A Therapist’s Guide to EMDR: Tools and Techniques for Successful Treatment


Buy It Now!

‘Highly useful’ book addresses EMDR
(February 2008 Issue)

“A Therapist’s Guide to EMDR: Tools and Techniques for Successful Treatment”
By Laurel Parnell
W.W. Norton & Company
New York, N.Y., 2007

By Paul Efthim, Ph.D.

Back in the early 1990s, when Francine Shapiro introduced eye-movement desensitization and reprocessing (EMDR), psychologists were skeptical of her claims and suspicious of her motives. But EMDR has stood the test of time. A recent report by the American Psychological Association ranked EMDR as one of several empirically supported therapies for PTSD.

Despite the research support, EMDR remains somewhat controversial, perhaps because no one seems to know why it works. As a practitioner who has not been trained in this approach, I was intrigued to delve into Laurel Parnell's new guidebook for EMDR clinicians. The overall impression is a strongly positive one - this is a book that will be highly useful to EMDR therapists and also quite illuminating and provocative for other clinicians as well.

"A Therapist's Guide to EMDR" is written specifically for practitioners who have already been through the training program, which typically takes place over several weekend workshops. Parnell, a clinical psychologist based in Northern California and author of several other EMDR texts, writes from extensive experience as a therapist, consultant and trainer.

At its core, EMDR is an integrative approach to facilitate the processing of traumatic material. Elements of behavior therapy, cognitive therapy and hypnotherapy are all present. The additional element is "bilateral stimulation," which initially referred to therapist-guided repetitive eye movement but now has been expanded to include other techniques such as alternating finger tapping and bilateral auditory stimulation.

Parnell's key assumption is that the therapist needs to honor the patient's innate wisdom and inherent capacity for healing. Once a working alliance has been built, goals and targets for processing are established. During the processing stage of treatment, the therapist follows the patient, keeping the flow of processing going, asking questions about memories, feelings and beliefs without getting derailed into intellectualized analysis and interpretative speculation. At appropriate moments, the therapist administers bilateral stimulation to help patients "clear" highly charged memories while the patient talks about them.

The book is divided into four sections. Part One contains a theoretical overview and refresher course. Part Two reviews how to prepare patients for EMDR, tools for ego strengthening, case formulation and target development. The third section offers detailed advice on how to structure sessions and deal with difficulties in processing. A final part discusses working with recent traumas, critical incidents and phobias, and therapist self-care. Throughout the text, case examples and diagrams help illustrate concepts.

Aside from its extensive practical guidance, the best thing about this book is Parnell's view of EMDR as more of an "art" than a procedure or technique. Although Shapiro's 2001 textbook lays out a highly structured treatment protocol, Parnell gives readers permission to deviate from the script. Working with complex PTSD and multiple trauma is particularly challenging and the author gives much helpful advice in this area. Her tone is accessible and at times irreverent, following in the tradition of Marsha Linehan.

Parnell may have inadvertently hurt her credibility in some circles by making several positive comments about Thought Field Therapy and nutritional supplements to treat depression. These discredited approaches have no place in this otherwise scholarly, clinically sound book.

EMDR-trained clinicians will definitely want this guidebook on their office desks. Any interested practitioner will benefit from an encounter with this novel approach to helping patients recover from trauma.

Paul Efthim, Ph.D. is a licensed psychologist in full-time practice in Brookline, Mass. He holds faculty appointments at the Massachusetts School of Professional Psychology and the Boston Institute for Psychotherapy.