Jane discovered her fiancé in another woman’s bed. The night of this confrontation, and the tumultuous end of her engagement, haunted her for years after the incident. Flashbacks to the “discovery” scene induced the same spell of nausea and vomiting that occurred on that fateful night. The simple fact of hearing her name caused hours of crying. Her desire to meet another man was thwarted by this spiral of emotional reactions, and by the time she came in for treatment, Jane’s dream of another romance had been dashed.
To help Jane with her traumatic memories, I embarked on an alternative therapy technique, Eye Movement Desensitization and Reprocessing (EMDR). Dr. Francine Shapiro, the creator of EMDR, outlines eight critical steps of this evidence-based psychotherapy. She had progressed to the Desensitization phase and was preparing Jane to confront the memory of her.
“Remember the image of the trauma,” I instructed. “Retain the thoughts and emotions of what you experienced.”
Jane reflected, “I feel nauseated in the pit of my stomach. I am inferior to this other woman. It is my fault, so I must never love again.”
I deliberately continued to activate his disturbing beliefs and feelings.
“Focus on the feelings of hurt, anger, and sadness. Feel the nausea in the pit of your stomach.”
When Jane’s thoughts and feelings were clearly present, I asked her to follow an unorthodox procedure.
“Now Jane, follow my fingers with your eyes.”
Jane followed my fingers left and right, and within ten bilateral movements, she began to breathe rapidly and sob. (Patients undergoing this procedure will often experience an intense emotional and bodily reaction during the first few movements.)
“You’re going to be fine, Jane. Stay with me,” I encouraged her as my fingers moved back and forth.
The images of her ex-fiancé and the strong feelings attached to him faded step by step with each set of eye movements, followed by a deep state of relaxation. We continue like this with each traumatic image associated with the scene of the “discovery” and the breakup.
Within three ninety-minute EMDR sessions, the catastrophic scenes had faded and Jane had difficulty remembering the knot in the pit of her stomach. Her feelings diary showed that the “spells” had disappeared and were not triggered when she completed a difficult therapy task; that is, confront her ex to demand payment of a loan.
EMDR sessions include the installation of positive self-affirmations that are visualized, repeated, and reinforced with eye movements. We had worked together to strengthen rational thoughts, and when Jane was released, she fervently believed… “It’s over, it’s all in the past. I’m adequate and valuable. I’ll love again.”
traumatic memories. A century ago, Freud proposed that traumatic memories lurk in the unconscious mind, pulsing in this subterranean hell to disturb our thoughts, feelings, and actions. Since then, scientists and practitioners have worked tirelessly to understand the role of what neuroscientists call “coded data”: do bad memories affect our daily lives? Can we harness them to help alleviate human suffering?
My renewed interest in “memory work” arose when I read about a psychologist who used rapid eye movement to extinguish traumatic memories. I may have dismissed this new therapy as unscientific, but Dr. Shapiro was a behaviorist in the tradition of the great scientists of the past, such as Pavlov, Watson, and BF Skinner. Why was this respected behavioral psychologist waving her fingers before a patient’s eyes? I decided to find out for myself.
Dr. Francine Shapiro is a gifted teacher and thinker. She began our training session with a fascinating account of her discovery. The psychologist was taking a walk in the park and she was concerned about a significant stressor in her life. She noticed her eyes dart from side to side. When she returned to the anxious thoughts, they had subsided in some mysterious way. A fundamental question arose from this experience: Is there a connection between spontaneous eye movements and the extinction of emotional distress? Did some natural neurological event eliminate her worries?
As a behavioral scientist, she was forced to put her clinical intuition to the test. Shapiro embarked on a program to treat Vietnam veterans who, after decades, were still traumatized by their war experiences. The immense success in de-traumatizing war victims spurred more work with eye movement therapy and a revolution in the field of mental health treatment.
For more than two decades, Shapiro has experimented with this exciting discovery, making it the fastest-expanding therapy in the history of mental health. Thousands of clinicians have completed EMDR training, and the technique is being tested in controlled studies in laboratories and universities around the world. Currently, EMDR is considered a scientifically validated procedure for the treatment of post-traumatic stress disorder (PTSD). In addition, successful results are documented for the treatment of other psychiatric disorders, mental health problems, and somatic symptoms.
Doctors report positive results, and the technique is now applied to symptoms such as chronic pain, anxiety, and panic disorders, as well as hurt reactions. The treatment procedure is also successful with traumatized children. An admirable feature of Shapiro’s approach is clearly evident in his training sessions: EMDR will not be claimed to be successful without scientific research to back it up.
Reprocessing Bad Memories. To gain a basic understanding of what happens during EMDR, consider this scenario: A child is surrounded by the safety of their home environment. Suddenly, the serenity is broken by the terrifying sounds of Mommy and Daddy fighting. The boy’s two heroes, the only dependable sources of safety in his life, are having a knockdown and drag. This frightens and overwhelms the child, and his reflex emotional reactions are fear and anxiety. His heart is pounding and his breathing is rapid. He wants to run, retreat to safety, but there’s nowhere to hide.
Fortunately, the fight dies down and Mom and Dad reach out to their son to calm his frazzled nerves: “It’s just a little disagreement, honey. It’s all good.” This parenting is helpful, and for the time being, you can let go of the trauma. But the brain has an important job to do: It stores this fear-inducing experience in a memory network coded as “dangerous altercations.”
Imagine the multitude of times this danger signal is activated in childhood. After years of labeling, storing, and coping with stress, our brains have developed numerous memory networks to remember, prepare, and protect us from future threats. And there are billions of brain cells dedicated to this task.
As adults, relationship conflicts can trigger the activation of this same neural network and avoidance/flight becomes the norm. The distinction between past and present threats is blurred. As far as our brains are concerned, we are still in danger and escape may be our only mode of survival.
In a case of chronic conflict avoidance, does an EMDR therapist encourage the individual to retrieve and retain the threatening memory while focusing on a compelling stimulus (a finger flicking in front of their eyes)? The dual task of paying attention and retrieving a memory is inherently difficult for the brain. And, when memory and focused attention occur together, one seems to dampen the other. This neural pathway to therapeutic success is one of several theories currently being investigated to help explain the rapid success of eye movement therapy.
A dual care task like eye movements, when used by a qualified clinician as part of a comprehensive eight-step treatment plan, speeds up the process of change. Every facet of therapy is accelerated: understanding problems, connecting the past to the present, releasing powerful emotions, relaxation, and behavior change.
Eye movements (and other comparable dual attention maneuvers developed by Shapiro) have a way of disrupting the neural network in the brain that contains dysfunctional memories. Once the doctor accesses the network, the data comes to life. And when this “liberation” occurs, the resolution is not far behind. According to Shapiro, the memory has been successfully reprocessed.
The eyes as healers. Could rapid eye movements be the neurological ‘keys’ that unlock the unconscious mind? Is mental health treatment on the verge of a great revolution, a giant leap in the way we think about the brain’s ability to heal? It is too soon to answer these questions with a resounding “yes.” The excitement builds with each trained physician, each successful treatment, and each completed research study. A brilliant woman with years of clinical experience took a simple walk in the park and reflected on herself. The science and practice of psychotherapy have benefited greatly from what she discovered.