Eye movement desensitization and reprocessing (EMDR) and mediative behavioral therapy for the treatment of suffocation related post-traumatic stress disorder (PTSD) in amyotrophic lateral sclerosis (ALS): A case report

Abstract

Objective Eye movement desensitization and reprocessing (EMDR) is an established treatment for post-traumatic stress disorders (PTSD). Some patients diagnosed with amyotrophic lateral sclerosis (ALS) experience PTSD following choking or suffocation in the course of progressive loss of the ability to breathe. Although a loss of breathing functions in ALS is relatively common, there are currently no studies available on treatment for the fear of choking following advanced ALS. Methods In this case study, we describe the positive effects of EMDR, an evidence-based form of trauma therapy, in a 48-year-old female, suffering from advanced ALS. As the consequence of ALS, she was not able to speak or breath independently, but could communicate through a speech-generating device. She experienced panic attacks, flashbacks, nightmares, and severe anxiety after her tracheostomy jammed, and she almost suffocated. Results Mediative treatment was started by instructing the care staff to respond neutrally with step-by-step instructions following tracheostomy jam, resulting in significantly less panic attacks and flashbacks. EMDR was initiated two weeks later, and resulted in full remittance of the trauma symptomatology. Significance of the results The present case study suggests that symptoms of PTSD, namely the strong fear of suffocation, can be successfully treated by means of mediative behavioral therapy combined with EMDR.

Psychosocial interventions for people with amyotrophic lateral sclerosis and motor neuron disease and their caregivers: a scoping review

“…Denmark, Iran, Japan, Russia, Spain, and Uruguay each published one study. In terms of study design, one group pre-post design [ 8 , 22 , 23 , 25 , 29 , 32 ] and RCT [ 7 , 9 , 19 , 24 , 35 , 38 ] were the most common with six studies, followed by five qualitative studies [ 6 , 10 , 18 , 30 , 31 ] and four quasi-experimental studies [ 5 , 28 , 34 , 39 ], and three each for mixed methods [ 33 , 36 , 40 ] and case studies [ 26 , 27 , 37 ].…”

“…The range of sample sizes used in data collection varied widely from one [ 26 , 27 , 37 ] to a maximum of 148 [ 9 ]. Most of the studies involved less than 50 participants, two studies [ 5 , 38 ] 50–100 participants, one study [ 9 ] had over 100 participants.…”

“…Most of the studies involved less than 50 participants, two studies [ 5 , 38 ] 50–100 participants, one study [ 9 ] had over 100 participants. Eleven studies [ 5 , 19 , 22 , 24 – 27 , 34 , 35 , 37 , 39 ] collected data from people with ALS/MND, six studies [ 8 , 30 – 33 , 40 ] from family members, and ten studies [ 6 , 7 , 9 , 10 , 18 , 23 , 28 , 29 , 36 , 38 ] from both persons with ALS/MND and also family members.…”

“When I am breathless now, I don’t have the fear that’s linked to it”: a case series on the potential of EMDR to break the dyspnea-anxiety cycle in COPD

“…A thorough search of the literature was performed on EMDR for COPD-related breathlessness (search terms and strategy described in Additional file 1 ). We found no previous research on this subject, although two case reports concerning the positive effect of EMDR on breathlessness due to other conditions—pediatric asthma and amyotrophic lateral sclerosis—were retrieved [ 18 , 19 ].…”

Eye Movement Desensitization and Reprocessing (EMDR) Treatment in the Medical Setting: A Systematic Review

“…27,30 The remaining pilot RCT compared an EMDR standard protocol to an EMDR pain protocol and control psychotherapy and found beneficial effects of both EMDR protocols over control therapy, in favor of the standard protocol which was found to be significantly better compared to the pain protocol. 32 Neurology 15 studies described the efficacy of EMDR in neurological disorders and focused on patients suffering from: dementia, [34][35][36] multiple sclerosis (MS), 37,38 stroke, [39][40][41] amyotrophic lateral sclerosis (ALS), 42 spinal cord injury, 43,44 migraine, 45 psychogenic seizures, 46 and concussion-like symptoms. 47 One study did not specify which neurological condition the patients suffered from.…”