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Finger-flash therapy catches on

February 21, 2000
Web posted at: 1:40 PM EST (1840 GMT)

(WebMD/Healtheon) -- Every night, insomnia and nightmares; every day, panic, anxiety, depression. These were the ruins of childhood and adolescence for Donna Bowers of Placentia, California, who was abused for 19 years by a close relative. Ten years of psychotherapy did little to ease her symptoms, the classic signs of post-traumatic stress disorder (PTSD).

"My therapist admitted we had hit a wall and couldn't move past it," says Bowers, 44. "He referred me to a doctor who had just started using a new therapy called Eye Movement Desensitization and Reprocessing (EMDR). Within the first six sessions of EMDR, all of my symptoms left and haven't returned in eight years."

Though skeptics still criticize this unusual treatment, in which therapists wave their fingers in front of their patients' eyes, EMDR is gaining acceptance in the psychotherapy community. The approach was first developed by psychologist Francine Shapiro, Ph.D., of the Mental Research Institute in Palo Alto, California.

While walking in a park in 1987, Shapiro noticed that when her eyes moved in a "rapid, ballistic, flicking" motion, unhappy thoughts became less disturbing to her. She soon began experimenting with ways of producing the same effect in trauma victims.

PTSD occurs after frightening experiences such as combat, rape, physical assault, natural disasters or automobile accidents. The principal method of treatment until now has been cognitive behavior therapy, which involves gradual exposure to circumstances reminiscent of the trauma, slowly reducing the fears in the patient. This approach usually takes months or even years to relieve symptoms.

Psychotherapy is not the only treatment for PTSD. In December, the U.S. Food and Drug Administration gave its first approval to a medication for the disorder. But this antidepressant, Zoloft (sertraline hydrochloride), works only as long as patients take it, and it suppresses only the symptoms of the illness rather than addressing their cause.

Eye movements

Treatment with EMDR involves elements of several therapeutic methods, including behavioral, cognitive, and even Freudian ideas, but in addition, the EMDR therapist induces rapid eye movements in the patient by asking him to follow the movements of a finger waved in front of his face. At the same time, the patient is encouraged to think and talk about the original stressful event. According to Shapiro, after three 90-minute sessions, at least 84 percent of trauma victims improve so much that their symptoms no longer fit the definition of PTSD.

The effect of EMDR is so rapid and dramatic that when he first read about it in a professional journal 10 years ago, Steven Silver, Ph.D., a U.S. Department of Veterans Affairs PTSD specialist, was skeptical. "I remember calling up the editor," he says, "and telling him that we were the victim of some kind of hoax." Silver now uses EMDR in his practice.

It's unclear how the treatment might work. Some experts have speculated that the eye movements restore activity in a part of the brain that was shut down as a result of the trauma. Others believe that EMDR is simply behavior therapy dressed up as something novel. They point out that similar results have been produced by using finger and hand taps, or repeated auditory tones, instead of finger movements.

"What is new is not effective," says James Herbert, Ph.D., associate professor of psychology at M.C.P. Hahnemann University in Philadelphia, "and what is effective is not new."

But recent research has begun to convince such mainstream organizations as the American Psychological Association and the International Society of Traumatic Stress Studies, both of which approved EMDR in 1999. One of the most impressive studies was published in the Journal of Traumatic Stress in 1998. Sixty traumatized young women in Colorado Springs, Colorado, were randomly assigned to either EMDR or "active listening" therapy. After only two sessions, the EMDR patients had markedly fewer symptoms of PTSD than the active-listening group.

For Donna Bowers, herself a psychotherapist, EMDR is nothing short of a miracle. "It opened up the entire world for me without the panic and fear that I'd had for 16 years," she says. "It gave me back my life."

© 2000 Healtheon/WebMD. All rights reserved.

Zoloft comes with caution
Overview of post-traumatic stress disorder

EMDR Institute
International Society for Traumatic Stress Studies
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