By Dr. Wilfried Busse, Ph.D.
My theoretical approach to psychotherapy is eclectic and integrative. This means I integrate the most effective aspects of cognitive-behavioral, humanistic and insight-oriented approaches to meet the unique needs of my client's personality and inner resources in the context of their family and social support system. I also work from a holistic perspective in which I consider the psychological, biological, social, and spiritual factors in understanding a client's motivation and behavior. I pay particular attention to the connection between mind and body and how the two affect one another. Clients are often unaware of how negative emotions get "stuck" in the body. They often feel a sense of liberation once they are able to identify and then release such physiological distress as muscle tightness, headaches, stomach upset and other physical signs of anxiety. Finally, what is often ignored in traditional psychological therapies is a focus on spiritual matters and how they are connected with one's psychological well being. Clients sometimes wonder whether they should see their priest or pastoral counselor. In fact, many practitioners will automatically tend to refer to such professionals when a spiritual indentity issue emerges as the presenting problem. Given my interest and training (Masters in Religion), I welcome any client whose psychological and spiritual issues are so interwoven that it would seem artificial to separate them out.
While training and experience in the theory and practice of psychotherary are important, they do not compare to the vital role played by a relationship of trust and collaboration between client and therapist. In fact, research consistently shows that this is the single most important factor that accounts for a satisfactory outcome in therapy. Thus, I seek to form a trusting and collaborative partnership with you, the client. Therapy is not what the therapist does to, or for, the client who passively absorbs the advice or "wisdom" of the clinical "expert." This kind of directive approach may work in the short run but tends not to be owned by the client in the long run. The best therapy outcome is when clients find their own "voice" and are motivated to change from within, in the context of the alliance between client and therapist.
So, the research clearly shows the "therapeutic alliance" is of primary importance. Does this mean technique counts for little? You may well get different answers from different therapists, depending on their orientation, but scientific research also claims that specific, best-practices approaches related to particular client problems tend to have the best outcomes. This brings me back to my earlier emphasis on on evidence-based practice in psychology (EBPP). This means simply that I integrate the best available research evidence with my clinical experience and expertise to address the client's unique characteristics, culture and personal preferences. Now, one of the most researched approaches in all of psychotherapy is Eye-Movement Desensitization and Reprocessing (EMDR) which I am really excited about. My enthusiasm for a particular approach is perhaps no different from that of many other therapists who favor their particular approach. But you will see that my enthusiasm is supported by a considerable body of research and by numerous international mental health organizations. Let me explain:
What is EMDR?
Eye-Movement Desensitization and Reprocessing (EMDR) is a method of psychotherapy that has been extensively researched and proven effective for the treatment of trauma and other conditions. It consists of a set of standardized protocols that incorporates elements from many different treatment approaches. It's effectiveness is no longer in doubt but there are lingering questions about how it works. No one really knows how any form of psychotherapy works neurobiologically or what actually happens in the brain during therapy. However, we do know that when a person is very upset, their brain cannot process information as it does ordinarily. One moment of a traumatic experience may become "frozen in time" and traumatic memories may be relived so vividly with all the attendant sounds, smells, and images, that it may seem like the event is re-experienced. Such memories and other symptoms have a lasting negative effect that interferes with the way a person sees the world and the way they relate to other people.
Let's take the example of a minor, non-traumatic, accident such as a fender bender which may still cause considerable upset. We may experience temporary symptoms such as confusion, hyper-alertness, physical sensations of reminders of the accident, and partial loss of memory of the details of the event. Usually, in a few hours or days these symptoms lessen and disappear entirely as the mind digests and re-processes the event and the memory of the accident becomes just a bad memory among others. However, in the case of a more traumatic experience, such symptoms tend to get "stuck" as fragments or undigested bits of information that raise havoc with the mind and body, often causing more lasting distortions of memory and other neurological processes. The wonder of EMDR is that such symptoms can be effectively desensitized and then reprocessed. This re-processing allows blocked or distorted memories to be brought back "on line" and hook up with the more healthy and adaptive networks in the brain. Think of the trauma like a computer virus being "overwritten" by new programming.
Does EMDR Really Work?
Over 25 controlled studies have investigated the effects of EMDR. These sutdies have consistently found that EMDR effectively decreases/eliminates the symptoms of post traumatic stress for the majority of clients. Clients often report improvement in other associated symptoms such as anxiety. According to the EMDR International Association, the aim of EMDR treatment is to activate the most profound and comprehensive treatment effects in the shortest period of time. Research indicates that EMDR can be a very efficient and rapid treatment, taking fewer sessions as well as being less onerous or aversive to the client when compared to other treatments for trauma.
Numerous Mental Health organizations and certifying agencies throughout the world have endorsed EMDR as a highly effective treatment. The current treatment guidelines for the American Psychiatric Association and the International Society for Traumatic Stress Studies designate EMDR as an effective treatment for post traumatic stress. EMDR was also found effective by the U.S. Department of Veterans Affairs and the Department of Defense, the American Red Cross, major HMO's such as Kaiser Permanente, as well as such prestigious clinics as the Menninger Clinic. International agencies that have endorsed EMDR include the United Kingdom Department of Health, the Israeli National Council for Mental Health, and many other international health and government agencies.
What Kind of Problems Can EMDR Treat?
According to the December, 2005 Harvard Mental Health Letter ("Post traumatic Stress Without Trauma"), experiences not usually regarded as traumatic can cause the characteristic symptoms of post traumatic stress disorder (PTSD). The authors state that life events such as relationship problems, work stress, financial problems, school problems, health problems, or significant losses or life changes were as likely as traumatic events to cause symptoms typical of PTSD. Traumatic events may reduce the ability to cope with other forms of stress. Both traumatic experiences and overall distress may increase risk of developing PTSD symptoms after either a traumatic experience or a non-traumatic life event. This means that the symptoms of stress, whatever their causes, can be successfully treated with EMDR. Even people who are highly successful in their relationships and jobs may be prevented from reaching their full potential because of certain psychological barriers that cause excessive stress and anxiety. Such barriers usually stem from earlier life experiences that the client may not be fully aware of. For example, a successful executive may have great anxiety performing public speaking assignments due to earlier experiences in school in which he was humiliated or unduly criticized attempting to give a class presentation. Similarly, a high functioning manager may have trouble relating to his highly demanding and abusive boss due to earlier experiences with an abuse and controlling father. Such people may not suffer from PTSD but have significant issues that can be successfully resolved via EMDR.
In sum, EMDR is a psychotherapeutic approach that can accelerate change with respect to a broad range of issues. These include:
- Post-traumatic Stress Disorder, Phobias, Panic Disorder
- Generalized Anxiety related to various stressors at home or at work
- Grief and Loss, Eating Disorders, Body Image Issues
- Low Self-Esteem; Lack of Assertiveness; Difficulty Making Decisions
- Anger Problems; Stress Management Issues; Procrastination
- Substance Abuse
- Pain Disorders
- Stress-related physical complaints: Chronic Fatigue Syndrome, chronic headaches, fibromyalgia
- Relationship Difficulties: Marriage conflict; trust issues; intimacy problems
- Peak Performance: barriers to success in business, sports, and relationships