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Over the years, there’s been no shortage of interesting alternatives to typical talk-based psychotherapy. Laughter therapy, sound therapy, horticultural therapy and even wilderness therapy have become popular ways to deal with psychological distress, helping with everything from general anxiety and depression to post traumatic stress disorder (PTSD). These aren’t the only fascinating alternatives, though.
Another form of therapy is Eye Movement Desensitization and Reprocessing (EMDR), which can be an effective method for treating PTSD.
EMDR helps victims of trauma re-process and learn to cope with difficult events by rapidly moving their eyes back and forth, following the movement of a therapist’s finger while concentrating on a distressing memory.
The origins of EMDR
EMDR began practically by accident in 1987, when California psychologist Francine Shapiro was taking a walk in the woods, reports Scientific American.
During her stroll, Shapiro said she was anxious. She soon realized, though, that her anxiety had subsided once she began moving her eyes back and forth while at the same time closely observing and concentrating on her surroundings. Once she discovered that the rapid movement of her eyes brought her to a more relaxed state, she decided to see if rapid eye movement might reduce stress and anxiety in her clients. After finding that the procedure was able to help ease distress in her clients, Shapiro published a study in 1989 on her research, dubbing the practice EMDR.
Since then, EMDR has been used as a treatment for PTSD and various other conditions such as depression, schizophrenia, sexual dysfunction, stress and other anxiety disorders.
What does EMDR do and how does it work?
EMDR trainer Roger Solomon is a clinical psychologist whose specialty is trauma and grief. He is the police psychologist for the South Carolina Department of Public Safety and a consultant to the trauma programs of the U.S. Senate and several state and federal law enforcement agencies.
"EMDR therapy is guided by the Adaptive Information Processing model,” says Solomon. "This model posits that present problems are the result of past distressing memories that have become 'frozen' or stuck in the brain (including the images, thoughts and beliefs, feelings and sensations), thus becoming maladaptively stored in the brain. When there is a reminder (either external or internal), this maladaptively stored information gets triggered and is experienced in the present.”
Based on that premise, EMDR seeks to help people effectively adapt to their lives once trauma has occurred. EMDR gives those who suffer from trauma the possibility of reprocessing traumatic memories, so that the memories are able to become "unstuck” and processed in a way that the traumatized person is able to understand.
EMDR allows for what Solomon sees as the "the transmutation of the perpetual re-experiencing of distressing events with a learning experience that becomes a source of resilience.”
All this takes place by using a simple technique such as moving one’s eyes back and forth, which "stimulates the information processing mechanisms of the brain,” says Solomon. Once the information processing mechanism of the brain is stimulated by following the movements of the therapist’s fingers with the eyes, the traumatized person is able to reprocess the memories that cause distress; it gives them the ability to effectively adapt, learn and understand that he or she has successfully made it through the trauma.
To illustrate, Solomon uses the experience of a war veteran. "A war veteran experiencing a near-death experience in battle may have concluded 'I am going to die,' which becomes maladaptively stored in the brain, unable to process," Solomon says. "When there is a present trigger, the distressing memory including the images, thoughts and beliefs and sensations associated with the event arise and are experienced as nightmares, flashbacks, and other symptoms of PTSD.”
Once the veteran is able to properly reprocess the information after undergoing EMDR, "the veteran can think of the battle event and know, at a felt body level, that 'I survived, it's over,'” says Solomon.
Theories behind the inner workings of reprocessing
Psychologists have come up with a number of theories as to how memory reprocessing during EMDR works — and more research is needed to determine the exact process — but here are a few that might explain exactly what’s happening in the brain during EMDR.
The working memory theory: Working memory is our short-term memory. It’s the part of our memory that allows us to store information that we need to reason, learn and comprehend.
"Studies looking at the specific effects of eye movements used in EMDR therapy show a significant reduction of memory vividness and associated emotion” says Solomon. "The working memory theory posits that the working memory system has a very limited capacity. When it is taxed by the competing tasks of holding a memory in mind while moving the eyes, there is a degradation of performance. This results in the distressing memory losing its quality and power.”
It’s almost as if the memory is unable to "keep up” with the reprocessing that occurs while the traumatized person’s eyes are moving back and forth — thus making the memory lose its grip over the person.
REM sleep theory: Rapid Eye Movement sleep (REM) is the stage of sleep in which we dream, and process and store memories.
Solomon explains that it’s "been hypothesized that eye movements stimulate the same neurological processes that take place during REM/dream sleep, which is important in processing and consolidating information.”
It’s possible the EMDR helps a person process a traumatic memory, in much the same way dreaming allows us to process the events of our daily lives while we sleep.
Memory reconsolidation theory: Memory reconsolidation is a process used by therapists to reorder and recode memories once a traumatic memory has been unlocked or accessed.
"Accessing a memory, and updating it with new contradictory information, enables the potential for the original memory to be transformed and reconsolidated, i.e., stored in altered form," Solomon explains. "This differs from other trauma-focused therapies (e.g. Cognitive Behavioral Therapy) where the underlying mechanism is hypothesized to be habituation and extinction, which are thought to create a new memory, while leaving the original one intact.”
In this instance, the traumatic memory changes and transforms; it doesn’t disappear completely. Here, there aren’t two separate memories — one being the traumatic memory and the other being a memory which is of a peaceful nature. You have one memory which has transformed from trauma into a state of acceptance. This might explain the transmutation aspect of EMDR.
Parasympathetic nervous system theory: The parasympathetic nervous system is the part of our nervous system that helps us calm down and relax. It slows the heart, dilates blood vessels, relaxes the muscles in the gastrointestinal tract, increases digestive juices and decreases pupil size.
As far the relation between the parasympathetic nervous system and EMDR, Solomon says it’s possible that the "eye movements elicit an orienting response which activates the parasympathetic nervous system and lowers arousal.” Simply put, rapid eye movement and EMDR seem to be relaxing. "This theory has support from research showing that eye movement lowers arousal for distressing memories,” says Solomon.
What makes EMDR different
EMDR is based more on how a person reprocesses memories, rather than the strict plan of a therapist.
"The therapist facilitates movement with attuned bilateral stimulation and 'stays out of the way' as the distressing memory is shifting in an adaptive direction," says Solomon. "Clients are able to find their own individualized and creative solutions and perspectives, in ways the clinician may never have thought of.”
A person undergoing EMDR doesn’t have to make themselves as vulnerable as they might during other forms of therapy. Sometimes not showing complete vulnerability makes things less taxing when undergoing treatment.
"The client does not have to describe the memory in detail. Not having to disclose shameful or humiliating moments may make it easier for some clients to engage in the therapeutic process," Solomon explains.
The fact that EMDR is not a talk-based therapy is unique in that that, "EMDR goes to places where words don’t go and enables the processing of implicit, painful memories and their associated emotions and body sensations that talking alone does not seem to reach,” says Solomon.
When asked about a particular case in which EMDR helped a client overcome trauma, Solomon reflected on his experience with a police officer involved in the tragedy of the Sandy Hook Elementary School shooting:
"A police officer who was one of the first on-scene was very distressed by the images of children killed. For the next two years, he had nightmares and flashbacks, and found it difficult to be around children. He started the EMDR processing with an initial image of a dead child and an associated belief of 'I’m helpless.' With processing he realized he did the best he could at the situation. Next he remembered that many police officers from many different agencies started arriving. He realized that these policemen were off duty and coming on their own time to help out. When asked his thoughts/feelings about the incident, he said "UNITY,” and no longer felt distress. This session humbles me as to how the mind can find an adaptive way to deal with a horrible tragedy and I am grateful for EMDR therapy’s ability to help people."