enhance treatment effectiveness, so exposure alone has gained more relative support than systematic desensitization (Foa et al., 2000).


As originally designed, EMDR includes saccadic eye movements (quick, jumping from one point of fixation to another) believed to reprogram brain function so emotional impact of trauma can be resolved (Friedman, 2003).2 In the EMDR process, the client is instructed to imagine a traumatic memory and negative cognition and articulates an incompatible positive cognition (e.g., personal worth). The clinician asks the client to contemplate memory while focusing on rapid movement of clinicians’ fingers. After 10–12 eye movements (back and forth) clinician asks client to rate strength of memory and his or her belief in positive cognition.


Explores psychological meaning of a traumatic event (Foa et al., 2000). Focus is on bringing unconscious traumatic memories into conscious awareness so that the PTSD symptomatology (which are presumed to be a result of these unconscious processes and memories) can be reduced. Treatment is given in weekly sessions 50 minutes in length, traditionally lasting from 12 sessions to more than 7 years (Friedman, 2003). Few empirical investigations with randomized designs, controlled variables, and validated outcome measures have been reported; case reports constitute the bulk of the literature (Foa et al., 2000). Brief psychodynamic psychotherapy (BPP) is typically conducted in 12 sessions and up to 20, and focuses on the traumatic event itself (Foa et al., 2000; Friedman, 2003).


Hypnosis may be used as an adjunct to psychodynamic, cognitive-behavioral, or other therapies, and has been shown to significantly enhance their efficacy for many clinical conditions; however, there is a lack of quality evidence on use of hypnosis with PTSD patients. Hypnosis requires professional training (Foa et al., 2000).


There is some controversy as to whether the eye movements or the cognitive processing of the traumatic event account for effectiveness of EMDR.

The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement