What is ART and How Can it Help?
Accelerated Resolution Therapy (ART) is an evidenced-based, rapid-eye-movement therapy for the treatment of anxiety, trauma, depression, PTSD, sleep problems, self-esteem problems and other issues. Research has demonstrated that ART therapy achieves rapid results and that the gains made by clients are maintained for at least 4 months after its conclusion.
Though the structure and protocols of ART are unique, the principles and theory behind ART are aligned with other trauma-focused therapies such as EMDR and its effectiveness for trauma recovery. ART incorporates similar core components, including memory reconsolidation and smooth-pursuit eye movements.
“The most difficult aspect of discussing ART is the fact that it sounds too good to be true.” – Laney Rosenzweig MS, LMFT
A Natural Therapeutic Evolution
Accelerated Resolution Therapy uses eye movements to facilitate visualization techniques that are focused on helping clients to reduce distress from traumatic memories. ART focuses directly on how negative images connect to the emotional and physical reactions related to them.
The unique and specific way in which ART is utilized results in a more rapid and complete recovery than many other evidence-based therapies. The result is that clients can find relief from their trauma in a significantly shorter period of time.
The Theory of ART
Accelerated Resolution Therapy was developed in 2008 by Laney Rosenzweig, LMFT. As a mental health clinician, Laney had been utilizing a variety of modalities, including EMDR. Although she recognized the therapeutic value of rapid eye movements she felt the need to modify how they were being used and integrated with additional techniques. ART incorporates a variety of techniques from different therapies in a unique and more effective way than the standard EMDR protocol.
When we recall an emotionally-based memory, one of the brain's natural processes is called “unfixing” or memory malleability. Scientists refer to this completely natural phenomenon as “Memory Reconsolidation.” Research has demonstrated that memories remains malleable for about 6 hours after recalling them in a period called the Reconsolidation Window.
Under the guidance of the trained therapist, during this period of memory malleability, the client can replace old troubling images previously combined with anger, fear, resentment, etc. with new memories that are pleasant and peaceful.
The new images the client has created and the accompanying positive feelings related to them remain attached to the memory for at least 4 months after the course of treatment has ended. Additional studies demonstrate that the new images and associated positive feelings related to the memory are still present a year later.
Smooth-Pursuit Eye Movements
Another core ingredient of the ART protocol is called “smooth pursuit” eye movements, which involves the client moving their eyes smoothly and rapidly side to side, similar to the way the eyes naturally track as we walk through nature. Evidence demonstrates that this type of eye movement, when repeated, can contribute to a relaxation of the amygdala, which is the part of the brain responsible for feelings of fear and anxiety.
The therapist uses their hand, a wand, or a similar device to guide the client through a series of eye movements in which they glide their eyes smoothly back and forth while the head is kept stationary.
Hypothesis About Eye Movements
There is still no definitive proof of how and why eye movements work beyond their effect on creating a relaxation response in the brain. One common theory is that smooth-pursuit eye movements mimic the process that occurs during REM sleep, which is the phase of sleep in which we consolidate our memories and eliminate the emotional charge from the day. As previously mentioned, rapid side-to-side eye movements are similar to the natural pattern that our eyes adopt when walking forwards through space, which may contribute to a sense of progress in relation to the problem that we are currently focused on.
When smooth-pursuit eye movements are performed during a period of memory malleability under the guidance of a trained therapist and paired with the intentional replacement of negative images for positive, peaceful images, they can have a powerful effect on the relationship that we have to experiences that were previously labeled as traumatic. We may "know" that things were actually worse, but the brain, now equipped with its newfound positive version of events, prefers to focus on the positive and allows us to remain calm and serene. As we recount our experiences without being emotionally triggered, we can extract the value and lessons that are there for us rather than being retriggered, resulting in post-traumatic growth.
Studies Demonstrate The Results
There have been a variety of research studies proving the benefits of ART that therapists have known for some time now. Below is a handful of studies, including the results:
- 2020: Randomized Controlled Trial of a Complicated Grief Intervention
- 2019: Stress Management Intervention to Present Post-Intensive Care Syndrome-Family in Patients' Spouses
- 2013: Brief Treatment of Co-Occurring Post-Traumatic Stress and Depressive Symptoms
- 2012: Brief Treatment of Symptoms of Post-Traumatic Stress Disorder (PTSD)
ART in Practice
Accelerated Resolution Therapy is a “manualized” protocol, meaning that each therapist is trained in a step-by-step procedure in which they can adjust which step clients are currently working on and in what order to conduct the steps. That said, the client will always remain in complete control over the content of their experience and which memories they choose to recall related to the problems they are working on. Clients also have total control over the new images that they create to replace old images that they no longer wish to see or experience anymore.
Clients also have the freedom to share which aspects of their memories they are comfortable discussing with the therapist, but they do not need to share every detail in order for ART to be successful. They also don't need to tell the therapist about the replacement memories that they imagine to use in place of the traumatic memories that they are working on. Clients are encouraged to stay focused on the memory they are processing during the session and its positive replacements, but sharing throughout the process is always permitted, as it can be a meaningful aspect of the session.
When a client presents with PTSD, if the trauma is caused by an isolated incident like a car accident or sexual assault, the scene that is targeted will be the recalled incident and all circumstances related to that incident that the client finds relevant. If the client has experienced numerous traumatic events, such as ongoing abuse or neglect resulting in cPTSD, the therapist will assist them in finding themes to their problems so they can identify a specific scene that represents each theme.
Once the client and therapist have agreed upon which scene to target, the therapist will then ask the client to gauge the intensity of feelings in the present moment while they think about that scene. Alternatively, if the client wishes to keep their problem and scene private, they can indicate the level of distress to the therapist without sharing the details of the scene.
Once the client has rated their distress level, they will begin to follow the therapist's hand as it moves side to side across their field of vision while they are encouraged to notice how feelings and sensations are experienced in their body. If feelings are particularly intense, the therapist can invite the client to imagine a tool or strategy to help relax the sensations while they continue performing side-to-side eye movements. This exercise will help to reduce the client's distress to a manageable level so that they can move on to the next steps. The therapist will then alternate the client between engaging in eye movements while imagining the scene that illustrates their problem and use the eye movements to relax any uncomfortable sensations that arise while replaying their scene.
Once the client has completed their scene, they will be invited to imagine the scene again and change any images or sensations that are distressing. In ART this is called the Director's Cut. In this phase, the client is free to adjust or replace any distressing aspects of the scene with positive images and sensations. The client will still remember all facts of their memory, but the positive images and sensations that are now associated will be brought forward instead of the original distress.
There are a several peer-reviewed studies demonstrating the effectiveness of ART in addressing a variety of issues, including anxiety, grief, depression, phobias, panic attack, obsessive-compulsive disorder (OCD), post traumatic stress disorder (PTSD), addiction/substance abuse, pain management, performance anxiety, job-related stress, family issues, victimization/poor self image, relationship issues/infidelity, codependency, memory enhancement, dyslexia