ALBANY, N.Y., March 27 (UPI) -- To hear some mental health professionals tell it, Eye Movement Desensitization and Reprocessing is an astonishing breakthrough therapy to treat Post Traumatic Stress Disorder.
Created by psychologist Francine Shapiro in 1989, EMDR requires a patient to recount emotionally disturbing incidents in sequential doses while simultaneously focusing on an external stimulus. Most often, the therapist prompts the patient's eye movements, but other stimuli such as hand-tapping and aural stimulation have been used as well.
"When I first heard of EMDR from a colleague in the early 1990s, I said, 'You've got to kidding, this can't possibly work,'" Jeffrey Y. Mitchell, associate professor of the Emergency Health Services Department at the University of Maryland in Baltimore told United Press International.
"I find it nothing short of remarkable for the severely traumatized. It's dumbfounding, especially because it takes so little time in comparison with cognitive therapy, which can take months to years," Mitchell said.
Mitchell said he first used the technique with a firefighter who had not slept more than two hours a night following an episode in which he was not able to rescue three children who drowned in a car. As Mitchell prompted the eye movement, he directed the firefighter to recount the rescue attempt.
"He started to get very clear images of the sunken car and he saw that the car was pointed downward (in the water) and that he would have endangered his own life had he entered the car," Mitchell said. "I watched his face turned from pasty white to healthy pink, I saw his knees move and all kinds of body tension movements turn relaxed."
The firefighter never returned for another session because he told Mitchell, "Whatever was wrong was fixed."
EMDR can take several sessions, depending on the length and severity of the trauma, but Mitchell said the firefighter slept seven hours the night of the session and continued to sleep better in the future.
Some therapists remain skeptical, however.
"The claims of EMDR outstrip the research evidence -- the research says EMDR is better than doing nothing but it is no more effective than other procedures," Scott Lilienfeld, associate psychology professor at Emory University in Atlanta, told UPI. "There's nothing magical about EMDR. It may work accidentally or it may have a placebo effect, and there's no evidence it works at a faster rate."
Robbie Dunston, coordinator of training at the EMDR Institute Inc. in Pacific Grove, Calif., said 60,000 clinicians have been trained in the two levels of EMDR. More than 1 million people have been treated for traumas, including sexual abuse, domestic violence, combat, crime and other mental health problems.
"Only degreed and licensed mental health professionals are allowed to be trained," Dunston told UPI. "It has been used by the FBI, firefighters, rescuers, police officers and for people in war-torn countries."
Several studies have calculated the decrease in PTSD diagnoses, ranging from 80 percent to 90 percent, according to Dunston.
"I've seen police and firefighters who have been exposed to experiences causing them massive damage, and most would never work again. But my experience with EMDR is at about 90 percent," Mitchell said.
"One man drove 450 miles to thank me for mentioning a center that used EMDR in a talk I gave. He said it saved his life because he couldn't live with the PTSD any longer. I've worked at 57 major disasters, and I can say that had we not had EMDR at Oklahoma City we would have had a lot of rescuers who would have been basket cases," he added.
Several PTSD researchers were asked to comment on EMDR, and most declined. One researcher who preferred not to be identified told UPI, "The jury is split on EMDR. A lot of people are using it, and some see problems with it, and some think it will save the world."
Lilienfeld said he thought there was a gap between those who research the science of psychology and those who are practitioners. He added there was no evidence EMDR could harm a person.
Shapiro, a licensed psychologist, senior research fellow at the Mental Research Institute in Palo Alto, Calif., and executive director of the EMDR Institute said she discovered EMDR by accident in 1987 when she realized certain eye movements alleviated her own disturbing thoughts.
"Her first study with trauma victims was completed in 1989 and since then eight more studies by other researchers have shown that EMDR is effective," Dunston said.
The eye motion is believed to stimulate thinking of images of trauma "stuck" in the brain. PTSD victims, who often cannot think of such an event without strong, upsetting emotions, tend to "numb down" or avoid anything that reminds them of the trauma.
"For some reason, the images are stuck, and the person with PTSD cannot process the images. While they try not to remember them, they intrude on their thoughts," Mitchell said. "EMDR allows the person to somehow process the images and afterward remember them without the emotion."
Shapiro admits it is not clear why EMDR works, but several theories exist. The eye movements may result in "accelerated information processing" by activating both brain hemispheres. Or, the constant sensory stimulation bombards the brain where the images are stuck. EMDR is not hypnosis, however.
Donald C. Sheehan, supervisory special agent at the FBI's Academy in Quantico, Va., said the FBI provides short-term counseling and referral and does not endorse any type of treatment. He said, however, he has seen good results from those who have sought EMDR treatment. He noted the treatment is becoming more popular among 17,000 police departments nationwide.
"What we try to do in our training is to inoculate our agents so that traumatic events are expected," Sheehan said. "We tell them that in 30 years they will fire their weapons, that people may be injured or die as a result, that everyone they know will die, that they have to expect the death of loved ones, so the way to deal with that is to treat them well while they are here."
Sheehan said the best way to cope before a traumatic event is to sleep, eat, exercise and communicate, which also is the best way to work through an event after the fact.
"The best defense to survive the trauma of a gunshot wound is to be fit, so exercise is important. During the stress of trauma, blood does not go into the stomach, so a person needs to make sure that they eat -- basically we say that they should follow the advice we all got in kindergarten -- eat right, sleep well and exercise."
With proper training and proper lifestyle choices, Sheehan believes PTSD can be kept to a minimum -- occuring in less than 10 percent of those experiencing a severe trauma.
"This is only my opinion, but I believe the small number of people who end up with PTSD, as opposed to those that only temporarily have PTSD-like symptoms, would benefit from a wide variety of treatment modalities," he said. "I do not believe we should limit the treatment to EMDR if there is clearly a full fledged case of PTSD. That is not saying EMDR is useless. As a matter of fact, I think it should be used, just not exclusively."
