In current clinical settings, I see EMDR being used in one of four ways, which reflect the Four Faces of EMDR that I will be referencing throughout the book:

1.)                Protocol-Oriented EMDR: Strict adherence to the current EMDRIA definition of EMDR (EMDR International Association, 2009), influenced largely by the protocols and procedures as developed by founder Dr. Francine Shapiro. In this “face,” EMDR is clearly viewed as an approach to psychotherapy, and Shapiro’s adaptive information model (2001) is regarded as the sole theoretical guide. Many practitioners described by this face use EMDR alongside other interventions but only if fidelity to the Shapiro protocols is maintained for the EMDR component. Within this face, as with all of the faces, there are different degrees of flexibility (e.g., some practitioners believe that eye movements are the only form of bilateral stimulation that should be used, and others are more open to the other forms; some insist on 90-minute sessions as Shapiro recommends, and others are willing to work within the 50-minute clinical hour).

2.)                Flexible EMDR: Use of Shapiro’s original protocols and procedures with modifications made by the clinician to better suit the clinician’s personal style or to better accommodate the client’s learning/processing styles and other unique needs. With this face, EMDR is still largely regarded as an approach to psychotherapy. However, many who practice flexible EMDR choose to incorporate other models of treatment conceptualization aside from Shapiro’s adaptive information processing model (2001). People who practice flexible EMDR are more likely than Face 1 practitioners to use the general EMDR approach to psychotherapy alongside of another approach to psychotherapy (e.g., 12 Step facilitation, ego state therapy).

3.)                EMDR as Technique: Same as Number 2 in terms of using the original Shapiro protocols and procedures with necessary modifications; however, with this face, EMDR is simply used as an adjunctive technique or procedure to another psychotherapeutic orientation (e.g., Gestalt, 12 Step, client-centered therapy, choice theory, psychoanalysis). With this face, EMDR does not dominate or guide the treatment. Some Face 3 practitioners stay true to Shapiro’s eight-phase main protocol, whereas others jump around as it suits their main orientation.

4.)                EMDR-Informed Interventions: Use of EMDR-informed interventions or evolutions of original EMDR elements into a new technique or approach to therapy. May also include the use of bilateral stimulation as a desensitization process, similar to the original EMD. 

I will go into a more detailed explanation of each face of EMDR in this chapter. These four faces are meant to be general classifications; of course I realize there are overlaps and some practitioners may find themselves meeting criteria for two or more of the faces. That’s okay. In fact, I feel that is healthy because it shows adaptability, an essential trait when it comes to working with the complex or oft-labeled “impossible” client (Duncan, Hubble, & Miller, 1997).  Many don’t realize this, but adaptability is an essential part of what constitutes an evidence-based practice as defined by the American Psychological Association as of 2006.

(c) Jamie Marich, 2011