Reading a ‘Critically evaluate Eye Movement Desensitization and Reprocessing (EMDR) as a treatment method for Post-Traumatic Stress Disorder (PTSD)” by Milauro Giovanni of the University of Kent (a review the literature on EMDR for treating PTSD, particularly in respect to certain co-morbidities) got me wondering about memory. I jotted down a few questions to perhaps take up some other time.
The “point” of the therapy is to erase the effect of a peculiarly unpleasant memory and thus the negative effects upon behavior, cognition, and affections which come with that memory. (I’m being careful here to not say that the memory causes the negative behavior; there may be any number of relationships between a behavior or thought and a memory. But there certainly is some connection between the two).
The unique aspect of EMDR is in the desensitization phase, which the APA describes as follows: “During this phase, the client focuses on the memory, while engaging in eye movements or other BLS. Then the client reports whatever new thoughts have emerged. The therapist determines the focus of each set of BLS using standardized procedures. Usually the associated material becomes the focus of the next set of brief BLS. This process continues until the client reports that the memory is no longer distressing.”
Somehow talking about the unpleasant memory while trying to keep track of the light causes the memory to fade in effect.
Giovanni reports that studies have not shown a distinction between moving the light up and down as opposed to side-to-side. This seems to rule out the theory that the light movement is integrating the hemispheres of the brain.
The other explanation for the effects of EMDR is that “the overcharging of working memory, that will lead to a less vivid memory of a traumatic memory and the related emotion.” (It should be noted that watching the light while discussing good memories, also results in good memories being less vivid.)
So, if I am understanding the research correctly, watching the light while speaking about a particular memory makes the memory less distinct.
There are some other observations which may be relevant here. First, there is a theory of dyslexia which explains certain effects as a failure of eye tracking and other effects as an inability to remember the correct sounds to visual image. It is as if the eye sees some X and the brain delivers a Y to the mouth.
Second, years ago I received some advice following an unpleasant interpersonal experience: Every time I began to recall the unpleasant event, I was to pinch my hand and deliberately think of a particularly pleasant event in its place.
Related to this would be the technique advanced by Jeffery Schwartz in “You are not Your Brain”. When my brain throws up a response to an unpleasant sensation (hey, why not get drunk/go shopping/etc rather than have this bad feeling), see this as a “deceptive brain message” and seek to repackage the event while heading in another direction: I’m feeling stress and my brain has grabbed my previous go-to response, but that is a terrible idea, let’s do this other productive thing in its place. In short, it is about reworking bad habits.
If this analogy is correct, then EMDR may be breaking a habitual connection between the emotional/behavior/cognitive response to the memory and the memory itself. The memory functions like a key to start a habitual chain of responses. The therapy disconnects the chain of memory-to-panic/anger, et cetera.
If it is merely a practice of disconnecting the memory from the responsive chain, is that always a good thing? Someone recalls the memory of being a victim of a crime. They respond with horror (and then perhaps some additional responses for the purpose of alleviating or displaying the horror). While I am certain that someone who has anxiety, inability to sleep, et cetera would be very happy to be freed from such painful experiences, does the disconnection of the memory from the chain of responses (as opposed to merely obscuring the memory), does this result in a desensitization to that particular stimulus in all events?
Say I am the victim of a violent crime who then suffers horrible memories and reactions to that crime. Thereafter, I undergo EMDR and no longer have that response. Am I desensitized to violent crime altogether? Or am I desensitized to only my particular memory?
Or, does it simply obscure the particular memory. The chain of memory to horror is still in place, but the first link in the chain (the memory) is removed so the remaining links do not arise.
Could the chain of memory and horror be reworked at the level of the horror? Is that what happens when someone turns to revenge rather than fear? (Anger is an easy substitute for fear).
What happens when I recount the event in terms of (1) the sovereignty of God, (2) the knowledge that God will judge all sin, (3) that God will vindicate, (4) that we will receive “praise, honor, and glory at the revelation of Jesus Christ”?
Is this something which can be reworked at the level of thought? What additional behavioral responses are necessary to respond effectively such that the memory does not perpetuate a cascade of dangerous behavioral/emotional/cognitive responses?