A Model of Clinical Intervention in the Maternity Ward: The Breastfeeding and Bonding EMDR Protocol

Low-Intensity Interventions and EMDR Therapy

Unlike high-intensity treatment, in which clients have face-to-face contact with a mental health specialist, clients in low-intensity treatment have limited or no contact with a specialist. Instead, their treatment is usually provided through self-help procedures, which are delivered via (guided) computer programs, books, or “mHealth" apps. Other treatments sometimes considered low-intensity are brief treatments, group therapy, and interventions delivered by nonspecialists. Advantages include effectiveness, accessibility, efficiency, and affordability. Concerns related to safety, engagement, and adherence to self-help programs may be addressed by (asynchronous) therapist guidance. This article describes low-intensity treatments and their relevance for eye movement desensitization and reprocessing (EMDR) therapy. Hundreds of randomized controlled trials (RCTs) have found self-help interventions to be efficacious, with many producing the same level of results as the traditional face-to-face procedure. Guided self-help cognitive behavioral therapy is recommended for the treatment of posttraumatic stress disorder in the guidelines of both the National Institute for Health and Care Excellence and International Society of Traumatic Stress Studies. Only three self-help-EMDR RCTs have been conducted. This author advocates for reconceptualizing EMDR group therapy as “guided self-help-EMDR therapy,” because it is a highly manualized, heavily scripted treatment in which the client works independently on their own material. In this respect, it offers an excellent template for the future development of efficacious low-intensity EMDR interventions. Developing safe, easy-to-use, affordable, and readily available low-intensity interventions will make effective EMDR treatment available to many millions of people around the world.

Prenatal and Perinatal EMDR Therapy: Early Family Intervention

This article discusses the integration of eye movement desensitization and reprocessing (EMDR) therapy with a family therapy treatment, which was designed for treating mothers and their babies from conception through the first year of life. The Calming Womb Family Therapy Model (CWFTM) is a multidisciplinary, Integrative, early intervention approach. Its foundations originate from Murray Bowen's family model of understanding the individual in the context of their families as emotional interactive systems; Selma Fraiberg's psychodynamic work and psychoeducational interventions with mothers and infants to resolve maternal trauma and transference reactions to their babies followed by educational guidance in infant development through the first year of their lives; and EMDR therapy. EMDR therapy can improve internal resources for expectant mothers; monitor their levels of psychological distress; and enable them to access and process traumatic memories, other adverse life experiences, recent stressors, and pre-perinatal concerns and bring them to adaptive resolution. EMDR therapy can also help pregnant mothers develop imaginal templates of future events that incorporate in utero developmental prenatal education and deepen their bonds with their babies. The pre-perinatal psychotherapist's knowledge of infant development and capacity for interpersonal warmth, affect tolerance, somatic resourcing, reflective stance, and relational attunement can provide a fertile ground for the expectant mother and womb baby relationship and enriching life together. The ultimate goal is to conceive and rear healthy children.

Intervening in the Intergenerational Transmission of Trauma by Targeting Maternal Emotional Dysregulation With EMDR Therapy

Many studies have shown that the relationship between child and caregivers is critical for healthy development of the child’s brain function, and for intergenerational transmission of attachment. Here, we propose a useful eye movement desensitization and reprocessing (EMDR) target for treatment of maternal emotional dysregulation that can cause maltreatment of the child, with the goal of interrupting intergenerational transmission of attachment trauma. First, we use schematics to demonstrate a hypothetical model of the interaction between a child’s attachment behavior and a mother’s bonding behavior. This schematic shows that the child’s physiologic reaction activates or triggers the mother’s negative affect and somatic sensations in her limbic system and brain stem and that, in turn, evokes the mother’s maltreatment behavior. The negative affect and somatic sensation (maternal emotional dysregulation) are Dysfunctionally Stored Information (DSI) that was produced in the mother’s past experience. We propose that the mother’s negative affect and somatic sensations activated by the child’s behaviors can be useful targets for EMDR therapy based on this hypothetical model. Two Japanese case reports (mothers with 4-year-old daughters) are described to illustrate this application. Further discussion highlights the feature of Japanese cultural relationship and the dissociation, and the meaning and scope of targeting maternal emotional dysregulation with EMDR therapy.