what doesn't make you stronger kills you...

I recently sat through a lecture on neuroscience and psychotherapy and the lecturer touched on EMDR. The way I understood it is that normally, emotional memory is processed from the amydgala through the hippocampus and into the cortex. The processing through the hippocampus normally takes place during REM sleep, but in the case of PTSD, the memory becomes "stuck" in the amydgala. EMDR helps "unstick" the memory and process it through the hippocampus the way it normally would be during REM sleep.

Obviously that's a layman's description and I don't know if it's pure hypothesis or if there's some evidence to back it up, but there it is.

> but we don't have much idea of *how* it works in the brain.

Isn't that the case more often than not?

Hi Kai

I have some sympathy.... was talking about this with a colleague last night. The EMDR practitioners' explanations are invariably metaphorical or expressed in similes... but I don't see how it can be any other way with our current state of neurological knowledge. We are still a long way off adequate descriptions of complex processes.

There is an argument that EMDR is no more effective in treating trauma than desensitisation, having the client stay with the trauma until the distress diminishes. It is, however, in my experience a damn site faster and works on a number of other levels (I have used it to help one guy erase an unwanted fetish response for example).

<irony>Hell Kai, if we waited for an adequate reductionist explanation, we would still be trapanning and applying electrical currents across people's temporal lobes </irony>

"and there's a lot of ethical debate around "erasing" memories (and lots and lots of potential side effects that are quite undesirable)."

One of the points in the McGill lecture was that the drugs could leave the non-amygdala-located aspects of the memory intact while preventing the reformation of the proteins produced in the amygdala which encode the strong emotional content. He started the lecture with a reference to "The Eternal Sunshine of the Spotless MInd" as a way to set up the later point that this potential therapy would differ from the complete wipe that occurs for the Jim Carrey character in that film.

My oomments earlier weren't meant as a hard-ass reductionist stance, more as an expression of frustration at the "poking around in the dark" (or at least a dim room) state of such psychological experimentation, with the hope that psychologists won't neglect the psychiatric goal of correlating recently gained knowledge about neurochemistry with these perceptual level manipulations which appear to have some empirical validity.

From my own recent experience, ironically enough, I can attest to the semi-witch-doctory state of current psychiatric drug therapies - i.e., they seem to accomplish their stated goals, but the side effects show how crudely aimed they still are. (So the "it seems to work, but we don't know exactly how yet" criticism applies just as much to neurochemical research and application.) Late last spring, after several months in the grip of a bout of debiliating depression that the usual counseling wasn't helping enough I finally decided to see about going on anti-depressants, something I had resisted for a long time. So I started on Celexa, was on that for 3 months, it reduced the mood extremes, sure enough, but introduced other unpleasantries like insomnia (which soon increased my anxiety, of course). switched to Zoloft, which let me sleep, but introduced recurrent nausea, among other things. So while they both kept me functioning better than I would have (based on my my past experiences with untreated depressive episodes, which I've recognized in hindsight, with outside help), and allowed me to process the events which had triggered the depressive plunge, get perspective, etc., the cost was too high in the long run. I stopped in early October and the return of my full emotional range, minus the darker depths and manic highs (because I'd methodically removed the triggers of the last episode from my life), was remarkable. (I emerged from my Zombie Summer, to exaggerate a bit.) I side with Brooke Shields over Scientology Poster Boy on the question of whether drugs should be used at all. (If you remember, Mr. Cruise Missile suggested that vitamins were enough. Twerp.) The drugs had some limited usefulness, not nil, and I don't regret having tried them, but a preventative and more holistic approach to depression remains a better long-term option until such time as neurochemical precision is achieved.

So anyway, sure; whatever works, eye movement, drugs, people need something *now* that works at least to some degree, but I don't want to lose sight of the goal of such precise therapies.