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1. Loris, M., & Johnson, D. R. (2001, December). Case study: Client treatment preference and imaginal exposure in three cognitive behavioral PTSD treatment. Poster presented at the 17th annual meeting of the International Society for Traumatic Stress Studies, New Orleans, LA.

Language: English

Format: Conference

Abstract: This case discussion will examine the intervention of EMDR (Shapiro, 1989), Prolonged Exposure (Foa, Rothbaum, Riggs & Murdock, 1990), and the Counting Method (Ochberg, 1996) on three adult female patients with PTSD symptoms. A recent treatment outcome study of 40 female trauma victims (Johnson and Lubin, 2001 in press) comparing these three treatments finds that the efficacy of the three treatments is supported and that the element of imaginal exposure may be the critical therapeutic factor. The presentation of these three cases focuses on the issue of client’s treatment preference and client personality traits as factors which may interface with imaginal exposure in treatment efficacy.

Keywords: Counting Method  Prolonged Exposure  Poster  

Accuracy Verified: Yes


2. Loris, M., & Johnson, D. R. (2001, December). Client treatment preference and imaginal exposure in three cognitive behavioral PTSD treatments. Presentation at the 17th annual meeting of the International Society for Traumatic Stress Studies, New Orleans, LA .

Language: English

Format: Conference

Abstract:
This case discussion will examine the intervention of EMDR (Shapiro, 1989), Prolonged Exposure (Foa, Rothbaum, Riggs & Murdock, 1990), and the Counting Method (Ochberg, 1996) on three adult female patients with PTSD symptoms. A recent treatment outcome study of 40 female trauma victims (Johnson and Lubin, 2001 in press) comparing these three treatments finds that the efficacy of the three treatments is supported and that the element of imaginal exposure may be the critical therapeutic factor. The presentation of these three cases focuses on the issue of client’s treatment preference and client personality traits as factors which may interface with imaginal exposure in treatment efficacy.

Keywords: Imaginal Exposure  Posttraumatic Stress Disorder  PTSD  

Accuracy Verified: Yes


3. Kristjánsdóttir, K., & Lee, C. W. (2011). A comparison of visual versus auditory concurrent tasks on reducing the distress and vividness of aversive autobiographical memories. Journal of EMDR Practice and Research, 5(2), 34-41. doi:10.1891/1933-3196.5.2.34.

Language: English

Format: Journal

Abstract:
This study investigated the benefits of eye movement similar to that used in eye movement desensitization and reprocessing (EMDR) on reducing the vividness and emotionality of negative autobiographical memories. It was hypothesized, based on the working memory model, that any task that disrupts working memory would reduce the vividness and emotionality of distressing memories. In addition, it was predicted that the more visual a memory, the greater the reduction in vividness by a concurrent visual task over an auditory task (counting). Thirty-six nonclinical participants were asked to recall an unpleasant autobiographical memory while performing each of three dual-attention tasks: eye movement, listening to counting, or control (short exposure). Results showed that vividness and emotionality ratings of the memory decreased significantly after eye movement and counting, and that eye movement produced the greatest benefit. Furthermore, eye movement facilitated greater decrease in vividness irrespective of the modality of the memory. Although this is not consistent with the hypothesis from a working memory model of mode-specific effects, it is consistent with a central executive explanation. Implications for enhancing exposure treatment for posttraumatic stress disorder (PTSD) are discussed.

Keywords: Autobiographical Memory  Counting Method  Eye Movement  Vividness  Working Memory  

Accuracy Verified: Yes


4. Greenwald, R., McClintock, S. D., & Bailey, T. D. (2012, October). A controlled comparison of eye movement desensitization & reprocessing (EMDR) and progressive counting (PC). Poster presented at the annual meeting of the EMDR International Association, Arlington, VA.

Language: English

Format: Conference

Abstract:
EMDR is the most effctive (Ho & Lee, 2012) and efficient (Greenwald et al, 2012) of the established trauma treatments and it is well tolerated by clients. However, EMDR is complex, making dissemination challenging and expensive (Greenwald, 2066a). PC is simplet, more qickly learned, and had shown promise in case stuidies (Greenwald, 2008a, 2008b) and open trials (Greenwald & Schmidt, 2010). If PC is comprable to EMDR, then dissemination of top-tier trauma treatment can be more economical.

Keywords: Poster  Progressive Counting  

Accuracy Verified: Yes


5. Greenwald, R., McClintock, S. D., & Bailey, T. D. (In press). A controlled comparison of progressive counting and eye movement desensitization & reprocessing. Journal of Aggression, Maltreatment, & Trauma.

Language: English

Format: Other

Abstract:
Ten therapists who were already trained and experienced in eye movement desensitization & reprocessing (EMDR) received training in progressive counting (PC), a newer trauma resolution method. Nineteen volunteers with single-incident trauma or loss were assigned to a therapist and then randomized to treatment condition; 15 completed treatment to termination criteria or until the fourth session. Participants in both conditions experienced significant reductions in PTSD symptoms, memory-related distress, and presenting problems at one week post-treatment, maintained at 12-week follow-up, with no significant differences in outcomes, treatment efficiency, or dropout rate. The preliminary findings of this pilot study suggest that PC is an efficient, well-tolerated, and effective trauma treatment that is relatively easy for therapists to master.

Keywords: CBT  Cognitive Behavior Therapy  Exposure  Loss  Progressive Counting  Trauma  Treatment  

Accuracy Verified: No


6. van den Hout, M. A., Engelhard, I. M., Smeets, M. A. M., Hornsveld, H., Hoogeveen, E., de Heer, E., Toffolo, M. B. J., & Rijkeboer, M. (2010, April). Counting during recall: Taxing of working memory and reduced vividness and emotionality of negative memories. Applied Cognitive Psychology, 24(3), 303-311. doi:10.1002/acp.1677.

Language: English

Format: Journal

Abstract:
While initially subject to debate, meta-analyses have shown that eye movement desensitization and reprocessing (EMDR) is effective in the treatment of posttraumatic stress disorder (PTSD). Earlier studies showed that eye movements during retrieval of emotional memories reduce their vividness and emotionality, which may be due to both tasks competing for limited working memory (WM)resources. This study examined whether another secondary task that taxes WM has beneficial effects, and whether the stronger the taxing, the stronger the reductions in vividness/adversity. A reaction time (RT) paradigm showed that counting backwards requiresWMresources, and that more complex counting is more demanding than simple counting. Relative to a retrieval-only condition, counting during retrieval of emotional memories reduced vividness and emotionality during later recall of these memories. However, the counting conditions did not differ in the magnitude of this reduction, and did not show the predicted dose-response relationship. Implications for a working-memory explanation of EMDR and for clinical practice are discussed. Copyright#2010 JohnWiley & Sons, Ltd.

Keywords: Counting  Reaction Time Paradigm  Working Memory  

Accuracy Verified: Yes


7. Johnson, D. R., & Lubin, H. (2006). The counting method:  Applying the rule of parsimony to the treatment of posttraumatic stress disorder. Traumatology, 12(1), 83-99. doi:10.1177/153476560601200106.

Language: English

Format: Journal

Abstract:
A study is described comparing Prolonged Exposure, Eye Movement Desensitization and Reprocessing, and the Counting Method with 51 multiply-traumatized women. Measures of PTSD were significantly reduced by all three methods, but differences among the methods were negligible. Because the Counting Method utilizes only imaginal exposure as a therapeutic element, support is given to the more parsimonious conclusion that imaginal exposure may be both the necessary and sufficient factor in therapeutic effect, countering a trend in the field toward more complex, multi-faceted treatment packages. [Author Abstract]

Keywords: Adults  Counting Method  Exposure Therapy  Females  Imaginal Exposure  Multiple Traumatic Events  Posttraumatic Stress Disorder  PTSD  Random Clinical Trial  RCT  Survivors  Treatment Effectiveness  Women  

Accuracy Verified: Yes


8. Hornsveld, H., & van den Hout, M. (2010, April). Een serie experimenten naar oogbewegingen en klikjes: Wat werkt beter? [A series of experiments on eye movements and clicks, what works better?]. Presentatie op de suxth congres van de Vereniging EMDR Nederlands, Nijmegen, Nederlands.

Language: Dutch

Format: Conference

Abstract:
Er zijn verschillende theorieën over de werkingsmechanismen van EMDR. De belangrijkste theorieën zullen kort worden toegelicht en het wetenschappelijk bewijs ervoor samengevat. Vervolgens zullen we een serie eigen experimenten presenteren: drie studies bij studenten en één studie bij PTSS- patiënten. In deze experimenten zullen oogbewegingen telkens worden vergeleken met andere taakjes of stimuli. Implicaties voor de theorievorming en voor de klinische praktijk zullen worden bediscussieerd tijdens de workshop aan de hand van stellingen. Exp 1 laat zien dat de positieve bevindingen voor oogbewegingen (ten opzichte van een controle conditie) ook gevonden worden bij negatieve herinneringen aan een verlieservaring. Dit geeft een empirische basis voor de suggestie dat EMDR ook zinvol toegepast kan worden bij gecompliceerde rouw. Exp 2 gaat over het werkgeheugen en een eventuele dosis respons relatie. Met andere woorden: geven taken die een grotere belasting voor het werkgeheugen vormen ook grotere SUD-dalingen? Exp 3 Laat zien dat de werkgeheugenbelasting van oogbewegingen veel groter is dan van de bekende koptelefoon met klikjes. Vervolgens vergelijken we de werkzaamheid van oogbewegingen, klikjes, en een controle-conditie bij studenten die negatieve herinneringen ophalen. Exp 4 is een klinische studie bij PTSS patiënten, waarbij we oogbewegingen, klikjes en controle (herinneringsbeeld zonder bilaterale stimulatie) met elkaar vergelijken. Verwacht wordt dat de eerste voorlopige data tijdens het congres beschikbaar zijn.
Hornsveld, H., Landwehr, F., Stein, W., Stomp, G., Smeets, M. &. van den Hout, M. (2010). Emotionality of loss-related memories is reduced after retrieval plus eye movements but not after retrieval plus music or retrieval only. Submitted.
Hout, M.A. van den, Engelhard, I.M., Rijkeboer, M., Koekebakker, J., Hornsveld, H. Toffolo, M., & Akse, N. (2010). Eye movements tax working memory, but binaural stimulation does not. Manuscript in preparation.
Hout, M.A. van den,, Engelhard, I., Smeets, M, Hornsveld, H., Hoogeveen, E., de Heer, E. & Rijkeboer, M. ( 2010). Counting during recall: taxing of working memory and reduced vividness and emotionality of negative memories. In press, Applied Cognitive Psychology.

There are several theories about the mechanisms of action of EMDR. The main theories will be briefly explained and summarized the scientific evidence before. Then we will present a series of own experiments: studies in three students and a study in PTSD patients. In these experiments will be compared with each eye movement or other minor assignments stimuli. Implications for theory and for clinical practice will be discussed during the workshop by means of propositions. Exp 1 shows that the positive findings for eye movements (compared to a control condition) also found associated with negative memories of a loss experience. This provides an empirical basis for the suggestion that EMDR is also useful can be used for complicated grief. Exp 2 is about memory and a possible dose response relationship. In other words, tasks that give a greater burden on working memory are also larger SUD decreases? Exp 3 Shows that the memory load of eye movements is much greater than the known Headphones clicks. Then we compare the efficacy of eye movements, clicks, and a control condition in which students negative memories. Exp 4 A clinical study in PTSD patients, we eye movements, clicks and control (memory image without bilateral stimulation) compared. It is expected that the preliminary data available at the conference.
Horn Field, H., Landwehr, F., Stein, W., Stump, G., Smeets, M. &. van den Hout, M. (2010). Emotionality or loss-related pleadings Reduced after retrieval plus eye movements but not after retrieval or retrieval plus music only. Submitted.
Wood, M.A. van den, Engelhard, IM, Rijkeboer, M., Koekebakker, J., Horn Field, H. Toffolo, M., & Akse, N. (2010). Eye movements tax working memory, but Does Not binaural stimulation. Manuscript in preparation.
Wood, M.A. van den, Engelhard, I., Smeets, M, Horn Field, H., Hoogeveen, E., Mr. E. Farmer & Rich, M. (2010). Counting consistently recall: Taxing of working memory and Reduced vivid ness and emotionality or negative statements. In press, Applied Cognitive Psychology.

Keywords: Eye Movements  Mechanism of Action  

Accuracy Verified: Yes


9. Chang, S. H. & Lee, Y. H. (2005, August). Interfering CLEM reduces vividness and emotionality of autobiographical memories. Presentation at the 2005 American Psychological Association Annual Convention, Washington, DC C. (NSC 93-2413-H-002-002-).

Language: English

Format: Conference

Abstract:
Research background: It was noted that when people recalled an emotional event, there is a spontaneous eye movements during retrieval of memory, known as conjugate lateral eye movements (CLEM). Eye movements during mental imagery are not epiphenomenal but assist the process of image generation (Hebb, 1968; Brandt & Stark, 1997). If restricted to a fixed point, then the image of recall is impaired (Laeng & Teodorescu 2002). These findings might shed light on why bilateral eye movements during imagery could decrease vividness and emotionality of recollections. Objectives: Based on the above findings, this study examined possible therapeutic mechanism of eye movements in Eye Movement Desensitization and Reprocessing (EMDR; Shapiro, 1989, 1995, 2001), of which eye movement was a crucial treatment component. Specifically, the hypothesis that interfering CLEM via introducing bilateral eye movements or a fixed position could reduce vividness and emotionality of autobiographical memories was examined in the present study. Further, whether there are different CLEMs (more rightward in positive and more leftward in negative) during retrieval of positive and negative memories was also investigated. Method: Seventeen healthy volunteers recalled two positive and two negative memories and rated their vividness and emotionality of the recollections. Next, memories were recalled whilst the participant was performing either bilateral eye movements (interference of CLEM) or mere image condition (non-interference of CLEM). Then participants were asked to recall the event again and to rate its vividness and emotionality. Vividness and emotionality ratings were analyzed using a 2 (EM condition: bilateral eye movement vs. mere image) × 2 (valence of memory: positive vs. negative) × 2 (time: before vs. after the intervention) repeated measures analysis of variance (ANOVA). During the first and last recall of each memory CLEM were recorded by a digital camera. To examine the effect of CLEM during recollections on emotionality and vividness of autobiographical memories, eye movements in each recall were counted into percentage time of eye gaze in three regions (leftward, middle, rightward), instead of counting the first lateral eye movement as used by the traditional method. Results: Compared to mere image condition, recollections after bilateral eye movements made subsequent recollections less vivid and less emotive, while the opposite was true for mere image condition. Regarding vividness, the 2 × 2 × 2 ANOVA showed that there was a significant condition × time interaction. None of the other interactions or main effects reached significance. Simple main effect indicated that the change in vividness was significant in the mere image condition, but not in the eye movement condition. As to emotionality, the three way ANOVA showed that there was also a significant condition × time interaction. None of the other interactions or main effects reached significance. Simple main effect indicated that the change in emotionality was significant in the mere image condition, and in eye movement condition. Concerning percentage of gaze direction (left, right) in positive and negative memories, pair t test showed that there was a significant right gaze difference between positive and negative memories, and approached significant left gaze difference between positive and negative memories. With regard to CLEM, negative memories showed less right gazes and more left gazes than positive memories. Conclusion:The bilateral eye movements made autobiographical memories less vivid and less emotive than mere image condition, while mere image increased the vividness and emotionality of autobiographical memories. Further, there is different CLEM for negative and positive memories. While the hypothesis that interference of CLEM reduced the vividness and emotionality of autobiographical memories was confirmed, the role of eye movement in the EMDR was discussed and future research possibilities are proposed.

Keywords: Autobiographical Memory  CLEM  Eye Movements  Gaze Direction  

Accuracy Verified: Yes


10. Greenwald, R., & Schmitt, T. A. (2010). Progressive counting: Multi-site group and individual treatment open trials. Psychological Trauma: Theory, Research, Practice, and Policy, 2(3), 239–242. doi:10.1037/a0019361.

Language: English

Format: Journal

Abstract:
Progressive counting (PC), a variant of the counting method, is a recently developed trauma resolution procedure that appears to be efficient and well tolerated by clients. This paper reports on the posttreatment, 1 week, and 1 month posttreatment outcomes of 232 participants in 6 countries who experienced a brief Group PC treatment—average about 5 minutes of exposure—of a minor upsetting memory during the course of their participation in trauma treatment workshops. Additional posttreatment and follow-up data is reported on 128 of these participants who experienced a second (untimed) individual PC session focused on a more significant upsetting memory. The positive and sustained benefit realized from such a brief dose of PC indicates this treatment’s potential value in individual and possibly group treatment of trauma and/or loss memories.

Keywords: Exposure  Loss  Progressive Counting  Trauma  

Accuracy Verified: Yes


11. Greenwald, R. (2008, November). Resolving early memories reduces the distress of later related memories. Poster presented at 24th annual meeting of the International Society for Traumatic Stress Studies, Chicago, IL.

Language: English

Format: Conference

Abstract:
Trauma therapists must make clinical judgments about which upsetting memories to target in what order, taking into account the particular client’s ability to tolerate a potentially challenging trauma-focused session. This paper presents the results of a study with 119 participants in 10 trauma workshops (either EMDR or Progressive Counting, an exposure variant) in 4 countries. Participants first provided a SUDS rating of an identified distressing memory, then “floated back” and worked on an earlier memory, and finally provided another SUDS rating on the initial (not worked-on) identified memory. The final SUDS rating was lower for almost every participant, often substantially so, indicating that work on earlier related memories is likely to reduce the distress associated with a later memory. Follow-up with a subset of participants at 1 and 4 weeks post-treatment indicated some deterioration but substantial maintenance of effect. When the client’s affect tolerance is a potentially limiting factor in proceeding with trauma work, the present findings support the strategy of first working through earlier related memories.

Keywords: Early Memories  Later Memories  

Accuracy Verified: Yes


12. Greenwald, R. (2008, June). Resolving early memories reduces the level of distress associated with later memories. Presentation at the annual meeting of the EMDR Europe Association, London, England.

Language: English

Format: Conference

Abstract:
EMDR practitioners must make clinical judgments about which memories to target in what order, taking into account the particular client’s ability to tolerate a potentially challenging trauma-focused session. This paper presents the results of a study in which x participants in trauma training (both EMDR and Progressive Counting, an exposure variant) first provided a SUDS rating on an identified distressing memory, then “floated back” and worked on an earlier memory, and finally provided another SUDS rating on the initial (not worked-on) target. The final SUDS rating was consistently lower, often substantially so, indicating that work on earlier related memories is likely to reduce the distress associated with a later memory. When the client’s affect tolerance is a potentially limiting factor in proceeding with EMDR, the present findings support the strategy of first working through earlier related memories.

Keywords: Memories  

Accuracy Verified: Yes


13. Moskovitz, R. A. (2000, December). Saccadic eye movements as a guide to EMDR technique. EMDRIA Newsletter, 5(Special Edition), 14-15.

Language: English

Format: Newsletter

Abstract:
The duration of each set of eye movement is one of several variables that must be managed during EMDR. As we begin to work with patients, we choose the direction and rate of speed of each set of movements as well as the total number of movements per set. The basic guideline calls for 24 bi-directional movements for the first set. While subsequent sets may also consist of 24 passes, the length of the sets may be adjusted up or down depending upon patient response or therapeutic goals. Processing intense emotions, for examples, may call for longer sets, while shorter sets may be sufficient to evoke sequences of cognitive associations. While some therapists prefer to adhere to a rigid protocol, counting out each set, may others determine the length of each set intuitively.

Keywords: Saccadic Eye Movements  

Accuracy Verified: Yes


14. de Heer, E. W., & Hoogeveen, E. M. (2009). Taxing working memory during recall of distressing memories with a counting task and EMDR benefits. Utrecht, Nederlands: Universiteit Utrecht.

Language: English

Format: Dissertation/Thesis

Abstract:
Dit experiment is gebaseerd op de hypothese dat de omvang van de EMDR-effecten kritisch hangt af van de mate waarin het werkgeheugen (WM) is belast tijdens het ophalen. De deelnemers deden herinneren aan pijnlijke herinneringen tijdens het uitvoeren van een van de twee afleidende taken (terugtellend met stappen van 2 of 7), het ene meer, afhankelijk van WM dan de andere. Hoe meer WM was belast, de grotere verlagingen van de levendigheid en emotionaliteit werden verwacht. De uitkomsten werden vergeleken met een controle conditie. Terugtellend met stappen van 2 of 7, terwijl we een verontrustende autobiografisch geheugen in het achterhoofd, verlaagt de emotionaliteit van het geheugen dat met name in vergelijking met het tellen van helemaal geen. De verlaging van de 7's staat, echter niet significant afwijken van de verlaging van de eenvoudige (dwz 2's) staat. Kortingen voor levendigheid werden niet gevonden. Deze resultaten ondersteunen het werkgeheugen account. Er is echter meer onderzoek nodig om de dosis-respons relatie tussen WM-load en EMDR-effecten en tot een beter begrip van de elementaire onderdelen van EMDR te krijgen verklaren.

This experiment is based upon the hypothesis that the magnitude of the EMDR effects critically depends on the degree to which working memory (WM) is taxed during retrieval. Participants did recall distressing memories while performing one of two distracting tasks (counting backwards with steps of 2 or 7); the one more depending on WM than the other. The more WM was taxed, the larger reductions in vividness and emotionality were expected. The outcomes were compared to a control condition. Counting backwards with steps of 2 or 7, while holding a distressing autobiographical memory in mind, decreases the emotionality of that particular memory compared to no counting at all. The reduction in the 7’s condition, however, did not differ significantly from the reduction in the simple (i.e. 2’s) condition. Reductions for vividness were not found. These results do support the working memory account. However, more research is needed to explain the dose-response relation between WM-load and EMDR-effects and to get a better understanding of the elementary components in EMDR.

Keywords: Retrieval  Working Memory  

Accuracy Verified: Yes


15. Lilley, S. A., Andrade, J., Turpin, G., Sabin-Farrell, R., & Holmes, E. A. (2009, September). Visuospatial working memory interference with recollections of trauma. British Journal of Clinical Psychology, 48(3), 309–321. doi:10.1348/014466508X398943.

Language: English

Format: Journal

Abstract:
Objectives: Laboratory research using a working memory framework has shown modality-specific reductions in image vividness and emotionality when concurrent tasks are performed while maintaining the image in consciousness. We extended this research to trauma images in a clinical population awaiting treatment for post-traumatic stress symptoms. Design: A within-subjects design was used, with each participant completing an imagery task under three concurrent task conditions: side-to-side eye-movements, counting, and exposure only (no concurrent task). Methods: Eighteen participants selected three images each, the images being those that were the most distressing from participants’ trauma memories and most likely to intrude involuntarily. Participants gave baseline ratings of the vividness and emotionality of each of their trauma images. Each image was assigned to a condition. Each condition comprised 8 trials in which participants recollected the appropriate image for 8 s while performing eye-movements, counting or no concurrent task, and then rated its vividness and emotionality. Follow-up ratings were obtained by telephone 1 week later. Results: The eye-movement task reduced vividness and emotionality of the trauma images relative to the counting task and exposure only, but did so only during the imagery period and not at follow-up. The images were predominantly visual. Conclusions: Concurrent tasks matched to the modality of trauma images may provide a useful treatment aid for temporarily dampening emotional responses to recollections of trauma.

Keywords: Trauma  Memory  Visuospatial Working Memory Interference  

Accuracy Verified: Yes


16. Greenwald, R., Smyth, N., & Maxfield, L. (2008, September). What makes trauma treatment work? Progressive counting research sheds light on EMDR. Presentation at the annual meeting of EMDR International Association, Phoenix, AZ.

Language: English

Format: Conference

Abstract:
Progressive Counting (PC) is a recently developed Exposure method that may prove to be as efficient as EMDR and as easy for clients to tolerate. PC is based on the Counting Method and has much in common with EMDR. Participants will learn about the research on PC, including research on mechanisms of effect. Participants will have a chance to try PC with one of their own minor upsetting memories. Then an expert panel will lead a discussion about similarities and differences between PC and EMDR, and possible mechanisms of effect across trauma treatments.

Keywords: Progressive Counting  Research  

Accuracy Verified: Yes