One spring afternoon, in 1987, a psychology student trying to get rid of a shattering memory wandered through a park in Los Gatos, California, distracting himself by throwing his eyes up and down. The sting of memory soon faded and the student, Francine Shapiro, glimpsed her future.
In the years that followed, she developed a treatment of popular trauma, although controversial, that attracted enthusiasts around the world: desensitization and reprocessing of eye movements, or E.M.D.R.
"I noticed that when disturbing thoughts crossed my mind, my eyes spontaneously started to move very quickly," Dr. Shapiro wrote in his therapy manual. "The thoughts disappeared and when I called them back, their negative charge was significantly reduced."
Dr. Shapiro died on June 16 at a medical center near her home in Sea Ranch, California, north of San Francisco. Robbie Dunton, a longtime friend and associate, said the cause was uncertain, but she had been suffering from respiratory and other disorders for over a year, he added, and suddenly declined.
Dr. Shapiro has established the case for a therapy based on eye movement, one person at a time, experimenting first on itself, then on friends and colleagues. The technique she got used to, having worked with about 70 people for six months, was simple: people reminded her of a troubling memory and at the same time followed her fingers when she made them move from one place to another. 39, back and forth, for 20 to 30 seconds.
She has incorporated this technique into a variation of what is known as exposure therapy, in which people engage in the treatment of painful memories to reduce their sharp contours, and then reinterpret them through memories or repeated exposures.
This work became his doctoral thesis and, in 1989, the basis of an article in the Journal of traumatic stress.
The reception was mixed. Some therapists have tried the technique of eye movement and found that it helped, and quickly, even for many people suffering from chronic post-traumatic stress.
"I was skeptical at first," said Roger Solomon, who was a psychologist at the Washington State Patrol and who is now consulting government agencies on therapy in Arlington, Virginia, at the time. ;a telephone interview. "But I went to see her talking, I started to try the technique and I found it worked."
He added, "I found E.M.D.R. be extremely powerful, effective and efficient, and I find it effective for any psychological disorder involving disturbing memories. "
Many other therapists were intrigued and Dr. Shapiro started organizing seminars and demonstrations all over the country and, over time, around the world.
The scientific community was harder to convince. The central question was whether the eye movement technique reliably added value to conventional exposure therapy, which is often effective in itself.
The studies published by Dr. Shapiro and his allies were almost all positive; several reported a cure rate of 80 to 100% in three sessions for people with post-traumatic symptoms resulting from a single incident, such as a car accident or a rape.
Studies by outside researchers were not as consistent and some found no additional effects. E.M.D.R. Practitioners retorted that the authors of these studies had not practiced the therapy properly. The struggle erupted in the late 1990s and early 2000s in online forums and journals.
"Many people consider E.M.D.R. Richard McNally, Harvard trauma expert and one of the foremost critics of therapy, wrote in a 2000 issue of the Journal of Anxiety Disorders. "Others believe that it is intended to transform the clinical intervention, from treatment of post-traumatic stress disorder to the treatment of premature ejaculation."
One of the most delicate issues was how simple eye movements could color the emotional face of a ghostly and imposing presence as a lifelong memory. Therapists, including Dr. Shapiro, had their theories, but the science of memory remained a work in progress and these theories required constant updating.
A good response has emerged in recent years thanks to the research conducted by Iris Engelhard from the University of Utrecht in the Netherlands. (It is not associated with the EMDR network) When people remember a shattering visual memory, the imagination steadily intensifies the image: the reds are denser, the faces more bypassed they were not there when initially storing memory. The work of Dr. Engelhard and others has shown that eye movements tax working memory to such an extent that this same disturbing memory is actually deflated and attenuated.
"I've changed my mind," Dr. McNally said during a phone interview. "I'm ready to do it based on new evidence. It looks like something is going on there; the representation of the trauma seems to be reconsolidated so as not to disturb people so much when we remember later. "
Hundreds of therapists made this decision years ago and some professional organizations, including the British National Health Service, have endorsed the approach for certain types of trauma, often combined with other approaches, such as as cognitive behavior or interpersonal therapies.
"Let's say it as follows: since his death, I have been receiving about 300 emails a day from Sri Lanka, Bangladesh and around the world," said Dr. Dunton, executive director of the EMDR Institute. "I gave up trying to answer all."
Francine Shapiro was born on February 18, 1948 in the eastern section of New York, Brooklyn. She is the eldest of four children of Daniel and Shirley Shapiro. His father was a car mechanic who owned a car parts store and his mother ran the household. Her sister Debra died in 1965, her sister Marion in 2015. She is survived by her husband, Robert Welch; his brother, Charles Shapiro; and a son-in-law, Jamie Welch.
A graduate of Thomas Jefferson High School in Brooklyn, she studied English at Brooklyn College, where she graduated with a bachelor's degree in 1968 and a master's degree in 1975. She was about to complete her Ph.D. in literature at the University of New York when she was diagnosed with breast cancer in the early 1980s. This led her to put aside her thesis and move to California to study psychoimmunology , the effect of stress on immune function.
She has conquered cancer, changed careers and earned a doctorate. in clinical psychology in 1988 from the San Diego School of Psychological Studies. She obtained a license to practice in California and began setting up a network of therapists trained in eye movement therapy.
In 1995, Dr. Shapiro published the first edition of her handbook on the "Desensitization and Reprocessing of Eye Movements: Basic Principles, Protocols and Procedures" approach. She has written or co-authored dozens of studies on E.M.D.R. as well as another half-dozen books, including "Getting Past Your Past" (2012), which sets out the approach for general readers.
"Many people become therapists with the feeling of having all the answers and that they will tell the client what to do," she replied. "With E.M.D.R., it's important to develop a healthy respect for people's healing potential and learn to be the facilitator of this healing."