Dose response, cognitive change and the working memory limit in eye movement desensitisation

The natural history of treatment with Eye Movement Desensitization (EMD), was investigated. EMD is defined as EMDR without the cognitive components, such as the positive cognition procedure or cognitive interleave. When EMD treatment does not proceed, then the flashback or distressing image is decomposed in various ways, until it does proceed. A retrospective audit showed that patients report an average of seven flashbacks, or images. We attempted to confirm this prospectively. One hundred and thirty patients in the Genito-Urinary Medicine Clinic were entered. Fifty-one completed treatment. Progress was assessed with questionnaires at all treatment sessions. All previously reported flashbacks or images were reassessed at the beginning of each session. All distressing images were treated, both to the initial presenting event and all other distressing life events or anxieties reported. The number of flashbacks desensitized was recorded. There was a six-month postal followup. We predicted there would be an average of seven flashbacks and that the questionnaires would reduce to low levels at this point. The mode and median values were seven. The mean was 7.9. Evaluation questionnaires reduced to good levels. An average of seven flashbacks or images was reported to completion of treatment. This seven may indicate the working memory limit. If PTSD and psychological disorder in general are caused by overloaded working memory capacity, maybe EMD works by unloading it. If WM bandwidth is liberated by treatment, then this may enable the cognitive and emotional change observed in EMD treatment. Further implications of this will be discussed.

Conference

English

Alan Hassard
Catherine Jeynes
Katherine Smith
Man Cheung Chung

Hassard, A., Jeynes, C., Smith, K., & Chung, M. C. (2008, June). Dose response, cognitive change and the working memory limit in eye movement desensitisation. Presentation at the 9th EMDR Europe Association Conference, London, England