EMDR -
A New Treatment for Traumatic Memories

EMDR is a new treatment for traumatic memories which is taking the mental health field by storm. It stands for "eye movement desensitization and reprocessing" - but don't worry, you don't have to remember that. In a nutshell, the patient is asked to concentrate on the worst part of the upsetting memory, while moving the eyes back and forth by following the therapist's finger. It's actually a lot more complicated than that, which is why specialized EMDR training is so important.

So what's the big deal? To explain EMDR, it helps to explain what would bring a person to therapy after a trauma or loss. Although some people are able to work through a trauma or loss and come out stronger, others seem to get stuck. Along with getting stuck comes a variety of distressing symptoms, which could include nightmares, depression, anxiety, and other problems. A therapist can help you to get unstuck, and work through the memory piece by piece, until you are finally "over it." Unfortunately, this process can take many months, and while most people get at least somewhat better, some of the problems can stubbornly hang on.

With EMDR, the process seems to go much more quickly. The EMDR session itself is different for each person, but can be very emotionally intense. Often an upsetting memory can be worked through in one to three sessions. And the results seem to be more consistent, with symptoms usually completely disappearing.

This is a fairly new treatment, but the research results are already pouring in. The controlled studies have been showing that EMDR is really as good as it sounds, for working through a single traumatic memory. There is not enough research on other uses (e.g., chronic trauma) yet. I just co-authored the first controlled study using EMDR with children, which also had very good results in just one session.

It looks like EMDR is a major advance in the mental health field. Now people who have trouble coping with trauma and loss experiences have a treatment option which can offer hope for relatively quick and lasting relief.

But remember that EMDR is just one tool to be used by a trained therapist. It is important to work with a therapist that you trust, who will know when to suggest EMDR and when to use other approaches.

1. "Charles"

When I met Charles he looked like any other 7-year-old boy: short curly hair, sloppy t-shirt, and a wide-eyed, inquisitive face. One thing made him different: he was lying down in a hospital bed. A few days before, he had skateboarded out of his driveway and gotten hit by a speeding car. His broken leg would heal, but his pride and confidence was another matter. He told me that he was having bad dreams. And he wouldn't admit it, but his father told me that he was wetting his bed. Both classic signs of a post-traumatic stress reaction. Of course, this wound also might heal in time - but it might not. So I decided to offer some help.

I told Charles and his father about EMDR, a new treatment for traumatic memories, that might help with the dreams and the wet bed. Charles wanted to try it, and his father said okay. So I had him concentrate on the memory of the accident, over and over again - and at the same time, had him move his eyes back and forth by following my hand. (Yes this sounds strange, but it works. And don't try this at home, it's a little more complicated than what you read here.) After about 20 minutes he said he was bored, and that thinking about the accident didn't bother him any more. So we stopped.

I checked on him a couple of times over the following week. No more bad dreams, no more wet bed. Just a broken leg, which would heal.

2. "Stella"

Stella was only four years old but her mother was worried. For about 6 months, Stella had been different. Biting her nails, nervous, hyperactive, bossy, and no longer talkative with her mother. And Stella was afraid of the Big Bear, making it hard to get to sleep. Our best guess was that she had been scared by her father, with whom she no longer had contact. Perhaps he had yelled, or hit her? She wouldn't say, and there was no one else to ask. We decided to try therapy.

We spent the first few sessions doing things that make parents think that nothing's happening. I used a puppet to role- play a shy little bear. Stella got to be the one to help the bear feel comfortable. Stella learned to feel safe in my room, to feel that she was in control.

Then her concerns started coming out in her play. Big bear! What to do? We spent several sessions killing Big Bear, putting him in jail, tying him up, killing him some more. Although Stella would pursue this activity with real drive and persistence, this was also a scary time. For a couple of sessions, she insisted that her mother sit right outside the door to the therapy room. She finally made friends with Big Bear, and then forgot about him.

A few more sessions, with a little family therapy and EMDR mixed in, and we were about done. Stella was no longer anxious or biting her fingernails, she was talkative with her mother again, and she was no longer worried about Big Bear. The funny thing about doing play therapy with young children is that sometimes you never really do find out what you were working on. We don't know what had made her scared. But she seemed happy again, and stayed that way at least for the next three months, after which I lost contact with her mother.

3. "Paul"

Paul was an eager, intelligent 11 year old boy who I met three months after Hurricane Andrew, when his mother brought him to participate in an EMDR study. She said that Paul had become easily frustrated, pessimistic, and irritable, and that he "just doesn't care anymore."

Although Paul checked his watch frequently, he was co- operative. The focus of the session was the scariest hurricane memory, of huddling in a closet with the house falling apart around him. In addition to fear he expressed helplessness, saying "I can't do anything." He felt better very gradually as he reexperienced different parts of the memory. He commented that "I get better and better at handling this the more times I go through it." Finally, he was able to imagine weathering another hurricane, but with less fear and more comfort and companionship.

A week later, Paul's mother reported a great drop in symptoms, "just about back to normal." After four weeks, his mother reported that he had caught up on his schoolwork and was doing well again, and that he had a "better attitude" in general. For example, he was more forgiving of himself, and didn't feel so badly after making a mistake. And he was looking forward to Christmas again.