I'm a skeptic through and through. Show me some evidence? I want to see the data and the methods that they used to back up their findings. I've never been a person to take things at face value. When I heard about Eye Movement Desensitization Reprocessing (EMDR) in school, it sounded awesome: a technique that had lower drop-out rates than other exposure therapies (Ironson et al. 2002) and had equal (or better) results than talk therapy (Power et al. 2002, van der Kolk et al. 2007). Thanks to some encouragement from my advisor, I decided to get trained in the method.
While I had read all of the EMDR procedures prior to arriving at the training, I had no idea how my skeptic thoughts would arise when it came time to actually do it. You see, when you get trained in EMDR, you practice with a partner who is another trainee. Each of you works with a real life situation so that you get the perspective both as the therapist and as the client. When it came time for me to be the client, I immediately thought "You want me to do what?" I knew, logically, that I was supposed to watch her fingers move back and forth and "go with" whatever thoughts came to mind. However, the actual thought of doing such a thing felt like a bunch of hooey. I did my best during the training, but I left feeling less confident in EMDR's effectiveness rather than more confident.
I had read the research. I knew it had good outcomes for PTSD. Yet, there was this nagging thought in my head about the eye movements. I read deeper into the research and found that there was not a whole lot of evidence for what the eye movements actually did. People hypothesized that they were like REM sleep and helped "reorganize" memories in your brain, but there was very little neuroscience to back these claims up.
This feeling left me with a conundrum. Do I continue my EMDR training or do I drop it because it feels weird? I decided that there was enough evidence that I would continue to pursue the process despite my doubts. In the end, I have seen what has been substantiated by the evidence: EMDR can help people reprocess traumatic memories without feeling overwhelmed. For some reason, bilateral stimulation seems to help people manage their experiences in ways that they were not able to in talk therapy.
When people have experienced overwhelming events, they often feel overwhelmed when they are reminded of them. Even though they can logically explain to themselves that what happened before is not happening again, it often feels like it's happening again. In many cases, they know what they want to logically believe yet their body or their emotions tell them that it's not safe. Somehow, EMDR keeps people from feeling overwhelmed while doing trauma reprocessing. People are able to think about a past trauma and connect to their logical thoughts while also validating what they are feeling: all without tipping outside of what they can handle. I have my own hypotheses about how EMDR works to do this, but they are just hypotheses, with no evidence.
While we don't know the specifics of why the bilateral stimulation is important for EMDR, there are many research studies demonstrating EMDR's effectiveness, including randomized clinical trials (for data nerds like me, here is a link to the specific studies). For now, I have decided that the overwhelming support is enough for me to keep doing it...even if it feels weird...and even if the evidence for bilateral stimulation is shaky at best.
I've heard the phrase "lean into the uncertainty" a lot as a therapist. While I am by no means suggesting leaping with wild abandon into techniques that have little to no evidence, I have decided that I can lean into the uncertainty of EMDR given the overall rates of effectiveness. For now, that's enough.