Eye Movement Desensitization & Reprocessing Therapy (EMDR)
Troubling thoughts have a way of repeatedly intruding into our lives, but just such an event sparked the development of a new therapy called Eye Movement Desensitization & Reprocessing (EMDR). EMDR is now offered as a treatment option for post-traumatic stress disorder.
The story begins in 1987 with a walk in the park. Psychologist Dr. Francine Shapiro was preoccupied with a number of troubling thoughts. At some point during her walk she became aware that these thoughts had simply disappeared. Moreover, when she recalled them, they appeared far less of an issue than before. Applying her knowledge of psychology to the task, Dr. Shapiro noted that rumination continues unless some action is taken, yet her own experience suggested troubling thoughts had gone away without effort. However, when worrying, she recalled that her eyes had been moving from side to side, a factor she considered had enabled her to process and in some way reconstruct her troubling thoughts. By 1989, and after a series of experiments, Shapiro produced the first of several academic papers and books on EMDR. In this Sharepost I outline the basic principles of EMDR and some of the reasons why opinion is so polarised as to its effectiveness.
The aim of EMDR is to desensitize the individual to images, thoughts and negative emotions following trauma, and to replace these with more adaptive coping mechanisms. The basic therapeutic procedure requires the client to hold in mind their traumatic thoughts whilst following the therapist's finger, usually from left to right. Sets of approximately 30 movements at a time are used. A particular set of images and thoughts will be repeated until the client feels no emotional or physical response. One complete session may last for up to 90 minutes, with several sessions required overall.
Shapiro suggests that traumatic memories are stored in the way they were captured. Effectively they become linked with previously stored material and become stuck in memory. Shapiro originally pointed out the similarities between rapid eye movement (REM) sleep and EMDR. Memories of events tend to be processed during REM sleep and this helps integrate them into memory. Therefore, all the sensory events such as the sounds, smells, pain and emotional distress associated with trauma become frozen within a neural mesh involving different areas of the brain. This, she says, explains why PTSD sufferers relive the moment of trauma by just one sensation being triggered.
Dr. Shapiro claims that the alternating eye movements of EMDR simulate REM sleep. She believes this has the effect of stimulating similar mental processes that help store memories and this allows the therapist to access and unpick the issues that lead to the client revisiting their trauma. Whether eye movements actually help with this is a matter of some debate. Several studies acknowledge the efficacy of EMDR but have failed to establish the necessity of eye movements, preferring to see it as little more than a variation on imagery, a well known therapeutic tool.
Although there appears to be evidence both for and against the efficacy of EMDR, well designed randomized controlled studies have reported rather disappointing results. As a result some writers have attacked EMDR as being little more than a pseudoscience. Others have said that EMDR is nothing new, but is being packaged as though it is. Overall, despite the fact that over 25,000 practitioners now use EMDR, it is probably the lack of a theoretical basis that has undermined its credibility within the wider scientific community.
There are however very many supporters of EMDR. The fact that EMDR appears to work in some contexts, or at least with some people is, to mind, sufficient to encourage more well controlled research and to explore its theoretical basis further.
If you would like to know more about EMDR, please visit the EMDR Institute Website.
EMDR Institute http://www.emdr.com
Barlow, D.H. (2002) Anxiety and its Disorders (2nd ed.). New York: Guildford Press.
Herbert, J., Lilienfeld, S., Lohr, J., Montgomery, R., O'Donohue, W., Rosen, G., & Tolin, D. (2000). Science and Pseudo-science in the Development of EMDR. Clinical Psychology Review, 20, 945-971.