What is the PAI Model and why is it fundamental in EMDR?
«The average number of neurons in the brain is 100 billion. The number of synapses in a ‘typical’ neuron is 1,000 to 10,000. The Information Processing System (IPS) is built-in and is the result of millions of years of evolution. Stored memories have millions and millions of connections.» — Isabel Fernández, President of the EMDR Europe Association
Origin and development of the PAI Model in the history of EMDR
You might be interested in reading: What is EMDR (Post 1)
Francine Shapiro's Discovery
Recommended Reading History of EMDR
Scientific evolution of the IPA
| Year | Scientific fact |
|---|---|
| 1989 | First pilot study published by Shapiro on EMDR |
| 1995 | Initial recognition by the American Psychological Association (APA) |
| 2004 | The WHO recommends EMDR as a treatment for PTSD |
| 2013 | The APA includes EMDR in its clinical practice guidelines |
| 2018 | Inclusion in the Clinical Practice Guidelines of the Spanish Ministry of Health |
How does the PAI system work? The neurobiology of adaptive processing
The brain as a network of neural learning
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Mental imagesVisual representations of the experience
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Thoughts and beliefsCognitions associated with the event
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Emotionsaffective responses linked
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Bodily sensationsphysical manifestations of remembrance
Everything is connected. The human brain does not store information in isolation, but rather creates neural maps where each element is related to others, forming an integral network of meaning.
Synapses: the foundation of information processing
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Process stimuli from the environment continuously
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Integrate new information with previous experience
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Generate adaptive responses unforeseen situations
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Store learnings for future reference
Recommended reading Debunking myths
Qué ocurre cuando el PAI falla? El trauma como información no procesada
The impact the brain cannot digest
Consequences of the EBA blockage
| Affected area | Clinical manifestations |
|---|---|
| Functional capacity | Difficulty concentrating, making decisions, performing at work or in studies |
| Personal resources | Feeling of exhaustion, lack of energy, lack of motivation |
| Social skills | Isolation, interpersonal conflicts, difficulty trusting |
| Mood | Anxiety, sadness, irritability, emotional blunting |
| Physical wellbeing | Chronic pain, muscle tension, sleep disturbances |
| Specific symptoms | Flashbacks, nightmares, hypervigilance, avoidance |
Traumatic information remains «frozen» in time, while conserving the original emotional intensity, bodily sensations, and negative beliefs, as if the danger were still present.
The role of EMDR in the reactivation of IAP
EMDR stimulates the adaptive processing system by using bilateral stimulation, such as eye movements, taps, or tones, to help the brain reprocess traumatic memories. This process, known as bilateral stimulation, is thought to activate both hemispheres of the brain, facilitating the integration and resolution of distressing experiences.
- Make access easier the dysfunctional neural network where traumatic memory is stored
- Promotes connection between disturbing information and pre-existing adaptive networks
- Allow reprocessing from experience, integrating it in a healthy way
- Update beliefs negatives associated with trauma from more adaptive perspectives
The result of reprocessing
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The symptoms of trauma subside or disappear
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The person recovers their resources and capabilities
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Emotional and physical well-being is restored
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New adaptive learnings to be generated for the future
Scientific evidence for the PAI Model and EMDR
Neuroimaging studies
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Decreased amygdala activity (centre of fear and alarm)
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Increased activation in the prefrontal cortex emotional regulation
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Normalisation of connectivity among relevant neural networks
Meta-analyses and systematic reviews
| Author(s) | Year | Key finding |
|---|---|---|
| Bisson et al. | 2007 | EMDR effective for PTSD in adults |
| Bradley et al. | 2005 | EMDR shows comparable results to exposure therapy |
| Cuijpers et al. | 2016 | EMDR effective for PTSD with sustained effects over time |
| Ho & Lee | 2017 | Altered brain activity post-EMDR in PTSD patients |
Clinical Applications of the PAI Model in EMDR
Disorders treatable by the IAP approach
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Anxiety disorders (phobias, panic disorder, generalised anxiety)
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Mood disorders Major depressive disorder, dysthymia
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Dissociative disorders
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Eating disorders
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Difficult duel
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Chronic pain of psychogenic origin
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Addictions and compulsive behaviours
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Personality disorders (especially limit)
The PAI in special populations
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Children and adolescentsusing techniques adapted to their cognitive development
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Elderly peopleProcessing accumulated trauma throughout life
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Victims of gender-based violenceAddressing complex trauma
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Emergency professionalsPrevention and treatment of work-related PTSD
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Refugee personsprocessing migratory and war trauma
Differences between the ABA Model and other therapeutic approaches
PAI vs. Cognitive Behavioural Therapy (CBT)
You might be interested in reading: What is CBT
| Aspect | EMDR (Eye Movement Desensitisation and Reprocessing) model | Traditional TCC |
|---|---|---|
| Focus | Information Processing and Neural Networks | Modification of thoughts and behaviours |
| Relationship with trauma | The trauma is «blocked» and must be reprocessed | Trauma generates dysfunctional schemas |
| Main technique | Bilateral stimulation and reprocessing | Exposure, cognitive restructuring |
| Duration | Generally shorter for simple trauma | May require more sessions |
| Between-session task | Minimal or nil | Frequently required |
PAI vs. Psychoanalysis
Ethical training and application of EMDR based on the API
Requirements for practising EMDR
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Basic Training (Levels 1 and 2)
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Clinical case supervision
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Continuing and specialised training
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Adherence to ethical and deontological codes
The importance of the prior clinical assessment
- Identify dysfunctional memory networks
- To assess the patient's emotional stability
- To determine the suitability of EMDR for the specific case
- Plan treatment on an individualised basis
Ethical training and application of EMDR based on the API
Requirements for practising EMDR
-
Basic Training (Levels 1 and 2)
-
Clinical case supervision
-
Continuing and specialised training
-
Adherence to ethical and deontological codes
Recommended reading What is EMDR actually about?
The importance of the prior clinical assessment
- Identify dysfunctional memory networks
- To assess the patient's emotional stability
- To determine the suitability of EMDR for the specific case
- Plan treatment on an individualised basis
Preguntas frecuentes sobre el Modelo PAI y EMDR
Is the PAI Model scientifically proven?
Do all people have the PAI system?
Is EMDR the only way to activate the PAI?
How long does it take for the PAI to reactivate with EMDR?
Post written by Samara Valenzuela
If after reading this entry you think you might need to attend to assess whether you require EMDR therapy and would like to know more about the professionals who provide it at CALMA PSICOLOGOS, please do not hesitate to CLICK.
References and Bibliography
Essential books
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Shapiro, F. (2001). Eye Movement Desensitisation and Reprocessing: Basic Principles, Protocols, and Procedures (2nd ed.). Guilford Press.
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Shapiro, F. (2018). Eye Movement Desensitisation and Reprocessing (EMDR) Therapy: Basic Principles, Protocols, and Procedures (3rd ed.). Guilford Press.
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Shapiro, F. (2012). Getting Past Your Past: Take Control of Your Life with Self-Help Techniques from EMDR Therapy. Rodale Books.
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Solomon, R. M., & Shapiro, F. (2008). EMDR and the adaptive information processing model: Potential mechanisms of change. Journal of EMDR Practice and Research, 2(4), 315-325.
Key scientific articles
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Bisson, J. I., Ehlers, A., Matthews, R., Pilling, S., Richards, D., & Turner, S. (2007). Psychological treatments for chronic post-traumatic stress disorder: Systematic review and meta-analysis. British Journal of Psychiatry, 190(2), 97-104.
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Bradley, R., Greene, J., Russ, E., Dutra, L., & Westen, D. (2005). A multidimensional meta-analysis of psychotherapy for PTSD. American Journal of Psychiatry, 162(2), 214-227.
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Cuijpers, P., Voshaar, R. C. O., & van Oppen, P. (2016). Are psychotherapies for depression equally effective in older adults? A systematic review and meta-analysis. International Psychogeriatrics, 28(6), 881-893.
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Ho, M. S. K., & Lee, C. W. (2017). Cognitive changes in PTSD patients treated with EMDR: A controlled study. Journal of EMDR Practice and Research, 11(3), 136-143.
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Pagani, M., Högberg, G., Salmaso, D., Nardo, D., Sundin, O., Jonsson, C., … & Jacobsson, H. (2007). Effects of EMDR psychotherapy on 99mTc-HMPAO distribution in occupation-related post-traumatic stress disorder. Nuclear Medicine Communications, 28(10), 757-765.
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van den Hout, M. A., & Engelhard, I. M. (2012). How does EMDR work? Journal of Experimental Psychopathology, 3(5), 724-738.
Clinical guidelines and international consensus
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American Psychiatric Association (APA). (2017). Clinical Practice Guideline for the Treatment of PTSD. American Psychiatric Association Publishing.
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World Health Organization (WHO). (2013). Guidelines for the Management of Conditions Specifically Related to Stress. WHO Press.
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National Institute for Health and Care Excellence (NICE). (2018). Post-traumatic stress disorder: Management. NICE Guideline [NG116].
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Department of Health, Consumer Affairs and Social Welfare. (2018). Clinical Practice Guideline for the Management of Post-Traumatic Stress Disorder. Madrid.
EMDR Europe Association Resources
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Fernández, I. (Ed.). EMDR Europe Training Manuals. EMDR Association Spain.
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EMDR Association Europe. (2020). Standards for training and practice. Retrieved on: https://www.emdr-europe.org
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You might be interested in reading: Debunking myths about EMDR
Quick reading to expand information on EMDR and/or related topics:
- What is trauma? https://calmapsicologos.com/es/que-es-un-trauma/
- Therapy service EMDR at Calma Psicólogos
- Treatment for the Calm Duel Psychologists