Eye Movement Desensitization and Reprocessing - Evidence-Based Treatment for PTSD
For over 30 years, eye movement desensitization and reprocessing (EMDR) therapy has repeatedly been shown to be an effective treatment for post traumatic stress disorder (PTSD).
In EMDR therapy, “the client attends to emotionally disturbing material in brief sequential doses while simultaneously focusing on an external stimulus” (emdr.com). A common way of performing EMDR is for the therapist to move their finger back and forth in front of the client’s face while the client focuses their eye on the moving target. This technique increases information processing while the client accesses distressing memories, allowing new associations to be made. By way of eye movement, the “vividness and emotionality of negative autobiographic memories” is reduced (Susanty et al, 2021).
Other therapeutic approaches have been developed over the years for the treatment of PTSD. One such treatment is cognitive behavioral therapy (CBT) which has also been shown in numerous trials to be effective in the treatment of PTSD (Moghadam et al, 2020). So which is better for the treatment of PTSD?
A recent experimental study documented in the article “Comparing the Effectiveness of Eye Movement Desensitization Reprocessing and Cognitive Behavioral Therapy in Reducing Post Traumatic Stress Disorder” by Sahar Moghadam, Reza Kazemi, Somayyeh Taklavi, and Mahdi Naeim compared the effectiveness of these two therapeutic approaches.
The authors of the study stated that the experiment was designed to “compare the effectiveness of cognitive behavioral therapy and eye movement desensitization reprocessing in reducing symptoms of post-traumatic stress disorder” (Moghadam et al, 2020). While the researchers did not state a specific expected outcome by way of hypothesis at the outset of the study, their aim was to contribute to the research of the effectiveness of both CBT and EMDR.
An Experiment to Compare EMDR and CBT
The research team used an experimental method and design composed of a pre-test-post-test of both experimental and control groups. The study participants included 45 patients who had been diagnosed with PTSD and were recommended to a local hospital in Ardabil, Iran. The patients were randomly assigned to two experimental groups (one for EMDR and one for CBT) and a control group, each with 15 participants each.
The participants were given a pretest based on the Posttraumatic Stress Disorder Checklist (PCL), a psychometric measure used for self-report of PTSD symptoms. The CBT experimental group received 8 sessions of therapy. The EMDR group received 4 sessions of post-processing eye-tracking repetition. A control group received neither intervention. At the conclusion of the therapeutic course, the participants were tested again using the PCL and the data was processed with analytic software.
So Which is Better?
The authors of the study summarize their findings this way: “According to the findings, both EMDR and CBT training methods are effective in reducing post-traumatic stress disorder symptoms and the effectiveness of the EMDR method is greater than that of the CBT method” (Maghadam et al, 2020). They theorize that the reason for EMDR’s increased effectiveness is due to “the activation of the nervous system and memory and emotional networks – which occur thought the stimulation of the eye” (Moghadam et al, 2020). Thus, they conclude that EMDR enhances talk psychotherapy by “facilitating the therapeutic effects of the brain’s self-healing mechanism” (Maghadam et al, 2020). The researchers also highlight how quickly therapeutic healing occurs in EMDR therapy compared to other forms of therapy.
The study reviewed above was fairly simple in design and straightforward in outcome. In sum, both CBT and EMDR are effective to treat PTSD. However, EMDR appears to be more effective; resulting in improved outcomes over a fewer number of sessions. This has implications in the therapy room. Although the more historically established CBT may be a “go-to” for therapists and a comfortable choice for clients, selecting this therapeutic treatment alone may lengthen the course of therapy and cause the client to miss out on “the brain’s self-healing mechanism” (Maghadam et al, 2020).
When first learning of or seeing a demonstration of EMDR, it may be off-putting to clients who are weary of psychotherapy as a discipline and cautious to avoid fringe practices in psychology that are not evidence-based. To overcome this prejudice, it may be necessary to explain more thoroughly the biological mechanisms underpinning EMDR’s effectiveness.
Susanty et al, suggest that the dual-attention stimuli of EMDR “elicit an orienting response with associated physiological de-arousal that enhances trauma material processing” (Susanty et al, 2021), a statement that has been tested in clinical trials. Clients could be shown brief videos and diagrams explaining the neurological areas impacted by EMDR and how this facilitates a decreased physiological response. This approach could make EMDR more assessable to many more who suffer from the debilitating symptoms of PTSD.
References:
EMDR Institute Inc. (2020) What is EMDR? Retrieved from: https://www.emdr.com/what-is-emdr/
Moghadam, S. A., Kazemi, R., & Taklavi, S. (2020). Comparing the effectiveness of eye movement desensitization reprocessing and cognitive behavioral therapy in reducing post‑traumatic stress disorder. Health Psychology Report, 8(1), 31–37. https://doi-org.ezproxy.umgc.edu/10.5114/hpr.2019.92305
Susanty, E., Sijbrandij, M., Srisayekti, W., & Huizink, A. C. (2021). Eye Movement Desensitization (EMD) to reduce posttraumatic stress disorder-related stress reactivity in Indonesia PTSD patients: a study protocol for a randomized controlled trial. Trials, 22(1), 181. https://doi-org.ezproxy.umgc.edu/10.1186/s13063-021-05100-3
