The eye movement desensitization and reprocessing approach in pain management – A case report of a patient with paraparesis

Abstract

Introduction

Somatic symptoms such as pain from psychiatric cause may result from abnormalities in information processing mechanisms in the central nervous system. Bilateral stimulation of the brain by using alternating eye movements assists to unlock and reprocess experiences.

Aim

The aim of this article is the presentation of the eye movement desensitization and reprocessing (EMDR) method in pain treatment.

Case study

A 23-year-old patient with paraparesis due to traffic accident three years earlier resulting in incomplete transverse spinal cord damage reported severe pain in paralyzed lower limbs from about one year. Thorough physical and imaging examination had ruled out organic causes of the pain and the patient was diagnosed with psychogenic pain. The standard EMDR protocol was used. In order to determine the mental state of the patient, the following tests were applied: (1) beck depression inventory, (2) the pain disability index, (3) subjective units of distress, and (4) validity of cognition. Therapy was completed when the patient declared resolution of leg pain and returned to rehabilitation. Measurements were performed three times: before treatment, immediately after treatment completion and four months after treatment completion.

Results and discussion

During a six-week EMDR therapy, the patient achieved a significant improvement. The importance of eye movements in planning rehabilitation strategies in other approach, i.e. modulation of motor control, indicates new research directions of the contemporary comprehensive rehabilitation approach. This study is a single case report, and thus further larger scale studies are required.

Conclusions

The EMDR method could be helpful in psychogenic pain treatment.

Introduction

The eye movement desensitization and reprocessing approach (EMDR) is based on Shapiro's theory on processing information and experience and adaptive information processing (AIP) model. This theory assumes that every human being has innate information and experience processing mechanisms required for optimal adaptational responses. Disorders that are the mental effect of the lived experiences that manifest also on a somatic level result from blocked, or “frozen”, information processing in the central nervous system.¹ Bilateral stimulation of the brain by using e.g. alternating eye movements assists to unlock and reprocess experiences (EMDR approach).¹ Pain, due to its psycho-physical duality, is difficult to define. Definition adopted by the International Association for the Study of Pain (IASP) describes pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage”.² In clinical practice, the most difficult are cases when no organic cause of pain can be established and pharmacological treatment does not provide satisfactory results. Regardless of the origin of pain – biological or psychological – both rehabilitation and psychotherapy may be long and not always provide the expected improvement. The purpose of this work was to present analgesic effects obtained with EMDR in a patient with paraparesis.