All the physical sensations and emotions that accompany the memory are identified. The individual then goes over the memory while focusing on an external stimulus that creates bilateral side to side eye movement. This is most often achieved by watching the therapist moving a finger.
- The 9th Inning!
- Search Harvard Health Publishing;
- Neurobiological Correlates of EMDR Monitoring – An EEG Study.
- The Man Who Saved Two Notch.
- Using eye movement therapy to reduce trauma after intensive care | Nursing Times!
After each set of bilateral movements, the individual is asked how he feels. This process continues until the memory is no longer disturbing. The individual is processing the trauma with both hemispheres of the brain stimulated. The chosen positive belief is then installed, via bilateral movement, to replace the negative one. Each session normally lasts for about one hour. This often results in increased insight regarding both previously disturbing events and long-held negative thoughts about the self that have grown out of the original traumatic event.
For example, an assault victim may come to realize that he was not to blame for what happened, he is now safe, that the event is really over, and, as a result, he can regain a general sense of safety in his world. According to studies, individuals who experience some form of trauma are more likely to develop eating disorders than those who lack a history of trauma.
When trauma occurs the brain does not process the event properly. The trauma is buried in the unconscious mind and can be triggered again in the present. Eating disorder behaviors can begin as a way to avoid the thoughts and feelings of the past traumatic event.
Treating Trauma: Why EMDR Might Be Right for You
How does EMDR work? Trauma in relation to eating disorders According to studies, individuals who experience some form of trauma are more likely to develop eating disorders than those who lack a history of trauma. I was sent to [Center for Discovery], an all women's eating disorder treatment facility, and I was terrified to go. I was told I would be there for a month and would return home after that. The first session included a narrative recollection of the traumatic event, with patients describing the event multiple times at least two.
The second session included an explanation of the therapeutic plan, relaxation exercises, trauma-focused psychoeducation and introduction to the upcoming exposure exercise. The third visit included recollection of traumatic events, exposure, and home assignments. Fourth-to-ninth visits started with i a review of home assignment, followed ii by relaxation exercises prior to exposure and iii psychoeducation, which included the differentiation between anxiety-based psychological and somatic responses to stress, strategies for managing intrusive thoughts and thoughts-blocking techniques.
Tenth-to-twelfth visits included Systematic desensitization i. The SCID is composed by open-ended questions introducing content areas, followed by a series of scripted questions. The SCID was administered via consensus of two trained psychiatrists. Seventeen items describe the classical PTSD cluster symptoms: re-experiencing, avoidance and numbing, and hyperarousal.
In addition to assessing the twenty DSM-5 PTSD symptoms, questions target the onset and duration of symptoms, subjective distress, impact of symptoms on social and occupational functioning, improvement in symptoms since a previous CAPS administration, overall response validity, overall PTSD severity, and specifications for the dissociative subtype depersonalization and de-realization. Respondents are asked to identify the trauma that is most disturbing to them and to rate, in the past week, how much trouble they have had with each symptom.
The WSAS is a self-report scale of functional impairment attributable to an identified problem Mundt et al.
Understanding What Actually Happens in EMDR Therapy - Center For Discovery
The WSAS is a short measure of work and social adjustment, with good validity and reliability in several patients populations e. A WSAS score above 20 suggest moderately severe psychopathology.
Scores between 10 and 20 are associated with significant functional impairment but less severe clinical symptomatology. Scores below 10 are usually associated with subclinical populations. Participants were provided with earplugs. Particular care was taken to minimize head motion via vacuum cushions and custom-made padding. The first three volumes were discarded for each subject to allow for steady-state magnetization. EPI images were slice-time corrected using the interleaved descending acquisition criteria, and realigned and re-sliced to correct for head motion using a mean functional volume derived from the overall fMRI scans.
Subject whose head motion exceeded 1. This allows a finer normalization into standard space and consequently avoids under- or overestimation of brain regions volume possibly induced by the adoption of an external template. Hidden Markov Random Field model was applied in all segmentation processes in order to remove isolated voxels. Customized tissue prior images and T1-weighted template were smoothed using an 8 mm full-width at half-maximum FWHM isotropic Gaussian kernel. Linear trends were removed to reduce the influence of the rising temperature of the MRI scanner and all functional volumes were band pass filtered at 0.
Finally, a CompCor algorithm has been applied in order to control physiological high-frequency respiratory and cardiac noise Behzadi et al. FC was calculated by computing the Pearson product-moment correlation coefficient between the average BOLD time series extracted from each brain region composing the Harvard-Oxford atlas, an anatomical atlas covering cortical and subcortical structures Smith et al. A connectivity matrix was built based on each pairwise connectivity between the regions.
Additionally, according to the network-based statistics framework proposed by Zalesky et al. Analysis was done by testing the effect of two factors, i. All the analyses included age, gender, pre—post interval, education and total brain volume as covariates. In the case of regions whose connectivity profile showed similar correlations with clinical scores in both EMDR and TF-CBT groups, an additional analysis aimed at increase spatial resolution was also performed, by looking at seed-based FC changes.
Specifically, selected regions were used as a seed, with their average BOLD signal being correlated with that of any other voxel of the brain, thus producing spatial correlation maps not relying on any anatomical parcellation scheme for an example see Figure 5. Common substrate for psychological benefit. Increased connectivity between superior frontal gyrus and right temporal pole regions, and decreased connectivity between left visual cortex and left temporal pole, explain positive changes in CAPS after psychotherapy. Given the aim of identifying clinically relevant changes in functional connectivity induced by EMDR and TF-CBT, the simple comparison of FC patterns before and after psychotherapy might be informative but also misleading.
Therefore, changes in FC were considered with respect to changes in clinical scores, i.
Comorbidities included hypertension, diabetes and dysthyroidism. Additional demographic and clinical information are reported in Table 1.
Psychotherapeutic effects on PTSD symptomatology. Results for both psychotherapies and each clinical score, including subscales, are reported in Figure 2 — 4 and Supplementary Figure S1. To facilitate replication attempts, a complete list of the regions of interest included in the analyses and their corresponding MNI coordinates is reported in Supplementary Table S1. Functional connectivity and CAPS changes.
Images are displayed in neurological convention. Functional connectivity and DTS changes. Functional connectivity and WSAS changes. The two treatments displayed a significant heterogeneity in terms of connectivity modifications supporting changes in symptomatology. Pre-existing structural and functional brain properties of each patient might contribute to the effectiveness of any given therapy Drysdale et al.
Predictors of response to psychotherapy. While both EMDR and TF-CBT exerted a beneficial effect on PTSD symptomatology, the two psychotherapeutic approaches displayed both common and dissociable effects on brain connectivity, with the overlap being represented by decreased connectivity between visual cortex and temporal lobe regions in the left hemisphere, and increased connectivity between bilateral superior frontal gyrus and right temporal pole regions. This is in line with existing literature, showing no evidence of greater efficacy for a specific psychotherapeutic approach in the treatment of PTSD patients Bradley et al.
This is not surprising, considering that many treatments for PTSD share not only factors common to all psychotherapeutic approaches Bradley and Follingstad, , but also some sort of exposure therapy. Exposure fosters habituation or extinction processes, while also providing an opportunity for a controlled re-elaboration of the traumatic event, which become a core element of the therapeutic process.