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Eye Movement Desensitization and Reprocessing (EMDR)

Eye Movement Desensitization and Reprocessing (EMDR) is a form of psychotherapy that was developed for treating Posttraumatic Stress Disorder (PTSD) and other mental health problems related to traumatic and unresolved experiences. It combines elements of various schools of therapy, including Cognitive Behavioral Therapy, Interpersonal Psychotherapy and Psychodynamic Psychotherapy, but what makes it unique is its method of using rapid eye movements or other forms of bilateral stimulation as a way to help traumatic memories become less troublesome.

Theory and Method of EMDR

EMDR is based on the theory that traumatic memories lead to ongoing emotional and psychological distress when they are stored in the brain in an isolated and unprocessed way, without connections or associations with other stored knowledge and memories. By being isolated in this way, these traumatic memories remain fresh and able to evoke raw, powerful and distressing emotions whenever they enter into consciousness.

The goal of EMDR is to reprocess these traumatic memories by strengthening their associations with other non-traumatic and more manageable memories and information. The therapist does this by having the client (ie. patient) recall elements of the traumatic memory for brief sets of about 15-30 seconds while at the same having the client focus on a dual attention stimulus.

This dual stimulus most commonly involves moving the eyes from side to side while tracking the therapist's finger, but can also include hearing sound pulses directed in an alternating fashion to one ear and then the other, or being touched on alternating sides of one's body. It is hypothesized that this dual stimulation elicits an "orientating response" and puts the brain in an optimal state for being able to form new connections between different memories and pieces of stored information.

Following each set of dual attention clients are asked what other thoughts have popped into their minds. These new thoughts then become of the focus of the next set, and the same process is repeated several times. The theory is that in this way the original traumatic memories will come to be associated with the various other thoughts and memories that come into the person's consciousness during this process, and this in turn will allow the traumatic memories to become processed and integrated into the person's general consciousness. Once this happens, the traumatic memory will no longer cause significant distress.

Controversy over the role of Dual Stimulation in EMDR

Much of the theory behind EMDR still has not been proven definitively, and several researchers and experts have questioned whether using the dual stimulation techniques in the therapy, such as eye movements or other bilateral forms of stimulation, does anything at all. Some studies concluded that the use of eye movements or bilateral stimulation does not play any real or useful role in the therapy [ref, ref]. Other research suggests that this component of the therapy is important [ref].

Applications of EMDR

EMDR is currently considered a first-line therapy for the treatment of PTSD. Although there have been efforts to apply this treatment to other mental health conditions, so far the evidence to support its use for conditions other than PTSD is sparse.