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. Korn, D., Weir, J., & Rozelle, D. (2005, June). Beyond the data: Clinical lesions learned from a four-year treatment outcome study comparing EMDR to prozac. Plenary presented at the annual meeting of the EMDR Europe Association, Brussels, Belgium.
Language: English
Format: Conference
Abstract:
"Bridging the gap between research and clinical practice" is a challenging
and elusive goal. Outcome data, while critical for the legitimacy and
advancement of clinical work, often fail to translate into practical skill sets. It
is only when clinicians look beyond the data that they learn some of the
most valuable lessons of research.
In this session, we will present the results of a four-year, randomized
controlled study comparing EMDR to Prozac in the treatment of PTSD. We
will also explore the clinical and practical lessons learned throughout the
study. We will address assessment and history taking, treatment planning,
readiness for processing, target selection. transference and
countertransference, and adult versus childhood onset trauma.
We hope to give EMDR practitioners an in-depth analysis of the real-life
processes, dilemmas, and learning that took place during our protocol based
treatment outcome study. Video segments will be used to illustrate
clinical concepts and key points. And perhaps, most importantly, these
same segments will be used to demonstrate how we struggled to recognize
and learn from our own mistakes.
Accuracy Verified: Yes
5. Leeds, A., & Mosquera, D. (2012, October). Borderline personality disorder and EMDR. Presentation at the annual meeting of the EMDR International Association, Arlington, VA.
Language: English
Format: Conference
Abstract:
BPD patients present difficulties with self-regulation and relating to others. The management of these difficulties is central to the treatment of BPD. Working with cases of BPD and complex trauma is intrinsically relational, often involving the need to manage moments of intense affect and affect phobias in the transference and countertransference. Understanding and having strategies for addressing these issues is essential. This workshop integrates theoretical exposition with the presentation of videos cases. The general structure of EMDR therapy in treating BPD and interventions for the preparation phase and considerations for trauma-focused EMDR work will be demonstrated and explained.
Keywords: Borderline Personality Disorder
Accuracy Verified: Yes
6. Goldman, J., & Coane, J. (2010, October). A case of strategic collaboration: Two therapists and one DDNOS patient in end phase treatment. Presenttion at the 27th Annual Meeting of the International Society for the Study of Trauma and Dissociation, Atlanta, GA.
Language: English
Format: Conference
Abstract:
A colleague, experienced in DID treatment, was
invited to collaborate by the primary therapist in the
end phase of treatment to facilitate patient movement
through the introduction of EMDR. The nature of the
collaborative relationship, its influence on transference
and countertransference, the contribution of the
different genders of the two therapists, as well as
issues of launching the patient more fully into adult
life as influenced by the collaboration will be explored. The rationale for introducing EMDR as well as its specific contribution will be explicated. The argument for therapeutic collaboration, as related to the patients
history and treatment process, will also be addressed.
Participants will be able to :
♦♦ List the indications for initiating adjunctive treatment.
♦♦ assess the effects of collaboration.
♦♦ appraise the treatment trajectory to decide
when to bring in another modality.
Keywords: DDNOS
Accuracy Verified: Yes
7. 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
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. Groenendijk, M. (2012, June). A demonstration of EMDR in the second phase of trauma-treatment of DID [Una demostración de EMDR en segunda fase del tratamiento de Trastorno de identidad disociativo]. Presentation at the annual meeting of the EMDR Europe Association, Madrid, Spain.
Language: English
Format: Conference
Abstract:
This
workshop
is
about
the
application
of
EMDR
in
the
treatment
of
secondary
and
tertiary
structural
dissociation
with
survivors
of
early
chronic
traumatization.
The
succeeding
of
the
EMDR
sessions
in
the
treatment
of
DID,
depends
mainly
on
the
appropriate
indication
and
a
thorough
preparation.
How
to
do
this
in
clinical
practice,
will
be
pointed
out
in
this
presentation.
What
follows
is
an
explanation
of
the
process
(and
the
essential
elements
in
it)
of
the
integration
of
traumatic
memories
and
this
process
will
be
demonstrated
by
a
dvd
of
Maria,
an
woman
with
DID.
We
can
select
and
analyze
particular
scenes,
depending
on
the
requests
from
the
audience.
For
example
scenes
about
confirming
positions
of
ANP's
and
EP's
at
the
beginning
of
the
session,
attacking
the
NC
by
the
self-‐destructive
part,
guiding
reliving
experiences,
presentification,
coping
with
anger,
differentiating
between
the
past
and
the
present,
personification,
preventing
the
flight-‐reaction,
coping
with
transference
and
facilitate
internal
cooperation.
After
reporting
on
the
outcome
of
this
therapy,
the
conclusion
will
be
that
EMDR
can
be
effective
for
dissociative
patients
if
several
specific
criteria
are
met.
These
criteria
are
about
conceptualization
according
to
the
model
of
structural
dissociation,
about
indication,
timing
and
preparation
of
the
sessions,
about
adaptations
in
the
EMDR-‐protocol
and
about
integration
of
EMDR
in
the
broader
phase-‐oriented
treatment
of
DID.
Este
taller
trata
la
aplicación
de
EMDR
en
el
tratamiento
de
disociaciones
estructurales
secundarias
y
terciarias
con
supervivientes
de
la
traumatización
crónica
temprana.
El
éxito
de
la
sesiones
de
EMDR
en
el
tratamiento
de
Trastornos
de
identidad
disociativo,
depende
principalmente
de
unas
instrucciones
apropiadas
y
una
dura
preparación.
Como
hacer
esto
en
la
práctica
clínica
será
el
tema
de
esta
presentación.
Continuaremos
con
una
explicación
del
proceso
(y
los
elementos
esenciales
dentro
de
este)
de
la
integración
de
los
recuerdos
traumáticos
y
este
proceso
será
demostrado
en
el
DVD
de
María,
una
mujer
con
trastorno
de
identidad
disociativos.
Podemos
señalar
y
analizar
escenas
particulares,
dependiendo
de
las
peticiones
que
hagan
los
participantes
a
la
presentación.
Por
ejemplo,
escenas
acerca
de
la
confirmación
de
posiciones
de
ANP
y
EP
al
principio
de
la
sesión,
atacando
al
NC
por
la
parte
autodestructiva
del
yo,
guiando
y
reviviendo
experiencias,
atención
al
presente,
gestionar
la
ira,
diferenciar
entre
pasado
y
presente,
personificación,
prevenir
la
evitación,
afrontar
la
transferencia
y
facilitar
la
cooperación
interna
Después
de
informar
acerca
de
los
resultados
de
la
terapia,
la
conclusión
es
que
el
EMDR
puede
ser
efectivo
para
pacientes
disociados
si
cumplen
muchos
requisitos
previos.
Este
criterio
es
sobre
la
conceptualización
de
acuerdo
con
el
modelo
estructural
de
disociación,
sobre
la
indicación,
temporalización
y
preparación
de
las
sesiones,
sobre
las
adaptaciones
del
protocolo
del
EMDR
y
la
integración
del
mismo
en
un
tratamiento
más
amplio
en
fases
del
tratamiento
del
Trastorno
de
Identidad
Disociativo.
Keywords: DID Dissociative Identity Disorder
Accuracy Verified: Yes
10. Titze, M. (1997). EMDR - Unterstützte thematisierung bei psychodynamisch fundierten fokaltherapien [EMDR - Supported theming in-depth psychodynamic focal therapy]. In C. T. Eschenröder: EMDR. Eine neue Methode zur Verarbeitung traumatischer Erinnerungen (pp. 179-188). Tübingen: DGVT-Verlag.
Language: German
Format: Book Section
Abstract:
Lange Zeit galt eine im Sinne der psychoanalytischen Standardmethode durchgeführte Langzeittherapie als qualitativ besonders hochstehend. Dabei ließ sich argumentieren, dass die entscheidenden Eckpfeiler des analytischen Prozesses (Erinnern, Wiederholen, Durcharbeiten) einer zeitaufwendigen Methodik (freie Assoziation, "gleichschwebende Aufmerksamkeit" und regressionsfördernde Zurückhaltung / Schweigen des Analytikers, Übertragungs- und Widerstandsdeutungen usw.) bedürfen (vgl. Thomä & Kächele, 1989). Eine unbestreitbare methodische Schwäche dieser Vorgehensweise resultiert allerdings aus dem Verzicht auf eine aktive Strukturierung durch den Analytiker. Dies kann dazu führen, dass sich manche Klienten in der realen therapeutischen Beziehung allein gelassen bzw. nicht ernst genommen fühlen. Eine nicht selten mehrjährige Behandlungsdauer kann zudem eine Unzufriedenheit hervorrufen, die dann zu realen Widerstandstendenzen auf Seiten des Klienten führen wird, wenn ein spürbarer Behandlungserfolg ausblieb (vgl. dazu Eschenröder, 1986, Kap. 11). Doch es sind nicht allein solche Einwände, die zu einer Relativierung der Bedeutung von analytischen Langzeittherapien geführt haben. Es waren auch reale ökonomische Gegebenheiten, die diese Bedeutung in den letzten Jahren zunehmend in Frage gestellt haben. Nachdem nämlich, zunächst in den Vereinigten Staaten, die Versicherungen dazu übergegangen sind, nur eine stark begrenzte Anzahl psychothe-rapeutischer Leistungen zu erstatten, kam es auch im Bereich der Tiefenpsychologie zu einer verstärkten Hinwendung gegenüber kurzzeittherapeutischen Verfahren (vgl. Goleman, 1981).
Long considered a standard in the sense of the psychoanalytic method carried out as long-term therapy of particularly high standing. It could be argued that the crucial cornerstone of the analytical process (remembering, repeating, working through) a time-consuming method require (free association, evenly suspended attention "and regression-promoting restraint / silence of the analyst, transference and resistance interpretations, etc.) (see Thoma & Kächele, 1989). One undoubted methodological weakness of this approach, however, results from the absence of an active structure by the analyst. This can cause that some clients feel in the real therapeutic relationship alone and not taken seriously. An often multi-year duration of treatment may also cause discontent that will lead to real resistance tendencies on the part of the client when a substantial treatment effect failed to (cf. Eschenröder, 1986, Chapter 11). But it is not only an objection that led to a relativization of the importance of long-term analytic therapies. There were also real economic conditions that have made this meaning in recent years increasingly in question. After that is to report first in the United States, the insurance companies have started, only a very limited number of psychotherapy therapeutic services were also provided in the field of depth psychology (1981 cf. Goleman,) to an increased turn over short-therapeutic procedures.
Keywords: Focal Therapy
Accuracy Verified: Yes
11. 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
12. 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
13. 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
14. Woller, W. (2003). EMDR in der psychotherapie von persönlichkeitsstörungen [EMDR in the treatment of personality disorders]. Zeitschrift für Psychotraumatologie und Psychologische Medizin (ZPPM), 1(3), 17-24.
Language: German
Format: Journal
Abstract:
Behandlung psychotraumatischer belastungsstörungen mit EMDR
Die Arbeit stellt dar, (1) welche Modifikationen oder Einschränkungen sich für die Behandlung Posttraumatischer Belastungsstörungen mit EMDR durch die Präsenz komorbider Persönlichkeitsstörungen ergeben und (2) welche Möglichkeiten EMDR darüber hinaus für die Behandlung von Persönlichkeitsstörungen ohne die Symptomatik einer PTBS bieten kann. Beim Vorliegen einer Persönlichkeitsstörung muss EMDR in einen Gesamtbehandlungsplan integriert werden, der neben umfassender Stabilisierung, Symptomkontrolle und Ressourcenaktivierung die Modifikation verzerrter interpersoneller Wahrnehmungsmuster und maladaptiver Interaktionsmuster umfasst. Probleme der therapeutischen Arbeitsbeziehung können die Stabilisierungsphase schwierig und zeitaufwändig gestalten. Die EMDR-Technik muss entsprechend dem Typ der Persönlichkeitsstörung, der Abwehrstruktur und der symptomatischen Komorbidität modifiziert werden. Zusätzlich zur Behandlung von Traumatisierungen kann EMDR zur Bewältigung aktueller und künftiger Stressoren und zur Ressourcenstärkung eingesetzt werden.
EMDR has been shown to be an effective treatment method in posttraumatic stress disorder (PTSD). There is a marked comorbidity between PTSD and personality disorders, some of which have been found to be long-term sequelae of cumulative childhood physical and sexual traumatization. Personality disorders are also included in the concepts of "complex PTSD" and "DESNOS". The paper discusses (1) modifications and limitations of EMDR technique required for treatment of posttraumatic stress disorder with comorbid personality disorders, and (2) further applications of EMDR in the treatment of personality disorders without PTSD. If comorbid personality disorder is present, EMDR has to be integrated into a complex treatment plan which includes stabilization, symptom control, resource installation, identification of distorted interpersonal perceptions, and modification of maladaptive interpersonal interactions. Because of the central role of generalized negative beliefs in maintaining cyclical maladaptive patterns, EMDR is regarded a valuable tool to modify negative beliefs along with processing traumatic memories and body sensations. Problems of therapeutic alliance due to transference phenomena and acting-out can make stabilization difficult and time-consuming. EMDR technique should be subjected to important modifications depending on personality disorder subtype, defence structure and symptomatic comorbidity. Structural dissociations of the personality (e.g. as in dissociative identity disorder) call for a consideration of all ego-states of the personality system before planning EMDR treatment. In addition to unresolved trauma, current and future interpersonal stressors can be chosen as EMDR targets.
Keywords: Personality Disorders
Accuracy Verified: Yes
15. Parnell. L. A. (1999, June). EMDR in the treatment of adults abused as children. Presentation at the annual meeting of the EMDR International Association, Las Vegas, NV.
Language: English
Format: Conference
Abstract:
Participants will: 1) be able to describe the three phases of treatment; 2) be able to use at least three ego strengthening methods using EMDR, including identification, development, and installation of inner and outer resources important for preparing clients for EMDR processing, such as: safe place, positive
internal resource images, such as the inner advisor child-self – adult-self assessment and
development, nurturer and protector figures,
spiritual resources, positive memories, images from nature, and others; 3) learn tips for successful target development; 4) learn how to develop and use special targets for EMDR processing such as: visual memories, including flashbacks; dreams; artwork; emotions, physical sensations, and body memories;
TV shows and movies; and negative cognitions; 5) learn helpful modifications to the standard EMDR procedural steps; 6) learn at least two interventions to help clients who experience problems during EMDR processing with, such as dissociation, numbness, sleepiness, lack of channel activation and integration, and memory chaining; 7) learn at least two suggestions for working with client transference; 8) learn at least five techniques for working with blocked processing and abreactions; 9) learn how to use a selection of imaginal and cognitive interweaves; and 10) learn at least three techniques for closing incomplete sessions.
Keywords: Abreaction Abuse Adults Blocked Processing Closing Incomplete Session Cogntive Interweave Ego Strengthening Imaginal Interweave Target Development Transference
Accuracy Verified: Yes
16. 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
17. Zangwill, W., & Britt, V. (2006, September). The EMDR therapist as case consultant. Presentataion at the annual meeting of the EMDR International Association, Philadelphia, PA.
Language: English
Format: Conference
Abstract:
As EMDR's reputation for powerful and effective
treatment grows, EMDR clinicians are
increasingly being asked to provide services as
consulting or adjunct therapists. These
consultations can be intensely productive and
stimulating if done properly; they can also be
counterproductive if not. This workshop will
provide the consulting therapist with specific
techniques for ethical and effective treatment of
the patient and guidelines for working with the
primary therapist. It will include: 1) setting
realistic goals with both the patient and the
primary therapist; 2) exploring the eight phases
of EMDR treatment from a consulting
perspective; 3) understanding the ethical issues
concerned with this type of treatment; 4) dealing
with treatment implications such as splitting and
transference; 5) how to avoid common pitfalls
such as judging the primary clinician's
performance; and 6) the satisfaction of developing
an ongolng productive, collegial relationships.
The workshop will provide a step-by-step
framework for consultation work, clear case
examples and didactic information woven into a
lively interactive format.
Keywords: Case Consultation
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. Wolff, R. P. (2004). Evaluation of effectiveness of individual therapy sessions over 60 minutes. California Institute of Integral Studies, San Francisco, CA. AAT 3158599.
Language: English
Format: Dissertation/Thesis
Abstract:
Research has produced few studies that support the 50-minute therapy session as the most effective session length for achieving optimal therapeutic results. This descriptive study attempted to determine differences in therapists' perceptions of how session length might impact therapeutic process, therapeutic outcome, treatment of specific psychological disorders, and if session length preference was based on theoretical orientation or procedures/techniques. A total of 65 practicing therapists drawn from the International Society for the Study of Dissociation, EMDR International Association, Trauma Incident Reduction Practitioners, San Francisco Society of Lacanian Study, and California Psychological Network completed questionnaires regarding their perceptions about psychotherapy for individuals employing longer session lengths versus the standard 50-minute session.Overall frequencies of questionnaire responses and between groups comparisons were analyzed using Chi-Square. The sample endorsed the use of longer sessions at statistically significant frequencies on the following questionnaire items: three therapeutic outcome items: Increases client's satisfaction, Shortens overall duration of therapy, and Facilitates corrective emotional experience; and nine therapeutic process items: Access to client's emotional material, Integration of experience before leaving session, Deepens development of transference, Working through defenses, Access to traumatic experiences, Integrate traumatic experience within session, Working through traumatic experience, and Improving likelihood of breakthrough experiences. The sample also agreed on the use of longer sessions as potentially contributing to positive outcome for treatment of the following disorders: Substance Abuse, Panic Disorder, Agoraphobia, Specific Phobia, Social Phobia, PTSD, GAD, and Eating Disorders. The findings of this study suggest that longer session lengths may have a positive impact on therapeutic process, therapeutic outcome, and certain disorders. Specific implications for the field of psychology and suggestions for research are discussed. [Author Abstract]
Dissertation Abstracts International: Section B: The Sciences and Engineering. 65(12-B), 2005, pp. 6680.
Keywords: Empirical Study Health Personnel Attitudes Individual Psychotherapy Posttraumatic Stress Disorder Psychotherapeutic Processes PTSD Quantitative Study Treatment Duration Treatment Effectiveness
Accuracy Verified: Yes
20. Rose, L. (2012). Eye movement desensitization and reprocessing: An exploration from science to soul. Pacifica Graduate Institute, Carpinteria, CA. 1507791.
Language: English
Format: Dissertation/Thesis
Abstract:
Eye Movement Desensitization and Reprocessing (EMDR) is a treatment for trauma that has been approached primarily from cognitive-behavioral and neurobiological perspectives. This thesis explores the notion that much of EMDR's effect in the way of transformation and healing trauma is due to its ability to provoke imagination. The possibility of EMDR's connection with the imaginal faculty of the psyche is investigated with an emphasis on the qualities of EMDR that are grounded in depth psychology principles. Trauma and the importance of imagination in the healing process are discussed from the approach of the analytical and archetypal schools of psychology in addition to current bioscience perspectives. The research methodology used is alchemical hermeneutics, which facilitates the mining of unconscious material through transference dialogues. The thesis demonstrates that EMDR, when practiced within the context of depth psychology, is one avenue for activating significant, transformative imagery and accessing the unconscious to facilitate healing.
Keywords: Archetype Biological Sciences Dream
Accuracy Verified: Yes
21. Maltz, W. (1995, June). Healing the sexual problems caused by sexual abuse. Presentation at the EMDR Network Conference, Santa Monica, CA.
Language: English
Format: Conference
Abstract:
Sexual abuse is abuse to a person's sexuality. It can seriously harm the development of healthy sexual attitudes, self-concept, and
behavior. In particular, survivors are often troubled by a variety of sexual problems, such as, fear and avoidance of sex, approaching
sex as an obligation, automatic negative reactions to touch, difficulty becoming aroused or feeling sensation, emotional detachment
during sex, disturbing sexual thoughts and fantasies, compulsive sexual behaviors, difficulty with intimate partners, and sexual
functioning concerns.
EMDR is a technique which can effect significant changes in cognition, sensation, and emotional experience. It can be a powerful tool to help survivors reprocess traumatic material blocking healthy sexual experience. But because sex is often an extremely loaded
issue for survivors, and EMDR is seen as technique in which the therapist "does something" to the client, precautions must be taken
to avoid negative, retraumatizing reactions and increase positive results. Due to the high potential for negative transference in sex
therapy with survivors, the therapist must present the EMDR technique in a style which values client safety and empowerment. This
can involve associating the techque with safe images and prior positive experiences, developing relaxation and containment skills,
and modifying the physical aspects associated with the technique.
There are a variety of sexual concerns which respond well to EMDR intervention. EMDR can be used to help replace old negative
messages about sex with new messages which view sex as based on consent, equality, respect and safety. Sexual self-concept can
be improved as survivors undo irrational belief systems which blame their sexuality and/or sexual parts for having caused the abuse.
EMDR can help introduce new experiences of self-forgiveness and self-acceptance. EMDR can also help desensitize particular
objects, sexual settings, types of touch, and associations to the intimate partner which trigger negative reactions.
Therapists who focus on sexual healing need to be familiar with a variety of sexual healing techniques. These include the sexual
response cycle exercise, relearning touch exercises, techniques for healing unwanted sexual fantasies, and techniques for improving
sexual functioning. Therapists can use EMDR to help survivors work through blocks and impasses encountered with the
techniques.
Keywords: Sexual Abuse Sexual Issues
Accuracy Verified: Yes
22. Leeds, A. M. (1997, July). In the eye of the beholder: Reflections on shame, dissociation, and transference in complex post-traumatic stress and attachment disorders. Presentation at the annual meeting of the EMDR International Association, San Francisco, CA.
Language: English
Format: Conference
Abstract:
This paper covered material on how affect theory, attachment theory and EMDR theory can help with case formulation and treatment planning. This paper provided the first in depth presentation on Resource Development and Resource Installation which previously had been presented only at EMDR Institute trainings at speciality presentations. [Author abstract]
Keywords: Neurobiological Correlates RDI Resource Development and Installation Shame
Accuracy Verified: Yes
23. Marcus, S. (2005, September). Integrated EMDR headache treatment. Presentation at the annual meeting of the EMDR International Association, Seattle, WA.
Language: English
Format: Conference
Abstract:
Ninety percent of the American public gets occasional headaches. An estimated fifty million Americans have severe re-occurring headaches. Up until now, the primary treatment for headaches has been pharmaceuticals. This workshop
seeks to familiarize you with a non-medication natural alternative for the treatment of headaches that utilizes EMDR. This workshop will employ lecture, demonstration and actual practice of the Integrated EMDR approach. The purpose of this teaching strategy is to prepare you for clinical practice. Objectives include understanding headache etiology, headache trigger
identification, threshold theory, training in the integrated EMDR prorocol used in Dr. Marcus' headache research, discussion of protocol utilization in clinical practice, informed consent, transference issues, and discussion of the role of provider when deploying this approach. This workshop is for advanced
EMDR practitioners but previous experience in headache treatment is not required.
Keywords: Headache
Accuracy Verified: Yes
24. Heber, R., Linnihan. C., Butler, P., Leighton, J., & Knipe, J. (2003, September). Integrating EMDR and psychoanalytic psychotherapies. Symposium conducted at the annual meeting of the EMDR International Association, Denver, CO.
Language: English
Format: Conference
Abstract:
The symposium will explore integration of EMDR into analytic framework and promote a dialogue among clinicians of various orientations. The chair will provide overview and panelists will present three cases representing somewhat different orientations. Issues addressed
will include reason for doing EMDR, timing, ways of introducing and incorporating EMDR, relational considerations, and challenges of identifying and dealing with such phenomena as transference,
countertransference, enactment or resistance. Discussant will provide additional perspective by reframing some analytic constructs in term of
the EMDR trauma-based, information processing model. Second part will consist of audience participation and discussion. Case materials are
invited. Clinicians from all perspectives (analytic, cognitive, etc.) are
encouraged to participate.
Keywords: Psychoanalytic Psychotherapies Symposium
Accuracy Verified: Yes
25. Grand, D. (1995, June). Integrating EMDR into the psychodynamic treatment process. Presentation at the EMDR Network Conference, Santa Monica, CA.
Language: English
Format: Conference
Abstract:
The discovery of EMDR (Eye Movement Desensitization and Reprocessing) has led to a structured treatment model conceptualized
in cognitive constructs (the three pronged approach). Based on the diagnostic and treatment situation, this may or may not, be easily
integrated into a psychodynamic (insight oriented) treatment approach. However, I have empirically found a dramatic, acceleration
and deepening of the psychodynamic treatment process with patients when flexibly utilizing EMDR in session. This presentation
will explore the different applications of EMDR incorporating Freudian, ego psychological, separation/individuation and self
psychological theories with practice wisdom derived from extensive case material. Attention will be given to the associative
process, screen memories, dream work, resistance, transference, countertransference and character analysis. The structural (id, ego
and superego) and topographical (unconscious, preconscious and conscious) models of the mind as well as the listening process will
be examined as they inform the use of EMDR. Particular focus will be devoted to how the cognitive interweave can be expanded
conceptually to incorporate the techniques of interpretation and mirroring. The anxieties, resistances and allegiance issues evoked in
the psychodynamically trained therapist, as they attempt to integrate EMDR into their practices will also be addressed.
Keywords: Psychodynamic
Accuracy Verified: Yes
26. 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
27. Dworkin, M. (2003, June). Integrative approaches to EMDR: Empathy, the intersubjective, and the cognitive interweave. Journal of Psychotherapy Integration, 13(2), 171-187. doi:10.1037/1053-0479.13.2.171.
Language: English
Format: Journal
Abstract:
EMDR represents an integrative model of psychotherapy at the theoretical level. During its 16-year history, it has created quite a controversy in academic psychology. Missing from these debates have been additional therapeutic elements that are necessary to propel productive thinking into ways of making greater use of the model. These elements—empathy, the intersubjective, and usage of the cognitive interweave in conjunction with transference and countertransference issues—are explored. This addition constitutes an assimilative approach to an ever-evolving model of resolving posttraumatic stress disorder.
Keywords: Empathy Intersubjective Cognitive Interweave Cognitive Processes Countertransference Integrative Model Integrative Psychotherapy Interpersonal Interaction Models Posttraumatic Stress Disorder Psychotherapy PTSD Transference Psychotherapeutic Transference Subjectivity
Accuracy Verified: Yes
28. Snyker, E. (1998). The invisible volcano: Overcoming denial of rage. In P. Manfield (Ed.), Extending EMDR: A casebook of innovative applications, (1st ed.) (pp. 91-112). New York: W. W. Norton. xii, 292 pp.
Language: English
Format: Book Section
Abstract:
The case in this chapter integrates EMDR and interpretive short-term dynamic therapy as contrasted with cognitive, interpersonal, or existential short-term therapies. I became interested in Davanloo's technique of intensive short-term dynamic psychotherapy (ISTDP) after attending a workshop in 1981. Short-term dynamic therapy, which is rooted in psychoanalytic theory, emphasizes brevity, focus, therapist activity, and patient selection. The goal is to effect change in the personality or character structure of the person, not simply alleviate symptoms. The treatment is dynamic in that it emphasizes a single focal issue that serves as a link to core conflicts arising from early life experiences. The transference relationship is used to examine and reexperience important past relationships that account for current difficulties. In addition to dealing with issues of transference and complexity of the case (single versus multi-foci), handling resistance (conscious and unconscious) aimed at avoiding painful affects must be addressed. [Text, p. 91]
Keywords: Adults Americans Anger Anxiety Disorders Brief Psychotherapy Case Report Child Abuse Defense Mechanisms Depressive Disorders Females Life Experiences Psychotherapeutic Processes Survivors Treatment Effectiveness
Accuracy Verified: Yes
29. 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
30. Woller, W. (2004, June). Is there a place for EMDR in the treatment of personality disorders?. In complex traumatisation and EMDR (K. Linder, Chair). Symposium conducted at the EMDR Europe Association annual meeting, Stockholm, Sweden .
Language: English
Format: Conference
Abstract:
There is substantial evidence that EMDR is an effective treatment method un posttraumatic stress disorder (PTSD). However, comorbid disorders have to be taken into account when treating PTSD with EMDR. Personality disorders are a frequent comorbid disorder of PTSD, and a high prevalence of childhood traumatization has been found in personality disorders as well. Given this background, the paper to be presented discussed (1) modifications and limitations of EMDR technique required for treatment of posttraumatic stress disorder with comorbid personality disorders, and (2) further applications of EMDR in the treatment of personality disorders without PTSD. If comorbid personality disorder is present, EMDR has to be integrated into a complex treatment plan which includes stabilization, symptom control, resource installation, identification of distorted interpersonal perceptions, and modification of maladaptive interpersonal interactions. Because of the central role of generalized negative beliefs in maintaining cyclical maladaptive patterns, EMDR is regarded a valuable tool to modify negative beliefs along with processing traumatic memories and body sensations, Problems of therapeutic alliance due to transference phenomena and acting out can make stabilization difficult and time-consuming. EMDR technique should be subjected to important modifications depending on personality disorder subtype, defence structure and symptomatic comorbidity. Structural dissociations of the personality (e. g., as in dissociative identity disorder) call for a consideration of all ego-sates of the personality system before planning EMDR treatment. In addition to unresolved trauma, current and future interpersonal stressors can be chosen as EMDR targets.
Keywords: Personality Disorders Symposium Trauma
Accuracy Verified: Yes
31. 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
32. Mosquera, D. (2012, March). Met behulp van EMDR bij de behandeling van borderline-stoornis bersonality [Using EMDR in the management of borderline personality disorder]. Preconference presentatie op de 6e congres van de Vereniging EMDR Nederland, Arnhem, Nederland .
Language: Dutch
Format: Conference
Abstract:
Onveilige en ongeorganiseerd bijlagen en het begin van relationele verwaarlozing en trauma diepgaand effect op het ontwikkelingstraject van de toekomstige volwassen en verhogen het risico op het ontwikkelen Borderline persoonlijkheidsstoornis (BPD). Mensen met een borderline-stoornis en een geschiedenis complex trauma hebben veel problemen met zelfregulering en met betrekking tot anderen. Het beheer van deze zelfregulering en relationele problemen zijn centrale aspecten in de behandeling van BPS.
De stabilisatiefase is opgemerkt als essentieel oor trauma werk. Bij de behandeling van de borderline-stoornis en complexe trauma betekent dit vele bijzonderheden die we moeten in gedachten houden, waaronder: de rol van gehechtheid-gerelateerde gemoedstoestanden en fobieën voor de bevestiging, beïnvloeden en traumatische herinneringen. Werken met gevallen van BPS en complex trauma is intrinsiek relationeel en vaak gepaard gaat met de noodzaak om momenten van intense beïnvloeden en invloed hebben op fobieën beheren in de overdracht en tegenoverdracht. Inzicht in deze aspecten en met strategieën voor het aanpakken van hen is van essentieel belang zowel voor als tijdens EMDR opwerking van traumatische herinneringen om ervoor te zorgen dat de verwerking van traumatische herinneringen veilig en effectief kan worden gedaan met deze patiënten. Deze workshop integreert theoretische uiteenzetting met de presentatie van video's gevallen. De algemene structuur van EMDR therapie bij de behandeling van BPD, interventies in de voorbereidings-en overwegingen voor trauma-gerichte EMDR werk zal worden gedemonstreerd en uitgelegd.
Insecure and disorganized attachments and early relational neglect and trauma profoundly affect the developmental trajectory of the future adult and increase the risk of developing Borderline Personality Disorder (BPD). People with BPD and a history complex trauma have many difficulties with self-regulation and relating to others. The management of these self-regulation and relational difficulties are central aspects in the treatment of BPD.
The stabilization phase has been remarked as essential prior to trauma work. In treating BPD and complex trauma this implies many particularities that we should keep in mind including: the role of attachment-related states of mind and phobias for attachment, affect and traumatic memories. Working with cases of BPD and complex trauma is intrinsically relational and often involves the need to manage moments of intense affect and affect phobias in the transference and countertransference. Understanding these aspects and having strategies for addressing them is essential both before and during EMDR reprocessing of traumatic memories to ensure that reprocessing of traumatic memories can be done safely and effectively with these patients. This workshop integrates theoretical exposition with the presentation of videos cases. The general structure of EMDR therapy in treating BPD, interventions for the preparation phase and considerations for trauma-focused EMDR work will be demonstrated and explained.
Keywords: Borderline Personality Disorder
Accuracy Verified: Yes
33. Manfield, P. (1995, June). Narcissistic disorders: Using EMDR with these difficult clients. Presentation at the EMDR Network Conference Santa Monica, CA.
Language: English
Format: Conference
Abstract:
Definition of client population:
Disorder of the self. The narcissistic character is often identified by his or her grandiose facade concealing an underlying sense of
emptiness and worthlessness. To experience the underlying emptiness is so painful for them that these people cut off their inner
experience and rely instead on external admiration and praise to support their grandiose or superior view of themselves; their
condition is often referred to as a "disorder of the self." Because of their dependence on others for their sense of themselves, they are
exquisitely sensitive to criticism or disapproval, often warding off deflation by becoming increasingly grandiose, superior, disdainful
or demeaning. Many conceal their grandiosity, maintaining a secret sense of superiority which may be based upon their
perfectionism or their quiet devaluing of others.
View of others: there is a range of severity of the narcissistic character from personality disorders to a narcissistic character style.
People with personality disorders, are unable to form a trusting bond with another person; they view people primarily as
interchangeable, performing a function which could equally be performed by many others. Less impaired narcissistic characters,
however, are able to form varying degrees of attachments to other people, although their ability to trust and care about other people
is limited. Most commonly they relate to people they can idealize or be admired by. People tend to be seen in extremes as either
superior and powerful or inferior and worthless; supportive and admiring or critical and attacking.
Difficulties in using EMDR:
Clinically these clients represent a difficult and often frustrating population to treat; they are brittle and easily injured if they to not
feel perfectly understood by their therapists, and they will distance at the slightest hint that they are being judged or used. They
resist focusing inward and defining their problems as arising within themselves, and find it difficult to sustain any genuine affect,
other than perhaps rage. If they feel understood and accepted, however, they will eventually talk about their sense of emptiness and
worthlessness and their confusion about who they are and what is truly meaningful and valuable to them.
Beck, Young and others have described factors that make it difficult to treat any personality disorder using a cognitive behavioral
approach. There have in fact been very few reported "successes" in the literature. Most of the difficulties are related to the self and
object splitting characteristic of these clients. These clients have limited access to feelings, limited access to spontaneous thoughts,
body sensations, memories, etc., and vague unfocussed presenting problems making targeting difficult. They usually have difficulty
with emotional and often intellectual continuity from session to session; they will rarely keep a log or follow through with
homework; transference issues often come into central focus and must be addressed before other targets; and their selfdefeating
beliefs and behavior patterns are extremely deeply held, pervasive and resistant to change.
In addition to varying degrees of these difficulties, narcissistic clients present all of the problems in EMDR that they do in more
traditional therapies; including their tendencies to act out, deny, and avoid. These and other defenses interfere with completion of
segments of therapeutic work and make it difficult for the clinician to keep work focused within one neural network. Self and object
splitting leads to continuity problems within or between sessions and a difficulty maintaining clarity about the reason for being in
treatment. The client may feel suicidal one week and declare himself or herself to be fully recovered the next. Perhaps the most
confirming aspect of the treatment of these clients, however, is their emotionally impoverished pasts; they have very limited
experience of nurturing, loving and caring to draw !?om in order to interweave new meanings and perspectives into traumatic or
painful past experiences.
Length of treatment:
I have found that I have been able to achieve good results with higher level narcissistic clients with whom I have had an established
relationship at the time I introduced EMDR into the treatment. My results with clients who have come to therapy asking specifically
for EMDR and with whom I have begun using EMDR soon after the beginning of treatment have been generally poorer, varying
with the severity of the client's disorder, the less severe doing best. The client needs to be able to establish a meaningful trusting
relationship with the therapist; the more severe the client's difficulties with attachment, the more time this process requires.
Narcissistic clients do not tend to see their difficulty with vulnerability, trust and intimacy as a problem within themselves. If they
are able to recognize personal problems, they are usually in the area of self esteem and obstacles to achievement. When they are
able to resolve some of these latter problems fairly rapidly through treatment they tend to terminate, no longer seeing a sufficient
purpose for treatment. In a sense, they can become better narcissists; their grandiose view of themselves is enhanced and they are
reinforced in their use of self-sufficiency as a defense against interpersonal vulnerability. I view the relative efficiency of EMDR as
a problem for deeper treatment of narcissistic clients because there is less time for the therapeutic relationship to develop and
consequently a limited opportunity to impact the client's object splitting. I believe that this is why I have found EMDR with
narcissistic clients to be most effective when it is introduced after a therapeutic relationship has had time to develop. Negative cognitions:
The early maladaptive schemas of narcissistic clients are pervasive in their lives and point to a plethora of negative cognitions.
Typical early schemas are: I must control myself (or my feelings, my behavior, my body) at all times; no one cares; my needs will
never be met; I can't trust anyone; I am deeply flawed and unlovable; I am dikeable, unattractive to others; I will always fail; my
flaws are totally unacceptable to others; I must be perfect or I am worthless; I deserve to be treated more specially than others; I must
please others to avoid attack; I'm alone; nobody understands me; I am OK if I am better than others; I am OK only if others admire
me. It is often helpful to narrow these cognitions down to make them manageable with EMDR
Treatment:
In addition to the recommended protocol of establishing a safe space to which the client can retreat if necessary, before doing an
EMDR session with one of these clients, the therapist should identify as many of the client's emotional resources possible, in
particular expriences if any of having felt loved and accepted ad examples of loving people or relationships the client has observed
Among other things, these facilitate more effective copitive interweaves.
The initial task in doing an EMDR session with this client population is to establish an appropriate and richly defined target. Since
it is more difficult for these clients to access meanm&l memories in an emotionally alive way, the therapist must be more active in
helping the client stimulate the associated neural netork as I l l y as possible. In addition to the client's reaction to the plight of
children he may be related to or observe (Level I1 training), a rich source of emotional responsiveness and resources is the client's
own response to situations he has witnessed in news media, TV, movies or theater.
A major challenge in addressing a narcissistic character type using EMDR is tracking the course of the session with these clients
and identifying when they drip out of the targeted neural network. This process can be subtle because it requires an ability to
differentiate true avoidance hm spontaneous associations which may appear at hat to be irrelevant; it requires a familiarity with
and sensitivity to the protective or defensive mechanisms they use to insulate themselves fiom painful memories and affect. As the
patterns ofmovement in and out of the targeted network are identified it is important to use interventions that are experienced by the
client as supportive but nevertheless make hun or her aware of having wandered.
Although the narcissistic client may initiate treatment with the stated goal of improving his performance in specified areas, he will
agree upon reflection that the real problem is that he feels an overriding need to perform in order to feel worthwhile. Since he has
never known any other way of dealing with his self-worth, he will be skeptical about whether it is possible to feel a sense of worth
that is not based upon performance, and it is easy for the therapist to lose perspective and join him in that beliet especially while
doing EMDR with its potential for reprocessing with extraordinary precision specific obstacles to performance. The therapist must,
however, retain her healthy perspective if the client is to learn to accept himself.
For more clinical information about treating disorders of the self:
1.)Beck, Aaron T., et al, Cognitive Therapy Of Personality Disorder Guilford Press, New York,
N. Y., 1990
2.)Manfield, Philip, Split Self/Split Object: Understanding And Treating Borderline, Narcissistic And Schizoid Disorders, Jason Aronson Publishers, Northvale, N.J., 1992.
3.)Young, Jeffrey, E, Cognitive Therapy For Personality Disorders: A Schema-Focused Approach,
Professional Resource Exchange, Inc., Sarasota, Florida, 1990.
Keywords: Narcissistic Personality Disorder
Accuracy Verified: Yes
34. 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
35. Schore, A. (2009, August). Part I: Right brain affect regulation: An essential mechanism of development, trauma, dissociation and psychotherapy. Plenary at the annual meeting of the EMDR International Association, Atlanta, GA.
Language: English
Format: Conference
Abstract:
Dr. Schore will discuss current models of the neurobiology of attachment, detailing the enduring positive and negative impact of interactively regulated and dysregulated bodily-based affective transactions on the organization of the infant’s developing right brain, which for the rest of the life span is dominant for the nonconscious processing of emotions, stress regulation, and intersubjectivity. Dr. Schore will then describe the negative impact of relational trauma on the developmental trajectory of the right brain and the origins of pathological dissociation. Applying the developmental model to the change process of psychotherapy, he will then describe the critical role of the right brain in implicit facial, gestural, and prosodic communications within the therapeutic alliance, in dysregulated states of affective hyper- and hypoarousal, and in empathy, transference-countertransference, and affect regulation. This work suggests that interactive regulation within the therapeutic alliance is a central mechanism in the treatment of patients with a history of early relational trauma.
Keywords: Dissociation Mechanism Plenary Right Brain Affect Regulation Trauma
Accuracy Verified: Yes
36. 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
37. Perkins, B. (2001, June). Psychoanalysis and EMDR: A theoretical and clinical bridge. Presentation at the annual meeting of the EMDR International Association, Austin, TX.
Language: English
Format: Conference
Abstract:
Participants will learn to identify: 1) the role of transference in psychotherapy in general and EMDR in particular; 2) the developmental levels of Lawrence Hedge's psychoanalytic model; 3) the influence of developmental states on later traumatic events; and 4) how the therapeutic relationship can come to constitute the essential non-traumatic relational pole of the EMDR process iself.
Keywords: Larence Hedge's Psychoanalytic Model Psychoanalysis Transference
Accuracy Verified: Yes
38. Hans Snijders, H., Oprel, D., & Romer, C. (2006, Januari). Psychotherapie leeft! De bruisende ontwikkelingen in de psychotherapie zelf [Psychotherapy is alive! The exciting developments in psychotherapy itself]. Tijdschrift voor Psychotherapie, 32, 144–147. doi:10.1007/BF03062215.
Language: Dutch
Format: Journal
Abstract:
Dit drukbezochte congres begon met drie workshops waarin ‘nieuwe’ behandelvormen werden gepresenteerd: Transference focused psychotherapy (TFP), de Kortdurende psychoanalytische steungevende psychotherapie (KPSP) en de Eye movement desensitisation and reprocessing (EMDR) bij kinderen. Van de laatste ontbreekt helaas een impressie in dit verslag. In de wandelgangen bleek dat deze workshop
hooglijk gewaardeerd werd.
This busy conference began with three workshops in which 'new' forms of treatment were presented: Transference focused psychotherapy (TFP), the Short-term psychoanalytic supportive psychotherapy (SPSP) and Eye Movement Desensitisation and Reprocessing (EMDR) in children. Of the latter sadly lacking an impression in this report. In the corridors showed that this workshop
was highly appreciated.
Keywords: Children Practice Theory
Accuracy Verified: Yes
39. Mosquera, D., Gonzalez, A., & Seijo, N. (2010, April). Relational problems in severely traumatized patients. Presentation at the 2nd Bi-Annual International European Society for Trauma and Dissociation Conference, Belfast, Northern Ireland.
Language: English
Format: Conference
Abstract:
A practical workshop focused on frequent clinical situations in therapy. Its main goal is help the participants to identify relational patterns based on reciprocal role procedures, in order to be able to overcome therapist-patient difficulties. A brief therapeutic exposure about different theoretical sources will be presented: Cognitive-Analytic Therapy, Adaptive Information Processing Model and EMDR, Theory of Structural Dissociation of the Personality, Attachment Theories, psychodynamic transference-countertransference conceptualizations, and therapies focused on relational issues (systemic family therapy, psychodramatic group therapy, etc) Vignettes of frequent reciprocal role procedures in therapeutic relationship with severely traumatized people will be presented, explained the different kinds of presentation. The linking of these vignettes with the traumatic history will be developed. Short video-cases will illustrate these situations and some interventions to overcome them. Modified EMDR interventions will be described and showed.
Learning Outcomes Therapeutic relationship problems are main issues in severely traumatized people. Different authors coming from different theoretical orientations have presented thoughtful approaches to these situations and how to overcome them. In this workshop we will review many of these contributions, but we will base our theoretical development on the concept of reciprocal role procedures from the Cognitive Analytic Therapy (Ryle). From this concept we will summarize frequent relationship problems in therapy, how we conceptualize them from the Adaptive Information Processing model from EMDR and how we work on these issues using EMDR methodology. An additional learning outcome of this workshop is that the participants will review their own experience with their patients through a specific evaluation, and will have the opportunity to share their experiences.
Keywords: Relationship Issues Trauma
Accuracy Verified: Yes
40. 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
41. 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
42. Dworkin, M., & Bender, S. (2000, September). The role of transference and countertransference in EMDR. Presentation at the annual meeting of the EMDR International Association, Toronto, Ontario Canada.
Language: English
Format: Conference
Abstract:
Participants will be able to: 1) identify countertransference issues in an EMDR session; 2) apply knowledge of transference and countertransference during any phase of EMDR therapy protocol; and 3) employ proactive stratgegies such as cognitives interweaves utilizing transference and countertransference principles.
Keywords: Cognitive Interweave Countertransference Transference
Accuracy Verified: Yes
43. 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
44. 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.
Accuracy Verified: Yes
45. 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
46. Dworkin, M. (2009, August). Solving transference and countertransference with dissociative disorders in EMDR. Presentation at the annual meeting of the EMDR International Association, Atlanta, GA.
Language: English
Format: Conference
Abstract:
This workshop will focus on transference and countertransference problems and solutions in EMDR with dissociative clients. There will be a short literature review on procedural modifications in dealing with dissociation in EMDR, and transference and countertransference with dissociative patients. Research findings on mirror neurons and embodied simulation will be taught to enhance the participant’s understanding of the neurobiological substrates for attunement and resonance, and for solving transference and countertransference with dissociatives in EMDR when ruptures to relatedness occurs. Identifying and using transference reactions to enhance dual awareness will be demonstrated in history taking. Enhancements in preparation phase will be shown through case example to limit induced transference. Transference and countertransference during the assessment phase will be identified and solutions offered. In the Desensitization phase EMDR processing may induce transference, countertransference, or both (even with procedural modifications). Intersubjective challenges seem to be more intense during phases 1 -4 and 7-8. Activated parts in the patient may cling or be angry with the therapist at the end of an EMDR session, or during Re-evaluation. Failure or defectiveness parts of the therapist may become activated then as well. Different parts of a dissociative patient may appear with different kinds of transferences during different EMDR phases. These transferences challenge therapist’s abilities to stay attuned. Strategies of attunement to the activated part of the patient will be demonstrated in order to repair or prevent ruptures to the alliance and to understand the nature of the dissociated communication. Bi-directional interactions may activate parts of the patient and therapist without conscious awareness. Strategies to somatically identify and use these countertransferential activations will be taught through experiential exercises so that the therapist may have a more in depth understanding of the dissociative patient’s communications. R/D/I strategies will be reviewed and applied to the therapist to limit countertransference activations. Dealing with dissociative enactments are crucial to identify ruptures to the therapeutic alliance, restore attunement and resonance, uncover dissociative messages that can be used during EMDR processing.. Solutions to the problems that occur during different EMDR phases will be taught using lecture, discussion, case examples, written and experiential exercises so that participants will leave the workshop with additional strategies. Solutions include how to maintain attunement to dissociative parts during transferential activations while enhancing dual awareness; how to identify transference and countertransference problems during phases 1-4 and 7-8 and use them as additional sources of dissociated communications that can be used in EMDR processing ; how to use the Clinician Self Awareness Questionnaire to identify and process countertransference problems ; how to use compartmentalization strategies using R/D/I to limit countertransference activations; how to develop self soothing skills for the therapist’s dissociated parts; how and when to use Relational, Empathic, and Transferential Interweaves during Desensitization; and how to identify moments of enactments, and using EMDR strategies to deepen the EMDR experience .
Keywords: Countertransference Transference
Accuracy Verified: Yes
47. Dworkin, M. (2009, June). Solving transference and countertransference with dissociative disorders in EMDR. Presentation at the annual meeting of the EMDR Europe Association, Amsterdam, the Netherlands.
Language: English
Format: Conference
Keywords: Countertransference Transference
Accuracy Verified: Yes
48. Woller, W. (2010, July). Therapeutic relationship in the treatment of traumatized clients with personality disorders. Preconference presentation at the 1st EMDR Asia Conference, Bali, Indonesia.
Language: English
Format: Conference
Abstract:
Therapeutic relationship is often a major challenge in the treatment of traumatized clients with
comorbid personality disorders. Maladaptive interpersonal styles and negative transferences resulting
from attachment trauma can make a trauma-oriented therapy very difficult. However, an understanding
of personality disorders as a consequence of attachment trauma creates new therapeutic possibilities
for patients who are considered difficult to treat though urgently in need of therapy.
Given this background, the workshop aims at enhancing the participants’ capacity to manage problems
of therapeutic relationship in traumatized clients with personality disorder.
In the first part of the workshop, an overview on possible neurobiological causes of specific patterns of experiencing and
behavior in personality disorders will be given. Deficits in emotion regulation, mentalization function, and personality
integration, all of which have been identified as underlying dysfunctional and self-destructive behavioral patterns, can
be understood as consequences of attachment trauma. In the second part of the workshop, a phase-oriented treatment
conception will be presented which combines elements from resource-oriented trauma therapies with aspects of a
psychodynamic understanding of attachment relationships. In the framework of this concept, the notions of transference
and countertransference will be introduced to explain difficulties typically arising in the relationship with traumatized clients
with severe personality disorders. On the basis of case material, strategies will be presented to deal with recurrent problems
of therapeutic relationship.
Keywords: Interpersonal Relationship Personality Disorders
Accuracy Verified: Yes
49. Haskin, P. S. (2005). Trauma and the relational matrix: The therapeutic relationship in eye movement desensitization reprocessing (EMDR): A project based upon an independent investigation. Smith College School for Social Work, Northampton, MA.
Language: English
Format: Dissertation/Thesis
Keywords: Countertransference Intersubjectivity Transference
Accuracy Verified: Yes
50. 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.
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?
Accuracy Verified: Yes
51. Manfield, D. C. (1998). Treating a highly defended client: reworking traditional approaches. In P. Manfield (Ed.), Extending EMDR: A casebook of innovative applications, (1st ed.) (pp. 217-231). New York: Norton.
Language: English
Format: Book Section
Abstract:
Several key points emerge for consideration when treating the highly defended client with EMDR, in particular clients whose primary defenses are distancing ones. The first is to carefully gauge the client's level of functioning, the depth of therapeutic alliance, and the client's perceived sense of safety. These factors determine the appropriateness of EMDR, and presuming that, the style and directiveness of the clinician.Secondly, the use of EMDR with highly defended clients may require a directiveness that exceeds the basic protocol designed by Shapiro. Once the therapeutic alliance has been established, the clinician must balance, while being sensitive to, the client's need for control over the therapeutic process, hopefully avoiding unproductive periods of defensive distancing. This balance and sensitivity, inherent in all effective treatments and psychotherapies, is particularly important when the modality is as potent and emotionally evocative as EMDR can be. The case of William illustrates the risks in a directive approach, such as initiating EMDR too early, promoting a withdrawing or angry transference, or choosing the wrong cognitions. Knowing your client well and securing an effective working alliance is crucial to success. [Text, pp. 230-231]
Keywords: Adults Americans Anxiety Disorders Case Report Defense Mechanisms Life Experiences Male Psychotherapeutic Processes Self Concept Survivors Treatment Effectiveness
Accuracy Verified: Yes
52. Marcus, S. (2007, June). Treating headaches with EMDR. Presentation at the annual meeting of the EMDR Europe Association, Paris, France.
Language: English
Format: Conference
Abstract:
Headaches are the most common pain-related complaint and the seventh leading ailment seen in medical practice. Yearly, over 35% of the population is affected by tension-type headaches. Migraine headaches are a common condition with one-year prevalence rates around 15%. Prevalence rates generally peak in the third and fourth decades but for many migraines become a chronic condition requiring a lifetime of treatment.
Migraine sufferers are frequently disabled during their acute attacks. A 2001 study found that 90% of migraineurs reported functional impairment. 53% required bed rest and nearly 30% missed 1 day of work or school within a 3-month period. Migraine in the USA results in 112 million bedridden days per year. The cost of the migraine to the total American work force is estimated at $13 billion per year in missed work days and lost productivity. Direct medical costs (i.e., MD office visits, prescription medication claims, and hospitalizations) for migraine care average $1 billion annually. Clouse & Osterhaus (1994) found that migraineurs generate twice the medical claims and two times the pharmacy claims in HMO’s when compared to patients without migraines.
Considering the sheet number of individuals afflicted with migraine and tension headaches, the societal impact with increased medical costs, lost work days, and reduced productivity represent a major public health concern.
The pharmacologic therapies have long been the most common and widely used method of treating headaches. Unfortunately, pharmacologic treatments are ineffective or inadequate for a sizeable number of patients. One third of patients participating in clinical trials with oral triptans fail to respond. Moreover, fewer than half become pain-free, which is the primary efficacy measure recommended by the International Headache Society. Reasons for considering an EMDR treatment for migraine and tension headaches are patient preferences for non-pharmacologic interventions, pregnancy, planned pregnancy or nursing, deficient stress coping skills, medication rebound, patient overuse of medications, medical contraindications, and poor medication tolerance.
In view of the state of the art of current headache treatment an EMDR approach that can eliminate severe headache pain in less time than an oral medication (20 to 30 min) and within 5 to 10 sessions may reduce frequency, duration and intensity of future headaches could result in a decrease in medication utilization, physician visits and overall medical costs, with an improvement in patient satisfaction. This would be a welcome addition to current headache treatments.
This workshop will employ lecture, demonstration and actual practice of an integrated EMDR approach. The purpose of this teaching strategy is to prepare you for clinical practice. Objectives include understanding headache etiology, headache trigger identification, threshold theory, training in the EMDR protocol used in Dr. Marcus’s migraine research, discussion of protocol utilization in clinical practice, informed consent, transference issues, and discussion of the role of provider when deploying this approach. This workshop is for advanced EMDR practitioners but previous experience in headache treatment is not required.
Keywords: Headaches Health Problems Illness Pain
Accuracy Verified: Yes
53. Lawson, C. A. (2004). Treating the borderline mother: Integrating EMDR with a family systems perspective. In M. M. McFarlane (Ed.), Family treatment of personality disorders: Advances in clinical practice (pp. 305-334). New York: Haworth Clinical Practice Press.
Language: English
Format: Book Section
Abstract:
Describes the features borderline personality disorders (BPD) in mothers and the impact it can have the family, then describes the treatment model, which combines Bowen's family systems theory with eye movement desensitization reprocessing (EMDR). Following illustrative case material, the author discusses the treatment model's strengths and limitations, benefits for the family, indications and contraindications, management of transference issues, management of crises and acting-out behavior, integration with psychiatric services and the role of medication, and cultural and gender issues. (PsycINFO Database Record (c) 2008 APA, all rights reserved)
Keywords: Borderline Personality Disorder Bowen's Family Systems Theory Family Therapy Mothers Treatment Model
Accuracy Verified: Yes
54. Parnell, L. (1995, June). The use of imaginal and cognitive interweaves with sexual abuse survivors. Presentation at the EMDR Network Conference, Santa Monica, CA.
Language: English
Format: Conference
Abstract:
This hour and a half presentation addresses the use of cognitive and imaginal interweaves in the treatment of adult survivors of
sexual abuse. The overall course of treatment with EMDR is briefly outlined including a variety of interweave interventions for use
in the beginning, middle and end of EMDR sessions.
In working with sexual abuse survivors with EMDR it is important to understand the issues commonly encountered in their
treatment. These include issues of safety, trust, responsibility, choice/control, interpersonal relationships, body awareness and
image, sexuality and self esteem. A sexual abuse assessment can be taken which includes information on the perpetrator(s), severity
and frequency of abuse, type of abuse, age of onset of abuse, duration of abuse, disclosure and family response.
Sexual abuse survivors present themselves in treatment in different ways. Some clients come to treatment remembering abuse and
want to clear it with EMDR. Other clients come to treatment with no clear memories of incidents but have a "feeling" something
happened to them and have symptoms of abuse. There are clients who have no clear memories but something has triggered
flashbacks and nightmares of sexual abuse. Finally, there are clients who have no memory of abuse and come to therapy for another
reason but uncover what they believe to be sexual abuse memories with EMDR.
There are three phases of treatment in sexual abuse cases. In the beginning phase, a history is taken and there is the establishment
of a trusting relationship. The client is prepared for EMDR. In the middle phase, there is the reprocessing and working through of
traumatic memories and transference work. In the end phase of treatment there is integration of the information which has been
uncovered and preparation for life outside of therapy.
Interweaves can be utilized in the beginning, middle and end of EMDR sessions.
In the beginning of individual EMDR sessions there is a check-in with clients to see how they have been doing during the week.
What has come up for them in their dreams or daily life since the last session? Next there is the selection and development of targets
for EMDR (body sensation, memory, flashback, symptom, dream, feeling, vague sense, negative cognition or drawing).
A safe place is then established where the client can go at the beginning, middle or end of the session as needed. Along with the
safe place an inner advisor or other inner resources can be contacted and developed for use in sessions. A connection with the
client's inner child is important which can be done through the use of guided imagery, photographs and/or artwork.
Instructions on how EMDR will be used are given with attention paid to issues of safety and control (they are in control, they can
stop at any time, they can return to the safe place, they know the signal for stop). Negative and positive cognitions are established
along with the EMDR protocol.
In the middle of individual EMDR sessions there are commonly problems with looping or being "stuck." This seems to occur
frequently with sexual abuse survivors because of the intensity of the trauma and because the child self is often frozen in time
lacking access to the adult self's information. Ways to work with this include looking for the blocking beliefs (i.e., The perpetrator
can hurt me), look for blocking images, and talking to the child part (what does he/she need?).
Imaginal and cognitive interweaves can be used in a variety of different ways in the middle of EMDR sessions. Some of these
include: imagining the adult self helping the child self in the traumatic scene, bringing in inner and outer resources for help (i.e., a
powdl imaginary being, a strong loving fiend, the therapist, etc.), and reality check interweave where is the perpetrator now?, can
helshe hurt you now?) It is also important to educate the child part that his or her feelings are normal, sexual feelings are normal etc.
It can be helpful to ask the adult self to talk to the child self explaining things to the child. Another useful interweave is to have the
adult self hold the perpetrator and allow the child to beat him or her up or have the adult self beat up the perpetrator allowing anger
to be expressed safely. Asking clients if they would like to return to the safe place for a break can also be helpful if they are feeling
too overwhelmed.
There are a number of ways to end or close incomplete EMDR sessions. Often it will not be possible to completely clear a traumatic
memory in a session or the memory worked on is completed but connected to a whole network of other traumatic events. For these
cases there are a number of interweaves that can be used. Clients can be requested to have the adult self comfort the child self in the .
safe place. The client can imagine putting the scary unfinished disturbance that has been uncovered in a file folder, box, safe, leave
it in the therapist's office, etc. The client can return to the safe place where the child and adult selves can play together. The adult
can comfort the child or do whatever is needed to create safety and containment. Clients can imagine their child self being held by
protector figures repeating cognitions related to safety, responsibility and choice. They can also be asked what they learned from the
session, installing their response with eye movements.
It is helpful to give homework to clients such as journaling, artwork, walks in nature, meditation, stress reduction, group work,
exercise, nutritious diet, and restriction of drugs and alcohol. Loving Kindness or Metta Meditation is another very helpful tool for
teaching self soothihg to adult survivors of sexual abuse.
Keywords: Cognitive Interweave Imaginal Interweave Sexual Abuse Survivors
Accuracy Verified: Yes
55. Tobin, S. (2002, June). Use of therapeutic alliance for resource installation. Presentation at the annual meeting of the EMDR International Association, San Diego, CA.
Language: English
Format: Conference
Abstract:
Dr. Tobin will show why it is important to address the often overlooked therapeutic relationship; how to notice transference and
countertransference issues, how to foster the therapeutic alliance; and how to utilize EMDR to install the alliance, once it has been established, as a resource to foster increased self-support, grounding, enhanced self-esteem
and self-soothing capacities. Relevant psychodynamic theory on transference and countertransference, the applicability of this approach to various diagnostic groups will be discussed, contraindications will be
cited and clinical examples will be presented.
Keywords: RDI Resource Installation Therapeutic Alliance
Accuracy Verified: Yes
56. Manfield, P., Knipe, J., & Snyker, E. (1998, July). Using EMDR with narcissistic personalities. Presentation at the annual meeting of the EMDR International Association, Baltimore, MD.
Language: English
Format: Conference
Abstract:
Participants will: 1) be able to identify narcissistic defenses of splitting, projective identification, avoidance, denial, primitive idealization, devaluation, grandiosity; 2) learn methods of addressing these defenses; and 2) learn how to use EMDR to process transference issues that typically arise.
Keywords: Narcissistic Defenses Transference
Accuracy Verified: Yes
57. 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
58. 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