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.

Nonpharmacological Techniques (NPT) have been suggested as an efficient and safe means to reduce pain and anxiety in invasive medical procedures. Due to the anxious and potentially traumatic nature of these procedures, we decided to integrate an eye movement desensitization and reprocessing (EMDR) session in the preprocedure NPT. The main purpose of this study was to evaluate the efficacy of one session of EMDR in addition to the routine NPT. Forty-nine pediatric patients (Male = 25; Female = 24) aged 8–18 years (M = 13.17; SD = 2.98) undergoing painful and invasive medical procedures were randomized to receive standard preprocedural care (N = 25) or a session of EMDR in addition to the standard nonpharmacological interventions (N = 24). Participants completed the anxiety and depression scales from the Italian Psychiatric Self-evaluation Scale for Children and Adolescents (SAFA) and rated anxiety on a 0–10 numeric rating scale. Participants in the NPT+EMDR condition expressed significantly less anxiety before the medical procedure than those in the NPT group (p = .038). The integration of EMDR with NPT was demonstrated to be an effective anxiety prevention technique for pediatric sedo-analgesia. These results are the first data on the efficacy of EMDR as a technique to prevent anxiety in pediatric sedo-analgesia. There are important long-term clinical implications because this therapy allows an intervention on situations at risk of future morbidity and the prevention of severe disorders.

Les investigations en neuroimagerie sur les effets des psychothérapies qui traitent l'état de stress post-traumatique (ESPT), dont l'EMDR (désensibilisation et retraitement par les mouvements oculaires), ont décrit des résultats cohérents avec des modifications au niveau du débit sanguin cérébral (DSC ; tomographie d'émission monophotonique [SPECT : single photon emission computed tomography]), du volume neuronal et de la densité neuronale (imagerie par résonance magnétique [IRM]) et, plus récemment, du signal électrique cérébral (électroencéphalographie [EEG]). De plus, récemment, des changements neurobiologiques en lien avec l'EMDR ont été relevés par EEG pendant la thérapie elle-même et a montré une modification de l'activation maximale depuis les régions cérébrales limbiques émotionnelles vers les régions corticales cognitives. C'était la première fois que des changements neurobiologiques se produisant au cours d'une séance de psychothérapie étaient rapportés, faisant de l'EMDR la première psychothérapie avec un effet neurobiologique prouvé. Le but de cet article est de résumer les résultats indiquant les changements fonctionnels et structurels se produisant lors du traitement de l'ESPT et présentés par divers groupes de recherche pendant la période 1999-2012. Les changements pathophysiologiques décrits sont présentés en fonction de la technique neuropsychologique et de la méthodologie employée, puis analysés de manière critique.

Numerous studies have identified links between psychopathology and a history of traumatic life events and dysfunctional attachment relationships. Hence, given the possible traumatic origins of this pathology, it may be useful to provide a trauma-focused intervention such as the eye movement desensitization and reprocessing (EMDR) therapy. This article illustrates a clinical case by describing the positive results of the EMDR therapy in the recovery of unremitting anorexia nervosa in a 17-year-old inpatient. She had previously been hospitalized on 4 occasions in the previous 4 years and received both psychodynamic and cognitive-behavioral therapy. At pretreatment, the client weighed (28 kg, 62 lb) and had a body mass index of 14. She was designated with a dismissing attachment style on the Adult Attachment Interview. EMDR therapy was provided for 6 months in hospital, in twice weekly 50-minute sessions and consisted of standard procedures primarily focusing on her relational traumas, interspersed with psychoeducational talk therapy sessions, and integrated with ego state therapy. At the end of treatment, the client weighed (55 kg, 121 lb) and had a body mass index of 21.5. She no longer met diagnostic criteria for anorexia nervosa, and her attachment style had changed to an earned free-autonomous state of mind. She reported an increase in self-confidence and in her ability to manage various social challenges. Results were maintained at 12 and 24 months follow-up. The treatment implications of this case study are discussed.

Breastfeeding is one of the main manifestations of the bond that a mother builds with her newborn baby. Literature on psychological support for mothers in the early stages of breastfeeding is limited and interventions often do not pinpoint the actual roots of the difficulties. Breastfeeding difficulties may cause emotional distress to women and this can impact significantly on bonding and the perinatal period may turn into a state of crisis. Therefore, it is essential for the clinical psychologist to intervene selectively and in a prompt, effective way, especially when working in a maternity ward. This article suggests a model of intervention: the Breastfeeding and Bonding EMDR Protocol. This protocol, created ad hoc for breastfeeding, combines the work with eye movement desensitization and reprocessing (EMDR) on recent events, the standard protocol and the installation of resources. The hospital case study presented here thoroughly illustrates the various stages of the protocol and the peculiarity and functionality of EMDR regarding breastfeeding and bonding issues in the immediate postpartum period. Prevention is the paramount subject of the model of clinical intervention on breastfeeding hereafter presented.

This pilot study examined the efficacy of eye movement desensitization and reprocessing (EMDR) treatment compared with cognitive behavioral therapy (CBT) in treating posttraumatic stress disorder (PTSD) in oncology patients in the follow-up phase of the disease. The secondary aim of this study was to assess whether EMDR treatment has a different impact on PTSD in the active treatment or during the follow-up stages of disease. Twenty-one patients in follow-up care were randomly assigned to EMDR or CBT groups, and 10 patients in the active treatment phase were assigned to EMDR group. The Impact of Event Scale—Revised (IES-R) and Clinician-Administered PTSD Scale (CAPS) were used to assess PTSD at pretreatment and 1 month posttreatment. Anxiety, depression, and psychophysiological symptoms were also evaluated. For cancer patients in the follow-up stage, the absence of PTSD after the treatment was associated with a significantly higher likelihood of receiving EMDR rather than CBT. EMDR was significantly more effective than CBT in reducing scores on the IES-R and the CAPS intrusive symptom subscale, whereas anxiety and depression improved equally in both treatment groups. Furthermore, EMDR showed the same efficacy both in the active cancer treatment and during the follow-up of the disease.

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 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.

The efficacy of eye movement desensitization and reprocessing (EMDR) therapy has been well established by numerous scientific studies over the past 25 years. The ability to achieve a rapid resolution of trauma symptoms often after only a few EMDR sessions allows clinicians to treat many survivors in a very short period of time. This makes EMDR an ideal intervention after a catastrophic event. The main objective of this article is to describe how European EMDR Associations have provided interventions in emergency situations. Natural and man-made disaster relief projects in Italy, Greenland, and the Netherlands are highlighted. EMDR Europe Humanitarian Assistance Program (HAP) projects sponsored by Austria and Sweden in the Ukraine and Estonia have provided trainings for clinicians. National EMDR Europe associations have developed initiatives in many other areas of the world, such as in Vietnam (EMDR Italy), Cuba (EMDR Spain and Italy), in Pakistan (EMDR United Kingdom and Ireland), in China (EMDR Germany), and in Kenya (EMDR Germany). These projects illustrate the resilience of the populations affected and the generosity of the EMDR Europe community.

Electroencephalography (EEG), due to its peculiar time and spatial resolution, was used for the first time to fully monitor neuronal activation during the whole eye movement desensitization and reprocessing (EMDR) session, including the autobiographical script. The present case report describes the dominant cortical activations (Z-score >1.5) during the first EMDR session and in the last session after the client processed the index trauma. During the first EMDR session, prefrontal limbic cortex was essentially activated during script listening and during lateral eye movements in the desensitization phase of EMDR. In the last EMDR session, the prevalent electrical activity was recorded in temporal, parietal, and occipital cortical regions, with a clear leftward lateralization. These findings suggest a cognitive processing of the traumatic event following successful EMDR therapy and support evidence of distinct neurobiological patterns of brain activations during lateral eye movements in the desensitization phase of EMDR.

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.

Neuroimaging investigations of the effects of psychotherapies treating posttraumatic stress disorder (PTSD), including eye movement desensitization and reprocessing (EMDR), have reported findings consistent with modifications in cerebral blood flow (CBF; single photon emission computed tomography [SPECT]), in neuronal volume and density (magnetic resonance imaging [MRI]), and more recently in brain electric signal (electroencephalography [EEG]). Additionally in the recent past, EMDR-related neurobiological changes were monitored by EEG during therapy itself and showed a shift of the maximal activation from emotional limbic to cortical cognitive brain regions. This was the first time in which neurobiological changes occurring during any psychotherapy session have been reported, making EMDR the first psychotherapy with a proven neurobiological effect. The purpose of this article was to review the results of functional and structural changes taking place at PTSD treatment and presented during the period of 1999–2012 by various research groups. The reported pathophysiological changes are presented by neuropsychological technique and implemented methodology and critically analyzed.

Cette étude-pilote teste l'efficacité comparée de la thérapie EMDR (désensibilisation et retraitement par les mouvements oculaires) et de la thérapie cognitive comportementale (TCC) dans le traitement de l'état de stress post-traumatique (ESPT) chez des patients atteints de cancer, dans la phase de suivi de la maladie. Le second objectif de cette étude était d'évaluer si l'EMDR avait un impact différent sur l'ESPT pendant la phase active du traitement ou au cours des étapes de suivi de la maladie. On a assigné aléatoirement vingt-et-un patients en soins de suivi à des groupes d'EMDR ou de TCC, et dix patients en phase active de traitement ont été assignés à un groupe EMDR. Pour évaluer l'ESPT en pré-traitement et à un mois après traitement, on a utilisé l'Impact of Event Scale-Revised (IES-R) et la Clinician- Administered PTSD Scale (CAPS). L'anxiété, la dépression et les symptômes psycho-physiologiques ont également été évalués. Pour les patients en phase de suivi, l'absence d'ESPT après traitement était associée à une probabilité significativement plus grande d'avoir reçu de l'EMDR que de la TCC. L'EMDR était significativement plus efficace que la TCC pour faire décroître les notes à la sous-échelle des symptômes intrusifs de l'IES-R et de la CAPS, mais l'anxiété et la dépression étaient améliorées de façon semblable dans les deux groupes de thérapie. En outre, l'EMDR se montrait aussi efficace dans le traitement actif du cancer que dans la phase de suivi de la maladie.

Neuroimaging-Untersuchungen zu den Auswirkungen PTSD-fokussierter Therapien, einschließlich Eye Movement Desensitization and Reprocessing (EMDR), berichten von entsprechenden Veränderungsbefunden in der zerebralen Durchblutung (CBF; single photon emission computed tomography SPECT), im neuronalen Volumen und der neuronalen Dichte (funktionelle Magnetresonanz-Tomographie; fMRT) und jüngst auch im EEG-Befund. Ebenso wurden vor kurzem neurobiologische Veränderungen während laufender Therapie nachgewiesen, wobei eine Verlagerung der maximalen Aktivierung von den emotionsprozessierenden limbischen zu den kortikal-kognitiven Hirnregionen zu verzeichnen war. Erstmals konnte hier von neurobiologischen Veränderungen während einer Therapiesitzung berichtet werden; EMDR war damit die erste Therapie mit einem nachgewiesenen neurobiologischen Effekt. Ziel dieses Artikels ist eine kritische Übersicht der Ergebnisse zu den funktionellen und strukturellen Veränderungen, die durch eine PTBS-Behandlung bewirkt werden und die im Zeitraum 1999–2012 von verschiedenen Forschungsgruppen vorgestellt worden sind. Die berichteten pathophysiologischen Veränderungen werden hinsichtlich ihrer neurophysiologischen Technik und der dabei angewandten Methodik dargestellt und kritisch analysiert.

Las investigaciones con neuroimagen sobre los efectos de las psicoterapias que tratan el trastorno de estrés postraumático (TEPT), incluyendo la terapia de desensibilización y reprocesamiento por movimientos oculares (EMDR), han mostrado hallazgos conformes con modificaciones en el flujo sanguíneo cerebral (FSC; tomografía computerizada de emisión monofotónica [SPECT]), en el volumen y la densidad neuronal (imágenes por resonancia magnética [MRI]) y, más recientemente, en las señales eléctricas del cerebro (electroencefalografía [EEG]). Además, en el pasado reciente, se han monitorizado, por medio de EEG, cambios neurobiológicos relacionados con EMDR durante la misma terapia y han mostrado un cambio en la activación máxima desde las regiones límbicas emocionales a las regiones cognitivas corticales del cerebro. Esta ha sido la primera vez que se han señalado los cambios neurobiológicos que tienen lugar durante una sesión de psicoterapia, lo que ha hecho que EMDR sea la primera psicoterapia con un efecto neurobiológico probado. El propósito de este artículo ha sido analizar los resultados de los cambios funcionales y estructurales que han tenido lugar durante el tratamiento del TEPT y que han sido presentados por diversos grupos de investigación durante el período entre 1999 y 2012. Los cambios fisiopatológicos referidos se presentan en función de las técnicas neuropsicológicas y la metodología implementadas y son analizados de manera crítica.

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.