Reversing Reciprocal Suppression in the Anterior Cingulate Cortex: A Hypothetical Model to Explain EMDR Effectiveness

Abstract

A theoretical model is proposed to explain desensitization during Eye Movement Desensitization and Reprocessing (EMDR) as resulting from the reversal of reciprocal suppression of cognitive processing in the anterior cingulate cortex (ACC). Dual-attention and error monitoring are known to activate dorsal regions of the ACC that mediate metacognitive processing. Neuroimaging research has produced evidence that cognitive areas in the upper ACC may reciprocally suppress affective processing in the lower areas and vice versa. It is therefore proposed that the original eye-to-fi nger tracking task of EMDR may achieve its therapeutic effect by using error monitoring to reverse suppression of the upper ACC by the lower ACC. Contributions to EMDR effectiveness from resource installation and novelty-driven orienting refl exes may also infl uence ACC functioning. A distraction effect is proposed to be a negative and potentially disruptive by-product of very interactive stimulation tasks. A semantic priming procedure is suggested to limit distraction effects during more interactive forms of stimulation.

EMDR’s Neurobiological Mechanisms of Action: A Survey of 20 Years of Searching

“…Although agreeing with MacCulloch and Feldman's (1996) investigatory orienting refl ex, Kaye proposed that, rather than attributing the OR to eye movements themselves, the OR should be conceptualized as novelty driven (Kaye, 2007). Therefore, in the second stage of his model, novelty-evoked ORs are resultant from the patients' own newly emerging contextual information, driven by resourcing techniques and/or the use of interweaves.…”

“…In a similar vein, Kaye (2007) pointed out that the action of eye movements in EMDR is distinctly different from auditory and tactile bilateral stimulation. He noted that the EMDR eye movement procedure is a visual tracking task that demands eff ortful divided attention, requiring the patient to synchronize his or her gaze on a moving target while concurrently noticing the target memory or its components.…”

Neurobiology and Stochastic Resonance: Going Deeper

“…In other words, by focusing on two targets and seeking errors, we stimulate the cognitive area of the ACC, which, it is proposed, then facilitates clients' capacity to think about how they are thinking; we refer to this as metacognition. Neurobiological interest in these brain regions is consistent with later work (Kaye, 2007) suggesting that EMs utilize error monitoring to reverse the suppression of the dorsal (cognitive) subdivision of the ACC by lowering activity of the ventral (affective) subdivision. In other words, we are proposing that DAS/BLS switches off the emotional area of the ACC, which then switches on the thinking area of the ACC.…”

Neurobiology of Eye Movement Desensitization and Reprocessing

“…In general, OR is assumed to enable new information to be noticed and integrated into consciousness, which may cause specific changes in neuronal activity and plasticity (Kaye, 2007). In this context, several interrelationships can be observed in OR and in EMDR (Hekmat et al, 1994;Armstrong & Vaughan, 1996;Kaye, 2007).…”

“…In general, OR is assumed to enable new information to be noticed and integrated into consciousness, which may cause specific changes in neuronal activity and plasticity (Kaye, 2007). In this context, several interrelationships can be observed in OR and in EMDR (Hekmat et al, 1994;Armstrong & Vaughan, 1996;Kaye, 2007). For example, during OR and EMDR perception of painful stimuli is decreased, which is frequently linked to parasympathetic dearousal effect (Hekmat et al, 1994;Armstrong & Vaughan, 1996).…”