Journal of EMDR Practice and Research

Bouman, Sacha; Müller, Fabiola; Onghena, Patrick; Knoop, Hans

2023 Journal of EMDR Practice and Research

doi: 10.1891/emdr-2022-0060

Background: While cognitive behavioral therapy (CBT) for chronic fatigue syndrome or myalgic encephalomyelitis (CFS/ME) can lead to the normalization of fatigue levels and resumption of activities, a subgroup of patients still evaluates fatigue negatively. Objective: The objective was to investigate whether eye movement desensitization and reprocessing (EMDR) therapy leads to a less negative evaluation of fatigue. Method: This was a randomized single-case experimental study. Five CFS/ME patients (all female, mean age of 35 years), who had completed CBT but still evaluated fatigue negatively, received EMDR therapy. The primary outcome, that is, negative evaluation of fatigue, was assessed daily (three items, e.g., “My fatigue is frustrating”). During EMDR therapy sessions, distress in response to a selected image was measured. Clinical assessments were performed before, directly after, and one month after EMDR therapy. Results: During EMDR therapy sessions, all patients reported high distress related to memories of having CFS/ME. EMDR therapy led to a reduction in this distress. Daily measured negative evaluations of fatigue declined in three patients, albeit not significantly. Three of five patients showed clinically relevant improvement in evaluations of fatigue on clinical pre-/post measures. Conclusion: EMDR therapy can reduce emotional distress associated with fatigue, but it is unclear whether it can change its negative evaluation.

Silva, Rosana Carvalho; Dattilo, Vincenzo; Perusi, Giulia; Mazzelli, Monica; Maffioletti, Elisabetta; Bazzanella, Roberta; Bortolomasi, Marco; Cattaneo, Annamaria; Gennarelli, Massimo; Minelli, Alessandra

2023 Journal of EMDR Practice and Research

doi: 10.1891/emdr-2023-0019

Early life stress (ELS) is associated with treatment-resistant depression (TRD), and trauma-focused psychotherapy benefits TRD patients exposed to ELS. We explored peripheral modulations of stress-response genes (nuclear receptor subfamily 3 group C member 1 [NR3C1] , FK506-binding protein 5 [FKBP5] , and serum/glucocorticoid-regulated kinase 1 [ SGK1 ]) in relation to ELS and symptom changes during psychotherapy. Forty-one TRD patients participated and 21 patients underwent trauma-focused psychotherapy, comprising eye movement desensitization and reprocessing or trauma-focused cognitive behavioral therapy. We used the Montgomery-Åsberg Depression Rating Scale, the Beck Depression Inventory-II and the Beck Anxiety Inventory for symptom evaluation, the Childhood Experience of Care and Abuse Questionnaire for ELS assessment, and the quantitative reverse transcription polymerase chain reaction (RT-qPCR) for transcript analysis. We found higher NR3C1 and FKBP5 baseline mRNA levels in patients with maternal neglect. Trauma-focused psychotherapy induced modifications in transcripts’ levels and symptom amelioration along psychotherapy correlated with genes’ modulations. Transcript levels for all genes were higher in patients relapsing after 24 weeks.

Leeds, Andrew M.

2023 Journal of EMDR Practice and Research

doi: 10.1891/emdr-2023-0006

Research has highlighted the negative effects of early neglect and abuse on the development of emotional self-regulation and attachment. Attention has focused more on negative affect states related to past adverse and traumatic experiences than on the deactivating effects of the absence of early shared positive affect states from parent-infant play, warmth, and affection. Treatment strategies for survivors of early neglect and abuse have focused on methods to metabolize memories of traumatic events. Skills development models have emphasized the benefits of distress tolerance, acceptance, and mindfulness training for patients with persistent negative affect states. Research on the benefits of therapeutic interventions intended to increase positive affect indicates they promote prosocial behaviors and creativity, broaden the scope of attention, reduce emotional symptoms and behavioral problems, and improve physical health. Within the field of eye movement desensitization and reprocessing (EMDR) therapy, procedures to increase positive affect have generally focused on resource development and installation procedures intended to increase access to positive affect-related memories and images. A neglected clinical issue is the inability of survivors of early neglect to tolerate and integrate actual positive interpersonal experience into positive emotional states, interpersonal scripts, or self-concepts. These deficiencies, characteristic of those with dismissing insecure attachment, help produce and maintain profound psychological, medical, and social problems that limit the ability of patients with these histories from progressing in psychotherapy. This article explores research supporting the potential benefits of an EMDR-related procedure, the positive affect tolerance (PAT) and integration protocol, along with possible mechanisms by which the PAT protocol in general, and its bilateral stimulation procedures, might produce clinical benefits for survivors of early neglect. Case vignettes illustrate the potential challenges of implementing and the potential impact of the PAT protocol. Research designs and assessment tools are described that could clarify the potential benefits of the PAT protocol compared to other treatments designed to increase positive affect.

Wakusawa, Keisuke; Sugiyama, Toshiro; Hotta, Hiroshi; Wada, Kohei; Suzuki, Futoshi; Morimoto, Takeshi; Shiino, Tomoko; Tomoda, Akemi

2023 Journal of EMDR Practice and Research

doi: 10.1891/emdr-2023-0014

The triadic therapy based on somatic eye movement desensitization and reprocessing (EMDR) for complex posttraumatic stress disorder (TSP) is a combination therapy, which comprises simplified EMDR, a triplet of micro-dose medicines, and a pair of Chinese medicines. The EMDR procedure is a tactile bilateral stimulation on the body surface with minimum verbal intervention within 15 minutes every two weeks in a period of 2–3 months. In this study, 22 adult patients were treated with TSP. The Impact of Event Scale—Revised, Beck Depression Inventory (second edition), and Global Assessment of Functioning scores of the patients were significantly improved. Moreover, TSP is a safe treatment procedure in terms of titration, cost-effectiveness, and time-effectiveness. It could also treat multiple difficulties in patients with cPTSD from medical problems to socioeconomic problems.

Yaşar, Alişan Burak; Kavakçı, Önder; Çiftçi, Zeynep Zat; Tunca, Görkem Alban; Uygun, Ersin; Gündoğmuş, İbrahim; Kubilay, Derin; Aksöz, Yasemin; Deveci, Hande; Konuk, Emre

2023 Journal of EMDR Practice and Research

doi: 10.1891/emdr-2023-0003

Introduction: As an innovative procedure, eye movement desensitization and reprocessing (EMDR) 2.0, which is based on standard EMDR, draws attention with its promising results. The adaptation of EMDR 2.0 to groups will be a significant contribution to the psychology literature. Considering the effectiveness of EMDR 2.0 on individual applications, this is a preliminary study that aims to explore the role of EMDR 2.0 on groups by developing the EMDR 2.0 group protocol (EMDR 2.0 GP). Methods: In this pilot study, EMDR 2.0 GP is applied to a group of seven participants who had been exposed to a traffic incident. The role of EMDR 2.0 GP (three sessions; 3.5 hours in total) on posttraumatic stress disorder (PTSD) symptoms, depression, anxiety, and stress was measured. The Impact of Event Scale—Revised and the Depression-Anxiety-Stress Scale-21 (DASS-21) were used to assess these symptoms at pretreatment, one-week posttreatment, and one-month posttreatment. Results: The participants (mean age = 47.14 ± 9.65) with a traffic accident experience (mean of the time elapsed = 88.57 ± 38.24 months) received EMDR 2.0 GP. Results showed that the EMDR 2.0 group had significantly lower depression (χ² [2, n = 7] = 9.364, p = .009, Kendall’s W = .668) and stress (χ² [2, n = 7] = 8.667, p = .013, Kendall’s W = .619) on the subscales of DASS-21 and lower intrusions (χ² [2, n = 7] = 6.333, p = .042, Kendall’s W = .452), avoidance (χ² [2, n = 7] = 7.280, p = .026, Kendall’s W = .520), and hyperarousal (χ² [2, n = 7]) = 10.800, p = .005, Kendall’s W = .771) at posttreatment. Conclusion: The pilot study of EMDR 2.0 GP indicated that this newly developed protocol that was first applied to the group may be effective in reducing depression, stress, and PTSD symptoms among a nonclinical sample. This pilot study supports future randomized controlled EMDR GP applications.