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Case Reports
. 2023 Dec 15:14:1283145.
doi: 10.3389/fpsyt.2023.1283145. eCollection 2023.

Case report: Brief, intensive EMDR therapy for borderline personality disorder: results of two case studies with one year follow-up

Laurian Hafkemeijer  1 , Karin Slotema  2 , Nicole de Haard  1 , Ad de Jongh  3   4   5   6
Affiliations
Case Reports

Case report: Brief, intensive EMDR therapy for borderline personality disorder: results of two case studies with one year follow-up

Laurian Hafkemeijer et al. Front Psychiatry. .

Abstract

Background: Exposure to adverse childhood events plays an important role in the development of borderline personality disorder (BPD). Emerging evidence suggests that trauma-focused therapy using eye movement desensitization and reprocessing (EMDR) can be beneficial for patients with BPD symptoms. To date, the effects of brief, intensive EMDR treatment for this target group have not been investigated in this population.

Objective: This study aimed to evaluate the effects of a brief and intensive trauma-focused therapy course using EMDR therapy in two patients diagnosed with BPD who did not fulfill the diagnostic criteria for post-traumatic stress disorder (PTSD). It was hypothesized that this approach would be associated with a decline in the core symptoms of BPD, and that this would have an enduring long-term effect on patients' diagnostic status.

Method: Ten sessions of EMDR therapy were carried out across four consecutive treatment days, with the aim of processing patients' core adverse childhood experiences. Both A-criterion-worthy memories (without intrusive reliving) and non-A-criterion-worthy memories that were considered responsible for the patients' most prominent symptoms were targeted. The effects of EMDR therapy on trauma symptom severity and BPD diagnostic status (as established by the Structured Clinical Interview DSM-5) were determined. Additionally, the effects on psychological distress, quality of life, and difficulties in emotion regulation were determined at intake, post-treatment, and at 3-, 6-, and 12-months follow-up.

Results: Both patients showed a strong decline in psychological distress and difficulties in emotion regulation, and reported an improvement in their quality of life. At post-treatment, and at 3-, 6-, and 12-months follow-up they no longer met the DSM-5 criteria for BPD.

Conclusion: The findings of this small case study are in line with mounting evidence that a brief track of intensive trauma-focused therapy can result in long-term remission in patients with BPD. EMDR therapy seems to be a promising treatment approach for patients with BPD; however, the results need to be replicated in clinical trials.

Keywords: EMDR; abuse; borderline personality disorder; case studies; neglect; trauma.

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Conflict of interest statement

AdJ reports personal fees from teaching activities, personal fees from books about trauma and its treatment (e.g., EMDR therapy), outside the submitted work; and has been a board member of the Dutch EMDR Association, and the EMDR Europe Association. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Means of CAPS-scores over time. *CAPS, clinician-administered PTSD Scale for DSM-5; T0: baseline measurement.
FIGURE 2
FIGURE 2
Mean SCID-5-P scores of BPD over time at pre-treatment (T0), 3-month follow-up, 6-month follow-up and 12-month follow-up. *BPD, borderline personality disorder; SCID-5-P, structured clinical interview for DSM-5; *SCID-5-P, structured clinical interview For DSM-5 personality disorder.
See this image and copyright information in PMC

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