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Using the Eyes to Overcome Stress and Anxiety

Many of the victims of the Oklahoma City bombing in 1995 had no physical wounds but were deeply wounded by psychological scars. Traumatized by memories of the tragedy and its aftermath, they experienced a form of lingering psychological paralysis called post-traumatic stress disorder that made it nearly impossible to live a normal life.

A disabling stress reaction is often the second blow suffered by people who have survived a traumatic event, such as combat, an automobile accident, a natural disaster, or rape. Some relive the original event through flashbacks, nightmares, and panic attacks, while others isolate themselves, become emotionally numb, and abuse drugs or alcohol.

Symptoms include sleeplessness, anxiety, phobias and difficulty concentrating. The condition can be long-lasting and is often difficult to cure with traditional psychological approaches.

Surprisingly, some affected people, including many who survived the Oklahoma bombing, appear to have responded quite rapidly to an unusual therapy called eye movement desensitization and reprocessing or EMDR.

Eyes Right (Then Left)

In EMDR, also dubbed "finger-flash therapy," a patient is asked to call up an image of the original stressful event while following a therapist’s fingers as they are moved rapidly back and forth in front of his face. At the same time, the therapist encourages the patient to talk about the trauma and experience the negative emotions that accompany it while rating his level of anxiety on a scale of zero to ten. The procedure is repeated for each distressing memory until the anxiety level drops to two.

A striking feature of EMDR therapy is its apparent speed. Often only two or three sessions are needed to provide benefits. These results are much more rapid than cognitive behavior therapy, for example, which can take months or even years.

Some psychotherapists hail EMDR as a breakthrough in the treatment of post-traumatic stress and other anxiety disorders, while others remain skeptical or dismiss the method as quackery.

An Insight While Walking

This innovative therapy arose out of a chance observation by clinical psychologist Francine Shapiro, Ph.D., now at the Mental Health Research Institute in Palo Alto, California. While out walking in the park one day in 1987, she found that some distressing thoughts she was having seemed to disappear when she moved her eyes rapidly back and forth. She came to believe that such rapid eye motions, and other rhythmic movements, somehow promote desensitization to the traumatic memories, allowing people to "digest" and reprocess them.

While researching this approach with trauma victims, Dr. Shapiro refined it by incorporating elements of cognitive, behavioral, and Freudian-based therapies. EMDR is now being used to treat a broad range of problems, including panic disorder, drug abuse, and public-speaking anxiety.

The Eyes Have It--Or Do They?

A number of controlled studies have supported the effectiveness of this curious therapy. In one study, 80 traumatized individuals were randomly assigned to either three EMDR sessions or delayed treatment. Those receiving EMDR showed significant improvement in anxiety and other symptoms compared with the control group (Journal of Consulting and Clinical Psychology, 12/95).

Another study randomly assigned 60 traumatized young women to either EMDR or an "active listening" approach (Journal of Traumatic Stress, 1/98). After just two sessions, those treated with EMDR had markedly fewer symptoms of post-traumatic stress disorder than those in the control group.

In 1999 the American Psychological Association rated EMDR as "probably efficacious in the treatment of civilian post-traumatic stress disorder."

Clinical psychologist Dr. Larry Stoler of the Chicago Medical School has found that people who respond to EMDR tend to remain free of their symptoms over the long term. "What generally happens with EMDR is that the frozen quality of the traumatic experience starts to break apart and new aspects of it emerge," he notes. "When the treatment is successful, the traumatic experience is neutralized, even transformed."

Doubts Remain

Many psychologists, however, remain skeptical. James Herbert, Ph.D., assistant professor of psychology at Hahnemann University in Philadelphia, maintains that EMDR has never been scientifically validated (Harvard Mental Health Letter, 8/95). And a recent review concludes that although EMDR appears to be effective in reducing some symptoms of post-traumatic stress, there’s no convincing evidence that the eye movements are important to its success (Journal of Anxiety Disorders, Jan-Apr, 1999).

Findings by Roger K. Pitman and colleagues at Veterans Affairs Medical Center in Manchester, New Hampshire support this contention (Comprehensive Psychiatry, Nov-Dec, 96). Pitman tried EMDR therapy in 17 veterans with symptoms of post-traumatic stress disorder. He varied the traditional EMDR approach by having one group keep their eyes fixed during therapy, while the other group moved their eyes as usual. Both groups experienced a modest improvement in symptoms, and the eye movements did not make a difference.

The developer of EMDR therapy, Dr. Shapiro, acknowledges this finding in her book EMDR: The Breakthrough Therapy for Overcoming Anxiety, Stress, and Trauma. She notes that "directed eye movements are only one form of stimulation used as a part of [EMDR’s] complex methodology."

Clearly, the final verdict is not yet in on EMDR. Although precisely how it works remains something of a mystery, the impressive results achieved by EMDR in at least some patients argue that it deserves serious consideration for victims of post-traumatic stress disorder.

Date Posted: 09/11/2000

Date Published: 09/10/2000
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