Developed in 1987 by Dr Francine Shapiro, eye movement desensitization and reprocessing (EMDR) has been proved to be an effective treatment for post-traumatic stress disorder. As well as combining elements of psychodynamic, cognitive, client-centred and behavioural therapies, EMDR adds a technique of eye-movements - thought to be similar to spontaneous eye movements in REM sleep.
Whilst some researchers claim that the benefits of EMDR come not from the eye movements but from the other therapies involved in the treatment, a number of randomized clinical trials suggest that EMDR does work.
The History of EMDR
Back in 1987, Dr Francine Shapiro was a PhD candidate in psychology in California when she discovered the techniques of EMDR - almost by chance. As she walked in a park, she noticed that by moving her eyes back and forth rapidly, she could reduce the intensity of her negative thoughts.
Following her discovery, Dr Shapiro went on to study the effects of EMDR on treating post-traumatic sstress disorder (PTSD) - and based her doctoral dissertation on her research. She has written 3 books on EMDR, and received the Sigmund Freud award from the World Council for Psychotherapy in 2002.
The Practice of EMDR
Whilst some negative media reports have claimed that EMDR is nothing more than moving the eyes back and forth at the same time as recalling unpleasant memories, in practice EMDR is much more complex.
A standard EMDR treatment involves eight phases, each using specific psychotherapeutic procedures. It is important to note that EMDR must be done by a professional trained in the techniques, otherwise recalling traumatic memories may cause more harm to be done. The EMDR Association in the United States and the European EMDR Association both have a strict certification process for practitioners of EMDR.
Training in EMDR is offered by the EMDR Associations in the Unites States and Europe; several university programmes in EMDR are also available worldwide.
The Eight Phases of EMDR
Because each patient's specific traumatic symptoms will be unique to them, each EMDR session will be unique to them - but with EMDR, eight steps are always followed.
- Stage 1 - the therapist asks questions to establish the nature of the problem, the negative behaviour and symptoms, so as to develop a treatment plan.
- Stage 2 - the patient will be taught relaxation and calming techniques to help them to deal with the disturbing memories that will occur during therapy.
- Stage 3 - the patient is asked to choose a scene from the traumatic event causing their symptoms and then makes a statement that expresses a negative self belief associated with the scene. Next the patient must find a positive self-statement to use as a substitute.
- Stage 4 - the focus is on desensitization - which in turn focuses on the emotions and sensations associated with the traumatic memory.
- Stage 5 - known as 'installation', which increases the strength of the positive belief that the patient has chosen to replace the negative belief.
- Stage 6 - centres on a 'body scan', which involves clearing physical responses - such as tension and headache - that are associated with the original disturbing memory.
- Stage 7 - otherwise known as closure - which refers to the way that each session is ended with self-calming and a briefing on what to expect between sessions. The patient may also be advised to keep a diary.
- Stage 8 - involves the re-evaluation of the results from previous sessions and the identification of new areas in need of treatment.
During each stage of EMDR treatment, rating scales are used to assess the patient's stress levels and their feelings towards the traumatic event.
EMDR as an Effective Treatment for PTSD
As a treatment for post-traumatic stress disorder (PTSD), EMDR has been studied more than any other, but despite this, experts still can't agree about its efficiency. Numerous trials have demonstated some effeciency, and few trials have produced negative results - but some trials have been criticised for having flawed methodology.
In 2004, the American Psychiatric Association recognized in its practice guidelines for PTSD that EMDR might be as effective as other treatments - but asked for more research to be done.
The Future of EMDREMDR may well be proved, with further research, to be an effective treatment for PTSD, but the challenge for people wanting to try EMDR therapy is to find a suitably qualified EMDR practitioner. EMDR generally produces results in fewer sessions than CBT and other therapies, and so may well emerge in the future as a popular treatment for PTSD.
Sources:
EMDR Training and Consultancy, What is EMDR? http://www.emdr.org.uk/
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