EMDR in Cancer Care: Treating the Trauma of Diagnosis

A cancer diagnosis is not only a medical event. For many people it is a psychological shock, followed by months of frightening procedures, uncertain waiting, and a permanently altered sense of the future. Unsurprisingly, a meaningful proportion of patients go on to develop post-traumatic stress symptoms specifically related to their diagnosis and treatment. Distress is now taken seriously enough in cancer care that the International Psycho-Oncology Society has described it as the sixth vital sign. Yet this side of cancer has historically received less attention than the physical treatment, and the psychological support offered has often been general rather than trauma-focused. That raises an obvious question. If the distress is genuinely traumatic in nature, would a trauma therapy work better than general support? A pilot randomised study by Liuva Capezzani and colleagues, published in the Journal of EMDR Practice and Research (2013), was the first to test this. Patients with cancer who met the criteria for PTSD took part: twenty-one in the follow-up phase of their illness were randomly assigned to either EMDR or CBT, and a further ten in the active treatment phase received EMDR. PTSD was assessed before treatment and one month afterwards using two standard measures. The results favoured EMDR on the trauma measures. It was significantly more effective than CBT at reducing PTSD scores, and this held for patients both in the active phase of treatment and in the follow-up phase. Most participants no longer met the criteria for PTSD afterwards. Anxiety and depression, by contrast, improved roughly equally in both groups. That split is the interesting part. It suggests EMDR was not simply better across the board, but better at the specific thing it was designed to do, which is process traumatic material. General distress responded to general therapy; the trauma responded to trauma treatment. The study was small, and the authors acknowledge this directly. It has since been followed by further work in psycho-oncology, including group protocols developed for settings where many patients need help at once. More and larger trials are needed. Still, the practical implication is worth stating plainly. Where someone is struggling after cancer treatment, and the difficulty looks like trauma rather than low mood, the type of therapy offered may matter a great deal. Source: Capezzani, L., Ostacoli, L., Cavallo, M., Carletto, S., Fernandez, I., Solomon, R., Pagani, M., & Cantelmi, T. (2013). EMDR and CBT for Cancer Patients: Comparative Study of Effects on PTSD, Anxiety, and Depression. Journal of EMDR Practice and Research, 7(3), 134 to 143.