A therapeutic technique with potential to support long-term HIV survivors
Giuli Alvarenga

“I remember all those beautiful masculine faces that grace the walls of my memory … [C]ountless [gay men] didn’t survive the angst of knowing they wouldn’t die … and so they dove deep into the darkness of crystal meth, alcohol, and the like, dancing their way into the arms of death.”

Alan Downs, PhD, preface, The Velvet Rage

People who lived through the 1980s and ’90s witnessed a generation lost to the AIDS epidemic: siblings, lovers, friends, parents, community members, culture bearers. Given the overwhelming grief and injustice embedded in those losses—experienced alongside their own health concerns, stigma and discrimination, survivors’ guilt, and other life-altering challenges—it is not surprising that many long-term survivors of HIV show signs of post-traumatic stress disorder (PTSD).

Left untreated, PTSD can lead someone to behaviors such as self-medicating as a way to process—or numb—those difficult experiences. The effects of living in the aftermath of this dire focal point in history are only recently starting to receive serious attention in community and research circles. Meanwhile, long-term HIV survivors may consider innovative ways to heal from their pain and loss. One such technique is known as Eye Movement Desensitization and Reprocessing, or EMDR.

Therapists who use this technique argue that EMDR can diminish the negative residual effects of traumatic memories. “EMDR is an effective treatment that uses increased bilateral brain stimulation to help resolve traumatic memories,” says David Fawcett, PhD, LCSW, a therapist practicing in South Florida. “This simply means that communication between the two halves of the brain is increased through alternating movements.”

A therapist may move their fingers back and forth in front of their patient’s face and have their patient follow hand motions with their eyes. At the same time, the trained therapist will have patients recall a disturbing event—including the emotions and body sensations that went along with that traumatic experience. The EMDR therapist will evaluate a patient’s distress levels, before and after the technique, in order to properly document if the patient has had any successful outcomes. It is crucial for the patient to have secure housing, along with other vital necessities, in order to properly support the evaluation of stress levels. This integrative psychotherapy technique has demonstrated a high success rate with PTSD, and is also used to treat eating disorders, panic attacks, and other conditions.

While there is still much research to be done on this approach, EMDR has shown positive results in treating people with substance misuse challenges, and the technique is currently being studied in greater depth. “EMDR has only been around for 30 years or so,” explains Portia Gordon, LPC, a therapist based in New Orleans. “Therapists need two to three years of study in order to practice EMDR on their patients.”

According to Fawcett, there are three levels to EMDR training: level one, level two, and a certified level that requires a certain number of practice hours with supervision. The first two levels simply reflect the number of hours of training.

It is important for patients to consult with their health care providers before moving forward with this approach. It is essential for anyone interested in this practice to do their homework first and regard the technique for what it is: therapy. Not a cure for HIV or the challenges of long-term survival, EMDR may simply provide an opportunity to help people heal that is supported by research.

To find an EMDR therapist in your area, go to emdria.org/find-a-therapist.

Giuli Alvarenga, co-editor of this special issue, is a law student and award-winning writer based in New Orleans.