Integrating neurobiology of emotion regulation and trauma therapy: reflections on EMDR therapy

Abstract

<jats:title>Abstract</jats:title><jats:p>Emotion dysregulation is a frequent feature in trauma-related disorders. Different kinds of emotion dysregulation seem to be linked to particular psychiatric conditions, and there is growing evidence of the association between neurobiological correlates and those dysregulation patterns. Nevertheless, many of the recent findings from the field of the neurobiology have not been translated into clinical practice and are insufficiently contemplated in trauma-oriented therapies. The aim of this article is to review recent developments in the field of emotion regulation connecting these issue with the practical implementation of psychotherapeutic procedures. The evaluation of emotion dysregulation patterns can guide decision making during the therapy independently to the approach, but there are some findings that can be especially useful for some concrete modalities of therapy. In this article we will focus our discussion on how emotion dysregulation may influence eye movement desensitization and reprocessing (EMDR) treatment in trauma-related disorders. EMDR is a well-defined and protocol-based intervention, with a strong empirical support for post-traumatic stress disorder (PTSD). We describe how different patterns of emotion dysregulation may influence EMDR treatment and procedures, and also how the application of EMDR beyond non-dissociative PTSD should take into account the predominant emotion-regulation strategies in specific posttraumatic disorders.</jats:p>

Treating Cognitive Symptoms of Generalized Anxiety Disorder Using EMDR Therapy With Bilateral Alternating Tactile Stimulation

“…However, in most studies carried out Pdf_Folio:46 with solid methodology designs, therapists used eye movement; other methods were not used as much as eye movement. There is consensus among researchers about the need to conduct more studies which provide evidence regarding the impact of each type of eye movement (e.g., horizontal vs. vertical) and the effectiveness of both tactile and auditory stimulation (González et al, 2017;Harricharan et al, 2019 ). In this study, it was the author's decision to use only tactile stimulation in all cases in all sessions in order to gather evidence on its usefulness.…”

“…Sessions 1-3 provided EMDR phases 1 and 2; sessions 3-15 provided phases 3-8; and session 16 was closure. Following advice from other researchers and due to the need for EMDR research studies to evaluate forms of stimulation other than eye movement, it was the author's decision to use only tactile stimulation in this study (González et al, 2017;Harricharan et al, 2019, Van den Hout et al, 2011Van den Hout et al, 2012). Tactile stimulation was provided by the therapist tapping with two fingers, alternately on the participant's hands, which were on their knees, palms up.…”

Overlapping frontoparietal networks in response to oculomotion and traumatic autobiographical memory retrieval: implications for eye movement desensitization and reprocessing

“…horizontal versus vertical, smooth versus saccadic eye movements) in a larger sample. Notably, other types of bilateral stimulation, including tactile or auditory alternating bilateral stimulation, have been used in clinical practice with EMDR (González, Del Río-Casanova, & Justo-Alonso, 2017;Nieuwenhuis et al, 2013). Additional research is therefore necessary to determine whether alternative bilateral stimulation methods show similar or different patterns of neural activation and of connectivity.…”

Borderline Personality Disorder and Childhood Trauma: The Posited Mechanisms of Symptoms Expression

“…A wealth of research reveals that exposure to adversities, stressors and neglect can chronically and pervasively alter biological, cognitive, psychological, and social development, giving rise to disturbances in impulse and affect regulation, alterations in attention, consciousness, attribution and schema, as well as interpersonal difficulties [14][15][16]. On the neurobiological level, exposure to trauma triggers a surge of neurochemical factors, potent enough to interfere with integrative capacity and the ordinary process of neurodevelopment [17,18]. Therein appraisal of adverse events and associated emotions might give rise to the stress response, prompting a cascade of biological events that alter various essential processes, namely neurogenesis, synaptogenesis, migration and neurochemical differentiation.…”