Re:Effect of eye movements

There is indeed some indirect evidence (and logical thinking) that dual attention is different than exposure. One issue concerning the purported similarities between EMDR and a pure
exposure approach involves the fact that in the former case the intention of the therapist is to disrupt exposure to the memory by directing patient's attention to his hand (or other external stimulus). In fact, in EMDR the initial internal focusing on the traumatic material is one of the few moments a directed form of exposure is applied. Therefore, the total amount of exposure a client receives will generally be less than 10 minutes per session. In the exposure literature this is considered to be ineffective: "Brief interrupted exposures are known to be ineffective for fear reduction, probably because they are insufficient for habituation to occur" (Foa & Kozak, 1985, p. 451).

Indeed, cognitive avoidance and distraction have been found to impede exposure therapy for animal phobia (Sartory, Rachman, & Grey, 1982). Conversely, there are indications that alternate (or dual) attention has a potentiating effect on exposure. In a study by Wells and Papageorgiou (1998) four socially phobic patients underwent one session of exposure alone. This was followed by one session of exposure plus an external attention focus. Four other patients received these sessions in reversed order. The results showed that by shifting to an external attention focus the effectiveness of brief exposure significantly increased; that is, the
manipulation facilitated decreases in both anxiety and negative beliefs. Likewise, Lohr, Tolin and Kleinknecht (1996) treated two claustrophobic subjects and found substantial changes in disturbance ratings, but only after the eye movements were added to an imagery exposure procedure. These findings are in line with the contention that short exposures to a feared image in combination with an alternate attention stimulus, as utilized in EMDR, act as an un-reinforced trial which, with repetition, results in the extinction of anxiety (e.g., Dyck, 1993).

Replies:

Re:Effect of eye movements, by Cahill, 10/30/02 Attention Divided and Conquered, by Sandra Paulsen Inobe PhD, 10/30/02 Re:Attention Divided and Conquered, by Cahill, 10/30/02 Re:Attention Divided and Conquered, by interested client, 10/31/02 Re:Attention Divided and Conquered, by Sandra Paulsen Inobe, PhD, 10/31/02

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