HCPC registered psychologists with expertise and experience in neurorehabilitation. We offer services such as neuropsychological assessment NPsych

#NPsychPick of the Month: Applying EMDR therapy with clients who have impaired cognitive abilities, EMDR Therapy Quarterly, Summer 2023

Neuro EMDR: Applying EMDR therapy with clients who have impaired cognitive abilities

Author: Dr Jonathan Hutchins Simon Proudlock

EMDR therapy has been shown to be highly effective and time efficient in addressing trauma memories in both adults and children. However, there are questions about how EMDR can be effective with adults who have experienced a brain injury or are experiencing other cognitive difficulties. This article summarises some of the recent research within the area and proposes adaptations to the standard protocol that can be made to make best use of EMDR therapy in this population.

Introduction

Within the UK in 2019-2020 there were 356,669 UK admissions to hospital with acquired brain injury (ABI), or any brain injury that has occurred after birth including traumatic brain injury (TBI), stroke or brain tumours, which is a 12% increase since 2005-2006 (Headway, 2023). In 2019, there were approximately 977 TBI admissions per day to UK hospitals, one every 90 seconds. The diagnostic criteria for TBI on the DSM V states that there must be an “impact to the head or other mechanisms of rapid movement or displacement of the brain within the skull with one or more of the following: loss of consciousness, posttraumatic amnesia, disorientation and confusion, neurological signs such as neuroimaging demonstrating injury or a worsening of a pre-existing seizure disorder” (American Psychiatric Association, 2013).

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#NPsychTeamResearch: Objects with motor valence affect the visual processing of human body parts: Evidence from behavioural and ERP studies. Lucilla C De Mattia. Cortex, Aug, 2022 via NPsych

NPsych Pick of the Month, April 2021: The impact of Covid-19 and lockdown on the lives of people with traumatic brain injury: Do we need an increased focus on the assessment and enhancement of resilience? Campbell and Parrett. NPsych. The Neuropsychologist, 11, 2021.

Neuroscience of Virtual Reality: From Virtual Exposure to Embodied Medicine. Cyberpsychol Behav Soc Netw, 2019

Neuroscience of Virtual Reality: From Virtual Exposure to Embodied Medicine.

Giuseppe Riva, Brenda K. Wiederhold, and Fabrizia Mantovani. Cyberpsychology, Behavior, and Social Networking, Vol. 22, No. 1 Closing Editorial. Published Online:16 Jan 2019

https://doi.org/10.1089/cyber.2017.29099.gri

Abstract

Is virtual reality (VR) already a reality in behavioral health? To answer this question, a meta-review was conducted to assess the meta-analyses and systematic and narrative reviews published in this field in the last twenty-two months. Twenty-five different articles demonstrated the clinical potential of this technology in both the diagnosis and the treatment of mental health disorders: VR compares favorably to existing treatments in anxiety disorders, eating and weight disorders, and pain management, with long-term effects that generalize to the real world. But why is VR so effective?

Here, the following answer is suggested: VR shares with the brain the same basic mechanism: embodied simulations. According to neuroscience, to regulate and control the body in the world effectively, the brain creates an embodied simulation of the body in the world used to represent and predict actions, concepts, and emotions. VR works in a similar way: the VR experience tries to predict the sensory consequences of an individual’s movements, providing to him/her the same scene he/she will see in the real world.

To achieve this, the VR system, like the brain, maintains a model (simulation) of the body and the space around it. If the presence in the body is the outcome of different embodied simulations, concepts are embodied simulations, and VR is an embodied technology, this suggests a new clinical approach discussed in this article: the possibility of altering the experience of the body and facilitating cognitive modeling/change by designing targeted virtual environments able to simulate both the external and the internal world/body.

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