Comparison of EMI and EMDR

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Although EMI shares many similarities with EMDR, another eye movement (EM) therapy, there are significant differences between the two. EMI and EMDR share certain similarities in the use of titrated imaginal exposure, eye movements and attention to multisensory manifestations of distress. However, the nature of the eye movements is quite distinctive in each case; EMDR uses typically lateral saccades similar to rapid eye movement (REM), at least in its original form, while in EMI smooth pursuit eye movements (SPEM) in multiple directions and patterns are an essential part of the therapy. In EMDR the eye movement are done as rapidly as possible, again as it was the case in its original form, when EMI was created, and within the client’s tolerance, while in EMI the speed and range of the movements is generally much slower, and done at the pace that the client prefers. Another distinction is that EMI uses 22 to 29 different EM patterns, while EMDR usually maintains the same pattern (or segment) until no more change is observed in the client’s responses; only then does the therapist revert to a different direction. There are also some differences in the protocol during and between the segments, such as following whatever emerges from each segment in EMDR, while EMI invites the client to remain focussed on the main trauma. EMDR has added tapping to its original technique; EMI does not include any tapping.

The underlying premise for the use of each type of eye movement is quite different in the two therapies as well. In EMI, application of the presupposition of NLP that the inner representation of a person’s experience can be mapped and accessed via eye movement accessing cues, often permits the client and the therapist to identify specific quadrants of the visual field that allow the client to make contact with either a highly resourceful state or intense reexperience of the trauma. While this is not always the case, when it occurs the therapist is able to guide the client’s gaze alternately into those specific quadrants (and corresponding region of the inner representation) that need to be linked in order to integrate the traumatic material. In EMDR, there is no indication of a connection between the range and direction of eye movements and the nature of the material being processed.

With regard to the similarities between the two methods, both approaches emphasize sound assessment of the client and the trauma before beginning the treatment. Both techniques should be learned in an experiential workshop, and practiced under supervision, before being offered to clients. Clinicians who have attended the second level of EMI training, as the one in EMDR, tend to have much better results than those who have received the first level only. One more important similarity between the two approaches is their capacity to retrieve fully, in all dimensions, the intensity of the memory. The therapist is often as surprised as the client by the physical manifestations of the multisensory disturbances related to a traumatic memory that are released by EM methods.

Despite significant additional distinguishing aspects, the similarities between the two procedures and the results obtained may indicate that eye movement techniques represent an effective approach to integrating traumatic memories in an ecological way.