Emdr (Göz Hareketleriyle Duyarsızlaştırma ve Yeniden İşleme) Terapisinin Nörobiyolojik Etkisi

Abstract

ÖZET Yüzlerce farklı psikoterapi yaklaşımından biri olan EMDR (Göz Hareketleriyle Duyarsızlaştırma ve Yeniden İşleme) terapisi, başlangıçta travma odaklı bir müdahale biçimi olarak geliştirilmiş olsa da günümüzde psikoterapinin çok çeşitli alanlarında yaygın biçimde kullanılmaktadır. EMDR’nin travmatik anıları doğrudan hedef alan özgün yapısı, nörobilim alanındaki güncel gelişmelerle birlikte ele alındığında, psikoterapötik süreçlerin beyinde özellikle bellek sistemleri ve duygu düzenleme ağları üzerinde nasıl derin değişiklikler yarattığını anlamaya yönelik son derece önemli bir çerçeve sunmaktadır. Yapılan nörogörüntüleme ve elektrofizyolojik çalışmalar; anı işlemeye dayalı bu tür müdahalelerin duygu ve farkındalık yönetiminde birincil işleve sahip prefrontal korteksin duygu düzenleme kapasitesini belirgin şekilde güçlendirebildiğini ortaya koymaktadır. Söz konusu araştırmalar aynı zamanda ödül-ceza ve hoşnutluk-hoşnutsuzluk değerlendirmesinde temel nörobiyolojik bir role sahip limbik sistemdeki aşırı uyarılmayı azaltabildiğini de kanıtlamaktadır. Bununla birlikte EMDR’nin, bellek ağları üzerinde duygu yönetimini olumlu yönde etkileyecek son derece uyumlu bir bellek bütünleşmesi sağlayabildiği görülmektedir. Bu bağlamda, çalışmada EMDR terapisinin karmaşık nörobiyolojik etkileşimleri kapsamlı bir şekilde ele alınmış; özellikle anıların adaptif biçimde yeniden işlenmesi, duygu düzenleme becerisinin yeniden dengelenmesi ve nöral konsolidasyon süreçlerinin güçlenmesi üzerindeki klinik etkileri ayrıntılarıyla değerlendirilmiştir.

Keywords

• EMDR
• Hafıza
• Konsolidasyon
• Psikoterapi
• Travma

Neurobiological Effects of Eye Movement Desensitization And Reprocessing (Emdr) Therapy

Abstract

ABSTRACT EMDR (Eye Movement Desensitization and Reprocessing) therapy, one among hundreds of psychotherapeutic approaches, was originally developed as a trauma-focused intervention but is now applied across a wide range of clinical contexts. Its direct focus on targeting traumatic memories, considered alongside advances in neuroscience, offers an important framework for understanding how psychotherapeutic processes modify the neural systems involved in memory and emotion regulation. Neuroimaging and electrophysiological studies indicate that memory processing-based interventions can significantly strengthen the emotional regulation capacity of the prefrontal cortex—which serves a primary function in emotion and awareness management. These studies also demonstrate that such interventions reduce hyperactivation within the limbic system, which plays a fundamental neurobiological role in evaluating reward–punishment and pleasure–displeasure. Furthermore, EMDR appears to facilitate a highly coherent integration across memory-related networks, thereby positively influencing emotion management. Within this framework, the present study examines the neurobiological correlates of EMDR, with particular attention to its effects on adaptive memory reprocessing, the modulation of affective regulation circuits, and the strengthening of neural consolidation processes.

Keywords

• EMDR
• Consolidation
• Memory
• Psychotherapy
• Trauma

References

1. Alberini, C.M. (2005). Mechanisms of memory stabilization: are consolidation and reconsolidation similar or distinct processes? Trends in Neurosciences, 28(1), 51-56.(pmc.ncbi.nlm.nih.gov)
2. Alberini, C. M., ve Ledoux, J. E. (2013). Memory reconsolidation. Current biology: CB, 23(17), R746–R750. https://doi.org/10.1016/j.cub.2013.06.046
3. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorder(5th ed., pp. 271–272). American Psychiatric Publishing.
4. Bailey, Ch. Bartsch, D. ve Kandel, Er. (1996). Toward a molecular definitionof long-term memory storage. Proc. Natl. Acad. Sci., 93, 13445–13452. Doi: https://doi.org/10.1073/pnas.93.24.13445
5. Bergmann, U. (2008). The neurobiology of EMDR: Exploring the thalamus and neural integration. Journal of EMDR Practice and Research, 2(4), 300–314. https://doi.org/10.1891/1933-3196.2.4.300
6. Boore, J. (1993). EMDR- A New Procedure. The California Therapist. Professional Exchange. 40-42. Erişim adresi: https://dr.blair-west.com/wp-content/uploads/2009/10/EMDR-Handouts1.pdf
7. Calancie, O. G., Khalid-Khan, S., Booij, L., ve Munoz, D. P. (2018). Eye movement desensitization and reprocessing as a treatment for PTSD: current neurobiological theories and a new hypothesis. Annals of the New York Academy of Sciences, 10.1111/nyas.13882. Advance online publication. https://doi.org/10.1111/nyas.13882
8. Coubard O.A. (2016) An Integrative Model for the Neural Mechanism of Eye Movement Desensitization and Reprocessing (EMDR). Front. Behav. Neurosci. 10,52. doi: 10.3389/fnbeh.2016.00052

9. De Jongh, A., van den Oord, H. J. M., ve ten Broeke, E. (2002). Efficacy of eye movement desensitization and reprocessing in the treatment of specific phobias: Four single-case studies on dental phobia. Journal of Clinical Psychology, 58(12), 1489–1503. https://doi.org/10.1002/jclp.10100
10. De Jongh, A., Ten Broeke, E. (2007). Treatment of specific phobias with EMDR: conceptualization and strategies fort he selection of appropriate memories. Journal Of EMDR Practice And Research, Springer Publishing Company, 1,48-58.
11. De Roos, C., Greenwald, R., den Hollander-Gijsman, M., Noorthoorn, E., van Buuren, S., de Jongh, A. (2011). A randomised comparison of cognitive behavioural therapy (CBT) and eye movement desensitisation and reprocessing (EMDR) in disaster-exposed children. Eur J Psychotraumatol, 2. 5694- 5705. doi: 10.3402/ejpt. v2i0.5694.
12. De Voogd, L. D., Kanen, J. W., Neville, D. A., Roelofs, K., Fernández, G., ve Hermans, E. J. (2018). Eye-Movement Intervention Enhances Extinction via Amygdala Deactivation. The Journal of neuroscience: the official journal of the Society for Neuroscience, 38(40), 8694–8706. https://doi.org/10.1523/JNEUROSCI.0703-18.2018
13. Demirci, O., Sağaltıcı, E., ve Yıldırım, A.(2015). Özgül Fobinin Göz Hareketleri ile Duyarsızlaştırma ve Yeniden İşleme Yöntemi ile Tedavisi: Bir Olgu Sunumu. Klinik Psikiyatri Dergisi, 18,124-129.
14. Denizli, S. (2008). Göz hareketleri ile duyarsızlaştırma ve yeniden işleme: yaklaşım etkililiği ve bugünkü durumu. Ege Eğitim Dergisi, 2(9): 79-92.
15. Di Lorenzo, G., Monaco, L., Daverio, A., Santarnecchi, E., Verrdo, Ar., Niolu, C., Fernandez, I., Pagani, M., Siracusano, A. (2015). EMDR therapy changes the resting-state eeg. European Psychiatry, 30, 677. Doi: https://doi.org/10.1016/S0924-9338(15)30537-X
16. Farrell, D. (2018). The neurobiology of Eye Movement Desensitization and Reprocessing therapy. Research Gate.Net, The Wiley Blackwell Handbook Of Forensic Neuroscience, 755-781. Doi:10.1002/9781118650868.ch29
17. González, A., Del Río-Casanova, L., & Justo-Alonso, A. (2017). Integrating neurobiology of emotion regulation and trauma therapy: reflections on EMDR therapy. Reviews in the neurosciences, 28(4), 431–440. https://doi.org/10.1515/revneuro-2016-0070
18. Guskjolen, A., & Cembrowski, M. S. (2023). Engram neurons: Encoding, consolidation, retrieval, and forgetting of memory. Molecular Psychiatry, 28, 3207–3219. https://doi.org/10.1038/s41380-023-02137-5
19. Kandel, E. R., Dudai, Y., ve Mayford, M. R. (2014). The molecular and systems biology of memory. Cell, 157(1), 163–186. https://doi.org/10.1016/j.cell.2014.03.001
20. Karaoğlan, G., Ekici, F., Demir, L. S., ve Güler, Ö. (2025). A population-based study assessing posttraumatic stress disorder and acute stress disorder in Turkish adults. Journal of Psychiatric Research, 190, 17–24. https://doi.org/10.1016/j.jpsychires.2025.07.034
21. Kavakçı, Ö. (2012). Ruhsal Travma Tedavisi İçin EMDR. Hekimler Yayın Birliği, 36-37, 80-81,147-150.
22. Kaye, B. (2007). Reversing Reciprocal Suppression in the Anterior Cingulate Cortex. A Hypothetical Model to Explain EMDR Effectiveness. Journal of EMDR Practice and Research, 1(2), Doi: 10.1891/1933-3196.1.2.88
23. Laugharne, J., Kullack, C., Lee, C. W., McGuire, T., Brockman, S., Drummond, P. D., & Starkstein, S. (2017). Amygdala volumetric change following psychotherapy for posttraumatic stress disorder. Journal of Neuropsychiatry and Clinical Neurosciences, Advance online publication. https://doi.org/10.1176/appi.neuropsych.16010006
24. Lansing, K., Amen, DG., Hanks, C., ve Rudy, L. (2005). High resolution brain SPECT imaging and EMDR in police officers with PTSD. Journal of Neuropsychiatry and Clinical Neurosciences, 17, 526–532.
25. Lapsekili, N., ve Yelboğa, Z. (2014). Treatment of flight phobia (Aviophobia) through the Eye Movement Desensitization and Reprocessing (EMDR) method: A case report. Düşünen Adam Journal of Psychiatry and Neurological Sciences, 27, 168-172.
26. LeDoux J. E. (2000). Emotion circuits in the brain. Annual review of neuroscience, 23, 155–184. https://doi.org/10.1146/annurev.neuro.23.1.155
27. Letizia, B., Andrea, F., ve Paolo, C. (2007). Neuroanatomical changes after eye movement desensitization and reprocessing (EMDR) treatment in posttraumatic stress disorder. The Journal of neuropsychiatry and clinical neurosciences, 19(4), 475–476. https://doi.org/10.1176/jnp.2007.19.4.475
28. Levin, P., Lazrove S., Bessel, Van Der Kolk. (1999). What Psychological Testing and Neuroimaging Tell Us about the Treatment of Posttraumatic Stress Disorder by Eye Movement Desensitization and Reprocessing. Journal of Anxiety Disorders, 13, (1–2), 159–172.
29. Liu, Y., Zhou, Z. X., Lv, Q., Huang, G., Zhang, H., Wang, Y. Q., Chen, J. G., ve Wang, F. (2024). A superior colliculus-originating circuit prevents cocaine reinstatement via VR-based eye movement desensitization treatment. National science review, 12(4), nwae467. https://doi.org/10.1093/nsr/nwae467
30. Luber, M. (2009). Eye Movement Desensitization and Reprocessing (EMDR) Scripted Protocols: Basics and Special Situations. Springer Publishing Company, 67-80. 85-88, 133-142, 155-173
31. Mattera, A., Cavallo, A., Granato, G., Baldassarre, G., ve Pagani, M. (2022). A Biologically Inspired Neural Network Model to Gain Insight Into the Mechanisms of Post-Traumatic Stress Disorder and Eye Movement Desensitization and Reprocessing Therapy. Frontiers in psychology, 13, 944838. https://doi.org/10.3389/fpsyg.2022.944838
32. Maxfıeld, L. (2009). EMDR milestones: The first 20 years. Journal of EMDR Practice and Research. Springer Publishing Company, 3 (4),211-216.
33. Oh, Dh., Choi, J. (2007). Changes in the regional cerebral perfusion after Eye Movement Desensitization and Reprocessing: A spect study of two cases. Journal of EMDR Practice and Research, 1,26-32.
34. Ohtani, T., Matsuo, K., Kasai, K., Kato, T., ve Kato, N. (2009). Hemodynamic responses of eye movement desensitization and reprocessing in posttraumatic stress disorder. Neuroscience research, 65(4), 375–383. https://doi.org/10.1016/j.neures.2009.08.014
35. Pagani, M., Hogberg, G., Salmaso, D., Nardo, D., Sundin, O., Jonsson, C. (2007). Effects of EMDR psychotherapy on 99m Tc-HMPAO distribution in occupationrelated post-traumatic stress disorder. Nuclear Medicine Communications, 28(10), 757–765.
36. Pagani, M., Di Lorenzo, G., Verardo, Ar., Nicolais, G., Monaco, L. (2012). Neurobiological Correlates Of EMDR Monitoring – An Eeg Study. Plos One, 7(9), E45753-. Doi: 10.1371/Journal.Pone.0045753
37. Pagani, M., Di Lorenzo, G., Monaco, L., Daverio, A., Giannoudas, I., La Porta, Patrizia., Verardo, Ar., Niolu, C., Fernandez, I., Siracusano, A. (2015). Neurobiological response to EMDR therapy in clients with different psychological traumas, Frontiers in Psychology, Clinical and Health, 6,1614.
38. Pagani, M., Amann, B. L., Landin-Romero, R., ve Carletto, S. (2017). Eye Movement Desensitization and Reprocessing and Slow Wave Sleep: A Putative Mechanism of Action. Frontiers in psychology, 8, 1935. https://doi.org/10.3389/fpsyg.2017.01935
39. Propper, R. E., Pierce, J., Geisler, M. W., Christman, S. D., ve Bellorado, N. (2007). Effect of bilateral eye movements on frontal interhemispheric gamma EEG coherence: implications for EMDR therapy. The Journal of nervous and mental disease, 195(9), 785–788. https://doi.org/10.1097/NMD.0b013e318142cf73
40. Rasolkhani-Kalhorn, T., Harper, M.l.. (2006). EMDR and low frequency stimulation of the brain. Traumatology, 12,9-24. https://doi.org/10.1177/153476560601200102
41. Raynaud, P., Boxus, A., Renoir, V., Sanchez, S. (2024). From mind to brain: event-related potentials and EMDR treatment of post-traumatıc stress disorder. 20th European Congress Of Psychiatry. https://doi.org/10.1016/S0924-9338(12)75142-8
42. Ridderinkhof, K. R., Ullsperger, M., Nieuwenhuis, S. T. (2004). The role of medial frontal cortex in cognitive control. Science, 306(5695), 443-447. https://doi.org/10.1126/science.110030
43. Rudoy, J. D., Voss, J. L., Westerberg, C. E., ve Paller, K. A. (2009). Strengthening individual memories by reactivating them during sleep. Science (New York, N.Y.), 326(5956), 1079. https://doi.org/10.1126/science.1179013
44. Santarnecchi, E., Bossini, L., Vatti, G., Fagiolini, A., La Porta, P., Di Lorenzo, G., Siracusano, A., Rossi, S., ve Rossi, A. (2019). Psychological and Brain Connectivity Changes Following Trauma-Focused CBT and EMDR Treatment in Single-Episode PTSD Patients. Frontiers in psychology, 10, 129. https://doi.org/10.3389/fpsyg.2019.00129
45. Seidler, G. H., & Wagner, F. E. (2006). Comparing the efficacy of EMDR and trauma-focused cognitive-behavioral therapy in the treatment of PTSD: A meta-analytic study. Psychological Medicine, 36(11), 1515–1522. https://doi.org/10.1017/S0033291706007963
46. Shapiro, F. (2001). Eye Movement Desensitization And Reprocessing: Basic Principles, Protocols And Procedures (2nd Ed.). The Guilford Press: 18-60,69-76,91-200,210-215.
47. Shapiro, F. (2002a). EMDR As An Integrative Psychotherapy Approoach. American Psychological Association. 151-160, 209-220.
48. Shapiro, F. (2002b). EMDR 12 years after its introduction: Past and future research. Journal of Clinical Psychology, 58(1), 1–22.
49. Shapiro, F., Maxfield, L. (2002). Eye Movement Desensitization And Reprocessing (EMDR): ınformation processing in the treatment of trauma. Journal Clinical Psychology, 58,933–946.
50. Shapiro, F. (2012). EMDR Terapisi Teknikleri İle Acı Anıları Silmek. Kuraldışı Yayıncılık: 27.
51. Siegel, D., (2002). EMDR As An Integrative Psychotherapy Approach. Edited By Shapiro F. United Book Press. 85.
52. Squire L. R. (1992). Memory and the hippocampus: a synthesis from findings with rats, monkeys, and humans. Psychological review, 99(2), 195–231. https://doi.org/10.1037/0033-295x.99.2.195
53. Stickgold, R. (2002). EMDR: A Putative Neurobiological Mechanism Of Action. Journal of Clincial Psychology, 58,61–75.
54. Szeska, C., Mohrmann, H., ve Hamm, A. O. (2023). Facilitated extinction but impaired extinction recall by eye movement manipulation in humans - Indications for action mechanisms and the applicability of eye movement desensitization. International journal of psychophysiology: official journal of the International Organization of Psychophysiology, 184, 64–75. https://doi.org/10.1016/j.ijpsycho.2022.12.009
55. Trentini, C., Pagani, M., Fania, P., Speranza, A. M., Nicolais, G., Sibilia, A., Inguscio, L., Verardo, A. R., Fernandez, I., ve Ammaniti, M. (2015). Neural processing of emotions in traumatized children treated with Eye Movement Desensitization and Reprocessing therapy: a hdEEG study. Frontiers in psychology, 6, 1662. https://doi.org/10.3389/fpsyg.2015.01662
56. Van der Heijden, A. C., van der Werf, Y. D., van den Heuvel, O. A., Talamini, L. M., ve van Marle, H. J. F. (2024). Targeted memory reactivation to augment treatment in post-traumatic stress disorder. Current biology: CB, 34(16), 3735–3746.e5. https://doi.org/10.1016/j.cub.2024.07.019
57. Van Minnen, A., Voorendonk, E. M., Rozendaal, L., ve de Jongh, A. (2020). Sequence matters: Combining Prolonged Exposure and EMDR therapy for PTSD. Psychiatry research, 290, 113032. https://doi.org/10.1016/j.psychres.2020.113032
58. Vojtova, H., Hasto, J. (2009). Neurobiology Of Eye Movement Desensitization And Reprocessing. Activitas Nervosa Superior. The Journal For Neurocognitive Research, 51 (3), 98–102.
59. Wang, S., He, Y., Hu, J., Xia, J., Fang, K., Yu, J., ve Wang, Y. (2024). Eye movement intervention facilitates concurrent perception and memory processing. Cerebral cortex (New York, N.Y.: 1991), 34(5), bhae190. https://doi.org/10.1093/cercor/bhae190
60. Wiltgen, B. J., Zhou, M., Cai, Y., Balaji, J., Karlsson, M. G., Parivash, S. N., Li, W., ve Silva, A. J. (2010). The hippocampus plays a selective role in the retrieval of detailed contextual memories. Current biology: CB, 20(15), 1336–1344. https://doi.org/10.1016/j.cub.2010.06.068
61. Yoshii T. (2021). The Role of the Thalamus in Post-Traumatic Stress Disorder. International journal of molecular sciences, 22(4), 1730. https://doi.org/10.3390/ijms22041730
62. Zegerius, L., Treur, J. (2021). Modelling Metaplasticity And Memory Reconsolidation During An Eye-Movement Desensitization And Reprocessing Treatment. Proceedings Of The 11th Annual Meeting Of The Bıca Society, 598-610. Https://Doi.Org/10.1007/978-3-030-65596-9_74