Eye Movement Desensitization and Reprocessing and Slow Wave Sleep: A Putative Mechanism of Action

Abstract

Eye Movement Desensitization and Reprocessing (EMDR) is considered highly efficacious for the treatment of Post-traumatic Stress Disorder and has proved to be a valid treatment approach with a wide range of applications. However, EMDR’s mechanisms of action is not yet fully understood. This is an active area of clinical and neurophysiological research, and several different hypotheses have been proposed. This paper discusses a conjecture which focuses on the similarity between the delta waves recorded by electroencephalography during Slow Wave Sleep (SWS) and those registered upon typical EMDR bilateral stimulation (eye movements or alternate tapping) during recurrent distressing memories of an emotionally traumatic event. SWS appears to have a key role in memory consolidation and in the reorganization of distant functional networks, as well as Eye Movements seem to reduce traumatic episodic memory and favor the reconsolidation of new associated information. The SWS hypothesis may put forward an explanation of how EMDR works, and is discussed also in light of other theories and neurobiological findings.

Neurobiological features and response to eye movement desensitization and reprocessing treatment of posttraumatic stress disorder in patients with breast cancer

“…EMDR is a trauma-focused psychotherapy using alternate bilateral stimulation (eye movements, tactile or audio) that seems to promote the reprocessing of dysfunctionally-stored information related to the traumatic event (Jeffries & Davis, 2013;Pagani, Amann, Landin-Romero, & Carletto, 2017). It has also been suggested to contribute to a better psychological adjustment to the disease in patients with cancer (Faretta & Civilotti, 2016;Lantheaume, 2018;Murray, 2016).…”

Eye movement desensitization and reprocessing as a treatment for PTSD: current neurobiological theories and a new hypothesis

“…After successful therapy, individuals demonstrated significantly reduced activation of the orbitofrontal cortex (OFC) and primary visual cortex and increased activation of the fusiform and lingual cortex . The authors offered support for the adjusted storage of traumatic memory theory, theorizing that during EMDR, the traumatic memory moves from emotional brain areas (i.e., OFC) to association areas (i.e., fusiform and lingual cortex) where the memory “is integrated and consolidated.” In three recent papers, Pagani, Carletto, and colleagues have proposed that this process is achieved by shifting the brain into a mental state similar to slow‐wave sleep, when the brain is admissible to memory recall and reconsolidation . This hypothesis is based on EEG studies that have reported increased prevalence of delta waves (0.5–4 Hz) during bilateral EMs while patients undergo EMDR .…”

“…Bergman describes direct routes from the cerebellum to the thalamus (and thence to the PFC) and from the cerebellum to the hypothalamus (and thence to limbic structures) as anatomical correlates of this relationship . Furthermore, Pagani and Carletto's slow‐wave sleep model considers the cerebellum as playing an integral role for memory reconsolidation during EMDR …”

EMDR as Add-On Treatment for Psychiatric and Traumatic Symptoms in Patients with Substance Use Disorder

“…It is guided by the adaptive information processing (AIP) model, that posits that stressful events not fully processed and integrated into the already existing memory networks are stored in a dysfunctional way. A distinct characteristic of EMDR therapy is the use of alternating bilateral stimulation (eye movements, tactile, or audio), which appears to produce a physiological effect promoting accelerated reprocessing of dysfunctionally stored information related to the traumatic event (Jeffries and Davis, 2013 ; Carletto et al, 2017 ; Pagani et al, 2017 ).…”