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Re: EMDR and sleep

Posted by Elizabeth on July 22, 1999, at 23:18:27

In reply to Re: EMDR - for DL and Elizabeth, posted by Toby on July 22, 1999, at 9:10:04


Perhaps I did not make myself clear. I do not need to see *all* the studies of EMDR; I can do a Medline search if I want that. I wanted a pointer to perhaps three of them that you consider to be among the better-designed and -executed.

One criticism I've heard and read is that EMDR is just exposure therapy ("DR") wearing a funny hat; i.e., that they eye movements don't have any specific effect. This is based on dismantling studies that compared cognitive-behavior therapies with EMDR; at best, EMDR equalled the other therapy.

Has any of EMDR's proponents, presumably well-trained in the procedure, attempted a dismantling study?

I'd like to know, as well, how one decides by reading a study whether or not EMDR was "done right" in that study - other than that the researchers studied EMDR without the aid of Dr. Shapiro and colleagues? That is, what leads you to the conclusion that they did it wrong?

It's an interesting hypothesis you offer about an association between EMDR and REM sleep. Perhaps I will ask one of my teachers about this (they run a sleep lab at Mass. Mental Health Center and have done quite a bit of research on sleep). To tell you the truth, though, it sounds like hand waving. My understanding of current thought on the subject is that rapid eye movements are not what drives REM/desynchronized sleep, but rather are a byproduct of it, so that forcing eye movements that mimick those of REM sleep will not induce a state of "waking REM." Have there ever been any polysomnographic studies of EMDR? If what you are claiming were true, then such studies would show some rather extraordinary things that would not be found with ordinary desensitization therapy.

As for dreaming and associative memory, two of the main things that are hypothesized (and not without good reason) to occur during REM sleep are (1) episodic memories are incorporated into a "network" of associative memories; and (2) forgetting (taking out the garbage, as it were) takes place. Regardless of self-image, the predominant emotions in REM sleep dreams are anxious ones, with little depressive or shameful feeling.

Posttraumatic dreams, incidentally, are not like normal REM sleep dreams, perhaps because of a (dare I say it?) chemical imbalance, namely in the interaction between norepinephrine and acetylcholine. As a result, you get nonbizarre dreams that replay the memory verbatim rather than incorporating it with other memories in unpredicted ways.

It should be noted that NREM/synchronized sleep is also apparently required for learning to take place.

The question in regard to Francine Shapiro's credentials had to do with the place where she did her doctoral work, and whether it was credible or not, as I recall.

I think perhaps the problem people have with EMDR not having a theoretical basis is that they are not convinced that it works, practically speaking, either. CBT is pretty much common sense, while psychoanalytic psychotherapy is subject to many of the same criticisms as EMDR is.

I doubt it bothers people that EMDR is being claimed useful for non-trauma-related disorders in particular; rather, it's that it's being claimed useful for disorders that don't respond to "DR," though EMDR has not been proven to be any more effective than "DR."

Thank you for the list of EMDR therapists in Boston. I've never heard of any of them, but perhaps someone else I know has.




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