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Frequently Asked Questions about EMDR
HOW WAS EMDR DEVELOPED?
In 1987, psychologist Francine Shapiro
discovered, by chance, that her voluntary eye movements reduced the intensity of
negative, upsetting thoughts. Dr. Shapiro studied the impact of EMDR on reducing
the symptoms of posttraumatic stress disorder (PTSD) in Vietnam combat veterans
and victims of sexual assault. She found that this new method showed promise in
decreasing the nightmares, flashbacks, and intrusive negative thoughts of the
participants in her investigation.
Since 1989, EMDR has developed through the
contributions of trained clinicians and researchers from all over the world.
EMDR is now a complex method that brings together elements from the major
clinical theoretical orientations, including psychodynamic, cognitive,
behavioral, and client-centered. There are eight phases of EMDR treatment
(Shapiro, 1995), to be utilized by licensed mental health professionals only
after completion of an approved training curriculum.
HOW DOES EMDR WORK?
It is not clear how EMDR works because
neuroscience researchers are still exploring how the brain works. Therefore, how
any method of psychotherapy works has yet to be established definitively.
However, there is evidence for an innate information processing system that
exists as part of human thinking processes. What research has suggested so far
is that when a person is very upset, the brain cannot process information as it
normally does. The event that provoked the upset becomes ‘frozen in time’, and
‘stuck’ in the information processing system. When a person remembers this
event, the recalling of sights, sounds, smells, thoughts, and emotions can feel
as intense as when it actually occurred. Such upsetting memories may have a
profoundly negative impact on the way a person sees the world and relates to
other people. Present-day incidents and interactions re-stimulate the experience
of this upsetting event.
EMDR appears to produce a direct effect on the
way the brain processes upsetting material. Researchers have suggested that the
eye movements or bilateral stimulation trigger a neurophysiological mechanism
that activates an "accelerated information processing system." Accelerated
information processing is a phrase used in EMDR to describe the rapid working
through, ‘metabolizing’, of upsetting experiences. Following successful EMDR
treatment, the upsetting experiences are worked through to "adaptive
resolution". The person receiving EMDR comes to understand that the event is in
the past, realizes appropriately who or what was responsible for the event
occurring, and feels more certain about present-day safety and the capacity to
make choices. What happened can still be remembered by the person, but with much
less upset.
Many types of therapy have similar goals.
However, EMDR can be thought of as a physiologically-based therapy that allows a
natural healing process to emerge. Clinical reports and some research findings
suggest that the eye movements and the specific targeting of information about
the upsetting events may permit direct access to the stored pathology in the
brain and more rapid working through of disturbance than more conventional forms
of therapy.
WHAT IS AN ACTUAL EMDR
SESSION LIKE?
EMDR is a client-centered approach in which
the clinician works with the client to identify the specific problem or problems
that will be the focus of treatment. Following a defined protocol, the mental
health professional helps the client identify the images, self-referenced
negative belief, emotions, and body sensations associated with a targeted
problem or event. The client is then asked to develop a new positive belief
about the self to replace the negative belief. The believability of this new
belief is rated while the client thinks of the disturbing event.
The client is prepared for EMDR and then is
asked to bring to mind all the negative information identified with the problem.
The client follows the fingers of the mental health professional to produce the
voluntary eye movements. After each set of eye movements, the client is asked to
briefly comment. The mental health professional facilitates the client’s
attention and works to support the client as he or she processes the upsetting
material, making clinical decisions about the direction of the intervention
along the way. The goal of EMDR treatment is the rapid processing of information
about the negative experience and movement toward an adaptive resolution. This
means a reduction in the client’s distress, a shift in the negative belief to
the client’s positive belief, and the possibility of behaving more optimally in
relationships with others and at work.
WHAT IS THE RESEARCH
EVIDENCE FOR EMDR?
Several controlled studies (Carlson et al,
1998; Marcus, Marquis, & Sakai, 1997; Rothbaum, 1997; Scheck, Schaeffer, &
Gillette, 1998; Wilson, Becker, & Tinker, 1995; Wilson, Becker, & Tinker, 1997)
have since been conducted, and results indicate that EMDR is a valid treatment
for civilian PTSD. As part of the survey conducted by the American Psychological
Association Division 12 Task Force that reviewed psychotherapies and their
effectiveness, Chambless and her colleagues (1998) recently placed EMDR on a
list of "probably efficacious treatments" as an intervention for civilian PTSD.
This designation specifies interventions which were "beneficial for patients or
clients in well-controlled treatment studies" (p.3).
A meta-analysis (Van Etten & Taylor, 1998)
looking at 59 studies of PTSD treatments indicated that EMDR and behavior
therapy were both effective for reducing the symptoms of PTSD. EMDR treatment
time was shorter than for behavior therapy (5 vs. 15 hours). Other controlled
studies have shown that EMDR is effective in treating phobias (de Jongh & ten
Broeke, 1998; de Jongh, ten Broeke, & Renssen, 1999), in reducing stress in law
enforcement employees (Wilson, Logan, Becker, and Tinker, 1999), and helping
reduce the distress experienced by traumatized children (Chemtob, Nakashima,
Hamada, & Carlson, in press; Greenwald, 1994; Puffer, Greenwald, & Elrod, 1998).
REFERENCES
Carlson, J.G., Chemtob, C.M., Rusnak, K., Hedlund, N.L., &
Muraoka, M.Y. (1998). Eye movement desensitization and reprocessing (EMDR)
treatment for combat-related posttraumatic stress disorder. Journal of Traumatic
Stress, 11(1), 3-24.
Chambless, D.L., Baker, M.J., Baucom,
D.H., Beutler, L.E., Calhoun, K.S., Crits-Christoph, P., Daiuto, A., DeRubeis,
R., Detweiler, J., Haaga, D.A.F., Johnson, S.B., McCurry, S., Mueser, K.T.,
Pope, K.S., Sanderson, W.C., Shoham, V., Stickle, T., Williams, D.A., & Woody,
S.R. (1998). Update on empirically validated treatments II. The Clinical
Psychologist, 51(1), 3-16.
Chemtob, C.M., Nakashima, J., Hamada,
R., & Carlson, J.G. (in press). Brief treatment for elementary school children
with disaster-related PTSD: A field study. Journal of Clinical Psychology.
De Jongh, A., & ten Broeke, E. (1998). Treatment of choking
phobia by targeting traumatic memories with EMDR: a case study. Clinical
Psychology and Psychotherapy, 5, 264-269.
De Jongh, A., & ten Broeke, E. & Renssen, M.R. (1999).
Treatment of specific phobias with eye movement desensitization and reprocessing
(EMDR): Research, protocol, and application, Journal of Anxiety Disorders, 13,
69-85.
Greenwald, R. (1994). Applying eye movement desensitization
and reprocessing in the treatment of traumatized children: Five case studies.
Anxiety Disorders Practice Journal, 1, 83-97.
Marcus, S.V., Marquis, P., & Sakai, C. (1997). Controlled
study of treatment of PTSD using EMDR in an HMO setting. Psychotherapy, 34(4),
307-315.
Puffer, M.K., Greenwald, R., & Elrod, D.E. (1998). A single
session EMDR study with twenty traumatized children and adolescents.
Traumatology, 3(2). Available Internet: http://www.fsu.edu/^trauma/v3i2art6.html.
Rothbaum, B.O. (1977). A controlled
study of eye movement desensitization and reprocessing for posttraumatic stress
disordered sexual assault victims. Bulletin of the Menninger Clinic, 61,
317-334.
Scheck, M.M., Schaeffer, J.A., & Gillette, C.S. (1998). Brief
psychological intervention with traumatized young women: The efficacy of eye
movement desensitization and reprocessing. Journal of Traumatic Stress, 11,
25-44.
Shapiro, F. (1995). Eye movement desensitization and
reprocessing. New York: Guilford.
Wilson, S.A., Becker, L.A., & Tinker, R.H. (1995). Eye
movement desensitization and reprocessing (EMDR) treatment for psychologically
traumatized individuals. Journal of Consulting and Clinical Psychology, 63,
928-937.
Wilson, S.A., Becker, L.A., & Tinker, R.H. (1997).
Fifteen-month follow-up of eye movement desensitization and reprocessing (EMDR)
treatment for posttraumatic stress disorder and psychological trauma. Journal of
Consulting and Clinical Psychology, 65(6), 1047-1056.
Wilson, S.A., Logan, C., Becker, L.A., & Tinker, R.H. (1999,
June). EMDR as a stress management tool for police officers. Paper presented to
the annual conference of the EMDR International Association, Las Vegas, Nevada.
johnhenson@clinicalsolutions.org