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1. Koshal, A. (2010, June). The 4-fields-technic in the traumatherapy of complex traumatized and drug-addicted people (in methadone-treatment). In Addictions. Symposium conducted at the annual meeting of the EMDR Europe Association, Hamburg, Germany.

Language: English

Format: Conference

Abstract:
Nowadays several international studies demonstrate that the problem of drug-addiction is very often found in combination with complex traumatization in early childhood and youth. (Felitti. 2903; Kufner et al. 2000; Langeland et al. 2006; Schmidt, 2000 etc.) As we all know PTSD and the other trauma symptoms cause a lot of psychophysical dysregulation. So the psychiatrist Khantrian postulated already 1985 the "self-medication hypothesis of addictive disorders". Janina Fisher, Trauma Center Boston, 2000, called this assumed combination of trauma-consequences and drug-addiction, "compensatory strategies aimed at self-regulation" In many years of working with drug-addicted people it became very obvious that a high percentage of this people are using drugs, for example to calm down after being aggressive, may be caused by an argue: or to reduce strong inner tensions; to sleep without nightmares, to alleviate the feeling of helplessness and fear etc. Drugs and alcohol do reduce all the mentioned symptoms for a while. To learn to cope in another, more adaptive way, the addicted people need to learn alternatives strategies for a good functioning self-regulation. After stabilization, the trauma therapy can start, so the patient can reduce some of the sources of psychophysiological dysregulation. Even when the addicted people still get methadone psychotherapy is possible. Practical experience over a long time. started 1990, did show a lot of successful treatments and that methadone does not interfere a traumatherapy. The 4-Fields-Technic is a special method of EMDR that was developed by Jarero et al. 1997 in Mexico after a hurricane disaster. Dorothee Lansch modified the group method into a therapy-setting for single persons. For complex traumatized and drug-addicted people this technic is very helpful. The focus is more easy to keep in mind, - in front of the eyes. In the 4-Fields-Technic the patient focuses on a self-painted picture, that represents the worst part of a trauma experience. The patient keeps his focus on this picture, combined with bilateral stimulation, till he feels the picture should be changed. And so the process is going on till finished. The participant will be able to learn: - about the correlation between complex trauma and drug-addiction - that drug-addicted people who get methadone are able to do trauma therapy -the 4-Fieids-Technic as a method to create resources. Psychotherapy and specially psychotraumatherapy with drug-addicted people who are as well in a methadone-treatment is for many therapists still controversial. This presentation will give you an idea how good it can work, based on various case series.

Keywords: 4-Fields-Technic  Complex Trauma  Drug Addiciton  Methodone Treatment  Symposium  

Accuracy Verified: Yes


2. Koshal, A. (2012, June). The 4-fields-technique in the trauma therapy of complex traumatized and addicted patients [La técnica de 4-­‐Campos en la terapia de trauma complejo y pacientes adictos, incluso en tratamiento de metadona]. Presentation at the annual meeting of EMDR Europe Association, Madrid, Spain.

Language: English

Format: Conference

Abstract:
This workshop will employ lecture and demonstration of several case studies. The 4-­‐Field-­‐Technique is a special method of EMDR that was developed by Jarero et al. 1997 in Mexico. For complex traumatized and drug addicted people this method is very helpful. The risk to trigger other trauma clusters is quite minor, because the patient’s concentration is focused on his specific picture and situation. Several international studies demonstrate that addicted people are very often complex traumatized. (Felitti et al., 2003; Schmidt, 2000 etc.) PTSD and other trauma symptoms cause a lot of psychophysical deregulation. The psychiatrist Khantzian realized 1985, that addicted people suffer a lot from different symptoms and try to reduce the unbearable inner tension in using drugs. So Khantzian postulated the “self-­‐medication hypothesis of addictive disorders”. Janina Fisher, Trauma Center Boston, 2000, interpreted the correlation of early traumatization and drug-­‐addiction as “compensatory strategies aimed at self-­‐ regulation”. 20 years of psychotherapeutic work revealed, a high percentage of addicted patients use drugs to influence their emotional states. Drugs and alcohol do short term reduce the mentioned symptoms. Addicted patients need to learn to cope in another, more adaptive way to get a better functioning self-­‐regulation. After stabilization, trauma-­‐therapy can start. So the patient can reduce his psycho-­‐ physiological deregulation. Even when addicted patients are still in a methadone-­‐ treatment trauma-­‐therapy is effective. Practical experiences show a lot of successful treatments.

Este taller empleará la presentación y demostración de muchos estudios de caso. La técnica de 4 campos es un método especial de EMDR que fue desarrollado por Jarero et al. 1997 en Méjico. Para gente con traumas complejos y adictos este método resulta ser muy adecuado. El riesgo de disparar grupos de traumas es menor, debido a que la concentración del paciente está centrada en una sola imagen y situación. Muchos estudios demuestran que los adictos son muy a menudo traumatizados de manera compleja. (Felitti et al., 2003; Schmidt, 2000 etc.) El TEPT y otros síntomas del trauma causan muchas desregulaciones psicofisiológicas. El psiquiatra Khantzian se dio cuenta en 1985, que la gente que sufre de adicción sufren también muchos otros síntomas diferentes e intentan reducir su tensión interna a través del uso de sustancias. Por ello Khantzian postuló “ La hipótesis de la automedicación en trastornos adictivos” Janina Fisher, Trauma Center Boston, 2000, interpretó la correlación de la traumatización temprana y la adicción a la drogas como “ Estrategias compensatorias dirigidas a la autorregulación”. 20 años de trabajo psicoterapéutico muestran que un gran porcentaje de pacientes adictos usan drogas para modificar sus estados emocionales. Las drogas y el alcohol reducen a corto plazo los síntomas mencionados. Los pacientes adictos necesitan aprender a afrontar de manera más adaptativa su autorregulación. Después de la estabilización, la terapia del trauma puede empezar. Por ello el paciente puede reducir su desregulación psicofisiológica. Incluso cuando aún están sometidos a un tratamiento de metadona la terapia del trauma es efectiva. Las experiencias en la práctica muestran una gran cantidad de tratamientos exitosos.

Keywords: 4-Fields-Technique  Addiction  

Accuracy Verified: Yes


3. Knipe, J. (2010, July). Adaptive information processing as a guiding framework for the treatment of addictive disorders and addictive behavior patterns. Presentation at the 1st EMDR Asia Conference, Bali, Indonesia.

Language: English

Format: Conference

Abstract:
Within our field, the term “addiction” has been used to describe not only chemical dependence but also entrenched, selfdefeating behavior patterns. Either type of addiction may develop in the context of traumatic experience. An impulse to engage in addictive behavior can be thought of as a part of a dysfunctionally-stored memory network connected with traumatic events. In this workshop, an Adaptive Information Processing model of addiction will be presented, including guidelines for treatment planning, preparation, resource installation, urge reduction, and (when necessary) transformation of the addict “identity.” The content of the presentation will be illustrated with video examples.

Keywords: Addictions  Addictive Behaviors  Addictive Disorders  

Accuracy Verified: Yes


4. Popky, A. J. (1995). Addiction research project. EMDR Network Newsletter, 5(3), 12.

Language: English

Format: Newsletter

Abstract:
Silke Voglemann-Sine, Ph.D., and Larry Sine, Ph.D., are developing a research design for addictions to be presented at the 1996 EMDR International Conference in Denver this June. This research project will cover a broad range pf substnace addictions as nicotine, marijuana, cocaine, crack, herion, alcohol, methamphetamine, and prescription drugs. Dysfunctional addictive ehaviors such as overearting, bulimia, and anorexia, sex, shoplifting, and work will also be included. The research project ill be built around and based on, "The Integrative EMDR Addiction Treatment Model."

Keywords: Addictions  Integrative EMDR Addiction Treatment Model  

Accuracy Verified: Yes


5. Vogelmann-Sine, S., Popky, A. J., Lazrove, S., Sine, L., Speare, J., Wade, D., & Wade, T. (1995, June). Advanced clinical applications of EMDR to addictive behaviors. Symposium conducted at the EMDR Network Conference, Santa Monica, CA.

Language: English

Format: Conference

Abstract:
This workshop addresses the application of standard and modified EMDR treatment protocols to addictive and compulsive behaviors including substance abuse/dependence, overeating, smoking, love addiction. Individuals with addictive and compulsive behaviors frequently have suffered from childhood trauma and neglect resulting in developmental arrests, as well as a variety of maladaptive behaviors which are trauma-related and serve to minimize pain. The successful implementation of EMDR to addictive behaviors requires that EMDR be used as part of an overall treatment program carefully addressing the needs of individuals who have been traumatized and are exhibiting addictive behaviors. A thorough diagnostic work up is needed aimed at assessing comorbidity, dissociation, and a detailed trauma history covering childhood traumas and traumas suffered as adults including traumas that occur as a consequence of addictive behaviors. Careful client preparation is essential to assist individuals in coping adequately with the high levels of emotion experienced during EMDR Clients' readiness to stop compulsive/addictive behaviors needs to be carefully evaluated. A decision tree aimed at determining the appropriateness of EMDR to individuals diagnosed with addictive behaviors is presented which assists clinicians in minimizing the premature use of EMDR. EMDR is a client centered method, and thus, careful pacing is needed with this population to reprocess underlying traumatic issues. This frequently implies utilizing a modified EMDR treatment protocol with only partial resolutions of underlying traumatic material. Guidelines will be discussed to assist clinicians in selecting EMDR targets for optional results which relate to the stages of recovery. EMDR can be used at all stages of recovery to neutralize the negative impact of memories contributing to problematic behaviors, such as urges to use, ambivalence about treatment, fear of facing painfull feelings from the past. EMDR also has the power to install templates for future actions which assist individuals with skill deficits in more rapidly acquiring necessary skills for a successful recovery. Examples of cognitive interweaves are presented which take into consideration clients' readiness, as well as the need to accelerate the recovery process. EMDR has a unique role in the recovery of traumatized individuals with addictive and compulsive behaviors since the accelerated processing of negative experiences and the installation of positive adaptive cognitions assist clients in more rapidly overcoming barriers throughout the recovery process. It also challenges rigid approaches to recovery which frequently stress that trauma work should not be attempted before abstinence has been accomplished for a specified period of time. EMDR is especially valuable in processing core issues which center around shame and manifest in cognitions, such as "I am defective," "There is something wrong with me," "I am not good enough," "I am not quite right," "I don't belong," "I don't deserve to live." Case examples will be given as to how such core issues can be targeted to accelerate the recovery process. A.J. Popky has developed a specialized EMDR treatment protocol which targets levels of urges of addictive/compulsive behaviors directly and installs a positive internal state of feeling empowered without relying on compulsive and addictive behaviors. Case examples fiom clinical practice indicate that when levels of urges are targeted directly, underlying traumas frequently emerge without increasing clients' usage. The symposium addresses the application of this protocol to a range of addictive and compulsive behaviors. The Wades' integrative psychotherapy combines ego-state therapy and EMDR in a psychosocial developmental context. Their substance use disorders treatment program incorporates specialized applications of their integrative psychotherapy, which includes both individual and group therapy and employs hypnosis as well as EMDR Their presentation focuses on applications of the standard EMDR protocol in individual therapy, which is limited primarily to desensitization of dysphoric affect and reprocessing negative cognitions associated with grief and trauma. Their conceptual framework of substance use disorders proceeds from a goal of reducing the harm caused by substance use and a primary distinction between functional and autonomous use (rather than the DSM conceptualizations of "dependence" or "abuse") because this guides interventions. Initial treatment planning depends upon external constraints (e.g., lack of support for positive change, hostile environment), internal limitations (e.g., severity of substance use and its effects, neurocognitive deficits, inadequate "ego strength," lack of skills, disrupted psychosocial development, psychological trauma) and the nature of the substance use disorder (i.e., functional, autonomous, or both). Methods include education about substance use disorders and processes of change, group therapy to develop skills and obtain feedback and support, individual therapy to correct disrupted development and resolve traumatic stress reactions, and exercises to apply what is learned in real-life situations. The standard EMDR protocol is applied to disrupted development involving grief and to resolve psychological trauma that lead to substance use. Case vignettes in which such applications of the standard EMDR protocol were employed are presented in detail.

Keywords: Addictions  Substance Abuse  Symposium  

Accuracy Verified: Yes


6. van Winkle, V. (1999, Fall). Breaking the cycle of violence: EMDR treatment of a traumatized violent teen girl. EMDRIA Newsletter, Child and Adolescent Issue, Special Edition, 4(4), 26-31.

Language: English

Format: Newsletter

Abstract:
Children, adolescents, and EMDR: A closer look
This is a case study of an 11-year-old girl in residential treatment with a poor prognosis. Her diagnoses include Fetal Alcohol Syndrome, ADHD, and PTSD with frequent explosive episodes.

Keywords: Adolescents  Violence  

Accuracy Verified: Yes


7. Omaha, J. (1998, July). Chemotion and EMDR: An EMDR treatment protocol based on a psychodynamic model chemical dependency. Presentation at the annual meeting of the EMDR International Association, Baltimore, MD.

Language: English

Format: Conference

Abstract:
Chemical dependency is a pervasive and rapidly growing problem in western societies. Chemical dependencies means obsessive and compulsive use of legal and illegal substances that is not affected by adverse consequences resulting from their consumption and is further characterized by denial of the relationship between consequences and consumption, by tolerance for the chemical, and by symptoms of withdrawal when the substance is unavailable. For the purposes of this paper, legal and illegal substances discussed include alcohol, tobacco, marijuana, cocaine, methamphetamine, opiates, hallucinogens, and prescription medications.

Keywords: Chemical Dependency  Chemotion  Protocol  

Accuracy Verified: Yes


8. Litt, B. (2007). The child as identified patient: Integrating contextual therapy and EMDR. In F. Shaprio, F. W. Kaslow, & L. Maxfield (Eds.), Handbook of EMDR and family therapy processes (pp. 306-324). Hoboken, NJ: John Wiley & Sons Inc.

Language: English

Format: Book Section

Abstract:
It is estimated that as many as 2% of children under age 12 and from 5% to 18% of adolescents suffer from a depressive disorder (Birmaher et al., 1996; Northey, Wells, Silverman, & Bailey, 2003) that will likely persist into adulthood (Northey et al., 2003; Wagner & Ambrosini, 2001). Contextual Therapy is a differentiation-based (e.g., Kerr & Bowen, 1988; Schnarch, 1991) approach in that it promotes self-determination in the face of family pressure for compliance, reliance on internal resources for self-validation rather than dependence on others for approval, and the overcoming of emotional discomfort in the interests of responsible action (Boszormenyi-Nagy & Krasner, 1986). Both the contextual approach and the Adaptive Information Processing (AIP) model predict that formative childhood experiences affect both psychological health and relational functioning. With its systemic paradigm and its ethical dimension of relationship, the contextual approach is complementary and additive to Shapiro's (2001) AIP model. The contextual approach shows the clinician where to look for the targets, and Eye Movement Desensitization and Reprocessing (EMDR) provides the potency to transform the experience. A general structure of phase-oriented therapy can be described that accounts for most, if not all, referrals for treatment. An assessment phase, a contracting phase, and an intervention phase characterize the main tasks of the therapist. In practice, these phases may overlap, coincide, or repeat themselves over the course of minutes, weeks, or months. This chapter describes only those practices that are unique to the integrated approach. (PsycINFO Database Record (c) 2008 APA, all rights reserved

Keywords: Adaptive Information Processing Model  Affective Disorders  Child Patients  Contextual Therapy  Depressive Disorder  Integrated Approach  Integrative Psychotherapy  Major Depression  Models  

Accuracy Verified: Yes


9. Freyberger, H. J., & Spitzer, C. (2005, Juli). Dissoziative störungen [Dissociative disorders]. Der Nervenarzt, 76(7), 893-900. doi:10.1007/s00115005-1956-z .

Language: German

Format: Magazine

Abstract:
Die dissoziative Störungen und Konversion sind mit erheblichen klassifikatorischen, diagnostische und therapeutische Schwierigkeiten, die nur in den historischen Kontext der Diskussion über die Hysterie verstanden werden kann, verbunden. Auch die Einstufung in die ICD-10 und DSM-IV ist heterogen. Prävalenzraten zwischen etwa 3% in der allgemeinen Bevölkerung und bis zu 30% in klinischen Populationen, jedoch beziehen sich auf die große klinische Bedeutung. Realtraumatisierungen eine wichtige Rolle in der Pathogenese. High Komorbiditätsraten mit anderen psychischen Störungen eine Tendenz zu chronischen somatischen Erkrankung und ein Konzept (insbesondere bei Patienten mit Erkrankungen erschweren Umwandlung) der psychotherapeutischen Behandlung. Dies erlaubt die Behandlung Ziele sind sowohl psychodynamische und kognitiv-verhaltenstherapeutischen in Abhängigkeit entwickelt, möglicherweise mit den Techniken der Trauma-Therapie, wie EMDR (Springer).

The dissociative and conversion disorders are associated with significant classificatory, diagnostic and therapeutic difficulties that can be understood only in the historical context of the discussion on hysteria. Even the classification in ICD-10 and DSM-IV is heterogeneous. Prevalence rates of between about 3% in the general population and up to 30% in clinical populations, however, refer to the great clinical significance. Realtraumatisierungen have an important role in the pathogenesis. High Komorbiditätsraten with other mental disorders, a tendency to chronic somatic disease and a concept (especially in patients with conversion disorders complicate) the psychotherapeutic treatment. This allows the treatment goals are designed both psychodynamic and cognitive-behavioral dependence in, possibly with the techniques of trauma therapy such as EMDR (Springer).

Keywords: Chronicity (Disorders)  Comorbidity  Conversion Disorder  Diagnosis  Dissociative Disorders  Epidemiology  Etiology Psychotherapy  Somatization  

Accuracy Verified: Yes


10. Butler, K. (1995, July-August). Divided memories. Family Therapy Networker, 19(4), 1.

Language: English

Format: Magazine

Abstract:
Ann Norris first went to see Laguna Beach psychologist Doug Sawin in 1988. She had recently graduated from college with a degree in music and suffered from insomnia and drank alcohol to sleep. But it was her relationship with her mother, Judy, that troubled her most. After Ann's triumphant college graduation vocal recital, Judy hadn't even congratulated her. Two days later, Judy had called and angrily attacked Ann over the phone until Ann cried.
It was the kind of issue that a good family or individual therapist might have addressed by building on Ann's obvious strengths, teaching her to contain and manage her feelings, and coaching her to develop a better relationship with her mother. But Sawin instead focussed intensely on the past. Ann soon had memories of her father sexually abusing her, and later of elaborate cultic abuse, which her three siblings didn't come close to corroborating. She was hospitalized after attempting suicide, and Sawin bluntly told her father, Al, over the phone, of Ann's charges Al collapsed in tears.
Over the years, Ann drew closer to Sawin while her relations with her family and her own mental state grew more troubled. She was diagnosed with Multiple Personality Disorder and, with Sawin's support, sued her parents and grandparents for $20 million. She spent six years in therapy with Sawin She now describes psychiatric hospitals where she still stays periodically because she cuts and burns herself as her "institutional mothers." She has not spoken to her true mother in six years. And she no longer sings.
It doesn't take a PhD in psychology or a seat on a state licensing board to see that Ann is worse off than when she entered therapy. Millions of nontherapists undoubtedly made just such an assessment when Ann, her therapist and her family told their stories before millions of prime-time viewers on "Divided Memories," a four-hour PBS Frontline documentary screened in early May.
In her wide-ranging investigation of therapy, sexual abuse and memory, producer Ofra Bikel used as her primary subject families divided by recovered memories of abuse. She also managed to persuade nearly half a dozen therapists to do therapy while her camera was running. It was a remarkable event, in which all of America was invited behind the one-way mirror to see therapy in action in the midst of its most divisive controversy and to judge it for themselves.

Keywords: MPD  Multiple Personality Disorder  

Accuracy Verified: Yes


11. Kruse, M. J. (2011, June). The effect of energy psychology on rates of relapse and recidivism for substance abuse offenders in a community correction setting. The University of the Rockies, Colorado Springs, CO. AAI3460565.

Language: English

Format: Dissertation/Thesis

Abstract:
This dissertation was a study of a community corrections program which incorporated adjunct Energy Psychology Therapies for Substance Abuse Offenders (SAOs), who were transitioning back into community. Rates of relapse and recidivism were compared, upon success/failure to complete drug and alcohol treatment. When Energy Psychology therapies were added, assisting offenders in resolving underlying trauma issues, there were significance differences between groups. The Choices Program used brief therapies including: Eye Movement Desensitization and Reprocessing, Thought Field Therapy, Emotional Freedom Techniques, (EMDR, TFT, EFT) along with group and individual classes/sessions to relieve underlying trauma symptoms. The results indicated that people who chose to resolve underlying trauma achieved more successful treatment outcomes, thereby lowering rates of relapse and recidivism significantly.

Keywords: Community Corrections  EFT  motional Freedom Techniques  Energy Psychology  Offenders Eye Movement  Social Sciences  Substance Abuse  Trauma  

Accuracy Verified: Yes


12. Aytun, O. A. (2010, June). The effectiveness of EMDR and support group treatment model in smoking cessation. In Addictions. Symposium conducted at the annual meeting of the EMDR Europe Association, Hamburg, Germany.

Language: English

Format: Conference

Abstract:
The purpose of this study is to assess the effectiveness of a treatment model in cigarette cessation. Among the volunteers who enrolled to participate in the study, 15 participants were selected as our subject group in terms of their scores in Fagerstrom Test for Nicotine Dependence (middle or upper level of dependency). The participants of this study attended 9 weeks of treatment including a preliminary session in the first week following 8 EMDR sessions (once a week) and 4 group sessions (once every two weeks). The 5 follow up sessions (15-day, a month, 3 month. 6 month. 1 year foilow-up) are included in the study to evaluate the efficacy of the model and the relapse rate of the subjects. EMDR (Eye Movement Desensitization and Reprocessing) DeTUR Protocol (Popky, 1993) and a support group format is used as treatment methods. Hughes-Watsukami Withdrawal Questionnaire, STAI, Traumatic Life Events Questionnaire (TLEQ) and Fagerstrom Test for Nicotine Dependence is the instruments of this study.

Keywords: Group Treatment  Smoking Cessation  Symposium  

Accuracy Verified: Yes


13. Dunn, T. M. (1995). Effectiveness of eye movement desensitization and reprocessing (EMDR) in a non-clinical population. University of Cincinnati, OH.

Language: English

Format: Dissertation/Thesis

Abstract:
Panic disorder, worsening of depression and relapse of alcohol symptoms (Pitman, et al.). A relatively new technique for treating PTSD is reported to result in lasting reduction of anxiety, changes in the cognitive assessment of memory and cessation of flashbacks, intrusive thoughts, and sleep disturbances. Eye Movement Desensitization and Reprocessing (EMDR) is an experimental treatment for PTSD which is reported to have almost immediate, long lasting effects (Shapiro, 1989a). EMDR involves having the patient engage in a series of therapist-directed saccadic eye movements accompanied by cognitive exercises. The treatment may take less than an hour to administer and, it is claimed, may completely eliminate some of the more severe symptoms associated with PTSD and can have long lasting effects (one subject showed desensitization a year later [Shapiro, 1989a.1) Shapiro found the treatment to produce the best effect if performed while the patient is recalls a disturbing memory of the traumatic event.

Keywords: Non-clinical Population  

Accuracy Verified: Yes


14. Nettz, S. L. (1995, August). Effects of a single session of EMDR, flooding, and a credible placebo treatment on traumatic memories in male veterans. Illinois Institute of Technology, Chicago, IL. AAT 9614404.

Language: English

Format: Dissertation/Thesis

Abstract:
This study explored the effectiveness of a single session of three different treatments for traumatic memories. Subjects were 45 adult males, randomly assigned to Eye Movement Desensitization and Reprocessing (EMDR), Flooding, or Placebo therapy (Modified Avoidance Response Conditioning [ MARC]). Self-report and physiological measures were employed to measure treatment effectiveness. Subjects completed the following pre-treatment inventories: Michigan Alcohol Screening Test, Impact of Event Scale, State-Trait Anxiety Inventory, Questionnaire on Mental Imagery, and the Treatment Credibility Questionnaire. Post-treatment measures included self-report measures (Subjective Units of Distress [ SUDs] and Treatment Credibility Questionnaire) and physiological measures (heart rate, skin conductance, and skin temperature). Treatments were rated as equally credible before and after the session. Both EMDR and Flooding produced a significant decrease in the self-report of anxiety compared to the Placebo (MARC) group. Neither heart rate or skin conductance channels showed a significant change for any of the three groups during post-treatment assessment phases. However, skin temperature was significantly lower for the Flooding group compared to the MARC group during two post-treatment phases, suggesting that the Flooding group was more physiologically aroused than Placebo (MARC) subjects. Findings suggest that during Flooding, exposure to disturbing elements of a trauma is associated with physiological arousal, which in turn leads to lessening of subjective distress. However, a different mechanism may account for EMDR treatment effects. (PsycINFO Database Record (c) 2008 APA, all rights reserved) Dissertation Abstracts International: Section B: The Sciences and Engineering. 57(1-B), Jul 1996, pp. 0687

Keywords: Adults  Emotional Trauma  Empirical Study  Evaluation  Male  Memory  Military  Treatment Effectiveness Treatment Outcome/Clinical Trial  Veterans  

Accuracy Verified: Yes


15. Fátima Panangeiro, M. F., Torres, A. F. S., Fernandez, R. M., & Trajano, S. R. (2012, Novembro). Eicácia do EMDR na prevenção e cura do transtorno de estresse pós-traumático em vítimas de terremoto [Efficacy of EMDR in the prevention and treatment of PTSD with victims of an earthquake]. In comunicações de pesquisa. Apresentação no II Congresso Brasileiro de EMDR, Brasília, Brasil.

Language: Portuguese

Format: Conference

Abstract:
Introdução: Sabemos que quando uma pessoa vivencia um incidente crítico, essa exposição tem impacto considerável sobre seu funcionamento global. Assim, para assegurar a recuperação dos militares brasileiros que estavam no Haiti, escolhemos a técnica EMDR criada pela Dra.Francine Shapiro, que encontra respaldo teórico em descobertas recentes no campo neuropsicológico para realizar as intervenções. Justificativa: O EMDR é uma técnica eficaz, que permite que o trauma armazenado na memória de curto prazo passe para a memória de longo prazo, uma vez que com os estímulos criam-se novas conexões neurais que trazem alívio, paz e aceitação. Atualmente existem mais de 20 estudos randomizados que apoiam sua eficácia. Objetivo: Avaliar a eficácia da técnica EMDR na recuperação de vítimas de terremoto no Haiti, que apresentavam Transtorno Estresse Pós-Traumático e/ou Transtorno Estresse Agudo. Método: O estudo foi realizado com 14 militares sobreviventes do terremoto ocorrido no Haiti em janeiro de 2010, divididos em dois grupos: A (soterrados) e B (não soterrados). Foram utilizados para avaliação: entrevista inicial entrevista inicial e final, os testes IES- Escala de Impacto de Eventos e ISSL - Inventário de Sintomas de estresse de Lipp (antes e após a intervenção), EMDR, e reencontro (follow-up) seis meses após o último atendimento. Resultados: De acordo com os resultados obtidos no IES, os sujeitos que tinham o nível de estresse entre grave, moderado e leve, passaram após a intervenção para o nível leve e recomendado. Em relação aos sintomas físicos e emocionais (flashbacks, insônia, pesadelos, agressividade, instabilidade de humor e aumento no consumo de álcool), os sujeitos não apresentavam mais a queixa ao término das intervenções. Conclusões: Com base nos resultados apresentados podemos afirmar que o EMDR é uma técnica eficaz para resolução do transtorno estresse pós-traumático, assim como na sua prevenção, em vítimas de terremoto.

Introduction: We know that when a person experiences a critical incident, such exposure has considerable impact on their overall functioning. Thus, to ensure the recovery of the Brazilian military who were in Haiti, we choose the EMDR technique created by Dra.Francine Shapiro, who finds theoretical support in recent discoveries in the field to perform neuropsychological interventions. Rationale: The EMDR is an effective technique that allows the trauma stored in short-term memory to pass the long-term memory, since with the stimuli it creates new neural connections that bring relief, peace and acceptance. Currently there are more than 20 randomized trials that support its effectiveness. Objective: To evaluate the efficacy of EMDR technique in the recovery of victims of the earthquake in Haiti, which had Post Traumatic Stress Disorder and / or Acute Stress Disorder. Method: The study was conducted with 14 military survivors of the earthquake in Haiti in January 2010, divided into two groups: A (buried) and B (not buried). All patients were evaluated: initial initial interview and final interview, tests IES-Impact of Events Scale and ISSL - Symptom Inventory stress Lipp (before and after the intervention), EMDR, and reunion (follow-up) six months after the last treatment. Results: According to the results of the IES, the subjects who had the stress level between severe, moderate and mild, passed after the intervention to the level recommended lightweight. Regarding the physical and emotional symptoms (flashbacks, insomnia, nightmares, aggression, mood instability and increased consumption of alcohol), subjects no longer had the complaint at the end of the interventions. Conclusions: Based on the presented results we can state that EMDR is an effective technique for resolution of post-traumatic stress disorder, as well as its prevention, earthquake victims.

Keywords: Acute Stress Disorder  Brazil  Earthquake  Haiti  Military  Posttraumatic Stress Disorder  Prevention  PTSD  Treatment  Victims  

Accuracy Verified: Yes


16. Albers, J. (2008, June). EMDR & cue exposure – How cue exposure catalyses the effectiveness of the EMDR protocol to diminish craving. Presentation at the annual meeting of the EMDR Europe Association, London, England.

Language: English

Format: Conference

Abstract:
A structured six-session group therapy has been developed for overcoming craving. Treatment is based upon a standard EMDR protocol supported by cue exposure techniques. The EMDR protocol supported by cue exposure catalyses the recovery process as follows: In the very beginning the participants are taught a set of three ideodynamic resources for coping with the urge to drink. Then they are exposed to alcohol until the urge to drink reaches it´s peak. At this moment they are taught to initialize the standard EMDR protocol - with continued exposure to alcohol. Subsequently, the power of desensitisation and reprocessing followed by one ideodynamic strategy influences the intensity of craving significantly. Craving symptoms diminish and finally disappear. In addition to that new experience the clients acquire greater and deeper knowledge about their personal drinking triggers. They also find out which strategy is the most effective one for each specific trigger. A strategy, which works well with one trigger, may not work with a different one. Workshop participants will learn the system of using cue exposure as a powerful cognitive interweave. This program is designed to improve the treatment of various types of addiction, such as gambling, etc. and can easily be integrated into existing EMDR treatment strategies.

Keywords: Cue Exposure  

Accuracy Verified: Yes


17. Omaha, J. (2004, June). EMDR and affect centered therapy. Presentation at the EMDR Europe Association annual meeting, Stockholm, Sweden .

Language: English

Format: Conference

Abstract:
Aim: This presentation will describe the integration of principles of emotion regulation into EMDR therapy for a range of disorders. Population: All ages; mostly Axis I and II disorders. Learning objectives: 1) to describe the development of emotion regulation beginning in the context of the attachment and continuing through adolescence; 2) to describe the origin of emotion dysregulation and psychopathology in deficit experience adversity, and trauma; 3) to describe a protocol, Affect Management Skills Training (AMST), that remediates failures of emotion regulation; 4) to describe how AMST prepares the client for uncovering therapy by providing for containment, safety, emotion regulation, improved left-right hemisphere integration, and remediation of attachment deficits; 5) to describe integration of MAST into EMDR therapies for substance abuse and eating disorders. Abstract: The workshop will summarize the principal affective developments that occur from birth through age four. These include fulfillment of yearning affect, facial imprinting, gaze transaction, stimulation of positive affect, and provision of optimal disapproval-shame experiences. The qualities of the child of “good enough” parenting are described. Developmental failures and their consequences for affect regulation and psychopathology will be described. These include: (1) avoidant attachment leading to problems of anger management, to depression, and development of narcissistic features; (2) anxious-ambivalent attachment leading to development of anxiety-related disorders and borderline features; (3) failure to elicit optimal positive affects leading to impaired vitality across the life span and depression; (4) socialization of the senior toddler with anger, leading to problems with anger expression, or with disgust, leading to problems with shame, impaired self-worth, and defective self-efficacy. Adversity (raised by a single parent, witness to spousal abuse, divorce, substance abuse in the home) and trauma (psychological, physical, and/or sexual abuse) occurring during latency and adolescence will be shown to exacerbate difficulties with emotional regulation.
The seven basic skills of the AMST protocol will be described. These skills provide for regocnition, tolerance, and regulation of both positive and negative emtoins. They include containment, safe place, sensation-affect recognition, sensation-as-signal, grounded and present, noticing, and regulation.
The workshop will describe how AMST prepares the client for uncovering therapy and for EMDR by teaching the client to regulate emotion prior to it elicitation in therapy, by improving hemispheric integration, and by correcting deficits in the attachment.
The workshop concludes by describing how MAST is integrated into EMDR therapy for substance abuse disorders (alcohol, drugs, nicotine) and eating disorders.

Keywords: Affect Centered Therapy  Affect Theory  

Accuracy Verified: Yes


18. Eimer, B. N. (1995, June). EMDR applications for pain management. Presentation at the EMDR Network Conference, Santa Monica, CA.

Language: English

Format: Conference

Abstract:
The focus of this 3-hour workshop will be on using EMDR to alleviate emotional distress attendant to coping with acute physical pain and living with chronic pain. Participants in this workshop will learn: (a) how to conduct a targeted assessment of the patient whose chief complaint is physical pain; (b) a guided pain healing meditation; (c) an EMDR protocol for installing pain relief imagery and self-care techniques; (d) an EMDR protocol for reprocessing covert pain talk, pain behaviors and pain-related memories; (e) how to apply A.J. Popky's EMDR protocol for reducing substance abuse (i.e., Overeating, drinking) and dependence on pain medication in this population. The presentation will first address how to conduct a structured assessment that identifies targets for EMDR treatment. The dysfunctional information package associated with chronic pain (termed the "biogram")and "seven keys" to understanding chronic pain will be discussed. Then, essential principles for designing an effective individual psychotherapy program for the pain sufferer will be presented. Next, use of the "seven keys for constructing a guided healing meditation (i.e., Self-care technique) for the pain patient that also incorporates Francine Shapiro's "light stream" and "spiral" guided meditations will be demonstrated. A script for this, termed the "C.O.M.P.I.S.S. Pain Healing Meditation," will be distributed. The workshop will then address how to introduce EMDR to the patient whose chief complaint is physical pain. What EMDR can do and probably cannot do for pain patients will then be discussed. Next, principles for choosing an initial tarqet for reprocessing will be discussed. The presentation will then cover (with clinical case examples): (1) Red flags and cautions to consider before proceeding with EMDR- (2) What to do and what not to do if the patient is dissociative; (3) How to "mirror" and install with EMDR empathic responses to underlying beliefs associated with "secondary gains" minus primary losses; (4) Teaching the distinction between pain sensations and suffering; (5) How to teach and install with EMDR self-care and pain coping techniques such as pain relief imagery, mental distraction techniques, safe place imagery, and positive motivation for healthy self-care behaviors; (6) How to directly address with the patient the application of "cognitive psychology" and imagery for pain reduction; (7) EMDR reprocessing of memories around the pain's origins; (8) EMDR reprocessing of pain-related conflicts, negative beliefs, negative past experiences, internalized self-identifications, self-punitive tendencies and self-defeating behaviors; (9) Eliciting core negative pain coping cognitions and suggesting preferable positive cognitions to the pain patient; (10) EMDR reprocessing of negative cognitions associated with depression and anxiety. (11) Use of EMDR to facilitate mental rehearsal of coping responses to pain triggers; (12) Material that often comes up in using EMDR with pain patients; (13) Strategically restructuring patient "resistance" with coanitive interweave; (14) Managing narcotic and pain medication seeking behavior and substance abuse; (15) Use of Popky's EMDR protocol for reducing medication dependence and substance abuse in this population; (16) Treating pain patients who also have PTSD. Videotaped case excerpts will be shown that illustrate important points covered. If time permits, participants may be able to briefly discuss EMDR applications to specific medical and pain patient populations.

Keywords: Chronic Pain  Pain  Pain Management  

Accuracy Verified: Yes


19. Hase, M. H. (2006, September). EMDR applied to reprocess the addiction memory in alcohol addicted in-patients – Outcome and follow-up data of a clinical study. Presentation at the annual meeting of the EMDR International Association, Philadelphia, PA.

Language: English

Format: Conference

Abstract:
Substance abuse and its sequels often mean intense suffering for the individual and huge costs for society. Established treatment modalities, as good as they are, lack effectiveness. Comorbid PTST with substance abusers is more the rule, than the exception. So the integration of traumatherapy, especially EMDR, into addiciton therapy seems necessary. Recent research in the field of neuroscience has shown that most experience is automatically processed on subcortical levels, i.e., by "unconscious" interpretations that are made outside of conscious awareness. Insight and understanding have only a limited influence on the operation of these subcortical processes. The concept of an addiction memory is helpful. It can be understood as a form maladaptive memory and EMDR could be the tool for resolution. Targeting the addiction memory and reprocessing should lead to a reduction in craving. Date of a study on alcohol addicted inpatient support the hypothesis. Data shown include outcome and follow-up data. Reprocessing of the addiction memory could lead to EMDR protocol beyond the EMDR Chemical Dependency Treatment Manual. Participants will be able to understand the concept of the addiction memory and its implications for therapy. They will be able to identify targets for EMDR. Video of treatment sessions illustrate common principles and differences.

Keywords: Addiction  Memory  Substance Abuse  

Accuracy Verified: Yes


20. Hase, M. H. (2006). EMDR in der behandlung der stoffgebundenen abhängigkeit [EMDR in the treatment of substance-dependence]. In: F. Lamprecht (Hrsg.), Praxisbuch EMDR: modifizierungen für spezielle anwendungsgebiete [EMDR practice book: modifications for special areas of application] (pp. 132-156) Stuttgart: Klett-Cotta.

Language: German

Format: Book Section

Keywords: Addiction  Substance Abuse  

Accuracy Verified: Yes


21. Zobel, M. (2006). EMDR in der behandlung von suchtpatienten mit posttraumatischer belas tungsstörung [EMDR in the treatment of addicted patients with post-traumatic stress disorder]. In Schriftenreihe des Fachverbandes Sucht, e.V. Band 29 "’Integrierte Versorgung’: Chancen und Risiken für die Suchtrehabilitation" Beiträge des 18. Heidelberger Kongresses 2005, Geesthacht: Neuland..

Language: English

Format: Other

Abstract:
Die Wahrscheinlichkeit, dass wir im Laufe unseres Lebens einem oder mehreren traumatisierenden Ereignissen ausgesetzt sind, ist relativ hoch: Die Lebenszeitprävalenzen von traumatischen Ereignissen und einer posttraumatischen Belastungsstörung betragen in internationalen epidemiologischen Studien für Frauen 17,7 – 74,2 Prozent (PTBS: 1,3 - 12,3 Prozent) und für Männer 25,2 - 81,3 Prozent (PTBS: 0,4 - 6,0 Prozent) (Kuhn, 2004). Menschen mit Suchtproblemen berichten dabei überzufällig häufig von Gewalt- und Missbrauchserfahrungen in Kindheit, Jugend und im Erwachsenenalter. In vielen Fällen kann ein Zusammenhang zwischen dem traumatischen Ereignis, der Entwicklung einer posttraumatischen Belastungsstörung und Alkoholmissbrauch und –abhängigkeit abgeleitet werden (Perkonigg et al., 2000; Zobel, 2006). Bei Vorliegen einer PTBS íst das Risiko einer Suchterkrankung oder anderer komorbider Störungen um das 4-5fache erhöht (Breslau, 2002).

The probability that we are in the course of our lives one or more traumatic events are exposed, is relatively high: the lifetime prevalence of traumatic events and posttraumatic stress disorder be in international epidemiological studies for women from 17.7 to 74.2 Percent (PTSD: 1.3 - 12.3 percent) for men and from 25.2 to 81.3 percent (PTSD: 0.4 - 6.0 percent) (Kuhn, 2004). People with addiction problems to report here than chance often violence and abuse experiences in childhood, adolescence and adulthood. In many cases, a connection between the traumatic Event, the development of post traumatic stress disorder and alcohol abuse and are derived dependence (Perkonigg et al., 2000; Zobel, 2006). In the event of a PTSD is a risk of addiction or other comorbid disorders at the 4-5-fold increased (Breslau, 2002).

Keywords: Addictions  Posttraumatic Stress Disorder  PTSD  

Accuracy Verified: Yes


22. Hase, M. (2010, June). EMDR in the treatment of addiction - Reprocessing of the addiction memory. Keynote presented at the annual meeting of the EMDR Europe Association, Hamburg, Germany.

Language: English

Format: Conference

Abstract:
The comorbidity of PTSD and substance abuse provides sufficient reason for treating patients, who are addicted, with EMDR while focusing on the PTSD diagnosis. However, there are several pathways leading to addiction, and PTSD is only one of them. Thirty years of addiction research have provided sufficient evidence for the crucial role of memory in drug dependency.
The Addiction Memory (AM) serves as a useful concept for "obsessive-compulsive craving" to be seen in drug addicted patients. The concept of an AM, and its importance in relapse occurrence and maintenance of learned addictive behaviour, has gained growing acceptance in the field of addiction research and treatment. The AM is interpreted as an individual-acquired memory following drug consumption in some individuals. The addiction memory is based on normal memory systems and systems of central nervous information processing. This is in accordance with the experience that the addiction memory can be activated at any time by relapse-endangering complexes as well as internal and/or external situations, which are experienced as cravings by the person in question. The implicit nature of the addiction memory seems to qualify it as a target for EMDR treatment.
Without adequate therapeutic interventions, it is hardly extinguishable, as shown in the animal model where a re-imprinting of the AM facilitated by steroids extinguished craving in opiate addicted rats. Thus, altering or extinguishing the AM in human addicts could add an important component to well-established treatment modalities. The reprocessing of the AM with EMDR should, thus, lead to measurable changes in addiction symptoms, if the AM qualifies for maladaptive memory within the AIP model. As the AM includes the urge to consume the drug being abused, more aptly named craving, reprocessing of the AM should lead to a reduction in craving.
Preliminary data demonstrates the efficacy to reduce craving in alcohol-addicted patients. Anecdotal reports from clinicians seem to indicate an effect of the reprocessing of the addiction memory in patients addicted to heroin or psycho-stimulants. According to research in the animal model, the same principles should apply.
There are, however, other aspects to addiction. Is there a difference between chemical dependency and other addictive behaviour? How much do we know already? What have we yet to discover? These questions lead to the direction of developing a comprehensive EMDR approach in the treatment of addictions.

Keywords: Addiction  Keynote  

Accuracy Verified: Yes


23. Sautai, G. (2011, June). EMDR intensive therapy (EMDRIT). Presentation at the annual meeting of the EMDR Europe Association, Vienna, Austria.

Language: English

Format: Conference

Abstract:
Therapeutic Process seems to be blocked for some patients with strong Developmental Disorders or exposed to Disturbing Early Life Experiences (Bessel A. van der Kolk). A specific approach during EMDR Intensive Therapy (EMDRIT) using the Case Conceptualisation (Andrew Leeds), based on the Adaptive Information Processing (AIP) model (Francine Shapiro), the Attachment Theory (John Bowlby) and the Useful and Necessary Renouncement Principe (Judith Viorst) allow those patients to progress. As a pilot experience, we have been able to use this EMDRIT framework with 64 clients. Their complex disorders included, for each of them, at least 3 of the following symptoms: Anxiety, depression, primary structural dissociation, alcohol addiction, eating behaviour disorders, travel phobia, emotional numbing, affective isolation, hypochondria, phantom limb syndrome, fibromyalgia, cancer, psychological or physical abuse survivor, perpetrator of violent aggressions. For the 25 first clients, we have used the PCL-S (pathology threshold > 44) test. Their pre-treatment average score was 70. It dropped to 28 after EMDRIT treatment, down to 26 after 3 months and stabilised at 29 after 1 year. These first results allowed us to define a target population and an adapted protocol that provides client safety, efficiency and result sustainability. For the 39 next clients, we measured a decrease of the SCL-90-R (pathology threshold > 1,5) test score from 3 before treatment down to 1,4 after treatment, 1,2 after 3 months and 1,3 after 1 year. We measure efficiency on 87% of the clients and a suppression of 80% of the symptoms after 1 year. At the same time, a control cohort of 20 people with identical pathologies saw their score drop from 3 to 2,3 with the same treatment time, using the standard EMDR protocol. From this preliminary result, we are developing some research hypothesis: •Selection criteria for EMDRIT, based on the patient ability accessing Adaptive Memory Networks (AMN). •The Targeting Sequence Plan, seen as an expression of the Dysfunctional Memory Networks (DMN). •The importance of the client emotional Window Of Tolerance (WOT) for the efficiency of the Adaptive Information Processing system. •Epigenetic show possible structural brain modifications by rehabilitation of fluid links across the 3 levels of the brain (reptilian, limbic and neo-cortical). These changes are immediate and permanent. •Need to standardize appropriate scale for database, in order to foster international research and results sharing. We sea AIP model as an opportunity to move from an analytic and sequential approach to a systemic and integrative approach based on Complex System for a global understanding.

Keywords: EMDR Intensive Therapy  EMDRIT  

Accuracy Verified: Yes


24. Hase, M., Schallmayer, S., & Sack, M. (2008). EMDR reprocessing of the addiction memory: Pretreatment, posttreatment, and 1-month follow-up. Journal of EMDR Practice and Research, 2(3), 170-179. doi:10.1891/1933-3196.2.3.170.

Language: English

Format: Journal

Abstract:
This randomized controlled study investigated the effects of eye movement desensitization and reprocessing (EMDR) in the treatment of alcohol dependency. EMDR was applied to reprocess the addiction memory (AM) in chronically dependent patients. The AM includes memories of preparatory behavior, drug effects (drug use), and loss of control (Wolffgramm, 2002). It is understood to involve extensive brain circuitry, drive part of conscious and unconscious craving, change environmental response at an organic level, and modify circuits that link to feelings of satisfaction, future planning, and hope. Thirty-four patients with chronic alcohol dependency were randomly assigned to one of two treatment conditions: treatment as usual (TAU) or TAU plus two sessions of EMDR (TAU+EMDR). The craving for alcohol was measured by the Obsessive-Compulsive Drinking Scale (OCDS) pre-, post-, and 1 month after treatment. The TAU+EMDR group showed a significant reduction in craving posttreatment and 1 month after treatment, whereas TAU did not. Results indicate that EMDR might be a useful approach for the treatment of addiction memory and associated symptoms of craving.

Keywords: Adaptive Information Processing  Addiction Memory  Craving  Treatment  TAU  Treatment As Usual  

Accuracy Verified: Yes


25. Hase, M. (2010, June). EMDR to treat substance abuse and addiction. Preconference presentation at the annual meeting of the EMDR Europe Association, Hamburg, Germany.

Language: English

Format: Conference

Abstract:
The comorbidity of PTSD and substance abuse provides sufficient reason for treating patients, who are addicted, with EMDR while focusing on the PTSD diagnosis. However, there are several pathways leading to addiction, and PTSD is only one of them. Thirty years of addiction research have provided sufficient evidence for the crucial role of memory in drug dependency. The Addiction Memory (AM) serves as a useful concept for "obsessive-compulsive craving" to be seen in drug addicted patients. The concept of an AM, and its importance in relapse occurrence and maintenance of learned addictive behaviour, has gained growing acceptance in the field of addiction research and treatment. The AM is interpreted as an individual-acquired memory following drug consumption in some individuals. The addiction memory is based on normal memory systems and systems of central nervous information processing. This neurobiological-based, imprinted, addictive behaviour seems to resist change under normal circumstances. The implicit nature of the addiction memory seems to qualify it as a target for EMDR treatment.
In a pilot-study group, 34 patients with chronic alcohol dependency in in-patient treatment for detoxification were randomly assigned to one of two treatment conditions: treatment as usual (TAU) or TAU+EMDR. In the TAU+EMDR group, patients received two sessions of EMDR focussing on memories of intense craving or relapse in order to activate and reprocess the addiction memory. The craving for alcohol was measured by the Obsessive-Compulsive-Drinking-Scale (OCDS) pre, post, and 1 month after treatment. The TAU+EMDR group showed a significant reduction in craving post-treatment and 1 month after treatment whereas TAU did not. The TAU+EMDR group showed lower relapse rates at the six-month follow-up. The results indicate that EMDR might be a useful approach for the treatment of addiction memory and associated symptoms of craving (Hase et al. 2008). Anecdotal reports show results with opiate and stimulant addicted patients.
This Workshop will address the EMDR treatment of comorbid PTSD and focuses on the application of EMDR as an adjunct in addiction treatment. Targets for a comprehensive EMDR treatment plan will be explained. A video demonstration, self-experience and discussion of cases shall contribute to learning.
REFERENCES Boening, J. A. (2001). Neurobiology of an addiction memory. J Neural Transm 108(6): 755-65.
Hase, M., Schallmayer, S. and Sack, M (2008). "EMDR reprocessing of the addiction memory: Pre-treatment, post-treatment, and 1-month follow-up" J EMDR 2 (3), 170-179.

Keywords: Addiction Memory  Posttraumatic Stress Disorder  PTSD  Substance Abuse  TAU  Treatment As Usual  

Accuracy Verified: Yes


26. Hase, M. (2006, November). EMDR toegepast op de addicition geheugen in alcohol verslaafde patiënten opnieuw te verwerken in - Resultaten en follow-up gegevens van een klinische studie [EMDR applied to reprocess the addicition memory in alcohol addicted in-patients – Outcome and follow-up data of a clinical study]. Keynote gepresenteerd aan de tweede congres van de Vereniging EMDR Nederland, Amersfoort, The Netherlands.

Language: English

Format: Conference

Abstract:
Alcohol afhankelijkheid en haar gevolg op betekenen vaak intens lijden voor het individu en enorme kosten voor de samenleving. Gevestigde behandelmethoden, zo goed als ze zijn, gebrek aan effectiviteit. Uit recent onderzoek op het gebied van de neurowetenschappen is gebleken dat de meeste ervaring wordt automatisch verwerkt op subcorticaal niveau, dat wil zeggen door 'onbewust' interpretaties die buiten bewustzijn gemaakt. Inzicht en begrip hebben slechts een beperkte invloed op de werking van deze subcorticale processen. Deze bevindingen zijn ook van toepassing op verslaafde mensen een bijdragen aan een nieuwe aanpak te creëren. Het concept van een addicition geheugen is behulpzaam (Wolffgramm 2000; Wolffgramm 2002). Het kan worden opgevat als een vorm van onaangepast geheugen en EMDR is het hulpmiddel voor de resolutie (Shapiro 2001). De presentatie richt zich op theorie en praktijk van een EMDR aanpak van de verslaving opwerken geheugen (Hase 2006). Gegevens van een klinische studie zullen worden gepresenteerd en besproken.

Alcohol dependency and its sequela often mean intense suffering for the individual and huge costs for society. Established treatment modalities, as good as they are, lack effectiveness. Recent research in the field of neuroscience has shown that most experience is automatically processed on subcortical levels, i.e. by “unconscious” interpretations that are made outside of conscious awareness. Insight and understanding have only a limited influence on the operation of these subcortical processes. These findings are also applicable on addicted people an help to create a new approach. The concept of an addicition memory is helpful (Wolffgramm 2000; Wolffgramm 2002). It can be understood as a form of maladaptive memory and EMDR is the tool for resolution (Shapiro 2001). The presentation focusses on theory and practice of an EMDR approach to reprocess the addiction memory (Hase 2006). Data of a clinical study will be presented and discussed.

Keywords: Addiction  Memory  Inpatients  

Accuracy Verified: Yes


27. Abel, N. J., & O'Brien, J. M. (2010). EMDR treatment of comorbid PTSD and alcohol dependence: A case example. Journal of EMDR Practice and Research, 4(2), 50-59. doi:10.1891/1933-3196.4.2.50.

Language: English

Format: Journal

Abstract:
Eye movement desensitization and reprocessing (EMDR) is a therapy that has been demonstrated to be effective in the treatment of posttraumatic stress disorder (PTSD). A relatively small but growing body of literature indicates that EMDR may be an effective adjunctive treatment for substance abuse. This article reviews the various protocols that have been developed for that purpose, including protocols by Vogelmann-Sine et al., Omaha, Popky, and Hase. A case study that incorporates the use of some of these interventions is presented to illustrate successful EMDR treatment of a woman who had long-standing comorbid alcohol abuse and PTSD. Two-year follow-up after EMDR showed that the woman was successfully maintaining sobriety and that the PTSD continued in full remission. After a discussion of the important aspects of this case, the authors explore future directions for research.

Keywords: Alcohol Dependence  Comorbid PTSD  

Accuracy Verified: Yes


28. Zobel, M. (2010, June). EMDR with alcohol addicted patients with comorbid PTSD in a treatment facility for alcoholism - experiences, outcome, perspectives. In Addictions. Symposium conducted at the annual meeting of the EMDR Europe Association, Hamburg, Germany.

Language: English

Format: Conference

Abstract:
Patients with alcohol addiction often report sexual abuse and neglect in childhood and/or other traumatic events during lifetime. In addiction treatment facilities symptoms of PTSD are frequently not treated, because there is no sufficient method. which could be completed within the addiction treatment period? The lecture will inform about an ongoing scientific project dealing with the question, if EMDR is an intervention, which is equal or superior to common multimodal stabilizing interventions. The project is supported by the Deutsche Rentenversicherung Bund. Patients with alcohol addiction and comorbid PTSD are divided into two groups: EMDR or multimodal therapy including stabilizing methods. Prevalence of PTSD-symptoms is measured before and after intervention and one year after treatment. Up to date nearly 90 Patients with alcohol addiction and PTSD have been treated. Data indicate, that both trauma treatments are effective but that EMDR leads to a significant larger decrease in trauma symptoms. The results of the one year after treatment evaluation are presented and discussed. Educational objectives: Addiction therapy in a treatment facility can be effectively combined with trauma therapy. EMDR is an effective method in the treatment of patients with alcohol addiction and comorbid PTSD. Most patients with alcohol addiction and PTSD show multiple trauma and need a prolonged period of treatment. What's new? There are only few studies in Germany, which have investigated the effects of EMDR in a sample of alcohol addicted patients. The presented study includes a follow up evaluation one year after treatment (currently in progress), which rarely is the case in research on EMDR-effectiveness.

Keywords: Alcoholism Treatment  Comorbid Posttraumatic Stress Disorder  Comorbid PTSD  Symposium  

Accuracy Verified: Yes


29. Vogelmann-Sine, S., & Sine, L. F. (1993, Winter). EMDR with clients in recovery from chemical dependency. EMDR Network Newsletter, 3(3), 12-15.

Language: English

Format: Newsletter

Abstract:
We have found that the treatment protocol outlined below has been very helpful in our work with clients suffering from substance abuse or dependence.

Keywords: Addictions  Chemical Dependency  Protocol  Substance Abuse  

Accuracy Verified: Yes


30. Jones, J. (1995, June). EMDR: A candid view from the psychiatrist's couch. Presentation at the EMDR Network Conference, Santa Monica, CA .

Language: English

Format: Conference

Abstract:
I will attempt to present an overview of the major psychiatric disorders, some medical and neurologic syndromes and general concepts on how I approach diagnosis, prognosis and treatment. Our time will include all this and put special focus on psychpharmacology. The nature and scope of this material will be mostly introductory but i will certainly be open to exploring my topic at greater depth depending the needs of the group present. The audience should be any among you who would likea way to begin organizing you approach to pharmacology and the impact that is having on your practice and the use of EMDR. Licensed clinical social workers, marriage and family counselors and psychologists should especially benefit form the discussion. You can expect to hear about major depression and its variants, bipolar disorder, panic disorder and the general anxiety disorders- some coverage of eating disorders, PTSD and adult attention deficit disorder but in less detail. I shall only touch upon schzophrenia and the psychotic disorders unless you show a special interest. The same is true for medical and neurologic diagnosis which have psychotic sequelas. I shall then to proceed to describe the differences and similarities among the antidepressants following that with a less detailed presentation of anit-anxiety agents, anti-psychotics, lithium and its siblings and a few of the "tried-and-true" substances of abuse like alcohol, stimulants, hallucinogens and narcotics. Please forgive me if I draw the line at designer drugs. This is a vast amount of information. I shall empasize general organizing concepts which will help the clinician who would like to understand some of his/her clients better, know better when to make a referral to a psychiatrist, now some of the potentials and limitations of EMDR when your clients are taking medications and/or have a major psychiatric disorder. Do not come to if you wish to set sail on a sea of psychiatric and medical details - 90 minutes just will not suffice! I will depend on you to speak up at any time with your concerns and queries (not to mention contradictions) so we can tailor the moment to the real interests of those present. I will attempt to reserve a substantial amount of time for question, answers, and observations but, if we are lucky, this will be happening throughout the ninety minutes. If we have time left I will explore the subject of "you and your psychiatrist" with both panache and hubris. We have a reputation for not being the most ingratiating of colleagues. I have a number of suggestions from a psychiatrist perspective which could make it easier to manage (sic) your psychiatrist. I hope we will be able to conclude with some high spirits and as they say here in California, a time for sharing and mutual understanding.

Keywords: Practice  Theory  

Accuracy Verified: Yes


31. Pacheco, J. Q. (2010, Febrero-Marzo). EMDR: Tratamiento de la fobia social [EMDR: Treatment of social phobia]. Communicacion presentada en: 11º Congreso Virtual de Psiquiatría, Trujillo, Peru, Interpsiquis 2010. Psiquiatria.com..

Language: Spanish

Format: Conference

Abstract:
Social phobia is one of the most common diseases in the general population, according to American Psychiatric Association (2000) cited by Olivares-Rodríguez (2006) (1) shows a prevalence ranges from 1% to 15.6% in Europe, being higher in women than in men (Olivares, J., 2003) (2), has its onset most frequently in middle adolescence (Olivares-Olivares and Other, 2007) (3) in these patients presenting symptoms associated with other disorders anxiety, depression and substance abuse such as alcohol or other legal and illegal drugs (Olivares, J., 2003) (2), constituting a serious public health problem or suffering ever had in your life for 9.5% of the population (Olivares, J., 2003) (2)

Social phobia is one of the most common diseases in the general population, according to American Psychiatric Association (2000) cited by Olivares-Rodríguez (2006) (1) shows a prevalence ranges from 1% to 15.6% in Europe, being higher in women than in men (Olivares, J., 2003) (2), has its onset most frequently in middle adolescence (Olivares-Olivares and Other, 2007) (3) in these patients presenting symptoms associated with other disorders anxiety, depression and substance abuse such as alcohol or other legal and illegal drugs (Olivares, J., 2003) (2), constituting a serious public health problem or suffering ever had in your life for 9.5% of the population (Olivares, J., 2003) (2)

Keywords: Social Phobia  Treatment  

Accuracy Verified: Yes


32. Brown, S. H., Stowasser, J. E., & Shapiro, F. (2011). Eye movement desensitisation and reprocessing (EMDR): Mental health-substance use. In D. B. Cooper (Ed.), Intervention in Mental Health-Substance Use (pp. 165-193) United Kingdom: Radcliffe Publishing Ltd .

Language: English

Format: Book Section

Abstract:
Substance use disorders remain a persistent social and medical problem. According to a recent report,1 addiction is the number one health problem in the United States. The report notes that when one considers the direct costs of drug-induced health problems, deaths due to accidents, Human immunodeficiency virus (HIV), or drug-related acts of violent crime, there are ‘more deaths, illnesses and disabilities from substance abuse than from any other preventable health condition’.1 Most experts today agree that substance use disorders are a complex interaction between genetics, environment, and experience. ‘Substance dependence is not a failure of will or of strength of character, but a medical disorder that could affect any human being. Dependence is a chronic and relapsing disorder, often co-occurring with other physical and mental conditions’.2 The question remains - Why has it been that over the course of human history, where people and cultures have had access to alcohol and potent mind-altering substances, that only some become addicted while the rest are able to regulate their use? The drugs that people experiencing substance use disorders select are not chosen randomly, but are a result of an interaction between the psychopharmacologic action of the drug and the dominant painful feelings with which they struggle. Edward Khantzian, observed that opiates are often preferred because of their powerful numbing action on the affects of rage and aggression. Cocaine has its appeal because of its ability to relieve distress associated with depression. Although ill-fated, ‘addicts discover that the short-term effects of their drugs of choice help them cope with distressful subjective states and an external reality otherwise experienced as unmanageable or overwhelming’. Thus emerges a compelling hypothesis, which proposes that people use psychoactive substances in an attempt to control painful symptoms resulting from psychological trauma. This is referred to as ‘self-medication’. Some studies in the United States show that more than 50% of people with mental disorders also suffer from substance dependence compared to 6% of the general population.2 It is from our interest in providing integrated treatment for the complex interaction of genes, environment, trauma, and psychological pain as a driving force behind mental health-substance use disorders, that this chapter is written.

Keywords: Substance Abuse  

Accuracy Verified: Yes


33. Vyas, K. J. (2008, April). Eye movement desensitization and reprocessing (EMDR) to decrease human immunodefiency virus (HIV) risk behaviors among Latino men who have sex with men (MSM). Presentation at the National Conference on Undergraduate Research, Salisbury University, MD.

Language: English

Format: Conference

Abstract:
Among Latino MSM, those who have reported early childhood sexual abuse continually report high levels of HIV risk behaviors. The objective of this study was to test if EMDR can be more effective as an HIV risk reduction behavioral intervention than a non-trauma based comparison, the Explore Study intervention. At a university-based outpatient clinic, 35 Latino MSM were randomized into Explore (n=13) and EMDR (n=22). The main outcome measure was a self-report questionnaire assessing unprotected anal sex, number of sexual partners, and use of substances before or during sexual activity during the previous month. Sexual risk behaviors were assessed at baseline, before randomization, and at one week post-intervention. Compared to baseline rates, participants who didn’t report unprotected receptive anal intercourse increased by 11% in Explore and decreased by 12% in EMDR. The corresponding comparisons for number of sexual partners were a 4% increase for Explore and a 41% decrease in EMDR. Explore and EMDR participants showed an increment of 25% and 9%, respectively, in those who denied having used alcohol or drugs before or during sexual activity. Follow-up data at 2 and 6 months post-intervention are being collected. This preliminary analysis suggests that certain HIV risk behaviors can be reduced by EMDR, while others can be equally reduced by more conventional interventions.

Keywords: AIDS  HIV  Latino  

Accuracy Verified: No


34. Hase, M. (2007). Eye movement desensitization and reprocessing in der behandlung der substanzabhängigkeit [Eye movement desensitization and reprocessing in the treatment of substance dependency. Alcohol - new strategies for an old problem]. Fachkonferenz der Deutschen Hauptstelle für Suchtfragen e.V., Mannheim .

Language: German

Format: Conference

Keywords: Addiction  Alcohol Dependence  Substance Abuse  

Accuracy Verified: Yes


35. Hase, M. (2007). Eye movement desensitization and reprocessing in der qualifizierten entzugsbehandlung [Eye movement desensitization and reprocessing in the treatment of qualified withdrawal]. Bundesdrogenkongresss, Mainz.

Language: German

Format: Conference

Abstract:
EMDR ist eine anerkannte Methode der speziellen Psychotraumatherapie. Bei der Komorbidität von Traumafolgestörung und Abhängigkeit liegt der Einsatz der EMDR-Methode nahe. Dabei ist unter den engen zeitlichen Grenzen des qualifizierten Entzugs eine Anwendung kritisch zu diskutieren. Anhand von Fallbeispielen wird die Praxis einer Anwendung der EMDR-Methode im qualifizierten Entzug beschrieben. Neben der Behandlung der komorbiden Traumafolgestörung bietet sich mit einer Anwendung der EMDR-Methode auf das Suchtgedächtnis eine störungsspezifische Intervention an (Wolffgramm 2000). Daten einer Pilotstudie an Alkoholabhängigen scheinen die Annahme zu bestätigen (Hase 2006).

EMDR is an accepted method of special Psycho-trauma therapy. In the comorbidity of Traumatic stress disorder and is a function of Use of the EMDR method close. It is under the tight time limits of the qualified Withdrawn an application to discuss critical. Using case examples, the practice of Application of the EMDR method in the qualified Withdrawal described. Besides the treatment of comorbid traumatic stress disorder lends itself to a Application of the EMDR method to the Addiction memory interference-specific intervention to (Wolffgramm 2000). Data from a pilot study of alcohol abusers seem to accept to confirm (Hare 2006).

Keywords: Addiction  

Accuracy Verified: Yes


36. Hase, M. H. (2006). Eye movement desensitization and reprocessing zur beeinflussung des cravings alkoholabhängiger [Eye movement desensitization and reprocessing to influence of cravings of alcohol]. Aus der Abteilung PsychosomatischeMedizin und Psychotherapie der Medizinischen Hochschule Hannover.

Language: German

Format: Dissertation/Thesis

Abstract:
Klinische Erfahrung und Ergebnisse der experimentellen Suchtforschung weisen auf die Existenz eines Suchtgedächtnisses hin (Heyne, May et al. 2000; Böning 2001; Spanagel 2001). Nach wie vor ist dies Konzept jedoch umstritten (Böning 2000; Tretter 2000; Wolffgramm and Heyne 2000). Dabei könnte eine mögliche therapeutische Beeinflussung eines Suchtgedächtnisses von erheblicher Bedeutung sein. Die etablierten Therapieangebote der Suchtmedizin versuchen eine angenommene und je nach theoretischem Hintergrund unterschiedliche Grundstörung zu behandeln, zielen auf ein verbessertes Coping, beeinflussen aber kaum die zugrunde liegenden Mechanismen der Abhängigkeit sui generis. Eine tiefgreifende Veränderung der Abhängigkeit ist somit nicht zu erwarten. Vielmehr liegt die Abhängigkeit beständig „auf der Lauer“ (Böning 2001b). Eine Aktivierung des Suchtgedächtnisses wird mit dem Phänomen des Suchtdrucks, des Cravings in Verbindung gebracht und ist hier im Kern der Abhängigkeit, dem Verlust an Kontrolle über das eigene Verhalten, zu sehen. Die therapeutische Beeinflussung des Cravings wird aufgrund der großen Bedeutung für eine Abstinenz zum Beispiel bei Alkoholabhängigen intensiv erforscht. Bisher wurden vordringlich medikamentöse Strategien untersucht. Obwohl hier einige Fortschritte erreicht wurden (Böning 1999; Croissant 2004; Croissant, Scherle et al. 2004 (b)), können die vorliegenden Ergebnisse noch nicht zufrieden stellen (Wiesbeck, Weijers et al. 1999; Wiesbeck,Weijers et al. 2000; Böning 2001; Schmidt, Kuhn et al. 2002; Körkel and Schindler 2003). Zudem ist in Anbetracht des Leib-Seele-Dualismus ein psychotherapeutischer Ansatz zur Ergänzung der medikamentösen Anti-Craving-Behandlung wünschenswert. Dabei ist in Anbetracht des intensiven Leidens abhängiger Menschen und der sozioökonomischen Belastung durch Abhängigkeitserkrankungen eine Effektivierung der Therapie von großerWichtigkeit.

Clinical experience and results of the experimental addiction research point to the existence of a Suchtgedächtnisses (Heyne, May et al. 2000; Böning 2001; Spanagel 2001). As before, this concept remains controversial (Boening 2000; Tretter, 2000; Wolff grams and Heyne 2000). This could be a possible therapeutic influence Suchtgedächtnisses one of considerable importance. The established treatment of Addiction Medicine offers an accepted and try to treat depending on the theoretical background of different basic fault, are aimed at improved coping influence, but hardly the underlying mechanisms of dependence sui generis. A profound change in the dependence is unlikely to happen. Rather, the dependence is constantly on the lookout "(Böning 2001b). Activation of the Suchtgedächtnisses is the phenomenon of craving, the Cravings brought together and is at the core of addiction, the loss seen in control over one's behavior. The therapeutic influence of craving is studied intensively because of the great importance for abstinence, for example, in alcoholics. So far, urgent medical strategies have been investigated. Although some progress has been achieved here (Boening 1999; Croissant 2004; Croissant, Scherle et al. 2004 (b)), these results may not satisfy (Wiesbeck, Weijers et al. 1999; Wiesbeck, Weijers et al. 2000; Böning 2001; Schmidt, Kuhn et al. 2002; Koerkel and Schindler 2003). Moreover, in view of the mind-body dualism, a psychotherapeutic approach to supplement the anti-craving drug treatment desirable. This is in view of the intense suffering of dependent people and the socio-economic burden of disease, more effective, depending on the treatment of großerWichtigkeit.

Keywords: Alcoholism  Posttraumatic Stress Disorder  PTSD  Therapy  

Accuracy Verified: Yes


37. Lui, L. (1996, July/August). Hand waving?  An unconventional for post-traumatic stress is put to the test. The Sciences, 36(4), 13.

Language: English

Format: Other

Abstract:
When Prometheus gave fire to the mortals, an angry Zeus chained him to Mount Causaus, where each day an eagle devoured his liver, and each night the liver grew back. Imagine for a moment that you must endure a variation of that Promethean hell. Instead of an eagle, your tormentor is a rapist, the murderer of your parents, a battlefield enemy who took away your legs and much more inside. For many people, the unbearable circumstances you are only imagining are real. The condition known as post-traumatic stress disorder (PTSD), forces it svictims to live the most traumatic events of their lives over and over again. Because the events are often wars, assaults or natural disasters, the persistence of memory alone would be difficult. But if you are a victim of PTSD, you may relive your tragic epiosde with such clarity that you can see the bloody bodies on the battlefield or smell the alcohol on your assailant's breath.

Keywords: Practice  Theory  

Accuracy Verified: Yes


38. Albers, J. (2010, July). The interplay of resourcefulness and resilience in recovery: A six session approach treating addictive behaviour, an extended EMDR protocol. Presentation at the 1st EMDR Asia Conference, Bali, Indonesia.

Language: English

Format: Conference

Abstract:
A structured six-session group therapy has been developed and approved for overcoming craving. The six session protocol can easily be integrated to well-applied EMDR protocols (DeTur from Popky, CravEx from Haase) supported by systematic implementation of cue exposure techniques and guided imagery. The EMDR protocol supported by cue exposure catalyses the recovery process as follows: At the beginning the patients are taught a set of three ideodynamic resources for coping with the urge to drink; “Rewards of sobriety”, “Support of relatives and friends” and “Irrepressible commitment to sobriety”. The patients learn rapid activation of these resources by the use of the “Seven Cue Word Induction–technique” and kinaesthetic bilateral stimulation (SingleblAiR). Then they are exposed to alcohol until the urge to drink reaches it´s peak. At this moment they are taught to initialize resourcefulness - with continued exposure to alcohol. Subsequently, the power of one ideodynamic strategy diminishes the intensity of craving significantly. Craving symptoms finally disappear and are replaced by self-reinforcing thoughts and feelings due to state dependent learning. In addition to this new experience the patients acquire a high level of self-efficacy as well as greater and deeper knowledge about their personal drinking triggers. They also find out which strategy is the most effective one for each specific trigger. After regaining self-control over triggers, the patients are more receptive to working with their core addiction issues, which have now become easier to treat by especially using Desensitization and Reprocessing of the Standard- EMDR protocol. Workshop participants will become acquainted with the six-session protocol by the use of DVD-demonstrations and by practising. In addition they will receive a manual with standardised instructions. Finally they will also be given the opportunity to participate in a cross-cultural research project proving the effectiveness of the six-step program which starts in 2011. This approach is designed to improve the treatment of various types of addiction and can easily be integrated into existing EMDR treatment strategies.

Keywords: Addiction  Addictive Behavior  Resourcefulness  Resilience  

Accuracy Verified: Yes


39. Snyder, M. (1996, December). Intimate partners: A context for the intensification and healing of emotional pain. Women and Therapy, 19(3), 79-92. doi:10.1300/J015v19n03_08.

Language: English

Format: Journal

Abstract:
A case of a lesbian couple is presented in which one partner experienced early sexual abuse and the other a series of major losses (beginning with the death of her mother) in early childhood. The first partner developed an alcohol addiction and the second a high level of emotional lability and some practices of self-harm. Both partners developed dissociative patterns. The couple is now in a committed relationship and have continued in therapy for the last 9 months, with sessions gradually becoming less frequent. The therapeutic work has included the "externalization" of the problem(s), some individual work within the couple session using Eye Movement Desensitization and Reprocessing (EMDR), and a strong emphasis on the development of empathic skill through the technique of "becoming" the other person. The case reveals the way in which a primary relationship often surfaces intense unresolved feelings and dysfunctional relationship practices, and also the way in which emotional commitment and a structure for the couple becoming therapeutic agents to each other allows for a deep level of healing. The couple comments on their relationship process and the therapeutic process as part of the article. [Author Abstract]

Keywords: Adults  Americans  Case Report  Child Abuse  Family Therapy  Females  Homosexuals  Incest  Interpersonal Interaction  Psychiatric Disorders  Rape  Survivors  

Accuracy Verified: Yes


40. Manfield, P. (1995, June). Narcissistic disorders:  Using EMDR with these difficult clients. Presentation at the EMDR Network Conference Santa Monica, CA.

Language: English

Format: Conference

Abstract:
Definition of client population: Disorder of the self. The narcissistic character is often identified by his or her grandiose facade concealing an underlying sense of emptiness and worthlessness. To experience the underlying emptiness is so painful for them that these people cut off their inner experience and rely instead on external admiration and praise to support their grandiose or superior view of themselves; their condition is often referred to as a "disorder of the self." Because of their dependence on others for their sense of themselves, they are exquisitely sensitive to criticism or disapproval, often warding off deflation by becoming increasingly grandiose, superior, disdainful or demeaning. Many conceal their grandiosity, maintaining a secret sense of superiority which may be based upon their perfectionism or their quiet devaluing of others. View of others: there is a range of severity of the narcissistic character from personality disorders to a narcissistic character style. People with personality disorders, are unable to form a trusting bond with another person; they view people primarily as interchangeable, performing a function which could equally be performed by many others. Less impaired narcissistic characters, however, are able to form varying degrees of attachments to other people, although their ability to trust and care about other people is limited. Most commonly they relate to people they can idealize or be admired by. People tend to be seen in extremes as either superior and powerful or inferior and worthless; supportive and admiring or critical and attacking. Difficulties in using EMDR: Clinically these clients represent a difficult and often frustrating population to treat; they are brittle and easily injured if they to not feel perfectly understood by their therapists, and they will distance at the slightest hint that they are being judged or used. They resist focusing inward and defining their problems as arising within themselves, and find it difficult to sustain any genuine affect, other than perhaps rage. If they feel understood and accepted, however, they will eventually talk about their sense of emptiness and worthlessness and their confusion about who they are and what is truly meaningful and valuable to them. Beck, Young and others have described factors that make it difficult to treat any personality disorder using a cognitive behavioral approach. There have in fact been very few reported "successes" in the literature. Most of the difficulties are related to the self and object splitting characteristic of these clients. These clients have limited access to feelings, limited access to spontaneous thoughts, body sensations, memories, etc., and vague unfocussed presenting problems making targeting difficult. They usually have difficulty with emotional and often intellectual continuity from session to session; they will rarely keep a log or follow through with homework; transference issues often come into central focus and must be addressed before other targets; and their selfdefeating beliefs and behavior patterns are extremely deeply held, pervasive and resistant to change. In addition to varying degrees of these difficulties, narcissistic clients present all of the problems in EMDR that they do in more traditional therapies; including their tendencies to act out, deny, and avoid. These and other defenses interfere with completion of segments of therapeutic work and make it difficult for the clinician to keep work focused within one neural network. Self and object splitting leads to continuity problems within or between sessions and a difficulty maintaining clarity about the reason for being in treatment. The client may feel suicidal one week and declare himself or herself to be fully recovered the next. Perhaps the most confirming aspect of the treatment of these clients, however, is their emotionally impoverished pasts; they have very limited experience of nurturing, loving and caring to draw !?om in order to interweave new meanings and perspectives into traumatic or painful past experiences. Length of treatment: I have found that I have been able to achieve good results with higher level narcissistic clients with whom I have had an established relationship at the time I introduced EMDR into the treatment. My results with clients who have come to therapy asking specifically for EMDR and with whom I have begun using EMDR soon after the beginning of treatment have been generally poorer, varying with the severity of the client's disorder, the less severe doing best. The client needs to be able to establish a meaningful trusting relationship with the therapist; the more severe the client's difficulties with attachment, the more time this process requires. Narcissistic clients do not tend to see their difficulty with vulnerability, trust and intimacy as a problem within themselves. If they are able to recognize personal problems, they are usually in the area of self esteem and obstacles to achievement. When they are able to resolve some of these latter problems fairly rapidly through treatment they tend to terminate, no longer seeing a sufficient purpose for treatment. In a sense, they can become better narcissists; their grandiose view of themselves is enhanced and they are reinforced in their use of self-sufficiency as a defense against interpersonal vulnerability. I view the relative efficiency of EMDR as a problem for deeper treatment of narcissistic clients because there is less time for the therapeutic relationship to develop and consequently a limited opportunity to impact the client's object splitting. I believe that this is why I have found EMDR with narcissistic clients to be most effective when it is introduced after a therapeutic relationship has had time to develop. Negative cognitions: The early maladaptive schemas of narcissistic clients are pervasive in their lives and point to a plethora of negative cognitions. Typical early schemas are: I must control myself (or my feelings, my behavior, my body) at all times; no one cares; my needs will never be met; I can't trust anyone; I am deeply flawed and unlovable; I am dikeable, unattractive to others; I will always fail; my flaws are totally unacceptable to others; I must be perfect or I am worthless; I deserve to be treated more specially than others; I must please others to avoid attack; I'm alone; nobody understands me; I am OK if I am better than others; I am OK only if others admire me. It is often helpful to narrow these cognitions down to make them manageable with EMDR Treatment: In addition to the recommended protocol of establishing a safe space to which the client can retreat if necessary, before doing an EMDR session with one of these clients, the therapist should identify as many of the client's emotional resources possible, in particular expriences if any of having felt loved and accepted ad examples of loving people or relationships the client has observed Among other things, these facilitate more effective copitive interweaves. The initial task in doing an EMDR session with this client population is to establish an appropriate and richly defined target. Since it is more difficult for these clients to access meanm&l memories in an emotionally alive way, the therapist must be more active in helping the client stimulate the associated neural netork as I l l y as possible. In addition to the client's reaction to the plight of children he may be related to or observe (Level I1 training), a rich source of emotional responsiveness and resources is the client's own response to situations he has witnessed in news media, TV, movies or theater. A major challenge in addressing a narcissistic character type using EMDR is tracking the course of the session with these clients and identifying when they drip out of the targeted neural network. This process can be subtle because it requires an ability to differentiate true avoidance hm spontaneous associations which may appear at hat to be irrelevant; it requires a familiarity with and sensitivity to the protective or defensive mechanisms they use to insulate themselves fiom painful memories and affect. As the patterns ofmovement in and out of the targeted network are identified it is important to use interventions that are experienced by the client as supportive but nevertheless make hun or her aware of having wandered. Although the narcissistic client may initiate treatment with the stated goal of improving his performance in specified areas, he will agree upon reflection that the real problem is that he feels an overriding need to perform in order to feel worthwhile. Since he has never known any other way of dealing with his self-worth, he will be skeptical about whether it is possible to feel a sense of worth that is not based upon performance, and it is easy for the therapist to lose perspective and join him in that beliet especially while doing EMDR with its potential for reprocessing with extraordinary precision specific obstacles to performance. The therapist must, however, retain her healthy perspective if the client is to learn to accept himself. For more clinical information about treating disorders of the self: 1.)Beck, Aaron T., et al, Cognitive Therapy Of Personality Disorder Guilford Press, New York, N. Y., 1990 2.)Manfield, Philip, Split Self/Split Object: Understanding And Treating Borderline, Narcissistic And Schizoid Disorders, Jason Aronson Publishers, Northvale, N.J., 1992. 3.)Young, Jeffrey, E, Cognitive Therapy For Personality Disorders: A Schema-Focused Approach, Professional Resource Exchange, Inc., Sarasota, Florida, 1990.

Keywords: Narcissistic Personality Disorder  

Accuracy Verified: Yes


41. Hofmann, A. (2009, June 15). New developments in research and application of EMDR. Presentation at the Pre Conference of the 11th European Conference on Traumatic Stress, Olso, Norway.

Language: English

Format: Conference

Abstract:
EMDR is one of the traumaspecific treatment methods that have shown to be effective in the treatment of PTSD. Even if studies and metaanalysis of EMDR have shown that EMDR is one of the most effective tools to treat traumabased disorders and it is recommended in all relevant international therapy guidelines on the subject, the mechanism of EMDR is still not fully understood. Recent studies have shown that the EMDR method is also effective in cases that go beyond the field of PTSD. Studies have shown that EMDR seems to be effective in complex PTSD, in the treatment of traumatized sex offenders, in certain pain disorders (like phantom limb pain) and may also be usefull in the treatment of alcohol abuse. These results, their possible basis as well as some useful EMDR interventions will be discussed. The presenter uses EMDR since 1991 and will report on the current research data and his experience with the method.

Keywords: Developments  

Accuracy Verified: Yes


42. Bodill, B. (2009, September). Patterns of reduction of distress in clinical conditions using eye movement desensitisation and reprocessing (EMDR). University of University of Kwa Zulu Natal.

Language: English

Format: Dissertation/Thesis

Abstract:
This study investigated the patterns of reduction of distress in clinical personality patterns, severe personality patterns, depressive constructs, other clinical syndromes, severe clinical syndromes and dissociation following EMDR treatment. Thirty-two people, ranging from 23 to 65 years old, underwent the full EMDR protocol treatment for up to three traumas. The findings regarding clinical personality patterns revealed that EMDR is most effective in reducing the symptoms of dependent personality pattern because 76% of participants with clinically significant dependent personality pattern before EMDR treatment no longer had a clinically significant score (>75) on the MCMI-III at the end of EMDR treatment; compared to 75% with masochistic personality pattern, 77% with negativistic personality pattern, 69% with avoidant personality pattern, 40% with depressive personality pattern and 29% with schizoid personality pattern. These gains were maintained on the MCMI-III at follow-up by 76% with dependent personality pattern, 64% with masochistic personality pattern, 46% with negativistic personality pattern, 38% with avoidant personality pattern, 30% with depressive personality pattern and 29% with schizoid personality pattern. The analysis of the severe personality patterns at the end of EMDR treatment revealed that the scores on the MCMI-III reduced from within one standard deviation above the mean (60-74) to below the mean (<60) for 84% of participants with borderline personality pattern, compared to 68% with paranoid personality pattern and 52% with schizotypal personality pattern. These gains were maintained on the MCMI-III at follow-up by 84% with borderline personality pattern, 68% with paranoid personality pattern and 48% with schizotypal personality pattern. The analysis of the depressive constructs revealed that EMDR is most effective in reducing symptoms of major depression as 86% of participants with clinically significant major depression before EMDR treatment no longer had a clinically significant score (>75) on the MCMI-III at the end of EMDR treatment; compared to 73% with dysthymia and 40% with depressive personality pattern. These gains were maintained on the MCMI-III at followup by 86% with major depression, 58% with dysthymia, and 33% with depressive personality pattern. The findings regarding the other clinical syndromes revealed that 91% of participants with clinically significant post traumatic stress before EMDR treatment, no longer had a clinically significant score (>75) on the MCMI-III at the end of EMDR treatment, compared to 75% of participants with anxiety. These gains were maintained on the MCMI-III at followup by 91% of participants with post traumatic stress and 69% of participants with anxiety. The analysis of the severe clinical syndromes at the end of EMDR treatment revealed that the scores on the MCMI-III reduced from within one standard deviation above the mean (60-74) to below the mean (<60) for 78% of participants with delusional disorder, compared to 67% with thought disorder, 32% with bipolar (manic), 28% with alcohol dependence and 28% with drug dependence. These gains were maintained on the MCMI-III at follow-up by 67% of participants with delusional disorder, compared to 63% with thought disorder, 53% with bipolar (manic), 48% with alcohol dependence and 57% with drug dependence. The analysis of the effects of EMDR on dissociation revealed that there was a significant decrease in symptoms of dissociation on the DES at the end of EMDR treatment and these gains were maintained at the follow-up measurement at the end of the study. Whilst the findings of the present study cannot be generalised due to the small sample size, the findings do suggest that EMDR is successful in the treatment of a number of clinical conditions in addition to post traumatic stress; with further research being strongly indicated in order to further explicate the efficacy of EMDR across different psychiatric conditions.

Keywords: Reduction of Distress  

Accuracy Verified: Yes


43. St-André, E. (2007, June). PTSD secondary to Fournier's grangrene: 1-Comparison of two eye modalities, 2-Legal and ethical issues. Presentation at the annual meeting of the EMDR Europe Association, Paris, France.

Language: English

Format: Conference

Abstract:
G. G., a man in his mid 30s was brought to medico-legal service to assess fitness to stand trial, and criminal responsibility, after a brief appearance in court: He was charged with death threats.
G. G. was quite angry about his situation, and argumentative against health and justice systems. Physically, he was short stature, extremely lean, his body was leaning forward.
He was living alone, has a girl of thirteen, which he saw once in a while.
He was not working for few years, after two major events; he lost his garage after a huge fire (from which he escaped alive and safe), and was few months earlier, found almost dead by a neighbor. Brought to the hospital, he had more than ten surgeries in a few days, to lance many wound, as he as suffering of Fournier’s disease. He was left with his body leaning forward about 45 degrees, 4 cm thick scar around his abdomen, a severely deformed genitalia, and chronic pain. Another surgery was performed later which permitted the man to be less leaned forward.
Before those events, he wasn’t known from psychiatry. He had a life that he considered, “okay,” even though he was separated. He has his own garage, a social life. He admitted some alcohol and drugs use in the past. After the illness and the fire, he was seen more often in psychiatry. Specialists concluded from time to time to chronic adjustment disorder, and drug addiction, and oriented him to resources for his problem. No follow-up in psychiatry.
G. G. was so much in pain that he took cocaine repeatedly for few minutes’ relief.
With this story and symptoms description, severe PTSD diagnosis was made and treatment initiated accordingly, with introduction of ISRS, and later, seroquel, to decrease dissociative episode he was still experimenting. With informed consent, we had three sessions of EMI, which helped him in various ways; The nightmares decreased of 50%, after the first treatment, he was less angry and afraid of hospital and care, and was more in control of dissociative episodes. Sleep improved, so did his mood. He was eve able to go for correction of his deformed genitalia. Even though still on medication, he felt that the therapy helped him much to recover. After his discharge and end of court process, he was able to go back home. We were at the time unable to do more treatments, as he was involved in his physical rehabilitation. He had at least 2 other reconstructive surgeries.
This case allows discussion about similarities, pros and cons of EMI and EMDR, in their theories and practice. More importantly, this case raises important ethical and legal questions about adequate diagnosis and treatment of PTSF which include powerful tools as EMDR. This tool is yet relatively unknown from general population, and available mainly (in Quebec, Canada) through private facilities. From ethical standpoint, it should be more readily available – without fees – in public services.

Keywords: Case Report  Ethical Issues  Fournier's Gangrene  Legal Issues  

Accuracy Verified: Yes


44. Kitchen, R. H. (1991, December). Relapse therapy. EMDR Network Newsletter, 1(2), 4-6.

Language: English

Format: Newsletter

Abstract:
Most therapists who treat Drug/Alcohol addicted clients have experienced the frustration of client relapse when therapy appeared to be working. Chronic relapse can occur even when the client is fully committed to an abstinent life. Chronic relapsers, and many recovering addicts to some extent, suffer from what Terry Gorski, MA, describes as Post Acute Withdrawal or "PAW." His premise, supported by an analytical study of a group of chronic relapse clients in 1974, identified the thirty-seven warning signs that were predictive of possible relapse. (For those who wish further information, these warning signs were first outlined in his book, Counseling For Relapse Prevention (T. Gorski, 1982).

Keywords: PAW  Post Acute Withdrawal  Relapse Therapy  Terry Gorski  

Accuracy Verified: Yes


45. Hase, M. H., Popky, A. J., & Woffgramm, J. (2007, June). Reprocessing of the addiction memory. Presentation at the annual meeting of the EMDR Europe Association, Paris, France.

Language: English

Format: Conference

Abstract:
A randomized pilot study demonstrated the efficacy of EMDR to reduce the craving in alcohol addicted in-patients (Hase, 2006). The rationale of this EMDR approach is based on the concept of the addiction memory (Woffgramm and Heyne, 1995; Heyne, May et al, 2000; Wolffgramm, Galli et al, 2000). The addiction memory qualifies as a maladaptive memory regarding to the Adaptive Information Processing Model. The DeTUR approach was introduced to reprocess triggers for abuse and to reduce the user to use a drug in 1998 (Popky, 1998; Popky, 2005). If differs slightly in it rationale. J. Wolffgramm established an animal model of addiction providing data to move towards the concept of memory of addiction (Wolffgramm, Galli et al, 200). A. J. Popky established the DeTUR approach. M. Hase conducted the randomized pilot study demonstrating the efficacy of EMDR in the treatment of alcohol addicts. Wolffgramm, Popky, and Hase will discuss research, theory, and practice of EMDR in the treatment of addictions representing the state of the art of EMDR addiction treatment.
Hase, M. (2006, September) EMDR applied to reprocess the addiction memory in alcohol addicted in-patients. Outcome and follow-up data of a clinical study, 2006 EMDRIA Conference, Philadelphia, PA.
Heyne, A., May, T. et al. (2000). "Persisting consequences of drug intake toward a memory of addiction," J. Neural Transm, 107(6), 613-638.
Popky, A. J. (1998). DeTUR, (Desensitization triggers and urge reprocessing). Monte Sereno, CA.
Popky, A. J. (2005). "DeTUR, an urge reduction. protocol for addictions and dysfunctional behaviors," in EMDR Solutions. R. Shapiro. New York: W. W. Norton, pp. 167-188.
Wolffgramm, J. G., Galli, G. et al. (2000). "Animal models of addiction: Models for therapeutic strategies." J. Neural Transm, 107(6), 649-668. Wolffgramm, J., & Heyne, A. (1995). "From controlled drug intake to loss of control: The irreversible development of drug addiction in the rat." Behav Brain Res, 70(1), 77-94.

Keywords: Addiction  

Accuracy Verified: Yes


46. Mosquera, D., González, A., & Vazquez, I. (2012, Enero ). Terapia EMDR (eye movement desensitization reprocessing) en el trastorno límite de personalidad: Reflexiones en torno a un caso de patología dual [EMDR (Eye Movement Desensitization Reprocessing) in BPD personality: Reflections on a case of dual diagnosis]. Revista Espanola de Drogodependencias, 37(1), 82-95.

Language: Spanish

Format: Magazine

Abstract:
Los pacientes con trastorno límite de la personalidad y adicciones suponen un desafío para los centros de atención específicos. Los pacientes con patología dual suelen presentar dificultades en los programas orientados a la evitación del consumo. No solo por sus frecuentes problemas interpersonales sino debido a que su problemática de adicción no se ajusta al patrón prototípico de abuso o dependencia de sustancias. La terapia Eye Movement Desensitization Reprocessing (EMDR), orientada al tratamiento de las experiencias desde las cuales se han desarrollado ambos trastornos, permite un abordaje integral de ambos problemas. EMDR es una terapia que aborda las situaciones relacionadas con trauma temprano y apego disfuncional, altamente prevalentes tanto en el trastorno límite de personalidad como en las conductas adictivas.A través de un caso clínico se ilustra un posible plan de tratamiento para trabajar la patología dual desde EMDR.

Patients diagnosed with borderline personality and substance abuse disorders represent a challenge for specific treatment centers.These patients tend to experience difficulties in substance or alcohol abuse programs due to their frequent interpersonal problems and their addiction patterns, which do not fit into a standard pattern of substance abuse or dependence. Eye Movement Desensitization Reprocessing (EMDR) therapy, oriented toward the treatment of the experiences that originate both disorders, allows an integrated approach of both problems. EMDR is a psychotherapy that addresses early trauma and dysfunctional attachment experiences, which are highly prevalent both in BPD and substance abuse disorders.We will illustrate a possible treatment plan from the EMDR perspective through a case example.

Keywords: Alcohol Abuse  Borderline Personaity Disorder  BPD  Dual Diagnosis  

Accuracy Verified: Yes


47. Abel, N. J., & O'Brien, J. M. (2012). Traitement par l’EMDR d’états comorbides d’ESPT et de dépendance à l’alcool: Un exemple de cas [EMDR treatment of comorbid PTSD and alcohol dependence: A case example]. Journal of EMDR Practice and Research, 6(2), E1-E11. doi:10.1891/1933-3196.6.2.E1.

Language: French

Format: Journal

Abstract:
L’EMDR (désensibilisation et retraitement par les mouvements oculaires) est une thérapie qui a démontré son efficacité dans le traitement de l’état de stress post-traumatique (ESPT). Une littérature clinique encore relativement réduite, mais croissante, montre que l’EMDR peut aussi être un traitement complémentaire efficace de la toxicomanie. Le présent article passe en revue les divers protocoles qui ont été développés dans ce but, avec les protocoles de Vogelmann-Sine et al., Omaha, Popky et Hase. Une étude de cas intégrant certaines de ces interventions est présentée afin d’illustrer la réussite du traitement par l’EMDR d’une femme souffrant de longue date d’une dépendance à l’alcool et d’un ESPT comorbides. Le suivi, deux ans plus tard, a montré que cette femme restait sobre et que l’ESPT était en rémission complète. Après une discussion des aspects importants de ce cas, les auteurs explorent de futures directions de recherche.

Eye movement desensitization and reprocessing (EMDR) is a therapy that has been demonstrated to be effective in the treatment of posttraumatic stress disorder (PTSD). A relatively small but growing body of literature indicates that EMDR may be an effective adjunctive treatment for substance abuse. This article reviews the various protocols that have been developed for that purpose, including protocols by Vogelmann-Sine et al., Omaha, Popky, and Hase. A case study that incorporates the use of some of these interventions is presented to illustrate successful EMDR treatment of a woman who had long-standing comorbid alcohol abuse and PTSD. Two-year follow-up after EMDR showed that the woman was successfully maintaining sobriety and that the PTSD continued in full remission. After a discussion of the important aspects of this case, the authors explore future directions for research.

Keywords: Alcohol Dependence  Comorbid PTSD  

Accuracy Verified: Yes


48. Albers, J. (2009, June). Treatment of alcohol addiction. Presentation at the annual meeting of the EMDR Europe Association, Amsterdam, the Netherlands.

Language: English

Format: Conference

Keywords: Alcohol Addiction  

Accuracy Verified: Yes


49. Klaff, F. R. (1995, June). Treatment of children's fears with EMDR. Presentation at the EMDR Network Conference, Santa Monica, CA.

Language: English

Format: Conference

Abstract:
Through case material, the usefullness of EMDR is illustrated for the treatment of children's fears and phobias. The issue of integrating EMDR treatment with more traditional treatment is also addressed, especially with more complex contextual problems. Three case histories are presented with emphasis on the most complicated case. Family therapy treatment espouses the notion that psychopathology in the child results from dysfunctional family functioning, and as such the entire family system has to be treated. This concept is broadened with the use of EMDR. The first case illustrates a single trauma event in which a 6 year old boy was bitten by a rottweiler. Presenting symptoms were nightmares, fear of sleeping alone, poor school performance, persistent thoughts and fear of dogs. The first session of EMDR was successful in eliminating most of these fears. A second EMDR session focusing on a nightmare was also successful. Two follow up sessions with the family dealt with other parenting issues and the possibility of attention deficit disorder. The targeted problem was eliminated via EMDR. The second case demonstrates a successful one session treatment of an otherwise healthy 6 year old girl who had fears of the dark and had slept in her parent's bed for years. In the third case, a complex symptomatology is presented of a nine year old girl (Lily) with a severe, life threatening heart condition for which she has undergone 4 delicate aortal surgeries since age 2 and is on a medication maintenance regimen. Future surgery is anticipated during adolescence. Family history is significant for mother's struggle to overcome alcohol addiction, depression and past abuse. The family has financial pressures. Family system analysis reveals over involvement between mother and daughter, peripheral father and sibling rivalry (daughter 11). Family treatment involved boundary and limit setting, hierarchical restructuring and family communication skills. The illness as an organizing factor in the family system was repeatedly addressed. Interspersed with this treatment approach were EMDR sessions for daughters and mother. Lily had fears of separation fiom mother, fears of dying, choking, becoming ill, swimming, going to bed, and fears of the devil (as learned in their fundamentalist religion) as well as several other fears. EMDR sessions targeted these fears, and sometimes several fears were intertwined, such as fear of sleeping, the devil coming into her room and taking her away to die. Cognitive interweave was used when she appeared stuck. Through the EMDR treatments, Lily was able to deeply examine her fears, based on the real life uncertainties she faced. Her progress demonstrated a particularly poignant attempt to make sense of the meaning of life and cope with the threat of death.

Keywords: Children  Fears  

Accuracy Verified: Yes


50. Popky, A. J. (2011, October). An urge reduction protocol as a new way to address addictions and dysfunctional behaviors based on the AIP model of EMDR. Presentation for Care For the Troops, Marietta, Ohio.

Language: English

Format: Other

Abstract:
The purpose of this document is to act as a training manual for those clinicians that work with addictive populations and that have completed already completed EMDR level 1 and 2 trainings. Previous research on EMDR has focused on its usefulness for treating trauma-related symptoms in a diverse sample of subjects. This protocol deals with targeting triggers that bring up urges rather than traumas. It is the authors beliefs that the targeting of triggers is a gentler way of dealing with this addictive population and that as triggers are reprocessed ego strength grows until the thread to the trauma or core issues are ready to emerge to be reprocessed. Background This treatment model and the theories involved are based on experience from personal client observation and anecdotal reports received from other therapists using this same protocol. It is an eclectic model and combines many methodologies, including but not limited to, cognitive-behavioral, solution focused, Ericksonian, narrative, object relations, EFT, TFT, to name a few. The bi-lateral stimulation from the accelerated information processing model (EMDR) seems to form the catalyst for rapid processing and change, the turbo-charger that speeds the healing process. Successful results have been reported across the wide spectrum of addictions and dysfunctional behaviors: chemical substances (nicotine, marijuana, alcohol, methamphetamine, cocaine, crack, heroin/methadone, etc.), eating disorders such as compulsive overeating, anorexia and bulimia, along with other behaviors such as sex, gambling, shoplifting, anger outbursts, OCD and trichotillomania, etc. Since this is an urge reduction protocol the scope of applications can include a wide variety of applications.

Keywords: Adaptive Information Processing  Addictions  AIP  Desensitization of Triggers and Urge Reprocessing  DeTUR  Dysfunctional Behaviors  

Accuracy Verified: Yes


51. Parnell, L. (1995, June). The use of imaginal and cognitive interweaves with sexual abuse survivors. Presentation at the EMDR Network Conference, Santa Monica, CA.

Language: English

Format: Conference

Abstract:
This hour and a half presentation addresses the use of cognitive and imaginal interweaves in the treatment of adult survivors of sexual abuse. The overall course of treatment with EMDR is briefly outlined including a variety of interweave interventions for use in the beginning, middle and end of EMDR sessions. In working with sexual abuse survivors with EMDR it is important to understand the issues commonly encountered in their treatment. These include issues of safety, trust, responsibility, choice/control, interpersonal relationships, body awareness and image, sexuality and self esteem. A sexual abuse assessment can be taken which includes information on the perpetrator(s), severity and frequency of abuse, type of abuse, age of onset of abuse, duration of abuse, disclosure and family response. Sexual abuse survivors present themselves in treatment in different ways. Some clients come to treatment remembering abuse and want to clear it with EMDR. Other clients come to treatment with no clear memories of incidents but have a "feeling" something happened to them and have symptoms of abuse. There are clients who have no clear memories but something has triggered flashbacks and nightmares of sexual abuse. Finally, there are clients who have no memory of abuse and come to therapy for another reason but uncover what they believe to be sexual abuse memories with EMDR. There are three phases of treatment in sexual abuse cases. In the beginning phase, a history is taken and there is the establishment of a trusting relationship. The client is prepared for EMDR. In the middle phase, there is the reprocessing and working through of traumatic memories and transference work. In the end phase of treatment there is integration of the information which has been uncovered and preparation for life outside of therapy. Interweaves can be utilized in the beginning, middle and end of EMDR sessions. In the beginning of individual EMDR sessions there is a check-in with clients to see how they have been doing during the week. What has come up for them in their dreams or daily life since the last session? Next there is the selection and development of targets for EMDR (body sensation, memory, flashback, symptom, dream, feeling, vague sense, negative cognition or drawing). A safe place is then established where the client can go at the beginning, middle or end of the session as needed. Along with the safe place an inner advisor or other inner resources can be contacted and developed for use in sessions. A connection with the client's inner child is important which can be done through the use of guided imagery, photographs and/or artwork. Instructions on how EMDR will be used are given with attention paid to issues of safety and control (they are in control, they can stop at any time, they can return to the safe place, they know the signal for stop). Negative and positive cognitions are established along with the EMDR protocol. In the middle of individual EMDR sessions there are commonly problems with looping or being "stuck." This seems to occur frequently with sexual abuse survivors because of the intensity of the trauma and because the child self is often frozen in time lacking access to the adult self's information. Ways to work with this include looking for the blocking beliefs (i.e., The perpetrator can hurt me), look for blocking images, and talking to the child part (what does he/she need?). Imaginal and cognitive interweaves can be used in a variety of different ways in the middle of EMDR sessions. Some of these include: imagining the adult self helping the child self in the traumatic scene, bringing in inner and outer resources for help (i.e., a powdl imaginary being, a strong loving fiend, the therapist, etc.), and reality check interweave where is the perpetrator now?, can helshe hurt you now?) It is also important to educate the child part that his or her feelings are normal, sexual feelings are normal etc. It can be helpful to ask the adult self to talk to the child self explaining things to the child. Another useful interweave is to have the adult self hold the perpetrator and allow the child to beat him or her up or have the adult self beat up the perpetrator allowing anger to be expressed safely. Asking clients if they would like to return to the safe place for a break can also be helpful if they are feeling too overwhelmed. There are a number of ways to end or close incomplete EMDR sessions. Often it will not be possible to completely clear a traumatic memory in a session or the memory worked on is completed but connected to a whole network of other traumatic events. For these cases there are a number of interweaves that can be used. Clients can be requested to have the adult self comfort the child self in the . safe place. The client can imagine putting the scary unfinished disturbance that has been uncovered in a file folder, box, safe, leave it in the therapist's office, etc. The client can return to the safe place where the child and adult selves can play together. The adult can comfort the child or do whatever is needed to create safety and containment. Clients can imagine their child self being held by protector figures repeating cognitions related to safety, responsibility and choice. They can also be asked what they learned from the session, installing their response with eye movements. It is helpful to give homework to clients such as journaling, artwork, walks in nature, meditation, stress reduction, group work, exercise, nutritious diet, and restriction of drugs and alcohol. Loving Kindness or Metta Meditation is another very helpful tool for teaching self soothihg to adult survivors of sexual abuse.

Keywords: Cognitive Interweave  Imaginal Interweave  Sexual Abuse  Survivors  

Accuracy Verified: Yes


52. Staff. (1997, May). Using EMDR to treat psychological trauma. Clinician's Research Digest, 15(5), 3.

Language: English

Format: Newsletter

Abstract:
This article discusses outcome studies on eye movement desensitization and reprocessing (EMDR). It is noted that EMDR was originally designed for rapid treatment of traumatic memories, but practitioners have also applied it to such other problems as phobias, panic disorder, grief, chemical dependence, and dissociative disorders. Since the development of EMDR, numerous outcome reports in the form of case studies, single-subject experiments, and group design experiments have appeared in the literature. Several studies and meta-analyses of EMDR are described. While one meta-analysis concluded that the effects of EMDR are (a) not strong, (b) most apparent with self-report measures but absent with physiological indices of the disorder, and (c) absent altogether in some studies, other authors believe this is an overstatement. Two other meta-analyses note that there have been more controlled studies of EMDR than all other treatments for post-traumatic stress disorder (PTSD), and both acknowledge a range in findings. It has been suggested that there are numerous explanations for negative or limited findings for EMDR, most notably the use of chronic, multiply traumatized veterans (where secondary gain may be a concern), lack of treatment fidelity, and insufficient length of treatment.

Keywords: Emotional Trauma  Posttraumatic Stress Disorder  PTSD  

Accuracy Verified: Yes