EMDR Research News December 2012
Several other articles of interest appear this month. Perhaps most crucial to EMDR's scientific acceptance is the long awaited meta-analysis from Chris Lee and Pim Cuijpers examining 15 clinical and 11 laboratory trials in which there was both an EMDR treatment and a no eye movement condition. They found "the additive effect of eye movements in EMDR treatment studies was moderate and significant." While this may seem like old news to EMDR clinicians who depend on this effect for clinical purposes, funding for EMDR research in the USA has languished in the long shadow of Davidson and Parker's (2001) statistically flawed paper which claimed eye movements made no difference over "exposure". Lee and Pim (2012) conclude, "Results ... suggest the processes involved in EMDR are different from other exposure based therapies."
Those who were concerned about Hornsveld et al.'s 2011 paper "Evaluating the Effect of Eye Movements on Positive Memories Such as Those Used in Resource Development and Installation" in Volume 5 number 4 of JEMDR, will want to read the commentary by Leeds and Korn "A Commentary on Hornsveld et al. (2011): A Valid Test of Resource Development and Installation? Absolutely Not" and the rebuttal by Hornsveld, de Jongh and ten Broeke "Stop the Use of Eye Movements in Resource Development and Installation, Until Their Additional Value Has Been Proven: A Rejoinder to Leeds and Korn (2012)" in Volume 6 number 4 of JEMDR. See the abstracts below.
This month I feature the trailer from the 2007 “The Legend of EMDR” from Director Michel Meignant.
With each reference below, you will find the citation, abstract and author contact information (when available). Prior quarterly summaries of journal articles can be found on the EMDRIA website and a comprehensive listing of all EMDR-related research is available at the Francine Shapiro Library. EMDRIA members can access recent Journal of EMDR Practice and Research articles in the member’s area on the EMDRIA website. JEMDR issues older than 12 months are available open access on IngentaConnect.
Spanish Edition of A Guide to the Standard EMDR Protocols for Clinicians, Supervisors, and Consultants
The Spanish edition of my 2009 book Guía de protocolos estándar de EMDR para terapeutas, supervisores y consultores appeared in November 2012 and is available direct from the publisher, Desclée De Brouwer as well as your local professional book store. I am grateful to Olaf Holm, M.D. for his dedicated technical copy editing of the translated manuscript to bring it in line with standard Spanish translations of EMDR and psychology terminology. While published in a slightly smaller format, the Spanish edition includes all of the tables and figures, the standard EMDR procedural scripts, guides to history taking, client and clinician forms and the fidelity rating scales found in the US edition.
Video of the month
This month I feature the trailer from the 2007 “The Legend of EMDR” from Director Michel Meignant, featuring interviews with Jacques Roques and David Servan-Schreiber of France, Roger Solomon, and Francine Shapiro and others. The full length film, available on DVD, shows an EMDR treatment session with Michel Meignant involving his World War II childhood Holocaust memories from Paris of starvation and fears of the German death camps.
Hornsveld, H. K., de Jongh, A., & ten Broeke, E. (2012). Stop the use of eye movements in resource development and installation, until their additional value has been proven: A rejoinder to Leeds and Korn (2012). Journal of EMDR Practice and Research, 6(4), 174-178. doi:10.1891/1933-3188.8.131.52
Dr. Hellen Hornsveld, Hornsveld Psychologen Praktijk, M.H.Trompstraat 8, 3572 XV, The Netherlands. E-mail: firstname.lastname@example.org
This brief article responds to Leeds and Korn's (2012) commentary on our article (Hornsveld et al., 2011) in which we found that eye movements (EMs) during recall of positive and resourceful autobiographic memories (such as those used in resource development and installation [RDI]) led to decreases of (a) vividness, (b) pleasantness, and (c) experienced strength of the intended quality or resource. Hence, we found an opposite effect than what was intended and critically discussed this in our article. In their comments, Leeds and Korn stress their positive clinical experience with RDI and emphasize the limitations of our study. Here we argue that our results, despite their limitations, are fully in line with mounting evidence supporting a working memory account for EMs. Moreover, opposite effects for EMs in the RDI and the safe place procedure accord with several other clinical observations. Given the absence of any confirmatory results, we again advocate, and now even more strongly, to stop the use of EMs in the RDI and safe place procedures until their additional value has been proven.
Lee, C. W., & Cuijpers, P. (2012). A meta-analysis of the contribution of eye movements in processing emotional memories. Journal of Behavior Therapy and Experimental Psychiatry. Published online first. doi:10.1016/j.jbtep.2012.11.001
Christopher William Lee. School of Psychology, Murdoch University, Perth, Australia. email@example.com
Background and objectives: Eye Movement Desensitisation and Reprocessing (EMDR) is now considered evidence based practice in the treatment of trauma symptoms. Yet in a previous meta-analysis, no significant effect was found for the eye movement component. However methodological issues with this study may have resulted in a type II error. The aim of this meta-analysis was to examine current published studies to test whether eye movements significantly affect the processing of distressing memories.
Method: A systematic review of the literature revealed two groups of studies. The first group comprised 15 clinical trials and compared the effects of EMDR therapy with eye movements to those of EMDR without the eye movements. The second group comprised 11 laboratory trials that investigated the effects of eye movements while thinking of a distressing memory versus the same procedure without the eye movements in a non-therapy context. The total number of participants was 849.
Results: The effect size for the additive effect of eye movements in EMDR treatment studies was moderate and significant (Cohens d = .41). For the second group of laboratory studies the effect size was large and significant (d = .74). The strongest effect size difference was for vividness measures in the non-therapy studies (d = .91). The data indicated that treatment fidelity acted as a moderator variable on the effect of eye movements in the therapy studies.
Conclusions: Results were discussed in terms of current theories that suggest the processes involved in EMDR are different from other exposure based therapies.
Leeds, A. M., & Korn, D. L. (2012). A commentary on Hornsveld et al. (2011): A valid test of resource development and installation? Absolutely not. Journal of EMDR Practice and Research, 6(4), 170-173. doi:10.1891/1933-3184.108.40.206
Andrew M. Leeds, 1049 Fourth St., Suite G, Santa Rosa, CA 95404-4345. E-mail: firstname.lastname@example.org
Researchers have published evidence supporting both the “working memory” and the “REM/Orienting Response” hypotheses as mechanisms underlying the documented treatment effects of EMDR on patients with posttraumatic stress disorder. Hornsveld et al. (2011) provide additional evidence of the impact of eye movements (EMs) on aspects of positive memory recall, but overstate their findings relevance to resource development and installation (RDI: Korn & Leeds, 2002) and to the interhemispheric interaction hypothesis (Propper & Christman, 2008). Most likely multiple mechanisms underlie the observed effects of EMDR and RDI. The needed RDI test is to randomly assign patients with Disorders of Extreme Stress not Otherwise Specified with measured coping difficulties to alternate conditions: one an RDI procedure without bilateral (or other distracting) sensory stimulation and one with bilateral EMs.
Lu, D. P., Wu, P. S., & Lu, W. I. (2012). Sedating pediatric dental patients by oral ketamine with alternating bi-lateral stimulation of eye movement desensitization and minimizing adverse reaction of ketamine by acupuncture and bi-digital o-ring test. Acupuncture & Electro-therapeutics Research, 37(2-3), 103-23.
Dominic P Lu, School of Dental Medicine University of Pennsylvania, USA.
Ketamine, besides being an anesthetic agent, is also a strong analgesic that can be especially useful for painful procedures. Vivid dreams and nightmare, considered as undesirable side effects of ketamine, are rarely encountered when administrated orally, making it one of the most desirable oral sedative for children because it partially protects the pharyngeal-laryngeal reflex. Besides, if used in recommended dosage, it does not suppress the cardiopulmonary function as most other sedatives do. Ketamine's bronchodilator effect makes it a good sedative for children with asthma, allergies, and hay fever. Alternating bi-lateral stimulation (ABLS) of eye movement desensitization, applying pre-operatively before ketamine was found to reduce the post-operative violent emergence and behavioral problems. Acupressure at P 6 (Neikuan) acupoint helps to decrease nausea and vomiting episodes by ketamine. 36 patients with history of unmanageable behavior were sedated with ketamine 3mg/kg and ABLS. To prevent possible adverse reaction, Bi-Digital O-Ring Test (BDORT) were used to test all patients. ABLS significantly decreased tearful separation from parent. It took 15 to 20 minutes for ketamine to take effect, peak effect took 20 to 25 minutes. Working time ranged from 20 to 40 minutes. Post-operative recovery was more pleasant when ABLS was combined with ketamine, acupuncture/acupressure not only prevented vomiting and BDORT safeguard the patients from unpredictable untoward side effects but also promoting calmness.
Martin, K. M. (2012). How to use Fraser's dissociative table technique to access and work with emotional parts of the personality. Journal of EMDR Practice and Research, 6(4), 179-186. doi:10.1891/1933-3220.127.116.11
Kathleen Martin, 1655 Elmwood Ave, Suite 125, Rochester, NY 14620. E-mail: email@example.com
This Clinical Q&A article responds to a question about what process to use to access and identify ego states when working with complex trauma. The procedure for implementing Fraser's Dissociative Table Technique is explained and detailed in 8 clearly defined steps. The author builds on Fraser's original instructions and adds several innovations for use by EMDR therapists. Tips on implementing this technique are given. The article then concludes with a session transcript to illustrate the use of this powerful tool.
Meysami-Bonab, S., Abolghasemi, A., Sheikhian, M., Barahmand, U., & Rasooliazad, M. (2012). The effectiveness of eye movement desensitization and reprocessing therapy on the emotion regulation and emotion recognition of addicted individuals. Zahedan Journal of Research in Medical Sciences , 14(10), 33-37.
Soheyla Meysami-Bonab, Department of Clinical Psychology, Mohaghegh Ardabili University, Ardabil, Iran.
Full text available: http://www.zjrms.ir/browse.php?a_id=2161&slc_lang=en&sid=1&ftxt=1
Background: The purpose of this study is to assess the effectiveness of eye movement desensitization and reprocessing therapy on the emotion regulation and emotion recognition of addicts with traumatic experience.
Materials and Methods: This research is an experimental study with pre and post-test design and a control group. The subjects of this study were selected using random sampling method on drug addicts of Ardebil Addiction Treatment Camp who have successfully completed the detoxification period and they were evaluated in two different experimental (15 individuals) and control (15 individuals) groups. The experimental group was treated with EMDR therapy for 8 sessions (each one for 60 minutes) and the control group received no special treatment. All participants filled a questionnaire of Emotion Regulation and Emotion Recognition at the onset of the research and 2 months after termination of treatment. For the data analysis, SPSS-17 software and covariance analysis were used.
Results: The results of covariance analysis test indicated that the eye movement desensitization and reprocessing therapy intervention increased the average of positive emotion regulation and emotion recognition scores in the post-test phase and significantly reduced the average of negative emotion regulation scores.
Conclusion: These results suggest that the treatment of eye movement desensitization and reprocessing is effective in improving regulation and recognition of emotions in addicts with traumatic experience.
Miller, R. (2012). Treatment of behavioral addictions utilizing the feeling-state addiction protocol: A multiple baseline study. Journal of EMDR Practice and Research, 6(4), 159-169. doi:10.1891/1933-318.104.22.168
Robert Miller, 1647 Moon Rock Rd., Fallbrook, CA 92028. E-mail: Dr.firstname.lastname@example.org
This article proposes a new treatment for behavioral addictions, which are commonly treated with some form of cognitive behavioral therapy. The Feeling-State Addiction Protocol (FSAP), based on the feeling-state theory of behavioral and substance addiction, proposes that just as single-event traumas can become fixated with negative feelings, intensely positive events can become fixated with positive feelings. This fixated linkage between an event and a feeling is called a feeling-state (FS). A multiple baseline study of the FSAP was performed using only the steps of the protocol that involved the processing of the FSs. The results of the study of 4 participants (each with at least two compulsions) indicated for 3 of the 4 participants a clear link between the processing of the FSs and reduced reactivity to the visualized behavior. The reactivity was measured by skin conductance level and a positive feeling scale. All four participants reported that their compulsive behavior was eliminated after the intervention targeted the FSs.
Murray, K. (2012). EMDR with grief: Reflections on Ginny Sprang's 2001 study. Journal of EMDR Practice and Research, 6(4), 187-191. doi:10.1891/1933-322.214.171.124
Katy Murray, EMDR Research Foundation, 5806 Mesa Drive, Suite 360, Austin, TX 78731. E-mail: katymurraymsw@ comcast.net or email@example.com
“Translating Research Into Practice” is a new regular journal feature in which clinicians share clinical case examples that support, elaborate, or illustrate the results of a specific research study. Each column begins with the abstract of that study, followed by the clinician's description of their own application of standard eye movement desensitization and reprocessing (EMDR) procedures with the population or problem treated in the study. The column is edited by the EMDR Research Foundation with the goal of providing a link between research and practice and making research findings relevant in therapists' day-to-day practices. In this issue's column, Katy Murray references Sprang's (2001) study, which investigated EMDR treatment of complicated mourning and describes how she used EMDR with three challenging cases-a mother mourning for her young adult son who died by suicide, a woman struggling with the loss of her mother to Alzheimer's disease, and a young mother whose baby was stillborn. Case examples are followed with a comprehensive discussion.
Nieuwenhuis, S., Elzinga, B. M., Ras, P. H., Berends, F., Duijs, P., Samara, Z., & Slagter, H. A. (2012). Bilateral saccadic eye movements and tactile stimulation, but not auditory stimulation, enhance memory retrieval. Brain and Cognition, 81(1), 52-56. doi:10.1016/j.bandc.2012.10.003
Sander Nieuwenhuis, Institute of Psychology, Leiden University, The Netherlands. Electronic address: firstname.lastname@example.org.
Recent research has shown superior memory retrieval when participants make a series of horizontal saccadic eye movements between the memory encoding phase and the retrieval phase compared to participants who do not move their eyes or move their eyes vertically. It has been hypothesized that the rapidly alternating activation of the two hemispheres that is associated with the series of left-right eye movements is critical in causing the enhanced retrieval. This hypothesis predicts a beneficial effect on retrieval of alternating left-right stimulation not only of the visuomotor system, but also of the somatosensory system, both of which have a strict contralateral organization. In contrast, this hypothesis does not predict an effect, or a weaker effect, on retrieval of alternating left-right stimulation of the auditory system, which has a much less lateralized organization. Consistent with these predictions, we replicated the horizontal saccade-induced retrieval enhancement (Experiment 1) and showed that a similar retrieval enhancement occurs after alternating left-right tactile stimulation (Experiment 2). Furthermore, retrieval was not enhanced after alternating left-right auditory stimulation compared to simultaneous bilateral auditory stimulation (Experiment 3). We discuss the possibility that alternating bilateral activation of the left and right hemispheres exerts its effects on memory by increasing the functional connectivity between the two hemispheres. We also discuss the findings in the context of clinical practice, in which bilateral eye movements (EMDR) and auditory stimulation are used in the treatment of post-traumatic stress disorder.