Can Help Us Keep Track of Your Progress

Date

Trigger

Thoughts about yourself

Emotion you experienced?

Bodily sensation?

How much did it botheryou (010)

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