A wave of the hand can be good therapy

A surprising technique helps trauma victims deal with their problems

Health & Fitness

April 28, 2002|By Linda Marsa | Linda Marsa,Special to the Sun

Watching a therapist's hands move back and forth in front of your face while recalling painful memories may seem an unlikely way to alleviate trauma. But hundreds of thousands of people have reportedly tried the technique, and some psychologists -- and their patients -- say it works.

The therapy, called eye-movement desensitization reprocessing, involves a combination of hand movements (or sometimes finger taps or sounds), accompanied by verbal commands. The patient follows the therapists' movements with his or her eyes while discussing the event or problem that led the patient to seek help.

"EMDR sounds like utter nonsense, but this weird thing has a profound effect on people," says Dr. Bessel A. van der Kolk, a psychiatry professor at Boston University who has studied EMDR.

Once employed mostly to treat severely traumatized patients, EMDR is now used for such common problems as depression, loneliness, fear of flying, claustrophobia and stage fright.

Since it was first devised by California psychologist Francine Shapiro in 1987, more than 40,000 therapists in the United States and abroad have attended EMDR workshops, and an estimated 2 million patients have been treated with this technique, according to the EMDR Institute in Pacific Grove, Calif., which conducts training workshops in the technique.

Even though no one is quite sure how EMDR works, it has received some notable endorsements. The American Psycholo-gical Association, the nation's primary professional organization for psychologists, has determined that it's an effective treatment for civilian post-traumatic stress disorder, and Kaiser Permanente, one of the nation's biggest HMOs, uses the technique to treat patients at mental health clinics in Northern California.

New techniques

EMDR's increasing acceptance is part of a larger trend in psychotherapy. Conventional talk therapy, which can be a lengthy process, has been augmented or supplanted by techniques that emphasize problem-solving, such as cognitive behavioral therapy, which tries to change abnormal reactions to ordinary stresses. Such experiential techniques, which seem to help patients more quickly, have been inspired by new insights into brain chemistry and how the mind deals with trauma.

"We thought that if people can talk about something, they will feel better -- but we've discovered just talking doesn't necessarily change your life," van der Kolk says.

Skeptics argue that there's nothing unique about EMDR. They contend it's just a repackaging of existing therapies.

"Patch this together with the placebo effect, and it's not surprising that it's helpful," says Richard J. McNally, a psychology professor at Harvard University. "There are a bunch of syndromes where EMDR does seem to work well -- with PTSD, phobias and panic disorder. But people are now using EMDR for everything -- even for improving golf games."

EMDR was first used on patients suffering from post-traumatic stress disorder: Vietnam veterans; victims of rape, incest or child abuse; and survivors of natural disasters or traumatic events, like car accidents, earthquakes, shootings and bombings.

When terrorists attacked the Pentagon and the World Trade Center, EMDR therapists traveled to Washington and New York to counsel survivors, victims' families, and rescue and recovery workers.

Tracking eye movement

A typical EMDR session begins with the therapist asking the patient to envision a safe place he or she can call to mind should the person feel threatened. The patient is then told to think of the disturbing experience while focusing on the therapist's hand movements (or sounds or taps). The therapist then asks the patient to talk about the image and the feelings about it. Next, the client returns to the distressing image and is told to imagine a better solution. The patient is then asked his or her feelings to the solution.

After repeating these steps several times, many patients say they're able to distance themselves from the trauma.

Even scientists who say EMDR works can't explain how it alleviates the effects of trauma. But, after three or four sessions, brain scans of people with post-traumatic stress disorder showed changes in the brain regions that govern emotion, memory and impulse control, says van der Kolk.

"The eye movements seem to cause a shift in the cognitive processes," says Shapiro, a senior research fellow at the Mental Research Institute, a nonprofit training and research center in Palo Alto, Calif. Shapiro stumbled upon the technique while out for a walk about 15 years ago. She noticed that rapidly moving her eyes back and forth eased her disturbing thoughts.

Linda Marsa is a reporter for the Los Angeles Times, a Tribune Publishing newspaper.

Information

For more information about EMDR, contact the EMDR Institute in Pacific Grove, Calif.; 831-372-3900; www.emdr.com. The institute can refer people to EMDR-trained therapists in their area.

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