Re: EMDR for Eating Disorders

The following is a June 1998 article of mine which appeared in the Toronto Hospital
National Eating Disorder Information Centre Bulletin about eating
disorders.
>

>EMDR: A New Therapy For Eating Disorders

>The National Eating Disorder Information Centre has published many articles
>in The Bulletin about various types of treatment for those struggling with
>food and weight preoccupation and / or serious eating disorders. When
>seeking help, it is important to be informed about the latest treatment
>methods in order to be able to make informed choices.
>
>EMDR (Eye Movement Desensitization and Reprocessing) is a therapeutic
>technique that came into being for the treatment of Post Traumatic Stress
>Disorder. After being trained in its use I realized that this was a method
>of therapy that would also help those with eating disorders. I contacted
>some researchers in the United States and was told that the use of EMDR for
>those suffering from eating disorders was very effective. And so I began to
>use it with a number of clients. The results are often dramatic. I believe
>that as we gain understanding and experience, EMDR will become one of the
>leading therapies for those who suffer from eating disorders.
>
>EMDR is a therapeutic technique that treats the disturbing experiences from
>the past that underlie many problems in the present. It is an effective way
>to deal with stress and anxiety arising from unresolved negative
>experiences. Most experts agree that there is a high correlation between the
>development of an eating disorder and with unresolved trauma from the past.
>To find true relief for the sufferer we must find these unresolved problems
>and treat them. When this is done correctly, using the EMDR protocol, the
>continuance of the eating disorder often disappears.
>
>Even though EMDR is less than ten years old, it is now in use by over 17,000
>practitioners around the world. EMDR is not a panacea, and there is still
>some uncertainty about exactly how it works. Dr. Francine Shapiro, a senior
>fellow at the Mental Research Institute in Palo Alto, California, is its
>originator. She believes that the mind, like the body, has its own healing
>system and when that mechanism is not fully functioning, EMDR can somehow
>unlock it.
>
>EMDR evolved from a chance observation made by Dr. Shapiro. She had been
>walking in a park, thinking about old painful memories. She noticed that
>while she was recalling those memories, her eyes were going into a
>spontaneous back-and-forth rapid eye movement (REM). She began to feel
>relieved. The disturbing thoughts she had been thinking about stopped having
>a negative charge. She was fascinated by what she had experienced and
>decided to investigate the phenomenon. In her book "Eye Movement
>Desensitization and Reprocessing" published in 1995, she describes how she
>took a group of twenty-two people who were rape victims, molestation
>survivors and Vietnam war veterans, all suffering from the symptoms of
>post-traumatic stress disorder. She divided them into two groups, the
>treatment group and the control group. The people in the treatment group had
>a single complete EMDR session while those in the control group also had a
>single session of the EMDR protocol but without the eye movements. All of
>the people in the treatment group reported that after the session, they felt
>better and some of their symptoms had gone. Three months later those
>symptoms had not returned. Those in the control group reported no change in
>their symptoms. This was the first study of its kind.
>
>Dr. Bessel van der Kolk, a Harvard neurological researcher, is doing brain
>scan imaging on people suffering from post-traumatic stress disorder using
>EMDR. He has found that two areas in the brain show increased activity after
>an EMDR session and it is now being hypothesized that recovery from
>traumatic events may depend on a brain intrahemispheric pipeline being
>opened up so that the traumatic memories may be processed. The eye
>movements may actually be causing the neurophysiological system to
>rebalance thus leading to memories being stored in a healthier way.
>
>The current EMDR model states that as information comes in, the brain works
>at a neurophysiological level to restore its own balance. It takes in new
>information, dissipates it, processes it, and tries to adjust and
>accommodate it. Unresolved trauma can be thought of as information in the
>system that has not been processed, causing an imbalance. Unprocessed
>information remains constantly available. Therefore new information coming
>in will become contaminated with whatever is there that has not been
>processed. The information from the traumatic event that has not been
>dissipated, is locked in the nervous system and causes a generalization to
>other events. The negative feelings and thoughts that occurred at the time
>of the original event still exist with the same intensity today. As EMDR
>sessions take place, the unprocessed information from the traumatic event
>gets stored in the brain in an appropriate manner and stops having a
>negative effect on the person's life in the present. One client told me "it
>is like getting rid of all the junk. Somehow it doesn't bother me any more".
>
>Many sufferers of eating disorders experience the following kinds of
>problems: disturbance in body image, misinterpretations of internal and
>external stimuli, inaccuracy in the way hunger is experienced, feelings of
>inferiority and an overwhelming sense of personal ineffectiveness in their
>lives. EMDR lends itself well to these kinds of problems. In addition,
>people often have problems such as phobias or negative attitudes about
>themselves or tendencies to sabotage themselves when they are on the verge
>of doing something they would really like to do. Even with a clear
>understanding of the senselessness of the behaviour and quite often even
>after years of psychotherapy, these problems persist. EMDR leads to the
>rapid resolution of these kinds of problems. It seems to bridge the
>mind-body connection.
>
>Many people struggling with unresolved trauma from the past may have an
>understanding of how their past experiences are affecting their behaviour in
>the present and yet are still not able to make changes. It seems as if the
>client understands the problem, knows the solution and yet is powerless to
>act on the knowledge that would change his or her behavior. Many clients
>tell me that they know they ought to stop bingeing and purging and always
>have the best intentions and yet can't seem to stop this behavior. EMDR
>often helps.
>
>In an EMDR session, the client is asked to focus on a specific incident and
>move his or her eyes back and forth many times, following the quickly-moving
>fingers of the therapist. The eye movements are similar to the Rapid Eye
>Movement known as REM which occurs while a person is asleep and dreaming.
>EMDR focuses not just on a person's troubling feelings, but also on the
>thoughts, physical sensations and behaviour patterns that are related to
>those feelings. The person integrates the emotion about the upsetting event
>("I am in danger") by processing it and storing it with a more appropriate
>emotion ("It is over, I am safe now"). This usually leads to a marked
>decrease in anxiety. Many of what we consider to be disorders are actually a
>result of the way information is stored in the brain. Healing begins when
>we unlock this information and allow it to emerge. EMDR seems to have a
>direct biological effect on the nervous system and somehow allows the
>information to be processed correctly.
>
>The basic protocol of EMDR involves eight phases of treatment. All eight
>phases can be completed within one session but the number of sessions needed
>can vary from one to many.
>
>1) Client history: The therapist obtains information about the client's
>current level of functioning, current symptoms, and assesses the client's
>stability, negative belief systems and secondary gain issues. With this
>information, targets are established for treatment
>
>2) Preparation of the Client: Tasks in this phase include rapport building,
>establishing methods for helping the client handle incomplete sessions, and
>helping the client build up ego strength.
>
>3) Assessment: This involves helping the client decide upon the scene to
>target and finding out the client's negative cognitions.
>
>4) Desensitization: Series of eye movements are used to reduce the negative
>affect of the targeted memory.
>
>5) Installation: Positive cognitions are installed using the eye movements.
>Negative thoughts are replaced with positive ones.
>
>6) Double check: Call up the original scene and see if any residual
>unresolved feelings remain.
>
>7) Closure: Help client re-establish equilibrium and stability.
>
>8) Re-evaluation: This is done at the beginning of the next session to see
>whether the treatment effects are being maintained.
>
>
>Beth is a 24 year old woman who came to see me because she had been
>diagnosed as having bulimia and was unable to stop bingeing and vomiting.
>She told me she was constantly obsessing about food. Her symptoms had not
>improved even after having been in therapy with a psychiatrist for a number
>of years. Using EMDR we focused on various negative incidents that had
>happened to her as a child and that seemed to be having an affect on her
>self-image and on her eating behaviour. During the first and second sessions
>she remembered many times when she had been teased and made to feel
>inadequate. She focused on many of these incidents while doing the eye
>movements. She reported feeling much less anxious and depressed almost
>immediately. Towards the end of the fourth session she started to cry and
>then laugh and said she realized that she was well on her way to recovery.
>Recently she told me "It's a miracle, I don't think about food all the time
>any more, and I don't even have to vomit any more".
>
>

Replies:

Re: EMDR for Eating Disorders, by Mary J. Harrell, LCSW, 06/06/00

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