This study was designed to investigate the question of whether psychophysiological changes during EMDR sessions are related to subjective and objective reduction of PTSD symptoms. During-session changes in autonomic tone in relation to session-to-session changes of subjective stress, trauma-related symptoms, and psychophysiological reactions during a traumatic reminder were investigated in 10 patients suffering from single-trauma PTSD. Treatment duration followed each patient’s individual needs and ranged between 1 and 4 sessions, resulting in a total of 24 EMDR treatment sessions from which psychophysiological data were completely recorded. Treatment with EMDR was followed by a significant reduction of trauma-related symptoms, elimination of the PTSD diagnosis in 8 of the 10 participants, as well as by significantly reduced psychophysiological reactivity to an individualized trauma script. Psychophysiological dearousal in sessions correlated significantly with decrease in script-related reactions in heart rate and parasympathetic tone, and with changes in subjective disturbance. Our results indicate that information processing during EMDR is followed by during-session decrease in psychophysiological activity, reduced subjective disturbance and reduced stress reactivity to traumatic memory.

EMDR combines stimuli that evoke divided attention – e.g. eye movements – with exposure to traumatic memories. Our objective was to investigate psycho-physiological correlates of EMDR during treatment sessions. A total of 55 treatment sessions from 10 patients with PTSD was monitored applying impedance cardiography. Onset of every stimulation/exposure period (n=811) was marked and effects within and across stimulation sets on heart rate (HR), heart rate variability (HRV), pre-ejection period (PEP) and respiration rate were examined. At stimulation onsets a sharp increase of HRV and a significant decrease of HR was noticed indicating de-arousal. During ongoing stimulation, PEP and HRV decreased significantly while respiration rate significantly increased, indicating stress-related arousal. However, across entire sessions a significant decrease of psycho-physiological activity was noticed, evidenced by progressively decreasing HR and increasing HRV. These findings suggest that EMDR is associated with patterns of autonomic activity associated with substantial psycho-physiological de-arousal over time.

Background: Patients suffering from dissociative disorders (DD) are characterized by an avoidance of aversive stimuli. Clinical experience has shown that DD patients typically avoid the confrontation with their own faces in a mirror (CFM).Objective: To investigate potential CFM-associated self-reported and psychophysiological stress reactions of DD patients, which most likely inform on the still unknown pathophysiology of dysfunctional self-perception in DD.Method: Eighteen DD patients and 18 healthy controls (HCs) underwent CFM. They were assessed for CFM-induced subjective self-reported stress, acute dissociative symptoms and sympathetic and parasympathetic drive using impedance cardiography.Results: DD patients experienced more subjective stress and acute dissociation than HCs upon CFM. Their psychological stress response did not activate the sympathetic and parasympathetic nervous system.Conclusions: In DD patients, CFM constitutes serious self-reported stress and is associated with a blunted autonomic reactivity. Therapeutic approaches promoting self-perception and self-compassion, in particular by using CFM, might serve as goal-oriented diagnostic and therapeutic tools in DD.

BackgroundBilateral sensory stimulation (BLS), such as eye movements or alternating tactile stimulation, is a key component of Eye Movement Desensitisation and Reprocessing (EMDR), a recommended treatment for post-traumatic stress disorder (PTSD). However, the neurophysiological mechanisms underlying BLS remain poorly understood.AimsThis study examined the physiological effects of visual and tactile BLS on frontal electroencephalography (EEG) activity and autonomic arousal in patients with PTSD and healthy controls, by varying the type of stimulation in different emotional stimuli.MethodTwenty female PTSD patients and twenty matched healthy controls participated in a counterbalanced, within-subjects design. Participants recalled a subjectively stressful or neutral event while receiving visual or tactile BLS. Frontal EEG and peripheral psychophysiological measures were recorded before and after stimulation. Data were analysed using mixed model analysis to examine the effects of stimulation type, memory condition and group.ResultsBoth visual and tactile BLS significantly increased the total power of frontal EEG and decreased spectral edge frequency and peripheral physiological activation. These effects were consistent between the groups and memory conditions.ConclusionsBLS, regardless of visual or tactile modality or emotional memory content, is associated with increased frontal EEG activity and reduced autonomic arousal. These findings support the hypothesis that BLS facilitates top-down cortical regulation, potentially aiding emotional processing in EMDR by using an inherent mechanism to promote psychological recovery. More research is needed to clarify the neural mechanisms and clinical implications.

BACKGROUND: Dissociative disorders frequently co-occur with post-traumatic stress disorder (PTSD), yet many individuals lack adequate treatment. Existing interventions often prioritise reducing arousal over promoting safety and self-soothing, tending to neglect the bodily experience.
AIMS: This randomised clinical within-person pilot study examined the effects of the nest position, a physiotherapeutic intervention designed to enhance safety and self-soothing, on patients with dissociative disorders and healthy controls (German Clinical Trials Register No.: DRKS00030669).
METHOD: Eighteen patients with dissociative disorders and 18 healthy controls alternated between the nest position and a neutral supine position across two rounds of a measurement session. The order of the experimental conditions (nest position or supine only) was randomised for each participant. We assessed self-reported distress and comfort (Subjective Units of Distress and Comfort) and autonomic nervous system activity during three baseline phases and imagination of stressful and comforting situations.
RESULTS: Both patients and healthy controls experienced lower distress and greater comfort in the nest position. Heart rate and sympathetic tone decreased, particularly in the healthy controls. There were no significant changes in parasympathetic tone in both groups. Linear mixed models revealed a significant effect of the nest position on distress, comfort and sympathetic tone.
CONCLUSIONS: The nest position is a potentially promising additional intervention for highly dissociative patients. Our findings help to better understand the importance of self-soothing and safety in these individuals and to address the research gap in physiotherapy within in-patient mental health care.