De nombreuses études ont identifié des liens entre la psychopathologie et des antécédents d’événement de vie traumatiques et de relations d’attachement dysfonctionnelles. Compte tenu des origines traumatiques possibles de cette pathologie, il pourrait être utile d’apporter une intervention centrée sur le trauma comme la thérapie EMDR (désensibilisation et retraitement par les mouvements oculaires). Cet article s’appuie sur un cas clinique pour décrire les résultats positifs de la thérapie EMDR dans le rétablissement d’une anorexie mentale résistante chez une patiente de 17 ans en hospitalisation. Elle avait déjà été hospitalisée à quatre reprises au cours des quatre dernières années et avait suivi des thérapies psychodynamique et cognitive comportementale. Au début de la prise en charge, la patiente pesait 28 kg et son indice de masse corporelle était 14. Elle s’est vu attribuer un style d’attachement désengagé/évitant sur l’entretien de l’attachement adulte (Adult Attachment Interview). La thérapie EMDR lui a été proposée à l’hôpital sur une durée de six mois sous la forme de séances de 50 minutes, deux fois par semaine, correspondant aux procédures standard qui se centraient principalement sur ses traumas relationnels ; elle était combinée à des séances de psychoéducation et intégrée à la thérapie des états du moi. À la fin de la prise en charge, la patiente pesait 55 kg et son indice de masse corporelle était 21,5. Elle ne remplissait plus les critères diagnostiques de l’anorexie mentale et son style d’attachement s’était modifié en faveur d’un état d’esprit libre-autonome acquis. Elle décrivait une confiance en soi accrue et une plus grande capacité à gérer différentes situations sociales. Les résultats étaient maintenus lors du suivi après 12 et 24 mois. Les implications de cette étude de cas pour la prise en charge sont examinées.

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.

We aimed to assess changes in the attachment internal working model and reflective function (RF) as mechanisms of change in eye movement desensitization and reprocessing (EMDR) treatment for patients with traumatic memories. Twenty adult female patients with parenting and relational problems participated in the study. Attachment organization was assessed with the Adult Attachment Interview (AAI) and the RF coding scale pre- and posttreatment. We found that EMDR therapy increased patients' narrative coherence and RF. We noted a significant decrease in the number of participants classified as unresolved following the course of EMDR treatment in which loss and/or trauma were resolved. This article summarizes the changes after EMDR therapy regarding attachment status and its efficacy to reprocess early traumatic memories in a more adaptive way. Finally, our results also support the usefulness of the AAI as a tool for understanding the changing processes during a therapeutic treatment.

Research in clinical psycho-oncology is becoming an area of key importance in investigating the effects of the interventions of support and/or psychotherapy with patients. This study was conducted with the aim of evaluating the effectiveness of the eye movement desensitization and reprocessing (EMDR) approach compared to a non–trauma-focused cognitive behavioral therapy (CBT) intervention. There were 11 male and 46 female participants, with mixed cancer diagnoses. Thirty-one subjects received EMDR therapy, and 26 received CBT for 12 sessions of 60 minutes each. The Symptom Checklist-90-R (SCL-90-R), COPE inventory, and Davidson Trauma Scale (DTS) were administered at three different times (T0, before intervention; T1, after the sixth session; and T2, after the 12th session); the Karnofsky Performance Status was administered at T0 only. In the EMDR group, a significant improvement was reported for the following 11 of the 17 dependent variables: COPE subscales, Avoidance Strategies and Positive Attitude; all three DTS subscales, Intrusion, Avoidance, and Hyperarousal; and 6 SCL-90-R subscales. In the CBT group, a significant improvement was reported for the following 4 of the 17 dependent variables: COPE subscales Positive Attitude and Transcendent Orientation; two DTS subscales, Intrusion, and Avoidance, with no improvement on any of the SCL-90-R subscales. This innovative study shows the value of trauma-focused treatment for patients with cancer and allows important preliminary suggestions on the usefulness of applying EMDR therapy in an oncological setting, although further research in this context is still needed.

Elevated psychophysiological parameters and heightened physiological reactivity to trauma-related cues are acquired changes following trauma exposure. Measuring improvement in these variables is an appropriate evaluation of outcome in treatment studies. Heart Rate Variability (HRV) is a computerized measure of physiological responsivity derived from Holter ECG recording. Four female outpatients with persistent post-traumatic symptoms and personal impairment following “small t” trauma exposure underwent a course of EMDR treatment and were assessed at baseline, end of treatment, day 30 and day 90 of follow-up, using self-report symptom scales and 90-min Holter ECG recordings. Symptom scores decreased between baseline and end of treatment, with improvement maintained at follow-up. Several HRV measures changed favorably in different recording intervals. HRV is a feasible and sensitive method to measure physiological changes in the treatment of individuals distressed by “small t” trauma. Further investigation is advisable to expand these preliminary data.