History of EMDR

In 1987,  Francine Shapiro was walking in the park when she realized that her eye movements (back and forth from one side to the other) appeared to decrease the negative feelings she had with her own distressing memories. She assumed that eye movements had a de-sensitizing effect, and when she experimented with friends and colleagues, she found that others also had the same response to eye movements. It became apparent however that eye movements by themselves did not create comprehensive therapeutic effects (eye movements were not enough). Shapiro included other treatment elements, including a cognitive component, and developed a standard procedure and process that she called Eye Movement Desensitization (EMD).
 

Shapiro wrote “a single session of the procedure was sufficient to desensitize subjects’ traumatic memories, as well as dramatically alter their cognitive assessments.” (How persons perceived their memories).

Shapiro continued to develop this treatment approach, incorporating feedback from clients and other clinicians who were using EMD. In 1991 she changed the name to Eye Movement Desensitization and Reprocessing (EMDR) to reflect the insights and cognitive changes that occurred during treatment, and to identify the information reprocessing theory that she developed to explain the treatment effects.

Because EMDR was an effective treatment, achieving results very quickly for many clients, Shapiro felt an ethical obligation to teach other clinicians so that individuals suffering from PTSD could find relief. However, EMDR was still experimental since it had not received independent confirmation through other controlled studies. She attempted to resolve this ethical dilemma by teaching EMDR only to licensed clinicians, and by ensuring that everyone who learned the approach was trained by the EMDR Institute in the same model. That way safeguards would be in place, clinicians would be taught to inform clients of its status, and a feedback system would allow everyone that was trained to get the most up to date information. In 1995, after other controlled studies had been published, the label “experimental” and the training restrictions were removed and a textbook of procedures was published. Shapiro has been severely criticized by some for her method of dissemination, because she initially restricted training and because she taught an experimental procedure. However, these critics ignore the APA ethics code mandated responsibilities of an innovator to determine training practices and the fact that even as late as 1998, there were no treatments for PTSD that were designated as well-established and empirically validated. At that time, independent reviewers for the Clinical Psychology Division of the American Psychological Association identified three treatments with “probable efficacy.” These were EMDR, exposure therapy, and stress inoculation therapy.

What Does EMDR Do?

All humans are understood to have a physiologically-based information processing system. This can be compared to other body systems, such as digestion in which the body extracts nutrients for health and survival. The information processing system processes the multiple elements of our experiences and stores memories in an accessible and useful form. Memories are linked in networks that contain related thoughts, images, emotions, and sensations. Learning occurs when new associations are forged with material already stored in memory.

When a traumatic or very negative event occurs, information processing may be incomplete, perhaps because strong negative feelings or dissociation interfere with information processing. This prevents the forging of connections with more adaptive information that is held in other memory networks. For example, a rape survivor may “know” that rapists are responsible for their crimes, but this information does not connect with her feeling that she is to blame for the attack. The memory is then dysfunctionally stored without appropriate associative connections and with many elements still unprocessed. When the individual thinks about the trauma, or when the memory is triggered by similar situations, the person may feel like she is reliving it, or may experience strong emotions and physical sensations. A prime example is the intrusive thoughts, emotional disturbance, and negative self-referencing beliefs of posttraumatic stress disorder (PTSD).

It is not only major traumatic events, that can cause psychological disturbance. Sometimes a relatively minor event from childhood, such as being teased by one’s peers or disparaged by one’s parent, may not be adequately processed. Such “small-t traumas” can result in personality problems and become the basis of current dysfunctional reactions.

Shapiro proposes that EMDR can assist to successfully alleviate clinical complaints by processing the components of the contributing distressing memories. These can be memories of either small or large traumas. Information processing is thought to occur when the targeted memory is linked with other more adaptive information. Learning then takes place, and the experience is stored with appropriate emotions, able to appropriately guide the person in the future. A variety of neurobiological contributors have been proposed.
 

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Shapiro, F. (1989). Efficacy of the eye movement desensitization procedure in the treatment of traumatic memories. Journal of Traumatic Stress, 2, 199-223.

Shapiro, F. & Forrest, M. (1997). EMDR The Breakthrough Therapy for Overcoming Anxiety, Stress and Trauma. New York: Basic Books

Shapiro, F. (1989). Eye movement desensitization: A new treatment for post-traumatic stress disorder. Journal of Behavior Therapy and Experimental Psychiatry, 20, 211-217.

Shapiro, F. (1989). Efficacy of the eye movement desensitization procedure in the treatment of traumatic memories. Journal of Traumatic Stress, 2, 199-223

Lohr, J. M., Tolin, D. F., & Lilienfeld, S. O. (1998). Efficacy of eye movement desensitization and reprocessing: Implications for behavior therapy. Behavior Therapy, 29, 123-156.

Shapiro, F. (1989). Efficacy of the eye movement desensitizatioin procedure in the treatment of traumatic memories. Journal of Traumatic Stress, 2, 199-223.

Brom, D., Kleber, R. J., & Defares, P. B. (1989). Brief psychotherapy for posttraumatic stress disorders. Journal of Consulting and Clinical Psychology, 57, 607-612

Cooper, N.A., & Clum, G.A. (1989). Imaginal flooding as a supplementary treatment for PTSD in combat veterans: A controlled study. Behavior Therapy, 20, 381-391.

Keane, T.M., Fairbank, J.A., Caddell, J.M., & Zimmering, R.T., (1989). Implosive (flooding) therapy reduces symptoms of PTSD in Vietnam combat veterans. Behavior Therapy, 20, 245-260.

Shapiro, F., (1991). Eye movement desensitization & reprocessing procedure: From EMD to EMD/R-a new treatment model for anxiety and related traumata. Behavior Therapist, 14, 133-135.

Shapiro, F. (1995). Eye Movement Desensitization and Reprocessing: Basic Principles, Protocols and Procedures (1st edition). New York: Guilford Press

Chambless, D.L., Baker, M.J., Baucom, D.H., Beutler, L.E., Calhoun, K.S., Crits-Christoph, P., Daiuto, A., DeRubeis, R., Detweiler, J., Haaga, D.A.F., Bennett Johnson, S., McCurry, S., Mueser, K.T., Pope, K.S., Sanderson, W.C., Shoham, V., Stickle, T., Williams, D.A., & Woody, S.R. (1998). Update on empirically validated therapies, II., The Clinical Psychologist, 51, 3-16.

For complete listing see See Shapiro, F., (2001). Eye Movement Desensitization and Reprocessing: Basic Principles, Protocols and Procedures (2nd edition). New York: Guilford Press