• Alejandro Checa Hospital de Especialidades Eugenio Espejo, Quito, Ecuador



EMDR, Psychological treatment, Suicide attempt


Background: EMDR (eye movement desensitization and reprocessing) is a structured psychotherapy method that facilitates the treatment of various psychopathologies and problems related to both traumatic events and more common but emotionally stressful experiences.1 Due to the confinement due to the COVID-19 (Coronavirus Disease 2019) pandemic, people have developed a mixture of anticipatory anxiety, stress, tiredness, misunderstanding and fear, a psychological and emotional mixture that does not fit into any of the existing boxes in the classification of mental disorders.2 Eye Movement Desensitization and Reprocessing (EMDR) has abundant evidence of efficacy in trauma spectrum disorders. Its efficacy in anxious and depressive disorders in children and adolescents has been scarcely studied.3

Objective: To evaluate the efficacy of an alternative EMDR protocol.

Methods: It is about a 13-year-old female adolescent who seeks care after having made her second suicide attempt after 9 months of failed psychological and psychiatric therapy, the standard EMDR protocol is executed in a first unsuccessful session and a variant of the EMDR protocol that occurred incidentally achieving the therapeutic goal.

Results: This is an adolescent with a history of failed mental health treatment, the standard intervention protocol with EMDR was executed without success, however; In a second attempt, the patient spontaneously proceeds with desensitization from positive experiences without ever directly addressing the traumatic event. In this case, the reprocessing of the events occurred through positive experiences for the patient instead of what is indicated in the standard protocol where the trauma is reprocessed through the negative event.

Conclusion: Psychological treatment using EMDR was effective despite its atypical execution, therefore variations to the original protocol can be applied.


Stickgold R. EMDR: A putative neurobiological mechanism of action. Journal of clinical psychology; 2002. 58(1):61-75. DOI: 10.1002/jclp.1129

Tarquinio C, Brennstuhl M-J, Rydberg JA, Bassan F, Peter L, Tarquinio CL, et al. EMDR in telemental health counseling for healthcare workers caring for COVID-19 patients: A pilot study. Issues in Mental Health Nursing; 2020. 42(1):3-14.

DOI: 10.1080/01612840.2020.1818014

Retamal MI, Sepúlveda E, Cortés JP, Barraza F, Arancibia M. Desensibilización y reprocesamiento por movimientos oculares (EMDR) para trastornos ansiosos y depresivos en niños y adolescentes: revisión de la evidencia disponible. Revista chilena de neuro-psiquiatría; 2022. 60(1):51-61.

DOI: 10.4067/s0717-92272022000100051

Shapiro F. EMDR: Desensibilización y reprocesamiento por medio de movimiento ocular: Editorial Pax México; 2010.

Oren E, Solomon R. EMDR therapy: An overview of its development and mechanisms of action. European Review of Applied Psychology; 2012. 62(4):197-203. DOI: 10.1016/j.erap.2012.08.005

Shapiro F. The role of eye movement desensitization and reprocessing (EMDR) therapy in medicine: Addressing the psychological and physical symptoms stemming from adverse life experiences. The Permanente Journal; 2014. 18(1):71.

DOI: 10.7812/TPP/13-098

Wilson G, Farrell D, Barron I, Hutchins J, Whybrow D, Kiernan MD. The use of eye-movement desensitization reprocessing (EMDR) therapy in treating post-traumatic stress disorder—A systematic narrative review. Frontiers in psychology; 2018. 9:923. DOI: 10.3389/fpsyg.2018.00923

Hase M, Brisch KH. The Therapeutic Relationship in EMDR Therapy. Front Psychol; 2022. 13:835470. DOI: 10.3389/fpsyg.2022.835470

Landin-Romero R, Moreno-Alcazar A, Pagani M, Amann BL. How does eye movement desensitization and reprocessing therapy work? A systematic review on suggested mechanisms of action. Frontiers in Psychology; 2018. 9:1395.

DOI: 10.3389/fpsyg.2018.01395

Rousseau P, El Khoury-Malhame M, Reynaud E, Zendjidjian X, Samuelian J, Khalfa S. Neurobiological correlates of EMDR therapy effect in PTSD. European Journal of Trauma & Dissociation; 2019. 3(2):103-11.

DOI: 10.1016/j.ejtd.2018.07.001

Carletto S, Porcaro C, Settanta C, Vizzari V, Stanizzo MR, Oliva F, et al. Neurobiological features and response to eye movement desensitization and reprocessing treatment of posttraumatic stress disorder in patients with breast cancer. European journal of psychotraumatology; 2019. 10(1):1600832. DOI: 10.1080/20008198.2019.1600832

March JS, Swanson JM, Arnold LE, Hoza B, Conners CK, Hinshaw SP, et al. Anxiety as a predictor and outcome variable in the multimodal treatment study of children with ADHD (MTA). Journal of Abnormal Child Psychology; 2000. 28(6):527-41.

DOI: 10.1023/a:1005179014321

Dinapoli L, Ferrarese D, Belella D, Carnevale S, Camardese G, Sani G, et al. Psychological treatment of traumatic memories in covid-19 survivors. Clin Psychol Psychother; 2022. DOI: 10.1002/cpp.2771

Teke E, Avşaroğlu S. Efficacy of eye movement desensitization and reprocessing (EMDR) therapy for children and adolescents with post-traumatic stress disorder. Journal of School and Educational Psychology; 2022. 2(1):1-12.

DOI: 10.47602/josep.v2i1.1

Karadag M, Gokcen C, Sarp AS. EMDR therapy in children and adolescents who have post-traumatic stress disorder: A six-week follow-up study. International Journal of Psychiatry in Clinical Practice; 2020. 24(1):77-82.

DOI: 10.1080/13651501.2019.1682171

Faretta E, Dal Farra M. Efficacy of EMDR therapy for anxiety disorders. Journal of EMDR Practice and Research; 2019. 13(4):325-32.

DOI: 10.1891/1933-3196.13.4.325

Mattera A, Cavallo A, Granato G, Baldassarre G, Pagani M. A Biologically inspired neural network model to gain insight into the mechanisms of post-traumatic stress disorder and eye movement desensitization and reprocessing therapy. Front Psychol; 2022. 13:944838. DOI: 10.3389/fpsyg.2022.944838

Poli A, Gemignani A, Miccoli M. Randomized Trial on the Effects of a group EMDR intervention on narrative complexity and specificity of autobiographical memories: A path analytic and supervised machine-learning study. Int J Environ Res Public Health; 2022. 19(13). DOI: 10.3390/ijerph19137684




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