Francine Shapiro Library - EMDR Bibliography Links

 

 

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1. De Divitiis, A. M. (2008, Novembre). Applicazione dello sviluppo e installazione delle risorse (RDI) nella psicoprofilassi al parto finalizzata alla prevenzione delle depressione post partum (DPP) [Application of resource development and installation (RDI) in psychoprophylaxis geared to the prevention of postpartum depression(DPP)]. Presentazione le Applicazioni Cliniche del EMDR Congresso Nazionale, Milano, Italia.

Language: Italian

Format: Conference

Abstract:
Dagli ultimi dati statistici risulta che la Depressione Post Partum viene sviluppata da circa il 13% delle puerpere nel corso del secondo – terzo mese successivi al parto e la durata dei sintomi varia da qualche settimana ad un anno, con rischi di recidiva. A differenza del Baby Blues (colpisce il 70% delle puerpere, insorge in III – VI giornata e si risolve spontaneamente nell’arco di un paio di settimane), imputabile essenzialmente alle fisiologiche modificazioni ormonali (calo degli estrogeni e progesterone) dell’im-mediato post partum, lo sviluppo della DPP sembrerebbe invece essere determinata da fattori di natura strettamente psicologica: l’esperienza del parto, il riemergere di problematiche irrisolte nelle relazioni con le figure di attaccamento, il cambiamento di ruolo della donna sia nell’ambito sociale che all’interno della coppia, il timore di non essere in grado di attendere adeguatamente alle nuove responsabilità (sia sul piano delle proprie capacità, che del nuovo carico di fatica fisica), ecc. Le donne che hanno vissuto il parto come esperienza traumatica risultano essere maggiormente destabilizzate da tale evento e quindi maggiormente esposte allo sviluppo della DPP. Il parto richiede alla donna il reclutamento di molteplici risorse personali. Nel corso del “travaglio” la donna deve riuscire a contenere il dolore, mentre nella fase dell’“espulsione” le viene richiesto inoltre di “spingere”, ossia di contrastare una reazione antalgica automatica (che chiuderebbe il canale da parto) per andare invece “incontro al dolore”. Se consideriamo che le “Prestazioni di Picco” si caratterizzano per essere “al di fuori” del proprio ambito di sicurezza, di agio e di conforto, nel tentativo di oltrepassare il limite estremo delle proprie capacità, l’esperienza del parto può essere inscritta a pieno titolo nelle “Prestazioni di Picco”. Nel presente lavoro vengono descritte le modalità e i tempi di applicazione del RDI nel corso della Preparazione al Parto, finalizzata al rafforzamento delle diverse risorse personali di cui ogni gestante ha bisogno per poter vivere il parto come esperienza egosintonica. In tal senso l’RDI, tramite EMDR, è da considerarsi un vero e proprio Intervento di Prevenzione Primaria, in grado di insegnare alle donne qualcosa di positivo riguardo sé stesse, contrastando efficacemente l’insorgere della DPP. Verranno esposti, inoltre, i risultati dell’applicazione di tale tecnica su 48 gestanti, raccolti nella fase del Post Partum.

The latest statistics show that postpartum depression is developed by about 13% of mothers during the second to third months after delivery and the duration of symptoms varies from few weeks to a year, with risks of recurrence. Unlike the Baby Blues (affects 70% of mothers, occurs in III - VI day and resolves spontaneously within a couple of weeks), largely because of the physiological hormonal changes (decline in estrogen and progesterone) of IM-mediated post-partum, the development of the DPP seems to be determined by factors strictly psychological: the experience of childbirth, the resurgence of unresolved issues in relations with attachment figures, the changing role of women both in social the couple, the fear of not being able to wait adequately to new responsibility (both in terms of its ability, that the new burden of physical labor, etc.). Women who have experienced childbirth as a traumatic experience become more undermined by this event and, therefore, at greater risk of developing the DPP. The birth of the woman requires the recruitment of many personal resources. During the "Labor" the woman must be able to contain the pain, while in phase the 'expulsion' is the also required to "push", i.e. a reaction to counter analgesic automatic (which close the channel by birth) to go instead "to meet the pain." If we consider that "Peak Performance" are characterized by being "outside" the extent of its security, ease and comfort, in an attempt to go beyond the bounds of their abilities, experience delivery can be fully inscribed in the "peak performance". The present paper describes the methods and timing of application of RDI during the preparation for childbirth, which aims to reinforce the various personal resources which each pregnant woman needs to live the experience of childbirth as ego syntonic. In this sense, the RDI, through EMDR is considered true primary prevention interventions that can teach women something positive about themselves to effectively counter the rise DPP. Will be exposed, in addition, the results of applying this technique on 48 pregnant women, collected at the stage of post-partum.

Keywords: Postpartum Depression  RDI  Resource Development and Installation  

Accuracy Verified: Yes

2. Solomon, R. M. (2007, June). The art of EMDR: Dealing with abreactions. Presentation at the annual meeting of the EMDR Europe Association, Paris, France.

Language: English

Format: Conference

Abstract:
The overall objective of this workshop is to enable the EMDR therapist to deal more effectively, and comfortably, with intense client affect. Treatment of complex trauma, where dissociation prevents the integration of traumatic emotions, often involved the processing of intense emotions. The abreaction can be quite shocking to the therapist who may then engage the client in talking therapy, utilize resource installation, or provide an interweave to lower the level of intensity. While this can, at times, be appropriate and helpful, often it is counter indicated and a perceived resolution may be short lived and/or needlessly circumscribed. It is important to recognize the markers of treatment, and what choices are appropriate. Ironically, it is often the therapist who is uncomfortable with the level of client affect, rather than the client being unable to deal with the intense emotion.
The hallmark of EMDR is “staying out of the way” if the dysfunctionally stored information is moving. An inherent value of EMDR is to facilitate natural processing and the client’s natural healing patterns. Assuming client readiness and preparation to deal with emotional material, an interweave (which elicits other neural networks), or resource installation (which initiates a state change) or prolonged talking (which initiates an interpersonal process) – though often useful – can interfere with the client’s own internal processing and take the client away form their natural and unique resolution and integration. The therapist can enable the client to process intense material utilizing a) strong attunement skills to hold the client one’s therapeutic presence, b) recognition of behavioral manifestations of processing to guide speed, rate and tempo of bilateral stimulation to maximize processing, c) using different rate, speed and tempo to control emotional intensity of the processing, d) and knowing when to verbally intervene and when to “stay out of the way.”
This workshop will focus on:
a) Assessment of client readiness
b) Therapeutic clinical presence and attunement skills
c) Detecting behavioral manifestations of processing and calibrating bilateral stimulation to the client in order to maximize processing and control intensity
d) Therapeutic choice points concerning verbal interventions and “staying out of the way."
Demonstration and video tapes will be used to illustrate teaching points. (Participants should be aware that the videos have intense emotional content).

Keywords: Abreactions  Intense Affect  

Accuracy Verified: Yes

3. Stofsel, M., & Mooren, T. (2012, March). Behandeling van complex trauma: EMDR en meer hoe geef je zo’n behandeling vorm, welke valkuilen kunnen er zijn, welke plek heeft EMDR en hoe bewaak je de rode lijn bij deze vaak langdurige behandelingen? [Treatment of complex trauma: EMDR and more how do you form such a treatment, what pitfalls may exist, which place has EMDR and how do you monitor the red line in these often long-term treatments?]. Presentatie op de 6e congres van de Vereniging EMDR Nederland, Arnhem, Nederland.

Language: Dutch

Format: Conference

Abstract:
Behandeling van ‘Complex trauma’ is lastig, omdat er vaak op veel verschillende levensgebieden problemen zijn. Daarbij is er sprake van een opeenstapeling van traumatische ervaringen. Dit kan leiden tot een soort schrik of terughoudendheid bij behandelaren, om complex trauma adequaat aan te pakken. In deze workshop willen wij duidelijk maken dat complex trauma goed te behandelen is, mits men de ruimte heeft om een langere behandeling aan te gaan, een therapeutische relatie (met tegenoverdrachtelijke valkuilen) aan kan gaan met cliënten met een geschokt wantrouwen in hun medemens en men niet te snel terugschrikt en mits men goed overzicht houdt over het verloop van de behandeling. Wij presenteren een model dat richting geeft aan de behandeling van complex trauma. We gaan uit van het drie-fasen model (Herman, 1992) met stabilisatie, verwerking en integratie en vullen dit aan met handvatten voor praktisch gebruik. Dit model gebruiken we om op systematische wijze de verandermogelijkheden te kunnen bepalen bij complexe traumaproblematiek. We zullen uit elke fase een of meerdere technieken demonstreren en op een rijtje zetten hoe EMDR toegepast wordt bij de behandeling van j complexe traumaproblematiek.

Treatment of 'Complex trauma is difficult, because there are often many different areas of life problems. In addition, there is an accumulation of traumatic experiences. This can lead to a kind of fear or reluctance of clinicians to adequately handle complex trauma. In this workshop we want to make clear that complex trauma can be treated well, provided they have the space for a longer treatment to enter a therapeutic relationship (with counter-transference traps) to can deal with clients with a shaken confidence in their fellow man and one not afraid to quickly and if one does good overview over the course of treatment. We present a model that gives direction to the treatment of complex trauma. We assume the three-phase model (Herman, 1992) with stabilization, processing and integration and supplement this with handles for practical use. The model we use to systematically change the options to determine in complex trauma problems. We will phase out any one or more techniques and demonstrate how this straight EMDR is used in the treatment of complex trauma problems j.

Keywords: Complex Trauma  

Accuracy Verified: Yes

4. Knipe, J. (2008, June). The CIPOS method -- procedures to therapeutically reduce dissociative processes while preserving emotional safety. Presentation at the annual meeting of the EMDR Europe Association, London, England.

Language: English

Format: Conference

Abstract:
It is well documented (Maxfield and Hyer, 2002) that the 8-phase EMDR model is highly effective for clients who are troubled by disturbing memories. However, clients who are dissociative often have great difficulty in maintaining present orientation and the "dual attention" that is a necessary condition for processing. Dissociative clients are highly vulnerable, during the EMDR Preparation, Assessment and Dissociation Phases, to becoming disoriented and overwhelmed by the surprising intrusion of dissociated parts that bring intensely disturbing images and other information. Since, with these clients, there is a greater risk of non-therapeutic dissociative abreaction, it is very important to counter this risk with an increased emphasis on safety and containment of affect. In this presentation, I will describe two procedures that can be helpful in making the healing power of EMDR available to clients who have this kind of vulnerability. One is the BHS (Back of the Head Scale), a procedure that can be useful in assessing a client’s moment-to-moment level of dissociation during a traumafocused EMDR session. The other is the CIPOS (Constant Installation of Positive Orientation and Safety) procedure, which is a method of slowing down processing, and carefully containing and controlling the emergence of potentially overwhelming post-traumatic material. These methods will be illustrated with video segments of a therapy session.

Keywords: Back-of-the-Head Scale  BHS  CIPOS Method  Contant Installation of Present Orientation and Safety  Emotional Safety  Psycholgical Defenses  Targeting  

Accuracy Verified: Yes

5. Brewin, C. R. (2001, April). A cognitive neuroscience account of posttraumatic stress disorder and its treatment. Behaviour Research and Therapy, 39(4), 373-393. doi:10.1016/S0005-7967(00)00087-5.

Language: English

Format: Journal

Abstract:
Recent research in the areas of animal conditioning, the neural systems underlying emotion and memory, and the effect of fear on these systems is reviewed. This evidence points to an important distinction between hippocampally-dependent and non-hippocampally-dependent forms of memory that are differentially affected by extreme stress. The cognitive science perspective is related to a recent model of posttraumatic stress disorder, dual representation theory, that also posits separate memory systems underlying vivid reexperiencing versus ordinary autobiographical memories of trauma. This view is compared with other accounts in the literature of traumatic memory processes in PTSD, and the contrasting implications for therapy are discussed. 2001 Elsevier Science Ltd. All rights reserved.

Keywords: Review  Posttraumatic Stress Disorder  PTSD  

Accuracy Verified: Yes

6. Seyhan, M. M. (2012). Conditionering en de rol van oogbewegingen bij US devaluatie [Conditioning and the role of eye movements in U.S. devaluation]. Utrecht, Nederlands: Universiteit Utrecht.

Language: Dutch

Format: Dissertation/Thesis

Abstract:

Keywords: Anxiety  Conditioning  Eye Movements  Fear Renewal  Intrusive Memories  Posttraumatic Stress Disorder  PTSD  U.S. Devaluation, U.S. Deflation  

Accuracy Verified: Yes

7. Bosma, F. (2011). De invloed van oogbewegingen op fear renewal en US devaluatie [The influence of eye movements in fear renewal and U.S. devaluation]. Utrecht, Nederlands: Universiteit Utrecht.

Language: Dutch

Format: Dissertation/Thesis

Abstract:

Keywords: Anxiety  Conditioning  Eye Movements  Fear Renewal  Intrusive Memories  U.S. Deflation  U.S. Devaluation  

Accuracy Verified: Yes

8. Berendsen, S. & de Jongh, A. (2006, November). Debriefing of EMDR: Praten en afwachten, of verwerking versnellen? [Debriefing and EMDR: Talking and wait, or processing speed?]. Presentatie aan de tweede congres van de Vereniging EMDR Nederland, Arnhem, Netherland.

Language: Dutch

Format: Conference

Abstract:
In de afgelopen 20 jaar is het aanvankelijke enthousiasme over debriefing en andere vormen van opvang na schokkende gebeurtenissen onder invloed van wisselende onderzoeksresultaten behoorlijk getemperd doordat de effectiviteit steeds meer ter discussie kwam te staan. De inleiders zullen een overzicht geven van de verschillende vormen van vroege hulp na schokkende gebeurtenissen en uiteenzetten hoe men hierbij geconfronteerd werd met het volgende dilemma: • Aan de ene kant mogen interventies het natuurlijke verwerkingsproces niet belemmeren. Zo kan het stimuleren van slachtoffers om direct over hun gedachten en gevoelens te praten conform het CISD (Critical Incident Stress Debriefing) model van Mitchell (1983) het risico vergroten dat zij overweldigd worden door de ervaring, hetgeen contraproductief kan werken. Omdat de meeste mensen (70 à 80 %) op eigen kracht herstellen raden de invloedrijke NICE richtlijnen uit 2005 ‘watchfull waiting’ aan: het monitoren van het beloop van de posttraumatische stressreacties bij slachtoffers en het therapeutisch interveniëren wanneer een diagnosticeerbare stoornis tot ontwikkeling komt. • Aan de andere kant zal zo vroeg mogelijk hulp geboden moeten worden aan zogenaamde ‘hoog-risico’ slachtoffers: dit zijn mensen waarvan direct duidelijk is dat ze niet zo maar op eigen kracht zullen herstellen. Vroege hulp is erop gericht om het lijden te bekorten en de ontwikkeling van secundaire problemen te voorkomen (zoals werkverzuim c.q.-verlies, relatieproblemen en middelenmisbruik). De inleiders stellen dat niet afgewacht moet worden totdat na 4 weken een PTSS gediagnosticeerd kan worden en dan pas therapeutisch te interveniëren. Bediscussieerd zal worden hoe vroeg na een schokkende gebeurtenis (enkele dagen tot weken) bij indringende herbelevingen (nare beelden met hoge SUD nivo’s) EMDR effectief ingezet kan worden (dit zal geïllustreerd worden met casuïstiek en videobeelden). Het doel is om bij de ‘laag risico’ mensen het natuurlijke verwerkingsproces te versnellen en bij de ‘hoog risico’ mensen een verwerkingstoornis te voorkomen.

Over the past 20 years, the initial enthusiasm for debriefing and other forms of relief after shocking events under the influence of changing research properly tempered by the effectiveness is increasingly being called on them. The speakers will give an overview of the various forms of early support after traumatic events and explain how this was confronted with the following dilemma: • On the one hand, the interventions do not impede natural process. Thus, encouraging victims to direct their thoughts and feelings to talk according to the CISD (Critical Incident Stress Debriefing) model of Mitchell (1983) increase the risk that they are overwhelmed by the experience, which is counter-productive work. Because most people (70 to 80%) on its own restore suggest the influential NICE guidelines 2005 'watchful waiting' to: monitoring the course of posttraumatic stress reactions in victims and therapeutic intervention when a diagnosable disorder develops. • On the other hand, as early as possible should be offered help in so-called high-risk victims, these are people whose right it is clear that not just on their own recovery. Early help is designed to minimize suffering and to the development of secondary problems occur (such as absenteeism or loss, relationship problems and substance abuse). The speakers that should not wait until 4 weeks after a diagnosis of PTSD can be and then therapeutic intervention. Discussed will be how soon after a shocking event (several days to weeks) in penetrating reliving (unpleasant images with high levels SUD's) EMDR can be used effectively (this will be illustrated with case studies and video). The goal is to "low risk" people's natural process to speed up and at 'high risk' people to avoid a processing disorder.

Keywords: Debriefing  

Accuracy Verified: Yes

9. 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

10. Khalfa, S. (2012, June). Effects of EMDR on cognition, psychophysiology and cerebral mechanisms in PTSD [Efectos del EMDR en cognición, psicofisiología y mecanismos cerebrales en TEPT]. Presentation at the annual meeting of the EMDR Europe Association, Madrid, Spain.

Language: English

Format: Conference

Abstract:
Despite the emergence of many theories on biological EMDR mechanisms, research is still needed to understand the healing processes of EMDR. We conducted four experiments to explore the effects of EMDR on PTSD with 17 to 22 patients suffering from one unique trauma. The first experiment evidenced attentional bias in PTSD towards negative words that disappeared after successful EMDR Therapy. The second experiment has shown a less efficient control of emotion in PTSD as compared to healthy controls. This altered emotional suppressing measured through psychophysiological responses was restored after symptoms disappearance following EMDR. The third experiment also using psychophysiological measures confirmed the increased fear sensitization and delayed fear extinction in PTSD and again the restoration of a normal fear conditioning and extinction processes after EMDR. The last experiment explored the negative emotional cerebral mechanisms using functional magnetic resonance imagery in PTSD. Activities in prefrontal structures were modified in PTSD as compared to healthy controls. After the EMDR treatment accompanied by symptoms removal, the prefrontal responses were not different between PTSD patients and their controls. Theoretical issues of these results will be discussed in order to integrate cognitive, psychophysiological and cerebral mechanisms observations.

A pesar del emerger de muchas teorías sobre los mecanismos biológicos del EMDR, la investigación aún necesita entender el proceso de curación que se produce en EMDR. Hemos realizado 4 experimentos para explorar los efectos del EMDR en TEPT de 17 a 22 pacientes que sufrieron un único trauma. El primer experimento evidencia un sesgo atencional del TEPT ante las palabras negativas que desaparecen después de una terapia exitosa de EMDR. El Segundo experimento mostró una baja eficiencia del control de las emociones en los TEPT comparados con el control de individuos sanos. Esta alterada supresión emocional medida a través de respuestas psicofisiológicas fue restaurada después de una desaparición de los síntomas realizando EMDR. El tercer experimento también confirma mediante medidas psicofisiológicas el aumento de la sensación de miedo y un retraso en la extinción del mismo en el TEPT. De nuevo tras administrar una terapia EMDR se produjo una restauración a una condición normal de miedo y un proceso de extinción. El último experimento explica los mecanismos negativos emocionales cerebrales usando resonancia funcional magnética en TEPT. La actividad en las estructuras prefrontales fue modificada en el TEPT comparado con el control. Después del tratamiento de EMDR acompañado de una remisión de los síntomas, las respuestas prefrontales no fueron diferentes entre los pacientes con TEPT y los controles. Cuestiones teoréticas sobre estos resultados serán discutidas con el fin de integrar cognitivamente, psicofisiológicamente y observar los mecanismos cerebrales del EMDR.

Keywords: Cognition, Psychophysiology and Cerebral Mechanisms  Posttraumatic Stress Disorder  PTSD  

Accuracy Verified: Yes

11. Becker, L., Black-Tanski, D., Nugent, N., & Thede, L. (1999, November). The effects of eye movement on the stream of consciousness. Poster presented at the annual meeting of the International Society for Traumatic Stress Studies, Miami, FL.

Language: English

Format: Conference

Abstract:
A recent meta-analysis of PTSD treatments (van Etten & Taylor, 1998) found EMDR to be as efficacious as behavioral and drug treatments. There is considerable controversy, but little research, on the underlying mechanisms of EMDR. A conditioning model by Dyck (1993) suggests that eye movements (EM) effect a distraction from trauma related thoughts, causing an extinction trial. According to this model, the distraction of EM should cause thoughts to be directed outward. A psychodynamic model by Allen and Lewis (1996) suggests that EM facilitate the formation of new associations to traumatic memories and allow the client to “remain in the present while thinking of the past.” This model postulates that EM cause thoughts to be directed inward. We report two experiments in which thought processes were studied using a stream of consciousness (SOC) technique (Singer, 1993). In both studies, undergraduate participants wrote down a sad (or happy) target event from their life. They then thought about the target event and let their thoughts go where they may for 10 minutes. At approximately 1-minute intervals they were asked to report their thoughts. The baseline study (n = 42) looked at SOC with eyes closed; the second study (n = 27) compared SOC with eyes open, eyes closed, and with EM. Relative the to the eyes-open condition, EM tended to keep the SOC internally focused. During the last 4 minutes of the SOC, eyes open participants were externally focused (thoughts about the surroundings) about 50% of time; EM participants were externally focused 25% of the time; and eyes closed participants were externally focused 3% of the time, F(1, 11) = 6.08, p = .017. Eye movements produced a blend of external (eyes open) and internal (eyes closed) thoughts, offering support to the psychodynamic model.

Keywords: Eye Movement  Poster  Stream of Consciousness  

Accuracy Verified: Yes

12. Lee, C. (2006, May). Efficacy and mechanisms of action of EMDR as a treatment for PTSD. Murdoch University, Perth, Australia.

Language: English

Format: Dissertation/Thesis

Abstract:
The first aim of this thesis was to describe the characteristics of Posttraumatic Stress Disorder (PTSD) and to elucidate its place as a symptom disorder that sometimes develops when people are exposed to a traumatic event. The current major theoretical approaches to account for why some people who are exposed to trauma develop PTSD and the mechanisms by which this occurs were described. Three classes of theories were reviewed: conditioning/learning approach; information processing theories with a particular focus on the meaning of the trauma event; and biological models with an emphasis on recent neurocircuitry and neurochemistry models. Successful treatment approaches were then reviewed which indicated two major contenders for the most efficacious treatment for PTSD: traditional cognitive behaviour therapies (CBT) using either stress inoculation or prolonged exposure; and eye movement desensitisation and processing (EMDR). Prior to the first study (Lee, Gavriel, Drummond, Richards, and Greenwald, 2002), a review of the literature indicated equivalent effects for EMDR and CBT. There had been very few direct comparison studies and each had serious methodological flaws, particularly with respect to random assignment and treatment fidelity. Therefore, the first study ensured adequate attention to these areas and involved a direct comparison between the two procedures using a sample of 24 participants diagnosed with PTSD. EMDR and stress inoculation training with prolonged exposure were found to lead to similar symptom improvement at the end of treatment, apart from a slight advantage for EMDR on intrusion symptoms. Both treatments led to significantly greater symptom reduction than a wait list control condition. At follow-up, EMDR led to greater gains on both self-report and observer rated measures of PTSD and self-report measures of depression. Overall, the findings were similar to those described in previously published studies, with a suggestion that EMDR was slightly more efficient than the standard CBT approach. Given that the evidence suggested that EMDR was a more efficient treatment, it became critical to understand the underlying processes. A process study was undertaken that examined the responses of people with PTSD receiving EMDR treatment (Lee, Taylor, and Drummond, 2006). Guided by process studies of other treatments and theories that might account for why EMDR is effective, participants' responses were examined to see which models better accounted for symptom improvement. The main analysis tested whether or not the responses were consistent with processes that occurred during traditional CBT treatment, which prior research had identified as reliving, or whether they were more consistent with Shapiro's proposal that enhanced information processing occurs because there is a dual focus of attention (that is, the person simultaneously focuses on an external stimulus and on the traumatic memory) (Shapiro, 1995). The responses made by 44 participants were coded by an independent rater according to whether they were primarily reliving, distancing, affect or material other than the primary trauma. The coding system was found to have satisfactory inter-rater reliability. Greatest improvement occurred when the participant processed in a more detached or distant manner, whereas reliving responses were not associated with improvement. Cross-lagged panel correlations suggested that processing in a more detached manner was a consequence of the EMDR procedure rather than a measure that co-varied with improvement. The findings underscored a difference in the processes that underlie EMDR and traditional CBT. The major question left unanswered from this second study was what causes this distancing process? Competing views were that it was facilitated by eye movement; alternatively, the therapist's instructions to participants might have precipitated this distancing phenomenon. The third study tested these ideas by randomly assigning 48 participants to either an eye movement or a no eye movement condition under two types of therapist instructions (reliving or distancing). Participants recalled personal distressing memories, and measures of distress and vividness were taken after treatment and at follow up. Only the eye movements made a significant difference to people's level of distress. This conclusion appeared at odds with some of the previous literature that had tested the effects of eye movement on levels of distress. A meta-analysis of some of this research had suggested that there was no significant advantage of including eye movement in EMDR treatment unless the person had been diagnosed with PTSD. However, a close examination of this meta-analysis indicated some major methodological flaws in the computation; therefore, this was recalculated. The conclusion from this fourth study was consistent with study three in that EMDR with eye movement was found to lead to significantly greater improvement that EMDR without eye movement. The results of these four studies were then discussed in terms of their implications for the theoretical models presented in Chapter 1. Aspects of learning theory that might account for EMDR efficiency were discussed as well as the failure of this model to account for treatment gains following EMDR. Information processing models were seen to better account for some of the phenomena observed in EMDR and for the findings from the four studies. Some suggestions of how eye movements might facilitate improved information processing were presented. Finally, the relative merits of EMDR and CBT treatments were discussed and suggestions made for when to combine approaches. The conclusions highlight the point that EMDR appears to be the most promising treatment for PTSD.

Keywords: Posttraumatic Stress Disorder  PTSD  

Accuracy Verified: Yes

13. de Jongh, A. (2008, September). EMDR and phobias: Treatment of fears and phobias with eye movement desensitization and reprocessing (EMDR)[EMDR bei angst: Und panikstörungen]. Pre-Congress presentation at the European Congress of Hypnosis, Vienna, Austria.

Language: English

Format: Conference

Abstract:
Eye Movement Desensitization and Reprocessing (EMDR) has been shown to be a structured, noninvasive, time-limited, and evidence-based treatment for the processing of memories of traumatic conditioning events and related symptomatology. There is a growing body of evidence showing the effectiveness of EMDR for specific phobias, a group of conditions that have been found to be more prevalent than any other group of psychiatric disorders studied. This workshop focuses on EMDR as a treatment approach for fear reactions related to - and avoidance of - specific objects and situations. The participants will learn: 1) about the fascinating possibilities of using EMDR in their work 2) how EMDR can be applied with clients who suffer from fears and phobias 3) to assess clients with patterns of fearful avoidance and to identify strategically important memories of earlier negative learning experiences for processing 4) to integrate EMDR interventions into a general (hypno)therapeutic approach. This will be illustrated by segments of video taped treatment sessions of clients suffering from a broad diversity of phobias (e.g., dental phobia, vomiting phobia, shark phobia).

Keywords: Phobias  Dental Phobias  Shark Phobias  Vomiting Phobias  

Accuracy Verified: Yes

14. Allon, M. (2004, June). EMDR and right-left brain stimulation. Poster presented at the EMDR Europe Association annual meeting, Stockholm, Sweden .

Language: English

Format: Conference

Abstract:
This presentation will present and demonstrate my clinical observations, that clients while talking or working on their issues will sometime lean their heads toward the right or the left shoulder. People with their heads to the left will tend to report thoughts, while those with their heads to the right will tend to report images and emotions. In therapy, utilizing EMDR when clients have leaned their heads to one side, I have tended to reinforce the side they put their head to, utilizing eye movements in a diagonal direction, corresponding to the direction the head was learning. That is. If the person learned their head to the left, I would move my hand from their upper left side to their lower right side, and opposite if their heads leaned to the right. The outcome of these diagonal eye movements was that it tended to evoke cognitions when the head leaned to the left or images when the head learned to the right. Client who come to therapy requesting help concerning fears, tend to lean their heads to the rights, corresponding with imagery and imagination of the right hemisphere and may lack the cognitive, logical thinking skills (left hemisphere) to counter their fears. With these clients, when the SUDS do not drop significantly, I will tend to do body-cognitive interweave. I request that the client lean their head on the left and work over and over with cirrsponding sets of diangonal eye movmenets. The left hemisphere of the brain is thus stimulated and logical thinking (PC) is enhanced. This helps to counter and balance out the negative images, and the fear decreased.
Through care histories and examples, I would like to accomplish the following objectives: 1) to make the participants more aware of body language and it its significance in therapy; 2) to examine the differences between the right and left hemispheres of the brain and their relationship to therapy with EMDR; and 3) to introduce and demonstrate a body-cognitive interweave in EMDR therapy with client s who request help with fears.

Keywords: Body-Cognitive Interweave  Left-Right Brain  Hemispheres of the Brain  Poster  

Accuracy Verified: Yes

15. Carvalho, E. R. (2013, May). EMDR and role therapy: Healing the folks who live inside. Presentation at the annual EMDR Canada Conference, Banff, Alberta CAN.

Language: English

Format: Conference

Abstract:
The integration of EMDR with Role Therapy will be presented as a comprehensive approach to the treatment of a wide spectrum of clients. Role therapy is presented as a “normalizing” approach to trauma and dissociation, treating clients’ inner roles as EMDR targets. Central to this approach is the conceptualization of self and one’s inner roles and counter-roles. Discussion will include how to use a developmental approach to assessment, and will review the identification, mapping and accessing of roles, as well as how to promote the use of role-specific EMDR targets, facilitating the enhancement of EMDR processing. Learning Objectives: • Participants will be able to discuss and implement the applications of Role Theory concepts and techniques to all phases of the EMDR protocol in order to facilitate the treatment of clients. • Participants will be able to discuss and describe how to developmentally assess, identify, map and access client roles and how to treat roles with traditional EMDR protocols. • Participants will be prepared to utilize EMDR targeting clients’ inner roles to enhance the processing of clients’ issues and resolution of symptoms.

Keywords: Role Therapy  

Accuracy Verified: Yes

16. Gaudiano, B. A. (2002, Fall/Winter). EMDR and the media - Is change in the wind?. The Scientific Review of Mental Health Practice, 1(2), 201-203.

Language: English

Format: Journal

Abstract:
Comments on the article "The finger-wagging cure. Saturday Night," (2001) by C. Milstone. The article began with the presentation of the harrowing story of a coal miner who developed symptoms of posttraumatic stress after being badly injured and nearly killed in a construction equipment accident. The man reported dramatic positive changes after only a few sessions of eye movement desensitization and reprocessing (EMDR) and testifies that the treatment "released the pain" of the trauma. This is usually the point at which many previous articles on EMDR would have presented one or two token skeptics and provided additional anecdotal evidence to counter any of the criticisms. However, Milstone's article did not follow this common formula. Instead, she chose to delve more deeply into the claims of EMDR proponents to contrast these claims with the research evidence. The article will likely be criticized by many EMDR proponents. Nevertheless, this article appears to be representative of a subtle shift hi the media coverage of EMDR that has been evident in recent years. (PsycINFO Database Record (c) 2007 APA, all rights reserved)

Keywords: Posttraumatic Stress Disorder  PTSD  

Accuracy Verified: Yes

17. Hofmann, A. (2000, May 6). EMDR in the treatment of dissociative disorders. Presentation at the annual meeting of the EMDR Europe Association, Utrecht, Netherlands.

Language: English

Format: Conference

Abstract:
Patients with dissociative disorders are a complex patient population in which EMDR can be one of the key treatment approaches in a therapy setting that usually needs to enclose a number of other treatment modalities and an overall comprehensive treatment plan. If undiagnosed, dissociative patients are, on the other hand, at increased risk of developing complications during the treatment with EMDR. In this workshop, participants will learn how to: (1) develop a comprehensive treatment plan that includes trauma work with EMDR, (2) integrate the 8 phases of EMDR with the three general phases of trauma treatment according to Janet (stabilization, trauma work, integration), (3) find a good balance to interchange in therapy between stabilization phases, trauma work with EMDR and work within the therapeutic relationship, and (4) recognize and possibly counter treatment complications.

Keywords: Dissociative Disorders  

Accuracy Verified: Yes

18. Frost, B. (2008, September). EMDR: Work with John. Counselling Children and Young People, 3.

Language: English

Format: Journal

Abstract:
As the game progressed, I provided some narrative designed to counter the limiting belief that it’s not OK to be focused on one thing. The SUDS reduced with each set of repetitions and very gradually I reduced the number of stimuli being presented until John was able to track a single blue circle moving from left to right on a white background. At the close of each set of 24 repetitions, the tracking object glides into the centre of the screen and stays at the centre of the screen. Making use of the opportunity, I asked John to focus only on the tracking object as he considered my SUDS and ‘What came up’ questions. {Excerpt]

Keywords: ADHD  Attention Deficit Hyperactive Disorder  Case Study  

Accuracy Verified: Yes

19. MacCulloch, M. J., & Feldman, P. (1996, November). Eye movement desensitisation treatment utilises the positive visceral element of the investigatory reflex to inhibit the memories of post-traumatic stress disorder:  A theoretical analysis. British Journal of Psychiatry, 169(5), 571-579.

Language: English

Format: Journal

Abstract:
Background: Eye movement desensitisation and reprocessing (EMDR) has attracted controversy and has led to publications covering a wide range of psychological problems treated by EMDR, in particular, PTSD. There is growing clinical evidence of the effectiveness of EMDR, but a lack of a convincing theoretical basis to explain its rapid effect. Method: This paper argues that a combination of Pavlovian and Darwinian theory provide a theoretical explanation for the therapeutic effectiveness of EMDR. Results: We suggest that the investigatory component of the orienting reflex is an evolutionary development enabling organisms to assess their environment for both opportunities and threats. We propose that EMDR is rapidly effective because it is a clinical method of Pavlovian conditioning by which the positive visceral element of the investigatory reflex can be paired with clinically-induced noxious memories to remove their negative affect. Conclusion: Compared with established forms of treatment for PTSD, EMDR is rapid, with resulting clinical and economic benefits. Our suggested theoretical basis for EMDR has implications for further explanatory research and for developments in EMDR treatment. [Author Abstract]

Keywords: Conditioned Emotional Responses  Literature Review  Posttraumatic Stress Disorder  PTSD  Treatment Effectiveness  

Accuracy Verified: Yes

20. Heber, R., & Shapiro, S. (2002, June). Integrating EMDR with psychoanalytic constructs in dealing with open-ended trauma. Presentation at the annual meeting of the EMDR International Association, San Diego, CA.

Language: English

Format: Conference

Abstract:
Recent acts of terrorism dictate re-examination of therapeutic srrategies when dealing wlth traumatic events without true closure and involving environmental stressors common to therapist and client. Thc participant will learn to 1) identify issues that arise open-ended and and shared events; 2) identify and address transference, counter-transference and subjective counter-transference; 3) the therapist's own triggers, responses, and needs for personal support; 4) utilize the client's narrative to identify past and current issues and client coping methods. Case illustrations will be included.

Keywords: Open-Ended Trauma  Psychoanalytic Constructs  

Accuracy Verified: Yes

21. Hermans, H. P., & de Putter, M. (2012). Is een toevoeging van een aspect uit de contraconditionering aan EMDR zinvol? [Is an addition of one aspect of the counter-conditioning to EMDR useful?]. Utrecht, Nederlands: Universiteit Utrecht.

Language: Dutch

Format: Dissertation/Thesis

Abstract:
Eye Movement and Desensitization Reprocessing (EMDR) is een beproefde methode voor de behandeling van posttraumatische stressstoornis (PTSS). Het verklaringsmechanisme van EMDR lijkt de werkgeheugentheorie te zijn. De werkgeheugentheorie voorspelt dat het belasten van het werkgeheugen tijdens het ophalen van een nare herinnering, de emotionaliteit van de herinnering doet afnemen. Het huidige onderzoek betrekt een aspect vanuit de contraconditionering bij oogbewegingen. Participanten werden ingedeeld in 3 condities: positief, negatief en neutraal. Elke participant voerde een tweetal reactietijd taken uit op de computer, waarvan één met een stilstaande stip en één met een bewegende stip. Daarnaast haalde elke participant 2 negatieve autobiografische herinneringen op, tijdens het ophalen van één herinnering keken participanten naar een stilstaande stip, terwijl bij de andere herinnering een bewegende stip gepresenteerd werd. Op het beeldscherm werd – afhankelijk van de conditie – een positieve, neutrale of negatieve foto als achtergrond geselecteerd om te kijken of de valentie van aangeboden foto’s het effect van oogbewegingen beïnvloeden. De reactietijd taken bieden inzicht in welke mate oogbewegingen een belasting voor het werkgeheugen vormen. De resultaten tonen significant tragere reactietijden wanneer participanten oogbewegingen moesten maken. Op het gebied van emotionaliteit is er eveneens een significant effect van oogbewegingen gevonden. De narigheid van de opgehaalde herinnering nam – onafhankelijk van conditie - af wanneer participanten oogbewegingen maakten. Uitkomsten van het huidige onderzoek vormen een bevestiging van de werkgeheugentheorie. Het verwachtte effect van valentie is uitgebleven, vermoedelijk doordat participanten de valentie van de foto’s niet goed meekregen. Adequaat vervolg onderzoek zal moeten uitwijzen of een toevoeging aan EMDR vanuit de contraconditioneringstheorie zinvol is.

Eye Movement Desensitization and Reprocessing (EMDR) is a proven method for the treatment of post traumatic stress disorder (PTSD). The declaration mechanism of EMDR seems to be working memory theory. The working memory theory predicts that taxing working memory during retrieval of a bad memory, the emotionality of the memory decreases. The present study involves an aspect from the counter-conditioning at eye movements. Participants were divided into 3 conditions: positive, negative and neutral. Each participant performed a two reaction tasks on the computer, one with a stationary dot and one with a moving dot. In addition, each participant took 2 negative autobiographical memories, while retrieving a reminder to participants watched a stationary spot, while the other memory a moving dot was presented. On the screen was - depending on the condition - a positive, neutral or negative picture as background selected to see if the valence of pictures presented the effect of eye movements influence. The response functions provide insight into the extent to which eye movements constitute a burden on the working memory. The results show significantly slower reaction times when participants had to make eye movements. In the area of ​​emotionality is also a significant effect of eye movements found. The misery of the retrieved memory Rose - regardless of condition - off when participants made eye movements. Results of the present study are a confirmation of the working memory theory. The expected effect of valence failed to materialize, probably because participants the valence of the pictures are not good afterworld. Adequate follow-up study is needed to determine whether an addition to EMDR from the contralateral conditioning theory makes sense.

Keywords: Counter Conditioning  Memory Theory  

Accuracy Verified: Yes

22. Munaro, D., Anchisi, R., Bossa, R., & Guzzi, R. (2001, October). Is orienting reflex in EMDR successful?. In International CIANS Conference (CIANS: Collegium Internationale Activitatis Nervosae Superioris; International Association for Integrative Nervous Functions, Neurobiology of behaviour and Psychosomatics, (pp 149-158) Palermo, Italy.

Language: English

Format: Conference

Abstract:
We tried to “dissect” the EMDR method in the component desensitization through rapid eye movement (EMD), that is also the original part, to explain the neurophysiological functioning, Charney et al, say that a lot of persistent symptoms of PTSD are caused by an elevate arousal of NVS, particularly due to the increase of norepinephrine. Others hypothesize, again, that EMDR method is rapid because it is based on Classic Conditioning. Pavlov found that every stimulus of environment causes to the organism (animal or human) an immediate orienting response due to the arousal of the Autonomic Nervous System. In this situation the animal begins to look around moving its eyes laterality (as it happens during ocular movements of EMD); if it perceives a danger in the environment it stimulates a visceral negative response (hyperactivation that means fear) that leads an an avoidance behaviour (stiffening) and/or fighting. In other cases it causes a visceral positive response (de-arousal process that means reassurance) that leads to an approach behaviour through interaction or exploration.
The EMD should produce an orienting reflex in the patient in a protective sitaution like a psychotherapeutic setting; that means an important reduction of neuro-vegetative nervous system activity (dearousal) and some visceral positive response. We propose an experimental design with a single subject (ABACADA) by interruption treatment and by monitoring Neurophysiological functions through biofeedback instruments to test this neurophyiological hypothesis.

Keywords: Orienting Reflex  

Accuracy Verified: Yes

23. Lazzari, D. (2008, Novembre). L'EMDR in ottica PNEI (interazione corpo-mente) [EMDR in optical PNEI (interaction body-mind)]. Presentazione le Applicazioni Cliniche del EMDR Congresso Nazionale, Milano, Italia.

Language: Italian

Format: Conference

Abstract:
In questi anni l’EMDR si è affermata come trattamento di evidenza nel più classico e più grave dei disturbi direttamente legati allo stress, cioè il PTSD (Bisson & Andrew, 2007) e sono stati evidenziati i suoi effetti sul SNC. Nonostante questo ed il suo progressivo impiego in una ampia varietà di situazioni sono ancora poche le riflessioni sull’EMDR dal punto di vista dell’integrazione mente-corpo, in particolare utilizzando i dati offerti dal campo di ricerca della PNEI. Nel presente lavoro ci soffermeremo su alcuni di questi aspetti per evidenziare come l’EMDR rappresenta una delle terapie più rispondenti alle nuove evidenze scientifiche ed alle esigenze di una scienza integrata della salute. Tre gli elementi salienti offerti dalla ricerca: 1. La vita ha plasmato nel percorso evolutivo strutture altamente integrate, descrivibili come sistemi complessi a rete in retroazione continua con il contesto. In particolare i sistemi nervoso, endocrino ed immunitario costituiscono nel network psicocorporeo un “super-sistema” di relazione e regolazione in grado di assicurare gli equilibri adattativi incorporando l’esperienza e gestendo la dinamica mantenimento-cambiamento (“regolazione allostatica”). Quindi l’organismo non è una macchina fatta di parti autonome tra loro assemblate, ma una realtà che parte dall’unità (zigote) e mantiene tale carattere unitario in tutte le sue articolazioni. 2. Lo stress non è qualcosa di per sé eccezionale e patologico, deve invece essere visto – all’opposto – come l’espressione di un insieme di processi (un sistema) che modulano la regolazione individuo-contesto a fini adattativi. In sostanza il sistema dello stress è sempre attivo e solo in situazioni di eccesso o di carenza (acute o croniche) produce effetti progressivamente dannosi per l’individuo. Le attività legate allo stress producono un “carico allostatico” (peso biologico, energetico) che – in relazione a fattori soggettivi ed esterni – può divenire “sovraccarico” innescando una catena di successive alterazioni nel funzionamento dell’organismo. Parallelamente vi è un “carico” ed un “sovraccarico psicologico” legati al primo da processi circolari. 3. Nel network corporeo e nel sistema dello stress, ovvero nei processi di regolazione generale interni e individuo-contesto, la mente svolge un ruolo cruciale di modulazione come dimensione nella quale i segnali (interni ed esterni) vengono trasformati in informazioni (assegnazione di significati) in base ai percorsi ed alle esigenze individuali di adattamento. La mente rappresenta così la più alta espressione dell’evoluzione della vita e delle sue strategie adattative e ciò spiega il suo ruolo rispetto al funzionamento complessivo dell’organismo. Le recenti acquisizioni delle neuroscienze hanno mostrato l’interdipendenza tra attività psichica, espressione genica e plasticità cerebrale che rende possibile il ruolo della mente. Il sovraccarico allostatico e psicologico legati allo stress dipendono in gran parte dall’attività mentale e costituiscono il principale fattore di rischio per la salute nelle società occidentali, antecedenti accertati delle patologie più diffuse. Se guardiamo a quanto detto sinora nell’ottica dello sviluppo individuale (fase intrauterina, processi di attaccamento, eventi significativi successivi) possiamo avere una idea di come mente, corpo e contesto interagiscono nella strutturazione dell’individuo ed il ruolo condizionante e de-strutturante delle situazioni e degli eventi che provocano una alterazione da stress. Le ricerche sul rapporto tra stress e sviluppo psicobiologico, tra modalità di attaccamento, strutturazione dei circuiti cerebrali, o tra queste e salute, confermano tali assunti (Lazzari, 2007). Venendo più da vicino all’EMDR, gli studi sulla psicobiologica del PTSD stanno mostrando che siamo di fronte sostanzialmente ad una manifestazione (particolarmente complessa ed accentuata) degli effetti dello stress sul network psicocorporeo (Iribarren et al., 2005). La ricerca sul PTSD (e gli altri disturbi da stress del DSM) deve incrociare necessariamente i filoni di studio sopra richiamati ed utilizzare la cornice concettuale che ne scaturisce. Gli effetti psicobiologici dello stress estremo e del trauma vanno inquadrati nell’ambito delle interazioni mente-corpo e della regolazione allostatica (carico vs sovraccarico allostatico). A nostro avviso, al di là degli specifici effetti sul SNC, l’EMDR si è mostrata efficace nel PTSD in relazione alla sua caratteristica generale di ricercare ed utilizzare come “target” non singoli aspetti di una esperienza, bensì l’esperienza nei suoi diversi aspetti: cognitivi, emotivi, fisiologici e relazionali. Il lavoro dell’EMR va a recuperare una integrazione perduta e lavora su questa. Si deve tenere presente infatti che, in via generale e preminente, lo stress compromette i livelli di integrazione, coerenza e flessibilità del sistema: lo stress cronico per processi progressivi di disregolazione, quello acuto per “rotture”, blocchi e sconnessioni. Pertanto l’elaborazione dell’informazione (e delle conseguenze) legata ad eventi e situazioni stressanti passa attraverso una re-integrazione di tutti gli aspetti psicobiologici correlati per giungere ad una ristrutturazione. Il livello di “penetrazione” (efficacia) di un approccio terapeutico è molto legato alla sua omogeneità con la realtà su cui interviene,cioè al fatto di parlare lo stesso linguaggio. E questo è un punto di forza notevole per l’EMDR. I dati disponibili sono coerenti con quanto enunciato: l’EMDR modifica i parametri fisiologici riducendo ed annullando l’attivazione da stress, spostando la bilancia dall’inibizione simpatica all’attivazione parasimpatica (Sack et al. 2007) e risulta associata l’abbassamento dell’arousal fisiologico, cioè con pattern di attività regolari e trofiche (Sack et al. 2008), mostrando similarità con quanto accade durante il sonno REM (Elofsson et al., 2008). L’EMDR incide altresì su disturbi fisici legati al sistema dello stress, come ad esempio hanno mostrato ricerche su patologie dermatologiche (Gupta, 2002).

In recent years, EMDR has established itself as the treatment of evidence in the most classical and most serious of disorders directly related to stress, that is, PTSD (Bisson & Andrew, 2007) and were highlighted its effects on the CNS. Despite this and its progressive use in a wide variety of situations are still few reflections from the perspective sull'EMDR mind-body integration, in particular using data provided by the search of PNEI. In this work we will focus on some of these issues to highlight how EMDR is one of the therapies are more responsive to new scientific evidence and the needs of an integrated science of health. Three main elements of research are: 1. Life has shaped the evolutionary highly integrated structures, we describe how systems complex feedback network continues with the context. In particular, the nervous, endocrine immune network and provide psycho in a "super-system" of relationship and adjustment able to ensure the balance incorporating adaptive expertise and managing the dynamic maintenance-change ( "regulation allostatica"). Then the body is a machine made of autonomous parts, assembled together, but a reality that leaves the unit (zygote) and maintains that unitary in all its joints. 2. Stress is not something in itself exceptional and pathological, but must be seen - in contrast -- as the expression of a set of processes (a system) that modulate the individual-regulation framework for adaptive. In essence, the system of stress is always on and only in situations of excess or deficiency (acute or chronic) effects progressively damaging to the individual. The Stress-related activity produces a "load allostatico" (weight biological energy) that -- relation to subjective factors and external - can become "overloaded" by triggering a chain of subsequent alterations in the functioning of the organism. In parallel there is a "load" and a "Overload psychological" processes related to the first round. 3. In the network system and body of stress, or in the process of setting general internal and individual-context, the mind plays a crucial role as a dimension of modulation in which signals (internal and external) are transformed into information (assigning meanings) depending on the paths and individual needs of adaptation. The mind is so the highest expression of the evolution of life and its adaptive strategies, which explains its role in relation to the overall functioning of the organism. The recent acquisitions of neuroscience have shown the interdependence of psychic activity, gene expression and plasticity brain that makes the role of the mind. Overload allostatico and psychological stress-related depend in large part by activism mental and constitute the main risk factor for health in Western societies, antecedents established disease spreading. If we look to the foregoing view of personal development (stage intrauterine attachment process, significant events later) we can have an idea of how mind, body and environment interact in the structuring the individual and the role conditioning and de-structuring of situations and events that cause an alteration by stress. Research on the relationship between stress and psychobiological development, including mode of attachment, structure of brain circuits, or between them and health, confirmation of these given (Lazzari, 2007). Coming closer all'EMDR, psychobiological studies of PTSD are showing that we are dealing essentially an event (especially complex and pronounced) the effects of stress on the network psycho (Iribarren et al., 2005). Research on PTSD (and other stress disorders DSM) must necessarily cross the strands study mentioned above and use the conceptual framework that arises. Psychobiological effects of extreme stress and trauma should be classified within mind-body interactions and regulation allostatica (load vs. overload allostatico). In our view, beyond the specific effects on the CNS, EMDR has been shown effective in PTSD in connection with his characteristic broad research and use as a "target" rather than individual aspects of an experience, but experience in its different aspects: cognitive, emotional, physiological and relational. Work dell'EMR goes to retrieve a lost and working on this integration. It should be remembered that, in general, and prominent, stress affects the levels of integration, consistency and flexibility of the system: chronic stress for progressive process of dysregulation, the acute "broken", blocks and disconnections. Therefore processing information (and consequences) related to events and stressful situations through a re-integration of all aspects related to psychobiological reach a restructuring. The level of "penetration" (effectiveness) of a therapeutic approach is very attached to his homogeneity with the reality on which it operates, namely the fact of speaking the same language. And this is a great asset for EMDR. The available data are consistent with the statement: EMDR change physiological parameters reducing and canceling the activation by stress, shifting the balance from the inhibition nice parasympathetic activation (Sack et al. 2007) and is associated with lowering dell'arousal physiological, ie regular patterns of activity and trophic (Sack et al. 2008), showing similarities with what happens during REM sleep (Elofsson et al., 2008). EMDR also impacts on physical ailments related to the system of stress, such as have Show searches on dermatological (Gupta, 2002).

Keywords: Body-Mind Interaction  PNEI  

Accuracy Verified: Yes

24. Selvini, M. (2011, Settember). L'Impatto delle terapie del trauma e dell'EMDR sul modello sistemico familiare-individuale [The impact of EMDR treatment of trauma and the family systems model-independent]. Presentazione al Congresso EMDR Nazionale "Trauma e relazione,” Roma, Italia.

Language: Italian

Format: Conference

Abstract:
Uno dei limiti di fondo del modello sistemico classico (si veda La pragmatica della comunicazione di Watzlawick, 1967, o Paradosso e contro paradosso, 1975, fino agli epigoni post-moderni) è dato dal semi-annullamento della dimensione individuale (la famosa scatola nera), tra cui come ovvia conseguenza quella dell’elaborazione del trauma. Il movimento EMDR impatta così utilmente sui terapeuti sistemici nell’aiutarli a riscoprire/approfondire/integrare i temi dell’elaborazione/difesa della sofferenza e dei diversi tipi di personalità/funzionamento. Le mie scuole da qualche anno stanno formando all’EMDR tutti i docenti e tutti gli allievi del quarto anno: perché solo circa un terzo dei formati al primo livello utilizza poi effettivamente questa tecnica? Lo stiamo studiando con incontri a piccolo gruppo subito dopo i tre giorni del primo livello, appare infatti chiaro che chi non utilizza subito la tecnica non lo farà più.

One of the limitations of the underlying classical system model (see The pragmatics of communication of Watzlawick, 1967, or Paradox and counter paradox, 1975, until the post-modern successors) is given by the semi-annulment of the individual dimension (the famous black box ), including the drawing as an obvious consequence of trauma. The movement thus usefully EMDR impacts on systemic therapists in helping them to discover / learn / integrate the development issues / defense of the suffering and the different personality types / functions. My schools a few years being trained EMDR all teachers and all pupils in the fourth year, because only about one third of the formats on the first level then actually uses this technique? We're studying with small group meetings in the three days immediately after the first level, it seems clear that those not using the technique just will not do it anymore.

Keywords: Family Systems  

Accuracy Verified: Yes

25. Giannantonio, M. (2001, Ottobre). L’eye movement desensitization and reprocessing (E.M.D.R.) negli adulti e adolescenti abusati sessualmente in età infantile [The eye movement desensitization and reprocessing (EMDR) in adults and adolescents sexually abused in childhood]. Congresso AIAMC, Palermo, Italia.

Language: Italian

Format: Conference

Abstract:
L’Eye Movement Desensitization and Reprocessing (EMDR) nasce come interevento elettivo nella terapia del Disturbo Post-traumatico da Stress (PTSD) e, in particolar modo nelle fasi iniziali del suo consolidamento clinico e teoretico, ha calibrato il proprio protocollo di intervento standard sul PTSD generato da combattimenti bellici, catastrofi naturali e provocate dall’uomo. L’abuso sessuale, soprattutto se avvenuto nell’infanzia, in modo prolungato ed all’interno di un contesto familiare (ovvero il tipo di abuso sessuale sul quale concentrerò ora la mia attenzione), è un tipo di evento traumatico che può presentare caratteristiche peculiari: elementi dissociativi da marcati ad assenti, alterazioni mnestiche e codifiche mnestiche statodipendenti, massicci meccanismi di repressione operanti anche per decenni, condizionamento negativo dell’evoluzione del sistema comportamentale dell’attaccamento, presenza di memorie somatiche di difficile gestione da parte del paziente, disturbi sessuali, difficoltà nell’instaurazione e nel mantenimento della relazione terapeutica. L’abuso sessuale intrafamiliare si accompagna abitualmente alla trascuratezza emotiva ed alla violenza psicologica, in alcuni casi anche a quella fisica. Di fronte ad un quadro 2 clinico così complesso (laddove la presenza di PTSD è semplicemente uno dei possibili esiti psicopatologici, e con ogni probabilità non il più frequente), l’intervento con l’EMDR richiede modificazioni rispetto al protocollo standard di intervento per il PTSD ma, soprattutto, l'inserimento all'interno di un intervento clinico di respiro decisamente più ampio rispetto all’impiego di algoritmi terapeutici ridotti all’essenziale. Il sottoscritto ritiene che, al momento attuale, lo studio più approfondito sull’argomento sia una pubblicazione di Laurel Parnell del 1999. Personalmente, ed in modo concorde con quest’ultimo autore, ho verificato la notevole efficacia nell’operare con l'EMDR - anche molto direttivamente - sulla storia di attaccamento del paziente al fine di colmarne le falle evolutive o eliminare gli ostacoli per il conseguimento di questo fondamentale obiettivo terapeutico.

The eye movement desensitization and reprocessing (EMDR) is born as interevento elective in the treatment of Posttraumatic Stress Disorder (PTSD) and, especially in the early stages of its consolidation clinical and theoretical, has calibrated their intervention protocols for the standard PTSD generated by fighting wars, natural disasters and caused man. Sexual abuse, especially if done in childhood, so Prolonged and within a family context (ie the type of abuse which focus on sex now my attention) is a type of event trauma that may have special characteristics: elements dissociative to be marked absent, changes in mnemonic and mnemonic encodings statodipendenti, massive repression mechanisms operating for decades negative evolution of behavioral conditioning system attachment, presence of somatic memories of unmanageable the patient's sexual problems, difficulty in establishing and maintaining the therapeutic relationship. Sexual abuse is intrafamilial usually accompanies the emotional neglect and violence psychological, in some cases to physical. Faced with a framework 2 clinical as complex (where the presence of PTSD is simply a possible outcomes of psychopathology, and probably not the most frequent), intervention with EMDR requires changes compared to standard protocol of intervention for PTSD but, more importantly, the inclusion within a clinical intervention to breath much larger than use of therapeutic algorithms reduced to essentials. My opinion that, at present, more thorough study on the subject is a Published by Laurel Parnell in 1999. Personally, and so agreed with this page, I checked the remarkable effectiveness in working with EMDR - very directly - on the history of attachment of the patient in order to bridge the evolutionary gaps or eliminate obstacles to achieving this important therapeutic target.

Keywords: Adolescents  Adults  Postttraumatic Stress Disorder  PTSD  Sexual Abuse  

Accuracy Verified: Yes

26. Suzuki, A., Josselyn, S. A., Frankland, P. W., Masushige, S., Silva, A. J., & Satoshi, K. (2004). Memory reconsolidation and extinction have distinct temporal and biochemical signatures. Journal of Neuroscience, 24(20), 4787–4795. doi:10.1523/jneurosci.5491-03.2004.

Language: English

Format: Journal

Abstract:
The article explores the differences between memory reconsolidation and extinction. This new area of investigation is worthy of additional attention. Reconsolidation may prove to be the underlying mechanism of EMDR, as opposed to extinction caused by prolonged exposure therapies. “Memory reconsolidation after retrieval may be used to update or integrate new information into long-term memories . . . Brief exposure … seems to trigger a second wave of memory consolidation (reconsolidation), whereas prolonged exposure . . leads to the formation of a new memory that competes with the original memory (extinction).”

Keywords: Consolidation  Extinction  Fear Conditioning  Reconsolidation  Protein Synthesis  Spatial Memory  

Accuracy Verified: Yes

27. Hogberg, G., Pagani, M., Sundin, Ö., Soares, J., Aberg-Wistedt, A., Tarnell, B., & Hallstrom, T. (2007, February). On treatment with eye movement desensitization and reprocessing of chronic post-traumatic stress disorder in public transportation workers – A randomized controlled trial. Nordic Journal of Psychiatry, 61, 54-61. doi:10.1080/08039480601129408.

Language: English

Format: Journal

Abstract:
Previous studies on post-traumatic stress disorder (PTSD) investigated a variety of treatments and included mostly patients victims of sexual and combat assault. This study aimed to determine the short-term efficacy of eye movement desensitization and reprocessing (EMDR) in occupation-based PTSD. Employees of the public transportation system in Stockholm, who had been experiencing a person-under-train accident or had been assaulted at work were recruited. Subjects with trauma exposure since more than 3 months but less than 6 years were included. Twenty-four subjects who fulfilled the DSM-IV criteria for PTSD were randomized to either EMDR therapy (n=13) or waiting list (WL, n=11). They were assessed pre-treatment and shortly after completion of treatment or WL period. The pre-defined primary outcome variable was full PTSD diagnosis. Secondary outcome variables were the results of various psychometric scales. Twelve participants began and completed five sessions of EMDR and nine completed the WL. After therapy, eight subjects in the EMDR group (67%) and one (11%) in WL did not fulfil the criteria for PTSD diagnosis (difference, P=0.02). Among the secondary outcome variables, there were significant differences post-treatment between the groups EMDR/WL in Global Assessment of Function (GAF) score and Hamilton Depression (HAM-D) score. This study indicates that EMDR has a short-term effect on PTSD in public transportation workers exposed to occupational traumatic events. Such intensive and brief therapy might be further validated in larger samples of exposed workers with longer periods of follow-up.

Keywords: Counter-Conditioning  Empirical Study  Occupational Health  Posttraumatic Stress Disorder  PTSD  Quantitative Study  Random Control Trial  RCT  

Accuracy Verified: Yes

28. Denny, N. (1995, March). An orienting reflex/external inhibition model of EMDR and thought field therapy. Traumatology, 1(1), 1-6, Article 1. doi:10.1177/153476569500100101.

Language: English

Format: Journal

Abstract:
The clinical phenomena of the conduct of EMDR and Thought Field Therapy were interpreted in light of concepts in the field of classical conditioning with emphasis on the orienting reflex and its external inhibiting effects on conditioned responses. A model was proposed using the temporary suppression through external inhibition of the fear and avoidance conditioned responses to disturbing memories. The clinically helpful effect proposed is the emergence of previously suppressed competing responses to the troublesome memories. Those newly emerged responses are responsible for spontaneous cognitive restructuring of the meaning attribution of the memories, thus lowering SUDS ratings. [Author Abstract]

Keywords: Conditioned Emotional Responses  Cognitive Processes  TFT  Thought Field Therapy  

Accuracy Verified: Yes

29. Armstrong, M., & Vaughan, K. (1996, March). An orienting response model of eye movement desensitization. Journal of Behavior Therapy and Experimental Psychiatry, 27(1), 21-32. doi:10.1016/0005-791(95)00056-9.

Language: English

Format: Journal

Abstract:
Dyck's conditioning model of EMD provides a useful description of failure of habituation in PTSD, but may not account for some common EMD phenomena. An alternative model proposes that the therapist's waving hand -- in the presence of a trauma-related cortical set -- triggers an intense orienting response (OR). Intrinsic effects of the OR facilitate continuing attention to the memory without avoidance, and provide for effective input of new trauma-related information. The person's neuronal model of the trauma alters to reflect his survival and current safety -- as true outcome of the trauma -- and associated conditioned responses extinguish. Proposals for experimental evaluation of the model are described. [Author Summary]

Keywords: Conditioned Emotional Responses  PTSD  Treatment Effectiveness  

Accuracy Verified: Yes

30. Vaughan, K., & Armstrong, M. (1995, June). An orienting response model to EMDR. Presentation at the EMDR Network Conference, Santa Monica, CA.

Language: English

Format: Conference

Abstract:
The authors reviewed the literature of EMDR and consulted their own clinical experiences to establish the characteristic phenomenology of EMDR. Dyck's (1993) conditioning model of eye movement desensitization provides a useful account of failure and habituation in post-traumatic stress disorder (PTSD), but does not account for some of these common EMDR phenomena. The authors propose an alternative model in which the therapist's waving hand-- in the presence of a trauma-related cortical set-triggers an intense orienting response (OR). Intrinsic effects of the OR facilitate continuing attention to the memory without avoidance, and provide for effective input of new trauma-related information. The person's neuronal model of the trauma alters to reflect their survival and current safety -- as true outcome of the trauma - and associated conditioned responses extinguish. Some proposals for experimental evaluation of the model are described.

Keywords: Orienting Response  

Accuracy Verified: Yes

31. Nickeson, C. (2002, June). Panic disorder and physiology phobia:  EMDR treatment. Presentation at the annual meeting of the EMDR International Association, San Diego, CA.

Language: English

Format: Conference

Abstract:
Panic disorder can be viewed as a phobic fear of the body's physical sensations. It results from conditioning by the traumatic experience of having panic attacks. Conceptualizing panic disorder in this way provides a powerful way to structure treatment with EMDR since EMDR is clearly effective with trauma resolution. This workshop will describe how the preparation phase is especially important and, must be expanded in order for reprocessing to be successful. Participants will also learn how to select appropriate targets for the desensitization phase, how to identify suitable negative cognitions and positive cognitions, and how to employ cognitive interweave when needed. A videotape illustrating an important part of a client's work will be shown.

Keywords: Panic Disorder  Phobia  Physiology  

Accuracy Verified: Yes

32. Elofsson, U. O. E., von Scheele, B., Theorell, T., & Sondergard, H. P. (2008, May). Physiological correlates of eye movement desensitization and reprocessing. Journal of Anxiety Disorders, 22(4), 622-634. doi:10.1016/j.janxdis.2007.05.012.

Language: English

Format: Journal

Abstract:
Eye movement desensitization and reprocessing (EMDR) is an established treatment for post-traumatic stress disorder (PTSD). However, its working mechanism remains unclear. This study explored physiological correlates of eye movements during EMDR in relation to current hypotheses; distraction, conditioning, orienting response activation, and REM-like mechanisms. During EMDR therapy, fingertip temperature, heart rate, skin conductance, expiratory carbon dioxide level, and blood pulse oximeter oxygen saturation, were measured in male subjects with PTSD. The ratio between the low and high frequency components of the heart rate power spectrum (LF/HF) were computed as measures of autonomic balance. Respiratory rate was calculated from the carbon dioxide trace. Stimulation shifted the autonomic balance as indicated by decreases in heart rate, skin conductance and LF/HF-ratio, and an increased finger temperature. The breathing frequency and end-tidal carbon dioxide increased; oxygen saturation decreased during eye movements. In conclusion, eye movements during EMDR activate cholinergic and inhibit sympathetic systems. The reactivity has similarities with the pattern during REM-sleep. [Author Abstract]

Keywords: Autonomic Physiology  Empirical Study  Heart Rate Variability  Males  Orienting Response  Posttraumatic Stress Disorder  Psychophysiology  PTSD  Quantitative Study  Respiration  Refugees  

Accuracy Verified: Yes

33. Commons, M. L. (2000, August). The power therapies: A proposed mechanism for their action and suggestions for future empirical validation. Traumatology, 6(2), 119-138. doi:10.1177/153476560000600205 .

Language: English

Format: Journal

Abstract:
Power Therapies claim to achieve rapid results in reducing fear elicited by a large number of situations. This paper presents a theory of how competition among stimuli may be the basis for how the Power Therapies work. The compelling features of these therapies are that they all interrupt old habits and conditioned reflexes and provide new habits and conditioning. Therefore, many of the protocols involve overcoming prior-stimulus dominance. In addition to proposing a mechanism for these therapies, this article also reveals that, despite superficial differences, power therapies fundamentally accomplish the same thing. These therapies reduce the intensify of emotional responses elicited by stimuli associated with trauma. It is proposed that they accomplish this end through working at the subcortical level of brain activity to interrupt the negative emotional responses elicited by the trauma stimuli. [Author Abstract]

Keywords: Conditioned Emotional Responses  TFT  Thought Field Therapy  Neurolinguistic Programming  NLP: Posttraumatic Stress Disorder  PTSD  TIR: Traumatic Incident Reduction  

Accuracy Verified: Yes

34. MacCulloch, M. J., Blore, D. C., & Gray, N. S. (1998). Pre and post session measures of traumatic memories by semantic differential indicate that EMDR is a rapid counter-conditioning process which catalyses stalled emotional processing. Presentation at the XXVIIIth EABCT Conference, Cork, Ireland.

Language: English

Format: Conference

Keywords: Semantic Differential  

Accuracy Verified: Yes

35. Dyck, M. J. (1993, September). A proposal for a conditioning model of eye movement desensitization treatment for posttraumatic stress disorder. Journal of Behavior Therapy and Experimental Psychiatry, 24(3), 201-210. DOI:10.1016/0005-7916(93)90022-O.

Language: English

Format: Journal

Abstract:
Although eye movement desensitization (EMD) was introduced as a specific treatment for traumatic memories, a satisfactory explanation of the therapeutic mechanism underlying the method has not been offered. This article describes a model of traumatic memories and EMD based primarily on principles of respondent conditioning, emotional interference with learning, and operant conditioning. A method for evaluating the conditioning model is briefly described. [Author Summary]

Keywords: Conditioned Emotional Responses  Posttraumatic Stress Disorder  PTSD  Review  

Accuracy Verified: Yes

36. Figley, C., Dietrich, A., Maxfield, L., & Gentry, J. E. (1999, November). Review of neoteric trauma treatments and suggested practice guidelines. In C. Figley (Chair) Discussion, Clinical Theory. International Society for Traumatic Stress Studies, Miami, FL.

Language: English

Format: Conference

Abstract:
Eye Movement Desensitization and Reprocessing (EMDR), Thought Field Therapy (TFT), Time-Limited Trauma Therapy (TLTT), Traumatic Incident Reduction (TIR), and Visual/Kinesthetic Dissociation (V/KD) are relatively new approaches in the treatment of trauma-related disorders. These approaches have come under intense scientific and professional scrutiny and criticism, with proponents and critics offering diverse and intriguing arguments in support of their respective points of view. This discussion will focus on the current empirical and anecdotal evidence on the efficacy of these five approaches, as well as various criticisms that have been proferred in response to the empirical and clinical literature on treatment efficacy and theory. EMDR will be highlighted, given the growing empirical database on EMDR outcome studies and the contention surrounding the treatment and its’ theory. The evidence for and/or against the other four approaches will also be presented, upon which we will raise for discussion issues relating to methodological rigour, scientific reporting of clinical data, and the interpretation of efficacy studies in general. The discussion will occur within the context of philosophical discourse on the ideal of integration of science and practice, and the feasibility of attaining this ideal within the current scientific Zeitgeist. INTERVENTION RESEARCH, CLINICAL CASE STUDY Sandringham Skills-Based Treatment of Dissociation: A Case Study 238 Chair: ELHAI, Jon D., Nova Southeastern University Discussant: GOLD, Stephen A clinical case study of skills-based treatment of a 48-year-old, female survivor of child sexual abuse (CSA) reporting severe dissociative symptomatology is presented. Chief complaints were daily amnestic episodes, depersonalization, panic attacks, agoraphobia, and consequent long-term unemployment. In contrast to most approaches to therapy for dissociative syndromes, it is argued that treatment does not need to be primarily trauma-focused. Instead treatment focused on targeting dissociation and anxiety by teaching skills to be implemented by the client outside of session. Functional behavioral analysis of particular recent incidents of dissociation were conducted over several sessions. Imagery-based relaxation and progressive muscle relaxation were used and monitored to help the client learn additional methods of reducing distress. Grounding techniques were implemented to counter the dissociative tendency to lose experiential awareness of the here and now. Cognitive interventions were utilized to challenge the erroneous notions reported about dissociative experiences, such as the panic she experienced when her dissociation had been revealed to others. Last, in vivo systematic desensitization was used with a fear hierarchy, ranging from the least to most fearful stimuli that precipitate dissociation, where graduated exposure was followed by relaxation. At termination the client reported elimination of panic attacks, resumption of driving, and marked reduction in frequency and duration of amnestic periods, with substantial additional gains and progress in finding full-time employment reported at 8 month follow-up. Treatment outcome is assessed based on psychological test data obtained at intake, discharge, and 8 month follow-up, as well as client anecdotal report.

Keywords: Neoteric Trauma Treatments  Practice Guidelines  

Accuracy Verified: Yes

37. Maxfield, L., Manfield, P., Renssen, M. R., Smyth, N., Servan-Schreiber, D., & Bartone, P. M. (2001, June). The role of eye movements and other bilateral stimulation in EMDR. In R. Greenwald (Chair), Research Symposium II. Symposium conducted at the annual meeting of the EMDR International Association, Austin, TX.

Language: English

Format: Conference

Abstract:
After a decade of treatment outcome research on EMDR, its effectivensss in the treatment of PTSD is no longer in question. However, the role of eye movements and bilateral stimulation, in general, remain controversial. Critics of EMDR hold that EMDR is simply cognitive behavioral treatment repackaged. Proponents of EMDR counter that much of the component analyses research on EMDR has been flawed and that several studies suggest the importance of eye movements. This panel symposium will explore the current status of the research on the importance of eye ovements and other bliateral stimulation in EMDR treatment. The research on this topic, to date, will be summarized and then the results of three studies investigating the role of bilateral stimulation will be presented. The symposium will conclude with a discussion of the key questions for future research.

Keywords: Bilateral Stimulation  BLS  Eye Movement  Symposium  

Accuracy Verified: Yes

38. Schubbe, O. (2011, June). Self care during the EMDR session: The application of the standard protocol for working with counter-transference. Presention presented at the annual meeting of the EMDR Europe Association, Vienna, Austria.

Language: English

Format: Conference

Abstract:
Secondary traumatization and appropriate self care are relevant current topics for psychotherapists, especially when working with complex trauma. During the application of the standard protocol, EMDR therapists are often confronted with reports of severe traumatic incidents, strong emotions, and different forms of transference. In reaction, they experience post-traumatic counter-transference, and sometimes even secondary trauma. The EMDR standard protocol provides the opportunity for dual application - parallel for client and therapist. Through processing of the initial counter-transference, the therapist experiences a unique EMDR process. This process resolves any disturbance that might occur through counter-transference issues. Learning objectives: The therapist can better support the EMDR process of the client, e.g. through more creative ideas for cognitive interweaves. The indication and contra-indications for this procedure will be discussed.

Keywords: Countertransference  Self-Care  

Accuracy Verified: Yes

39. Forrest, M. S. (1995, June). Self-soothing and the multiple trauma survivor. Presentation at the EMDR Network Conference, Santa Monica, CA.

Language: English

Format: Conference

Abstract:
Remember the joke about the doctor who says, "The operation was a success, but the patient died"? That's how some clients feel about EMDR. They succeed in accessing deep and important material, but find themselves extremely depressed and/or anxious in the days afterward. For these clients, who are often survivors of multiple trauma such as long-tenn child abuse or incest, the ability to self-soothe (both during and after an EMDR session) makes the difference between whether they regard EMDR as a useful tool or a necessary evil. To find out what self-control techniques work best for such clients, I interviewed EMDR clients (all women) who had experienced long-term sexual abuse in childhood. The first thing I learned was that for survivors of multiple trauma, the ability to feel safe starts long before EMDR is ever used. Many women cited their relationship with their therapist as the foundation of their feeling safe with EMDR: "I trust my therapist absolutely." One client's therapist told her he had used EMDR himself: "That made a huge difference to me," she said. Other advance work included planning and taking preventative measures. Planning means picking the right time (and pace) for doing EMDR: being sure the therapist and/or other support people will be available in the days after the session; not driving or going back to work afterward (if possible); being able to have plenty of alone time; and going slowly, doing EMDR in small increments. "I didn't expect myself to go out in the world and be social afterward. I was pretty raw for a few days, sometimes for a whole week," B. told me. Planning also means taking preventive measures, such as teaching the client how to find "a safe place." Most clinicians know the importance of this, but one of the women I interviewed was emphatic that creating a safe place was very different from being able to go to it when she was in a session and reliving the experience of being a three-year-old overwhelmed by extreme grief or terror. She said she needed a lot of practice accessing her safe place and some special interventions (see below) to get through the intense times. Being able to self-soothe between sets of eye movements was very difficult for most clients. "I cry all the time we do it," S. told me. "I have to sit near the door and not have my therapist sit too close," said M. Another woman said, "We do the eye movements for a few seconds and we talk in between."One successful intervention, especially for clients overwhelmed by the intensity of their feelings, involved the therapist asking his client to listen to the sound of his breathing and to breathe along with him. Another clinician has his client when she gets extremely upset ask her "inner guide or "higher power" whether it's "okay to continue;" a third asks, "Is there more underneath or is it time to wind down?" Letting the client control the pace and progress of his/her own processing can be an important way to teach self-trust -- especially to people for whom loss of power was endemic to their abuse. Some clients are able to repeat special phrases or afirmations over and over between sets to calm themselves. L., a ritual abuse survivor, said she grounds herself by silently reciting a mindfulness verse from Zen master Thich Naht Hanh in time with her inbreath and out-breath: "In, out. Deep, slow, Calm, ease. Smile, release. In, out. Deep, slow ...... Different kinds of self-soothing techniques work best after the eye-movement sets are completed. Immediately afterwards, while still in session, one client said she falls asleep for a few minutes -- she finds this a big help in countering the dissociated state in which she typically concludes an EMDR session. Another said she and her therapist share a cup of tea and talk over what happened as a way to "come down" and normalize the experience. Some clinicians close a session by doing eye movements to reinforce the client's safe place. One woman said her therapist has her "cement the present in place" by doing eye movements on either a present-day image, an image of her inner child in the safe place, or a positive statement. Francine Shapiro has often said that what happens after the EMDR session can be as important as what happens during it. The women I interviewed felt exactly the same way. They had learned the necessity of talung exquisitely good care of themselves in the hours and days that follow. "I take time-and time out," declared B., who often has a delayed fear reaction following EMDR. Most clients said they go home and either curl up in bed or in a favorite rocking chair with their stuffed animals. They cry, sleep, write in their journals, draw pictures, listen to music, look at favorite photographs, and/or call a support person. M. uses self-talk to ease her feelings: "I say to myself, 'You know that knot of fear. I know it's only fear. I know that nothing is going to hurt me right now'." For others, going home immediately is not the best option: D. takes a walk along the shores of Long Island Sound; C., the mother of three young children, finds solace in a favorite bookstore. Sometimes all the planning in the world doesn't help: the abreaction seems to launch the client back to the age she was when she was abused - and she simply can't remember how to calm herself. To counter this, several clients said they carry a list of things they can do to quiet themselves. S. finds reading mystery stories comforting("At the end you always find out what really happened."), but has to keep two of them on her bedside table at all times: "If they're not in full view, I forget about using them." One interesting example of "assigned" self-soothing was given by a ritual abuse survivor who was new to EMDR. After a session when a lot of memories came up about how her sexuality was used and degraded during the abuse, her therapist gave her very specific instructions on how to care for herself, including buying a romantic nightgown and soaking in bath salts for 45 minutes; listening to romantic music; and not touching or kissing her partner for 48 hours. "It worked out great!" she told me happily. "I felt SO pretty and so safe." The conclusion I reached about how multiple-trauma survivors learn to self-soothe in the face of the intense feelings EMDR can trigger is not revolutionary. The recipe is: Step 1. Plan for the worst. Step 2. Let the client select the self-soothing techniques that specifically fit for her or him. Step 3. Make sure s/he is able to use these techniques no matter how intense his/her emotions are. Sometimes this will call for the therapist to take an active role by either leading the client in specific calming techniques or by assigning very clear-cut homework. If the recipe calls for planning and practicing, then the pot in which the ingredients are cooked is labeled "TRUST"-trust before initiating EMDR, trust during the eye movements, and trust after the sets are completed. Unless the client deeply trusts the clinician, the method itself, and his or her own capacity to go into the feelings and me out safely, the recipe for success with EMDR can turn into a recipe for disaster.

Keywords: Survivor  Trauma  

Accuracy Verified: Yes

40. Dworkin, M. (2010, March). Solving transference and counter-transference with dissociative disorders in EMDR. Presentation at the 8th EMDR Association UK & Ireland Annual Conference & AGM, Dublin, Ireland.

Language: English

Format: Conference

Abstract:
Chair, Michael Paterson
This workshop will focus on the types of transference and counter-transference that arise in EMDR with dissociative clients and teach solutions. Procedural modifications have been the focus in dealing with pathological dissociation in EMDR treatment. Separately, transference and counter-transference with dissociative patients have been written about extensively by experts in the dissociation field. Research findings about the effects of mirror neurons and embedded simulation on the inter-subjective field of patient and therapist have also been published. Strategies for dealing with these transference and counter-transference in EMDR treatment have received little attention even though this population has intense transference, and can activate intense counter-transference. These issues may begin during an evaluation of the presenting problems. Strategies for identifying and using transference to enhance dual awareness during history taking will be demonstrated. An elongated preparation phase to develop enough trust and stabilization before exploring traumatic memories can limit induced transference. Different parts of a dissociative patient may have different kinds of transferences. These transferences may cause the patient to withdraw, cling or attack; affecting the therapist’s abilities to stay attuned and focused on the work in different phases of EMDR. Strategies of attunement to the activated part of the client will be demonstrated in order to repair or prevent ruptures of attunement. Interactions are bi-directional, and different (transferential) parts may activate dissociative parts of the therapist. Strategies to somatically identify and use these counter-transferential activations in the therapist will be taught through body based awarenesses. R/D/I strategies can be used to limit countertransference to remain grounded and attuned. Transference and counter-transference during the assessment phase will be identified and solutions presented. During the Desensitization phase under-accessing or over-accessing target memories; abreaction vs. vehement emotions will be discussed as unacknowledged dissociative moments with indications for inducing transference, counter-transference, or both. Decisions need be made collaboratively whether to process or contain these events. Understanding and dealing with dilemmas of dissociative enactments are crucial to keeping the healing process going. These inter-subjective issues may be most intense during the first four phases, but some problems may continue into Installation and the Body Scan. Problems and solutions during Incomplete Closure and the Re-evaluation phases will be given. Activated parts in the patient may cling or be angry with the therapist at the end of an EMDR session. Failure or defectiveness parts of the therapist may become activated as well. Solutions to these issues that occur during different phases will be taught so that participants will leave the workshop with additional strategies to use with their dissociative patients. Attunement to dissociative parts, identifying transference and counter-transference binds; The Clinician Self Awareness Questionnaire ; Compartmentalization; use of self soothing skills; using Relational, Empathic, and Transferential Interweaves; identifying moments of projective identification and enactments, and then to use them to deepen EMDR will be taught, as well as innovative inter-subjective strategies . Case examples and awareness exercises will used throughout the workshop to facilitate intellectual and experiential learning.

Keywords: Counter-transference  Dissociative Disorders  Transference  

Accuracy Verified: Yes

41. Zantvoord, J. (2012, November). Trauma focused psychotherapies from a neurodevelopmental perspective: fMRI and physiological pilot outcome data from a RCT conducted in the Netherlands with children suffering from PTSD. Symposium conducted at the 28th annual meeting of the ISTSS, Los Angeles, CA.

Language: English

Format: Conference

Abstract:
Neurobiological treatment outcome studies in adults with PTSD have shown that successful treatment is associated with changes in activity of frontal brain areas and the amygdala, brain areas which are involved in fear conditioning and extinction. Frontal brain regions undergo considerable maturation during childhood and adolescence and only reach anatomical and functional maturity well within the third decade of life. In this light, results obtained in neurobiological studies in adults can’t be readily translated to children and adolescents. Neurobiological treatment outcome studies in children with PTSD are thus required, yet are almost nonexistent to date. Neurobiological treatment outcome studies addressing the mechanism involved in treatment response or non response can contribute to improve treatment strategies for non responders especially for treatment non responders and in time help clinicians to tailor treatment for individuals with PTSD. In this part of the symposium we will present treatment outcome data of our neurobiological pilot study conducted in children with PTSD in the Netherlands. Children aged 8 to 18 with PTSD were randomly assigned to receive either 8 sessions of manualized Trauma Focus cognitive behavioral therapy or EMDR. fMRI data of a working memory task with emotional distracters and physiological data obtained during script driven imagery will be presented. Treatment outcome results will be placed in a neurodevelopmental framework.

Keywords: Children, fMRI  Netherlands  Neurodevelopment  Pilot  Posttraumatic Stress Disorder  PTSD  Random Control Trial  RCT  

Accuracy Verified: Yes

42. Loibl, B. (2009). Traumatherapeutische elemente in der akutphase - Der ansatz des eye movement dezensitization and reprocessing (EMDR)...[Trauma therapeutic elements in the acute phase - The approach of the eye movement desensitization and reprocessing (EMDR)...] . In B. Loibl, Psychische Traumatisierungsprozesse beim Grundschulkind nach Elternsuizid: Ursachen, Warnsignale, Akutmassnahmen [Mental traumatisation the primary school child to parent suicide: causes, warning signs, acute measures,] (pp. 70-78), Protestant University of Applied Sciences Dresden, GRIN Verlag für Akademische Texte, 129 p. ISBN (eBook): 978-3-640-30050-1, ISBN (Book): 978-3-640-30533-9, DOI:10.3239/9783640300501.

Language: German

Format: Book Section

Abstract:
In der vorliegenden Arbeit geht es im Nähren um die Darstellung dreier Sachverhalte. Zum einen soll das elternbezogenen Bindungsgefüge beleuchtet werden, welches konstitutiv einen Einfluss auf die gesunde biopsychosoziale Entwicklung eines Kindes nimmt. Die irreversible Auflösung dieser fundamentalen Beziehung beansprucht weiterhin die Erörterung des kindlichen Verlusterlebens und des daraus resultierenden physischen, psychischen und sozialen Gefährdungspotenzials. Dahingehend wird besonders eine Betrachtung hinsichtlich der emotionalen Schemata des Trauerns relevant sowie gegenüber den damit korrespondierenten Phänomen der psychischen Traumatisierung. Letztlich wird es von Bedeutung sein, Hilfeinterventionen zu beleuchten, die einer Gefährdung des Kindes entgegenwirken. Da meine berufliche Handlungsfähigkeit im Arbeitsfeld der Notfallversorgung verankert ist, möchte ich diesbezüglich nach der Möglichkeit von Sofortmassnahmen suchen, die unmittelbar nach dem Verlusterlebnis eingeleitet werden können. Hinsichtlich dieser Betrachtungsweise lassen sich zwei thematische Fragestellungen formulieren. (1) Welche Relevanz übt eine Eltern-Kind-Beziehung auf die kindliche Entwicklung aus und inwieweit leitet ihre Auflösung, im Kontext eines Eltersuizides, eine mögliche trauma-basierende, psychopathologische Störung des Kindes ein? (2) Welche Massnahmen der kindlichen Akutbetreuung lassen einen adäquaten Beitrag zur kognitiven und emotionalen Rehabilitierung des Kindes versprechen?

In the present work is in nurturing the image of three issues. On the one hand, the parents moved into bond structures are illuminated, which constitutively takes a biopsychosocial influence on the healthy development of a child. The irreversible resolution of this fundamental relationship claims continue to discuss the child's loss experience and the resulting physical, mental and social potential hazard. To that effect, is a consideration particularly with regard to the emotional patterns of mourning and relevant in relation to the phenomenon of psychological trauma that korrespondierenten. Ultimately, it will be important to shed light on using interventions to counter the threat of the child. Since my professional capacity is rooted in the working field of emergency care, I would look in this regard to the possibility of immediate measures that can be initiated immediately after the loss experience. Regarding this approach can be formulated in two thematic issues. (1) What relevance exerts a parent-child relationship on child development and how far forward its resolution in a context of parental suicide, a possible trauma-based, psycho-pathological disorder of the child? (2) What measures of children's emergency care can be an adequate contribution to cognitive and emotional rehabilitation of the child's promise?

Keywords: Trauma  Treatment  

Accuracy Verified: Yes

43. Hogberg, G., Pagani, M., Sundin, Ö., Soares, J., Aberg-Wistedt, A., Tarnell, B., & Hallström, T. (2008, May). Treatment of post-traumatic stress disorder with eye movement desensitization and reprocessing: Outcome is stable in 35-month follow-up. Psychiatry Research, 159(1-2), 101-108. doi:10.1016/j.psychres.2007.10.019.

Language: English

Format: Journal

Abstract:
PTSD is an anxiety disorder that may follow major psychological trauma. The disorder is longstanding, even chronic, and there is a need for effective treatment. The most effective short-term treatments are cognitive behavioural therapy and eye movement desensitization and reprocessing (EMDR). 20 subjects with chronic PTSD following occupational health hazards from "person under train" accidents or assault at work were treated with five sessions of EMDR. They were assessed with psychometric scales and diagnostic interviews before treatment, directly after treatment, at 8 months, and at 35 months after the end of Therapy. The primary outcome variable was full diagnosis of PTSD according to the DSM-IV diagnostic criteria. Results from interview-based and self-evaluation psychometric scales were used as secondary outcome variables. Immediately following treatment, the patients were divided up into two groups, initial remitters (12 of 20) and non-remitters (8 of 20). There were no drop-outs during therapy, but 3 patients withdrew during follow-up. The initial result was maintained at the 35-month follow-up. The secondary outcome variables also showed a significant immediate change towards normality that was stable during the long-term follow-up. After 3 years of follow-up, 83% of the initial remitters had full working capacity. [Author Abstract]

Keywords: Accidents  Adults  Assault  Conditioning  Follow-up Study  Longitudinal Study  Occupational Health  Posttraumatic Stress Disorder  Psychotherapy  PTSD  Railroad Accidents  Swedes  Transport Workers  Treatment Effectiveness  

Accuracy Verified: Yes

44. Grant, M. (2001). Understanding and treating chronic pain as trauma, with EMDR. Author.

Language: English

Format: Other

Abstract:
It is generally accepted that pain, particularly chronic pain, involves psychological factors, whether as a reaction to pain (Fordyce 1975; Turk & Meichenbaum, 1989) or as a predisposing factor for pain (Engel, 1959, Goodwin & Attias, 1999). Different theoretical approaches emphasize the role of psychological factors differently. For example, Cognitive- behavioral approaches emphasize people’s reactions [to injury and pain] as a factor in causing and maintaining pain. One of the main theoretical constructs of CBT is secondary gain which is based on operant conditioning and posits that pain can be maintained by ‘rewards’ such as too much attention or sympathy. Psychodynamic approaches place more emphasis on pre-existing trauma and emotional states as a causal factor for chronic pain (Engel, 1959, Goodwin & Attias, 1999). One of the main psychodynamic theories of pain is .. which posits that pain is .. There is evidence to suggest that there is some truth to both approaches. However, the research regarding behavioral theories of chronic pain has often produced mixed results (..) and been found to have many problems (King..). However, there is reliable data to suggest that trauma and emotional processes associated with trauma are often associated with chronic pain.

Keywords: Chronic Pain  Trauma  

Accuracy Verified: Yes

45. Ponzano, R. A., & Gozzano, E. (2008, June). Use and consumption of the traumatic experience as a defence from pain: EMDR and defence mechanisms. Poster session presented at the annual meeting of the EMDR Europe Association, London, England.

Language: English

Format: Conference

Abstract:
Objective: to illustrate the EMDR usefulness within the psycho-dynamical therapy. Foreword: a type of pain exists that’s nameless and inenarrable. During our psycho-dynamical practice as EMDR specialists, we met various defensive modalities adopted by patients presenting diverse pathologies to elude grief associated to that type of pain left segregated within the emotional portion of the brain. In particular, we take into account patients keen to coactively repeat the traumatic experience either directly in-person or through using others. The presumption is that the traumatic experience, when too early, too invasive or reiterated, may render it impossible to be expressed verbally (by use of the cortex), leading to express it either through the body or through reiterated use of the traumatic experience itself (coactions to repeat). This last point, within our clinical experience, seems being linked to ambivalent feelings vs. the very resolution of the experience itself (healing). Patients living this type of situation may namely be entangled by two conflicting wishes to either wish a real improvement of their condition or to seek maintaining that pathology in the fear of loosing the sense of security inspired them by the type of fake identity they built around the trauma. Benefits: using the technique of bilateral sensorial stimuli strives breaking off that defensive mood that feeds pathological coactions to reiterate the experience as the means to tolerate the grief. Namely its purpose is to penetrate through those defensive modalities and to successfully aid patients to abandon them thanks to a low structured context adequately freed by internal or external conditioning (ambivalence, judgement, rationalization, etc.).

Keywords: Defense Mechanisms  Pain  

Accuracy Verified: Yes

46. Zantvoord, J. B., Diehle, J., & Lindauer, R. J. (2013, March). Using neurobiological measures to predict and assess treatment outcome of psychotherapy in posttraumatic stress disorder: Systematic review. Psychotherapy and Psychosomatics, 82, 142-151. doi:10.1159/000343258.

Language: English

Format: Journal

Abstract:
Background: Trauma-focused cognitive-behavioral therapy (TF-CBT) and eye movement desensitization and reprocessing (EMDR) are effective treatments for posttraumatic stress disorder. However, little is known about their neurobiological effects. The usefulness of neurobiological measures to predict the treatment outcome of psychotherapy also has yet to be determined. Methods: Systematic review of randomized controlled trials (RCTs) focused on neurobiological treatment effects of TF-CBT or EMDR and trials with neurobiological measures as predictors of treatment response. Results: We included 23 publications reporting on 16 separate trials. TF-CBT was compared with a waitlist in most trials. TF-CBT was associated with a decrease in heart rate and blood pressure and changes in activity but not in volume of frontal brain structures and the amygdala. Neurobiological changes correlated with changes in symptom severity. EMDR was only tested against other active treatments in included trials. We did not find a difference in neurobiological treatment effects between EMDR and other treatments. Publications on neurobiological predictors of treatment response showed ambiguous results. Conclusion: TF-CBT was associated with a reduction of physiological reactivity. There is some preliminary evidence that TF-CBT influences brain regions involved in fear conditioning, extinction learning and possibly working memory and attention regulation; however, these effects could be nonspecific psychotherapeutic effects. Future trials should use paradigms aimed specifically at these brain regions and physiological reactivity. There are concerns regarding the risk of bias in some of the RCTs, indicating that methodologically more rigorous trials are required. Trials with neurobiological measures as predictors of treatment outcome render insufficient results to be useful in clinical practice. Copyright © 2013 S. Karger AG, Basel.

Accuracy Verified: Yes

47. Dworkin, M. (2008, June). Using the therapeutic relationship in EMDR with patients with complex PTSD. Presentation at the annual meeting of the EMDR Europe Association, London, England UK.

Language: English

Format: Conference

Abstract:
Now that the therapeutic relationship is firmly part of EMDR, it is time to show its uses with difficult populations. Skilful emphasis on empathic attunement beginning in the history taking phase with emphasis on using the Procedural Steps Outline diagnostically, and Light stream as an affect management tool, starting in the first session will be shown to be of use specifically with this population. This population needs special attention regarding alterations in affect regulation, self perception, consciousness and attention, somatisation, trust, and identity. In the preparation phase participants will learn various relational strategies to accomplish these tasks. They will also learn to use the relationship as an additional resource for containment with appropriate boundaries. Relational concepts such as “Implicit Relational Knowing”, “Moments of Meeting”, and “Dyadic Expansion of Consciousness” will be taught to expand methods of stabilization for preparation, and for active trauma work. Modifications of active trauma work using active resourcing; titrating or dosing; treating transference and counter transference phenomenon will all be demonstrated to enhance EMDR work with complex PTSD and Dissociation. Dworkin's Trauma Case Conceptualization Questionnaire and his Clinician Self Awareness Questionnaire will be taught and used to

Keywords: Complex Posttraumatic Stress Disorder  Complex PTSD  C-PTSD  Therapeutic Relationship  

Accuracy Verified: Yes

48. Donneau, D., Barry, S., Heteau, C., Hamrioui, M., Journniac, K., Ferric, O., Heron, A., & Paris, P. (2012, Decembre). Utilisation de l'outil EMDR pour améliorer la prise en charge des psycho-traumatismes dans un service d'urgence psychiatrique [Using EMDR tool to improve the management of psychological trauma in a psychiatric emergency service ]. Poster présenté au 40ème Congrès annuel de l'Association Française de Thérapie comportementale cognitive de et), Paris, France.

Language: French

Format: Conference

Abstract:
Problématique : L’outil thérapeutique EMDR est recommandé par l’HAS dans la prise en charge du psycho-traumatisme. Mais comment le mettre en place en pratique dans nos unités d’urgence psychiatrique ? Méthode : La structuration suit les 8 phases du protocole validé, dont la « préparation » où l’on détermine l’indication et les cibles à traiter , une phase « ressources » indispensable dans les traumatismes complexes et en cas de risque de déstabilisation. Enfin, la phase de « désensibilisation des cognitions inadaptées et « d’installation » des cognitions plus adaptées amenant à une restructuration cognitive. Résultats : 83 patients (sex ratio=0.76) ont mobilisé 330 interventions, soit 3.9 interventions/patient en moyenne. Ces PEC ont conduit à 6% de séances complètes de désensibilisation à l’impact de souvenir traumatique, 10% de séances incomplètes de désensibilisation, 13% d’arrêts précoces en raison d’une déstabilisation persistante ce qui est la Contre-Indication fonctionnelle principale . Dans le cas des traumatismes récents, l’efficience de l’EMDR a été confirmée avec un nombre moyen de 3 séances de 90 min par patient, permettant d’obtenir une désensibilisation complète. Dans les cas de traumatismes complexes, le nombre de séances de préparation est plus important (>5 séances) car ils nécessitent une recherche de ressources. Discussion : L’EMDR est un outil utilisable aux urgences psychiatriques qui peut être très efficace dans le cas de traumatismes récents et simples. Le protocole est structurant et permet ainsi une bonne implication des patients et des intervenants. Mais cela nécessite une formation exigeante et couteuse. L’organisation est plus difficile dans le cas des traumatismes complexes, anciens, avec comorbidités psychiatriques. L’espacement des séances de 10j est difficile à respecter en pratique hospitalière, elles sont chronophages et fatigantes, aussi bien pour le soigné que le soignant. Projet : à la suite de cette observation, démontrer en 2013 que cette approche pourrait réduire la durée d’hospitalisation et la fréquence des récidives dans les cas de troubles de la personnalité souvent associés à des traumatismes anciens en permettant en quelque sorte d’activer une restructuration cognitive.

Problem: The EMDR therapeutic tool is recommended by the HAS in the management of psychological trauma. But how to set up in practice in our emergency psychiatric units? Method: The structure follows the eight phases of the validated protocol, the "preparation" where we determine the indication and the target process, a phase "resources" essential in complex trauma and in case of risk of destabilization. Finally, the phase of "desensitization inadequate cognitions and" installation "cognitions leading to a more appropriate cognitive restructuring. Results: 83 patients (sex ratio = 0.76) mobilized 330 interventions, or 3.9 interventions / patient on average. These PEC led to 6% of full sessions of desensitization to the impact of traumatic memories, 10% incomplete desensitization sessions, 13% of stops early due to a persistent destabilization which is the main functional Counter Indication . In the case of recent trauma, EMDR efficiency was confirmed with an average of 3 sessions of 90 minutes per patient to obtain a complete desensitization. In cases of complex trauma, the number of preparation sessions is larger (> 5 sessions) because they require research resources. Discussion: EMDR is a useful tool for psychiatric emergencies that can be very effective in the case of recent trauma and simple. The protocol allows structuring and good involvement of patients and stakeholders. But it requires a demanding and costly. The organization is more difficult in the case of complex trauma, elders with psychiatric comorbidities. The spacing of sessions 10j is difficult to achieve in hospital practice, they are time consuming and tiring for both the cared caregiver. Project as a result of this observation, in 2013 demonstrate that this approach could reduce the duration of hospitalization and the frequency of relapses in cases of personality disorders often associated with trauma Oldest to somehow activate a cognitive restructuring.

Keywords: Emergency Service  Trauma  

Accuracy Verified: Yes