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EYE MOVEMENT THERAPY FOR PTSD GOES MAINSTREAM
--
EMDR divides mental health experts as Marines
go forward with treatment.
Some in the Marine Corps consider EMDR a
"cure" for PTSD.
That background story here...
http://www.vawatchdog.org/old%
20newsflashes%20MAY%2006/newsflash05-26-2006-7.htm
Latest story here...
http://www.newhousenews.com/archive/glaser082506.html
Story below:
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Eye Movement Therapy for Post-Traumatic Stress
Goes Mainstream
BY GABRIELLE GLASER
Newhouse News Service
Since its debut in the late 1980s, Eye Movement Desensitization and
Reprocessing, EMDR, has divided mental health experts. Some say it's a
painless therapy for the treatment of single-incident traumas, such as
natural disasters, rape or combat. Others dismiss a main component --
eye movements or other bilateral stimulation -- as unnecessary to
recovery.
Richard McNally, a psychologist at Harvard University, said EMDR is
successful in treating post-traumatic stress disorder because it uses
exposure therapy, an established treatment in which the patient
visualizes the feared incident. "What is effective in EMDR is not new,
and what is new is not effective," McNally said.
In any case, it has recently gained mainstream approval. Since 2004, the
American Psychiatric Association and the departments of Veterans Affairs
and Defense have recommended EMDR as a method to treat post-traumatic
stress disorder.
The treatment, developed in the late 1980s by California psychologist
Francine Shapiro, occurred by chance.
Shapiro had just recovered from cancer treatments and was questioning
the role of stress in illness. During a walk in the park, she realized
that the intensity of some disturbing thoughts she had had diminished
after her eyes spontaneously moved back and forth.
"Something -- I don't remember what -- was bothering me, and then it
wasn't," she said.
Shapiro then conducted a controlled study of eye movement's effects on
Vietnam veterans, publishing her findings in a 1989 scientific journal.
At first, they were ridiculed as outlandish.
"People thought it was hocus-pocus," said David Manfield, a Portland,
Ore., psychologist who has used EMDR in treatment since the early 1990s.
But last year, more than 25 articles on EMDR were published in
scientific journals. It has been endorsed by government mental health
agencies in the United Kingdom and Israel, and is in wide use throughout
the United States and Europe, said Scott Blech, executive director of
the EMDR International Association in Austin, Texas.
No one can explain precisely how EMDR works, but Shapiro thinks its
effects are similar to that of REM, or rapid eye movement, sleep.
Researchers say that during REM, the brain consolidates learning and
memories; it is also when we dream.
EMDR sessions work much like this: A client identifies a problem, such
as nightmares after a sexual assault. She then describes what the event
made her believe about herself. For example, she might be convinced that
the assault was her fault, and feel guilt and shame for being unable to
prevent it. She also states what she hopes to believe about herself in
the future.
In 15- to 20-second "sets," the clinician waves a hand or baton in front
of the client, who follows the movements with her eyes, listens to tones
or feels pulses.
The client recalls the disturbing event, as well as its sights, sounds
and smells. Meanwhile, the therapist continues the "sets."
Clients remain awake and aware. After each set, the therapist asks the
client how her perceptions of herself may have changed.
"The patient guides you," said Ann Kafoury, a Portland counselor who has
used EMDR for 14 years. "As long as the process is moving, we continue."
Some clients may require only one session of EMDR before finding the
offending memory less disturbing, while others may need 10. But after
several sets, most people experience a lessening of negative emotions
around the event, said Michael Maxwell, a therapist who specializes in
treating post-traumatic stress disorder at the Veterans Affairs Medical
Center in Portland.
Many therapists think EMDR helps the rational left side of the brain to
"knit" a disturbing memory from the emotional right side. Often,
therapists describe this as "processing."
One reason people tend to repeat tales of traumatic events -- for
decades, even -- is that they were never "processed," said psychologist
Ricky Greenwald, executive director of the nonprofit Child Trauma
Institute in Greenfield, Mass.
Relentless tales of a parent's violence, or a spouse's cheating, may
indicate that a person is "stuck." Memory of the trauma, lodged deep in
the primitive, emotional region of the brain, can flood the body with
the hormones adrenaline and cortisol. Unprocessed, that reaction can be
provoked by minor, everyday interactions, making muscles tense and the
heart pump fast.
That's fine, therapists say, if you need to run from a bear, but not so
great in a relationship or the workplace.
"We all walk around with sore spots that can be triggered at any time,"
Greenwald said. "EMDR lets people put the past where it belongs: in the
past."
Like most therapists, Greenwald uses EMDR, which requires five days of
intensive training, in conjunction with other forms of therapy.
Therapists caution that the treatment is far more complex than it may
seem. "People shouldn't try EMDR unless they are fully trained," Kafoury
said. "It is a powerful method of therapy."
Maxwell said he was initially dubious about EMDR when he heard about it
in the early 1990s. "How could anything work so well, so rapidly?" said
Maxwell, who has worked with combat veterans for 27 years. Eventually,
he took the training.
He began using it on a longtime patient, a Vietnam vet marooned with a
troubling memory.
For years, the man had blamed himself for the combat death of a friend.
He experienced anxiety, depression, flashbacks, guilt and rage -- all
common in post-traumatic stress disorder.
EMDR, Maxwell said, allowed his patient to see the experience in a
larger context. "He came to see that he could never have changed the
outcome."
"Finally he could make sense of those fragmented memories and move on,"
he said.
But, he cautioned, EMDR is only one of many therapies used to treat
those suffering the effects of trauma. "It's a useful tool," he said.
"All good mechanics have a lot of tools in their toolbox."
(Gabrielle Glaser is a staff writer for The Oregonian of Portland, Ore.
She can be contacted at
gabrielleglaser@news.oregonian.com )
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Larry Scott
