EMDR as a Special Form of Ego State Psychotherapy
Eye Movement Desensitization and Reprocessing (EMDR) from an Ego State Perspective
We shall now review the highlights of the EMDR technique, looking at it from the perspective of the ego state model described above.
The ego state bridge and EMDR
The first step in doing an ego state bridge is to identify and amplify the problematic ego state. In EMDR, the patient is asked the following questions: What is the problem or symptom you want relief from? What image represents the problem to you? What cognition about yourself do you have associated with that image? What affect do you experience when you have that image and cognition? What body sensations do you have when you have that image and cognition?
Clearly, these questions are an attempt to elucidate several, although not all, of the components of an ego state in a very systematic fashion. The patient is asked to focus on each of these components sequentially, which will tend to amplify all of them, both separately and together. When the patient is asked to assign a numerical evaluation to the intensity of affect or cognition, that also tends to amplify those ego state components. When the patient is asked to bring all of these components together, i.e. the image, the cognition, the affect, and the sensation, he is in effect being asked to immerse himself in the ego state that holds all of those components. This is the basis for developing an ego state bridge.
Then the EMDR processing begins, with the patient being invited to let thoughts, images, body sensations, or feelings unfold spontaneously, while simultaneously attending to the left/right alternations (eye movement, sound, or touch) presented to him. Images, thoughts, feelings and memories do unfold, eventually leading, with repeated sets of processing, to uncovering traumatic memories and/or to reduced anxiety or affect associated with the presenting experience. This is the desensitization phase of the EMDR therapy. The unfolding of these associational linkages is exactly what one would expect from the ego state model — with one exception. No specific effort is made to help the patient dissociate or minimize the anxiety that previously had contributed to the maintenance of the dissociative barriers among the various ego state components. Yet important associational connections do emerge, with or without intense affect.
Shapiro (1995) herself describes this process as accessing the neuro network where the problem resides. It could just as easily be described as accessing the biological infrastructure for the ego state with the presenting problem; the ego state is the neuro network. It is remarkable that EMDR appears to transcend the dissociative barriers that hypnotic techniques are sometimes unable to resolve.