Treatment Of Posttraumatic Stress Disorder

Posttraumatic stress disorder, PTSD, is diagnosed when an individual exposed to a traumatic event continued to experience distress and symptoms after 4 weeks of the event. Treatment plays a vital role in the lives of those living with PTSD, approximately half of those diagnosed with PTSD improve within six months; however, “more than one-third of people with PTSD do not respond to treatment even after many years (Comer, 2010, pg.192). Eye movement desensitization and reprocessing, EMDR, is a form of exposure therapy used to treat PTSD. EMDR requires a trained therapist to lead a patient’s eyes in a rhythmic motion during their recollection of the traumatic experience (Taylor, 2003).

On one hand, some theorists argue that the eye movements are unnecessary for efficacy of EMDR because it is the exposure component of EMDR that is effective in treatment for PTSD. On the other hand, some studies show that EMDR including eye movement is effective in treatment for people with PTSD. Literature will be reviewed and a personal stance will be provided. Eye movement unnecessary in desensitization and reprocessingAccording to an article written by Roger & Silver (2001), when Francine Shapiro presented EMDR as an effective treatment for PTSD in 1989, early arguments claimed that the eye movement component was unnecessary. A later meta-analysis from Davidson & Parker (2001) set out to examine if the presence of eye movements influenced effectiveness.

This meta-analysis compared data from thirty-four studies, thirty-three were controlled trials. The research from Davidson & Parker (2001) provided support that EMDR with eye movement was not more effective than EMDR without eye movement or exposure therapy. With the amount of exposure therapies available today, it was surprising that no significant variance between the treatments without eye movement compared to treatments with eye movement were produced in the studies. Unfortunately, this meta analysis did not only focus on eye movement, but included the influence of therapist training and other factors of the mental health disorder which is a limiting factor because the analysis had a broad range of focus. Another limiting factor was that this analysis was based on the data of thirty-four studies and was not a clinical trial performed, relying on data of others. A controlled study should have been performed.

No long term effects or data are provided to show the lasting impact, if any of these treatments. Many skeptics of EMDR claim that without the eye movements, EMDR is just exposure therapy which leads to the argument that adding eye movements is unnecessary. Taylor (2003) mentions that both EMDR and exposure therapy require the patient to undergo memories and reexperiencing of a trauma, but differ in length of treatment. Taylor (2003) conducted a study with forty-five patients that completed treatment that consisted of exposure therapy, EMDR, or relaxation therapy. A strength of this study is that all the gold standards were met and the treatments were controlled through therapist efficacy. This study eliminated bias by using blind evaluators for the data report.

Two trained and accredited EMDR therapists administered the treatment to participants under supervision of the same psychologist. This well designed study by Taylor (2003) claimed that the participants were less likely to meet PTSD criteria after exposure therapy and reduced the greatest amount of symptoms compared to EMDR and relaxation therapy. All three of the therapies consisted of a homework component which is unusual for EMDR because it is typically completed within a therapy session. A limiting factor in this study is that EMDR was paired with a coping strategy known to reduce distress, so the typical eye movements, reprocessing, and desensitization had another factor to incorporate and possibly interfere with the procedure.

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