What is EMDR? And Does it Work to Help Reduce Anxiety?
We recently received a question on the site about EMDR and whether or not this type of therapy was effective in treating anxiety. EMDR stands for "eye movement desensitization and reprocessing." This therapy was "discovered" by Dr. Francine Shapiro in 1987. She went for a walk in the woods, preoccupied with anxious and disturbing thoughts. After moving her eyes back and forth, she found that her anxiety dissipated. Encouraged, she tried it out on her patients and reported that they were also helped by the procedure.
What Goes on During EMDR Treatment?
During EMDR, patients recount traumatic events and situations while paying attention to external stimulus. This is most commonly a stick or light that is moved back and forth as patients follow it with their eyes, however, other stimulus such as hand tapping or audio stimulation can also be used. According to the EMDR Institute, treatment consists of several different phases:
Phase 1 - Assessment and history - the therapist identifies causes of emotional distress including past traumatic events or current situations
Phase 2 - The therapist teaches the patient different strategies to handle emotional distress including imagery or other stress reducing methods to be used in between sessions
Phase 3 through 6 - The patient works to identify visual images related to the memory, a negative belief about the self and related emotions and physical reactions that occur because of the memory. The patient focuses on these things while also paying attention to the external stimulus being used and then to allow their mind to go blank, paying attention to what thoughts come to mind. This process is repeated several times during each session. Patients are also taught to replace negative thoughts with more positive thoughts during the session.
Phase 7 - The patient keeps a log throughout the week to document any emotional distress and what strategies were used to overcome it.
Phase 8 - Phase 8 is a review of the process thus far and determining if further treatment is needed.
The Rising Popularity of EMDR
There is no doubt that EMDR is receiving a lot of attention. The EMDR International Association provides indicates that in 2006, they reached 4,000 members and continue to grow. More than 20,000 practitioners have received training in this type of therapy. Even so, this type of therapy is still considered controversial and out of the mainstream by many mental health professionals. A number of studies have been completed and have shown this treatment to be effective in treating PTSD, however, critics point out the small sample size in these studies. Some organizations have issued statements or guidelines for using this type of treatment:
- The American Psychiatric Association (APA) has stated that this type of treatment may be helpful for those who have trouble talking about traumatic events.
- The Department of Veterans Affairs strongly recommend EMDR in the treatment of PTSD
What the Research Shows
There have been a number of controlled studies on the effectiveness of EMDR. According to an article in Scientific American:
- Patients receiving EMDR treatment showed more improvement than those who did not receive any treatment
- EMDR treatment was most effective in treating civilian PTSD (non-military related trauma)
- Patients may receive more benefits from EMDR than from listening only
- EMDR does not work better than cognitive behavior therapy or exposure therapy. Some studies show no difference in improvement between EMDR and exposure type therapies; that is, patients improved with both types.
Some scientists are skeptical about the results of these studies, or at least cautious and interested in seeing further research. Other researchers believe that the eye movements are not necessary for treatment. Therapists have patients visualize the traumatic event or situation over and over while moving their eyes back and forth - the researchers believe that it is the visualizing of the event - repeated exposure - that helps to dissipate the anxiety rather than the eye movements.
What do you think? Have you had experience with this type of therapy? Please share your thoughts.
"Does EMDR Work? And if so, Why? A Critical Review of Controlled Outcome and Dismantling Research, 1999, Jan-Apr, SP Cahill et al, Medical University of South Carolina: http://www.ncbi.nlm.nih.gov/pubmed/10225499
"EMDR: Taking a Closer Look," 2008, Jan 3, Scott O. Lilienfeld, Scientific American: http://www.scientificamerican.com/article.cfm?id=emdr-taking-a-closer-look&page=2
"Frequently Asked Questions," Date Unknown, Staff Writer, EMDR Institute: http://www.emdr.com/faqs.html
"The History of EMDR International Association," Date Unknown, Staff Writer, EMDR International Association: http://www.emdria.org/displaycommon.cfm?an=1&subarticlenbr=3