Wants talk psychotherapy but cannot talk: EMDR for post-stroke depression with expressive aphasia
Description
Objective:
While post-stroke depression (PSD) is a common sequelae of stroke, many stroke survivors also have expressive aphasia (i.e., the inability to produce spoken or written language) which limits or prevents treating depression with talk psychotherapy. Unlike most psychotherapy modalities, eye movement desensitization and reprocessing (EMDR) does not require extensive verbal communication to therapists, which may make EMDR an ideal treatment modality for aphasic patients with mental health concerns.
Method:
This is the first known case reporting EMDR in aphasia, describing the treatment of a 50 year old woman with a history of depression following a left middle cerebral artery stroke. Left frontal lobe strokes are independently associated with both PSD and expressive aphasia. EMDR began 2 years following the stroke at which point she continued to have persistent expressive aphasia despite previously completing over a year of speech therapy.
Results:
Using the Blind to Therapist Protocol, EMDR successfully led to improvement in depressive symptoms and, surprisingly, improvement in aphasia.
Conclusions:
This case report suggests that EMDR should be considered for those with mental health concerns who have expressive communication impairments that may prevent treatment with other psychotherapy modalities. We discuss potential challenges and technical workarounds with EMDR in aphasia, we speculate about potential biopsychosocial explanations for our results, and we recommend future research on EMDR for PSD and other mental health concerns in the context of aphasia, as well as possibly for aphasia itself.
While post-stroke depression (PSD) is a common sequelae of stroke, many stroke survivors also have expressive aphasia (i.e., the inability to produce spoken or written language) which limits or prevents treating depression with talk psychotherapy. Unlike most psychotherapy modalities, eye movement desensitization and reprocessing (EMDR) does not require extensive verbal communication to therapists, which may make EMDR an ideal treatment modality for aphasic patients with mental health concerns.
Method:
This is the first known case reporting EMDR in aphasia, describing the treatment of a 50 year old woman with a history of depression following a left middle cerebral artery stroke. Left frontal lobe strokes are independently associated with both PSD and expressive aphasia. EMDR began 2 years following the stroke at which point she continued to have persistent expressive aphasia despite previously completing over a year of speech therapy.
Results:
Using the Blind to Therapist Protocol, EMDR successfully led to improvement in depressive symptoms and, surprisingly, improvement in aphasia.
Conclusions:
This case report suggests that EMDR should be considered for those with mental health concerns who have expressive communication impairments that may prevent treatment with other psychotherapy modalities. We discuss potential challenges and technical workarounds with EMDR in aphasia, we speculate about potential biopsychosocial explanations for our results, and we recommend future research on EMDR for PSD and other mental health concerns in the context of aphasia, as well as possibly for aphasia itself.
Format
Journal
Language
English
Original Work Citation
Guina, J., & Guina, C. (2017, October). Wants talk psychotherapy but cannot talk: EMDR for post-stroke depression with expressive aphasia. Innovations in Clinical Neuroscience, Innovations in Clinical Neuroscience, 15(1/2), 45-48
Citation
“Wants talk psychotherapy but cannot talk: EMDR for post-stroke depression with expressive aphasia,” Francine Shapiro Library, accessed May 15, 2024, https://francineshapirolibrary.omeka.net/items/show/24668.