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What is the Role of Eye Movements in Eye Movement Desensitization and Reprocessing (EMDR) for Post-Traumatic Stress Disorder (PTSD)? A Review

Published online by Cambridge University Press:  29 October 2012

Fiona W. Jeffries  and
Paul Davis
Fiona W. Jeffries
Affiliation:
University of Surrey, Guildford, UK
Paul Davis*
Affiliation:
University of Surrey, Guildford, UK
*
Reprint requests to Paul Davis, Department of Psychology, Faculty of Arts and Human Sciences, University of Surrey, Guildford GU2 5XH, UK. E-mail: p.e.davis@surrey.ac.uk
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Abstract

Background: Controversy continues to exist regarding how EMDR works and whether its mechanisms differ from those at work in standard exposure techniques. Aims: To investigate first whether eye movement bilateral stimulation is an essential component of EMDR and, second, the current status of its theoretical basis. Method: A systematic search for relevant articles was conducted in databases using standard methodology. Results: Clinical research evidence is contradictory as to how essential EMs are in PTSD treatment. More positive support is provided by analogue studies. With regards to potential theoretical support, some evidence was found suggesting bilateral stimulation first increases access to episodic memories; and second that it could act on components of working memory which makes focusing on the traumatic memories less unpleasant and thereby improves access to these memories. Conclusions: The results suggest support for the contention that EMs are essential to this therapy and that a theoretical rationale exists for their use. Choice of EMDR over trauma-focused CBT should therefore remain a matter of patient choice and clinician expertise; it is suggested, however, that EMs may be more effective at reducing distress, and thereby allow other components of treatment to take place.

Keywords

Posttraumatic stress disordereye movement desensitization and reprocessingcomponents of therapytheoretical support
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 41 , Issue 3 , May 2013 , pp. 290 - 300
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2012

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References

Andrade, J., Kavanagh, D. and Baddeley, A. (1997). Eye-movements and visual imagery: a working memory approach to the treatment of post-traumatic stress disorder. British Journal of Clinical Psychology, 36, 209–223.CrossRefGoogle Scholar
Armstrong, M. S. and Vaughan, K. (1996). An orienting response model of eye movement desensitization. Journal of Behavior Therapy and Experimental Psychiatry, 25, 283–291.Google Scholar
Baddeley, A. D. (1986). Working Memory. Oxford: Oxford University Press.Google Scholar
Bakan, P. and Svorad, D. (1969). Resting EEG alpha asymmetry of reflective lateral eye movements. Nature, 223, 975–976.CrossRefGoogle ScholarPubMed
Barrowcliff, A. L., Gray, N. S., MacCulloch, S., Freeman, T. C. A. and MacCulloch, M. J. (2003). Horizontal rhythmical eye movements consistently diminish the arousal provoked by auditory stimuli. British Journal of Clinical Psychology, 42, 289–302.Google Scholar
Bisson, J. and Andrew, M. (2007). Psychological treatment of post-traumatic stress disorder (PTSD). Cochrane Database of Systematic Reviews 2007, Issue 3: CD003388Google Scholar
Boudewyns, P. A. and Hyer, L. A. (1996). Eye movement desensitization and reprocessing (EMDR) as treatment for post-traumatic stress disorder (PTSD). Clinical Psychology and Psychotherapy, 3, 185–195.Google Scholar
Brunyé, T. T., Mahoney, C. R., Augustyn, J. S. and Taylor, H. A. (2009). Horizontal saccadic eye movements enhance the retrieval of landmark shape and location information. Brain and Cognition, 70, 279–288.Google Scholar
Cahill, S. P., Carrigan, M. H. and Frueh, B. C. (1999). Does EMDR work? And if so, why?: a critical review of controlled outcome and dismantling research. Journal of Anxiety Disorders, 13, 5–33.Google Scholar
Christman, S. D., Garvey, K. J., Propper, R. E. and Phaneuf, K. A. (2003). Bilateral eye movements enhance the retrieval of episodic memories. Neuropsychology, 17, 221–229.Google Scholar
Christman, S. D. and Propper, R. E. (2001). Superior episodic memory is associated with interhemispheric processing. Neuropsychology, 15, 607–616.Google Scholar
Compton, R. J. and Mintzer, D. A. (2001). Effects of worry and evaluation stress on interhemispheric interaction. Neuropsychology, 15, 427–433.Google Scholar
Davidson, P. R. and Parker, K. C. H. (2001). Eye movement desensitization and reprocessing (EMDR): a meta-analysis. Journal of Consulting and Clinical Psychology, 69, 305–316.Google Scholar
Ehlers, A., Clark, D. M., Hackmann, A., Grey, N., Liness, S., Wild, J., et al. (2010). Intensive cognitive therapy for PTSD: a feasibility study. Behavioural and Cognitive Psychotherapy, 38, 383–398.Google Scholar
Gunter, R. W. (2009). EMDR works. . . but how? Recent progress in the search for treatment mechanisms. Journal of EMDR Practice and Research, 3, 161–168.Google Scholar
Gunter, R. W. and Bodner, G. E. (2008). How eye movements affect unpleasant memories: support for a working memory account. Behaviour Research and Therapy, 46, 913–931.Google Scholar
Hertlein, K. M. and Ricci, R. J. (2004). A systematic research synthesis of EMDR studies: implementation of the platinum standard. Trauma, Violence and Abuse, 5, 285–300.Google Scholar
Högberg, G., Pagani, M., Sundin, O., Soares, J., Aberg-Wistedt, A., Tärnell, B., et al. (2007). On treatment with eye movement desensitization and reprocessing of chronic post-traumatic stress disorder in public transportation workers: a randomized controlled trial. Nordic Journal of Psychiatry, 61, 54–61.Google Scholar
Ironson, G. I., Freund, B., Strauss, J. L. and Williams, J. (2002). Comparison of two treatments for traumatic stress: a community-based study of EMDR and prolonged exposure. Journal of Clinical Psychology, 58, 113–128.CrossRefGoogle Scholar
Kavanagh, D. J., Freese, S., Andrade, J. and May, J. (2001). Effects of visuospatial tasks on desensitization to emotive memories. British Journal of Clinical Psychology, 40, 267–280.Google Scholar
Kilpatrick, D. G. and Best, C. L. (1984). Some cautionary remarks on treating sexual assault victims with implosion. Behavior Therapy, 15, 421–423.Google Scholar
Lee, C. W. and Drummond, P. D. (2008). Effects of eye movement versus therapist instructions on the process of distressing memories. Journal of Anxiety Disorders, 22, 801–808.CrossRefGoogle ScholarPubMed
Lilley, S. A., Andrale, J., Turpin, G., Sabin-Farrell, R. and Holmes, E. (2009). Visuospatial working memory interference with recollections of trauma. British Journal of Clinical Psychology, 48, 309–321.CrossRefGoogle ScholarPubMed
Lohr, J. M., Lilienfeld, S. O., Tolin, D. F. and Herbert, J. D. (1999). Eye movement desensitization and reprocessing: an analysis of specific versus nonspecific treatment factors. Journal of Anxiety Disorders, 13, 185–207.Google Scholar
MacCulloch, M. J. and Feldman, P. (1996). Eye movement desensitization treatment utilises the positive visceral element of the investigatory reflex to inhibit the memories of post-traumatic stress disorder: a theoretical analysis. The British Journal of Psychiatry, 169, 571–579.Google Scholar
Maltzman, I. and Raskin, D. C. (1965). Effects of individual differences in the orienting reflex on conditioning and complex processes. Journal of Experimental Research in Personality, 1, 1–16.Google Scholar
Maxfield, L., Melynk, W. T. and Hayman, C. A. G. (2008). A working memory explanation for the effects of eye movements in EMDR. Journal of EMDR Practice and Research, 2, 247–261.Google Scholar
National Institute for Clinical Excellence (2005). Post-Traumatic Stress Disorder (PTSD): the management of PTSD in adults and children in primary and secondary care. London: NICE Guidelines.Google Scholar
Power, K., McGoldrick, T., Brown, K., Buchanan, R., Sharp, D., Swanson, V., et al. (2002). A controlled comparison of eye movement desensitization and reprocessing versus exposure plus cognitive restructuring versus waiting list in the treatment of post-traumatic stress disorder. Clinical Psychology and Psychotherapy, 9, 299–318.Google Scholar
Propper, R. E. and Christman, S. D. (2008). Interhemispheric interaction and saccadic horizontal eye movements: implications for episodic memory, EMDR and PTSD. Journal of EMDR Practice and Research, 2, 269–281.CrossRefGoogle Scholar
Rogers, S. and Silver, S. M. (2002). Is EMDR an exposure therapy? A review of trauma protocols. Journal of Clinical Psychology, 58, 43–59.Google Scholar
Samara, Z., Elzinga, B. M., Slagter, H. A. and Nieuwenhuis, S. (2011). Do horizontal saccadic eye movements increase interhemispheric coherence? Investigation of a hypothesized neural mechanism underlying EMDR. Front Psychiatry, 2, 4.Google Scholar
Schubert, S. and Lee, C. W. (2009). Adult PTSD and its treatment with EMDR: a review of controversies, evidence, and theoretical knowledge. Journal of EMDR Practice and Research, 3, 117–132.CrossRefGoogle Scholar
Schubert, S., Lee, C. W. and Drummond, P. D. (2011). The efficacy and psychophysiological correlates of dual-attention tasks in eye movement desensitization and reprocessing (EMDR). Journal of Anxiety Disorders, 25, 1–11.Google Scholar
Shapiro, F. (1989a). Efficacy of the eye movement desensitization procedure in the treatment of traumatic memories. Journal of Traumatic Stress, 2, 199–223.Google Scholar
Shapiro, F. (1989b). Eye movement desensitization: a new treatment for post-traumatic stress disorder. Journal of Behavior Therapy and Experimental Psychiatry, 20, 211–217.CrossRefGoogle ScholarPubMed
Shapiro, F. (2001). Eye Movement Desensitization and Reprocessing: basic principles, protocols and procedures (2nd edn). New York: Guilford Press.Google Scholar
Shapiro, F. (2002). EMDR 12 years after its introduction: past and future research. Journal of Clinical Psychology, 58, 1–22.CrossRefGoogle ScholarPubMed
Shapiro, F. and Maxfield, L. (2002). Eye movement desensitization and reprocessing (EMDR): information processing in the treatment of trauma. Journal of Clinical Psychology, 58, 933–946.Google Scholar
Shepherd, J., Stein, K. and Milne, R. (2000). Eye movement desensitization and reprocessing in the treatment of post-traumatic stress disorder: a review of an emerging therapy. Psychological Medicine, 2000, 863–871.Google Scholar
Sokolov, E. (1990). The orienting response, and future directions of its development. Pavlovian Journal of Biological Sciences, 25, 142–150.Google Scholar
Stickgold, R. (2002). EMDR: a putative neurobiological mechanism of action. Journal of Clinical Psychology, 58, 61–75.CrossRefGoogle ScholarPubMed
Stickgold, R., Hobson, J. A., Fosse, R. and Fosse, M. (2001). Sleep, learning and dreams: off-line memory reprocessing. Science, 294, 1052–1057.CrossRefGoogle ScholarPubMed
Tulving, E., Kapur, S., Craik, F. I. M., Moscovitch, M. and Houle, S. (1994). Hemispheric encoding/retrieval asymmetry in episodic memory: positron emission technology findings. Proceedings of the National Academy of Science USA, 91, 2016–2020.CrossRefGoogle Scholar
van den Hout, M., Muris, P., Salemink, E. and Kindt, M. (2001). Autobiographical memories become less vivid and emotional after eye movements. British Journal of Clinical Psychology, 40, 121–130.Google Scholar
Wilson, D. L., Silver, S. M., Covi, W. G. and Foster, S. (1996). Eye movement desensitization and reprocessing: effectiveness and autonomic correlates. Journal of Behavior Therapy and Experimental Psychiatry, 27, 219–229.Google Scholar
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