Wednesday, January 19, 2011

Eye movement desensitization and reprocessing (EMDR)


EMDR was discovered by Francine Shapiro in 1987 when she noticed a decrease in her anxiety when her eyes were moving. Since then, there has been much research into the efficacy of this therapy in the treatment of all types of psychiatric disorders, most commonly PTSD, though the neurological mechanism of action has yet to be discovered.

In EMDR, the patient is asked to concentrate on a troubling thought while the therapist directs their eye movement back and forth (auditory or tactile stimuli may also be used). The therapy also uses relaxation and positive imagery techniques. This combination of relaxation, cognitive methods, and distraction is probably what makes EMDR effective.

Evidence does suggest that EMDR is beneficial. Some studies claim it is superior to other therapies, while others suggest there is no significant difference. As with all therapies, I suggest a person be open minded to anything that might work and to work through the different types until they find what style, or combination of styles and medications, works best for them. (EMDR requires less work from the patient outside of sessions and arguments could be made on both sides why this may or may not be beneficial).


References:

http://www.ncbi.nlm.nih.gov/pubmed/20709492
Findings indicate that the eye movement component in EMDR is beneficial, and is coupled with distinct psychophysiological changes that may aid in processing negative memories.

http://www.ncbi.nlm.nih.gov/pubmed/11037095
In most cases EMDR was shown to be effective at reducing symptoms up to 3 months after treatment. In one case benefit was maintained up to 9 months and in another (uncontrolled) follow-up treatment effect was present at 15 months. Two studies suggest that EMDR is as effective as exposure therapies, three claim greater effectiveness in comparison to relaxation training, and three claim superiority over delayed treatment groups. Of the studies examining specific treatment components, two found that treatment with eyes moving was more effective than eyes fixed, while three studies found the two procedures to be of equal effectiveness.

http://www.ncbi.nlm.nih.gov/pubmed/16740177?ordinalpos=6&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
Our results suggest that in the treatment of PTSD, both therapy methods tend to be equally efficacious. We suggest that future research should not restrict its focus to the efficacy, effectiveness and efficiency of these therapy methods but should also attempt to establish which trauma patients are more likely to benefit from one method or the other. What remains unclear is the contribution of the eye movement component in EMDR to treatment outcome.

http://www.ncbi.nlm.nih.gov/pubmed/17636720?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=1&log$=relatedreviews&logdbfrom=pubmed
There was some evidence that individual TFCBT and EMDR are superior to stress management in the treatment of PTSD at between 2 and 5 months following treatment, and also that TFCBT, EMDR and stress management were more effective than other therapies.

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