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Q5: Can you tell us why EMDR works? - EMDR with Dr. Andrew M. Leeds Ph.D. - ONE80CENTER

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Published on Sep 5, 2012

Dr. Andrew Leeds is talking about the EMDR: Eye Movement Desensitization and Reprocessing.

Q5: Can you tell us why EMDR works?

Well, we aren't sure exactly how EMDR works and there are several leading models to explain the well established effectiveness of EMDR. So the first thing to make clear is that EMDR is a well established approach to psychotherapy and has shown to be effective for post traumatic stress disorder acute stress disorder and for specific phobias and there is quite a bit of emerging evidence for other conditions as well. The two primary models that are given the widest attention for how EMDR works, the first is the REM orienting response hypothesis and the second is the working memory hypothesis.

The REM, rapid eye movement or orienting response hypothesis, assumes that the system in the brain for orienting response is behind the effectiveness of EMDR. The REM hypothesis which explains how memory is reorganized during REM sleep. These two actually fit together. So as most mental health professionals are aware all mammals have REM sleep and deep sleep phases and in the REM phase of sleep memory is pruned. Parts of the memory are thrown away without this we would be left with a flood of images and feelings and physiological responses to mildly and severely distressing life experiences.

During REM sleep memory is digested and the unimportant aspects of memory are discarded taking away the emotional vividness, taking away the sensory vividness of memories and leaving us with a gist of these life experiences. The most important parts and the parts we can learn from. Something similar seems to happen during EMDR during the eye movements with EMDR. The unimportant parts of memory. The vividness of the feelings, the vividness of the sensory impressions become weakened and fade. In a way very similar to what happens during REM sleep.

Partially this may be caused by what's called the orienting response developed by Sokolov a contemporary of Pavlov, who described a multi-phase process for how mammals respond to novel stimuli in the environment. When there's a novel stimulus in the environment say a noise in the bush and there's a deer out grazing. Acting under instinctual behavior it hears this noise and it orients towards it. It turns it's head, it's ears swivel, it's eyes scan the environment, it's nostrils sniff the air, trying to determine whether it's a threat or not.
One of three things happen at that point. The first is that with orientation there is a spike of arousal and during this appraisal phase that comes right afterwards the animal checks a database stored in the amygdule the flight/fight site of the brain for all previous threat cues and it compares the incoming sensory inputs against what's stored in the emotional part of the brain. If it's a predator emerging from the bushes the deer sees it and in 1/25 of a second it's fleeing. If it's a big male deer with antlers and the doe was in rut she smells the air and goes prancing of toward the male, something good.

But, if it's just the wind blowing the bushes it's determined to be neutral, uninteresting and the arousal hoes down. Well this is what happens with eye movements with EMDR. You have an orienting response. There is a brief spike up as the eye movements begin and then as the amygdule looks out through the eyes it's kind of in this paradoxical situation because the therapist has activated all the trauma cues active in the imaging in the brain and the same part of the brain where you see current imagery.

When you bring up old memories that are traumatic the same parts of the brain are active as during current sensory perception but the amygdule now is looking at the lights or the hand of the therapist going back and forth and sees something boring. It's not a threat, it's not exciting either. So arousal goes down. So the orienting response model says the dearousal is a compelled relaxation response. That's what David Wilson called it. Part of the normal investigatory or orienting response process. That's when the emotional parts of the brain perceive boring sensory stimuli.

So, what happens during REM is that emotionally intense material moves to the right hemisphere stored in vivid sensory to the left through a process organized primarily by dopamine. These things seem to go together. The orienting response the REM system in the brain being activated, information becomes decreasingly vivid decreasingly intense and moves from the right hemisphere into a narrative form in the left hemisphere. So that's the first hypothesis...Read more : http://www.one80center.com/can-you-te...

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