David E. Dillon, Ed.D.
David E. Dillon, Ed.D.
Eye Movement Desensitization and Reprocessing (EMDR) took
me by surprise in the fall of 1994, when a person we'll call Ann told me how
she had recovered from Post-Traumatic Stress Disorder (PTSD) symptoms in one
two-hour session. While in a foreign country, she had seen several violent acts
that she could not forget. For two years after returning to the States, Arm had
tried to escape the flashbacks and frightening dreams.
Then someone told her about a therapist who practiced
a new therapy (EMDR) that might help her free
herself from the crippling effects of the trauma. Ann took her advice by
seeing this therapist for one two-hour interview that liberated her from the
PTSD symptoms.
Obviously, I was
incredulous but could not easily discount her experience. Ann went on to
explain how the nonhyypnotic therapy proceeded. Apparently her visual memory of
the traumas was so strong the therapist had to use alternating left-right
sounds instead of eye movements to process the memories. Through most of the
two hours, Ann remembered and abreacted until the memories had no further
power to torment her. She left the session completely free from the symptoms
of PTSD.
My first reaction was
to not take her very seriously, even to think that Ann's experience was an
aberration explainable by the high motivation and faith she had in this
therapist. In short, I "blew it off" until I learned that Ann was a
very reliable person and an excellent student. I could not take her experience
lightly. So when I learned the first EMDR training session
was to be offered in January of 1995 in Chicago, I registered, hoping I would
either be convinced or dismiss the matter completely.
WHAT IS EMDR?
What is this EMDR that
changed Ann so dramatically? EMDR uses right brain/left brain stimulation
(visually, tactically, and/or audibly) while counselees focus on a distressing
memory, with the result of desensitizing the memory until it has little or no
effect on them. It's unfortunate that eye movement became a part of the name,
since sound and touch will also facilitate desensitization and re-processing.
Francine Shapiro serendipitously discovered the effect of eye movement when she would walk in a
park while at the same time thinking about troublesome issues. Her emotional
pain decreased, a phenomenon that puzzled her so much that she began to
investigate why this happened. Shapiro hypothesized that the increased eye
movements, occurring naturally in a scenic setting, had something to do with
the reduction in emotional pain associated with her issues.
Armed with this clue,
she experimented with eye movement in therapy, discovering that her clients
needed some guidance to get their eyes to move during the therapy session.
Shapiro started using her hand to help guide their eyes while they focused on
painful memories. Similar to her experience in the park, they began to recover.
Shapiro designed a
study with a treatment and control group, but when she learned that the
treatment group was getting better and the control group was not, she treated
both groups out of concern for their pain.1Compassion has guided Shapiro's decisions about the
dissemination of information and training of EMDR therapists.
Like Freud, Shapiro has chosen to control how and
when the EMDR protocols will be given. Though she set up her own institute
rather than turning her findings over to the academy for confirmation through
research, Shapiro has consistently welcomed research findings. But because of
the personal nature of therapy, psychological research is difficult at best, if
not impossible. There are several reasons why this is particularly true of
EMDR research.
WHY RESEARCH IS DIFFICULT
First, EMDR is not a
therapy system but a method or procedure that fits within many existing
therapy models. Effects of treatment (as in any system of therapy) are dependent
on many factors. Among these is the therapeutic relationship. EMDR works best
within an empathic relationship. Current methods of research require strict
control of extraneous variables that might confound the results of the study.
This restraint, unfortunately, removes rapport which is a key ingredient for
success with EMDR (and most other methods and models). Katy Butler raises the
same question: "How do you dissect something as seamless and subtle
and multifaceted as good therapy without killing it, like a bug on a pin?"2
Spontaneity is a second
reason for the difficulty of experimentally examining EMDR. Putting therapist
and counselee under experimental scrutiny creates a "be spontaneous"
paradox that hinders accurate findings.3 In short, people are not
able to respond spontaneously on command,
because if they could it would no longer be spontaneous, and if they don't
they are not obeying the command. Experimental controls create a paradoxical "no win"
situation that reduces therapeutic efficiency.
A third reason involves the credentials of the researcher and the unfortunate gap
between research and clinical practice. Researchers learn and practice EMDR
protocols in order to test the method fairly. Typically researchers are not
clinicians, and even if they are, practicing a method like EMDR without
adequate training and experience is clinically unethical and/or academically
useless. Clinical experience with EMDR convinces people of its efficacy. But is
this replicable in the lab? At the Uni;versity of Florida in 1993, Charles
Figley and Joyce Carbonell attempted to discover the effectiveness of EMDR
along with three other avant-garde approaches to PTSD (and less severe
emotional disorders).4 They designed a different experimental approach that
involved bringing successful practitioners to the University for a week-long
inquiry by observation of actual therapy, measurement of before-and-after
indices of symptoms, and discussion of possible commonalities among the
methods.
As expected, tight
research protocols were absent or violated by sincere attempts on the part of
the clinicians to actually help their subjects. Each method, however, brought
some relief to the subjects chosen by Figley and Carbonell. But any commonality
an-tong the methods remained elusive.
Jay Efran, a Temple
University psychology professor, comments: "They [the academic establishment]
are holding EMDR (and other methods) to an unfair standard, and requiring more
in the way of proof than is normally required, simply because the method does
not make sense to them."5 (Brackets
are mine.) Mary Sykes Wylie quotes one psychology professor who impugns much
academic research because the method under study is turned over to
"inexperienced students" who get frustrated with the manual, do their
own ad hoc therapy, and "write it up as if the manual did the trick.”6
Good research controls
confounding variables by removing them from the study (e.g., limiting the
subjects to one gender, intelligence level, and/or educational level) or by,
statistically controlling their influence. But statisticians know that when a
population is divided into two groups, there are members of each group who are
most unlike each other (these people are the ones used for comparison on a
dependent variable), but the closer people come to the mean or average the less
the distinction. The largest number of people in both groups are the approximately
two-thirds within one standard deviation above and below the mean. The closer
to the mean, the more people are alike. The fact that EMDR is used by thousands
of therapists who report successful results suggests there is little
possibility that one or even a few factors are influencing the outcome of EMDR
results. For example, if these therapists were of one theoretical persuasion,
personality, or sex, we could then say that similarity is consistently influencing
the outcome of EMDR therapy.
Another reason to
disqualify EMDR as an effective method is to question the veracity of the
reported successes. At best, this says EMDR therapists are naive and at worst,
charlatans. Such deductions pale when we consider the sheer number of
therapists who are claiming enthusiastically that EMDR works. Wylie comments:
"These reports, heard over and over, sound like stories of conversion and
salvation--first 1 was lost, then I was found--that have been too easy for
skeptics to dismiss as so much pseudo-religious hot air. Clearly something
"real" is happening--to simply' reject out of hand the experiences
of hundreds of thousands clients and therapists because empirical trials are
lacking seems perverse."7
We may disagree with Wylie, but the fact remains: Anyone who sincerely learns
and practices EMDR knows that it works. Thousands of clinicians are
claiming the success of EMDR as well as numerous people who have been helped.
The good news is that solid research is beginning to appear in journals.
Wilson, Becker, and Tinker report significant decreases in anxiety and
increased positive cognition regarding stressful experiences of 80
participants.8 The study
employed an independent assessor and several EMDR therapists who were strictly
monitored. Above average statistical procedures were employed to assure
accurate results.
PERSONAL EXPERIENCE
My own experience also
supports the efficacy of EMDR. I have used EMDR in a single session to relieve
symptoms resulting from witnessing an auto accident where several children were
injured to one case that lasted 10 months, involving childhood emotional and
physical abuse. Before learning EMDR, I would not have had the same success
with such cases, other than to work through the memories and encourage the
sufferer to know where the pain is coming from and then focusing on the present
and future. But now, cases like these are resolved, and the client happily
terminates, reporting no need for further help.
Another case involved a
woman who for all of her adult life had a lingering dissatisfaction with life.
She was constantly looking for "something" to satisfy a deep
longing within. We decided to try EMDR and, in one double session, we
discovered memories connected to her understanding of sex and her sexuality.
We worked through her memory of how she had learned about heterosexuality, how
disgusted she had felt, and her conclusion as a child that she was not like the
neighbor kids who told her about sex and who appeared happy about what they
knew.
We also worked through
a teenage memory of learning that she had been sexually abused as an infant.
These and other unprocessed memories had led her to conclude that she was bad.
When we faced this cognition with EMDR, she worked through not only the shame
and guilt but also the false conclusion about her own sexuality. At the end of
that EMDR session, she reported that a great weight had been lifted and those
memories were now faded and unimportant.
Success like this is a
regular experience for me. But none of this comes without considerable
emotional pain. EMDR is not effortless emotionally for the counselee or the
therapist. We must be willing to experience their pain as it is desensitized.
Yet EMDR therapists continue to practice it because it works--people get
better--and EMDR counselees return for subsequent sessions--even though the
last one was painful--because they find permanent relief from distressing
memories and their influence on their lives.
Since learning EMDR, I
have terminated more satisfied counselees than in the same
time period before EMDR. Counselees spontaneously and enthusiastically report
how much better they feel and think. Before EMDR, people I had treated might,
after several years, tell me how much I had helped them, or I would learn
indirectly from another person that a previous counselee appreciated the
therapy he or she had with me. EMDR has revolutionized my counseling practice.
BIBLICAL & THEOLOGICAL CONSIDERATIONS
What happens when
anyone heals whether physically or psychologically? Consistent with a theistic
view (as contrasted with a deistic one), I believe God's influence in the
world is both constant and ubiquitous, resulting in his common grace working
both for believers and nonbelievers alike. He provides for physical and
psychological healing for all human beings, even when the psychological and
medical interventions are given by those who do not believe in him. It is
easier to see how medical interventions free the body from the sway of evil in
the various forms of disease. Psychological procedures free the human mind and
heart from distressing attitudes, thoughts, beliefs, memories, and experiences.
Generally when medical and psychological practitioners help another human
being, they are making a way for God's common grace to heal the sufferer. EMDR,
like the surgeon's scalpel or the dentist's drill, opens and removes the
problem, allowing counselees to heal on their own.
What general biblical
principles are applicable to the EMDR method? Paul expected believers to
progress toward Christlikeness as part of their sanctification process (Rom.
8:28-30). Believers are to change both cognitively (Rom. 12:2; Eph. 4:17-24)
and behaviorally (Eph. 4:25-5:15). Most people may not have painful memories to
hinder their spiritual and psychological development. But what about those who
are plagued by distressing childhood and/or adult experiences?
David Seamands
addresses painful memories by practicing what he calls the healing of damaged
emotions. In a careful fashion, Seamands enters into the counselee's past,
primarily assisting the counselee into prayers of confession and petition for
God's help with the painful memory. This kind of intervention allows counselees
to view themselves, others, and the world differently. Cognitive change
accompanies the healing of the memory.
EMDR as used by an
unbelieving therapist functions in a similar way without the religious
practices of prayer and confession. I include prayer as part of the EMDR protocol,
and I have repeatedly found my Christian counselees turning toward the Lord
Jesus or discovering he is right there with them in the painful moment.
Obviously EMDR, like
many other modern psychological interventions, is not found in the Bible. Yet, the is biblical warrant for forgetting and that is what EMDR helps people to
do. In Philippians 3:13, Paul illustrates the importance of future focus by
emphasizing his forgetting those things that were behind him. We can not fully
look to the future while we cling to the past. But forgetting what is behind
is not always easy or possible. What then?
Paul could brag about
his birth, education, and religious practices. But he also fiercely persecuted
the church. He sanctioned and witnessed the death of Stephen. Paul's pedigree
and heinous acts were indelibly etched on his mind. Yet he recommends in
Philippians that his readers forget just as he has forgotten the past. How?
Forgetting is usually a natural process. Memories are processed by talking
about them, reviewing their meaning, and emoting their pain. Paul may have
forgotten his past in this natural way, or he may have had the help of the Lord
either on the Damascus road or during the three years of special training the
Lord gave him after his conversion.
Either way, Paul forgot
the past and focused on the future. Can we do the same thing? Usually we do.
But there are experiences so hard to forget that we are not able to let go of
them and focus on the present and future. People need help in these cases, and
EMDR has proven itself effective.
Some have said, "The
proof of the pudding is in the eating." The same is true for EMDR. If
you're looking for proof, first look within. Are there memories that still seem
vivid and laden with emotion? Do they interfere with your progress as a
Christian? Like the "proof of the pudding," tasting EMDR for yourself
is the best way to determine its effectiveness and veracity.
David E. Dillon, Ed.D., is associate professor at Trinity international University in Deerfield, Illinois.
Endnotes
Dr. David R.Henson
303-987-4660
http://www.trauma-relief.com