Eye Movement Desensitization and Reprocessing – EMDR

Eye Movement Desensitization and Reprocessing (EMDR) is not a new form of mental health therapy and throughout its history, it has been the subject of controversy since first introduced by psychologist Dr. Francine Shapiro in 1987.

EMDR was intended as a treatment of Post-Traumatic Stress Disorder (PTSD) for adult survivors of sexual assault and physical abuse, including past child abuse and rape victims. This article isn’t meant to be a fully inclusive report on EMDR, but only as an overview and indicator of where other information on the subject can be obtained on the Internet.

In the 1990’s, EMDR was an internationally-recognized form of neurology-based psychotherapy based upon the influence of the sleep stage of rapid eye movement  (REM) where, according to Shapiro and others, memory forms and learning takes place. While this is undisputed, part of the EMDR controversy stems from Shapiro’s hypothesis that REM can be used to unlearn emotionally disturbing recollections in a person’s waking state, of traumatic events. Today, Shapiro is a Senior Research Fellow at the Mental Research Institute, Palo Alto, California, Executive Director of the EMDR Institute, Watsonville, CA, and founder and President Emeritus of the EMDR Humanitarian Assistance Programs. As in 1987, she continues to teach and practice the technique of EMDR.

A bit like Brussels sprouts, EMDR appears to be one of those things that is either loved or hated. Some mental health and addiction professionals believe that the academic research and literature supports  EMDR  as an effective and therapeutic technique like cognitive behavioral therapy (CBT), the “gold standard” of psychotherapy since its introduction by Albert Ellis more than two decades ago. Shapiro originally proposed that, although a number of different neurological and psychological conditions lie at the core of EMDR, the eye movements are essential constructs to the therapy’s effectiveness because they produce neurological and physiological changes in the brain that aid in the processing of specific trauma memories being treated. Detractors of EMDR maintain that the eye movements are merely neuropsychological “wild cards,” completely unnecessary, and that EMDR is simply a form of progressive desensitization to the normal recollection of painful memories.

EMDR is really better described as a therapy process rather than as a single therapeutic tool since it has eight distinct stages that range from a basic goal-setting stage to the final re-evaluation stage to ascertain whether the process has been successful in the recollection and then neutralization of what were once unbearably painful memories of a traumatic event. The professional, over these eight stages, leads the patient through focusing on specific eye movements that are associated with learning and memory. These are rapid eye movements that occur naturally in deep sleep. Finally, the therapist helps the patient recall painful memories without feeling distressed.

Since veterans of the United States Armed Forces began to return from the war in Iraq and Afghanistan with not only horrific physical disabilities but with full-blown Post-Traumatic Stress Disorder and/or substance dependence, EMDR has seen resurgence as a therapeutic tool to assist these service members in coping with their symptoms. Since the conflicts in the Middle East show no signs of abating and the median age of the US warriors continues to decrease to adolescents, their abilities to cope with their distress also decrease. The co-morbidity of PTSD and addiction is being rigorously evaluated by the offices of the Surgeons General of each service branch. Whether or not EMDR can go the distance in alleviating PTSD symptoms and substance addiction among veterans has yet to be determined. The technique is rarely practiced in military mental health clinics simply because few, if any, uniformed clinicians are familiar with it – much less certified to conduct it. Instead, top-notch military professionals proficient in CBT, addiction evaluation and recovery, and state-of-the-art psychiatric treatment lead the way in providing the nation’s pivotal forms of treatment that our veterans deserve. EMDT is a “tool in the toolbox” for any therapist treating trauma victims who, through no fault of their own, urgently need help.