Desensitization of eye movement and reprocessing ( EMDR ) is a form of psychotherapy developed by Francine Shapiro using eye movements or other forms of bilateral stimulation to assist trauma victims in processing sad memories and confidence. Usually used for the treatment of post-traumatic stress disorder (PTSD). The theory behind treatment assumes that when a traumatic or distressing experience occurs, it may overload normal coping mechanisms, with associated memory and stimuli not being adequately processed and stored in isolated memory networks.
Therapy includes having patients recall a sad picture when receiving one of several types of bilateral sensory input, such as side-to-side eye movement or hand-tapping. EMDR is most commonly used to treat adults with PTSD, but EMDR is also used to treat trauma and PTSD in children and adolescents.
This is recommended in some treatment guidelines for PTSD; however, this is controversial and its efficacy is debatable because of concerns about the quality of evidence, contradictory findings, significant bias levels of researchers, and dropout rates in the study.
Video Eye movement desensitization and reprocessing
Medical use
Therapy includes having patients recall a sad picture when receiving one of several types of bilateral sensory input, such as side-to-side eye movement or hand-tapping. According to the guidelines of the World Health Organization 2013: "This therapy [EMDR] is based on the idea that negative thoughts, feelings and behaviors are the result of unprocessed memories Treatment involves standard procedures that include simultaneous focus on (a) spontaneous associations. , thoughts, emotions and body sensations and (b) the most frequent bilateral stimulation in the form of repetitive eye movements.As cognitive behavioral therapy (CBT) with trauma focus, EMDR aims to reduce subjective pressure and strengthen adaptive beliefs associated with traumatic events. such as CBT with a traumatic focus, EMDR does not involve (a) detailed descriptions of events, (b) direct challenges to beliefs, (c) extended exposure, or (d) homework ".
Two meta-analyzes from 2013 found that EMDR therapy was better than no treatment and similar in efficacy for CBT in chronic PTSD. However, because the quality of the evidence is "very low", the bias level of the researcher is significant, and some participants drop out, meta-analysts warn against the interpretation of the results of the analyzed study.
In one PTSD meta-analysis, EMDR was reported to be as effective as exposure therapy and SSRIs. Two separate meta-analyzes suggested that traditional exposure therapy and EMDR had an equivalent effect immediately after treatment and on follow-up. A review of the results of rape treatment concluded that EMDR has some efficacy. Other meta-analyzes concluded that all "bona fide" treatments were equally effective, but there was some debate over the choice of research on which treatments were "bona fide". Another review concluded that EMDR has similar efficacy to other exposure therapy and is more effective than SSRIs, problem-centered therapy, or 'usual treatment'.
A meta-analysis of 2013 concluded, 'eye movement does have additional value in EMDR care'. However, the authors of this analysis discuss some limitations with this study by stating, "This study has some limitations, the most important being that the quality of the research included is not optimal.It may have altered the results of our research and meta-analysis. adequate on the quality of treatment, there are other serious methodological problems with studies in the context of therapy ".
Although an initial meta-analysis conducted in 2002 concluded that EMDR was ineffective, or durable, as traditional exposure therapy, other researchers using meta-analysis have found EMDR to be at least equivalent in size to its effect on specific exposure therapy.
Position statement
International Trauma Stress Studies Practice Guidelines 2009 classifies EMDR as evidence-based treatment A for PTSD in adults. Other guidelines recommending EMDR therapy - as well as CBT and exposure therapy - to treat trauma have included NICE starting in 2005, Australia's Post-Traumatic Mental Health Center in 2007, Guidelines of the National Steering Committee of the Netherlands Mental Health and Maintenance in 2003, the American Psychiatric Association n 2004, the Department of Veterans and Defense Affairs in 2010, SAMHSA in 2011, the International Society for Traumatic Stress Studies in 2009, and the World Health Organization in 2013.
Since 1999, EMDR has become a controversial approach within the psychological community, and the 2000 review states that eye movement does not play a central role, that the mechanism of eye movement is speculative, and that the theory leading to practice is not falsified and therefore can not accept scientific questions. This goes on to refer to EMDR as "pseudoscience", citing non-falsifiability as one of the few advantages of pseudoscience encountered by EMDR. As discussed in 2013 by Richard McNally, one of the earliest and most important critics: "Shapiro (1995) The Desensitization and Reprocessing (EMDR) Movement provoked a lively debate when it first appeared on the scene in the late 1980s. Skeptics question whether decisive materials, bilateral eye movements, have any therapeutic efficacy beyond the EMDR imaginal exposure component.A meta-analysis 2001 shows that EMDR with eye movement is no more efficacious than EMDR without eye movement (Davidson & Parker ), 2001), implying that " what is effective in EMDR is not new, and what's new is not effective " (McNally, 1999, p.619).
Other apps
Although controlled studies have concentrated on the application of EMDR to PTSD, a number of studies have investigated the efficacy of EMDR therapy with other disorders, such as threshold personality disorder, and somatic disorders such as ghost pain.
Children
EMDR has been used effectively in the care of traumatized and traumatized children. EMDR is often cited as a component in the treatment of complex post-traumatic stress disorder. A recent meta-analysis of randomized controlled trials in children and adolescents with PTSD using MetaNSUE to avoid biases associated with missing information found that EMDR was at least as beneficial as cognitive behavioral therapy (CBT), and superior to waiting lists or placebo.
Maps Eye movement desensitization and reprocessing
Mechanism
The proposed mechanism underlying eye movement in EMDR therapy is still under investigation and no definitive findings have been found. The consensus on the underlying biological mechanism involves two who have received the most research attention and support: (1) the memory work tax and (2) orientation/sleep orientation of REM.
Salkovskis in 2002 reported that eye movement is irrelevant, and that the effectiveness of EMDR is solely due to having properties similar to CBT, such as desensitization and exposure.
History
EMDR therapy was first developed by Francine Shapiro after realizing that certain eye movements reduce the intensity of distracting thoughts. He then conducted scientific research with trauma victims in 1988 and the research was published in the Journal of Stress Trauma in 1989.
Shapiro notes that, when he experiences disturbing thoughts, his eyes unknowingly move quickly. He notes further that, when he brings his eye movements under voluntary control while thinking of a traumatic mind, anxiety diminishes. Shapiro developed EMDR therapy for post-traumatic stress disorder. He speculates that traumatic events "disrupt the balance of excitability/inhibition in the brain, causing pathological changes in nerve elements".
Society and culture
Shapiro was criticized for repeatedly increasing the length and cost of training and certification, allegedly in response to controlled pilot results that cast doubt on EMDR's prosperity. This includes requiring the completion of an EMDR training program to be eligible to properly manage EMDR, after researchers using the initial written instruction found no difference between the non-eye-motion control group and the EMDR-designed experimental group. Further changes in training requirements and/or EMDR definitions include requiring level II training when researchers with first-degree training still find no difference between the experimental group of eye movements and the control of eyeless movements and considers "alternative forms of bilateral stimulation" (such as finger -tapping) as an EMDR variant at a time when a study found no difference between EMDR and finger tapping control groups. Changes in definitions and training for EMDR have been described as "ad hoc measures [created] when confronted with embarrassing data"
References
Source of the article : Wikipedia
0 Comments