PTSD is Caused by Inadequately Processed Memories
Distressing events can overwhelm and interrupt the brain’s normal information processing system. When this happens, the sensory, cognitive, and emotional components of the traumatic experience are dysfunctionally held in isolated memory networks instead of being categorized and integrated with other experiences. The experience becomes fragmented and these disturbing memory fragments can resurface over and over again, causing the PTSD symptoms of “reexperiencing:” (APA, DSM-5)
- Unwanted upsetting memories
- Emotional distress after exposure to traumatic reminders
- Physical reactivity after exposure to traumatic reminders
Because their memories are inadequately processed, trauma survivors may have an inability to recall key features of the trauma and may show a failure to learn or gain perspective as time goes on. This can lead to negative thoughts, feelings, and behaviors such as: (APA, DSM-5)
- Overly negative thoughts and assumptions about oneself or the world
- Exaggerated blame of self or others for causing the trauma
- Negative affect
- Decreased interest in activities
- Feeling isolated
- Difficulty experiencing positive affect
Trauma memories maintain their emotional charge. They feel vivid, intense, and carry a sense of imminent threat. That’s why many trauma survivors experience the following symptoms of prolonged nervous system arousal: (APA, DSM-5)
- Irritability or aggression
- Risky or destructive behavior
- Heightened startle reaction
- Difficulty concentrating
- Difficulty sleeping
EMDR Therapy Processes Memories and Can Eliminate PTSD
EMDR therapy for PTSD gives clients a second chance to fully process trauma-related information and to integrate them into the fabric of our history. EMDR Therapy procedures activate our built-in information processing mechanism while reducing nervous system arousal and eliminating the emotional intensity of traumatic memories. Traumatic events become integrated with other experiences long-term memory storage, where they are firmly a part of the past. Survivors can remember what happened but are no longer held hostage by it. They are no longer at the mercy of the intense and painful emotions, flashbacks, and body sensations. As fear and anxiety decrease, more helpful and healthy attitudes, insights, and perspectives emerge spontaneously. Clients can finally let go of the guilt, shame, and powerlessness that have haunted them. They no longer need to avoid trauma reminders and are free to live life more fully.
Research, Research, Research
In 1989 Dr. Francine Shapiro published the first controlled studies on EMDR in the Journal of Traumatic Stress. The study showed clinically significant effects of desensitization, cognitive restructuring, and elimination of intrusions for subjects with PTSD due to sexual assault, molestation, or combat in Vietnam. Since then, more than 30 randomized controlled trials and more than 22 nonrandomized studies show that EMDR is effective therapy for psychological trauma (Shapiro & Solomon, 2017).
Multiple randomized and nonrandomized studies with children show effectiveness (with age-appropriate modifications) (Shapiro, 2018).
- Gains are maintained over time
- Clients treated with EMDR Therapy show continued post-treatment improvement as compared to those who received Prozac.
- Meta-analyses of EMDR vs. Trauma Focused Cognitive Behavior Therapy show comparable results but EMDR appears more efficient due to:
- fewer sessions
- little to no homework
- less exposure
- a greater decrease in intrusive symptoms
- no need to narrate event in detail
- lower dropout rates
EMDR is considered effective treatment for PTSD in National & International Practice Guidelines Including:
- International Society for Traumatic Stress Studies ISSTD (2018)
- Department of Veteran’s Affairs & Department of Defense (2017)
- World Health Organization (2013)
- California Evidence-Based Clearinghouse for Child Welfare (2010).
- SAMHSA’s National Registry of Evidence-based Programs and Practices (2011) (for PTSD, anxiety and depression symptoms)
“Trauma-focused CBT and EMDR therapy are 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.” – World Health Organization
At Connect, we love training new and experienced therapists in Basic and Advanced EMDR Therapy methodologies. We teach only research validated, evidence-based protocols, and we are constantly awed and inspired as clinicians begin to realize that trauma can be resolved in such a comprehensive, rapid, and respectful way.
Reflections on 30 Years of Research:
Interested in learning more about where we’ve been and where we’re heading in terms of EMDR Therapy for PTSD? Here’s a great article to dive into.
The Status of EMDR Therapy in the Treatment of Posttraumatic Stress Disorder 30 Years After Its Introduction
Jongh, Ad & Amann, Benedikt & Hofmann, Arne & Farrell, Derek & Lee, Christopher. (2019). The Status of EMDR Therapy in the Treatment of Posttraumatic Stress Disorder 30 Years After Its Introduction. Journal of EMDR Practice and Research. 13. 261-269. 10.1891/1933-3188.8.131.521.
Given that 2019 marks the 30th anniversary of eye movement desensitization and reprocessing (EMDR) therapy, the purpose of this article is to summarize the current empirical evidence in support of EMDR therapy as an effective treatment intervention for posttraumatic stress disorder (PTSD). Currently, there are more than 30 randomized controlled trials (RCT) demonstrating the effectiveness in patients with this debilitating mental health condition, thus providing a robust evidence base for EMDR therapy as a first-choice treatment for PTSD. Results from several meta-analyses further suggest that EMDR therapy is equally effective as its most important trauma-focused comparator, that is, trauma-focused cognitive behavioral therapy, albeit there are indications from some studies that EMDR therapy might be more efficient and cost-effective. There is emerging evidence showing that EMDR treatment of patients with psychiatric disorders, such as psychosis, in which PTSD is comorbid, is also safe, effective, and efficacious. In addition to future well-crafted RCTs in areas such as combat-related PTSD and psychiatric disorders with comorbid PTSD, RCTs with PTSD as the primary diagnosis remain pivotal in further demonstrating EMDR therapy as a robust treatment intervention. Full Article here