This article reviews the literature on EMDR treatment of somatic complaints and describes the application of Shapiro’s Adaptive Information Processing (AIP) model in the treatment of phantom limb pain. The case study explores the use of EMDR with a 38-year-old man experiencing severe phantom limb pain 3 years after the loss of his leg and part of his pelvis in an accident. Despite treatment at several rehabilitation and pain centers during the 3 years, and the use of opiate medication, he continued to experience persistent pain. After 9 EMDR treatment sessions, the patient’s phantom limb pain was completely ablated, and he was taken off medication. Effects were maintained at 18-month follow-up. The clinical implications of this application of EMDR are explored.
Your search for all content returned 13 results
- Go to article: EMDR and Phantom Limb Pain: Theoretical Implications, Case Study, and Treatment Guidelines
- Go to article: A Brief Narrative Summary of Randomized Controlled Trials Investigating EMDR Treatment of Patients With Depression
A Brief Narrative Summary of Randomized Controlled Trials Investigating EMDR Treatment of Patients With Depression
Depression, one of the most common mental disorders, is characterized by enormous social costs and limited rates of treatment success, even though psychotherapeutic and pharmacological treatments currently contribute to an increase in the remission rate. In light of recent studies that have shown that traumas and adverse life experiences may represent risk factors for the onset of depression, the therapeutic approach of eye movement desensitization and reprocessing (EMDR) therapy has been seen as potentially effective in the treatment of depression. The purpose of the present brief narrative review is to summarize the current literature on the efficacy of EMDR in patients with depression, in particular by referring to randomized controlled clinical trials (RCTs) that examined depression as a primary outcome. The data examined are updated to March 2019 and count seven RCT studies covering the years from 2001 to 2019. They are heterogeneous by type of intervention and demographic characteristics of the sample. Although the selected studies are few and with different methodological critical issues, the findings reported by the different authors suggest in a preliminary way that EMDR can be a useful treatment for depression.
Supervision de cas est une nouvelle rubrique régulière du Journal of EMDR Practice and Research. Dans cet article, un clinicien EMDR (désensibilisation et retraitement par les mouvements oculaires) décrit brièvement le cas difficile d'un homme, Georges, qui avait été orienté en EMDR pour le traitement d'une dépression ayant débuté plus de deux ans auparavant. Après traitement de tous ses souvenirs traumatiques, il reste aujourd'hui gravement déprimé et son thérapeute demande comment avancer efficacement. Des réponses sont données par trois experts. Le premier, Robin Shapiro, décrit une liste complète d'étiologies possibles : attachement, traumas précoces, facteurs génétiques ou autres causes biologiques, avec les traitements appropriés (EMDR, états du moi ou médicaments). Le second expert, Arne Hofmann, passe en revue le traitement administré et propose d'autres cibles de traitement, suggérant au thérapeute d'aborder la croyance de son client que “rien ne changera” et d'essayer le protocole EMDR inversé. Le troisième expert, Earl Grey, recommande que le clinicien se concentre sur les traumas “t”, même si le client les trouve peu ou pas perturbants, et explique comment développer et mettre en œuvre un “plan de ciblage réparateur de l'ensemble du cours de la vie”.
Violence and aggression in the workplace is an increasing international concern. No studies have yet determined the most efficacious psychotherapeutic strategies to alleviate the consequences of workplace violence, and none have identified interventions that might fortify workers who are repeatedly exposed to danger. This case series describes the eye movement desensitization and reprocessing (EMDR) treatment of seven bank employees and one transportation worker who suffered repeated acute traumatization. The Impact of Events Scale, the Post-Traumatic Stress Syndrome 10-Questions Inventory, and the Beck Depression Inventory were used to measure changes in symptom severity. Results showed that EMDR effectively reduced symptoms and may provide a possible protective buffer in situations of ongoing workplace violence.
In 2015, more than 1.5 million refugees arrived in Germany, many severely traumatized. Eye movement desensitization and reprocessing (EMDR) therapy has been proven to be an effective treatment for acute and chronic traumatic stress symptoms. A modification for provision in group settings was developed by E. Shapiro: the EMDR Group Traumatic Episode Protocol (G-TEP). In this field study, we investigated the effectiveness of 2 sessions of EMDR G-TEP in treating traumatized refugees. After receiving a psychoeducation session, 18 Arabic-speaking refugees from Syria and Iraq who had come to Germany during the previous 5 months were assigned to treatment and/or waitlist. The Impact of Event Scale-Revised (IES-R) and Beck Depression Inventory (BDI) were administered at pre- and posttreatment. Analysis was conducted using the Mann–Whitney U test and planned Kolmogorov–Smirnov tests. Results showed significant differences between the treatment and the waitlist groups, indicating a significant decline in IES-R scores (p < .05). Although differences in BDI scores did not reach significance (p = .06), a large decline in BDI scores was seen in the treatment group. These results provide preliminary evidence that it might be effective to treat groups of traumatized refugees with EMDR G-TEP.
- Go to article: The Current Status of EMDR Therapy Involving the Treatment of Complex Posttraumatic Stress Disorder
Complex posttraumatic stress disorder (CPTSD) is a diagnostic entity that will be included in the forthcoming edition of the International Classification of Diseases, 11th Revision (ICD-11). It denotes a severe form of PTSD, comprising not only the symptom clusters of PTSD (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition [DSM-IV-TR]), but also clusters reflecting difficulties in regulating emotions, disturbances in relational capacities, and adversely affected belief systems about oneself, others, or the world. Evidence is mounting suggesting that first-line trauma-focused treatments, including eye movement desensitization and reprocessing (EMDR) therapy, are effective not only for the treatment of PTSD, but also for the treatment of patients with a history of early childhood interpersonal trauma who are suffering from symptoms characteristic of CPTSD. However, controversy exists as to when EMDR therapy should be offered to people with CPTSD. This article reviews the evidence in support of EMDR therapy as a first-line treatment for CPTSD and addresses the fact that there appears to be little empirical evidence supporting the view that there should be a stabilization phase prior to trauma processing in working with CPTSD.
- Go to article: The Status of EMDR Therapy in the Treatment of Posttraumatic Stress Disorder 30 Years After Its Introduction
The Status of EMDR Therapy in the Treatment of Posttraumatic Stress Disorder 30 Years After Its Introduction
Given that 2019 marks the 30th anniversary of eye movement desensitization and reprocessing (EMDR) therapy, the purpose of this article is to summarize the current empirical evidence in support of EMDR therapy as an effective treatment intervention for posttraumatic stress disorder (PTSD). Currently, there are more than 30 randomized controlled trials (RCT) demonstrating the effectiveness in patients with this debilitating mental health condition, thus providing a robust evidence base for EMDR therapy as a first-choice treatment for PTSD. Results from several meta-analyses further suggest that EMDR therapy is equally effective as its most important trauma-focused comparator, that is, trauma-focused cognitive behavioral therapy, albeit there are indications from some studies that EMDR therapy might be more efficient and cost-effective. There is emerging evidence showing that EMDR treatment of patients with psychiatric disorders, such as psychosis, in which PTSD is comorbid, is also safe, effective, and efficacious. In addition to future well-crafted RCTs in areas such as combat-related PTSD and psychiatric disorders with comorbid PTSD, RCTs with PTSD as the primary diagnosis remain pivotal in further demonstrating EMDR therapy as a robust treatment intervention.
This study was designed to investigate the question of whether psychophysiological changes during EMDR sessions are related to subjective and objective reduction of PTSD symptoms. During-session changes in autonomic tone in relation to session-to-session changes of subjective stress, trauma-related symptoms, and psychophysiological reactions during a traumatic reminder were investigated in 10 patients suffering from single-trauma PTSD. Treatment duration followed each patient’s individual needs and ranged between 1 and 4 sessions, resulting in a total of 24 EMDR treatment sessions from which psychophysiological data were completely recorded. Treatment with EMDR was followed by a significant reduction of trauma-related symptoms, elimination of the PTSD diagnosis in 8 of the 10 participants, as well as by significantly reduced psychophysiological reactivity to an individualized trauma script. Psychophysiological dearousal in sessions correlated significantly with decrease in script-related reactions in heart rate and parasympathetic tone, and with changes in subjective disturbance. Our results indicate that information processing during EMDR is followed by during-session decrease in psychophysiological activity, reduced subjective disturbance and reduced stress reactivity to traumatic memory.
- Go to article: Eye Movement Desensitization and Reprocessing as an Adjunctive Treatment of Unipolar Depression: A Controlled Study
Eye Movement Desensitization and Reprocessing as an Adjunctive Treatment of Unipolar Depression: A Controlled Study
Depression is a severe mental disorder that challenges mental health systems worldwide. About 30% of treated patients do not experience a full remission after treatment, and more than 75% of patients suffer from recurrent depressive episodes. Although psychotherapy and medication can improve remission rates, the success rates of current treatments are limited. In this nonrandomized controlled exploratory study, 21 patients with unipolar primary depression were treated with a mean of 44.5 sessions of Cognitive Behavioural Therapy (CBT) including an average 6.9 adjunctive sessions of Eye Movement Desensitization and Reprocessing (EMDR). A control group (n = 21) was treated with an average of 47.1 sessions of CBT sessions alone. The main outcome measure was the Beck Depression Inventory II (BDI-II). The treatment groups did not differ in their BDI-II scores before treatment, and both treatments resulted in significant improvement. There was an additional benefit for patients treated with adjunctive EMDR (p = .029). Also the number of remissions at posttreatment, as measured by a symptom level below a BDI-II score of 12, was significantly better in the adjunctive EMDR group, the group showing more remissions (n = 18) than the control group (n = 8; p < .001). This potential effect of EMDR in patients with primary depression should be examined further in larger randomized controlled studies.
Case Consultation is a new regular feature in the Journal of EMDR Practice and Research. In this article, an eye movement desensitization and reprocessing (EMDR) clinician briefly describes a challenging case in which a man, “George,” was referred for EMDR for treatment of a depression that began more than 2 years previously. After all his reported traumatic memories were completely processed with EMDR, George remains severely depressed and the therapist asks how to proceed effectively with treatment. Responses are written by three experts. The first expert, Robin Shapiro, describes a comprehensive list of possible etiologies, including attachment, early trauma, genetic, and other biological causes and their appropriate EMDR, ego state, or medical treatments. The second expert, Arne Hofmann, reviews the treatment that was provided and makes suggestions for alternate treatment targets, suggesting that the therapist could address the client’s belief that “nothing will change” and try the EMDR inverted protocol. The third expert, Earl Grey, recommends that the clinician focus on addressing small “t” traumas, even if the client indicates that he or she has little to no disturbance and explains how to develop and implement a “restorative life span target sequence.”