The E Have It Technique Uses Rapid Eye Movement To Desensitize Patients To Past Traumas

Therapists are entranced by a finger-waving treatment that some say relieves posttraumatic stress, a kind of latter-day hypnotism exotic enough to evoke images of a bewhiskered psychiatrist spinning his patients into a daze with a swinging watch.

Acting on the maxim that extraordinary claims require extraordinary proofs, researchers are setting out to discover if the therapy known as Eye Movement Desensitization and Reprocessing, or EMDR, offers help to rape victims, veterans and cancer survivors.

Several of those researchers presented their findings on EMDR last summer at the national meeting of the American Psychological Association in Los Angeles.

Developed by Francine Shapiro, EMDR has been controversial because of its apparent simplicity. Therapists and patients say that in only a few sessions it addresses problems that have proved resistant to treatment. Another root of the controversy is that no one understands its physiological basis.

Shapiro said she believes the therapy has been met with skepticism at least partly simply because of its novelty. “When there is a breakthrough, there’s a natural sense that this is too good to be true. But I think that’s because we tend to set our sights too low.

“We shouldn’t expect less of psychology than we do of medicine. The body can be healed in a matter of weeks or months from significant trauma. I believe the brain can heal at the same rate as the rest of the body,” she said.

“The problem is that the effects clinicians are reporting are so dramatic compared to conventional therapy that a lot of resistance comes up because they haven’t seen it before. People in a very long-term model of therapy find this impossible to believe.”

In an EMDR treatment, the patient holds an image of a past trauma in mind while moving his or her eyes from side to side, following a therapist’s quickly moving fingers. Since Shapiro developed the technique in 1987, she and other therapists have refined the system so that it sometimes includes other forms of right-left alternating stimulation, such as having the therapist tap a patient’s hands alternatively.

The patient then reports the images, thoughts, emotions and physical sensations that emerge, according to proponents. That process is repeated until the client becomes desensitized to the troubling thoughts. While the technique does not erase memories, it does reduce or eliminate the pain those memories cause, according to the method’s supporters.

In reporting on a study of EMDR conducted by herself, Robert Tinker and Lee Becker, Sandra Wilson of The Union Institute of Cincinnati described EMDR as a “new and complicated method of treatment” that “appears to be a very effective treatment for post-traumatic stress.”

The Wilson-Tinker-Becker study involved 40 men and 40 women, ranging in age from 21 to 63, with a wide range of income and education. Members of the group had had a variety of traumatic experiences, ranging from physical or mental abuse to combat trauma to rape. These traumatic incidents had occurred between a few months to 54 years before the study.

After all of the patients had received EMDR treatment, Wilson said, only one person did not report improvement in his condition.

But Wilson cautioned against perceptions that the technique is a simple one.

“EMDR is very much like a chess game. If you watch people playing chess without knowing the rules, then it appears simple as well - just people moving figures from one square to another. But that doesn’t make chess a simple game. In the same way, EMDR is not just wiggling the eyes back and forth,” she said.

Steven Lazrove, a Yale University psychiatrist, is about to begin a follow-up study to the WilsonTinker-Baker one. He also spoke at the American Psychological Association conference, saying that based on his clinical experience with EMDR he believes that the therapy will be validated.

Howard Lipke, psychologist at the Veterans Administration Medical Center in North Chicago, Ill., who presented another paper on EMDR at the APA meeting, said that the technique is growing in popularity.

“I think that people in the field are flexible enough that they will accept any new therapy once they see results compared to the ones that EMDR produces. This technique has received an extraordinary amount of scrutiny,” he said.

“I think that the research that is being done on it will prove its effectiveness to people who may now be skeptical because they are not yet well educated about it.”

Although the idea came to Shapiro suddenly one day, it came as part of a longer search for alternative treatments for people who had survived cancer and other traumas.

Shapiro, a cancer survivor, became convinced that there must be alternatives to the standard medical solutions, especially concerning the psychological effects of cancer.

“It struck me that we were putting men on the moon, but we weren’t able to deal with our own minds and bodies,” she said.

Shapiro, who lives in Moss Beach, south of San Francisco, and holds a doctorate in clinical psychology, made the discovery that would lead to EMDR while walking in a city park one day in 1987. Ending her own search for an effective method to treat post-traumatic stress, that revelation became the beginning of another journey that has launched a therapeutic movement now used by hundreds of psychologists, psychiatrists, social workers and therapists across the country.

“Some disturbing thoughts were disappearing, and when I brought them back they didn’t have the same charge. And they were leaving more quickly than I would have expected.”

Shapiro said that in analyzing what had happened, she realized that when troubling thoughts came to mind her eyes started moving very rapidly and that after that rapid eye movement her pain receded.

The discovery brought such quick relief to stress that Shapiro was eager to try it out on others. She gathered together willing human guinea pigs and started experimenting.

“I found that most people didn’t have the control to do it themselves, and the easiest thing was to have them follow my fingers.”

Shapiro began to develop a detailed procedure for carrying out the technique, publishing a paper on EMDR in the Journal of Traumatic Stress in 1989 and beginning to train other licensed therapists to use the method in 1990.

While no one understands how EMDR might work, Shapiro and other researchers say it may be connected to what happens naturally during deep sleep in the REM or rapid eye movement, phase of sleep in which the eyes also move back and forth quickly.

Last year Shapiro traveled 36 weeks of the year, presenting workshops on EMDR and attending conferences. The demand from therapists has escalated to the point where she said she has decided to teach 10 other people to assist her in training therapists who will join the 9,500 already trained in the technique.

Behind her drive to spread the word about EMDR, Shapiro said, is a deep concern for people and their suffering.

“My life’s devoted to it,” she said. “When you see the amount of pain and suffering that’s going on, you react to it. Every clinician I teach will be able to help hundreds of people,” she said.

“Sometimes all I can do is feel grateful. It’s a blessed life to see something improve people’s lives. Other times it makes me sad because there can be so much resistance to something new. And sometimes it’s frustrating because I’d like to have seen everybody helped last year.”