Tuesday, April 06, 2010

Does EMDR Work?

This is actually Roy's post.

Eye Movement Desensitization and Reprocessing is a technique that is used to treat patients who have difficulties after a traumatic event or events. If you read the wikipedia link, it works. If you ask people, the jury remains out, and the technique has not found a place in mainstream psychiatry. That's not to say that there aren't psychiatrists who do this treatment or who refer patients for it, but most psychiatrists remain skeptical.

Roy was kind enough to do a little research and here's what he learned about the research on EMDR:

A Pubmed search for EMDR and limiting to Randomized Controlled Trials brings up 28 studies.
  • 2008 study in BDD showed sig less negative body image in usual tx +EMDR vs usual tx (no placebo comparison).
  • 2007 Swedish study in 33 kids 6-16yo with PTSD found sig lower sx. Again no placebo comparison.
  • This 2008 Australian study is more interesting, splitting up the therapist's instruction from the actual eye movement behavior. The eye movement was the discriminating factor in producing lower sx of distress. No placebo.
  • Van der Kolk's 2007 study of 88 people with PTSD randomly assigned to Prozac, EMDR or pill placebo was quite remarkable, with 75% of EMDR group having long-term relief vs 0% in Prozac group. Again, no placebo control for the eye movements. If we can do sham ECT and sham TMS, someone should be able to come up with sham EMDR.
  • This one from Vancouver (from a co-resident of mine from Western Psych whom I would think to be a skeptic) broke out the different types of alternating stimulation, again finding a treatment effect.
Feel free to review the rest of them, but the data so far look promising. I did not see anything about harm from the treatment, so the risk/benefit analysis seems favorable, especially in an individual who has already completed unsuccessful trials of standard treatment.

What's your experience? Please tell us if you're a patient or a therapist who does this, or even if your friend had a good/bad experience with EMDR.


HappyOrganist said...

I know of two people (actually three) for whom EMDR has worked (helped them). One was a couple who lost their daughter in an automobile accident. The wife said that she was able to walk into the courtroom and see the woman responsible for her daughter's death without feeling - well without going into utter hysterics and not being able to handle it, I think. The "can't handle it" was apparently taken out of the experience for her because of the EMDR work.
I have another friend who has said that EMDR is helping her, as well.

onelongjourney said...

Timely post as my T mentioned this to me a few weeks ago. I've done some reading and it looks promising although the skeptic in me thinks it seems a bit hokey. I purchased a book on the use of EMDR in abuse survivors - not far into it though.

You mentioned one of the large issues - there are not a lot of practitioners - for me it would mean seeing a different therapist.

Anonymous said...

It worked remarkably well for me for decades-old PTSD. I think a lot of whether it is successful would depend on the therapeutic relationship, though. I could not have dealt with those scary issues even with the EMDR if not for feeling safe with my therapist. The EMDR is the thing that helped though. We had worked on my PTSD issues for a long while, and though I made progress, not enough progress. EMDR made the difference.

Anonymous said...

I had EMDR for PTSD but failed to tell the practitioner that I suffer from borderline personality disorder (as it had been kind of gone for such a long time - I am 36). Unfortunately the EMDR raised up a lot of old and nasty memories which were clearly better off left where they were and I ended up self-harming again after almost a decade without.

The therapy itself is difficult as it requires you to revisit, over and over again, the cause of the problem - in my case a car accident. If you are a person who locks away your emotions and issues it can be too confrontational to revisit them in this way.

Anonymous said...

Along with myself, at least 4 other people I know have tried EMDR as a therapy. The majority of us found it to be effective for managing PTSD symptoms.

One person complained that EMDR was completely ineffective, however she had difficulty understanding Why anyone would want to visualize anything,because visualizing wasn't real.

The other person who complained, tried again with a different therapist & found it to be effective, when, as she says, "it's done right" ;P

Another friend tried EMDR to come to terms with the passing of her mother, and found immediate and long-lasting results in every area of her life.

For me, as a survivor of long-term childhood trauma, EMDR worked wonders on many of the overt PTSD symptoms I was plagued with, which then gave me the freedom to work on the many deficits that occurred as a result.

I can't attest to the validity of how EMDR effects the storing and processing of memories, but I can say:

That sitting in the room with someone calmly guiding me through some of the memories, along with the physical sensation of the 'tappers', and my vocalizing of the thoughts, those things?

Gave me permission to look fully at the memories, without avoiding, or having a panic response (which is like avoiding) talk about the thoughts, soothe myself & be soothed by the encouraging ideas.

Those effects, completely eliminated ALL flashbacks, intrusive thoughts, body-memories and a good deal of hyper-vigilance, and fear.

At some point, I just realized that was past, and focused on improving the present.

Sorry this was so long!!!

Anonymous said...

Oops...the first four paragraphs of what I wrote above are irrelevant. Delete them. =)

David Bradley said...

Several months ago I interviewed an EMDR practitioner, and we spoke about the evidence for EMDR's efficacy. My opinion is that there's probably something going on that makes it more effective than other talk therapies, at least for the treatment of PTSD, but that the mechanism has nothing to do with the particular pattern of taps or eye movements.

Did you come across Gunter & Bodner's 2008 study, Roy (in Behaviour Research and Therapy)? The study suggested that moving the eyes vertically was as effective as moving the eyes horizontally, which blows a hole in EMDR's theory. It may be that the distraction of coordinated eye movements while recalling the trauma is the key.

The Monkeyman said...

I went through some EMDR for panic/anxiety. Rooted out some long forgotten events, helped me revisit them. Definitely had the feeling that it helped, although in terms of measuring efficacy I was receiving other talk therapy which may have been beneficial.

It's certainly interesting stuff. Incredibly intense.

Anonymous said...

Is EMDR covered under Obama's plan?

Anonymous said...

I have a friend who insists it did the trick for her.

Anonymous said...

I tried it once, and my therapist used glasses with lights on them. I felt like I was stuck in the trunk of a car - very claustrophobic, very trapped.

Sarebear said...

Does EMDR help you remember stuff that you can't really remember? I know my therapist would never suggest memories, and that's something that gets controversial, but I've had an experience with what I call "a blackness" and in that blackness there were some images and very intense feelings associated with those, feelings and sensations. As well as ones associated with the whole "blackness" itself, until it lifted.

It was horror, and horrifying.

But I don't know what memories or trauma it comes from, although I can make suspectful guesses about age and such based on the . . . primitiveness of some of the feelings involved. The level of horror, though . . .

I just don't know if I want to know. But then, there's that part of me that hates the mystery, and is tired of most of my childhood being a big blank. Then again, maybe it's a big 'ole blank for a reason, and maybe I should leave well enough alone.

On the other hand (am I on hand three by now? heh) if I'm ever going to get better, wouldn't knowing and processing whatever it is, no matter how hellish that may be, help me in the long run?

So when people have said it's helped them remember things, that makes me curious, but . . . kind of in a way that makes me want to run the other way, too.

onelongjourney said...

Sarebear -
I'm with you - I'm wondering if it will help me remember things - much of my childhood is one black hole. But I'm not sure I want to.

From what I've read - recovered memories are variable.

Sarebear said...

onelongjourney - what does that last statement mean? That being able to recover them varies? That the veracity of them varies? That recovering them but then your memory of them will come and go?

And yeah, ditto on the I'm not sure I want to.

I had never heard of body memories before I actually had one, once, and it seems to indicate something really bad. Like I say, it's like you are tired of having baggage from what you do not know, but then again, there are reasons your mind may have kept you from knowing. But if there IS something, I'm tired of it bloody F-ing with my personality and my entire life, pardon my french. Whatever it is, has affected my whole bloody life, and whoever or whomever(s) did whatever(s) need to not have that much power over me. If, indeed, there is any such thing.

But, I've had just a few too many psychological indicators, I think. I dissociated (or is it dissassociated) at a family in-law thanksgiving some years ago, and THAT was freaky. The only reason I remember it is because immediately after, the object that brought me out of it was the subject of someone being peeved at me for having wandered off with it whilst I was . . . . gone. I wasn't there, there was no ME, no SELF, no selfHOOD, no PERSNhood, NOBODY home, no ONE in control. There was no I. Literally no person inside that could be referred to as a "me" or as an "I". I just remember that there was a sense of some vague botheredness, and having got up from the Thanksgiving table with, as it turned out, my niece's drinking cup, which pissed off my SIL to no end, and was wandering the kitchen with it. Eventually the "will" of the cup was borrowed to give a purpose to the entity that I was at the time, not that I would have referred to myself as an I or myself, in that state. I wasn't there, nobody was. I just remember borrowing the "will" of the cup for a purpose to go back to the table and sit down, and then I was "back", and "ME" again.

Like I say, just too many psychological signs that something happened, not that I want it to have. I can punch myself in my sleep, and yet, when beat up in junior high school a couple of times, I tried to summon my hands and fists to defend myself and physically harm someone else, and all they would do is wave around in front of my face, out of conscious control, no matter how I willed them to do as I wanted.

So I can hit me, and apparently swing at will around me in bed, but nowhere and nowhen else? Not even in self defense. It's stupid.

Like I say, I hope I am wrong and there's nothing. Part of me has wanted an explanation for why I'm so . . . messed up. Something about me always wants to know the WHY of things. I dunno, gone far off the thread subject, here. Part of me has felt bad for wondering, like I'm defective, or "wrong", for wanting to know if something bad happened. And then, like you say, a big part runs the other way. I just wish my mind would make up its mind.

onelongjourney said...

Sarebear - sorry for the delay in responding -

My take from the book (and I'm only half way through - too much to read at one sitting) -

is that it is variable whether some will recover new memories.

Anonymous said...

I know this is old but I am a new reader to the blog. EMDR. It works but not quite in the way the peron who invented it claimed it does. Basically EMDR works mainly because of the D or desensitization piece which is a therapy that has been in use for years. As one commenter stated "it requires you to revisit, over and over again, the cause of the problem".

I had recently read a study (kicking myself for not saving the url) about attention and how it may be that we are only able to maintain focus/attention on up to two things at once. If this proves to be true then it would also explain why EMDR may be helpful. It has the client focusing on 2 things (eye movement or tapping and concentrating on the traumatic event) so that the emotional response may be zero or lessened a great deal.

Anyway there is this scientific american article about it as well http://www.scientificamerican.com/article.cfm?id=emdr-taking-a-closer-look

Anonymous said...

Tried it and it's very risky. You gotta revisit traumas and if they're not fully cleared in one session, you're left w/ open exposed trauma with no way to deal with it until the next session tries to finish clearing it..... personally, I felt almost in a trance so it helped temporarily w/ some lesser trauma, but nothing long term- oh and it made my more serious trauma worse...... so be careful!

jlmmjr said...

My family doc of 9 years recommended this...especially after she learned more about my past.

I haven't started the EMDR process yet, but have been meeting with the therapist that will be doing it. I was VERY glad that she is being very cautious and won't proceed until I am prepared to do so. Right now much of my past has come rushing to the surface and I'm already angry and agitated enough...so I'm glad she's not rushing me into this.

Also, I asked the opinion of a Psychiatrist who is a friend...he's ultra-pragmatic and I knew he wouldn't pull my chain. He said, "I think it's poor-man's hypnosis. However, it works for some people and the good thing is that it cannot cause any harm." ...and he encouraged me to go ahead and try it.

For me, coming to the realization of how much my past has affected me--the emotions I'm feeling are overwhelming...I'm angry, sad, confused, in denial, you name it...so I'm really anxious to try this so that I can get my life back. The therapist has been great and I trust her and she's even given me "assignments" to work on at home...so I think the combination of emdr and talk therapy will do the trick, God willing....Thanks for everyone sharing their experiences. :)

Anonymous said...

It absolutely works! I am still in therapy with it and have resolved so many traumas in my life to include 9/11, date rape, workplace violence and even some childhood things. I am currently receiving EMDR therapy for sexual abuse. I have struggled with all of the PTSD symptoms in the book for over 10 years and can finally see the light at the end of the tunnel. Warning: It isn't easy! It will bring many things to light that have been buried deep for years! There will be hard days and nights, but don't quit! It is crucial that you have a therapist you can trust and feel safe with. Do your homework to find the right therapist - one who is not only supportive, but one who can help "push" you when needed. There were many times that I didn't want to revisit something and go through the pain, but one needs to do so to "get to the other side" of it. For me, my therapist is not only EMDRIA certified, but also a consultant for other therapists - she knows her stuff! I don't necessarily use the lights that go with the EMDR and instead seem to get more benefit from the tapping and audio that also accompanies the lights. It is over an hour drive for me to get to therapy, but it is so worth it. I may actually have my life back in the near future and no longer be tortured by all of the PTSD symptoms and the horrible dissociation that I have become an expert with.

Anonymous said...

i am currently receiving EMDR for multiple event trauma that was literally dictating my life, coupled with moderare depression and generalised anxiety disorded topped off by insomnia. i wonder how i ever got up in the morning. I was advised to do some talking and therapy courses (NLP) to see if they would help me 'cope' but didnt really work too well. then my psychiatrist in conjunction with a councillor (he discovered that i may be suffering from PTSD, caused by physical abuse, sexual abuse as a child, death of children and a catalogue of other things,via a talking session) recommended EMDR. i would have tried anything to try to feel 'normal' again. i have had two sessions so far ind it seems to be working somewhat although it is difficult and it takes some time for the linked memories to begin and then to see them, as for me they came REALLY quickly but with time im hopeful it will get better. for me it is a thumbs up and i have something to look forward to now. getting rid of these ghosts that have haunted me for decades now.

Me said...

I went and did it a while back and it felt like 50lbs was lifted!! I can't tell you how amazing that felt! I am returning this month to continue much needed work and I can't wait to be the Me I once was! If someone is hurt and skeptical they have nothing to loose but inner peace to gain!

Anonymous said...

I am a Certified EMDR Therapist and I have been a client of another EMDR Therapist Two words: It Works.

It is the bi-lateral stimulation that engages both sides of the brain that makes the difference. The theory is that a traumatic memory is encoded in the brain in a different way than the memory of what you had for dinner last night. The intense feelings, thoughts, images, sounds, textures are strongly linked in the memory network in such a way that if something in the present is like the past trauma, we respond automatically with fight or flight. If you stop to think about what is dangerous, you would be eaten by the tiger (or whatever threatening object is in your space.) So that traumatic memory is easily accessible in all it's sensory glory in the here and now. EMDR reprocesses and reintegrates that trauma memory in a way that does not trigger all the PTSD symptoms. You relive the memory with one foot in the here and now and one foot in the past in a controlled way and with both sides of the brain stimulated by the bi-lateral stimulation. Therefore, resulting in the memory being integrated like other benign memories of your life. Valerie Myers, LCSW

mismissy74 said...

i walked in the therapists office sick to my stomach, shaking, pounding headache and weeping. the way ive been feeling for weeks after talking about trama. I left the office with this odd calmness with no headache shakiness or nausea. I think its working.

Anonymous said...

Had a very revealing second EMDR experience, left the office feeling lighter and more in control of issues related to my pTSD. BUT, in the following week, experienced extreme fatigue, vertigo, and serious balance issues. Skipped the next week. Am going to retry tomorrow. I felt like it helped (my brain anyway) but my body seems to be showing a reaction...so much so that for several days I didn't trust myself to drive.

anonymous said...

I started my journey with EMDR years ago in rehab. It was ok i guess but no big WOW moments. Now fast forward about 6 years and the experience now is amazing. I actually just had a session this morning.
Its not fun or easy by any means. Its hard work, emotional, and exhausting but its worth it. I had a lot of trama as a child around my parents and now have to deal with all the issues that have branched from those early years of fear.
It was explained to me that as a child when we went into survival mode some areas of our brain go "off-line" while one area is dominant. So now, years later, its about filling in those blanks and seeing the whole picture.
Hope this helps and if your considering EMDR then DO IT. and give yourself a few sessions to get comfortable with your therapist and this type of treatment. GOOD LUCK! :)

Peggy said...

I am a clinical socal worker who does EMDR therapy. I have found it effective in about 98% of my clients.One purpose of the eye movement or tapping is to help the client have a dual awareness, i.e., the safety of the room she is in while, at the same time, being with whatever horrible memory is needing work and being with that memory with all the senses, vision, smell, touch hearing, thoughts, or some combination of those senses which contain the memory.

EMDR therapy is an eight phase process, desensitizing and reporcessing is just one part of it. It is based on the theory of Adaptive Information Processing, that if we access memories improberly stored, our own adative information processing system will take them toward health.

It is not meant to recover memories. Some do recover memories, and these are accurate in how they impacted the person, not necessarily true in facts.
It is a "controversial" therapy only to those persons who feel their theories are threatened by EMDR and those who haven't bothered to read the research.

Anonymous said...

I had a bad experience with EMDR. I think much more stringent research needs to be done. It would take a long essay to go into all the reasons I think EMDR is dangerous. Within Somatic Experiencing, a lot of care is taken to make sure the client is not re-traumatized by the therapy. The way EMDR works violates this principle. EMDR has various components; the good should be kept and the bad thrown out as the bad experiment it is. I am not the only one to have a negative experience...

Jenny said...

Hi, Both myself and my 3 year old son were treated with EMDR following a violent armed robbery some years ago. The results for my son were astounding, after his 2nd session he went from being a terrified little boy who couldn't be in a room alone back to his normal self. It worked exceptionally well for me too. There were side effects, as others have mentioned, of extreme fatigue and a little vertigo but well worth it. I was extremely skeptical but It certainly worked for us.

Anonymous said...

I have a 25 yr old step son receiving EMDR for childhood trauma and to recover from(last year) mentally breaking down and hasn't been able to work. He really likes the sessions, his therapist says he works hard at getting better (staying in the session when it get's really tough) and has received about 16 sessions. We are paying for it.

He was taking schizophrenic medication but stopped about the time he came to live with us. He drinks heavily every night (has been for years, it would seem as he handles his alcohol well) and now is starting to smoke. His therapist says give him time he's really working hard. His Dad and I have been extraordinarily patient and affirming and hold him accountable to following through on job apps, chores, etc. Now we are hearing, from his therapist, that we need to be extra careful to not expect too much at this time and give him lots of praise. We are paying for his sessions and he is drinking, smoking and playing video games.(and moving slower than a snail to get a job) There is something really wrong with this picture. A combination of psychiatric issues and poor character development. I feel like our EMDR therapist is trying to fix the forementioned with EMDR, as wonderful as she is.

Anonymous said...

In case anyone is still wondering, EMDR is, in fact, covered by Obama's plan, provided that an EMDR therapist in your area accepts your insurance, and you have good reasons for needing therapy. My Cal-optima provider referred me to an EMDR therapist.
There's a lot of evidence that believing in a therapy increases its efficacy. My therapist reminded me of that repeatedly before starting the treatment, because she knows I am a skeptic.
I just started the program, but I sincerely wish that the lights on the panel could flash in a different pattern, at a different frequency, vertically, with different sounds and vibrations. Furthermore, I would like to be paid for the clinical trial.
In all seriousness, I am a young cancer survivor, and I couldn't afford any more healthcare if Obama weren't helping me. So I am very thankful for his help.

Unknown said...

Same here... at least I now know I am not alone.