EMDR in Anorexia Nervosa: From a Theoretical Framework to the Treatment Guidelines

Abstract

Studies on the risks and on the positive factors implied in the onset of anorexia nervosa ("N) have reported the role of an insecure or disorganized state of mind (SoM) with respect to atachment. We compare the efects of eyes movement desensitization and reprocessing (EMDR) approach with cognitive behavioral therapy (C"T) in the treatment of "N in terms of SoMs, relective function (RF), and narrative coherence (Coh). Our results are part of a broader observational clinical comparative study of the two approaches, and it is based on the "dult "tachment Interview (""I) outcomes. Diferences in terms of belongingness to a secure group and an unsecure group before and after the treatments in EMDR and C"T group have been reported through McNemar's test. The generalized linear model (GLM) repeated-measures multivariate "NOV" (RM-M"NOV") has been selected. Our results suggest that EMDR allows an active reprocessing of traumatic memories related to family dynamics and to eating behaviors, which could enable a positive resolution of eating disorder (ED) symptoms. The emotional reprocessing of unresolved atachment issues can allow a beter modulation of the control-related rigidity that is a commonality between "N patients.

State of Mind Assessment in Relation to Adult Attachment and Text Analysis of Adult Attachment Interviews in a Sample of Patients with Anorexia Nervosa

“…Most importantly, we believe it is key to emphasize the clinical implications of this work in light of the guidelines proposed by the NICE (National Institute for Health and Care Excellence), which emphasize the importance of clinical work that also integrates an elaborative component on emotional strategies. This underscores the medium-to-long-term efficacy of interventions for AN, including an integrative intervention plan in which behavioral and emotional aspects play distinct but synergistic roles (e.g., Ego State Therapy [ 136 ], EMDR [ 137 , 138 , 139 ], and CBT-E [ 140 , 141 ]).…”

When do anorexic patients perceive their body as too fat? Aggravating and ameliorating factors

“…She also no longer fulfilled the criteria for diagnosis of anorexia nervosa. Another recent paper from the same authors contrasts CBT with EMDR therapy and provides guidelines for the treatment of anorexic patients [60].…”

Attachment insecurity predicts worse outcome in patients with eating disorders treated with enhanced cognitive behavior therapy: A one‐year follow‐up study

“…Therefore, several improvements that embrace a developmental perspective should be considered. For example, the integration of techniques aimed at reprocessing memories of dysfunctional attachment relationships, such as Eye Movement Desensitization and Reprocessing Therapy (Shapiro, 2018), and satisfying frustrated attachment needs, such as imagery rescripting from Schema Therapy (Young et al, 2003), might ameliorate treatment outcomes (Balbo et al, 2017; Parnell, 2013; Pugh, 2015; Wesselmann et al, 2012; Zaccagnino, Civilotti, et al, 2017; Zaccagnino, Cussino, et al, 2017). Furthermore, considering the close relationship between insecure attachment and emotional dysregulation, a dimension that is not fully covered in the current CBT‐E model (Trompeter et al, 2021), additional interventions to stabilize the most compromised patients in the initial stages of psychotherapy could facilitate subsequent work and improve adherence and outcome.…”