Eye Movement Desensitization and Reprocessing (EMDR) was developed by psychologist Dr. Francine Shapiro. The general process of EMDR involves having the client reflect on events that produce anxiety while the therapist moves a finger back and forth in front of the client’s visual field. This process induces saccadic eye movements as the client follows the therapist’s finger with the eyes.
According to Shapiro and her followers, this procedure helps to reprocess emotionally disturbing information. Individuals can deal with events that happened in the past, traumatic experiences, emotional distress, anxiety-provoking stimuli, and so forth.
The Theoretical Foundations of EMDR
There is little evidence from research or from understanding neuroanatomy to support the notion that inducing saccadic eye movements assists in the reprocessing of emotionally laden memories or traumatic experiences. Shapiro developed the initial technique based on her own personal experiences that she was able to process emotionally meaningful and even disturbing memories when using these types of eye movements, and she began experimenting with them in her therapy practice. There is empirical evidence associated with other aspects of the EMDR treatment process; however, these aspects of EMDR are borrowed from other forms of behavioral therapy and Cognitive Behavioral Therapy. These aspects include:
- Exposure therapy: A type of behavioral therapy practice is known as exposure therapy. Individuals who have experienced severe emotionally traumatic events in the past or who suffer from issues with anxiety, such as phobias, can learn to reduce anxiety by simply being exposed to the events or stimuli that causes anxiety while at the same time not producing conditions that are harmful or potentially dangerous. By gradually being exposed to instances that provoke little anxiety and then building up to instances that provoke more anxiety, the individual is emotionally desensitized to the anxiety-provoking stimuli or to the traumatic event.
- Cognitive restructuring: Part of the process of EMDR involves having clients identify “targets” (past events or stimuli that are associated with distress) and their personal beliefs associated with these targets that are irrational and emotionally disturbing or stressful to them. The client then identifies an opposite personal belief (opposite targets so to speak) that is not stressful. The client restructures the original irrational beliefs in favor of the more functional positive viewpoints. This is very similar to the process of cognitive restructuring in Cognitive Behavioral Therapy.
- The use of homework assignments: Many types of cognitive therapy, behavioral therapy, and Cognitive Behavioral Therapy assign homework to clients.
Thus, aside from the eye movement component of EMDR, the treatment process is very similar to existing behavioral and cognitive behavioral techniques. Moreover, therapists have replaced the eye movement component with other distracting stimuli, such as finger tapping, and achieved similar results, suggesting that eye movement components add little to the treatment.
Uses of EMDR
According to the EMDR International Association, EMDR can be used to treat:
- Panic attacks
- Performance anxiety
- Disturbing memories
- Complicated grief
- Stress reduction
- Dissociative disorders
- Pain disorders
- Sexual and/or physical abuse
- Body dysmorphic disorders
- Personality disorders
The course of treatment in EMDR can be quite complicated and consists of eight basic phases. However, the phases may need to be repeated if the therapist does not believe that the individual is sufficiently recovering from emotional distress regarding any particular target. Thus, EMDR attempts to be comprehensive and thorough in its approach to treating individuals with psychological disturbances.
Controversy Concerning EMDR
The research associated with use of EMDR indicates that there is a bit of controversy. Part of the controversy regarding EMDR is related to the notion that the eye movement component aspect of the treatment does not add anything significant to the treatment process. The treatment appears to work the same when just the behavioral and cognitive behavioral components of the treatment are administered without the eye movement component. As EMDR is often marketed as a specialized form of therapy, and it is often more expensive than typical Cognitive Behavioral Therapy, this presents an ethical dilemma for many healthcare professionals and researchers.
EMDR proponents are loyal group of supporters who believe that this particular treatment is a near panacea for psychological disorders. There are a number of resources that can be found online praising this treatment. Researchers in EMDR publish consistently, and there is a journal devoted to the technique. However, most of the positive research regarding EMDR comes from this loyal group of supporters and not from independent sources. Those that question the effectiveness of EMDR point out that:
- A great deal of the evidence regarding the treatment effectiveness of EMDR comes from endorsements and anecdotal evidence from individuals claiming to have benefited from its use. This type of evidence is not considered to be relevant when attempting to report the effectiveness of the therapeutic technique in a scientific environment.
- Research does indicate that being treated with EMDR is superior to receiving no treatment at all; however, this is not sufficient evidence that EMDR is an effective therapeutic technique. In many research trials, treatments are compared to some type of a placebo or other existing treatment. By definition, a placebo is a technique or substance that has no therapeutic effect. Even individuals who are given placebos in many treatment studies for psychological disorders demonstrate improvement over individuals who receive nothing. Placebos are used in treatment research studies to determine the therapeutic effects of the medication or therapy being studied, above and beyond mere individual expectations. Research demonstrating that EMDR is better than no treatment does not rule out that the effects of EMDR are significantly better than placebo effects.
- A large body of independent empirical research has supported the notion that the eye movement component of EMDR is not beneficial or does not add anything to the treatment. Without this specialized component, EMDR is simply repackaged Cognitive Behavioral Therapy or behavioral therapy.
- Research has indicated that EMDR is equivalent to other forms of therapy in the treatment of trauma-related issues; however, this simply supports the notion that the eye movement component of the treatment adds nothing.
Thus, the research indicates that EMDR is not harmful, and individuals who undergo the treatment will not likely be worse off than individuals who undergo other treatments; however, they most likely will end up spending more money on the treatment as a result of either paying for more expensive treatment sessions or longer total times in therapy.