Journal of EMDR Practice and Research

Online ISSN: 1933-3196
Publications
Article
In eye movement desensitization and reprocessing (EMDR), one might argue, "Change occurs when distressing memories are processed." But the question is—how does the information get processed? How can one isolate and measure the mechanism that makes this happen? Others will respond, "EMDR works because the eye movements have a certain effect." However, there is a lot of confusion about the role of eye movements and tactile and auditory stimulation. When people talk about EMDR's mechanism of action, they generally are referring to the mechanism of eye movements (EM). They tend to overlook the fact that there is a lot more to EMDR than EM. This special issue of the Journal of EMDR Practice and Research contains a number of articles that address preliminary issues related to the complex questions. There are two research studies: a study investigating the physiological effects of EM and a study evaluating the effect of EM on the components of autobiographical memory. There are several articles by researchers who have summarized their findings and provided a theoretical perspective on related issues. Two theoretical articles propose neurobiological and other mechanisms of action. All these articles make a real contribution to our conceptualizations of EMDR mechanisms. It is our hope and intention that this issue will stimulate thinking, and provide ideas and models for future research, with the expectation that findings will help to guide and direct clinical practice. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
 
Article
On December 26, 2004, an earthquake in the Indian Ocean triggered a catastrophic tsunami. In Sri Lanka, 35,000 people died, 21,000 were injured, and more than half a million were displaced. An EMDR training program was conducted as a joint project of three organizations: EMDR Humanitarian Assistance Programs (HAP), International Relief Teams (IRT), and the Sri Lankan National Counselors Association (SRILNAC). Between March and December 2005, 30 Sri Lankan counselors were trained in EMDR. These counselors demonstrated competence in EMDR on several measures, treated more than 1,000 children and more than 350 adult tsunami victims with EMDR in 2005, provided narrative reports and outcome measures for most of their clients, and formed the Sri Lanka EMDR Association (SEA). The crucial steps in establishing and implementing this training program are explained, with a summary of the subjective impressions and learning experiences most valued by the training team, including an excerpt from a trainer's journal. This information may be useful to future cross-cultural humanitarian efforts following large-scale disasters.
 
Article
Forty-three individuals diagnosed with classic or common migraine headache were randomly assigned to either phase 1 of integrated eye movement desensitization reprocessing (EMDR) treatment or a standard care medication treatment. Integrated EMDR combines diaphragmatic breathing, cranial compression, and EMDR for abortive migraine treatment. The comparison standard care medication group received various abortive medications, including Demerol, DHE, oral triptans, Excedrin, Fiorinal, Percocet, Toradol, and Vicodin. Participants were treated during mid- to late-stage acute migraine and assessed by an independent evaluator at pretreatment, posttreatment, 24 hours, 48 hours, and 7 days for migraine pain level. Both standard care medication and integrated EMDR treatment groups demonstrated reduced migraine pain levels immediately at posttreatment, 24 hours, 48 hours, and 7 days. However, integrated EMDR treatment reduced or eliminated migraine pain with greater rapidity and showed significantly greater improvement compared to standard care medication immediately posttreatment.
 
Article
This article reviews research that investigated the idiosyncratic effects of sexual abuse perpetrated by Roman Catholic priests and makes related treatment recommendations. The research determined that this distinct form of sexual trauma generated unique posttraumatic symptoms not accounted for within the existing Posttraumatic Stress Disorder conceptual frameworks. These included significant anxiety and distress in areas such as theological belief, crisis of faith, and fears surrounding the participant's own mortality. This article makes recommendations about EMDR treatment with clergy abuse survivors, based on these research findings utilizing a survivor's story to illustrate case formulation and the utilization of process and content cognitive interweaves in addressing episodes of blocked processing.
 
Article
Since 2001, the wars in Iraq and Afghanistan have caused considerable strain on military medicine to effectively manage the growing mental health demand from deployed personnel. This article examines the ability of the U.S. Department of Defense to provide quality mental health services based on the availability of (a) clinical training, (b) mental health interventions, and (c) funded research of treatments for posttraumatic stress disorder. While notable progress has been made in cognitive-behavioral treatment access and research, eye movement desensitization and reprocessing is far less available—perhaps attributable to ongoing controversy over the technique. We suggest that underserved veterans would benefit from increased availability of evidence-based behavioral treatments, perhaps through continuation of a recent regional training program.
 
Article
Eye movement desensitization and reprocessing (EMDR) was used with 11 children who developed posttraumatic stress disorder (PTSD) after road traffic accidents. All improved such that none met criteria for PTSD on standardized assessments after an average of only 2.4 sessions. Significant improvements in PTSD, anxiety, and depression were found both immediately after treatment and at follow-up. Attentional, memory, and attributional processes associated with PTSD were assessed and their relationship to therapeutic change examined. Treatment was associated with a significant trauma-specific reduction in attentional bias on the modified Stroop task, with results apparent both immediately after therapy and at follow-up.
 
Article
There are commonalities between neurologic syndromes arising from lesions of the parietal cortex and psychiatric syndromes secondary to psychological trauma. Additionally some posttraumatic syndromes may reflect functional disruption of parietal areas. Directional or bilateral alternating peripheral sensory stimulation appear to assist in the amelioration of a wide range of clinical conditions, including the neglect syndrome and Posttraumatic Stress Disorder. It is posited that the stimulation may exert its effect through activation of parietal higher-order functions. The activation may result in an integration of sensory information and an updating of the current representation of person and space, which incorporates an awareness of current body reality, sense of self, and world view. It is hypothesized that the EMDR procedure is ideally constructed to facilitate parietal activation through multimodal sensory stimulation, attention and episodic memory retrieval and focus on internal and external body, space, and self. Further investigations and an integration of data between disciplines are suggested, in order to expand our range of effective treatments.
 
Article
Historically, mechanisms of action have often been difficult to ascertain. Thus far, the definitive discovery of eye movement desensitization and reprocessing (EMDR)'s underlying mechanisms has been equally elusive. We review the neurobiological studies of EMDR, as well as the theoretically driven speculative models that have been posited to date. The speculative theoretically driven models are reviewed historically to illustrate their growth in neurobiological complexity and specificity. Alternatively, the neurobiological studies of EMDR are reviewed with regard to their object of investigation and categorized as follows: findings before and after EMDR therapy (neuroimaging and psychophysiological studies) and findings during the EMDR set (psychophysiological, neuroimaging, and qEEG studies).
 
Article
The unique efficacy of eye movement desensitization and reprocessing (EMDR) in the treatment of posttraumatic stress disorder is thought to result from changes in the brain/mind state induced by bilateral sensory stimulation, but the nature and specific consequences of these changes remain unknown. The possibility that bilateral stimulation induces a brain/mind state similar to that of rapid eye movement sleep is supported by studies showing that sleep facilitates forms of memory processing arguably necessary for the resolution of trauma. Such studies, along with direct studies of the impact of bilateral stimulation on memory and emotional processing, and dismantling studies identifying the requisite features of such bilateral stimulation for effective trauma processing, will eventually lead to an understanding of the neurobiological basis of EMDR.
 
Response to single-session modifi ed EMDR in 86 trauma victims with acute stress syndrome.
Participant Characteristics
The Effect of Single-Session Modifi ed EMDR on Terror Victims Group
Article
A single session of a modified, abridged EMDR protocol was provided in a general hospital inpatient and outpatient setting to 86 patients with acute stress (AS) syndrome suffering from intrusion distress following accidents and terrorist bombing attacks. Fifty percent reported immediate fading of intrusive symptoms and general alleviation of distress, 27% described partial alleviation of their symptoms and distress, while 23% reported no improvement. Partial and nonresponders were provided with or referred for more comprehensive treatment. At 4-week and 6-month follow-up, the immediate responders in the terror victims group remained symptom free. The immediate responders tended to have uncomplicated AS symptoms with fewer risk factors for posttraumatic stress disorder (PTSD), while the nonresponders had higher exposure to former traumas and endorsed more risk factors for PTSD. These results support other anecdotal reports on the rapid effects of brief EMDR intervention on intrusive symptoms in early uncomplicated posttraumatic cases. Although more controlled studies are essential, this immediate method for symptomatic relief may be a potential addition for focused interventions in acute trauma victims.
 
Article
Research indicates that EMDR is effective for the treatment of posttraumatic stress disorder (PTSD), with numerous studies showing a high percentage of symptom remission after 3 sessions. The case of a tsunami survivor with acute PTSD is presented. Treatment for overt trauma symptoms was completed within 3 sessions, including all 8 phases and the 3-pronged protocol (i.e., past, present, future targets). One EMDR session was sufficient to process the trauma and alleviate the related symptoms, while another session was necessary for re-evaluation and processing present triggers and future templates. Resource installation was particularly helpful to prepare him for those future situations that had been generating anxiety as a result of his traumatization.
 
Article
Eye movement desensitization and reprocessing (EMDR) is a therapeutic approach guided by the adaptive information processing (AIP) model. This article provides a brief overview of some of the major precepts of AIP. The basis of clinical pathology is hypothesized to be dysfunctionally stored memories, with therapeutic change resulting from the processing of these memories within larger adaptive networks. Unlike extinction-based exposure therapies, memories targeted in EMDR are posited to transmute during processing and are then again stored by a process of reconsolidation. Therefore, a comparison and contrast to extinction-based information processing models and treatment is provided, including implications for clinical practice. Throughout the article a variety of mechanisms of action are discussed, including those inferred by tenets of the AIP model, and the EMDR procedures themselves, including the bilateral stimulation. Research suggestions are offered in order to investigate various hypotheses.
 
Article
EMDR is an integrative, client-centered psychotherapy approach that emphasizes the brain's information processing system and memories of disturbing experiences as the bases of those pathologies not caused by organic deficit or insult. EMDR addresses the experiences that contribute to clinical conditions and those needed to bring the client to a robust state of psychological health. Overviews of the history, development, and research that have established EMDR as an empirically supported treatment are provided. Subsequent to an explanation of the adaptive information processing model, an extended case example is used to illustrate the recommended EMDR case conceptualization and eight phases of treatment. This approach is used to process the early memories that set the foundation for the pathology and the present situations that trigger the dysfunction, while providing templates for appropriate future action that incorporate the information and behaviors needed to overcome skill and/or developmental deficits. The benefits of integrating EMDR and family systems perspectives to provide the most comprehensive therapeutic effects are described.
 
Article
There have been suggestions in the literature since 1994 that eye movement desensitization and reprocessing (EMDR) may serve as an effective adjunct to the addiction treatment process; however, follow-up research in this area has been limited. This case study of a cross-addicted female includes a case review illustrating how EMDR was used in the continuing care process and a semistructured phenomenological interview conducted at 6-month follow-up. Prior to this course of treatment, the participant was treated 12 times with traditional approaches but was unable to achieve more than 4 months of sobriety at any given time. Following EMDR, the participant reported 18 months of sobriety and important changes in functional life domains. The phenomenological interview revealed six critical themes about the addiction and recovery process that can offer insight to clinicians treating co-occurring addiction and trauma.
 
Flow of participants through the study.
Comorbid Diagnoses in EMDR and TAU
Changes in Obsessive-Compulsive Drinking Scale. a = Statistically signifi cant difference to pretreatment score (p < .05); b = Statistically signifi cant difference to pretreatment score (p < .05); c = Statistically signifi cant difference between EMDR and TAU posttreatment (p < .05); d = Statistically signifi cant difference between EMDR and TAU P1M (p < .05); OCDS = Obsessive-Compulsive Drinking Scale; P1M = 1-month follow-up data.
Number of relapses in EMDR and TAU. * Statistically signifi cant difference according to Fisher's exact test ( p < .05).
Article
This randomized controlled study investigated the effects of eye movement desensitization and reprocessing (EMDR) in the treatment of alcohol dependency. EMDR was applied to reprocess the addiction memory (AM) in chronically dependent patients. The AM includes memories of preparatory behavior, drug effects (drug use), and loss of control (Wolffgramm, 2002). It is understood to involve extensive brain circuitry, drive part of conscious and unconscious craving, change environmental response at an organic level, and modify circuits that link to feelings of satisfaction, future planning, and hope. Thirty-four patients with chronic alcohol dependency were randomly assigned to one of two treatment conditions: treatment as usual (TAU) or TAU plus two sessions of EMDR (TAU+EMDR). The craving for alcohol was measured by the Obsessive-Compulsive Drinking Scale (OCDS) pre-, post-, and 1 month after treatment. The TAU+EMDR group showed a significant reduction in craving posttreatment and 1 month after treatment, whereas TAU did not. Results indicate that EMDR might be a useful approach for the treatment of addiction memory and associated symptoms of craving.
 
Article
A growing body of literature indicates that eye movement desensitization and reprocessing (EMDR) can be useful in the treatment of addictions. When combined with traditional addictions treatment approaches, EMDR can enhance client stability, prevent relapse, and promote recovery. Clinical decision making about when and how to use EMDR techniques with clients who present with addictions is complicated. The purpose of this article is to explore the use of EMDR interventions with clients presenting various levels of awareness of their addiction as well as varied levels of motivation to change. The authors explore the Stages of Change and suggest appropriate pre-EMDR EMDR interventions at each stage.
 
Article
Research on psychotherapy with children is generally underrepresented in the empirical literature. Currently, there are four randomized clinical trials (RCT) evaluating EMDR in individual psychotherapy with traumatized children—two for children diagnosed with PTSD and two for children presenting with symptoms of posttraumatic stress. Since the first case studies of EMDR with children were published in 1993, 19 studies were identified that met the inclusion criteria for this review. The gold standards identified by Foa and Meadows (1997) to assess the methodology of studies designed to treat trauma were applied to the research on EMDR with children. This analysis discusses the challenges to conducting research on psychotherapy with children including the debate regarding the assessment and diagnosis of PTSD in children. Recommendations for future studies designed with methodological rigor are suggested to investigate the efficacy of EMDR with children who have experienced trauma and other mental health symptoms and diagnoses.
 
Signifi cant Correlations Between Variables (with two-tailed signifi cance)
Article
This study used a naturalistic design to investigate the effectiveness of eye movement desensitization and reprocessing (EMDR) with children and adolescents who were exposed to single-incident trauma. Participants were 36 children and adolescents ranging in age from 1 year 9 months to 18 years 1 month who were referred consecutively to the author's private practice. Assessments were conducted at intake, post-waitlist/pretreatment, and at follow up. EMDR treatment resulted in significant improvement (Cohen's d = 1.87). Follow-ups after 6 months revealed stable, further slight improvement. It was shown that children younger than 4 years of age can be treated using EMDR and that the group of preschool children had the same benefit from the treatment as the school-age children.
 
Differential Diagnosis of Choking Phobia 
Article
Given the limited number of reported cases in literature, it might be concluded that it is rare to develop a choking phobia in childhood. However, it appears as though confusion in terminology and the time lapse between the onset of the disorder and treatment often results in the diagnosis being missed. In this article, we discuss a review of the clinical symptoms, differential diagnosis, comorbidity, etiology, and treatment options for choking phobia. We present a case series, describing the successful EMDR treatment of choking phobia for 4 children and adolescents, with positive outcomes achieved in 1 or 2 sessions. In addition, a detailed transcript is presented of a 15-year-old girl with a choking phobia related to an incident that occurred 5 years previously. The rapid elimination of symptoms in all 4 cases indicates that EMDR can be an effective treatment for choking phobias resulting from previous disturbing events. Randomized research on this promising intervention is strongly suggested.
 
Mr. B: Changes in AAI 9-Point Scales and Overall AAI Category Designation Pre-and Post-EMDR Treatment AAI 9-Point Scales Pre-and Post-EMDR Treatment
Mrs. K: Changes in AAI 9-Point Scales and Overall AAI Category Designation Pre-and Post-EMDR Treatment AAI 9-Point Scales Pre-and Post-EMDR Treatment
Article
Three case studies illustrate pre- and post-eye movement desensitization and reprocessing (EMDR) adult attachment status as measured by the Adult Attachment Interview (AAI). Two adult males and one adult female presented for outpatient therapy; all of them were categorized with an insecure or disorganized attachment status at pretreatment. All presented with symptoms of depression and anxiety and complaints regarding problems in their current marital and family relationships. The three patients received 10 to 15 EMDR sessions over the course of approximately 1 year, interspersed with talk therapy sessions for the purpose of debriefing and psychoeducation. The EMDR approach utilized all eight phases of treatment within the three-pronged approach. Following EMDR therapy, all three patients made positive changes in attachment status as measured by the AAI, and all three reported positive changes in emotions and relationships. This article provides an overview of the literature related to adult attachment categories and summarizes the effect of adult attachment status on emotional and social functioning. The rationale and scoring procedures for the AAI are explained.
 
Article
Eye movement desensitization and reprocessing (EMDR) is a therapy that has been demonstrated to be effective in the treatment of posttraumatic stress disorder (PTSD). A relatively small but growing body of literature indicates that EMDR may be an effective adjunctive treatment for substance abuse. This article reviews the various protocols that have been developed for that purpose, including protocols by Vogelmann-Sine et al., Omaha, Popky, and Hase. A case study that incorporates the use of some of these interventions is presented to illustrate successful EMDR treatment of a woman who had long-standing comorbid alcohol abuse and PTSD. Two-year follow-up after EMDR showed that the woman was successfully maintaining sobriety and that the PTSD continued in full remission. After a discussion of the important aspects of this case, the authors explore future directions for research.
 
Article
A theoretical model is proposed to explain desensitization during Eye Movement Desensitization and Reprocessing (EMDR) as resulting from the reversal of reciprocal suppression of cognitive processing in the anterior cingulate cortex (ACC). Dual-attention and error monitoring are known to activate dorsal regions of the ACC that mediate metacognitive processing. Neuroimaging research has produced evidence that cognitive areas in the upper ACC may reciprocally suppress affective processing in the lower areas and vice versa. It is therefore proposed that the original eye-to-finger tracking task of EMDR may achieve its therapeutic effect by using error monitoring to reverse suppression of the upper ACC by the lower ACC. Contributions to EMDR effectiveness from resource installation and novelty-driven orienting reflexes may also influence ACC functioning. A distraction effect is proposed to be a negative and potentially disruptive by-product of very interactive stimulation tasks. A semantic priming procedure is suggested to limit distraction effects during more interactive forms of stimulation.
 
Results on the Self-Report Measures Across the Three Evaluation Times (Pretreatment, Posttreatment, and Follow-Up)
Scores on the Penn State Worry Questionnaire.
Article
This preliminary study sought to evaluate the potential effectiveness of eye movement desensitization and reprocessing (EMDR) as a treatment modality for generalized anxiety disorder (GAD). Using a single-case design with multiple baselines across four subjects, the effectiveness of 15 EMDR sessions was evaluated. Results indicate that subsequent to targeting the experiential contributors to GAD and the current and anticipated situations that caused excessive worry, the scores of anxiety and of excessive worry dropped to levels below diagnostic threshold and in two cases to full remission of GAD symptoms. At both posttreatment and at 2 months follow-up, all four participants no longer presented with GAD diagnosis. In addition, time-series analyses (ARMA) indicate statistically significant improvement on both daily measures of worry and anxiety over the course of the EMDR treatment.
 
Article
Based on the assumptions of Shapiro's adaptive information-processing model, it could be argued that a large proportion of people suffering from an anxiety disorder would benefit from eye movement desensitization and reprocessing (EMDR). This article provides an overview of the current empirical evidence on the application of EMDR for the anxiety disorders spectrum other than posttraumatic stress disorder (PTSD). Reviewing the existing literature, it is disappointing to find that 20 years after its introduction, support for the efficacy of EMDR for other conditions than PTSD is still scarce. Randomized outcome research is limited to panic disorder with agoraphobia and spider phobia. The results suggest that EMDR is generally more effective than no-treatment control conditions or nonspecific interventions but less effective than existing evidence-based (i.e., exposure-based) interventions. However, since these studies were based on incomplete protocols and limited treatment courses, questions about the relative efficacy of EMDR for the treatment of anxiety disorders remain largely unanswered.
 
Article
Effective presentation skills are vital for success in most organizations. Preparing students for their careers, college educators often require that students demonstrate effective presentation skills. While traditional approaches to managing presentation anxiety help some students, EMDR may offer an effective intervention for those with serious presentation anxiety. This case study involves a student with presentation anxiety referred for EMDR from an organizational communication class. The subject delivered videotaped presentations and completed the State-Trait Anxiety Inventory (STAI) prior to and after completing three EMDR sessions. The subject's pre-post STAI scores reduced from the 98th to the 55th percentile. Blind expert ratings of the videotaped presentations indicated pronounced performance improvement. At 12-month follow-up, the subject was successfully employed in a management position, making effective presentations without intense anxiety.
 
Procedural Steps of Shapiro's Phobia Protocol
Article
Eye movement desensitization and reprocessing (EMDR) has been shown to be a structured, noninvasive, time-limited, and evidence-based treatment for unprocessed memories and related conditions. This paper focuses on EMDR as a treatment for specific fears and phobias. For this purpose, the application of EMDR is conceptualized as the selection and the subsequent processing of a series of strategically important memories of earlier negative learning experiences concerning specific objects or situations. Firstly, the practical application and conceptualization of the treatment of phobias with EMDR is presented and compared with an exposure-based treatment approach. Next, specific attention is given to the assessment and selection of appropriate memories for processing. It is hypothesized that phobias with a non-traumatic background, or those in later stages of treatment after some reduction in anxiety has been achieved, would profit more from the application of a gradual in vivo exposure, whereas trauma-based specific phobias and those with high initial levels of anxiety would respond most favorably to EMDR.
 
Article
The mental health impact of war is often underestimated by military, government, and media officials who focus primarily on well-known conditions like depression and posttraumatic stress disorder (PTSD) while ignoring the complex toll of modern warfare. These effects are clearly evident in "war syndromes," many of which can be collectively understood as medically unexplained symptoms (MUS). The current study provides a brief historical review of combat-related MUS as well as an analysis of present evidence of a possible "Iraqi War Syndrome." An overview of past and current treatments for combat MUS is followed by a single case study treating an Iraqi war combat veteran with combat-related MUS with eye movement desensitization and reprocessing (EMDR). Therapy resulted in significant improvement of the patient's 1-year psychophysical condition and comorbid PTSD. We provide a detailed account of those treatment sessions as well as a discussion of EMDR's potential to simultaneously treat a range of combat-related psychophysical conditions without requiring extensive homework or self-disclosure that some military patients may resist. The results are promising, but they require further research.
 
Article
This study investigates changes of stress-related psychophysiological reactions after treatment with EMDR. Sixteen patients with posttraumatic stress disorder (PTSD) following type I trauma underwent psychometric and psychophysiological assessment during exposure to script-driven imagery before and after EMDR and at 6-month follow-up. Psychophysiological assessment included heart rate (HR) and heart rate variability (HRV) during a neutral task and during trauma script listening. PTSD symptoms as assessed by questionnaire decreased significantly after treatment and during follow-up in comparison to pretreatment. After EMDR, stress-related HR reactions during trauma script were significantly reduced, while HRV indicating parasympathetic tone increased both during neutral script and during trauma script. These results were maintained during the follow-up assessment. Successful EMDR treatment may be associated with reduced psychophysiological stress reactions and heightened parasympathetic tone.
 
Article
Following the attacks on the New York World Trade Center on September 11, 2001, the EMDR Humanitarian Assistance Program initiated a response establishing the New York City Disaster Mental Health Recovery Network. The network provided coordination and assistance to local psychotherapists who volunteered to provide treatment to individuals directly affected by the tragedy. The psychotherapists utilized both the EMDR standard protocol and the EMDR Recent Events protocol during the initial aftermath and ongoing recovery at the World Trade Center site. The development of the network is reviewed, and detailed descriptions are provided regarding three cases to illustrate the use of the EMDR Recent Events protocol. The research findings reported by Silver, Rogers, Knipe, & Colelli (2005) that demonstrated support for EMDR as a postdisaster treatment are summarized. Further research is recommended.
 
Flow of participants through the study.  
Means and Standard Deviations for Behavioral Measures
Article
This study compared eye movement desensitization and reprocessing (EMDR) with cognitive-behavioral therapy (CBT). Twenty-six children (average age 10.4 years) with behavioral problems were randomly assigned to receive either 4 sessions of EMDR or CBT prior to usual treatment provided in outpatient and inpatient clinics. To evaluate the effectiveness of treatment, parents and mentors completed a wide variety of self-report instruments and behavioral measures, and the children completed self-assessment instruments prior to therapy, directly after completion of therapy, and at 6-month follow-up. EMDR and CBT were found to have significant positive effects on behavioral and self-esteem problems. Although the differences between treatment effectiveness for EMDR and CBT were small, the children who originally received EMDR showed significantly larger changes in target behaviors than those in the CBT group. The results support the use of EMDR, focused on the desensitization of a series of meaningful memories, to produce significantly positive and sustained effects on children's self-esteem and related problems.
 
Article
The current research used a quantitative single-case study design to investigate the effectiveness of eye movement desensitization and reprocessing (EMDR) treatment for a participant diagnosed with comorbid major depressive disorder (MDD), severe without psychotic features, and panic disorder with agoraphobia. Treatment frequency was three sessions per week, with twelve 90-minute reprocessing sessions provided over a period of 1 month; the study also evaluated this application of “concentrated EMDR.” At baseline, mean scores on the Beck Depression Inventory-II (BDI-II) and Beck Anxiety Inventory (BAI) were 49 and 38, and at 3-month follow-up, the scores had decreased to 8 and 7 respectively. The results of this pilot study indicate that concentrated EMDR may be effective in treating comorbid MDD and panic disorder with agoraphobia. The study also evaluated the application of concentrated EMDR, with treatment frequency increased from one session to three sessions per week. Twelve 90-minute reprocessing sessions were provided over a period of 1 month. Results show the apparent effectiveness of concentrated EMDR.
 
Article
A number of studies indicate that EMDR (eye movement desensitization and reprocessing) may be efficacious in treatment of children and young people with symptoms of posttraumatic stress. However, reports are limited in the use of the EMDR psychotherapy approach in situations of ongoing violence and trauma. This case study describes work with seven children in an area of ongoing violence who were subject to repeat traumas during the course of an EMDR psychotherapy intervention, using a group protocol. Results indicate that the EMDR approach can be effective in a group setting, and in an acute situation, both in reducing symptoms of posttraumatic and peritraumatic stress and in "inoculation" or building resilience in a setting of ongoing conflict and trauma. Given the need for such applications, further research is recommended regarding EMDR's ability to increase personal resources in such settings.
 
Article
This pilot study evaluated the effectiveness of eye movement desensitization and reprocessing (EMDR) in treating posttraumatic stress disorder (PTSD) symptoms and concomitant depressive and anxiety symptoms in survivors of life-threatening cardiac events. Forty-two patients undergoing cardiac rehabilitation who (a) qualified for the PTSD criterion “A” in relation to a cardiac event and (b) presented clinically significant PTSD symptoms were randomized to a 4-week treatment of EMDR or imaginal exposure (IE). Data were gathered on PTSD, anxiety, and depressive symptoms at pretreatment, posttreatment, and 6-month follow-up. EMDR was effective in reducing PTSD, depressive, and anxiety symptoms and performed significantly better than IE for all variables. These findings provide preliminary support for EMDR as an effective treatment for the symptoms of PTSD, depression, and anxiety that can follow a life-threatening cardiac event.
 
Article
This article examines the use of EMDR in a rehabilitation center to deal with traumatic experiences associated with serious incapacitating disease. Through clinical examples, the author describes the utility and function of EMDR treatment in helping both patients and their families overcome the frightening events related to the worsening of the illness and in helping them cope with feelings of loss and separation. The usefulness of attachment theory for a better comprehension of the dysfunctional interpersonal patterns that can arise between family members is discussed. In addition, the importance of eye movement desensitization and reprocessing (EMDR) is explored in helping to facilitate secure attachment relationships between patients and their caregivers, allowing the families to grow closer and more supportive. EMDR appears to offer specific advantages in treating this especially difficult population, affording patients who live with a chronic condition of extreme physical vulnerability a sense of greater control over their own bodies and therefore over their own lives.
 
Article
Eye movement desensitization and reprocessing (EMDR) has emerged as a promising new treatment for trauma and other anxiety-based disorders. However, the neurobiological mechanism of EMDR has not been well understood. This study reports changes in the resting regional cerebral blood flow after successful EMDR treatment in two patients with posttraumatic stress disorder (PTSD). Brain 99mTc-ECD-SPECT (Technetium 99m-ethyl cysteinate dimmer-single photon emission computerized tomography) was performed before and after EMDR, and, in addition, a pre- and posttreatment comparison was made with 10 non-PTSD participants as a control group. After EMDR, cerebral perfusion increased in bilateral dorsolateral prefrontal cortex and decreased in the temporal association cortex. The differences between participants and normal controls also decreased. Changes appeared mainly in the limbic area and the prefrontal cortex. These results are in line with current understanding of neurobiology of PTSD. EMDR treatment appears to reverse the functional imbalance between the limbic area and the prefrontal cortex.
 
Article
Chronic fatigue syndrome (CFS) is a condition characterized by a new and persistent fatigue unexplained by other conditions and resulting in a substantial reduction in the individual's activity levels. Current treatment includes psychotherapeutic procedures such as cognitive-behavioral therapy, pharmacological interventions, and graded exercise therapy. This article considers the effectiveness of eye movement desensitization and reprocessing (EMDR) for the condition of CFS. The case study describes the use of EMDR with a 49-year-old male client who had suffered debilitating CFS for nearly 5 years despite accessing other treatment methods. After 9 sessions, the client indicated that his energy levels were significantly higher, his need for sleep had reduced (from 15-20 hours to 9.5 hours in a 24-hour period), and he was able to resume employment. Results suggest that EMDR may be useful in treating CFS within a personalized treatment plan.
 
Table of the Types of Intervention/Abilities/Results
Article
Trauma and its ensuing accommodations, including challenging behaviors, have been a growing consideration for practitioners working with people with intellectual and developmental disabilities (IDD). Recognizing the importance of one's client's trauma history, practitioners are seeking effective methods of providing therapy to IDD clients with posttraumatic stress disorder (PTSD) and other trauma-related diagnoses. In this exploratory study, using a multiple single case study design, six individuals with IDD and known trauma histories were treated with eye movement desensitization and reprocessing (EMDR). The researchers employed the standard EMDR protocol, adapting it when necessary to accommodate the needs of each participant. Outcomes provide preliminary evidence that EMDR may be an effective method of trauma treatment for clients with intellectual abilities, pointing to EMDR as a treatment with potential for facilitating healing from trauma with IDD clients.
 
Example of a child's drawings before and during EMDR-IGTP treatment. Note. The numbers represent the child's self-reported SUD scores. A) Drawing A: The fi gures trapped inside the mine (his father one of them) are saying: "Ha," "Help," "Help us" (SUDS = 5). B) Drawing B: "Me" and "Picture of my Dad" (SUDS = 10). C) Drawing C: "My mother," "me," "Bertha," "Martha" (his sisters) (SUDS = 0). D) Drawing D: "My Dad" (SUDS = 0).
Example of the same child's drawing of his imagined future. Note. The Spanish statement reads "Feliz = Happy. Pintor = Painter." The zero represents the child's self-reported SUD score at the end of Phase 4 for the most disturbing drawing.
Scores on the CRTES Measure
Treatment process changes as measured by mean SUD scores for the four pictures and for the most disturbing picture at the end of Phase 4.
Article
The EMDR Integrative Group Treatment protocol (EMDR-IGTP) has been used in different parts of the world since 1998 with both adults and children after natural or man-made disasters. This protocol combines the eight standard EMDR treatment phases with a group therapy model, thus providing more extensive reach than the individual application of EMDR. In this study the EMDR-IGTP was used with 16 bereaved children after a human provoked disaster in the Mexican State of Coahuila in 2006. Results showed a significant decrease in scores on the Child's Reaction to Traumatic Events Scale that was maintained at 3-month follow-up. Although controlled research is needed to establish the efficacy of this intervention, preliminary results suggest that EMDR-IGTP may be an effective means of providing treatment to large groups of people impacted by large-scale critical incidents (e.g., human-provoked disasters, terrorism, natural disasters).
 
Article
A vignette is a brief case report that makes a contribution to the literature, but which has used only EMDR's standard protocol measures. This vignette describes the treatment of a woman who developed a severe choking phobia following an allergic reaction to a herbal beverage. She was hospitalized on several occasions because of her resultant inability to consume food and liquids. She received four years of various types of treatment for this phobia, including eating disorder treatment, brief psychodynamic therapy, cognitive behavioral therapy, and psychopharmacological treatment. None were successful in eliminating the disorder. Then when Mary received a course of EMDR treatment, addressing childhood etiological events, there was complete remission of the choking phobia and elimination of all related behaviors.
 
Article
Chronic pain can significantly diminish life quality, causing depression, anxiety, and sleep disturbances, and may lead to neuroplastic processes that influence pain modulation. The current study investigated eye movement desensitization and reprocessing (EMDR) treatment of 38 patients suffering from chronic pain with 12 weekly 90-minute sessions. A battery of self-reported questionnaires assessing quality of life, pain intensity, and depression level were administered pre- and posttreatment for objective outcome evaluation. The Structured Clinical Interview for DSM was administered at pretreatment to identify participants' personality traits that may influence pain perception. Patients showed statistically significant improvement relative to baseline after 12 weeks of EMDR treatment. Our findings suggest that EMDR is an effective tool in the psychological treatment of chronic pain, resulting in decrease pain sensations, pain-related negative affect, and anxiety and depression levels. We examine possible theories about the mechanisms by which EMDR achieves these effects. Results were consistent with the underlying EMDR premise that posits the important effect of emotions on pain perception.
 
Article
This article proposes that eye movement desensitization and reprocessing (EMDR) would be strengthened by being conceptualized as a two-person therapy; that is, a therapy that employs dialogue between clinician and client about the resonance, attunement, and intention of their relationship. Current research on the mirror neuron system provides a hypothetical neurological underpinning to this proposal. Detailed clinical examples illustrate rupture (Now Moments) and subsequent repair (Moments of Meeting) of the therapeutic relationship in the Eight Phases of EMDR. The high potential for relationship rupture during EMDR therapy is discussed. Suggestions are made for improving EMDR practice, training, and consultation by attending to the intersubjective experience between client and clinician, especially when working with clients who have experienced repeated and pervasive disappointments in love and work.
 
Article
After the 2004 tsunami devastation in Sri Lanka, many citizens experienced severe psychological reactions. The effectiveness of EMDR is illustrated in the treatment of seven of these individuals: 3 children and 2 adults with posttraumatic stress disorder (PTSD) symptoms and 2 adults with depressive symptoms. After 3-8 sessions of EMDR the symptoms were eradicated and these clients were free from their depressive feelings, anxieties, intrusions, and nightmares, were able to function normally, and were able to lead productive lives. These outcomes replicate those in the research literature demonstrating that EMDR is an efficacious treatment for PTSD in general, with specific utility for disaster-related PTSD. It is recommended that future controlled studies be conducted to evaluate the effectiveness of EMDR in the immediate aftermath of disasters and to assess its effectiveness with major depressive disorder.
 
Integration of the Two Method Model within the EMDR procedure and its various components.  
Outline of course and severity of the complaints in time as displayed by a graph representation.  
Article
This article outlines a comprehensive model that helps to identify crucial target memories for EMDR treatment. The "Two Method Approach" can be used for conceptualization and treatment implementation for a broad spectrum of symptoms and problems, other than those related to PTSD per se. The model consists of two types of case conceptualizations. The First Method deals with symptoms whereby memories of the etiological and/or aggravating events can be meaningfully specified on a time line. It is primarily aimed at the conceptualization and treatment of DSM-IV-TR Axis I disorders. The Second Method is used to identify memories that underlie patients' so-called dysfunctional core beliefs. This method is primarily used to treat more severe forms of pathology, such as severe social phobia, complex PTSD, and/or personality disorders. The two methods of case conceptualization are explained step by step in detail and are illustrated by case examples.
 
Article
Patients with posttraumatic stress disorder (PTSD) demonstrate abnormal psychophysiological responses to stressful events. Given that eye movement desensitization and reprocessing (EMDR) therapy appears to be a treatment of choice for trauma victims, the aim of the present study was to determine if psychophysiological responses to stress decreased after a single EMDR session. Six PTSD patients were treated by an EMDR therapist. Their psychophysiological responses (heart rate and skin conductance) were recorded before and after the EMDR session under two conditions: (a) in a relaxed state and (b) while visualizing their own traumatic event. At the end of the session, all patients had a significant reduction in their PTSD symptoms, which confirms previous results demonstrating the efficacy of the EMDR approach. Second, after only one EMDR session, heart rate and skin conductance during the trauma recall decreased significantly as compared to a relaxing state.
 
Article
Eye movement desensitization and reprocessing (EMDR) is thought to successfully treat not only posttraumatic stress disorder (PTSD) but also other psychiatric disorders and mental health problems inasmuch as these have experiential contributions. This randomized clinical trial investigated the effects of treatment of distressful experiences (or small “t” trauma) that fail to meet the criteria for PTSD. Three hours of a slightly adapted form of EMDR were compared to active listening (attentional placebo, also 3 hours) and wait list. Results with 90 participants showed that EMDR produced significantly lower scores on the Impact of Event Scale than active listening or wait list. EMDR also resulted in a significantly smaller increase on the State-Trait Anxiety Inventory (State subscale) after memory recall. Some limitations and implications of findings are discussed.
 
Comparison of proportion of responses classifi ed as Distancing, Reliving, and Associated at the end of each set.  
Article
The processes that underlie the effectiveness of eye movement desensitization and reprocessing (EMDR) are examined by evaluating the procedural differences between it and exposure therapy. Major factors include the degree of emphasis placed on reliving versus distancing in the therapies and the degree to which clients are encouraged to focus on direct trauma experiences versus experiences associated with the trauma. Research results indicate that, unlike traditional imaginal exposure, reliving responses in EMDR did not correlate with symptom improvement. Instead, consistent with an information processing model, the degree of distancing in EMDR was significantly associated with improvement. A case study is described to highlight these methodological divergences in the respective therapies relating to reliving. Finally, the research regarding the possible sources of the distancing response within EMDR was examined. The results indicate that the distancing process was more likely to be an effect produced by eye movements than by any therapist instructions. Theoretical and research evaluations indicate that the mechanisms underlying EMDR and traditional exposure therapy are different.
 
Article
This interview with Dr. Francine Shapiro, originator and developer of Eye Movement Desensitization and Reprocessing (EMDR), provides an overview of the history and evolution of EMDR from its inception to current findings and utilization, as well as future directions in research and clinical development. Dr. Shapiro discusses the psychological traditions that informed the development of EMDR and the Adaptive Information model, as well as the implications for current treatment. The rationale for the application of EMDR to a wide range of disorders is discussed, as well as its integration with other therapeutic approaches. Topics include research on the role of eye movements, the use of EMDR with combat veterans, somatoform disorders, attachment issues, and the distinct features of EMDR that have allowed it to be used for crisis intervention worldwide.
 
Article
This review provides the groundwork for a basic understanding of articles written about eye movement desensitization and reprocessing (EMDR), including a brief overview of theory and practice. It documents EMDR's established efficacy in the treatment of posttraumatic stress disorder and specifies specific subsets of this population in need of further investigation. The article also provides a review of recent studies evaluating a range of EMDR's clinical applications and outlines new directions for research investigations and for developments in clinical practice. It concludes with an overview of current research evaluating pre- and post-neurobiological changes, and mechanisms of action. Specific recommendations for future areas of investigations are outlined, and rigorous evaluation is strongly encouraged.
 
Article
Disasters, both natural and "man-made," affect a large portion of the Earth's population and can be expected to increase in intensity over the coming decades. The impact of disasters on mental health of affected populations is substantial and likely to be insufficiently addressed in the overall context of disaster response. While successful mental health intervention has been demonstrated in a variety of cases, including through the use of EMDR treatment, this problem needs more attention. Effective mental health response will be greatly supported by increased research on questions related to the incidence, form, and prognosis of disaster-generated traumatic stress, as these are affected by type of disaster, culture of affected population, sociological conditions, and neuropsychological factors, and the interactions among these. A brief summary of desirable research is presented that could help responders meet these challenges.
 
Subjective units of disturbance (SUD) recorded every 3 minutes by the participant during the four stages of the scanning session. Note. The regressor was compiled from the mean of the fi ve ratings from each time point. A = safe-place imagery (6 minutes), B = traumatic memory (6 minutes), C = traumatic memory and audio bilateral stimulation (6 minutes), D = traumatic memory and audio bilateral stimulation (27 minutes).  
(continued ) 
BOLD Responses Associated With the SES Regressor Across the Entire 45-Minute Scanning Session (block A to block D; signifi cance threshold defi ned as t = 34) 
Axial images of the brain showing BOLD responses associated with safe-place imagery versus traumatic memory (block A vs. block B). Note. The red clusters correspond to regions demonstrating a signifi cant increase in the BOLD response, while blue clusters depict a signifi cant decrease.  
Article
This study assessed the effects of a session of eye movement desensitization and reprocessing (EMDR) with auditory alternating bilateral stimulation (ABS) using functional magnetic resonance imaging (fMRI) of brain activations. A case study was conducted with a female participant who was suffering from posttraumatic stress disorder following a severe assault. The fMRI scan began with safe-place imagery, for purposes of comparison, and then attention to the trauma memory without ABS. After this, ABS was provided as she began using EMDR procedures to process the traumatic memory. At postsession, the traumatic memory showed robust and significant changes on self-report measures. The initiation of the EMDR protocol with provision of ABS was associated with a marked change in brain activation within the prefrontal cortex demonstrating a ventromedial shift. The authors argue that the structure of the EMDR protocol encourages such a ventromedial activation, which is then intensified by ABS to overcome the block to information processing that has been preventing natural healing from occurring spontaneously.
 
Top-cited authors
Ignacio Nacho Jarero
  • EMDR Mexico and the Mexican Association for Mental Health Support in Crisis
Francine Shapiro
  • EMDR Institute
R.M. Solomon
Lucina Artigas
  • Asociación Mexicana para Ayuda Mental en Crisis A.C.
Louise Maxfield