Can Eye-Movement Therapy Reduce Stress?
For the first time in decades Sam is feeling good about himself."Even though I never considered myself a victim when I was growing up, I received a lot of negative feedback from my stepfather that I didn't matter," says Sam, who asked that his real name not be used. "I was looking for a way to accept myself and receive acceptance from others."What helped Sam turn his life around is a controversial new treatment called eye movement desensitization reprocessing or EMDR. First used in 1989, it's geared toward patients of post-traumatic stress disorder, who suffer the sort of deep psychological wounds that often afflict combat veterans. Patients and therapists credit the therapy with defusing the psychological effects of deep trauma caused by rape, accidents, abuse, war and other shattering events.But now this new tool -- which has grabbed headlines due to claims that label it the miracle cure of the '90s -- is also being used by psychotherapists across the country to treat people with such problems as low self- esteem, career-threatening dilemmas, relationship problems and even bad habits. Psychologist Arden Mahlberg, at Madison, Wisc.'s Integral Psychology Center, suggested that Sam try EMDR after his fourth session. Sam thought the process sounded a bit weird, but he was game. Now, he's a satisfied customer: "I've been in other forms of therapy. And while I've made progress, EMDR has had the most tangible results."There's no getting around it, EMDR looks bizarre.The patient and therapist sit opposite each other, in separate chairs placed close together. The therapist rapidly waves his fingers back and forth horizontally through the patient's line of vision. The patient focuses on the waving fingers as if watching a tennis match in fast forward; the therapist watches the patient's face.But first, the client and therapist discuss what thoughts the client will concentrate on during eye-movement therapy. If a client is struggling with low self-esteem, for instance, he or she might conjure up an incident where those memories are particularly sharp. Sam, for instance, recalled an incident from his high school days in rural Wisconsin when he asked his stepfather to drive him to his SAT test in another town. His stepfather, a tradesperson who didn't care what a college education meant to Sam, refused. It was the opening day of deer-hunting season, and he had other plans. Undaunted, Sam got up at dawn and started walking. He tried hitchhiking, but never got a ride. He stopped unannounced at the house of a classmate he vaguely knew. She got dressed and drove him to the test."What I learned through EMDR was how much courage and determination I had," says Sam. "And how grateful I still am for that girl who helped me."It adds to the confusion and controversy surrounding eye-movement therapy that patients often experience quick, seemingly magical results. In some cases there's dramatic recovery in only one session.No one knows for sure how it works. It may represent a unique doorway into the human psyche. One theory suggests EMDR triggers some mechanism for filing away painful memories. Another theory suggests the therapy somehow dissolves whatever has led to frozen traumas. Mahlberg and his colleague Delia Unson think that traumas may get crystallized in memories, and EMDR helps shake loose those harmful thoughts.EMDR founder Francine Shapiro believes that the eye movements trigger a neurological mechanism similar to what goes on during the rapid-eye-movement (REM) stage of sleep. Scientists have evidence that during the REM stages of dream sleep, the mind is working through troubling information and resolving it. REM, in other words, is a natural built-in health safeguard that allows people to work through conflicts while they're sleeping. Sara (not her real name), for instance, found that EMDR helped her work through on-the-job conflict. She sought out Mahlberg because of problems she was having with the board of directors. Sara even got physically sick after meetings with the board. After six EMDR sessions, she made the connection between the board meetings and the manipulation that took place when she was a child at her family dinner table. Somehow EMDR reprocessed this information."Through EMDR I learned the answers were in me all along," says Sara. "It seemed to work between sessions as well as cumulatively."Critics of eye-movement therapy say if it seems too good to be true, it probably is. That it's finger waving voodoo and New Age nonsense. They stress that it has yet to be documented through controlled clinical studies.Yet even the naysayers can't eradicate the growing body of evidence that is quietly accumulating in support of the therapy's results.It's only been practiced in the past seven years, but, according to Shapiro, the majority of those treated with EMDR experience positive effects. She says only 10% of patients are not helped by the treatment. Some practicing therapists have found it less effective than that.Shapiro stumbled onto the principle by accident in 1987 and several years later founded the EMDR Network Inc., through which all EMDR therapists are trained. The institute has been criticized for this closely held training, but Shapiro asserts it's the best way to assure quality control.Chuck Heikkinen, a psychologist with Counseling and Consultation Services at the University of Wisconsin, has used EMDR with many students. But he warns that EMDR should only be used by trained therapists. "In untrained hands, there's a danger of reinjuring the person you're trying to help," says Heikkinen. "EMDR looks deceptively easy to manipulate, but an untrained person may bring up terrors they are not trained to deal with."Health insurance that includes psychotherapy also covers EMDR. In the Madison area the fee is the same as other therapy sessions: approximately $85-$120 a session. (While each EMDR session averages 90 minutes, the intense finger-waving portion does not take the entire period.)But even when administered by trained hands, not every patient is able to handle the consequences. A small number of people may actually feel worse after EMDR. Therapists warn people of that danger, but it's almost impossible to assess who is most apt to have a temporary breakdown of emotions. Patients are advised to have flexible schedules after EMDR sessions, just in case they suddenly become overcome with sadness and tears. Some people experience a great rush of emotions, crying for hours; others go right on with their day."If someone is in a very fragile place," cautions Mahlberg, "EMDR is not for them." According to Unson, the best candidates are those people who are open to trying something new and have developed a trusting relationship with their therapist.Certain personality types also appear better candidates. Unfortunately, not enough research has been done to conclusively define what those types are. The common wisdom is that EMDR works best on people who are reflective, good with imagery and have a rich fantasy life."You don't know in advance," says Heikkinen. "Only after two or three sessions do you know if it's going to be helpful."