Eye Movement Therapy Helps For Psychological Problems

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Seeing is Believing

Eye movement therapy helps some people with psychological problems, but nobody yet knows why.

About 10 years ago, word of a curious new therapy began trickling into psychologists' offices. Proponents claimed that the therapy could relieve anxiety, phobias, and frightening flashbacks related to past hurts - and in a matter of weeks or months instead of years.

Now, the trickle has become a torrent. The treatment, called eye movement desensitization and reprocessing, or EMDR, is the hottest new therapy in years, and therapists of many schools are rushing to learn to do it. EMDR was first used with patients suffering from post-traumatic stress disorder, but it's now being offered for problems ranging from panic attacks to the effects of depression, addiction, and low self-esteem.

How well it works, and for which mental troubles, remains controversial. But even in Massachusetts, interest is soaring, says Deborah Korn, a Needham therapist who conducts training sessions in EMDR. She says that more than 1,000 professionals in the state have been trained in the therapy since 1991, most in the last few years. "This is a very, very exciting time in Boston," says Korn. "My phone just rings off the hook and around the clock."

Some 60,000 therapists around the world have been trained to use the therapy, and more than 1 million patients have been treated, according to Andrew Leeds, a California psychologist and consultant to EMDR International in Austin, Texas. A humanitarian organization affiliated with that group has sent EMDR specialists to war-torn Kosovo, to scenes of plane crashes and hurricanes, to the Oklahoma City bombing site, and to other crisis situations.

Scott Coffey, a psychologist specializing in post-traumatic stress disorders at the State University of New York in Buffalo, says he's never seen anything quite like the popularity of EMDR. But he notes that in a review of treatments for such disorders published last year in the Journal of Clinical Psychiatry, EMDR was ranked sixth out of nine in effectiveness by experts and was not recommended. But other evaluations are more positive. The American Psychological Association lists EMDR among the "probably efficacious" treatments for PTSD.

EMDR shares much with other therapies for people who can't free themselves from the persistent, intrusive memories of traumas such as serious accidents, losses of loved ones, abuse, rape, incest, criminal assaults, illnesses, and so on. An EMDR therapist, like more traditional ones, will have the patient reexperience the key incidents in a safe atmosphere as he or she transforms the memories into a less toxic form.

EMDR has an additional component, though: The patient is told to follow with his eyes as the therapist moves his fingers rapidly back and forth in front of the patient's face. Sometimes eye movements are replaced by sounds alternating between right and left ears through headphones, or by tapping the right and left knees in rapid succession.

Therapists say that EMDR helps patients view their past in a less threatening way, and often does it in just two or three sessions, whereas conventional "talk" or behavioral therapy can take years. One theory is that the alternating eye movements stimulate both hemispheres of the brain - the left, more verbal and literal; the right, more intuitive and artistic - to reprocess "stuck" memories.

"EMDR seems to engage nonverbal areas of the brain and physical sensations and feelings" better than traditional therapy, says Janina Fisher, a Watertown therapist. Another explanation is that the back-and-forth eye movements of EMDR mimic the rapid movements our eyes make when we dream. Like dreams, then, EMDR helps the brain become reconciled to bad experiences lodged in memory.

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One of Fisher's former clients who says he was helped dramatically is Rodney Gardner, 62, of Greenland, New Hampshire. Burdened by depression, he was prescribed Prozac by Fisher, but after two years he suffered a relapse. Gardner then underwent a number of EMDR sessions, which he says "enabled me to go back to memories I had suppressed all my life." Today, Gardner says that he no longer needs therapy. "I feel as good as I've ever felt in my life."

Several years ago, Bruce Bridgeman, a professor of psychology at the University of California at Santa Cruz, wrote that EMDR "has all the characteristics of a cult cure. It makes miraculous claims, backed by thin evidence; it is simple, yet can be learned only at the founder's seminars or in a handful of approved programs." Today, he is less critical, saying that recent studies have given EMDR more credibility: "There is no question that it helps some people. The question is why."

Dr. Bessel Van der Kolk of Boston University, a leading specialist in post-traumatic stress disorder, has used EMDR frequently and has done some testing of it. He says it is "extraordinarily effective" for victims of a single, recent event like a car accident but that "it's not a panacea" for someone with years of traumatic experiences in the past.

In treating these more complex cases, Van der Kolk says he views EMDR as "a nice adjunct to more traditional therapy. We can use it to help people over small hurdles or stuck points" that keep them from working through painful memories.

The jury is still out on whether EMDR is effective for a wider range of disorders such as depression and low self-esteem.

At McLean Hospital in Belmont, Dr. James A. Chu, the chief of hospital clinical services, says he was initially skeptical. Now "I have a kind of measured support for the technique. There is far too much continued enthusiasm for this simply to be a kind of fad."

Source: Boston Globe, 10-20-2000

Seeing is Believing

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