Targeting temptation: The feasibility and efficacy of addiction-focused eye movement desensitization and reprocessing therapy

EMDR therapy is a well-established, evidence-based, trauma-focused treatment for PTSD (Chen, 2014). The theoretical framework underlying EMDR therapy, the Adaptive Information Processing (AIP) model (Shapiro, 2018; Solomon & Shapiro, 2008), suggests that most types of psychopathology are related to dysfunctionally stored memories. This dysfunctional storage is thought to be due to the traumatic nature (both PTSD and non-PTSD) of the causal events. When triggered, they elicit associated and maladaptive attitudes, emotions, and sensations. In accordance, research shows that traumatic events can negatively impact the onset and prognosis of severe mental disorders (Kim & Lee, 2016). When these traumatic memories are processed with EMDR (see Fig. 1), they are thought to be transformed in a more adaptive form and re-stored in long-term memory by a process of reconsolidation (Calancie, Khalid–Khan, Booij, & Munoz, 2018) within larger neural networks. As a result, triggering or re-activating these altered memories no longer evokes the previously associated symptoms.

One central element in the EMDR procedure that has been proven to be crucial for its effectiveness is working memory competition by means of inducing eye movements in the patients (Lee & Cuijpers, 2013). This is done concurrently with the instruction to the patient to keep the traumatic memory “in mind” (effectively reactivating it from passive long term memory storage to an active state in working memory).

The potential clinical utility of EMDR therapy, either as a standalone or add-on treatment, in diverse non-PTSD disorders has been supported by many randomized clinical trials, such as in phantom limb pain (Rostaminejad, Behnammoghadam, Rostaminejad, Behnammoghadam & Bashti, 2017), acute pain (Hekmat, Groth, & Rogers, 1994), non-specific chronic back pain (Gerhardt et al., 2016) and post - operative pain (Maroufi, Zamani, Izadikhah, Marofi, & O’connor, 2016), prevention of post-concussion-like symptoms and post-traumatic stress disorder in patients presenting at an emergency room (Gil-Jardiné et al., 2018), depression in patients with myocardial infarction (Behnammoghadam, Alamdari, Behnammoghadam, & Darban, 2015), recurrent depression (Ostacoli et al., 2018), panic disorder (Horst et al., 2017), obsessive-compulsive disorder (Marsden, Lovell, Blore, Ali, & Delgadillo, 2018; Nazari, Momeni, Jariani, & Tarrahi, 2011), dental phobia (Doering, Ohlmeier, de Jongh, Hofmann, & Bisping, 2013), low self-esteem (Griffioen, van der Vegt, de Groot, & de Jongh, 2017; Staring et al., 2016), negative body image in eating disorder (Bloomgarden, & Calogero, 2008) and alcohol dependence (Hase, et al., 2008). In most cases the rationale is that the emergence and/or course of these disorders are, at least partly, due to unprocessed traumatic experiences. In addiction disorders, an additional rationale is suggested, namely that these may not only be the result of and maintained by dysfunctionally stored trauma memories but are also fueled by an addiction memory network (Böning, 2009). Thus far, whether the associated addiction memories may also be targeted with EMDR therapy and whether this results in clinical improvement with regard to the addiction, remains an empirical question.

In order to gain a perspective on some relevant research questions regarding addiction-focused (AF-)EMDR therapy specific elements of addiction, central to this dissertation, will be discussed. Then, the focus will shift to the role of memory networks in addiction and relevant lab studies connecting indices of addiction with elements relevant to AF-EMDR therapy. Subsequently, the questions that arise form this body of research will be discussed and translated into research questions. Finally, an overview of the rest of this dissertation is provided.

Dissertation/Thesis

English

Wiebren Markus

Markus, W. (2019, June). Targeting temptation: The feasibility and efficacy of addiction-focused eye movement desensitization and reprocessing therapy. (Doctoral dissertation, Radboud University Nijmegen)