And it was hard to explain why it (EMDR) worked (it still is): Somehow, by moving eyes from side-to-side, trauma memories become less distressing allowing for them to be reframed and put in the past. Justin Hendriks, End Recurrence: EMDR
Last post I introduced the trauma treatment EMDR (Eye Movement Desensitisation and Reprocessing). This treatment was initially laughed at due to its mysterious use of bilateral eye movements. Nobody’s laughing now. It is currently one of the most widespread and most highly recognised treatments for emotional trauma.
Somehow, by accessing traumatic memories in a semi-structed way, at the same time as receiving bilateral stimulation, the memories become less negatively impactful. Bilateral stimulation usually means the eye movements. However more recently, bilateral sounds or physical tapping has also been shown to be effective methods of EMDR.
But how does it work?
Francine Shapiro, the psychologist who developed EMDR, developed the Adaptive Information Processing (AIP) Model to understand how EMDR works. According to AIP theory, trauma memories are stored in the brain/mind dysfunctionally. This accounts for the recurring nature of trauma memories: they haven’t been processed and stored in the past, so they are the forever-present.
The idea in AIP is that blockages of the trauma memories are removed through the EMDR process, allowing for adaptive memory processing of the trauma.
Sounds good. But is there any evidence of how this unblocking and processing method might work?
Over 30 research and review papers have explored the how of EMDR. And short answer is we don’t know how it works. Science involves the setting and disproving of theories. The most highly respected theories are those that have some evidence-based backing. Two of the best theories are: The Working Memory Theory and the Orienting Response Theory.
The Working Memory Theory suggests that the eye movements and its associated attention uses up limited working memory capacity. By keeping the mind busy while recalling the distressing thoughts, the emotional impact is lessened, and the brain doesn’t go into automatic avoidant mode. Imagine singing a song to a toddler getting an injection – distracting from the ouchy.
The Orienting Response Theory proposes that bilateral stimulation of eyes (or through other senses) elicits an orienting response (a “what’s that!” reaction). When we have an orienting response naturally, for example when we see someone walk past our house, the “what’s that!” reaction is closely followed by a “nothing, still safe” reaction.
In this theory, it’s the second part (the “still safe” part) which makes EMDR effective. By persistently paring the trauma memory with the “what’s that”/”still safe” eye movements, the trauma becomes associated with safety.
Which theory do I prefer?
I suppose, out of the common theories, I lean more towards the boring old Working Memory Theory. My simple mind can understand easily how this would work. And I guess I have a tendency to think that the simple explanations are usually the correct ones.
I do have my own theory, however. It’s called the Bugs Bunny theory. It goes like this:
Several generations grew up watching popular culture luminaries, such as Bugs Bunny, interacting with watch waving hypnotists. Our personal and collective subconsciousness soaked up the idea that bilateral eye movements are a powerful therapeutic tool. Because of the placebo effect, this tool actually became highly effective: Life imitating art! What do you think?
Whichever theory is correct, the evidence from both my work-life and from research is that EMDR can really work. Perhaps in future they’ll work out how.
Just remember you heard the Bugs Theory here first.