Why eye movement therapy works

It involves recalling your horrific experience and then following your therapist’s moving finger with your eyes, which may sound a bit wacky, but as a treatment for post-traumatic stress, eye movement desensitisation and reprocessing therapy (EMDR) is endorsed by National Institute for Clinical Excellence guidelines.

However, the treatment continues to attract controversy, not least because it’s unclear how it works. But now Christopher Lee and colleagues report that EMDR’s critical ingredient is that it allows traumatised people to relive their trauma ‘at a distance’, as a detached observer.

Lee’s team followed 44 traumatised patients – some were car crash survivors, others had been sexually assaulted – through their first session of EMDR. Those patients whose statements during therapy suggested they were recalling their trauma at a distance (e.g. “The faces seem all blurred”; “It doesn’t seem so real”) showed the most improvement in their symptoms a week later.

By contrast, there was no association between the number of statements made by patients that related to reliving the trauma first-hand (e.g. “I am in the ambulance”; “I see her crawling away from me”) and their improvement a week later.

The researchers said this undermines the notion that EMDR works like traditional exposure therapy, in which patients are encouraged to relive their trauma first-hand. “A distancing process…was associated with more improvement than when participants relived the trauma experiences,” they said.

Although critics of EMDR have doubted the importance of the eye movement aspect of the therapy, Lee’s team concluded “The distancing may be partly facilitated by the distraction of the eye movement task…[or] facilitated by the therapist encouraging a dual focus of attention, that is, simultaneously being aware of the trauma material and of being in the therapist’s office”.

Further reading

Lee, C.W., Taylor, G. & Drummond, P.D. (2006). The active ingredient in EMDR: Is it traditional exposure or dual focus of attention? Clinical Psychology and Psychotherapy, 13, 97-107.