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Hoe het komt dat EMDR werkt

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Directieve therapie

Samenvatting Eye Movement and Desensitisation Reprocessing (EMDR) is een effectieve behandeling van traumasymptomen en de positieve effecten worden teruggevonden in het laboratorium, onder goed gecontroleerde omstandigheden. Dat biedt de mogelijkheid om na te gaan hoe EMDR werkt. Er wordt verslag gedaan naar de bevindingen uit een lange reeks experimenten. De hypothese dat oogbewegingen (of andere taken die worden uitgevoerd tijdens het ophalen van herinneringen) overbodig zijn en dat de exposure aan aversieve herinneringen tijdens EMDR de effecten verklaart, is niet houdbaar. Het idee dat ‘bilaterale stimulatie’ noodzakelijk is, snijdt evenmin hout. Je kunt net zo goed de ogen van boven naar beneden laten bewegen of taken laten doen waarbij helemaal geen oogbewegingen worden gemaakt. Belangrijk is dat de taak het werkgeheugen belast. Uit de werkgeheugenverklaring van EMDR is een lange reeks voorspellingen af te leiden. Die blijken wonderwel bestand tegen kritische experimentele tests en er tekent zich een solide verklaring af van hoe EMDR werkt. Die theorie en de empirische bevindingen hebben allerhande implicaties voor de techniek van EMDR.

Abstract Eye Movement and Desensitization Reprocessing (EMDR) is an effective treatment of trauma symptoms, while beneficial effects can be reproduced under controlled laboratory conditions. This opens the door for testing how EMDR works. The paper reports data from a long series of experiments. The hypothesis that eye movements (or other dual tasks) are superfluous and that EMDR effects are explained by exposure is untenable. The idea that ‘bilateral stimulation’ is crucial, does not match the data either. One can just as well move the eyes vertically, or carry out tasks that do not involve eye movements. The crucial factor seems to be that the dual task is taxing working memory. From the working memory account of EMDR a long series of predictions can be derived. The predictions survived critical experimental tests. The theory and empirical data have a range of technical implications for carrying out EMDR. These implications are discussed.

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van den Hout, M., Engelhard, I. Hoe het komt dat EMDR werkt. DIRECT. THERAP. 31, 5–23 (2011). https://doi.org/10.1007/s12433-011-0002-5

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