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EMDR technique has always been a subject of scientific criticism. But the recent research claims that method does work better than many others. Further understanding of EMDR may pave the way to therapeutic treatments of trauma.

A slightly bizarre (at least unusual in terms of methodology) technique for treating trauma and post-traumatic psychological disorders was introduced in 1989 by French psychologist Francine Shapiro. The technique is called Eye Movement Desensitization and Reprocessing (EMDR) and involves fast back and forth movement of eyes by patient when therapist asks to recall the details of traumatic experience.

Even though the performing of these two activities seems to be disconnected from one another, both patients and specialists claim that EMDR works much better than any traditional approach in reducing the anxiety.

How EMDR works?

The method comes from a simple empirical observation. Francine Shapiro noted that the eyes of patients move rapidly and chaotically when they recall a disturbing memory or thought. She noticed then that if this eye movement is put under voluntary control by asking the patients to move eyes in certain way, the level of anxiety tends to reduce. Shapiro’s theory says that the stressful events can overwhelm the normal neurological coping mechanisms. In this case, memories get processed inadequately and stored disfunctionally in an isolated memory network. The purpose of EMDR is to reprocess these memories thus allowing the patient to develop a more adequate coping mechanism.

Neurological basis of EMDR is still to be discovered

The theory does not say why eye movement in particular helps in developing this new mechanism of coping with the traumatic events of the past, and this was a constant source of criticism of both the method and its theoretical foundation.

Clearly, Shapiro’s theory lacks physiological basis. At present time we simply don’t know well enough how memories are formed, processed and stored. To somehow compensate for the gap in our understanding, many theories attempting to explain psychological phenomena operate on the level of scientific fact mixed with semi-philosophical concepts. These vaguely defined concepts are open for interpretation.

EMDR is rejected by many specialists as completely unscientific and impossible to prove. Many critics of this technique claim that the method is nothing more than a version of desensitization approach. In their view, eye movement is an irrelevant epiphenomenon and can be substituted by any other activity which can divert the full attention from the traumatic events of the past in the course of therapy.

Clinical Trials Confirm The Efficiency Of EMDR

But the experimental and clinical evidences accumulated over the last decade stubbornly point out that, scientific or not, EMBR works better than other methods.

In 2007, a review of 33 randomised clinical trials comparing various treatments for post-traumatic stress disorder was published. Self-reports of the patients clearly confirmed on the statistical basis that EMDR works better than other therapeutic approaches.

Further review published in 2009 by CNS Spectrums confirmed the earlier findings that EMDR is as good as other accepted forms of psychotherapies and in many cases works better than traditional approaches.

Two interesting studies were done recently attempting to find out whether the eye movement really plays any role in the therapy outcome. In 2011, an article published in Journal of Anxiety Disorders reported the results of clinical trials involving two groups of patients. EMDR was employed for one of the groups while the other, control group was doing everything the same except eye movements. The level of psychological arousal (measured by the sweating of the skin) in the group performing the eye movements decreased and the self-reported level of distress reduced more significantly in comparison with control.

Another study, published last year in Behaviour Research and Therapy compared classical EMDR with the version where eye movements were substituted by beep tones. Again, the technique involving eye movement over-performed the alternative approach which used a different sensory stimulus.

The lack of generally accepted explanation doesn’t discourage various authorities from adopting and approving the technique. American Psychiatric Association, the International Society for Traumatic Stress Studies, and the Departments of Defence and of Veterans Affairs all recognised EMDR as an effective method of treatment for past-traumatic stress disorder.

So what is behind EMDR? And can we get anything even better?

Some kind of reprocessing and storage of memories should certainly be involved in the effect of EMDR, but nobody is able to say today exactly what it is. Good question to ask is whether the same result, in terms of soothing the negative effects of trauma, can be achieved differently?

Eventually it will be possible, once we understand better the mechanism of formation and storage of memories. Important breakthrough was recently achieved by researchers from the Johns Hopkins University School of Medicine who have demonstrated that bad memories can be completely and selectively wiped out from the brain of experimental animals. The key to do this lies in the understanding of memory formation on molecular level. Researchers were looking on the chemistry going on in the part of brain called amygdala.

Amygdala is responsible for memory processing and emotional response. They found that in experimental mice, in response to fearful experience, specific proteins called calcium-permeable AMPARs are formed. These proteins are very unstable and can be removed from nervous cells thus preventing the memory from forming. Researchers suggest that a drug designed to enhance and facilitate the removal of calcium-permeable AMPARs can significantly contribute to the erasure of bad memories.

Complete erasing of bad memories is not a science fiction anymore

It is possible that one day we will have pills that, when taken after stressful experience, will simply eliminate the memory of this event from the brain, or at least weaken its significance in our perception. Now, when scientists have a good clue about how to do it, this science fiction scenario is not so fictional anymore.

But the drug of this kind with the promise of ultimate treatments of PTSD is still years away. In the meantime EMDR seems to be a good empirical approach, even though our understanding of how it works remains limited.

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  • Bisson, J. and Andrew, M. (2007). Bisson, Jonathan. ed. "Psychological treatment of post-traumatic stress disorder (PTSD)". Cochrane Database of Systematic Reviews (3): CD003388
  • Cloitre, M (2009) Effective psychotherapies for posttraumatic stress disorder: a review and critique. CNS Spectrums 14 (1 Suppl 1). 32–43
  • Shapiro F. (2001). EMDR: Eye Movement Desensitization of Reprocessing: Basic Principles, Protocols and Procedures (2nd ed.). New York: Guilford Press
  • Schubert, S.J. et al. (January 2011) The efficacy and psychophysiological correlates of dual-attention tasks in eye movement desensitization and reprocessing (EMDR). Journal of Anxiety Disorders 25, 1–11
  • van den Hout, M.A. et al. (May 2012) Tones inferior to eye movements in the EMDR treatment of PTSD. Behaviour Research and Therapy 50, 275–279
  • Photo courtesy of rickyjustus on Flickr: