Eye Movement Desensitization and Reprocessing
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Eye Movement Desensitization and Reprocessing
Overview and General Description
EMDR is an acronym for Eye Movement Desensitization and Reprocessing. It is an innovative clinical treatment that has successfully helped over a million individuals who have survived trauma, including sexual abuse, domestic violence, combat, crime, and those suffering from a number of other complaints including depressions, addictions, phobias and a variety of self-esteem issues.
EMDR is a complex approach to psychotherapy that integrates many of the successful elements of a range of therapeutic approaches in combination with eye movements or other forms of rhythmical stimulation in ways that stimulate the brain’s information processing system. With EMDR therapy it is unnecessary to delve into decades-old psychological material, but rather, by activating the information-processing system of the brain, people can achieve their therapeutic goals at a rapid rate, with recognizable changes that don’t disappear over time.
Fourteen controlled studies support the efficacy of EMDR, making it the most thoroughly researched method ever used in the treatment of trauma. The most recent 5 studies with individuals suffering from events such as rape, loss of a loved one, accidents, natural disasters, etc. have found that 84-90% no longer had post-traumatic stress disorder after only three treatment sessions. A recent study financed by Kaiser Permanente revealed that EMDR was twice as effective in half the amount of time compared to the standard traditional care. However, clients and clinicians should note that EMDR is not a race. While many people show dramatic responses in a short amount of time, there are also those who will progress more slowly and that the slower progression is not abnormal. For instance, those with multiple traumas such as molestation and combat veterans will generally need longer treatment. The one study offering a full course of treatment to combat veterans found that after twelve sessions, 77% no longer had PTSD. Just as in any therapy, we all progress at the rate appropriate to the individual and the clinical situation.
The major significance of EMDR is that it allows the brain to heal its psychological problems at the same rate as the rest of the body is healing its physical ailments. Because EMDR allows minds and body to heal at the same rate, it is effectively making time irrelevant in therapy. Given its wide application, EMDR promises to be the therapy of the future.
Dr. Francine Shapiro is the creator of EMDR. She is a licensed psychologist and a senior research fellow at the Mental Research Institute in Palo Alto. She is the Executive Director of the EMDR Institute, which trains clinicians in the EMDR approach. She is the recipient of the 1993 Distinguished Scientific Achievement Award presented by the California Psychological Association.
EMDR is an acronym for Eye Movement Desensitization and Reprocessing. It is an innovative clinical treatment that has successfully helped over a million individuals who have survived trauma, including sexual abuse, domestic violence, combat, crime, and those suffering from a number of other complaints including depressions, addictions, phobias and a variety of self-esteem issues.
EMDR is a complex approach to psychotherapy that integrates many of the successful elements of a range of therapeutic approaches in combination with eye movements or other forms of rhythmical stimulation in ways that stimulate the brain’s information processing system. With EMDR therapy it is unnecessary to delve into decades-old psychological material, but rather, by activating the information-processing system of the brain, people can achieve their therapeutic goals at a rapid rate, with recognizable changes that don’t disappear over time.
Fourteen controlled studies support the efficacy of EMDR, making it the most thoroughly researched method ever used in the treatment of trauma. The most recent 5 studies with individuals suffering from events such as rape, loss of a loved one, accidents, natural disasters, etc. have found that 84-90% no longer had post-traumatic stress disorder after only three treatment sessions. A recent study financed by Kaiser Permanente revealed that EMDR was twice as effective in half the amount of time compared to the standard traditional care. However, clients and clinicians should note that EMDR is not a race. While many people show dramatic responses in a short amount of time, there are also those who will progress more slowly and that the slower progression is not abnormal. For instance, those with multiple traumas such as molestation and combat veterans will generally need longer treatment. The one study offering a full course of treatment to combat veterans found that after twelve sessions, 77% no longer had PTSD. Just as in any therapy, we all progress at the rate appropriate to the individual and the clinical situation.
The major significance of EMDR is that it allows the brain to heal its psychological problems at the same rate as the rest of the body is healing its physical ailments. Because EMDR allows minds and body to heal at the same rate, it is effectively making time irrelevant in therapy. Given its wide application, EMDR promises to be the therapy of the future.
Dr. Francine Shapiro is the creator of EMDR. She is a licensed psychologist and a senior research fellow at the Mental Research Institute in Palo Alto. She is the Executive Director of the EMDR Institute, which trains clinicians in the EMDR approach. She is the recipient of the 1993 Distinguished Scientific Achievement Award presented by the California Psychological Association.
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EMDR is a complex approach to psychotherapy which combines salient elements of the major modalities (e.g., psychodynamic, behavioral, cognitive, physiological, and interactional). Although the eye movement, or other forms of dual stimulation, has garnered the most attention, the approach actually consists of eight phases and numerous procedural elements that all contribute to its efficacy (see Shapiro, 1995a). Far from being viewed as a panacea, EMDR should be used only within a comprehensive treatment plan by a licensed and trained clinician who is experienced in working with the targeted population.
To date, fourteen controlled studies of EMDR have been completed, making it the most intensively researched of any approach for the treatment of trauma. Two of these studies reported mixed results (Boudewyns et al., 1993; Pitman, et al., 1996) and one obtained null results (Jensen, 1994). Five demonstrated superiority of EMDR over one or more alternative treatments (Boudewyns & Hyer, 1996; Carlson et al., 1998; Marcus et al. ,1996; Scheck et al., 1998; Vaughan, Armstrong et al., 1994) and two found EMDR to be more effective than a wait-list control (Rothbaum, 1997; Wilson, Becker & Tinker, 1995 and 1997). In addition, substantial alleviation of PTSD symptomatology was reported in two controlled component analyses (Renfrey & Spates, 1994; Wilson, Silver, Covi, & Foster, 1996), as well as in numerous case studies. The most recent and rigorously controlled studies with single trauma victims indicate that after three sessions, 84 - 90% of the subjects no longer meet the criteria for PTSD.
Regardless of the primary psychological orientation, clinicians would generally agree that most psychological complaints stem from the impact of earlier life experiences. The EMDR protocols guide clinicians to utilize specific history-taking procedures to ascertain (a) what earlier life experiences have contributed to the symptomatology, (b) what present triggers elicit the disturbance, and (c) what behaviors and skills are necessary to prepare the client for appropriate future action. For instance, the clinician identifies the specific events which taught the client such negative self-assessments as: I'm not good enough; I'm not lovable; I can't succeed; I'm worthless; I can't trust, etc. The assumption is that these earlier life experiences are stored in a dysfunctional fashion, contributing to the client's inappropriate reactions in the present. Consistent with recent conjectures regarding memory (van der Kolk, 1994), it is believed that experiences which provide the underpinnings of pathology have been stored without sufficient processing. When these earlier experiences are brought to mind, they retain a significant level of disturbance, manifested by both emotions and physical sensations. Reprocessing these experiences with EMDR allows the client to gain insight, shift cognitive assessment, incorporate ecological emotions and body reactions, as well as adopt more adaptive behaviors.
<a href="http://www.emdr.com" target="_blank">http://www.emdr.com</a>
To date, fourteen controlled studies of EMDR have been completed, making it the most intensively researched of any approach for the treatment of trauma. Two of these studies reported mixed results (Boudewyns et al., 1993; Pitman, et al., 1996) and one obtained null results (Jensen, 1994). Five demonstrated superiority of EMDR over one or more alternative treatments (Boudewyns & Hyer, 1996; Carlson et al., 1998; Marcus et al. ,1996; Scheck et al., 1998; Vaughan, Armstrong et al., 1994) and two found EMDR to be more effective than a wait-list control (Rothbaum, 1997; Wilson, Becker & Tinker, 1995 and 1997). In addition, substantial alleviation of PTSD symptomatology was reported in two controlled component analyses (Renfrey & Spates, 1994; Wilson, Silver, Covi, & Foster, 1996), as well as in numerous case studies. The most recent and rigorously controlled studies with single trauma victims indicate that after three sessions, 84 - 90% of the subjects no longer meet the criteria for PTSD.
Regardless of the primary psychological orientation, clinicians would generally agree that most psychological complaints stem from the impact of earlier life experiences. The EMDR protocols guide clinicians to utilize specific history-taking procedures to ascertain (a) what earlier life experiences have contributed to the symptomatology, (b) what present triggers elicit the disturbance, and (c) what behaviors and skills are necessary to prepare the client for appropriate future action. For instance, the clinician identifies the specific events which taught the client such negative self-assessments as: I'm not good enough; I'm not lovable; I can't succeed; I'm worthless; I can't trust, etc. The assumption is that these earlier life experiences are stored in a dysfunctional fashion, contributing to the client's inappropriate reactions in the present. Consistent with recent conjectures regarding memory (van der Kolk, 1994), it is believed that experiences which provide the underpinnings of pathology have been stored without sufficient processing. When these earlier experiences are brought to mind, they retain a significant level of disturbance, manifested by both emotions and physical sensations. Reprocessing these experiences with EMDR allows the client to gain insight, shift cognitive assessment, incorporate ecological emotions and body reactions, as well as adopt more adaptive behaviors.
<a href="http://www.emdr.com" target="_blank">http://www.emdr.com</a>
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....what is new in EMDR does not appear to be helpful, and what is helpful is what we already know about relaxation, education, and psychotherapy.*
EMDR is a therapeutic technique in which the patient moves his or her eyes back and forth, hither and thither, while concentrating on "the problem." The therapist waves a stick or light in front of the patient and the patient is supposed to follow the moving stick or light with his or her eyes. The therapy was discovered by therapist Dr. Francine Shapiro while on a walk in the park. (Her doctorate was earned at the now defunct and never accredited Professional School of Psychological Studies. Her undergraduate degree is in English literature.*) It is claimed that EMDR can "help" with “phobias, generalized anxiety, paranoid schizophrenia, learning disabilities, eating disorders, substance abuse, and even pathological jealousy” (Lilienfeld 1996), but its main application has been in the treatment of post traumatic stress disorder (PTSD). No one has been able to adequately explain how EMDR is supposed to work. Some think it works something like acupuncture (which allegedly unblocks chi): rapid eye movements allegedly unblock "the information-processing system." Some think it works by a sort of ping-pong effect between the right and left sides of the brain, which somehow restructures memory. Or perhaps it works, as one therapist suggested, by the rapid eye movements sending signals to the brain which somehow tame and control the naughty part of the brain which had been causing the psychological problems. I heard the latter explanation on a television news report (December 2, 1994). The television station provided a nice visual of a cut-away head with sparks flying in the brain. The anchorman warned us not to try this at home, that only licensed mental health professionals were qualified to give this kind of therapy. One such professional is Dr. Ann T. Viviano who thinks EMDR works this way: "The client, by following a moving light with their eyes, activates the healing process of the brain, much as what occurs in sleep. As a result, the painful memories are re-processed and the original beliefs which sprang up from them are eliminated. New, healthy beliefs replace these." The healing occurs by activating the healing process.
Evidence for the effectiveness of EMDR is not much stronger than the theoretical explanations for how EMDR allegedly "works." The evidence has the virtue of being consistent, unlike the theoretical explanations, but it is mainly anecdotal and very vague. It has not been established beyond a reasonable doubt by any controlled studies that any positive effects achieved by an EMDR therapist are not likely due to chance, the placebo effect, patient expectancy, posthypnotic suggestion, other aspects of the treatments besides the eye movement aspect, etc. This is not to say that there have not been controlled studies of EMDR. Dr. Shapiro cites quite a few, including her own. The reader is invited to look at her summaries of the research and determine for him or herself just how adequate the evidence is in support of EMDR as the main causal agent in recovery from PTSD. The latest study by Wilson, Becker and Tinker is to be published in The Journal of Consulting and Clinical Psychology. It reports a "significant improvement" in PTSD subjects treated with EMDR. The study also provides significant evidence that spontaneous healing cannot account for this improvement. Nevertheless, the study is unlikely to convince critics that EMDR is the main causal agent in measured improvement of PTSD subjects. I suspect that until a study is done which isolates the eye movement part from other aspects of the treatment, critics will not be satisfied. It may well be that those using EMDR are effecting the cures they claim and thereby benefiting many victims of horrible experiences such as rape, war, terrorism, murder or suicide of a loved one, etc. It may well be that those using EMDR are directing their patients to restructure their memories, so that the horrible emotive aspect of an experience is no longer associated with the memory of the experience. But, for now, the question still remains, whether the rapid eye movement part of the treatment is essential. In fact, one of the control studies cited by Shapiro seems counter-indicative:
In a controlled component analysis study of 17 chronic outpatient veterans, using a crossover design, subjects were randomly divided into two EMDR groups, one using eye movement and a control group that used a combination of forced eye fixation, hand taps, and hand waving. Six sessions were administered for a single memory in each condition. Both groups showed significant decreases in self-reported distress, intrusion, and avoidance symptoms (Pitman et al. 1996).
Maybe hand taps will work just as well as eye movements. According to one EMDR practitioner, Dr. Edward Hume,
...taps to hands, right and left, sounds alternating ear-to-ear, and even alternating movements by the patient can work instead. The key seems to be the alternating stimulation of the two sides of the brain.*
According to Dr. Hume, Shapiro now calls the treatment Reprocessing Therapy and says that eye movements aren't necessary for the treatment! Maybe none of these movements are needed to restructure memory. In short, EMDR is a scientifically controversial technique at present. This has not prevented thousands of practitioners from being certificated to practice EMDR by Shapiro and disciples.
EMDR is controversial and not accepted practice by the American Psychological Association. Advocates disagree, of course, and claim that EMDR is "a widely validated treatment for Post Traumatic Stress Disorder" and other ailments such as "traumatic memories of war, natural disaster, industrial accidents, highway carnage, crime, terrorism, sexual abuse, rape and domestic violence." [David Drehmer, Ph.D., Licensed Clinical Psychologist & Director, Performance Enhancement Laboratory, Associate Professor of Management, DePaul University, personal correspondence.] So far, the validation referred to by Dr. Drehmer is mainly in the form of unconvincing research studies and testimonials by practitioners relating anecdotes and their interpretations of those anecdotes. What is needed is not proof that PTSD subjects are being helped by the treatment, but that it is the eye movement part of the treatment that is essential. Once that is established, a theory as to how it works would be most gratifying. At present, we are being given theories to explain something which we can't yet be sure is even occurring: that eye movements are restructuring memory. If it turns out that that claim is true, I suggest it will have significance far beyond the treatment of PTSD subjects.
Finally, when evidence came in that therapists were getting similar results to standard EMDR with blind patients whose therapists used tones and hand-snapping instead of finger-wagging, Shapiro softened her stance a bit. She admits that eye movement is not essential to eye movement desensitization processing, and claims attacks on her are ad hominem and without merit.
update (Dec 20,2000): Ranae Johnson has founded the Rapid Eye Institute on a blueberry farm in Oregon where she teaches Rapid Eye Technology. This amazing new therapy is used "to facilitate releasing and clearing of old programming, opening the way to awareness of our joy and happiness." It helps us "find light and spirituality within us that has always been there." Apparently, people are paying some $2,000 for the training and all the blueberries you can eat.
<a href="http://skepdic.com/emdr.html" target="_blank">http://skepdic.com/emdr.html</a>
EMDR is a therapeutic technique in which the patient moves his or her eyes back and forth, hither and thither, while concentrating on "the problem." The therapist waves a stick or light in front of the patient and the patient is supposed to follow the moving stick or light with his or her eyes. The therapy was discovered by therapist Dr. Francine Shapiro while on a walk in the park. (Her doctorate was earned at the now defunct and never accredited Professional School of Psychological Studies. Her undergraduate degree is in English literature.*) It is claimed that EMDR can "help" with “phobias, generalized anxiety, paranoid schizophrenia, learning disabilities, eating disorders, substance abuse, and even pathological jealousy” (Lilienfeld 1996), but its main application has been in the treatment of post traumatic stress disorder (PTSD). No one has been able to adequately explain how EMDR is supposed to work. Some think it works something like acupuncture (which allegedly unblocks chi): rapid eye movements allegedly unblock "the information-processing system." Some think it works by a sort of ping-pong effect between the right and left sides of the brain, which somehow restructures memory. Or perhaps it works, as one therapist suggested, by the rapid eye movements sending signals to the brain which somehow tame and control the naughty part of the brain which had been causing the psychological problems. I heard the latter explanation on a television news report (December 2, 1994). The television station provided a nice visual of a cut-away head with sparks flying in the brain. The anchorman warned us not to try this at home, that only licensed mental health professionals were qualified to give this kind of therapy. One such professional is Dr. Ann T. Viviano who thinks EMDR works this way: "The client, by following a moving light with their eyes, activates the healing process of the brain, much as what occurs in sleep. As a result, the painful memories are re-processed and the original beliefs which sprang up from them are eliminated. New, healthy beliefs replace these." The healing occurs by activating the healing process.
Evidence for the effectiveness of EMDR is not much stronger than the theoretical explanations for how EMDR allegedly "works." The evidence has the virtue of being consistent, unlike the theoretical explanations, but it is mainly anecdotal and very vague. It has not been established beyond a reasonable doubt by any controlled studies that any positive effects achieved by an EMDR therapist are not likely due to chance, the placebo effect, patient expectancy, posthypnotic suggestion, other aspects of the treatments besides the eye movement aspect, etc. This is not to say that there have not been controlled studies of EMDR. Dr. Shapiro cites quite a few, including her own. The reader is invited to look at her summaries of the research and determine for him or herself just how adequate the evidence is in support of EMDR as the main causal agent in recovery from PTSD. The latest study by Wilson, Becker and Tinker is to be published in The Journal of Consulting and Clinical Psychology. It reports a "significant improvement" in PTSD subjects treated with EMDR. The study also provides significant evidence that spontaneous healing cannot account for this improvement. Nevertheless, the study is unlikely to convince critics that EMDR is the main causal agent in measured improvement of PTSD subjects. I suspect that until a study is done which isolates the eye movement part from other aspects of the treatment, critics will not be satisfied. It may well be that those using EMDR are effecting the cures they claim and thereby benefiting many victims of horrible experiences such as rape, war, terrorism, murder or suicide of a loved one, etc. It may well be that those using EMDR are directing their patients to restructure their memories, so that the horrible emotive aspect of an experience is no longer associated with the memory of the experience. But, for now, the question still remains, whether the rapid eye movement part of the treatment is essential. In fact, one of the control studies cited by Shapiro seems counter-indicative:
In a controlled component analysis study of 17 chronic outpatient veterans, using a crossover design, subjects were randomly divided into two EMDR groups, one using eye movement and a control group that used a combination of forced eye fixation, hand taps, and hand waving. Six sessions were administered for a single memory in each condition. Both groups showed significant decreases in self-reported distress, intrusion, and avoidance symptoms (Pitman et al. 1996).
Maybe hand taps will work just as well as eye movements. According to one EMDR practitioner, Dr. Edward Hume,
...taps to hands, right and left, sounds alternating ear-to-ear, and even alternating movements by the patient can work instead. The key seems to be the alternating stimulation of the two sides of the brain.*
According to Dr. Hume, Shapiro now calls the treatment Reprocessing Therapy and says that eye movements aren't necessary for the treatment! Maybe none of these movements are needed to restructure memory. In short, EMDR is a scientifically controversial technique at present. This has not prevented thousands of practitioners from being certificated to practice EMDR by Shapiro and disciples.
EMDR is controversial and not accepted practice by the American Psychological Association. Advocates disagree, of course, and claim that EMDR is "a widely validated treatment for Post Traumatic Stress Disorder" and other ailments such as "traumatic memories of war, natural disaster, industrial accidents, highway carnage, crime, terrorism, sexual abuse, rape and domestic violence." [David Drehmer, Ph.D., Licensed Clinical Psychologist & Director, Performance Enhancement Laboratory, Associate Professor of Management, DePaul University, personal correspondence.] So far, the validation referred to by Dr. Drehmer is mainly in the form of unconvincing research studies and testimonials by practitioners relating anecdotes and their interpretations of those anecdotes. What is needed is not proof that PTSD subjects are being helped by the treatment, but that it is the eye movement part of the treatment that is essential. Once that is established, a theory as to how it works would be most gratifying. At present, we are being given theories to explain something which we can't yet be sure is even occurring: that eye movements are restructuring memory. If it turns out that that claim is true, I suggest it will have significance far beyond the treatment of PTSD subjects.
Finally, when evidence came in that therapists were getting similar results to standard EMDR with blind patients whose therapists used tones and hand-snapping instead of finger-wagging, Shapiro softened her stance a bit. She admits that eye movement is not essential to eye movement desensitization processing, and claims attacks on her are ad hominem and without merit.
update (Dec 20,2000): Ranae Johnson has founded the Rapid Eye Institute on a blueberry farm in Oregon where she teaches Rapid Eye Technology. This amazing new therapy is used "to facilitate releasing and clearing of old programming, opening the way to awareness of our joy and happiness." It helps us "find light and spirituality within us that has always been there." Apparently, people are paying some $2,000 for the training and all the blueberries you can eat.
<a href="http://skepdic.com/emdr.html" target="_blank">http://skepdic.com/emdr.html</a>
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Join Date: Apr 2002
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Mg....
I will..............let me think it through a bit. He also counsels me...I think you need the two to get anywhere with it. I started just for my panic and he really helped me in many ways. I will get my brain out tomorrow and try to write a bit about it
Love Kitty
I will..............let me think it through a bit. He also counsels me...I think you need the two to get anywhere with it. I started just for my panic and he really helped me in many ways. I will get my brain out tomorrow and try to write a bit about it
Love Kitty
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Join Date: Jul 2002
Location: British Cloumbia, Canada
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I have done this form of therapy too...
Hi,
I have been for this therapy. My Dr. reccomended a *stress and anxiety* clinic and that is where I found about about it.
Originally, the brain two sides of the brain were stimulated utilizinglight in the left and right eyes. The theory being that one side of the brain processes and the other side stores. Unfinished business needs to be brought out and processed so that it can be properly stored. By stimlating the brain in this way many memories can come out (both consciously and un-consciously). It is felt on a very emotional level.
My therapist used painless electrodes strapped to my thighs. This stimulates the brain in the same way be is less work intensive for the therapist and thus she can concentrate more on the patient. The T takes down your background and starts from early memories forward until they do not cause anxiety. It is amazing. You close your eyes and think about what ever she directs you to, such as the feeling that you had when your brother forced you outside (or whatever). You work on this until your anxiety level is neutral, then work on the next. You close your eyes with the electrodes pulsing, and images, dreams and emotions come out from the depths of your brain. You can even remember things you'd forgotten! I love it.
I went for a few months and was doing well, but due to my unemployment (the result of my problems) i could not afford it any longer
I hope that answers some basic questions. Feel free to ask anything else about it.
Lynda :okay:
I have been for this therapy. My Dr. reccomended a *stress and anxiety* clinic and that is where I found about about it.
Originally, the brain two sides of the brain were stimulated utilizinglight in the left and right eyes. The theory being that one side of the brain processes and the other side stores. Unfinished business needs to be brought out and processed so that it can be properly stored. By stimlating the brain in this way many memories can come out (both consciously and un-consciously). It is felt on a very emotional level.
My therapist used painless electrodes strapped to my thighs. This stimulates the brain in the same way be is less work intensive for the therapist and thus she can concentrate more on the patient. The T takes down your background and starts from early memories forward until they do not cause anxiety. It is amazing. You close your eyes and think about what ever she directs you to, such as the feeling that you had when your brother forced you outside (or whatever). You work on this until your anxiety level is neutral, then work on the next. You close your eyes with the electrodes pulsing, and images, dreams and emotions come out from the depths of your brain. You can even remember things you'd forgotten! I love it.
I went for a few months and was doing well, but due to my unemployment (the result of my problems) i could not afford it any longer
I hope that answers some basic questions. Feel free to ask anything else about it.
Lynda :okay:
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Thanks Lynda,
It sounds very interesting. Most people I know who have tried it have positive things to say.
Please continue to share anything that may be helpful to others.
Hugs,
MG
It sounds very interesting. Most people I know who have tried it have positive things to say.
Please continue to share anything that may be helpful to others.
Hugs,
MG
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Join Date: Aug 2002
Location: Chicago, Illinois
Posts: 176
It has been a long time since I posted about EMDR. I just wanted you all to know I think it has really helped me. With all that is going on with the A......he has managed to keep me more calm than I would have been. I admit we have not done the process for a bit and I feel that I need it as I can feel the crazies trying to rip right through my Klonopin!
Next week we pickup again. I think it has been useful.
Love Kitty
Next week we pickup again. I think it has been useful.
Love Kitty
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