The Role of the Traumatic Component in the Etiology of Sexual Dysfunctions and Its Treatment with Eye Movement Desensitization Procedure

EMDR Treatment of Childhood Sexual Abuse for a Child Molester: Self-Reported Changes in Sexual Arousal

Expanding on previous findings that eye movement desensitization and reprocessing (EMDR) therapy may alter deviant sexual arousal in adult child molesters with a history of childhood sexual abuse (CSA), this article describes the changes reported following the application of EMDR therapy to the memories of CSA in an adult male who had sexually offended against prepubescent children. The client had previously completed a cognitive behavioral intervention to address his offending behavior. EMDR therapy took place over 11 months and consisted of 32 sessions, including preparation and review phases. The aim of the therapy was to alleviate current reported distress and symptoms of posttraumatic stress disorder (PTSD) related to his memories of CSA. The client reported positive changes in emotional, cognitive, and physiological functioning, consistent with reductions on a range of subscales of the Trauma Symptom Inventory 2 and the Inventory of Altered Self-Capacities. However, on completion of therapy, he also reported a reduction in the frequency and strength of sexual arousal to children, which was maintained at a 3-year follow-up, although this was not a target for treatment. The experiences described during the EMDR process by this client are discussed and related to the adaptive information processing (AIP) model and previous findings on reported changes in sexual arousal in this client group.

The cognitive dismantling of Eye Movement Desensitization and Reprocessing (EMDR) treatment of Posttraumatic Stress Disorder (PTSD)

Twenty-seven subjects were exposed to standard Eye Movement Desensitization and Reprocessing (EMDR) treatment or a similar treatment without the explicit cognitive elements found in EMDR. Standardized psychometric assessments were administered (Structured Interview for Post Traumatic Stress Disorder, Impact of Event Scale, Revised Symptom Checklist-90) by independent assessors at pretest, posttest and two separate follow-up periods. Potential subjects met specific inclusion/exclusion criteria. Subjective measures including Subjective Units of Disturbance and Validity of Cognition assessments were also conducted. A two-factor repeated measures analysis of variance revealed that both treatments produced significant symptom reductions and were comparable on all dependent measures across assessment phases. The present findings are discussed in light of previous dismantling research that converges to suggest that several elements in the EMDR protocol may be superfluous in terms of the contribution to treatment outcome. These same elements have nevertheless entered unparsimoniously into consideration as possible explanatory variables.

Brief psychological intervention with traumatized young women: the efficacy of eye movement desensitization and reprocessing

To study the efficacy of eye movement desensitization and reprocessing (EMDR) with traumatized young women, 60 women between the ages of 16 and 25 were randomly assigned to two sessions of either EMDR or an active listening (AL) control. Factorial ANOVA interaction effects and simple main effects for outcome measure (Beck Depression Inventory, State-Trait Anxiety Inventory, Penn Inventory for Posttraumatic Stress Disorder, Impact of Event Scale, Tennessee Self-Concept Scale) indicated significant improvement for both groups and significantly greater pre-post change for EMDR-treated participants. Pre-post effect sizes for the EMDR group averaged 1.56 compared to 0.65 for the AL group. Despite treatment brevity, the posttreatment outcome variable means of EMDR-treated participants compared favorably with nonpatient or successfully treated norm groups on all measures.

The empirical status of the clinical application of eye movement desensitization and reprocessing

The published reports of the clinical application of eye movement desensitization and reprocessing (EMDR) are reviewed in terms of empirical validity. Case studies, single-subject experiments and group design experiments on clinical problems are evaluated for the effectiveness of the protocol, component effects, comparative effects and treatment fidelity. Classification of disorders and measurement issues are addressed. The protocol frequently reduces verbal report and independent observer ratings of distress--strikingly in some instances. Psychophysiologic measures show little effect of treatment. There is little empirical evidence to indicate the effect of treatment on motoric or behavioral indices. Eye movements do not appear to be an essential component of treatment, and there have been no substantial comparisons with other treatments. No studies have adequately controlled for nonspecific (placebo) effects of treatment. Suggestions are made for applying improved methodological controls for future applications of EMDR to clinical disorders.

Eye movement desensitization of public-speaking anxiety: a partial dismantling

Forty college students suffering from public speaking anxiety and having experienced a specific traumatic speech-related event were exposed to either a standard EMD protocol with eye movements; a moving audio stimulus in place of the eye movements; a protocol with eyes resting on the hands in place of the eye movement, or a no-treatment control condition. The results revealed that EMD is comparable in limited effectiveness to the other procedures and that the eye movements are not a crucial component of the treatment with this population.

Eye movement desensitization of medical phobias: two case studies

We treated two medical phobic subjects with eye movement desensitization (EMD). Using detailed images of fear-related events, the treatment design conformed to an additive, within-series phase change to examine enduring effects. Results indicated that both subjects' verbal reports of fear decreased substantially using the EMD procedure. There were no consistent changes in heart rate. Similarly, self-reported fear toward a simulated blood draw decreased, but heart rate and blood pressure did not. Data for a number of standardized measures of medical fear indicated posttreatment reduction for both subjects. Anecdotal reports of medical procedures revealed limited generalization of treatment effects.

Eye movement desensitization and reprocessing: treating trauma and substance abuse

Eye Movement Desensitization and Reprocessing (EMDR) is a new psychological methodology that has been applied to a wide range of psychological disorders. Clinical reports over the past three years indicate that it is an important addition to the treatment of substance abuse. EMDR offers a structured, client-centered model that integrates key elements of intrapsychic, behavioral, cognitive, body-oriented, and interactional approaches. Treatment effects are quite rapid and, during an individual session, the therapist may witness accelerated processing of information involving a shift of cognitive structures (including the assimilation of positive beliefs) along with the desensitization of attendent traumata. The application of EMDR apparently stimulates an inherent physiological processing system that allows dysfunctional information to be adaptively resolved, resulting in increased insight and more functional behavior. The judicious use of EMDR includes a comprehensive client history and extensive preparation, allowing the client to deal with the high levels of disturbance often engendered by the treatment itself. After the inauguration of a sufficient therapeutic alliance, adequately addressing potential issues of secondary gain, and appropriate client stabilization, EMDR may be used to ameliorate the effects of earlier memories that contribute to the dysfunction, potential relapse triggers, and physical cravings. In addition, EMDR is used to incorporate new coping skills and assist in learning more adaptive behaviors. Other potential targets for reprocessing include treatment noncompliance, ambivalence about abstinence, and present crises. Finally, EMDR should be used on this clinical population only by a trained clinician who is educated and experienced with this problem area.