Eye movement desensitization and reprocessing (EMDR) mimics rapid eye movement (REM) sleep. The nurse working with injured soldiers knows that EMDR is an intervention suggested for the treatment of:
1. Bipolar I.
2. Childhood-onset trauma victims.
3. Dissociative identity disorder.
4. Depression.
3
Rationale: Eye movement desensitization reprocessing is a controversial intervention suggested for PTSD and dissociative identity disorder. Clients are asked to recall traumatic memories or a feared stimulus while making a series of rapid lateral eye movements. There is no definitive theoretical explanation of how EMDR might work other than that it is the repetitive redirection of attention in EMDR that induces a neurobiologic state, similar to that of rapid eye movement (REM) sleep, which assists in the integration of traumatic memories into the cortex of the brain. As with conventional medicine, there has been inaccurate and selective reporting of research, inadequately designed studies, and biased or inaccurate reviews. EMDR has been described as having a significant healing outcome for an adult with a childhood memory of medical trauma resulting from a tonsillectomy. However, a randomized clinical trial that compared the short- and long-term benefits of medication (fluoxetine) with those of EMDR in subjects diagnosed with PTSD found that 75% of adult-onset subjects at the six-month follow-up were asymptomatic compared with none in the fluoxetine group. EMDR is not used for treatment of depression or Bipolar I. For most childhood-onset trauma victims, neither medication nor EMDR produced complete symptom remission.
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