Eye Movement Desensitization and Reprocessing
There has been a great deal of controlled research conducted on the various methods of helping clients to work through and resolve their trauma memories. All methods have not been found to be equal. Some tend to be slow and haphazard, whereas others work relatively quickly and thoroughly.
The big dividing line is between:
- so-called “traditional” talk therapy methods and
- the structured focused trauma resolution methods such as
- prolonged exposure,
- stress inoculation training,
- cognitive processing therapy, and
- eye movement desensitization and reprocessing (EMDR).
The structured, focused treatments win hands down (Foa, Keene, & Friedman, 2000). They are faster- often by months or even years- and more effective. One study (Ironson et al., 2002) found that the level of distress both during and between sessions was lower for EMDR; this study also found a lower dropout rate in the EMDR group.
EMDR is a complex method that combines elements of behavioral and client-centered approaches. To oversimplify, the client is asked to concentrate intensely on the most significant segment of a traumatic memory while moving the eyes rapidly from side to side. Other than the eye movements, EMDR is quite different from exposure; with EMDR the client is not required to stay with the upsetting part of the memory for an extended period. In fact free association is encouraged.
Of the numerous additional theories regarding EMDR’s possible mechanism(s) of effect, a few are of particular interest.
- One theory is that EMDR replicates the rapid eye movements (REM) that occur during dreaming, thus tapping into the brain’s natural information processing and affect desensitization mechanism (Greenwald, 1995; Perls & Neilsen, 1993; Stickgold, 2002).
- Another theory is that eye movements increase the cognitive load while the trauma memory is being accessed, thus competing with working memory and causing a decrease in vividness and affect (Kavanaugh, Freese, Andrade, & May, 2001)
- The eye movements may also serve as a distraction, preventing a full focus on the trauma memory; this may help the client to “stay in the room” instead of being overwhelmed by the memory.
Overall, the literature suggests that EMDR may be at least equal to other approaches while being more efficient. In EMDR much less homework is required and the treatment effect may be achieved in fewer therapy sessions.
Taken from EMDR- Within a phase model of trauma-informed treatment, Ricky Greenwald, Psy.D. (2007)