EMDR FORUM ARCHIVE, 2000
Effect of eye movements
Louise Maxfield · 10/29/02 at 7:33 ET
Four studies investigated the effects of eye movements (EMs) on the vividness and emotionality of memory images. (Andrade, Kavanagh, & Baddeley, 1997; Kavanagh, Freese, Andrade, & May, 2001; Sharpley, Montgomery, & Scalzo, 1996; van den Hout, Muris, Salemink, & Kindt, 2001). These studies consistently demonstrated that EMs have a significant desensitization effect that is greater than that of various control conditions, including exposure. They found that EMs resulted in a significant decrease in the vividness of memory images and the associated emotion, and that this effect was significantly greater than those of control conditions such as tapping, complex tapping, imagery, fixed gaze, and visual noise. These results cannot be explained by exposure, as mere imagery (exposure) did not result in decreased vividness nor decreased emotionality (Andrade et al., 1997; Kavanagh et al., 2001; van den Hout et al., 2001). It appears likely that EMs contribute to treatment process in EMDR through their desensitization effects, and that they are probably an active treatment component. Kavanaugh et al. (2001) concluded that EM may function in EMDR as a therapeutic “response aid” to assist clients to access painful and distressing memories. Van den Hout et al. (2001) wrote that during EMs “the recall of an emotional event is attended by distinctly unusual responses” (p. 129) and suggested that these responses consequently changed perceptions, resulting in desensitization through a process similar to that of reciprocal inhibition. They proposed that, in EMDR, this effect “may be to temporarily assist patients in recollecting memories that may otherwise appear to be unbearable” (p. 129). The study by Kavanagh et al. (2001) suggest that the effects may dissipate within a week. Whether the desensitization effect of EMs operates primarily in session or whether it has longer effects is unclear, as the failure to show an effect after one week does not imply that a stronger manipulation would not have a larger effect. However, it may be possible that the desensitization effects of EMs are operative primarily within session and are not measurable after treatment is ended. If so, this could explain the difficulty in identifying the contribution made by EMs to outcome. Nevertheless, if the role of eye movements is primarily to decrease in session distress and to make other material more accessible, then these effects may be of great benefit to some clients. These studies appear to address the issue raised by numerous reviewers who have suggested that the beneficial effects of EMs and EMDR may be due primarily to imaginal exposure (e.g., Cusack & Spates, 1999; McNally, 1999a,b). The Andrade et al. (1997), Kavanagh et al. (2001), and van den Hout et al. (2001) studies all included an imagery or exposure control, in which the participant focused on the memory image without a dual attention task. Unlike the EM condition, the exposure condition did not significantly decrease image vividness or emotiveness, and EMs resulted in significantly larger decreases than the exposure condition. In the van den Hout et al. study, participants in the imagery condition reported a significant increase in vividness for the positive images. Aggregate results indicate that EMs have a distinct effect on emotional visual images, and one that differs significantly from the effects of exposure. In conclusion, a number of studies have demonstrated that EMs have a unique desensitization effect, that decreases the emotiveness and vividness of autobiographical memory images. This effect is distinct from that of exposure. In EMDR treatment, this effect may serve to titrate exposure to painful memories and assist clients in accessing other related material, and may reduce in session distress.
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