Observed and Experiential Integration (OEI) is a 'bottom-up' neurobiological therapy that addresses sensations and trauma that is stored in the body, and is similar to another approach that was developed later, called 'brainspotting'.
From my experience, OEI therapy is an advancement of EMDR therapy. This is both in terms of the greater range of techniques that can be very helpful in addressing more tricky or inaccessible traumas and trauma responses, but also because it can pick up on and heal trauma that EMDR misses. So, if you've ever had EMDR before and the therapist has concluded that the trauma has been reprocessed but you find the issue is still impacting you, one possible reason can be that the EMDR techniques didn't quite reach as far as they needed to. I experienced this myself in my own training and therapy, where I brought a memory that had been completed with EMDR and I thought it was resolved, until my trainer applied an OEI technique for addressing dissociation and revealed a whole other layer of trauma that I didn't even know about. I was filled with a fear that was lying underneath the surface. We were able to reprocess that fear using OEI methods and after that session I felt more 'in my body' and present than I had ever felt before. This was something I would have missed out on had I only used EMDR to heal my trauma.
The other wonderful part about OEI is that you don't need to know what the trauma was to heal it. I find this a very hopeful and optimistic aspect of OEI for when working with clients who were unconscious during a trauma or don't remember it. Not remembering trauma can be because it happened when they were so young, or because the brain is actively preventing a person from remembering as a form of self protection (e.g. dissociative amnesia).
We can access those memories without remembering them consciously through eye movement. When something traumatic happens (and that can be anything that was unexpected and negative, and that made you feel confused, powerless, or overwhelmed) the brain records everything it can to help prevent it from happening again. The logic being that if you can recognise the signs in the future, you can avoid that trauma. This doesn't always work in practice and the brain can record a whole bunch of irrelevant stuff (like the scent an abuser wore or what the weather was like). During this 'data collection', the brain records the position your eye was in at the time of the trauma, as well as the surrounding eye muscles, and your neck muscles (and more!). So, we can 'trigger' that trauma and activate it in the brain by getting you to either think about the trauma (if you can) or experience the physical sensations that are bothering you that are tied to it (such as anxiety, anger, fear, and so on), while moving your eye back into that position. Then we can use eye movements to reprocess that trauma.
This can sound like a weird process and it can be one of those things that you need to experience for yourself to truly understand what it's like. I was surprised in my own therapy and training just how accurate OEI can be. A millimetre of eye movement could be the difference between feeling perfectly fine and calm to being a sobbing mess as a deep trauma is accessed. Simply moving a millimetre away from that point and those overwhelming feelings subsided. Once you learn where those traumas lie in the eye's location (known in OEI as 'glitches') you can use reprocessing methods to heal them. OEI also is founded on the belief that we do not need to suffer in therapy, and always aims to reduce emotional intensity and spend as little time as possible accessing those painful sensations. In my own practice, especially when working with survivors of violence and abuse, I take the gentlest approach possible to healing.
The neuroscience
From SightPsych Seminars Inc. and 'A word to new psychologists on levels of intervention: Don't forget neurobiological treatments in your training and practice' by Rick Bradshaw, published in BC Psychologist:
Observed & Experiential Integration (OEI) is a new psychotherapy for psychological trauma and dissociation that involves alternately covering and uncovering the eyes, and tracking a visual stimulus. Deeper parts of the brain associated with intense symptoms like panic attacks, nausea, hyperventilation, and throat constriction are the targets of this new intervention, along with areas of the prefrontal cortex associated with emotional processing. The theory is that during psychological traumas the 6 major muscles of the eye are moving the eyeball in various directions to follow or locate visual stimuli and intra-ocular muscles adjust to focus the lens and dilate or constrict the pupil. It is hypothesised that messages from the visual fields and the eye muscles are transmitted to the brain through the visual pathway to the visual cortex in the back of the brain. When someone then recalls that same experience, the information is brought forward, including the sensations, visual movement patterns, and body symptoms. As the therapist guides the eye, tiny halts, skips, and 'glitches' can be seen at the points that seem associated with these earlier traumatic experiences. By 'massaging' (guiding) one or both eyes in various directions, the stored multisensory experiences can be re-accessed briefly and released in terms of intensity, providing relief from current and future 'triggers' associated with those cues in the environment. This 'integration' is thought to occur both across the hemispheres of the brain, and vertically within the hemispheres. It is used to treat many conditions, including PTSD, agitated depression, eating disorders, dissociation, addictions, and relationship conflicts.
OEI Therapy was originated in 1995 in Vancouver, BC by marriage and family therapist (Audrey Cook), and co-developed with a registered psychologist (Rick Bradshaw).
What to expect at a session
During OEI treatment, you will be asked to focus on upsetting events, people, emotions, and physical sensations. As you do so, we believe that the brain and eyes work together to bring forward 'mappings' of the eye movements that occurred during the related traumas (e.g. whether an upsetting person or object was moving toward or away from you, above or below your eye level, in the centre or to the side of your eyes, at particular distances from your eyes). By guiding your eyes over specific places in your eyes, the therapist can dissipate the associated physical and emotional intensity.
'It's a bit weird, but it works!'