Content deleted Content added
Markworthen (talk | contribs) more logical order, and consistency with similar articles (text not changed; just moved the section |
Markworthen (talk | contribs) reorganize - trying to group sections according to logical relationships ... not perfect, but hopeuflly you understand my intention. There might be better ways to organize. |
||
Line 24:
The person being treated is asked to recall an image, phrase, and emotion that represent a level of distress related to a trigger while generating one of several types of bilateral sensory input, such as side-to-side [[eye]] movements or hand tapping.<ref name=feske>{{cite journal | vauthors = Feske U |title=Eye Movement Desensitization and Reprocessing Treatment for Posttraumatic Stress Disorder |journal=Clinical Psychology: Science and Practice |date=June 1998 |volume=5 |issue=2 |pages=171–181 |doi=10.1111/j.1468-2850.1998.tb00142.x | issn = 0969-5893}}</ref> The 2013 World Health Organization practice guideline says that "Like [[cognitive behavioral therapy]] (CBT) with a trauma focus, EMDR aims to reduce subjective distress and strengthen adaptive beliefs related to the traumatic event. Unlike CBT with a trauma focus, EMDR does not involve (a) detailed descriptions of the event, (b) direct challenging of beliefs, (c) extended exposure or (d) homework."<ref name="WHO 2013">{{cite report |publisher=World Health Organization |year=2013 |title=Guidelines for the Management of Conditions that are Specifically Related to Stress |___location=Geneva |url=https://www.who.int/mental_health/emergencies/stress_guidelines/en/ |archive-url=https://web.archive.org/web/20131129075320/http://www.who.int/mental_health/emergencies/stress_guidelines/en/ |url-status=dead |archive-date=November 29, 2013 |page=Glossary page 1 |pmid=24049868}}</ref>
==Possible mechanisms==▼
===Incomplete processing of experiences in trauma===▼
Many proposals of EMDR efficacy share an assumption that, as Shapiro posited, when a traumatic or very negative event occurs, information processing of the experience in memory may be incomplete. The trauma causes a disruption of normal adaptive information processing, which results in unprocessed information being dysfunctionally held in memory networks.<ref>{{cite journal | vauthors = Solomon RM, Shapiro F | s2cid=7109228 |title=EMDR and the Adaptive Information Processing ModelPotential Mechanisms of Change |journal=Journal of EMDR Practice and Research |date=November 2008 |volume=2 |issue=4 |pages=315–325 |doi=10.1891/1933-3196.2.4.315 }}</ref> According to the 2013 World Health Organization practice guideline: "This therapy [EMDR] is based on the idea that negative thoughts, feelings and behaviours are the result of unprocessed memories."<ref name="WHO 2013" /> This proposed mechanism has no known scientific basis.<ref name=non/>▼
===Other mechanisms===▼
Several other possible mechanisms have been proposed:▼
* EMDR may impact working memory.<ref>{{cite journal | vauthors = van den Hout MA, Engelhard IM, Beetsma D, Slofstra C, Hornsveld H, Houtveen J, Leer A | title = EMDR and mindfulness. Eye movements and attentional breathing tax working memory and reduce vividness and emotionality of aversive ideation | journal = Journal of Behavior Therapy and Experimental Psychiatry | volume = 42 | issue = 4 | pages = 423–431 | date = December 2011 | pmid = 21570931 | doi = 10.1016/j.jbtep.2011.03.004 }}</ref> If a patient performs bilateral stimulation task while remembering the trauma, the amount of information they can recall is thought to be reduced, making the resulting [[negative emotion]]s less intense and more bearable.<ref name="Chen2015">{{cite journal | vauthors = Chen L, Zhang G, Hu M, Liang X | title = Eye movement desensitization and reprocessing versus cognitive-behavioral therapy for adult posttraumatic stress disorder: systematic review and meta-analysis | journal = The Journal of Nervous and Mental Disease | volume = 203 | issue = 6 | pages = 443–451 | date = June 2015 | pmid = 25974059 | doi = 10.1097/NMD.0000000000000306 | s2cid = 34850645 }}</ref> This is seen by Robin Logie of the EMDR Association UK and Ireland as a "distancing effect". The client is then believed to re-evaluate the trauma and process it in a less-harmful environment.<ref name=Logie2014>{{cite journal | vauthors = Logie R |title=EMDR - more than just a therapy for PTSD? |journal=The Psychologist |date=July 2014 |volume=27 |issue=7 |pages=512–517 |url=https://thepsychologist.bps.org.uk/volume-27/edition-7/emdr-more-just-therapy-ptsd }}</ref> This explanation is plausible, given research showing that memories are more modifiable once recalled.<ref name=epid/>▼
* Horizontal eye movement is thought to trigger an "[[orienting response]]" in the brain, used in scanning the environment for threats and opportunities.<ref name="Jeffries & Davis 2012">{{cite journal | vauthors = Jeffries FW, Davis P | title = What is the role of eye movements in eye movement desensitization and reprocessing (EMDR) for post-traumatic stress disorder (PTSD)? a review | journal = Behavioural and Cognitive Psychotherapy | volume = 41 | issue = 3 | pages = 290–300 | date = May 2013 | pmid = 23102050 | doi = 10.1017/S1352465812000793 | s2cid = 33309479 }}</ref>▼
* The idea that eye movement prompts communication between the two sides of the brain. This idea is not grounded in accepted [[neuroscience]].<ref name=epid>{{cite book |veditors=Zeigler-Hill V, Shackelford TR |entry= Eye Movement Desensitization and Reprocessing (EMDR) |title= Encyclopedia of Personality and Individual Differences |year= 2020 |vauthors= Patihis L, Cruz CS, McNally R |publisher=Springer |doi=10.1007/978-3-319-24612-3_895 }}</ref>▼
===Bilateral stimulation, including eye movement===▼
Bilateral stimulation is a generalization of the left and right repetitive eye movement technique first used by Shapiro. Alternative stimuli include auditory stimuli that alternate between left and right speakers or headphones and physical stimuli such as tapping of the therapist's hands or tapping devices.<ref name="Rodenburg2009">{{cite journal | vauthors = Rodenburg R, Benjamin A, de Roos C, Meijer AM, Stams GJ | title = Efficacy of EMDR in children: a meta-analysis | journal = Clinical Psychology Review | volume = 29 | issue = 7 | pages = 599–606 | date = November 2009 | pmid = 19616353 | doi = 10.1016/j.cpr.2009.06.008 }}</ref>▼
Most meta-analyses have found that the inclusion of bilateral eye-movements within EMDR makes little or no difference to its effect.<ref name=ps-in>{{cite book |chapter=Chapter 4: Pseudoscience in Treating Adults Who Experienced Trauma |title=Science and Pseudoscience in Social Work Practice |vauthors=Thyer BA, Pignotti MG |year=2015 |publisher=Springer |pages=106, 146 |doi=10.1891/9780826177698.0004 |isbn=9780826177681}}</ref><ref>{{cite journal | vauthors = Cuijpers P, Veen SC, Sijbrandij M, Yoder W, Cristea IA | title = Eye movement desensitization and reprocessing for mental health problems: a systematic review and meta-analysis | journal = Cognitive Behaviour Therapy | volume = 49 | issue = 3 | pages = 165–180 | date = May 2020 | pmid = 32043428 | doi = 10.1080/16506073.2019.1703801 | s2cid = 202289231 | doi-access = free | hdl = 11577/3461344 | hdl-access = free }}</ref><ref name="RodenburgBenjaminde Roos2009">{{cite journal | vauthors = Rodenburg R, Benjamin A, de Roos C, Meijer AM, Stams GJ | title = Efficacy of EMDR in children: a meta-analysis | journal = Clinical Psychology Review | volume = 29 | issue = 7 | pages = 599–606 | date = November 2009 | pmid = 19616353 | doi = 10.1016/j.cpr.2009.06.008 | quote-page = {{page needed|date=May 2024}} | quote = "Results indicate efficacy of EMDR when effect sizes are based on comparisons between the EMDR and the non-established trauma treatment or the no-treatment control groups, and the incremental efficacy when effect sizes are based on comparisons between the EMDR and the established (CBT) trauma treatment." }}</ref> Meta-analyses have also described a high risk of [[allegiance bias]] in EMDR studies.<ref name="CuijpersVeenSijbrandij2020">{{cite journal | vauthors = Cuijpers P, Veen SC, Sijbrandij M, Yoder W, Cristea IA | title = Eye movement desensitization and reprocessing for mental health problems: a systematic review and meta-analysis | journal = Cognitive Behaviour Therapy | volume = 49 | issue = 3 | pages = 165–180 | date = May 2020 | pmid = 32043428 | doi = 10.1080/16506073.2019.1703801 | quote = "EMDR was found to be significantly more effective than other therapies in the treatment of PTSD. However, these results are not convincing for a number of reasons. First, there were few studies with low risk of bias. Furthermore, studies with low risk of bias did not point at a significant difference between EMDR and other therapies. The difference between studies with low risk of bias and those with at least some risk of bias was significant and we found considerable indications for researcher allegiance. Because studies with low risk of bias found no difference between EMDR and other therapies, we conclude that there is not enough evidence to decide about the comparative effects of EMDR." | quote-page = {{page needed|date=May 2024}} | s2cid = 202289231 | eissn = 1651-2316 | doi-access = free | hdl = 11577/3461344 | hdl-access = free }}</ref> One 2013 meta-analysis with fewer exclusion criteria found a moderate effect.<ref name=pmid23266601>{{cite journal | vauthors = Lee CW, Cuijpers P | title = A meta-analysis of the contribution of eye movements in processing emotional memories | journal = Journal of Behavior Therapy and Experimental Psychiatry | volume = 44 | issue = 2 | pages = 231–239 | date = June 2013 | pmid = 23266601 | doi = 10.1016/j.jbtep.2012.11.001 | url = http://researchrepository.murdoch.edu.au/id/eprint/13100/ }}</ref>▼
===Training===
Line 61 ⟶ 76:
=== Other conditions ===
EMDR has been tested on a variety of other mental health conditions with mixed results.<ref name = "Cuijpers 2020"/>
* A 2021 systematic review and meta-analysis found EMDR to have a moderate benefit in treating [[Depression (mood)|depression]], but the number and quality of the studies were low.<ref name="Carletto_2021">{{cite journal | vauthors = Carletto S, Malandrone F, Berchialla P, Oliva F, Colombi N, Hase M, Hofmann A, Ostacoli L | display-authors = 6 | title = Eye movement desensitization and reprocessing for depression: a systematic review and meta-analysis | journal = European Journal of Psychotraumatology | volume = 12 | issue = 1 | pages = 1894736 | date = April 2021 | pmid = 33889310 | pmc = 8043524 | doi = 10.1080/20008198.2021.1894736 }}</ref>
Line 67 ⟶ 81:
* EMDR has been found to cause strong effects on [[dissociative identity disorder]] patients, leading to recommendations for adjusted use.<ref>Recommended Guidelines: A General Guide to EMDR's Use in the Dissociative Disorders (authored by the EMDR Dissociative Disorders Task Force and published in Shapiro, 1995, 2001)</ref><ref>p. 159, Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision, International Society for the Study of Trauma and Dissociation. 3 Mar 2011</ref>
* A 2023 systematic review of evidence found EMDR's effectiveness in treating mental health conditions of children and adolescents who have been sexually abused is limited.<ref name="Caro-2023">{{cite journal | last1=Caro | first1=Paola | last2=Turner | first2=William | last3=Caldwell | first3=Deborah M | last4=Macdonald | first4=Geraldine | title=Comparative effectiveness of psychological interventions for treating the psychological consequences of sexual abuse in children and adolescents: a network meta-analysis | journal=Cochrane Database of Systematic Reviews | volume=2023 | issue=6 | date=2023-06-05 | pages=CD013361 | pmid=37279309 | pmc=10243720 | doi=10.1002/14651858.CD013361.pub2 }}</ref>
▲==Possible mechanisms==
▲===Incomplete processing of experiences in trauma===
▲Many proposals of EMDR efficacy share an assumption that, as Shapiro posited, when a traumatic or very negative event occurs, information processing of the experience in memory may be incomplete. The trauma causes a disruption of normal adaptive information processing, which results in unprocessed information being dysfunctionally held in memory networks.<ref>{{cite journal | vauthors = Solomon RM, Shapiro F | s2cid=7109228 |title=EMDR and the Adaptive Information Processing ModelPotential Mechanisms of Change |journal=Journal of EMDR Practice and Research |date=November 2008 |volume=2 |issue=4 |pages=315–325 |doi=10.1891/1933-3196.2.4.315 }}</ref> According to the 2013 World Health Organization practice guideline: "This therapy [EMDR] is based on the idea that negative thoughts, feelings and behaviours are the result of unprocessed memories."<ref name="WHO 2013" /> This proposed mechanism has no known scientific basis.<ref name=non/>
▲===Other mechanisms===
▲Several other possible mechanisms have been proposed:
▲* EMDR may impact working memory.<ref>{{cite journal | vauthors = van den Hout MA, Engelhard IM, Beetsma D, Slofstra C, Hornsveld H, Houtveen J, Leer A | title = EMDR and mindfulness. Eye movements and attentional breathing tax working memory and reduce vividness and emotionality of aversive ideation | journal = Journal of Behavior Therapy and Experimental Psychiatry | volume = 42 | issue = 4 | pages = 423–431 | date = December 2011 | pmid = 21570931 | doi = 10.1016/j.jbtep.2011.03.004 }}</ref> If a patient performs bilateral stimulation task while remembering the trauma, the amount of information they can recall is thought to be reduced, making the resulting [[negative emotion]]s less intense and more bearable.<ref name="Chen2015">{{cite journal | vauthors = Chen L, Zhang G, Hu M, Liang X | title = Eye movement desensitization and reprocessing versus cognitive-behavioral therapy for adult posttraumatic stress disorder: systematic review and meta-analysis | journal = The Journal of Nervous and Mental Disease | volume = 203 | issue = 6 | pages = 443–451 | date = June 2015 | pmid = 25974059 | doi = 10.1097/NMD.0000000000000306 | s2cid = 34850645 }}</ref> This is seen by Robin Logie of the EMDR Association UK and Ireland as a "distancing effect". The client is then believed to re-evaluate the trauma and process it in a less-harmful environment.<ref name=Logie2014>{{cite journal | vauthors = Logie R |title=EMDR - more than just a therapy for PTSD? |journal=The Psychologist |date=July 2014 |volume=27 |issue=7 |pages=512–517 |url=https://thepsychologist.bps.org.uk/volume-27/edition-7/emdr-more-just-therapy-ptsd }}</ref> This explanation is plausible, given research showing that memories are more modifiable once recalled.<ref name=epid/>
▲* Horizontal eye movement is thought to trigger an "[[orienting response]]" in the brain, used in scanning the environment for threats and opportunities.<ref name="Jeffries & Davis 2012">{{cite journal | vauthors = Jeffries FW, Davis P | title = What is the role of eye movements in eye movement desensitization and reprocessing (EMDR) for post-traumatic stress disorder (PTSD)? a review | journal = Behavioural and Cognitive Psychotherapy | volume = 41 | issue = 3 | pages = 290–300 | date = May 2013 | pmid = 23102050 | doi = 10.1017/S1352465812000793 | s2cid = 33309479 }}</ref>
▲* The idea that eye movement prompts communication between the two sides of the brain. This idea is not grounded in accepted [[neuroscience]].<ref name=epid>{{cite book |veditors=Zeigler-Hill V, Shackelford TR |entry= Eye Movement Desensitization and Reprocessing (EMDR) |title= Encyclopedia of Personality and Individual Differences |year= 2020 |vauthors= Patihis L, Cruz CS, McNally R |publisher=Springer |doi=10.1007/978-3-319-24612-3_895 }}</ref>
▲===Bilateral stimulation, including eye movement===
▲Bilateral stimulation is a generalization of the left and right repetitive eye movement technique first used by Shapiro. Alternative stimuli include auditory stimuli that alternate between left and right speakers or headphones and physical stimuli such as tapping of the therapist's hands or tapping devices.<ref name="Rodenburg2009">{{cite journal | vauthors = Rodenburg R, Benjamin A, de Roos C, Meijer AM, Stams GJ | title = Efficacy of EMDR in children: a meta-analysis | journal = Clinical Psychology Review | volume = 29 | issue = 7 | pages = 599–606 | date = November 2009 | pmid = 19616353 | doi = 10.1016/j.cpr.2009.06.008 }}</ref>
▲Most meta-analyses have found that the inclusion of bilateral eye-movements within EMDR makes little or no difference to its effect.<ref name=ps-in>{{cite book |chapter=Chapter 4: Pseudoscience in Treating Adults Who Experienced Trauma |title=Science and Pseudoscience in Social Work Practice |vauthors=Thyer BA, Pignotti MG |year=2015 |publisher=Springer |pages=106, 146 |doi=10.1891/9780826177698.0004 |isbn=9780826177681}}</ref><ref>{{cite journal | vauthors = Cuijpers P, Veen SC, Sijbrandij M, Yoder W, Cristea IA | title = Eye movement desensitization and reprocessing for mental health problems: a systematic review and meta-analysis | journal = Cognitive Behaviour Therapy | volume = 49 | issue = 3 | pages = 165–180 | date = May 2020 | pmid = 32043428 | doi = 10.1080/16506073.2019.1703801 | s2cid = 202289231 | doi-access = free | hdl = 11577/3461344 | hdl-access = free }}</ref><ref name="RodenburgBenjaminde Roos2009">{{cite journal | vauthors = Rodenburg R, Benjamin A, de Roos C, Meijer AM, Stams GJ | title = Efficacy of EMDR in children: a meta-analysis | journal = Clinical Psychology Review | volume = 29 | issue = 7 | pages = 599–606 | date = November 2009 | pmid = 19616353 | doi = 10.1016/j.cpr.2009.06.008 | quote-page = {{page needed|date=May 2024}} | quote = "Results indicate efficacy of EMDR when effect sizes are based on comparisons between the EMDR and the non-established trauma treatment or the no-treatment control groups, and the incremental efficacy when effect sizes are based on comparisons between the EMDR and the established (CBT) trauma treatment." }}</ref> Meta-analyses have also described a high risk of [[allegiance bias]] in EMDR studies.<ref name="CuijpersVeenSijbrandij2020">{{cite journal | vauthors = Cuijpers P, Veen SC, Sijbrandij M, Yoder W, Cristea IA | title = Eye movement desensitization and reprocessing for mental health problems: a systematic review and meta-analysis | journal = Cognitive Behaviour Therapy | volume = 49 | issue = 3 | pages = 165–180 | date = May 2020 | pmid = 32043428 | doi = 10.1080/16506073.2019.1703801 | quote = "EMDR was found to be significantly more effective than other therapies in the treatment of PTSD. However, these results are not convincing for a number of reasons. First, there were few studies with low risk of bias. Furthermore, studies with low risk of bias did not point at a significant difference between EMDR and other therapies. The difference between studies with low risk of bias and those with at least some risk of bias was significant and we found considerable indications for researcher allegiance. Because studies with low risk of bias found no difference between EMDR and other therapies, we conclude that there is not enough evidence to decide about the comparative effects of EMDR." | quote-page = {{page needed|date=May 2024}} | s2cid = 202289231 | eissn = 1651-2316 | doi-access = free | hdl = 11577/3461344 | hdl-access = free }}</ref> One 2013 meta-analysis with fewer exclusion criteria found a moderate effect.<ref name=pmid23266601>{{cite journal | vauthors = Lee CW, Cuijpers P | title = A meta-analysis of the contribution of eye movements in processing emotional memories | journal = Journal of Behavior Therapy and Experimental Psychiatry | volume = 44 | issue = 2 | pages = 231–239 | date = June 2013 | pmid = 23266601 | doi = 10.1016/j.jbtep.2012.11.001 | url = http://researchrepository.murdoch.edu.au/id/eprint/13100/ }}</ref>
== Society and culture ==
| |||