Long Term Stats

[Eden06]

Hi,

I have been a therapy client for a number of years, and EMDR has been used throughout those years, at different parts of my therapy. It certainly works, but not in the "regular" ways that I have read about. Without becoming too candid, my youth was spent in a number of abusive situations, as well as mirroring my youth to a great extent, in my early adulthood.

I am wondering if there are any stats around, now that EMDR has been used for a number of years, about its use over a long period of time ( I am not suggesting the use has been constant, but rather as part of my therapy) - I know, from my reading (I should tell you I am a psychotherapy student), that it was originally thought of as a one time quick thing, but this belief has changed with its use, and the types of clients it has been done with.

Are there any stats around from therapists who have used EMDR with their clients over a long period of time? Will it still work as well? What information is there?

I look forward to any and all answers.

Thanks, Eden

[Sandra Paulsen]

This is a great question. I currently know of no studies of its use adjunctively with psychotherapy over a long period of time. Most of the studies are on its use with PTSD.

Here's my understanding of what happens, based on clinical experience, not research.

With PTSD, the maladaptively held material is held relatively discretely as if in a capsule or "neuro-network." EMDR catalyzes this material, enabling the brain to process it relatively directly and completely, in a few sessions, if the PTSD is from single incident trauma in adulthood, like a rape or car accident or single combat experience. The more complex the trauma history, over more developmental periods, the more complex the treatment is.

Some of us use EMDR quite broadly, targeting what we call "small t traumas," like th eincident in the lunchroom in 7th grade, the dinnertable tension ages 7 to 11, the absence of nurturing in childhood, and so forth. These involve many many smaller capsules or schema, as a cognitive behaviorist would say. There are many developmental layers over time, (I'm seeing the strata of rocks on a hillside). Targeting these with EMDR very often DOES produce lovely results, but its much more of an art.

The therapist has to have a rich theoretically informed way to formulate the material so that the EMDR targeting is spot on. Here the picture I'm seeing is of a laser surgery of a small tumor, or of a tumor that has tendrils throughout tissue. The focusing is a big deal. It is easy to misfocus the laser by millimeters, getting near the target or getting part of the tumor, but not all of it. That's what happens in the long-term use of EMDR with complex trauma histories from childhood. Over even just complex childhoods, like alot of people have.

I still like the use of EMDR for such cases because we often hit a pocket of trapped energy that gets released and the person reports shifts, but its more like a rheostat effect than a lightning bolt. The light comes on slowly in the room, rather than in a moment. With EMDR with PTSD, the light comes on suddenly in a few short sessions.

I doubt there will be good controlled studies on this use of EMDR because it would be quite complex to do, and there would be many variables involved, so lots of noise in the data.

That's my best understanding of things.