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EMDR and the Energy Therapies: Psychoanalytic Perspectives

Author(s) : Phil Mollon

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David C. Blore on 26/04/2005

(5 out of 5)

For me, 'EMDR and the ENERGY THERAPIES' initially conjured up the amusing image of a 1960's pop group. So, I reasoned, is this is a book suggesting how psychological treatments can work in harmony (so to speak)? Actually Chapter One sets the scene nicely, immediately drawing together an interesting triad of therapies: Eye Movement Desensitisation & Reprocessing (EMDR) originally discovered by Francine Shapiro in 1987; Emotional Freedom Techniques (EFT), Gary Craig's standardisation of Callahan's original Thought Field Therapy; and Psychoanalysis. Whilst this is a combination that will sit nicely with some clinicians - it will fit far less so with others.

EMDR and EFT are very much the 'new therapies on the block', whilst Psychoanalysis is 'the old wisdom', but what have they all in common? The answer is quite simply 'controversy'. Such is the passion generated that all three seem to warrant referral to a United Nations Special Committee as the only way to avoid all-out war. Arguments for and against outshine, by orders of magnitude, the lacklustre of the electioneering going on around me as I write this review. Nothing new in controversy then, nothing new in resistance to change either. Perhaps history really is replaying itself with EMDR & EFT undergoing the very 'birth pangs' that Psychoanalysis underwent all those years ago. I suspect that Mollon recognises this as he alludes to this 'birth' in his quotation of Gallo: 'This is the dawning of the new age in psychological therapy. Enjoy the sunrise.' Perhaps this should read 'enjoy the birth, enjoy the war'. I think we can take it, therefore, that this book may turn out to be amongst the first in a line of combination therapy guides 'fired off' to see us through this 'new day'. However, analogies to daylight, birth pangs and war are all very well, but what are the constituents of this 'new day' according to Mollon?

Constituent one: EMDR, along with the more familiar Cognitive Behavioural Psychotherapy, has become a trauma focussed psychological treatment of choice. I say 'has become', because the National Institute of Clinical Excellence (NICE) report into Post Traumatic Stress Disorder (PTSD) came out in March 2005 (whilst the equivalent report in Northern Ireland from the Clinical Resource Efficiency Support Team (CREST), recommended precisely the same in 2003. NICE and CREST, to me are reminiscent of the instruments of Foucault's (1972, 1980), 'regimes of truth' relating to the accepted wisdom of a given era. The key word is 'wisdom' but the political agenda speaks to me of 'edict'. I was brought up with the fervent beliefs associated with Illich's 'Medical Nemisis: the expropriation of health' so in this Marxist context, I think it brave of Mollon to take on the 'edict-driven' intelligentsia of psychological medicine, and say "hang on a minute, try this one out for it seems to work".

Actually, I went through the same experience with EMDR (Blore 1997) and had to head off a lynch mob headed by a (bourgeois?) psychiatrist who asked me "What on Earth are you doing, man, call yourself a psychotherapist? Get your empirical feet back on the ground." Ironic then, that 8 years later the 'regime of truth' had changed to actually sanction this bizarre treatment called EMDR, characterised by its combination of eye movements (or other bilateral stimulation), free association, and a structured 8-phase method of conducting treatment. Still, a few diehard counter revolutionaries fight on and EMDR duly remains controversial in some quarters. The reasons for this would require another book to explain, suffice to say that however EMDR works, it certainly works.

Constituent two: Energy therapies, consisting of Thought Field Therapy and Emotional Freedom Techniques are, by contrast, rather less structured than EMDR. The book takes us through the different types and essentially stresses the underpinning concept that emotional distress is fundamentally located in disturbance of the body's energy fields. This concept, as Mollon points out, is far from new and has its corollaries in yoga, various alternative therapies and more recently, in applied kinesiology. The impression is that we are still all finding our feet with something we have known about for centuries. Probably the greatest contrast between EMDR and the Energy Therapies, is that none of the later belong to the current 'regime of truth'. That is, NICE says nothing about them at all.

Constituent three: Psychoanalysis doesn't require an introduction, just a reminder to the reader, that psychoanalysis in this book are the 'glasses' by which Mollon views this new day that dawns in psychology. The reader wishing to view this 'day' through different glasses must rely on other perspectives (e.g. Hartung & Galvin 2003). By the way, it hasn't escaped my notice that NICE says very little about Psychoanalysis as well.

The book itself? Well none of the wading through treacle you get with some tomes, but a volume that is easily read from cover to cover or one you can just as easily dive into by reading one or more of the subheadings (useful resource for clients?). Whereas I fully understand the overall psychoanalytic perspective taken by Mollon, I do have one disagreement: (p209) says that "in order to make good use of EMDR or an energy method in complex cases, the psychotherapist will need to have an adequate understanding of psychodynamics as revealed by psychoanalysis." As a Cognitive Behavioural Psychotherapist I have had, like many of my peers around the world, considerable and numerous successes over the past 12 years with EMDR, and without this 'understanding of psychodynamics'. No matter. However, the impression given is clearly that a psychodynamic theoretical base is a crucial necessity to be able to utilise either EMDR or energy therapies. This is just not so. Shapiro, the discoverer of EMDR is quite clear about this: EMDR respects the orientations of all clinical approaches (Shapiro, van der Kolk & Grand 1999). The basic need is for a thorough understanding of mental health and its issues. I fully appreciate, that what exactly constitutes 'understanding' in this context, is open to interpretation.

From a minor but important disagreement to an area of clear strength: Mollon's book highlights that we have had, at least some of the answers to clinical needs for centuries. It would have been interesting to investigate the politics of why that knowledge has been (to say the least) under-utilised. Maybe it is only now that the regime of healthcare truth is ripe for reviewing this knowledge and maybe those green shoots are starting to extend toward NICE. After all, recommendations from NICE relate to government funding. Government funding drives the NHS and therefore availability of a given treatment is ultimately dependant upon NICE. There is also the complex issue of just what comes first:

1 A treatment or combination of treatments known by clinician and client alike, to be effective but which research struggles with, or

2 Research, and the budgets of those doing the research, leading to decisions of treatment availability.

Metaphorically, I can see Illich nodding in the background: that no matter how insightful Mollon's ideas are, who will ultimately allow these ideas to see widespread dispensing? With the emphasis on 'value for money' in healthcare, and value for money being dictated by research, then perhaps Phil Mollon's next book title needs to be:

'EMDR and the ENERGY THERAPIES: persuading the powers that be,
that there are effective therapies, which need far more
(unbiased) research attention if the client is to benefit'

A long title, I hear you say, but one that will certainly ring true with clinicians and clients in the early years of the 21st century.

To his credit, Mollon attempts to pre-empt this situation with good examples of case reports and also succinctly details the current research positions. However, given that certain lobbies are set against EMDR despite the research, one wonders how these influential 'sceptics' will see EMDR being allied to energy therapies. This may just be one step too far for the current 'regime of truth', and the medical mafia may have to be unleashed.

Most clinicians, and I am one, will have little problem adopting Mollon's ideas, but there are many 'out there' that will. The conclusion must be that Mollon's day has actually dawned early. Congratulations then Phil, this may indicate that your book is ahead of its time.

References and bibliography:

Blore, D.,C. (1997).
Reflections on 'A Day when the Whole World seemed to be Darkened'", Changes International Journal of Psychology and Psychotherapy, 15(2):89-95.
Foucault, M. (1972).
The Archaeology of knowledge, New York: Harper Colophon
Foucault, M. (1980).
Power/knowledge, New York: Pantheon.
Hartung, J.G., & Galvin, M.D., (2003)
Energy Psychology and EMDR: combining forces to optimise treatment, New York: W.W.Norton & Company
Illich, I., (1977). Medical nemesis: the expropriation of health. London: Penguin.
NICE website: www.nice.org.uk
Shapiro, F., van der Kolk, B., & Grand, D., (1999)
EMDR: Looking through hemispheres: an introduction (Video) San Francisco: Fran Donovan Productions