Hockenbury Discovering Psychology 5th txtbk

604 CHAPTER 14 TherapiesSCIENCE VERSUS PSEUDOSCIENCEEMDR: Can You Wave Your Fears Away?In the late 1980s, a psychology graduate student named FrancineShapiro was walking alone in a park, grappling with some troublingthoughts. According to Shapiro, “I noticed that when a disturbingthought entered my mind, my eyes spontaneously startedmoving back and forth. At the same time, I noticed that my disturbingthought had shifted from consciousness, and when Ibrought it back to mind, it no longer bothered me as much”(Shapiro & Forrest, 1997, 2004). Speculating that her back-andfortheye movements were simulating the rapid eye movements(REM) of dreaming sleep, Shapiro developed a treatment techniquein which patients suffering from traumatic memories visuallyfollowed her waving finger while simultaneously holding amental image of disturbing memories, events, or situations.Ultimately, Shapiro earned her doctorate in psychology by treating22 patients with post-traumatic stress disorder (PTSD) with hernew therapy, which she dubbed eye movement desensitizationreprocessing, abbreviated EMDR. In two published papers,Shapiro (1989a, 1989b) reported that almost all of her patients experiencedsignificant relief from their symptoms after just oneEMDR therapy session (see also Shapiro, 2007).This was the beginning of what was to become one of thefastest-growing—and most lucrative—therapeutic techniques ofthe last 20 years (Herbert & others, 2000). How popular isEMDR? Since Shapiro established her EMDR Institute in 1990,more than 40,000 therapists have been trained in EMDR. Closeto a million patients have been treated with the new therapy(EMDR Institute, 2001).Since its launch, the claims, techniques, and jargon of EMDRhave undergone some changes. While originally touted as a onesessiontreatment for the distress associated with traumaticmemories in PTSD (Shapiro, 1989a), EMDR therapy today frequentlyinvolves multiple sessions. According to Shapiro (1995),comprehensive EMDR treatment involves eight phases, whichcombine elements of psychodynamic, behavioral, and cognitivetherapies. Along with the eye movements, other forms of “bilateralstimulation” may be used, such as tones in alternating earsor taps on different sides of the body.Along with post-traumatic stress disorder, EMDR has beenused to treat panic disorder and other anxiety disorders, addiction,substance abuse, and sleep disorders. Proponents claimthat EMDR is also effective in overcoming depression, phobias,pathological gambling, and self-esteem problems, as well ashelping athletes and workers achieve “peak performance” (seeEMDR Institute, 2001; Shapiro & Forrest, 2004).Originally, Shapiro (1989b) contended that the eye movementssimulated brain processes during sleep, “releasing” andEye Movement DesensitizationReprocessing (EMDR) InEMDR therapy, the clientvisually follows the therapist’smoving finger whilementally focusing on atraumatic memory or vividmental image of a troublingsituation. Supposedly, therhythmic eye movementshelp the client to “release”and “integrate” the trauma.“integrating” traumatic memories. Later, Shapiro (1995) proposedthat EMDR facilitates what she calls “Accelerated InformationProcessing,” in which “dysfunctionally stored informationcan be properly assimilated through a dynamically activatedprocessing system.” Supposedly, EMDR “accelerates a natural informationprocessing” that helps heal the nervous system.Is EMDR “the breakthrough therapy for overcoming anxiety,stress, and trauma,” as is claimed on the cover of Shapiro’s 1997book? Does it represent a “paradigm shift” in psychotherapy, as itsfounder (Shapiro, 1995, 2007) claims? Let’s consider the evidence.Does EMDR Provide Therapeutic Benefits Compared toNo Treatment?Yes. Numerous studies have shown that patients experience relieffrom symptoms of anxiety after EMDR. In a meta-analysis ofdozens of studies examining EMDR, Canadian psychologists PaulDavidson and Kevin Parker (2001) concluded the following:“When outcomes of EMDR treatment are compared with notreatment, and when outcomes are compared with pretreatmentstatus, clients are better off with EMDR treatment thanwithout.” Other researchers have also found that patients benefitfrom EMDR and that EMDR is more effective than no treatmentat all (DeBell & Jones, 1997; Goldstein & others, 2000).Is EMDR More Effective Than Other Standard Therapies?The alert reader will have noticed that EMDR has many elementsin common with other treatment techniques, some of them wellestablished and based on well-documented psychological principles.For example, exposure therapy is one technique that haslong been recognized as an effective treatment for PTSD andphobias. Exposure therapy is related to systematic desensitization:The person gradually and repeatedly relives the frightening experienceunder controlled conditions to help him overcome his fearof the dreaded object or situation and establish more adaptivebeliefs and cognitions. Using a combination of behavioral andeclecticism(eh-KLEK-tuh-sizz-um) The pragmatic andintegrated use of techniques from differentpsychotherapies.“match” between the person seeking help and the specific psychotherapy techniquesused. One person may be very comfortable with psychodynamic techniques, such asexploring childhood memories and free association. Another person might be moreopen to behavioral techniques, like systematic desensitization. For therapy to beoptimally effective, the individual should feel comfortable with both the therapistand the therapist’s approach to therapy.Increasingly, such a personalized approach to therapy is being facilitated by themovement of mental health professionals toward eclecticism—the pragmatic andintegrated use of diverse psychotherapy techniques (Lambert & others, 2004). To-