EMDR for Complex Posttraumatic Stress Disorder and Depression

By Jeff Dwarshuis LMSW ACSW

EMDR (Eye Movement Desensitization and Reprocessing) is a highly effective treatment for eliminating the negative impacts of traumatic memory.  Created as a treatment for Posttraumatic Stress Disorder, EMDR also is used with dramatic speed and effectiveness for depression. This is particularity true with individuals who have a history of repeated abuse or repeated traumatic incidences causing Complex Posttraumatic Disorder.

Depression

Depression can be mild or severe with symptoms that include sleep disturbance, weight gain or weight loss, difficulty concentrating, low motivation, low self esteem, suicidal thoughts, gestures or plan, feelings of worthlessness and frequent thoughts of death. The causes of depression are complex and range from chemical imbalances to unhealthy communication patterns, repressed memories and negative thought patterns. Treatment for depression may include medication, emotive processing, problem solving and Cognitive Therapy.

EMDR

EMDR is a neurobiological treatment that uses eye movements to eliminate the negative impacts of bad memories. Clients using EMDR follow a strict protocol that includes the identification of a disturbing memory and an evaluation of the negative feelings, body sensations and disturbing self beliefs (cognitions) that result when the memory is remembered. Reprocessing the memory happens as the client imagines the memory and then moves their eyes back and forth as facilitated by the therapist. The eye movements create an intense relaxation response which parallels the deep sleep experienced following REM sleep. The negative memory treated in therapy, like all negative memories, requires for its existence the collective involvement of a negative feeling, negative cognition, and a related negative body sensation. If one of these stated elements disappears then all elements will disappear, and the bad memory no longer creates a negative reaction. In therapy, because the client is using eye movements while imagining the negative memory and is experiencing intense relaxation at the same time, the negative impacts disappear all together. Generally, a negative memory can be identified and reprocessed successfully in one session.

Cognitive Therapy

Cognitive Therapy is a treatment intervention that changes a person’s thought patterns and cognitions. Studies have shown that people who are depressed have negative thought patterns called “distortions” and negative self beliefs called “negative cognitions”. Both distortions and negative cognitions can be recognized by questionnaires. In Cognitive Therapy, symptom reduction is said to occur as one teaches themselves to think more positively.

EMDR, Cognitive Measures and “Closing the Gap”

The EMDR Protocol, combined with Cognitive Therapy questionnaires, creates a very fast and effective method of treatment for depression. For example, after the client completes the questionnaire, the therapist collects a list of the client’s most negative cognitions. Then, related to each one of these negative cognitions, the therapist asks the client “When did you start believing this negative self belief and how did you learn it?” Almost always the client will refer to memories of relational conflict with their parents. Also, it is common that the client mentions memories of childhood loss or trauma experienced in school. Following this, the therapist and client use this information to create a list of all the negative experiences leading to negative cognitions and then treat each of these memories using the EMDR Protocol explained above. The client follows the EMDR treatment, eliminates the negative impacts of these childhood memories and no longer has the negative cognition contributing to depression. This is a dramatic change for the client as it is nearly impossible for a depressed person to realistically see themselves accomplishing all that they are able to based on their abilities. In general terms, before therapy the client has a gap between what they can do and what they believe they can do. The EMDR intervention eliminates the gap between perceived inabilities and realistic potential. This change of perception is shocking, comforting and euphoric often putting the client in a position of well-being not felt since their early childhood.

The treatment of depression using EMDR is an intense and highly effective method of therapy that permanently changes negative self-beliefs leading to depression and Complex Posttraumatic Stress Disorder. Also, the length of therapy is much less often taking 50%-75% less time than traditional therapy.

Resources

Cognitive Therapy – Basic and Beyond by Judith Beck (1995)

Cognitive Therapy for Challenging Problems by Judith Beck (2005)

Eye Movement Desensitization and Reprocessing: Basic Principles, Protocols and Procedures by Francine Shapiro PhD (2001)

Getting Past Your Past: Take Control of Your Life with Self Help Techniques from EMDR Therapy by Francine Shapiro PhD (2012)  

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