EMDR: An Evidence-Based Treatment for Trauma

Eye Movement Desensitization and Reprocessing (EMDR) was discovered quite by accident in 1987 by Francine Shapiro, PhD.  She went for a walk  in the park and noticed that by the end of the walk she was no longer upset about something that had been bothering her.  When she thought about what had happened, she realized that she had engaged in spontaneous rapid eye movements while contemplating the problem and hypothesized that this had helped her to process and resolve her distress.  She later realized that most people do not spontaneously engage in these eye movements when awake, so she experimented with having people follow her fingers back and forth while focusing on their problems and discovered that it resolved their problems as well. 

In 1988, Dr. Shapiro graduated from using EMDR with "mundane problems" to experimenting with the "highly-charged memories" of people with post traumatic stress disorder (PTSD).*  She had similarly promising results using EMDR with this population.  At the time, PTSD was a fairly new diagnosis (it was first introduced in 1980) and there was no rigorous research about treatment effectiveness, other than studies that came out at about the same time evaluating cognitive behavioral therapy (CBT) as a  PTSD treatment .

There is now a substantial body of research that demonstrates the effectiveness of EMDR for the treatment of PTSD.**  In fact, only CBT and exposure therapy (and to a lesser degree stress inoculation therapy), have as much research supporting their use as a treatment for people suffering from PTSD. Despite this, some clinicians continue to mistakenly believe that EMDR is not evidence-based. 

Other clinicians mistakenly believe EMDR is just another exposure therapy.  EMDR uses brief exposure to the traumatic event, combined with bilateral stimulation (eye movements, tones, vibrations or tapping) and sensory, cognitive, affective and somatic components, to facilitate  adaptive information processing (AIP) and reconsolidation of the traumatic experience.

There are several theories about the role of the bilateral stimulation (BLS). One theory is that focusing on a distressing memory and a neutral visual, auditory or tactile stimulus at the same time helps to keep one foot in the present and one foot in the past to prevent retraumatization and facilitate adaptive reprocessing. Another theory is that the sensory stimulation may help process disturbing events in a mechanism similar  to dream sleep, also known as REM (rapid eye movement) sleep.  A third theory is that the bilateral stimulation activates both hemispheres of the brain to link right brain intuitive, sensory information with left brain logical, sequential, language-based information. Studies have been conducted about each of these theories and research continues to be done to answer our questions about how EMDR works.

What questions do you have about EMDR? What experience have you had with EMDR therapy, as a client and/or as a therapist?  What are your impressions about its effectiveness? Please share your comments and questions below. 

*See the recent article by Francine Shapiro in the Huffington Post online  where she talks about this: http://www.huffingtonpost.com/francine-shapiro-phd/ptsd-military_b_1250202.html)

**See http://emdrnj.com/emdr_research.html for citations and a brief summary of practice guidelines for PTSD treatment from the International Society for Traumatic Stress Studies (ISTSS), the American Psychiatric Association, the American Psychological Association, Cochrane Database of Systematic Reviews,  Department of Veteran's Affairs & Department of Defense (VA/DoD), and the Substance Abuse and Mental Health Services Association (SAMHSA)