A few people on the list have mentioned being depressed or having to 
battle with bad childhood experiences, so I wondered if this article, 
from today's London Independent, would be of interest to anyone.

Sarah


The eyes have it

It sounds like a quack remedy -just moving the eyes from side to side 
to treat emotional suffering. But it works, says Julia Stuart, for 
anything from childhood abuse to post-traumatic stress disorder

08 January 2003

It sounds too good, and frankly too bizarre, to be true. After just 
three 90-minute sessions, people suffering emotionally after severe 
trauma such as rape, a car accident or abuse, can be rid of their 
debilitating symptoms. Add the fact that the therapy involves moving 
the eyes rapidly from side to side, and that it was discovered by an 
American while out for a walk, and one would forgive a sceptical 
raising of eyebrows.

Yet the treatment, Eye Movement Desensitisation and Reprocessing 
(EMDR), is believed by some to be one of the most effective 
treatments for post-traumatic stress disorder (PTSD). It has been 
used to help Britons affected by September 11, survivors of the 
Paddington and Hatfield rail disasters, and those traumatised by the 
Hillsborough football tragedy. Further afield, it has offered relief 
to those caught up in the earthquake in Turkey, the floods in 
Bangladesh and the wars in Bosnia and Croatia.

EMDR was developed by the American psychologist Dr Francine Shapiro, 
who, struggling to come to terms with a cancer diagnosis in 1987, 
noticed that her distressing thoughts lessened when she moved her 
eyes from side to side. Her subsequent research, published in 1989 in 
the Journal of Traumatic Stress, found in a randomised controlled 
study of 23 PTSD sufferers, who included victims of rape and abuse 
and Vietnam veterans, that symptoms were dramatically reduced after 
one long session of treatment.

The therapy was brought to Britain by Dr John Spector, a consultant 
clinical psychologist at Watford General Hospital. Impressed by a 
paper in the Journal of Behaviour Therapy and Experimental Psychiatry 
in 1991, written by the American psychologist Dr Joseph Wolpe (one of 
the founders of behavioural therapy), Dr Spector started using the 
treatment on his patients with "astonishingly good" results.

Dr Spector, who then trained in the method under Dr Shapiro, has 
since organised the training of more than 2,000 British mental-health 
professionals, about half of whom work in the NHS. EMDR is now used 
almost exclusively at the PTSD clinic at Watford General Hospital, 
and is commonly used at the Maudsley in south London.

PTSD symptoms include nightmares, flashbacks and intrusive and 
disturbing memories, believed to be the result of trauma too severe 
to process. The disturbing memories are held in the right hemisphere, 
the more primitive, non-verbal part of the brain, on which 
traditional talking therapies are thought to have little effect. Each 
time a person is reminded of the trauma, perhaps by a sound or image, 
they experience high anxiety and panic, which rational thought from 
the left hemisphere does little to quell.

EMDR appears to work by stimulating connections between the right and 
left hemispheres. "It may be related to what happens in REM sleep, 
which we know is a time when we process information," says Dr 
Spector. "During that period the eyes are moving quite rapidly and if 
you have a nightmare and get to a very frightening point you wake up. 
What we are doing in EMDR is keeping the eye movements going to get 
the processing through that point to resolution."

Clients are asked to concentrate on a visual image that represents 
the most upsetting aspect of their trauma, a corresponding belief 
such as "I'm bad" or "It was my fault", and notice what they 
experience physically. Meanwhile, the therapist moves his or her 
finger swiftly back and forth about 2ft from the client's face. About 
24 movements are performed, watched by the client, who is then asked 
what they experienced. The process is typically repeated 20 to 40 
times per session, which lasts from 60 to 90 minutes. The stimulation 
can also be achieved by tapping alternative hands, or by audio 
stimulation in each ear, but research has found the eye movement to 
be more effective.

"The therapist doesn't talk much apart from asking for information 
such as 'What did you notice?' As long as we are getting new 
information then we're happy. All we look for is movement of 
information," says Dr Spector. "At some point in this process, which 
is often intense and emotional for the person, they get to a point 
where they begin to notice that it feels less and less disturbing. 
They begin to notice that their view of themselves in this situation 
changes in a more positive way. They bring more functional 
information into the picture which connects with the traumatic 
material and they start to understand, for example, that it wasn't 
their fault that they were raped."

Interestingly, neurological changes also take place. Scans have shown 
a normalisation of brain wave-patterns after three sessions, with 
dormant left-hemisphere functions beginning to become active again 
and the right hemisphere dulling down. A client suffering from the 
effects of a one-off trauma, such as a road accident, would typically 
need between three and five sessions. Complex trauma, such as 
childhood abuse, can require up to 40.

EMDR also appears to be useful for anxiety disorders, pain, panic 
disorder and body dysmorphia (where people have an irrational belief 
that some part of their body is disfigured or unpleasant), claims Dr 
Spector. It has been used to help with gambling, personality 
disorders and depression, but the evidence base is much less strong 
than that for trauma.

A spokesman for the Department of Health said: "Compared to other 
treatments in this field, EMDR has been reasonably well evaluated... 
and the reported outcomes are generally favourable. The DH views any 
developments in this area with interest."

For Tony Knibb, 39, a constable with Hertfordshire Police, the 
treatment was "miraculous". At one stage, the policeman's PTSD 
symptoms were so severe that he contemplated suicide. Problems began 
several weeks after attending a stabbing incident in March 2001. "It 
was an upsetting scene, but nothing I hadn't experienced before," he 
says. "There was a large pool of very dark blood outside a fast-food 
restaurant and the person who had been attacked was in hospital, and 
later died."

Over the next few weeks, he thought of the scene more and more. "I 
couldn't seem to get the pool of blood out of my mind, and I started 
to have flashbacks. I then started having flashbacks of when I was in 
the army and had seen similar scenes in Northern Ireland. I hadn't 
thought about it for 20 years, but I could smell it and hear it. To 
all intents and purposes I was there. I wasn't able to focus on my 
normal life. I was overtaken by fear and a bit of guilt about 
situations I had been to and maybe could have done more about.

"I became very focused on my own personal safety. We were having 
difficulties getting protective vests, and I train probationers, so I 
was with quite inexperienced officers. I felt vulnerable. I didn't 
want to go out. I thought: 'Any time now I'm going to get killed.' I 
was depressed and it got to the point where I was contemplating 
suicide. I couldn't see beyond these flashbacks. I was in this world 
I couldn't get out of."

He turned to the force's occupational health department, and was 
eventually referred to Watford General. His first treatment was in 
October 2001. "It was traumatic because I had to think very carefully 
about the incidents, but I went out more relaxed than I had been in 
six months and more in control of my emotions." After his second 
session, he felt almost completely recovered.

Several weeks later he dreamt that he had been sexually abused as a 
child. Slowly memories came back and his parents confirmed they had 
suspected something had occurred. The officer had a third and final 
session of EMDR in January last year. By March he was back to full 
operational duties. "I haven't had any flashbacks since. I've got the 
memories, but I'm not disturbed by them. It's put all the ghosts in 
the past. It's miraculous as far as I'm concerned. I've been in the 
police for seven years and I haven't enjoyed it as much as I have in 
the last six months."

EMDR Association UK & Ireland, 020-8752 0429; PTSD clinic at Watford 
General, 01923 217554

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