EMDR therapy for specific fears and phobias: the phobia protocol

This chapter illustrates how EMDR Therapy can be applied in the treatment of fears and specific phobias. These conditions are highly prevalent in the general population, and are characterized by an unreasonable and severe fear related to exposure to specific objects or situations, which tend to result in active avoidance of direct contact with these stimuli. Clients with specific phobias display commonalities with PTSD in that they often experience vivid and disturbing memories of earlier events associated with the beginning of their fears. Activation of these mental representations plays an important role not only in the symptomatology of fears and phobias, but also in the process contributing to the maintenance and aggravation of clients’ symptoms. EMDR Therapy has been shown to be capable of resolving such memories, alleviating clients’ fears, and successfully reducing clients’ avoidance tendencies (de Jongh et al., 1999, 2011; Doering et al., 2013). Like most other anxiety disorders, for specific phobia there are treatment approaches that have been found to be effective, particularly those with a cognitive behavioral signature. Although there always should be good reasons to deviate from such evidence-based treatment standards, EMDR has proven to fulfill a pivotal role in resolving memories of past events that started the fear or phobia, or those that still contribute to the severity of the client’s fear response (de Jongh, Ernst, Marques, & Hornsveld, 2013), particularly when these are likely to be activated when the clients are confronted with their phobic stimuli. Contrariwise, in many instances EMDR Therapy could profit from elements of CBT that add significant practical value and elevate the effectiveness of its use. That is the reason that
in the present phobia protocol, EMDR is used for the processing of memories, while cognitive behavioral procedures (e.g., applied tension and in vivo exposure)—that are meant to teach clients to confront their feared stimuli until they feel they have achieved a degree of self-mastery that is needed to feel comfortable with handling these situations—are included as well.