Eye movement desensitization and reprocessing (EMDR) is a recently developed psychotherapy method for working through traumatic memories and related psychological problems.

EMDR (Eye Movement Desensitization and Reprocessing) was developed by Dr. Francine Shapiro in the late 1980s. While still a graduate student in psychology, Shapiro noticed that her own upsetting thoughts faded when her eyes spontaneously moved rapidly from side to side. Over the next several years, she and her colleagues developed and refined this discovery into a systematic therapeutic approach.

Today, EMDR is defined as a complex treatment approach that combines salient elements of the major therapeutic schools (e.g., cognitive, behavioral, psychodynamic, physiological, and interactional). Although the eye movement stimulation (and other forms of dual stimulation used in the approach) have garnered the most attention professionally and publicly, EMDR actually involves a much broader spectrum of interventions, which are organized into eight phases of therapy.

Currently, 13 completed controlled studies of EMDR make it one of the most researched methods of psychotherapy used in the treatment of trauma. Its efficacy has been supported by these studies: the four most recent studies of victims who have suffered single traumas have demonstrated that after the equivalent of three 90-minute sessions, 84% to 90% of patients no longer have symptoms of posttraumatic stress disorder (PTSD; Rothbaum, 1997; Wilson, Becker, & Tinker, 1995).

How Does EMDR Work?

EMDR is based on the assumption that specific experiences from the past continue to guide the client's responses in the present. These experiences can be the "big T" traumas that result in PTSD or the "small t" traumas that are the ubiquitous experiences known to have a less dramatic but still negative impact on personality and behavior.

To influence such experiences from the past, EMDR draws on an information processing model of behavior. Conceptually, disturbing trauma-related information is believed to be held in the patient's nervous system in state-dependent form (e.g., the perceptions and sensations experienced at the time of the trauma are encoded in the nervous system). EMDR allows the processing of this information in an adaptive fashion so that what is useful from the experience can be learned; stored appropriately, cognitively, and affectively; and made available for behavioral guidance in the future. What is useless to adaptation, such as excess negative emotions, irrational self-assessments, and disturbing physical sensations, can be discarded.

Assessment is focused not on global diagnoses but rather on specific delineations of problematic behaviors, attitudes, and affects that need to be transmuted to allow for adaptive resolution of trauma or conflict. Specifically, the EMDR clinician asks, what is the patient being influenced by past experiences to do in the present that is dysfunctional and what is he or she prevented from doing that would be adaptive?

Although originally applied to PTSD, EMDR shows promise in a variety of clinical complaints that are based on earlier life experiences that underlie the pathology and current experiences and that restimulate the disturbance. EMDR allows clients to access and reprocess these experiences as well as to learn new skills and behaviors for managing future life events. In all cases, the goal of EMDR is to produce the most comprehensive and profound treatment effects in the shortest period of time, while helping the client to remain reasonably stable.

EMDR as an eight-phase intervention approach can be considered a complete treatment in some clinical cases, or it may be part of a more complex treatment plan that includes other more traditional approaches to treating a specific pathology (e.g., borderline personality disorder). Within this latter integrative context, EMDR appears to be useful for a broad range of clinical complaints and seems to provide more rapid achievement of positive treatment effects than do these more traditional approaches alone.

next: The Different Phases of EMDR Treatment

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Reviewed: 02/2006