Journal of Psychotherapy Integration

© 2019 American Psychological Association 2019, Vol. 29, No. 1, 23–31

1053-0479/19/$12.00 http://dx.doi.org/10.1037/int0000136

Integrating EMDR in Psychotherapy

Marina Balbo Francesca Cavallo

EMDR Italy Association, Bovisio Masciago, Italy Centro Terapia Metacognitiva Interpersonale,
Rome, Italy, and Institute San Raffaele Sulmona,
Spinal Cord Unit, Italy
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

Isabel Fernandez
This document is copyrighted by the American Psychological Association or one of its allied publishers.

EMDR Italy Association, Bovisio Masciago, Italy

Eye movement desensitization and reprocessing (EMDR) has significantly contributed

to psychotherapy in the last 30 years. Studies support EMDR as effective for posttrau-
matic stress disorder symptoms. It was also applied to other disorders because it can
help resolve and reprocess memories of traumatic experiences that can contribute, as
risk, precipitating and predisposing factors to the development of mental disorders.
What these disorders have in common is the maladaptive processing of information
associated with stressful and pathogenic events. EMDR therapy has given a contribu-
tion to psychotherapy as an effective method that can help the innate processing system
process all aspects of a traumatic experience. After working with traumatic memories
that may be part of the patient’s life story, EMDR therapy focuses on current triggers
and symptoms and then provides the patient with instruments to deal with future
situations that may cause anxiety. While working with this method, it is possible to
enhance metacognitive skills and promote a change in dysfunctional emotions, beliefs,
and behaviors. These are some common objectives that EMDR therapy shares with
most psychotherapy approaches.

Keywords: posttraumatic stress disorder, eye movement desensitization and

reprocessing, psychotherapy, mental disorder

Eye movement desensitization and reprocess-
ing (EMDR) is a therapeutic approach developed
by Francine Shapiro (1989), which became a fun-
damental tool for many psychotherapists, sup-
ported by a large number of publications prov-
ing its empirical validity in treating, in
particular, posttraumatic stress disorder
(PTSD). The theoretical model is adaptive in-
Marina Balbo, EMDR Italy Association, Bovisio Mas-
ciago, Italy; Francesca Cavallo, Centro Terapia Metacogni-
tiva Interpersonale, Rome, Italy, and Institute San Raffaele
Sulmona, Spinal Cord Unit, Italy; Isabel Fernandez, EMDR
Italy Association, Bovisio Masciago, Italy.
This research was supported by the TMI Center, Pescara.
Correspondence concerning this article should be ad-
dressed to Francesca Cavallo, Department CTMI Rome,
Institute San Raffaele Sulmona, Spinal Cord Unit, Italy,
Corso Umberto 25, Pescara, Italy 65126. E-mail:
francycavallo@hotmail.it
23
formation processing (AIP), which states that
pathological phenomena can be associated with
some past disturbing experiences, dysfunction-
ally stored in memory, that can trigger a perma-
nent dysfunctional pattern of emotions, behav-
iors, and cognitions (Shapiro, 2001). Such a
model explains the experiential factors that can
contribute to the development of several mental
disorders. This can be used to create a struc-
tured therapeutic plan to work on the memories
of key experiences in the patient’s life story,
which may be connected to the patient’s current
difficulties and symptoms. According to AIP,
the memories of the patient’s traumatic and
stressing events are stored in a static form
within the neural networks, and this leads to the
development of cognitive, emotional, and be-
havioral patterns that characterize a number of
dysfunctions. Traumatic experiences can be as-
sociated with complex, painful, and extremely
 24 BALBO, CAVALLO, AND FERNANDEZ
stressful experiences and with early relation-
ships or attachment. It is important to consider
that, regardless of the selected therapeutic ap-
proach, clinicians use narrative to understand
how patients interpret these events because, for
instance, it is not always possible to identify the
complex dysfunctional adaptations originating
from chronic abuse and neglect (Balbo, 2016).
Many supportive RCTs confirm the therapeu-
tic efficacy of EMDR therapy for processing
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traumatic memories. The effectiveness of
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EMDR therapy in treating PTSD has undergone
the scrutiny of several meta-analyses (Benish,
Imel, & Wampold, 2008; Bradley, Greene,
Russ, Dutra, & Westen, 2005; Chen, Zhang, Hu,
& Liang, 2015; Davidson & Parker, 2001; Jonas
et al., 2013; Seidler & Wagner, 2006; Van Etten
& Taylor, 1998), and the World Health Orga-
nization considers EMDR the treatment of
choice for PTSD in children, teenagers, and
adults. This is in contrast with guidelines from
the American Psychological Association
(2017), which suggests that there is strong evi-
dence for cognitive-behavioral therapy, cogni-
tive-processing therapy, and cognitive therapy
but only weak evidence for EMDR. Clearly,
future studies are needed to better understand
whether one treatment works better than an-
other. Psychotherapy can use different ap-
proaches, but working on memories of the most
important experiences with EMDR is some-
thing very useful to facilitate integration.
EMDR can foster psychotherapy effectiveness
if integrated with other methods. Such an inte-
gration would offer more possibilities to suc-
cessfully process the traumatic memories.
Case Context and Method
A principle explaining EMDR contribution
consists of considering the existence of an in-
nate system, which is physiologically oriented
to process information to promote mental
health. Such an adaptive mechanism allows to
resolve any negative emotions and beliefs,
which could otherwise lead to anxiety and other
symptoms (Shapiro, 1989). Memory and its
spontaneous processing, thanks to the reactiva-
tion of the innate processing system, allowed
EMDR to become a common language in psy-
chotherapy. Alternating bilateral stimulation
(eye movements, tapping, etc.) during EMDR
processes allows the adaptive processing of
such experiences to attain full integration in the
neural networks that are naturally driven toward
mental health (Shapiro, 2001). Traumatic and
highly stressful emotional experiences may
block the information-processing mechanism.
EMDR acts on these blocks and activates the
innate self-healing mechanism (Balbo, 2016) by
bilateral stimulation. Recent research has aimed
to confirm the effectiveness of eye movements
by investigating what happens in the human
brain during an EMDR process. At the end of a
therapeutic trial involving 20 patients with a
diagnosis of PTSD, researchers observed that
eye movements were correlated with changes in
the brain blood dynamics at the prefrontal cor-
tex level. As such, EMDR is associated with
lower oxyhemoglobin concentration, which
could be linked to a reduced prefrontal cortex
activity and to reduced stress as well (Balbo,
2016).
The AIP paradigm (the model at the basis of
EMDR therapy), then, offers a unified theory
that can be considered as a common substrate
for all therapeutic approaches because it con-
ceptualizes disorders associated with informa-
tion stored in a dysfunctional way (Solomon &
Shapiro, 2008). This aspect provides a valuable
contribution to several approaches in psycho-
therapy because EMDR works on memories of
meaningful traumatic experiences in the pa-
tient’s life story, which is a common point of
many therapies. In EMDR therapy, memories
are actually processed therapeutically to desen-
sitize emotional and dysfunctional feelings, al-
lowing to change the cognitive perspective and
body sensations. Memory-targeted work makes
EMDR a method that can be easily integrated
into other approaches. Memory and its sponta-
neous processing, thanks to the reactivation of
the innate processing system, allowed EMDR to
become a common language in psychotherapy.
Adverse childhood, teenage, and adult experi-
ences, including dysfunctional attachment rela-
tionships, can be considered as traumatic and
highly stressful experiences, which can be pro-
cessed and resolved through EMDR therapy
along with contributions from all major psycho-
therapy approaches (Burke Harris, 2018). In this
regard, we can talk about an integrated ap-
proach (Goldfried & Newrnan, 1992) and a
common language (Balbo, 2016). The integra-
tion of EMDR therapy into clinical practice is a
process that can allow clinicians to develop
 INTEGRATING EMDR IN PSYCHOTHERAPY
further competences and effectiveness also us-
ing this therapeutic tool. The characteristics of
EMDR processes make it specifically suitable
to be integrated into other theoretical-method-
ological perspectives. The common need to un-
derstand the multiple dimensions of personality
has revolutionized the boundaries of psycho-
therapy (Rimini et al., 2016). Any psycho-
therapy aims at changing the meaning people
ascribe to interpersonal relationships. Psycho-
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therapy is a cooperative and experiential pro-
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cess, and it aims at improving patients’ aware-
ness of the way they process information to
decrease suffering and let them live a more
fulfilling life. Three main classes of factors are
to be considered along this path. The first con-
sists of cognitive factors, including the normal-
ization mechanism by which patients under-
stand that they are not alone, that other people
have similar problems, and that human suffer-
ing is universal. The patient’s insight is impor-
tant because growth takes place when patients
understand themselves and others by acquiring
a different perspective of their motivations and
behaviors. Finally, a paramount aspect is related
to behavioral modeling through which people
observe other people who are not suffering as
they are, and this can have beneficial effects.
With regard to emotional factors, the accep-
tance mechanism is fundamental to learn how to
recognize and earn the others’ full respect, par-
ticularly the therapist’s respect. Change, in ther-
apy, means being in a healthy relationship based
on altruism and on taking care of the other
person. In addition, transference is a kind of
emotional connection between the therapist and
the patient, which can be referred to earlier
memories (Safran & Muran, 2000). Psycho-
pathological disorders often develop when one
is unable to create, maintain, or end significant
relationships. Processing of current negative ex-
periences, which is the main concern for people
turning to therapy, requires their connection
with previous experiences. EMDR is basically
focused on the identification of relational and
interpersonal traumas that may have contributed
to such discomfort, disturbance, and difficulties
causing the patient to seek professional help and
start therapy. It is possible, therefore, to detect
some relational traumatic events (minor trau-
mas) in the patient’s life history, which are
apparently less meaningful and represent unre-
solved issues arising from abandonment, abuse,
25
and neglect by significant persons (Siegel,
2003). Minor traumas may also be associated
with experiences in which caregivers failed to
provide physical and psychological support or
were emotionally violent. If the memories of
these experiences are not processed, they can
continue to affect the patient’s life. EMDR ther-
apy can be an important tool to approach these
memories and turn them into adaptive resolu-
tion. Furthermore, if abreactions occur, they
enable the patient to express anger, pain, cry, or
desperation in a context in which he or she feels
accepted and protected (Alexander & French,
1946). The processing of traumatic memory and
the recognition of the suffering it has generated
promotes patient improvement. The change oc-
curs when the client experiences new behaviors
during the therapy session, with the support and
feedback of the therapist. The need to overcome
our own theoretical boundaries arises from a
number of reasons, which may be summarized
as follows. On the one hand, scientific and cul-
tural changes create a stimulating ground for a
complex and multidisciplinary understanding of
human beings and psychological and natural
phenomena. On the other, the need for a stron-
ger awareness of the limits and constraints of
each theoretical orientation fosters more open-
mindedness. These are some of the aspects that
EMDR shares with other approaches.
Resources
EMDR therapy includes some techniques to
enhance the patient’s ego through the installa-
tion of positive memories of a safe place or
memories of achievements or protective figures.
Clinicians can use these resources to prepare
patients to better deal with everyday life and
also to enhance their strength. The positive
memory, skill, and ability installation protocol
can be used also to prepare patients for trauma
processing.
Identifying and Processing Appropriate
Targets
The first stage of EMDR is focused on case
conceptualization to identify key traumatic or
highly stressful situations in the patient’s life
story that have contributed to the difficulties or
disorders for which the patient decided to seek
professional help and engage in therapy. This is
 26 BALBO, CAVALLO, AND FERNANDEZ
a common factor of all psychotherapeutic inter-
ventions. When EMDR is applied, several strat-
egies and techniques can be used to identify key
memories (targets), which are still disturbing
and which will be later processed through the
protocol. During this phase, the clinician and
the patient agree on the therapeutic plan, which,
after addressing past memories, will focus on
current triggers and then prepare the patient for
the future.
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Cognitive Aspects
These are characterized by dysfunctional
scheme concepts (empirical inference rules)
connected to the self, linked to both negative
and positive cognitions. The dysfunctional cog-
nitive scheme is one of the references to identify
the experiences that contributed to shape these
negative beliefs, and later the memories of these
experiences shall be processed through EMDR
processes. The goal is to remove the associa-
tions and information stored in a dysfunctional
way in the memory, which maintain the dys-
functional cognitive scheme. At the end of each
EMDR session, a positive belief will be in-
stalled, connected with the traumatic memory,
to help strengthening the patient’s self-image.
Elements Originating From the Cognitive-
Evolutionist Perspective
The attachment theory represents the most
effective reference for the identification of
childhood traumatic experiences, particularly
when such experiences have contributed to a
disorganized attachment (Bowlby, 1973).
EMDR therapy fosters the resolution of attach-
ment traumas by reprocessing the most signifi-
cant episodic memories that represent relation-
ships with early caregivers and/or parents.
Somatic Aspects
Body aspects are of paramount importance in
EMDR therapy because special attention is paid
to body sensations and to the localization of
emotions during several phases of the EMDR
process while the patient is processing traumatic
memories. In one of the last protocol phases, the
absence of body tension will support that the
memory has really been processed. The body
has the last word when checking whether the
memory has been completely reprocessed.
Systemic Aspects
Chronic dysfunctional family dynamics hav-
ing an impact on the family members are at the
core of family therapy. Their understanding was
crucial and showed therapists new scenarios. In
EMDR therapy, the identification of memories
representing these dynamics is fundamental be-
cause they will become part of a work plan so
that they can be processed and a change will be
brought about not only for the single individual
but also for the whole family system.
Let us now go through some of the main-
stream approaches currently existing in the
world of psychotherapy, whose theoretical
cores are in line with EMDR and may be inte-
grated into it. The processing process promoted
by EMDR processes activates the patient’s abil-
ity to make free associations. Freud (1901)
identified a primary and a secondary process to
lay the foundations for a treatment strategy sim-
ilar to that of EMDR, focused on the need to
consider the primary process, fostering a better
integration between the primary and the second-
ary process. There is a similarity between
Freud’s theory and that of the EMDR. Often
processing takes place during EMDR through a
free association process that leads to an adaptive
resolution of all parts of traumatic memory. The
processing of traumatic memories can therefore
take place through the associative channels (as
Freud claimed) of the different phases of the
therapeutic process (Shapiro, 2001). Recalling
the past to understand the present through the
patient’s past experiences is common to both
approaches. EMDR fosters the recovery of past
material and its treatment through an adaptive
resolution, in which the memory spontaneously
loses its negative emotional charge at the end of
the session, and it is associated with a positive
self-belief. The psychodynamic approach and
EMDR share the idea that the therapeutic pro-
cess must free the person from any psychoevo-
lutionary fixations and from relived experiences
or intruding memories. To this purpose, Shapiro
(2001) stated that the model can be applied to
diseases caused by earlier experiences that trig-
ger a continuous pattern of emotions, behaviors,
and cognitions and create identity structures.
Through alternated bilateral stimulation,
EMDR leads the patient out of the dimension of
conversation and narrative memories and in-
vites him/her to focus on the details of the
 INTEGRATING EMDR IN PSYCHOTHERAPY
situation, like the experiential fragments at a
sensory, cognitive, somatic, and emotional level
while doing sets of eye movements. Such stim-
ulation and the therapeutic presence of the cli-
nician activate reexperiencing, free association,
and processing possibilities under safety condi-
tions. This condition is essential in treating a
posttraumatic disorder; it fosters the possibility
to tackle the traumatized patient’s fears working
only through memory. Patients can relive a
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trauma with a supportive continuum. This con-
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dition also fosters the patient’s trust in his abil-
ities and resources, thus helping him/her feel
safe and able to handle emotions. There are also
points in common with the Gestalt. EMDR has
in common, with Gestalt, the importance of
contact with the emotional and body experi-
ences, encouraging the integration of these as-
pects on a cognitive level, through the use of the
individual’s own resources. Furthermore, both
approaches underscore the importance of a good
therapeutic alliance (Balbo, 2016).
As in cognitive formulations, EMDR therapy
is based both on the formulation and conceptu-
alization of the individual patient’s understand-
ing and specific disorder (Balbo, 2016). Thera-
pists try to help patients changing the cognitions
with which they gave meanings to event to
change affect responses and behavior strategies
(van der Kolk, 1994). In EMDR therapists as-
sess negative beliefs about the self that the
patients have in that moment (negative cogni-
tion) when they think about a traumatic mem-
ory. Exploration is focused on beliefs about
responsibility, safety, self-defectiveness (self-
value), and control. In EMDR, negative think-
ing and beliefs will be changed after processing
memories of those experiences that had contrib-
uted to its development. Once these memories
are processed, a positive belief is installed, and
after working with some of these memories, the
dysfunctional negative cognitive schema will
lose its foundation so that it will no longer
generate discomfort. From a cognitive-behav-
ioral perspective, the patient can return to the
present without their load of negative emotions
and memories, which used to limit their ability
to function in everyday life and which had con-
tributed to developing symptoms, discomforts,
and difficulties. After reprocessing a traumatic
memory, patients are more capable of exposing
themselves to those situations causing anxiety
they used to avoid. During spontaneous pro-
27
cessing in an EMDR process, patients usually
have new insights and become aware of their
abilities, and at the same time, some of their
positive beliefs are enhanced. At the end of a
session, patients reconsider the event in a more
adult and functional way, feel more empower-
ment, and integrate more appropriate emotions
regarding the memory, without any disturbing
body sensations.
It should be pointed out that a strong point of
EMDR therapy is the use of eye movements to
weaken the connections between subcortical
emotional variables and the cortical cognitive
ones, and the fact that it allows the innate in-
formation processing system to complete what
it had not been able to do by itself (van der Kolk
et al., 2007). For this reason, therapists accom-
panies the patient’s processing and follow the
different stages in the protocol only during the
sets of bilateral stimulation (lasting about 25 s
each). After each set, patients give feedback of
what they noticed; the clinician is not directive
and usually does not intervene to avoid inter-
fering and disrupting the patient’s natural pro-
cessing.
The attachment theory underlines that the
attachment safety experienced in the therapeutic
relationship allows the exploration of painful
feelings and promotes introspection (Holmes,
1993). So therapists, according to the attach-
ment theory, try to increase the patient’s sense
of safety and empowerment because this will
increase his or her introspective and exploration
abilities (Balbo, 2016). To this purpose, the
EMDR approach seems particularly useful:
Therapists accompany and support processing
without judging, respecting the patient’s timing
and trusting his or her innate ability to process
memories, reactivated by alternated bilateral
stimulation. Therapists therefore trust the pro-
cess and show this with their therapeutic pres-
ence, focused on the patient and on the different
stages of reprocessing. Feeling safe in therapy
temporarily deactivates the attachment system
and activates an explorative and collaborative
attitude to be shared with the clinician. The
above considerations show how the integration
between psychotherapies starts only when dog-
matism preventing the enrichment of theoretical
aspects with new and scientific perspectives is
abandoned.
The contribution of EMDR (van der Hart,
Nijenhuis, & Solomon, 2010) to such a process
 28 BALBO, CAVALLO, AND FERNANDEZ
promotes research and focus on how disorders
develop by assuming a common origin for the
disease in the maladaptive processing of infor-
mation concerning stressing and pathogenic
events. In the holistic EMDR idea of biological,
psychological, and social dimensions, each psy-
chotherapist can access different patients’ aspects.
Furthermore, aspects concerning all psychothera-
pies, such as the therapeutic alliance, the rela-
tionship, and the therapeutic contract, are con-
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sidered as extremely important through
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assessment phases and the therapy protocol. In
the last decades, EMDR has become a tool for a
constructive, stimulating, and creative dialogue,
always aimed at investigating the most effective
method to provide the help that patients need to
adaptively resolve the experiences underneath
psychological disorders from a self-healing per-
spective (Balbo, 2016). A further element of
interest is the increasing support for EMDR as a
concrete and accessible tool for working with
patients. EMDR helps patients to recognize that
the dysfunctional material associated with cur-
rent symptoms and distress is linked to their
trauma history, and, by working on those trau-
matic memories, patients can change their emo-
tions, beliefs, and behaviors (van der Hart, Ni-
jenhuis, & Steele, 2006).
Case Study: PTSD After a Stressful
Experience
Antonella (not the patient’s real name; in-
formed consent of the patient was obtained to
guarantee the confidentiality of the information
provided) is 35 years old. Her complaint in the
first clinical interview is that “she has been
dragging on for about 4 months, when a trau-
matic situation occurred at work.” During a
bank robbery, a thief approached her desk,
pointed a gun at her head, and ordered her to
deliver the money in the safe. She does not feel
like talking about the event because it triggers a
lot of anxiety. Since then, she has always tried
to avoid people, objects, and situations associ-
ated with that condition. During the days imme-
diately after the robbery, the client chose to take
a sick leave because it was extremely difficult
for her to restart her daily routine at the bank.
She spent entire days without leaving her home
to avoid friends and relatives’ questions about
what had happened. Until consultation, Anto-
nella says she has always been convinced “to be
able to handle this by herself,” without asking
for anyone’s help. The reason she changed her
mind is because she has become too irritable
and feels a growing discomfort caused by
emerging intrusive thoughts and memories con-
nected to the robbery. The latter—so vivid and
recurrent—prevent her from sleeping and pro-
voke night anxiety and insomnia. For instance,
she suddenly remembers the robber’s tone of
voice or the frightened face of her colleague
who was sitting at the desk near her at the time.
She also reports serious, recurrent impaired
concentration and moments of blank mind,
which hinder her search for a new job. Her
irritability and prostration trigger social discom-
fort too.
Antonella understands that she often answers
to small criticisms in a way that is not adequate,
even though she cannot identify a specific cause
for such behaviors. In addition, she often reports
feeling unsafe and prone to self-blaming. Be-
fore the event, Antonella says that she has al-
ways been a lively, patient, happy, and extro-
verted woman. Such characteristics are opposite
to those she uses to define herself upon consul-
tation, when she describes herself as constantly
being on alert and with hyperarousal, prone to
isolation, and she reports avoiding crowded
places. Her speech is well articulated and con-
sistent; however, it rapidly accelerates when she
talks about the robbery. Her history showed no
former psychological problems before the trau-
matic robbery. No clinical or dysfunctional in-
formation is reported regarding her family en-
vironment. In addition, Antonella will soon get
married. From the clinical interview (Phase 1 of
EMDR) and Impact Event Scale (Weiss & Mar-
mar, 1997), she meets the criteria for PTSD. In
Phase 2, we proceed with psychoeducation, and
Antonella is informed about PTSD symptoms
and reactions to stressful situations. At this
stage, the clinician provides information to un-
derstand the patient’s symptoms through psy-
choeducation and normalization. The clinician,
together with the patient, identifies needs and
the therapeutic goals and after that explains the
method (EMDR) that will be used and its dura-
tion. So the psychological contract is based on
cooperation and shared objectives. This is im-
portant to build a therapeutic alliance to be able
to proceed with the other stages of EMDR ther-
apy. To help the patient familiarize with EMDR
and eye movements, we start with a positive
 INTEGRATING EMDR IN PSYCHOTHERAPY
memory. We install a positive and pleasant
memory with the safe place exercise. After in-
stalling this resource, Antonella uses it to relax
and manage anxiety. After this preparation
phase (Phase 2), we can start working with the
memory of the robbery.
During the assessment, Phase 3, we ask the
patient to think about the most disturbing frag-
ments of the memory through structured ques-
tions. Regarding her experience, Antonella
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identified the worst image (the moment in
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which she feels the gun in touch with her skin),
the self-referred negative belief, the negative
cognition (I am going to die), the disturbing
emotion she feels now when thinking about the
image, and the negative cognition (fear and
helplessness), the level of disturbance (subjec-
tive units of disturbance [SUD] from zero to
10 ⫽ 9) during which she feels the disturbance
in the body when thinking about the image and
the negative cognition (stomach and head). In
Phase 4, desensitization, Antonella is asked to
focus on the worst image, the negative belief,
and the body sensation and to follow the fingers
of the clinician, which makes sets of brief eye
movements. After each set, Antonella is able to
give a feedback and talk about the whole expe-
rience. While processing, she feels the weapon
coldness, the robber’s cigarette smell, and his
words in her ears . . .; everything is as it was in
that moment. She was reliving it. She remem-
bers her colleague’s frightened face confirming
her same feeling of fear linked to the possibility
of dying. During the processing stage (making
associations, seeing the image less vivid, etc.),
she has a positive insight; the patient refers that
she could hear that the police was arriving,
and she remembered when the thief escaped
without hurting anyone. She also refers that
after trying to calm down her colleagues and
realizing it was over, she was very active. The
SUD level drops to zero, the memory lost the
negative feelings, and she could think about it
as a bad experience, but it was not triggering
any anxiety or discomfort at the end of the
session. The positive cognition “I am safe” was
installed (Phase 5: installation of the positive
cognition) and she could think about the mem-
ory of feeling safe and feeling that everything
was finally over. In Phase 6, body sensations are
checked, and she reports no body disturbance or
tension when the memory of the experienced
danger is recalled. There was no tension in her
29
body. Any possible residues of trauma, in the
body memories, were processed. After 1 week,
SUD is still zero in Phase 8 (reevaluation), so
the results were maintained. She reported she
was able to sleep better and was considering
going back to work at the bank because it is the
job she likes the most. The following sessions
were addressed to resolve the triggers related to
her being stuck at home and to her fear of
meeting thieves in the street. Also, watching
robbery scenes on TV and hearing the police
sirens were not provoking anxiety as they used
to. Standard EMDR therapy was used to process
current triggers.
The future template included one session
only, related to her return to work. In this ses-
sion, Antonella was asked to imagine going
back to work, entering the bank, going to her
desk, staying with her colleagues with a positive
cognition, “I am safe,” and while doing this,
bilateral stimulation was done until she could
think about this future situation without anxiety
and with a positive feeling. Treatment of this
PTSD case took five sessions. Follow-ups after
3, 6, and 12 months were still showing stable
results. After this traumatic experience, Anto-
nella went back to her everyday life and was not
constrained to find a new job and her lifestyle.
Conclusion
EMDR is an effective treatment to reduce
symptoms of PTSD, although there is debate
about what are the actual neural mechanisms
that contribute to its effect (Calancie, Khalid-
Khan, Booij, & Munoz, 2018). The integrative
therapist can take advantage by using EMDR
techniques when working on traumatic memo-
ries, and this has significant changes of achiev-
ing therapeutic gains faster. Future studies are
needed to understand which patients benefit
from EMDR work and which may refuse it or
fail to respond completely. This would open the
way for both motivating therapies from differ-
ent orientations to adopt memory desensitiza-
tion and reprocessing strategies and EMDR
therapists to continue adopting other tech-
niques. EMDR therapy, as most therapies, is
focused on the therapeutic relationship and con-
tributes to the need of having a tailored therapy
to suit best the needs of every single client.
 30 BALBO, CAVALLO, AND FERNANDEZ
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Integración de EMDR en psicoterapia

La desensibilización y el reprocesamiento del movimiento ocular (EMDR por sus siglas en inglés) han contribuido
significativamente a la psicoterapia en los últimos 30 años. Los estudios apoyan EMDR como eficaz para los síntomas del
trastorno de estrés postraumático. También se ah aplicado a otros trastornos porque puede ayudar a resolver y reprocesar
recuerdos de experiencias traumáticas que pueden contribuir, como factores de riesgo, precipitantes y predisponentes al
desarrollo de trastornos mentales. Lo que estos trastornos tienen en común es el procesamiento inadaptado de la información
asociada con eventos estresantes y patógenos. La terapia EMDR ha contribuido a la psicoterapia como un método eficaz
que puede ayudar al sistema de procesamiento innato a procesar todos los aspectos de una experiencia traumática. Después
de trabajar con recuerdos traumáticos que pueden formar parte de la historia de la vida del paciente, la terapia EMDR se
centra en los desencadenantes y síntomas actuales y luego le proporciona al paciente instrumentos para enfrentar situaciones
futuras que pueden causar ansiedad. Mientras se trabaja con este método, es posible mejorar las habilidades metacognitivas
y promover un cambio en las emociones, creencias y comportamientos disfuncionales. Estos son algunos de los objetivos
comunes que la terapia EMDR comparte con la mayoría de los enfoques de psicoterapia.

Trastorno por estrés postraumático, desensibilización y reprocesamiento por movimientos oculares, psicoterapia, trastorno
mental

在心理治疗中整合快速眼动法（EMDR)
眼动脱敏重建（EMDR，又称“快速眼动法”）在过去的30年里对心理治疗发挥了重大的贡献。研究证明快速眼动法
（EMDR）对于治疗创伤性应激障碍的症状很有效。它也被应用于其他病症因为它能够帮助解决和重建创伤相关
经历的记忆，这些经历作为潜在风险，可以导致促成和诱发心理疾病发展的因素。这些疾病的共同之处在于它们
对于压力相关及病理性事件信息的非适应性地处理。快速眼动（EMDR）疗法作为一种有效的方式对心理治疗很
有贡献，它能够帮助内在的处理系统处理创伤经历的各个方面。在同那些或许是患者部分人生故事的创伤记忆工
作后，快速眼动（EMDR）疗法专注于现阶段的触发因子以及症状，并且接下来为患者提供方式去处理未来可能
造成焦虑的情况。在使用这一方法的时候，很可能能够提升元认知技能，并且促进失衡情绪、信念和行为的改变。
快速眼动（EMDR）疗法的这些普遍目的同其他心理治疗方式都是相通的。

创伤性应激障碍, 眼动脱敏及重建, 心理治疗, 心理疾病

Received March 1, 2018

Revision received July 12, 2018
Accepted July 17, 2018 䡲