With a Wave of Her Hand

Debbie appears comfortable, seated in a padded, living room-style chair. But in the same way the soft, tufted leather wraps around her body, DebbieÕs mind is wrapped around a nightmare. Following the instructions of Linda Ronconi, who sits in front of her and slightly to the right, Debbie concentrates on a detailed mental image of the most dreadful experience of her life; something that happened to herÑsomething that was done to herÑwhen she was 15 years old.While Debbie, with eyes open, faces her past, Ronconi faces Debbie, her right hand held 18 inches from her patientÕs face. RonconiÕs index and middle fingers are extended side-by-side as she moves her hand horizontally across DebbieÕs field of vision, repeating the motion once every couple of seconds. DebbieÕs eyes follow RonconiÕs hand, but what she sees is her own pictureÑher own trauma.This isnÕt hypnotism, and Ronconi isnÕt a New Age shaman waving her hand to conjure DebbieÕs inner demons. Ronconi is a licensed counselor and marriage and family therapist whose practice features the hottestÑperhaps most controversialÑnew trend in the psychiatric field: Eye Movement Desensitization and Reprocessing.EMDR, according to its advocates and practitioners, benefits patients suffering from post-traumatic stress reactions by clearing Òneurological blockagesÓ between areas of the brain. Since 1987 EMDR has been used on HIV/AIDS patients, Vietnam veterans, and victims of hurricanes, earthquakes, fires, and the Oklahoma City bombing. The inventor of EMDR, Francine Shapiro, Ph.D., claims that more than 20,000 therapists have been trained in EMDR, to the benefit of more than 1 million patients around the world.But some in the psychiatric profession see the California-spawned regimen as experimental and fear it may be displacing proven, more effective therapies.Debbie is a believer. After a single, one-hour session of hand waving and remembering, she waved goodbye to Ronconi and left the office. Patient and therapist agree she probably wonÕt need to come back, though Debbie says her improvement wasnÕt Earth-shaking or instantaneous. She recalls feeling Òa little bit of reliefÓ as she left the office. ÒItÕs not like I was transformed or healed or anything. I felt like IÕd been through something emotional. I was kind of tired.Ó That night, after she put her daughter to bed, Debbie noticed more. ÒI felt...I just felt different, like IÕd been changed. It was a kind of calm.ÓDebbie was surprised. Now 41 and single, that incident in her past (which she will not reveal) has affected her behavior throughout her life. Only recently did she see a link between her frequent bouts of anxiety and what happened 26 years ago. After learning about EMDR and Ronconi, Debbie sought her out.ÒIÕve been in situations since the therapy that have shown me itÕs a lot better, with the anxiety I was dealing with,Ó says Debbie. ÒItÕs almost like my brain doesnÕt remember it. When I start getting into that [anxious] behavior, itÕs like something kind of shuts down...like, ÔOh, well, IÕm different."The difference, Shapiro says in her book, is that EMDR patients like Debbie are enabled to access memories they have previously closed off. This is also a goal of traditional therapies, but Shapiro says EMDR speeds up the process and Òdoes not dwell on them and does not, as traditional therapy can, last for years.Ó Like a microwave oven compared to a gas stove, EMDR Òuses eye movements and other forms of rhythmical stimulation, such as hand taps or tones, in a way that seems to assist the brainÕs information-processing system to proceed at a rapid rate.ÓThe secret to EMDR lies not in the eye movement itself, says Ronconi, but in the groundwork the therapist and patient lay before the actual procedure.ÒItÕs critical that I do a complete history,Ó she stresses. ÒYour lifestyle, if youÕve been in therapy before, your medical history, your family medical history, just so I get a grasp of the person. If you have a lot of unresolved issues we may need to talk about them first, because if we just plow right into EMDR thereÕs no telling what weÕre going to dredge up. The case history may take two or three sessions.ÓItÕs during those preliminary sessions that Ronconi helps a patient create a mental picture to represent the trauma, and the three sessions it took Debbie to paint that picture were the most difficult steps in the process. ÒShe does a lot to get that picture super, super clear in your mind with a lot of detail,Ó Debbie recalls. ÒI remembered a lotÑthe curtains, where the window was, what the person was wearing. It was painful. Feelings came up that surprised me.ÓÒWhat I want to do is recapture all of the sensesÑthe sounds you heard, what you saw, what your body felt,Ó explains Ronconi. ÒThe critical thing is, ÔWhat are you telling yourself? WhatÕs the negative belief about the incident?ÕÓ Revealing that negative belief leads to the creation of a counterbalance, says Ronconi.ÒWe want to create the positive cognitionÑthe positive belief we want to install and replace that negative beliefÑsomething like, ÔIÕm OK, I can go on living.ÕÓ Only with that tool in hand does Ronconi begin the visible component of EMDR.ÒWeÕre not quite sure how it works,Ó says Beth Shepard, an assistant professor in the psychology department at Trinity University, who raises a skeptical voice concerning EMDR. ÒIn my psychopathology class we discuss it as a controversial type of intervention. There are certainly claims out there of unusual cures of people who suffered from post-traumatic stress disorder for years and years, whoÕve been in traditional kinds of therapy, who participate in two or three sessions of EMDR and then report a remediation of symptoms.ÒI think that in general,Ó Shepard continues cautiously, Òthe jury is still out because there arenÕt enough methodologically sound, empirical investigations to demonstrate its efficacy yet. Those studies are starting to be done, mostly in VA hospitals around the country.ÓIn the July 1997 edition of the electronic peer review journal Traumatology, Nathan Denny, Ph.D. of Texas A&M proposes that EMDRÕs repetitive motions simply distract the patient, allowing Òpreviously suppressed alternative responses to the traumatic memory to emerge.Ó That memory is then treated like any other: the patient processes it, interprets it, and Òfeels better.Ó Denny likens the phenomenon to a person who learns from his own experiences while writing an autobiography. The magic is in the patientÕs mind, not the therapistÕs hand.The psychiatric jargon being flung around in the debateÑÒsubjective units of distress scale,Ó Òorienting reflex,Ó Òconditioned stimulus,Ó Òconditioned responseÓÑdoesnÕt matter to Debbie. She just knows that, for her, EMDR worked.ÒI made the ending of the picture different,Ó she says proudly. ÒI changed part of it. And when I go back to the picture in my mind, itÕs now the way it was when I ended the session, not the way I referred to it before. ItÕs better.Ó

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