E ye movement desensitization and reprocessing (EMDR) is a therapeutic approach that emphasizes the brain's intrinsic information processing system and how memories are stored. Current symptoms are viewed as resulting from disturbing experiences that have not been adequately processed and have been encoded in state-specifi c, dysfunctional form (Shapiro, 1995(Shapiro, , 2001(Shapiro, , 2007a. The heart of EMDR involves the transmutation of these dysfunctionally stored experiences into an adaptive resolution that promotes psychological health. For EMDR to be applied effectively, the clinician needs a framework that identifi es appropriate target memories and order of processing to obtain optimal treatment effects. The adaptive information processing (AIP) model, which informs EMDR treatment, contains a variety of tenets and predictions that implicate various potential agents of change. A comprehensive examination of all the AIP principles is beyond the scope of this article (see Shapiro 2001Shapiro , 2006. However, because EMDR is a complex approach with many elements, the purpose of this article is to highlight a range of possible agents of change in addition to the eye movement and other bilateral stimulation that have garnered the most attention.The article begins with a brief overview of the AIP model and the proposed basis of clinical pathology. The observed transmutation of processed memories is discussed, along with conjectures regarding recent research on the reconsolidation of memory, which is a neurobiological process hypothesized to underlie EMDR's effects. As reconsolidation is believed to be different from extinction in terms of the neurobiological processes involved, the similarities and differences between the AIP model and those offered for extinction-based exposure therapies are explored along with implications for clinical practice. Research investigations are proposed to test both the tenets and potential mechanisms of actions. Then the potential mechanisms of action attendant to the EMDR procedures, including the bilateral stimulation, are considered. It should be noted that, although theories abound, the precise mechanisms of change are unknown in any form of therapy, and randomized Eye movement desensitization and reprocessing (EMDR) is a therapeutic approach guided by the adaptive information processing (AIP) model. This article provides a brief overview of some of the major precepts of AIP. The basis of clinical pathology is hypothesized to be dysfunctionally stored memories, with therapeutic change resulting from the processing of these memories within larger adaptive networks. Unlike extinction-based exposure therapies, memories targeted in EMDR are posited to transmute during processing and are then again stored by a process of reconsolidation. Therefore, a comparison and contrast to extinction-based information processing models and treatment is provided, including implications for clinical practice. Throughout the article a variety of mechanisms of action are discussed, including those...

This pilot study examined the efficacy of eye movement desensitization and reprocessing (EMDR) treatment compared with cognitive behavioral therapy (CBT) in treating posttraumatic stress disorder (PTSD) in oncology patients in the follow-up phase of the disease. The secondary aim of this study was to assess whether EMDR treatment has a different impact on PTSD in the active treatment or during the followup stages of disease. Twenty-one patients in follow-up care were randomly assigned to EMDR or CBT groups, and 10 patients in the active treatment phase were assigned to EMDR group. The Impact of Event Scale-Revised (IES-R) and Clinician-Administered PTSD Scale (CAPS) were used to assess PTSD at pretreatment and 1 month posttreatment. Anxiety, depression, and psychophysiological symptoms were also evaluated. For cancer patients in the follow-up stage, the absence of PTSD after the treatment was associated with a significantly higher likelihood of receiving EMDR rather than CBT. EMDR was significantly more effective than CBT in reducing scores on the IES-R and the CAPS intrusive symptom subscale, whereas anxiety and depression improved equally in both treatment groups. Furthermore, EMDR showed the same efficacy both in the active cancer treatment and during the follow-up of the disease.

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This pilot study evaluated the effectiveness of eye movement desensitization and reprocessing (EMDR) in treating posttraumatic stress disorder (PTSD) symptoms and concomitant depressive and anxiety symptoms in survivors of life-threatening cardiac events. Forty-two patients undergoing cardiac rehabilitation who (a) qualified for the PTSD criterion "A" in relation to a cardiac event and (b) presented clinically significant PTSD symptoms were randomized to a 4-week treatment of EMDR or imaginal exposure (IE). Data were gathered on PTSD, anxiety, and depressive symptoms at pretreatment, posttreatment, and 6-month follow-up. EMDR was effective in reducing PTSD, depressive, and anxiety symptoms and performed significantly better than IE for all variables. These findings provide preliminary support for EMDR as an effective treatment for the symptoms of PTSD, depression, and anxiety that can follow a life-threatening cardiac event.

EMDR can be utilized within a comprehensive framework for the treatment of grief and mourning. EMDR can process the obstacles that can complicate the grief and mourning processes. This seems to facilitate the emergence of positive memories of the deceased, which aids the formation of an adaptive inner representation. The utilization of EMDR within six processes necessary for adaptive assimilation of the loss is described with case examples.