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--BOH: Initially you named this EMD, and then as you worked on these protocols you added another element. Why the R?
--FS: Because at first, coming from a behavioral therapy vantage point, I was thinking in terms of decreasing anxiety. I thought I was doing the equivalent of systematic desensitization while using the brain’s own mechanism for it. It seemed like it might be linked with REM sleep, which is when those kinds of rapid saccadic eye movements would often spontaneously go back to a past event, and there we are in psychodynamic territory. I discovered that it was easier and more efficient if I started with the past. If I cleaned that out, generally the present didn’t bother them any longer.
--FS: Because at first, coming from a behavioral therapy vantage point, I was thinking in terms of decreasing anxiety. I thought I was doing the equivalent of systematic desensitization while using the brain’s own mechanism for it. It seemed like it might be linked with REM sleep, which is when those kinds of rapid saccadic eye movements would often spontaneously go back to a past event, and there we are in psychodynamic territory. I discovered that it was easier and more efficient if I started with the past. If I cleaned that out, generally the present didn’t bother them any longer.
--BOH: Initially you named this EMD, and then as you worked on these protocols you added another element. Why the R?
--FS: Because at first, coming from a behavioral therapy vantage point, I was thinking in terms of decreasing anxiety. I thought I was doing the equivalent of systematic desensitization while using the brain’s own mechanism for it. It seemed like it might be linked with REM sleep, which is when those kinds of rapid saccadic eye movements also occur. I tested the procedure in a randomized study and when it was published in 1989, it was called EMD, Eye Movement Desensitization, focused on getting rid of anxiety.
But as I continued working with the procedures, I noticed that if I let it keep going, new associations were occurring. Emotions were changing dramatically from anxiety to sadness to joy. There were cognitive and emotional changes when I allowed this association process to take place.
--BOH: When you say cognitive, just to clarify: self-talk, beliefs…?
--FS: Yes. People’s beliefs would au-tomatically shift.
--BOH: So those beliefs that used to occur automatically were suddenly new beliefs that were more helpful, less self-condemning, less fearful?
--FS: Yes. If I let the associations move, people were getting insights about themselves, about whatever they were dealing with. And it wasn’t just anxiety that was changing, it was guilt, shame; all the negative feelings moved into healthier emotions. What I was seeing was spontaneous and simultaneous changes in emotion, belief, and somatic responses. I also discovered that if I started with a present issue, it would often spontaneously go back to a past event, and there we are in psychodynamic territory. I discovered that it was easier and more efficient if I started with the past. If I cleaned that out, generally the present didn’t bother them any longer.
--FS: Because at first, coming from a behavioral therapy vantage point, I was thinking in terms of decreasing anxiety. I thought I was doing the equivalent of systematic desensitization while using the brain’s own mechanism for it. It seemed like it might be linked with REM sleep, which is when those kinds of rapid saccadic eye movements also occur. I tested the procedure in a randomized study and when it was published in 1989, it was called EMD, Eye Movement Desensitization, focused on getting rid of anxiety.
But as I continued working with the procedures, I noticed that if I let it keep going, new associations were occurring. Emotions were changing dramatically from anxiety to sadness to joy. There were cognitive and emotional changes when I allowed this association process to take place.
--BOH: When you say cognitive, just to clarify: self-talk, beliefs…?
--FS: Yes. People’s beliefs would au-tomatically shift.
--BOH: So those beliefs that used to occur automatically were suddenly new beliefs that were more helpful, less self-condemning, less fearful?
--FS: Yes. If I let the associations move, people were getting insights about themselves, about whatever they were dealing with. And it wasn’t just anxiety that was changing, it was guilt, shame; all the negative feelings moved into healthier emotions. What I was seeing was spontaneous and simultaneous changes in emotion, belief, and somatic responses. I also discovered that if I started with a present issue, it would often spontaneously go back to a past event, and there we are in psychodynamic territory. I discovered that it was easier and more efficient if I started with the past. If I cleaned that out, generally the present didn’t bother them any longer.
--BOH: It generalized out to several things, sometimes things you’d never even talked about?
--FS: Exactly. So I added the Reprocessing around 1990 in order to demonstrate that it was more than just Eye Movement Desensitization. If I had it to do over again, I’d call it Reprocessing Therapy. Unfortunately, it’s too late. But, to be clear, EMDR is now an eight-phase psychotherapy with a wide range of applications.
--BOH: There seems to be two themes: one is practical and experiential, and the other is, “Let’s look at the evidence.” Why did you put so much emphasis on doing scientific research?
--FS: The way to alleviate suffering is to rigorously evaluate what you’re doing. In the first study, results could have been due to characteristics of me as a therapist. The replication studies were extremely important to prove that it worked. I ended up being invited to a variety of VAs and agencies. We would give free trainings if they were going to do research. We continue to do that to this day. Unfortunately, some of the early studies were done badly, so it needed a lot of additional research to convince people that it actually worked. At this point there are about 24 randomized studies on the effect of EMDR therapy with a wide range of trauma victims. The World Health Organization has now stated there are only two validated approaches for the treatment of PTSD in children, adolescents and adults: trauma-focused CBTand EMDR therapy. That’s because of the research base.
--FS: Exactly. So I added the Reprocessing around 1990 in order to demonstrate that it was more than just Eye Movement Desensitization. If I had it to do over again, I’d call it Reprocessing Therapy. Unfortunately, it’s too late. But, to be clear, EMDR is now an eight-phase psychotherapy with a wide range of applications.
--BOH: There seems to be two themes: one is practical and experiential, and the other is, “Let’s look at the evidence.” Why did you put so much emphasis on doing scientific research?
--FS: The way to alleviate suffering is to rigorously evaluate what you’re doing. In the first study, results could have been due to characteristics of me as a therapist. The replication studies were extremely important to prove that it worked. I ended up being invited to a variety of VAs and agencies. We would give free trainings if they were going to do research. We continue to do that to this day. Unfortunately, some of the early studies were done badly, so it needed a lot of additional research to convince people that it actually worked. At this point there are about 24 randomized studies on the effect of EMDR therapy with a wide range of trauma victims. The World Health Organization has now stated there are only two validated approaches for the treatment of PTSD in children, adolescents and adults: trauma-focused CBTand EMDR therapy. That’s because of the research base.