Neuro-auricular Modulation to Resolve EMDR Challenges Related to Defense Mechanisms, Targeting and Processing

Neuro-auricular Modulation to Resolve EMDR Challenges Related to Defense Mechanisms, Targeting and Processing

The lead authors of the CIAM training series, Neuromodulation for EMDR — a collaboration between West Side Therapy Services in Los Angeles, Create Balance Psychotherapy & Counselling in Melbourne, and CIAM in New Glasgow for advancement in the mental health field — received approval from the journal, Frontiers in Neurology, for their abstract on the topic, “Neuro-auricular Modulation to Resolve EMDR Challenges Related to Defense Mechanisms, Targeting and Processing: 
The ear as an adjunctive tool for neurological understanding and regulation in trauma-related psychotherapy.”

The abstract supports an ongoing evolution in the fields of EMDR, Somatic Experiencing, and Vagus Nerve Stimulation, resulting from neurological insights for trauma therapy gained from the neuro-auricular portal of the ear.


From scientific evaluations of Eye Movement Desensitization Reprocessing (EMDR) including endorsement by the International Society for the Study of Trauma and Dissociation,[1-3] designation by the American Psychological Association as highly effective and empirically supported,[4] and recommended by the World Health Organization for psychological interventions in adult post traumatic stress disorder,[5] it is clear that EMDR is useful in the treatment of trauma.[4] Yet, the big challenge for therapists using EMDR has been that, while EMDR is among the main treatments to restore dual attention and even dissociation, it is these same defense mechanisms that present concerns and risks for the EMDR therapist.[6-10]
We suggest that the growing body of related research in neuro-auricular modulation — we include Vagus Nerve Stimulation (VNS), transcutaneous auricular Vagus Nerve Stimulation (taVNS), medical ear acupuncture, Auriculotherapy, and Auricular Medicine — presents an opportunity to address these challenges and, more broadly, advance mental health care. To present our case for the broader implications for trauma-related psychotherapy and the advancement of mental health care, we focus on the use of neuro-auricular modulation as a supportive adjunct alongside EMDR practice when 1) clients do not have the dual attention necessary to proceed with EMDR therapy; 2) clients are unable to provide adequate targeting insight; and 3) clients are ‘stuck’ and unable to process, e.g. clients are looping, or unable to report a decrease in subjective units of disturbance (SUDs) during processing.
Based on the evidence from related research (including specific related mechanisms of action),[12-58] initial clinical observations, as well as the relationships between the neurobiological framework used in the modern psychology practice and the advancement of somatic approaches in the mental health field[33-36], the use of neuro-auricular modulation bypasses pre-frontal cortex involvement and can therefore efficiently address the 3 key challenges in EMDR (defense mechanisms, targeting, processing). Neuro-auricular modulation can help prepare clients for EMDR without the risks that would otherwise be associated with proceeding with EMDR when dual attention is not sufficient or dissociation is detected. And, its use alongside EMDR can serve as a model for its use to support mental health practices for trauma therapy in general.

Potential Conflict of Interest Statement: The authors believe in the promising adoption of neuro-auricular modulation within the practice of psychotherapy, owing to improved outcomes for clients as reported in both, documented history of clinical anecdotal observation, and published research (in journals across a broad selection of fields including psychology, acupuncture, nursing, neuroscience and others). With improved mental health outcomes as a goal, the authors and reviewers of this paper have an interest through the Canadian Institute of Auricular Medicine (CIAM) to promote auricular methods training and courses, as well as the auricular methods in therapy services offered by their own clinics.

The Frontiers topic, Neuromodulation by the ear: beyond non-invasive vagus nerve stimulation, edited by professors Frédéric Canini, Emmanuel Sagui, and Taras Usichenko, is one of many topics in support of growing interest and research in transcutaneous auricular neuromodulation. CIAM stongly urges colleagues in the CIAM network of auricular professionals to submit their work in support of this topic.

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Course details for the CIAM series, Auricular Methods in Psychology and Neuromodulation for EMDR

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[22] Kroening RJ, Oleson TD. Rapid narcotic detoxification in chronic pain patients treated with auricular electroacupuncture and naloxone. Int J Addict. 1985 Sep;20(9):1347-60. (link to abstract only)

[23] Yoshizumi AM, Asis DG, Luz FA. Auricular Chromotherapy in the Treatment of Psychologic Trauma, Phobias, and Panic Disorder. Med Acupunct. 2018;30(3):151-154. doi:10.1089/acu.2018.1281

[24] Kurebayashi LF, Turrini RN, Souza TP, Marques CF, Rodrigues RT, Charlesworth K. Auriculotherapy to reduce anxiety and pain in nursing professionals: a randomized clinical trial. Rev Lat Am Enfermagem. 2017;25:e2843. Published 2017 Apr 6. doi:10.1590/1518-8345.1761.2843

[25] Stanton G. Auriculotherapy in Neurology as an Evidence-Based Medicine: A Brief Overview. Med Acupunct. 2018;30(3):130–132.

[26] Alimi D. Medical Auriculotherapy: Scientific Bases, Principals and Therapeutic Strategies.[in French]. Paris: Elsevier–Masson; 2017

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[36] Shapiro, F. (2007). EMDR, adaptive information processing, and case conceptualization. Journal of EMDR Practice and Research, 1(2). Open access:

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