How Does Eye Movement Desensitization and Reprocessing Therapy Work? A Systematic Review on Suggested Mechanisms of Action
Open accessAbstract
Background: Eye movement desensitization and reprocessing [EMDR] is an innovative, evidence-based and effective psychotherapy for post-traumatic stress disorder [PTSD]. As with other psychotherapies, the effectiveness of EMDR contrasts with a limited knowledge of its underlying mechanism of action. In its relatively short life as a therapeutic option, EMDR has not been without controversy, in particular regarding the role of the bilateral stimulation as an active component of the therapy. The high prevalence of EMDR in clinical practice and the dramatic increase in EMDR research in recent years, with more than 26 randomized controlled trials published to date, highlight the need for a better understanding of its mechanism of action. Methods: We conducted a thorough systematic search of studies published until October 2017, using PubMed, ScienceDirect, Web of Knowledge and Scopus databases that examined the mechanism of action of EMDR or provided conclusions within the framework of current theoretical models of EMDR functioning. Results: Seventy-five studies were selected for review and classified into three overarching models; (i) psychological models (ii) psychophysiological models and (iii) neurobiological models. The evidence available from each study was analysed and discussed. Results demonstrated a reasonable empirical support for the working memory hypothesis and for the physiological changes associated with successful EMDR therapy. Recently, more sophisticated structural and functional neuroimaging studies using high resolution structural and temporal techniques are starting to provide preliminary evidence into the neuronal correlates before, during and after EMDR therapy. Discussion: Despite the increasing number of studies that published in recent years, the research into the mechanisms underlying EDMR therapy are still in its infancy. Studies in well-defined clinical and non-clinical populations, larger sample sizes and tighter methodological control are further needed in order to establish firm conclusions.
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The intervention is strongly grounded in theory as well as experimental research.
“our intervention is strongly grounded in theory as well as experimental research [42–44].”
From Eye movement desensitization and reprocessing (EMDR) therapy or supportive counseling prior to exposure therapy in patients with panic disorder: study protocol for a multicenter randomized controlled trial (IMPROVE) (2023) · cites this paper as [43]
The Results review theoretical models and empirical studies of EMDR, and the Conclusions report direct experimental support for some proposed mechanisms. But the Conclusions also describe important limitations and incomplete explanations. The paper does not establish that the citing authors’ particular intervention is *strongly* grounded in both theory and experimental research. (LLM, conf=0.84)
Experimental — accuracy not yet measuredA large body of experimental research suggests that the emotional intensity and vividness of aversive memories can be reduced when the person performs a distracting task that taxes working memory while recalling the aversive memory.
“A large body of experimental research suggests that the emotional intensity and vividness of aversive memories can be reduced when the person performs a distracting task that taxes working memory while recalling the aversive memory [42–44].”
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- Authors
- Landin-Romero, R., Moreno-Alcazar, A., Pagani, M., & Amann, B. L.
- Affiliations
- Institute of Cognitive Sciences and Technologies (IT)
- Universitat Autònoma de Barcelona (ES)
- Venue
- Frontiers in Psychology
- Publisher
- Frontiers Media SA
- Published
- 2018-08-13
- Volume
- 9
- Pages
- 1395-1395
- ISSN
- 1664-1078 (ISSN-L)
- PMC
- PMC6106867
- OpenAlex
- W2885644971
- Cited by
- 188
- References
- 161
- Citations by year
- 2026: 26 · 2025: 23 · 2024: 31 · 2023: 32 · 2022: 25 · 2021: 27 · 2020: 16 · 2019: 8
- FWCI
- 2.15
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Frontiers in Psychology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Dipòsit Digital de Documents de la UAB (Universitat Autònoma de Barcelona) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Repositori digital de la UPF (Universitat Pompeu Fabra) (submittedVersion, cc-by)
- Funders
- National Alliance for Research on Schizophrenia and Depression
- Centre of Excellence in Cognition and its Disorders, Australian Research Council (CE110001021)
- Centro de Investigación Biomédica en Red de Salud Mental
- Instituto de Salud Carlos III (2008-2011, PI15/02242)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- EMDR, post-traumatic stress disorder, bilateral stimulation, psychophysiological model, neurobiological model, psychological model, trauma treatment
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