Eye movement desensitization and reprocessing (EMDR) is a form of psychotherapy in which the person being treated is asked to recall distressing images while generating one of several types of bilateral sensory input, such as side-to-side eye movements or hand tapping.
It is included in several guidelines for the treatment of post-traumatic stress disorder (PTSD).
It was developed by Francine Shapiro in the 1990s and has been controversial, with some critics calling it pseudoscience and there have been ongoing concerns over the quality of evidence, contradictory findings, significant rates of researcher bias. and dropout rates in studies.
The person being treated is asked to recall distressing images while generating one of several types of bilateral sensory input, such as side-to-side eye movements or hand tapping. The 2013 World Health Organization practice guideline says that “Like cognitive behavioral therapy (CBT) with a trauma focus, EMDR aims to reduce subjective distress and strengthen adaptive beliefs related to the traumatic event. Unlike CBT with a trauma focus, EMDR does not involve (a) detailed descriptions of the event, (b) direct challenging of beliefs, (c) extended exposure, or (d) homework”.
The proposed mechanisms that underlie eye movements in EMDR therapy are still under investigation and there is as yet no definitive finding. The consensus regarding the underlying biological mechanisms involve the two that have received the most attention and research support: (1) taxing working memory and (2) orienting response/REM sleep.
According to the 2013 World Health Organization practice guideline: “This therapy [EMDR] is based on the idea that negative thoughts, feelings and behaviours are the result of unprocessed memories. The treatment involves standardized procedures that include focusing simultaneously on (a) spontaneous associations of traumatic images, thoughts, emotions and bodily sensations and (b) bilateral stimulation that is most commonly in the form of repeated eye movements.”
Salkovskis in 2002 reported that the eye movement is irrelevant, and that the effectiveness of EMDR was solely due to its having properties similar to CBT, such as desensitization and exposure.