Eye movement desensitization and reprocessing: Effectiveness and autonomic correlates

doi:10.1016/S0005-7916(96)00026-2

Journal of Behavior Therapy and Experimental Psychiatry

Volume 27, Issue 3, September 1996, Pages 219-229

https://doi.org/10.1016/S0005-7916(96)00026-2 Get rights and content

Abstract

Eighteen subjects distressed by memories of a specific traumatic event were randomly assigned to a single session of one of three conditions: Eye Movement Desensitization and Reprocessing (EMDR), a Time Interval Condition (TIC), or Tapping Alternate Phalanges (TAP). All subjects treated in the EMDR group showed desensitization as monitored by SUDs, which correlated with the physiological data and cessation of pronounced symptomatology. Only one subject in a control group showed desensitization. Compared to TIC and TAP, autonomic measures showed distinct changes during EMDR: (1) respiration synchronized with the rhythm of the eye movements in a shallow, regular pattern; (2) heart rate slowed significantly overall; (3) systolic blood pressure increased during early sets, invariably declined during abreactions, and decreased overall; (4) finger tip skin temperature consistently increased; and (5) the galvanic skin response consistently decreased in a clear “relaxation response.” This relaxing effect of the eye movements suggests that at least one of the mechanisms operating during EMDR is desensitization by reciprocal inhibition, by pairing emotional distress with an unlearned or “compelled” relaxation response.

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EMDR therapy is recommended in several guidelines in the International field of psychological trauma. The dual attention stimuli/alternating bilateral stimulation (DAS/ABS) element of EMDR therapy has no proposed mechanism of action agreed upon, which explains the rapid shifts in cognitions and dysfunctional traumatic memory networks that are central to its observable efficacy. This paper discusses an innate, biological mechanism found in biological systems, including the human nervous system that may explain the efficacy of DAS/ABS. This mechanism is stochastic resonance (SR). SR is observed to make unintelligible, subthreshold signals intelligible and facilitates signal transmission. It provides a potential mechanism for discrimination and the selective focusing of attention, which are important factors in effective psychotherapy for the psychologically traumatised individual. The body/mind complex aims to achieve the functional encoding of memories in the neocortex and a key structural crossroads in this process is the thalamus. Activity in the thalamus is decreased in Post-Traumatic Stress Disorder (PTSD) compared to non-PTSD patients and a form of ‘gating’ is known to occur at the thalamic level. This ‘gating’ is adaptive and it is postulated to protect the higher neocortical systems in times of trauma. Although the model is initially somewhat counterintuitive, Stochastic Resonance; a form of random ‘noise’, can be considered ‘helpful randomness’ and when present in the thalamus SR can help filter and control sensitivity to incoming signals; helping to discriminate what is communicated. Naturally occurring SR is normally present as a result of descending cortico-thalamic activity, but appears attenuated as a result of exposure to trauma. The view of ‘noise’ in the current era of cell phones and High Definition is generally negative with science going to significant lengths to clean up signals: i.e. removing noise from them. We do not want white noise in our music or during our cell phone calls. However, some researchers invite us to consider that not all noise is bad and the downward cortico-thalamic ‘noise’ is an example of this category of ‘helpful noise’. This paper will discuss the potential role of SR, as the mechanism by which DAS/ABS generates a random (stochastic) signal, facilitating a return to functional memory processing, where there is a lack of naturally occurring noise from the descending cortico-thalamic connections because of exposure to trauma. Modelling the mechanism as SR will facilitate further study into EMDR therapy and this will hopefully encourage perspicacity, where there has previously been derision.
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Citation Excerpt :
EMDR trials have tended to emphasize psychological outcomes, although some research has examined neurobiological outcomes. For example, changes have been observed on SPECT neuroimaging scans following EMDR (Lansing, Amen, Hanks, & Rudy, 2005; Levin, Lazrove, & van der Kolk, 1999), and desensitization during EMDR has been associated with autonomic changes (e.g., increased fingertip skin temperature and decreased heart rate, blood pressure, and galvanic skin response [Wilson, Silver, Covi, & Foster, 1996]). In addition, individuals who received EMDR at an HMO used fewer medication appointments compared to individuals offered standard care (Marcus, Marquis, & Sakai, 1997).
Research has consistently demonstrated a link between the experience of adverse childhood experiences (ACEs) and adult health conditions, including mental and physical health problems. While a focus on the prevention or mitigation of adversity in childhood is an important direction of many programs, many individuals do not access support services until adulthood, when health problems may be fairly engrained. It is not clear which interventions have the strongest evidence base to support the many adults who present to services with a history of ACEs. The current review examines the evidence base for psychosocial interventions for adults with a history of ACEs. The review focuses on interventions that may be provided in primary care, as that is the setting where most patients will first present and are most likely to receive treatment. A systematic review of the literature was completed using PsycInfo and PubMed databases, with 99 studies identified that met inclusion and exclusion criteria. These studies evaluated a range of interventions with varying levels of supportive evidence. Overall, cognitive-behavioral therapies (CBT) have the most evidence for improving health problems – in particular, improving mental health and reducing health-risk behaviors – in adults with a history of ACEs. Expressive writing and mindfulness-based therapies also show promise, whereas other treatments have less supportive evidence. Limitations of the current literature base are discussed and research directions for the field are provided.

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ArticleEye movement desensitization and reprocessing: Effectiveness and autonomic correlates

Abstract

Journal of Behavior Therapy and Experimental Psychiatry

Journal of Behavior Therapy and Experimental Psychiatry

Journal of Anxiety Disorders

Journal of Behavior Therapy and Experimental Psychiatry

Journal of Behavior Therapy and Experimental Psychiatry

Journal of Behavior Therapy and Experimental Psychiatry

Journal of Behavior Therapy and Experimental Psychiatry

Journal of Behavior Therapy and Experimental Psychiatry

Journal of Behavior Therapy and Experimental Psychiatry

Journal of Behavior Therapy and Experimental Psychiatry

Journal of Behavior Therapy and Experimental Psychiatry

Journal of Behavior Therapy and Experimental Psychiatry

Journal of Behavior Therapy and Experimental Psychiatry

Journal of Behavior Therapy and Experimental Psychiatry

Article
Eye movement desensitization and reprocessing: Effectiveness and autonomic correlates