EYE MOVEMENT DESENSITIZATION AND REPROCESSING E.M.D.R. 

WHAT IS E.M.D.R. ? 

EMDR stands for Eye Movement Desensitization Reprocessing. It 
works in the brain at the neurological level. It has been known 
for sometime that when we dream we have corresponding periods of 
Rapid Eye Movements (REM). While these Rapid Eye Movements are 
still somewhat of a mystery, it is now known that they perform a 
very important function. It is believed that EMDR triggers a 
physiological process in the brain, one that involves the way you 
process memory. The Rapid Eye Movements stimulate a part of the 
brain stem that activates other areas of the brain controlling 
memory, and speeds up the brains ability to process information. 
When you dream, your brain is attempting to process information to 
resolve problems that occur during the daytime waking state. 
The average individual has a dream about every 90 minuets while 
asleep. We usually do not even remember most of these dreams. 
Most dreams are usually a rehashing of events which have occurred 
thoughout the day. However, if the dream is recurrent, or the 
theme of the dream is recurrent, or the dream is associated with 
very intense emotions (nightmares), this can indicate some 
significant stress and/or trauma. Dreams are part of the brain's 
built in biological mechanism to help us resolve problems that we 
are unable to resolve during the waking state. EMDR allows you to 
do this while awake, when done with an EMDR trained therapist. 

Eye Movement Desensitization and Reprocessing (EMDR) is an 
interactional, standardized approach and method to therapy that 
integrates into, and augments, a treatment plan. EMDR accelerates 
the treatment of a wide range of pathologies and self esteem 
issues related to both upsetting past events and present life 
conditions. Controlled studies of victims of Vietnam combat, rape, 
molestation, accident, catastrophic loss and natural disaster 
indicate that the method is capable of a rapid desensitization of 
traumatic memories, including a cognitive restructuring and a 
significant reduction of client symptoms (e.g., emotional 
distress, intrusive thoughts, flashbacks and nightmares. There are 
more controlled studies to date on EMDR than on any other method 
used in the treatment of trauma. A literature review indicated 
only six other controlled clinical outcome studies (excluding 
drugs) in the entire field of PTSD (Solomon, Gerrity, and Muff, 
1992). 

EMDR was developed by Francine Shapiro, Ph.D. in 1988, and to 
date over 15,000 licensed mental health therapists in thirty eight 
countries have been trained. Because a clinical background is 
necessary for the effective application of EMDR, workshops are 
limited to mental health professionals who are licensed or 
certified to provide treatment. Training is considered mandatory 
for appropriate use (Shapiro, 1991b). EMDR is a specialized 
approach and method that requires supervised training for full 
therapeutic effectiveness and client safety. Clients are at risk 
if untrained clinicians attempt to use EMDR (Behavior Therapist, 
1991). 

HOW DOES IT WORK? 
The client focuses on a past memory that is disturbing and words 
or messages the person received that created trauma, lowered self-
esteem, created negative thinking, body illness etc. At the same 
time you are focusing on the memory, you are performing eye 
movements that allows the brain to covert the traumatic memories 
into normal less disturbing memories. My experience working with 
clients using this method has been the memory is not wiped away, 
but it no longer creates the upsetting response it has in the 
past. For example, you have many concious memories that you never 
really think about, until someone brings them up and you recall 
them. For example, if you are with an old friend, or at your 
class reuion, etc. When you are traumatized, however, you tend to 
go over, and over the same issues, with little or no resolution. 
You may be hypervigilant to certain issues related to this 
problem, and you may even have nightmares, etc. According to 
(Leslie M. Drozd, Ph.D.) "when you are traumatized, information 
processing stops. There is an over-excitation in the brain and a 
resulting pathological change of neural elements." In plain 
language there is an overload, and information processing is 
blocked. Completing EMDR therapy with a trained EMDR therapist 
will allow you to complete the processing of this information 
which significantly reduces the Subjective level of Disturbance 
(of intensity of the emotion) associated with the event. The 
memory is still there, just as any other memory, but without the 
disturbing emotional distress usually associated with it. In 
studies conducted on EMDR, it appears the brain actually changes 
after a memory is worked through with EMDR. 

HOW DOES THIS EFFECT ME? 
Well, when the information is stored in your brain, it is stored 
in its anxiety-producing form with the original picture emotions, 
sensations and negative self-assessments. And when you are in 
similar situations, this anxiety producing picture and emotions is 
retriggered. For instance, as a child you were told you were not 
very smart, and probably wouldn't be very successful. So when you 
go to learn something new that old message is still in your brain 
along with any negative feelings that may accompany it. Your boss 
wants you to learn a new program and you panic or become highly 
anxious and you don't know why. It's because that old tape is 
being triggered again and again. 

So you see when (EMDR) is done properly, it may reactivate 
unresolved issues or feelings that are best handled with a trained 
therapist. EMDR has been used for a number of problems Post-
traumatic stress, anxiety disorders, phobias, low self-esteem 
issues, and depression. I am not claiming this is the answer to 
all your problems, but is a fast way to access unresolved issues. 
I have had positive effects with clients I have worked with, who 
poor self-esteem, low self-confidence, dysfunctional family 
issues, and depression, etc. 

WHAT ABOUT MY OWN CHANGES? 

EMDR is not given to just anyone. It takes one or two sessions to 
determine if the EMDR is the right tool for this individual. 
Background questions, learned relaxation techniques, and a general 
evaluation are necessary to determine if this is the right 
technique to deal with a troubling memory. Then in the second or 
third session the eye movement process is used which takes between 
1-1.5 hours. There is usually a positive effect even after only 
one session, however, 4 to 6 sessions are normally required to 
complete the therapy effectivley. At the end of the sessions the 
memory has lost most of its impact.

RESEARCH: 

Since the initial efficacy study (Shapiro, 1989), positive 
therapeutic results with EMDR have been reported with a wide 
number of populations, including: 

Combat veterans from Desert Storm, the Vietnam War, the Korean 
War, and World War II who were formerly treatment resistant and 
who no longer experience flashbacks, nightmares, and other PTSD 
sequelae (Carlson, Chemtob, Rusnak, & Hedlund, in press; Daniels, 
Lipke, Richardson, & Silver, 1992; Lipke & Botkin, 1992; Perry, in 
press; Taber, in press; Thomas & Gafner, 1993; Viola & McCarthy, 
1994; Young, in press). 

Persons with phobias who revealed a rapid reduction of fear and/or 
symptomatology (Doctor, 1994; Kleinknecht, 1993; Lohr, Tokin, & 
Kleinknecht, in press-a, in press-b). 

Sufferers of panic disorder who are recovering at a rate more 
rapid than that achieved by other treatments (Goldstein, 1992; 
Goldstein & Feske, 1994; O'Brien, 1993). 

Crime victims and police officers who are no longer disturbed by 
the after effects of violent assaults (Baker & McBride, 1991; 
Kleinknecht, 1992; Page & Crino, 1993; Shapiro & Solomon, in 
press; Solomon, 1995). 

People relieved of excessive grief due to the loss of a loved one 
or to line-of-duty deaths, such as engineers no longer devastated 
with guilt because their train unavoidably killed pedestrians 
(Puk, 1991a; Solomon, 1994, 1995; Solomon & Shapiro, in press). 

Children healed of the symptoms caused by the trauma of assault or 
natural disaster (Abruzzesse, 1994; Cocco & Sharpe, 1993; 
Greenwald, 1994; Pellicer, 1993; Shapiro, 1991a). 

Sexual assault victims who are now able to lead normal lives and 
have intimate relationships. (Gould, 1994; Parnell, 1994; Puk, 
1991a; Shapiro, 1989b, 1991a, 1994a; Wolpe & Abrams, 1991). 

Accident and burn victims who were once emotionally or physically 
debilitated and who are now able to resume productive lives 
(McCann, 1992; Puk, 1992; Solomon & Kaufman, 1994). 

Victims of sexual dysfunction who are now able to maintain healthy 
sexual relationships (Levin, 1993; Wernik, 1993). 

Clients at all stages of chemical dependency who now show stable 
recovery and a decreased tendency to relapse (Kitchen, 1991; 
Shapiro, Vogelmann-Sine, & Sine, 1994). 

People with dissociative disorders who progress at a rate more 
rapid than that achieved by traditional treatment (Fine, 1994; 
Lazrove, 1994; Marquis & Puk, 1994; Paulsen, in press; Paulsen, 
Vogelmann-Sine, Lazrove, & Young, 1993; Puk, 1994; Rouanzoin, 
1994; Young, 1994). 

Clients with a wide variety of PTSD and other diagnoses who 
experience substantial benefit from EMDR (Cohn, 1993; Fensterheim, 
1994a; Figley & Carbonell, 1995; Forbes, Creamer, & Rycroft, 1994; 
Marquis, 1991; Puk, 1991b, 1994; Spates & Burnette, in press; 
Spector & Huthwaite, 1993; Vaughan, Wiese, Gold, & Tarrier, 1994; 
Wolpe, 1991). 

CONTROLLED STUDIES: 

The following controlled EMDR studies have been completed: 

Boudewyns, Stwertka, Hyer, Albrecht, and Sperr (1993). A pilot 
study randomly assigned 20 chronic inpatient veterans to EMDR, 
exposure, and group therapy conditions and found significant 
positive results from EMDR for self-reported distress levels and 
therapist assessment. No changes were found in standardized and 
physiological measures, a result attributed by the authors to 
insufficient treatment time considering the secondary gains of the 
subjects who were receiving compensation. Results were considered 
positive enough to warrant further extensive study, which has been 
funded by the VA. Preliminary reports of the data (Boudewyns, 
Hyer, Peralme, Touze, & Kiel, 1994) indicate that EMDR is superior 
to a group therapy control. 

Jensen (1994). A controlled study of the EMDR treatment of 25 
Vietnam combat veterans suffering from PTSD, as compared to a non-
treatment control group, found small but statistically significant 
differences after two sessions for in-session distress levels, as 
measured on the SUD Scale, but no differences on the Structured 
Interview for Post-traumatic Stress Disorder (SI-PTSD), VOC, GAS, 
and Mississippi Scale for Combat-Related PTSD (M-PTSD; Jensen, 
1994). This study was done by two psychology interns who had not 
completed formal EMDR training. Furthermore, the interns reported 
low fidelity checks of adherence to the EMDR protocol and skill of 
application, which indicated their inability to make effective use 
of the method to resolve the therapeutic issues of their subjects. 

Levin, Grainger, Allen-Byrd, and Fulcher (1994). A controlled 
study of 45 Hurricane Andrew (Florida) survivors found significant 
differences in scores on the SUD and Impact of Event scales, 
indicating a superiority of EMDR treatment to supportive crisis 
counseling and non-treatment controls at l-month and 3-month 
follow-ups. 

Pitman et al. (1993). In a controlled component analysis study of 
17 chronic outpatient veterans, using a crossover design, subjects 
were randomly divided into two EMDR groups, one using eye movement 
and a control group that used a combination of forced eye 
fixation, hand taps, and hand waving. Six sessions were 
administered for a single memory in each condition. Both groups 
showed significant decreases in self-reported distress, intrusion, 
and avoidance symptoms. SCL-90-R changed in the eye movement 
condition only, while the Clinician Administered PTSD Scale 
(CAPS), Mississippi Scale for PTSD, and State Anxiety remained 
unchanged in both. 

Renfrey and Spates (1994). A controlled component study of 23 PTSD 
subjects compared EMDR with eye movements initiated by tracking a 
clinician's finger, EMDR with eye movements engendered by tracking 
a light bar, and EMDR using fixed visual attention. All three 
conditions produced positive changes on the CAPS, SCL-90-R, Impact 
of Event Scale, and SUD and VOC scales. 

Shapiro (1989a). The initial controlled study of 22 rape, 
molestation, and combat victims compared EMDR and a modified 
flooding procedure that was used as a placebo to control for 
exposure to the memory and to the attention of the researcher. 
Positive treatment effects were obtained for the treatment and 
delayed treatment conditions on SUDs and behavioral measures, 
which were independently corroborated at 1- and 3-month follow-up 
sessions. 

Vaughan, Armstrong, et al. (1994). In a controlled comparative 
study, 36 subjects with PTSD were randomly assigned to treatments 
of (1) imaginal exposure, (2) applied muscle relaxation, and (3) 
EMDR. Treatment consisted of four sessions, with 60 and 40 minutes 
of additional daily homework over a 2- to 3-week period for the 
image exposure and muscle relaxation groups, respectively, and no 
additional homework for the EMDR group. All treatments led to 
significant decreases in PTSD symptoms for subjects in the 
treatment groups as compared to those on a waiting list, with a 
greater reduction in the EMDR group, particularly with respect to 
intrusive symptoms. 

D. Wilson, Covi, Foster, and Silver (1991). In a controlled study, 
18 subjects suffering from PTSD were randomly assigned to eye 
movement, hand tap, and exposure-only groups. Significant 
differences were found using physiological measures (including 
galvanic skin response, skin temperature, and heart rate) and the 
SUD Scale. The results revealed, with the eye movement condition 
only, a one-session desensitization of subject distress and an 
automatically elicited and seemingly compelled relaxation 
response, which arose during the eye movement sets and which 
appears to support a conditioning model. 

S. Wilson, Becker, and Tinker (in press). A controlled study 
randomly assigned 80 trauma subjects (37 diagnosed with PTSD) to 
treatment or delayed-treatment EMDR conditions and to one of five 
trained clinicians. Substantial results were found at 30 and 90 
days and 12 months post treatment on the State-Trait Anxiety 
Inventory, PTSD-Interview, Impact of Event Scale, SCL-90-R, and 
the SUD and VOC scales. Effects were equally large whether or not 
the subject was diagnosed with PTSD. Non-randomized studies 
involving PTSD symptomatology (not noted in Table 1) include: 

An analysis of an inpatient veterans' PTSD program (n = 100) 
compared EMDR, biofeedback, and relaxation training and found EMDR 
to be vastly superior to the other methods on seven of eight 
measures (Silver, Brooks, & Obenchain, 1995). 

A study of Hurricane Andrew survivors found significant 
differences on the Impact of Event Scale and SUD scales in a 
comparison of EMDR and non-treatment conditions (Grainger, Levin, 
Allen-Byrd & Fulcher, 1994). 

A study of 60 railroad personnel, suffering from high-impact 
critical incidents, compared a peer counseling debriefing session 
alone to a debriefing session that included approximately 20 
minutes of EMDR (Solomon & Kaufman, 1994). The addition of EMDR 
produced substantially better scores on the Impact of Event Scale 
at 2- and 10-month follow-ups. 

Of 445 respondents to a survey of trained clinicians who had 
treated over 10,000 clients, 76% reported greater positive effects 
with EMDR than with other methods they had used. Only 4% found 
fewer positive effects with EMDR (Lipke, 1992b, 1994). 

FOR MORE INFORMATION CONTACT:

EMDR Institute, Inc.
PO Box 51010
Pacific Grove, CA 93950-6010 USA
Tel: 408-372-3900 Fax: 408-647-9881
Internet Address: http://www.emdr.com 
email: inst@emdr.com