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Your Results - you searched for the keyword Dissociative Avoidance 520 Results
1. Wieland, S., & Baita, S. (2009, November). "Blank" ...Using EMDR with children who dissociate. Presentation at the International Society for the Study of Trauma and Dissociation, Washington, DC.
Language: English
Format: Conference
Abstract: Dissociation is a common response for children who experience abuse, severe neglect, or extreme disorganized attachment. EMDR can help (1) increase a child´s sense of safety and stability, (2) decrease disconnection between aspects of self, and (3) process trauma. While the part of the child existing in the `now´ may be aware of safety, the younger or infant part of the child to whom trauma occurred often is not aware of present safety. This younger part which continues in fear disrupts the child´s functioning. Ideas will be presented for using EMDR to increase knowledge of present safety across the child´s dissociative system as well as recognizing where safety may not exist. Use of EMDR for building secure attachment with child and parent, processing triggers, increasing the child´s connection between dissociative states, and processing both explicit and implicit memories will be described. Dissociative children are often difficult to work with. Ideas will be given for adapting EMDR for use with these highly volatile, dissociative children. The importance of recognizing and acknowledging dissociation when it appears within the child´s EMDR processing will be emphasized. This workshop is appropriate for therapists already trained in EMDR. Numerous case examples will be given.
Keywords: Children Dissociation
Accuracy Verified: Yes
2. 仁木 啓介 [Niki Keisuke]. (2006年3月). 痙攣発作とパニック発作を繰り返した解離性同一性障害の症例--観念運動シグナル法を用いて [A patient with dissociative identity disorder who repeatedly developed seizures and panic attacks: use of ideomotor signaling] . 臨床催眠、7、52から58の日本誌 [Japanese Journal of Clinical Hypnosis, 7, 52-58].
Language: Japanese
Format: Journal
Keywords: DID Dissociative Identity Disorder
Accuracy Verified: Yes
3. 仁木 啓介 [Niki Keisuke]. (2008年6月). 精神科病院でのEMDR―犯罪被害者と解離性同一性障害の治療について― 仁木啓介 [EMDR at psychiatric hospitals: Therapy for criminal victims and dissociative identity disorder] . こころのりんしょう 第27巻02号 [Clinical Psychology: Various Aspects, 27(2), 263-269].
Language: Japanese
Format: Journal
Keywords: Criminal Victims DID Dissociative Identity Disorder Psychiatric Hospitals
Accuracy Verified: Yes
4. 安 克昌[An Katsumasa]. (1999). 解離性障害患者におけるEMDRの使用 [The use of EMDR in patients with dissociative disorders]. こころの臨床ア・ラカルト, 18(1), 88-92 [Clinical Psychology: Various Aspects, 18(1), 88-92].
Language: Japanese
Format: Journal
Keywords: Dissociative Disorders
Accuracy Verified: Yes
5. Lanius, U. (2005, April). 'Dissociative processes' and EMDR - Staying connected. Presentation at 3rd Annual Conference of the EMDR Association of UK and Ireland, Jordanstown, Northern Ireland .
Language: English
Format: Conference
Abstract: D
issociative processes, common in a wide variety of psychological disorders (e.g., PTSD, Anxiety Disorders, Personality Disorders, Dissociative Disorders, etc.) can interfere with effective EMDR treatment. The information processing system gets overwhelmed and shuts down, thereby barring the integration and resolution of traumatic experience. The workshop presents a model, based on recent developments in neuroscience and the neurobiology of dissociation, that guides therapeutic interventions in general and EMDR treatment in particular. Treatment planning, target selection, the use of both body-oriented (bottom-up processing) versus cognitive and ego-state (top-down processing), and other interventions are discussed. Participants will become familiar with specific interventions designed to minimize dissociative symptoms, as well as techniques that aid clients in becoming reconnected once dissociative processes have occurred. A comprehensive therapeutic approach is described that aids clients with dissociative symptoms to stay connected and thereby enhance the likelihood of efficient information processing during EMDR treatment.
Keywords: Dissociation Dissociative Disorders
Accuracy Verified: Yes
6. Wilson, S., Becker, L., & Tinker, R. H. (1995, June). 15-Month follow up of EMDR treatment for traumatic memory. Presentation at the EMDR Network Conference, Santa Monica, CA.
Language: English
Format: Conference
Abstract:
We previously reported on the outcomes of a controlled study of eye movement desensitization and reprocessing (EMDR)
effectiveness in the treatment of traumatic memory (Wilson, Tinker, & Becker, 1994; Wilson, Becker, & tinker, in press). In that
study we found that three, 90-minute sessions of EMDR (Shapiro, 1995) "normalized the psychological functioning of the previously
traumatized participants (g = 80) on all dependent measures. The present study is a 15-month follow up of those participants.
I Method:
The research design is shown in Table 1. Participants were randomly assigned to EMDR or to Delayed EMDR conditions.
Pretreatment measurement occurred at measurement time TI. Participants in the EMDR condition received EMDR between T1 and
T2; those in the Delayed EMDR condition received EMDR between T2 and T3. All participants were tested immediately following
treatment and at 3 months following treatment (at T4). The 15 month, long-term follow up occurred at measurement time T5. An
independent assessor collected all of the following dependent measures: Subjective Units of Disturbance Scale (SUDS; Wolpe,
1990), Impact of Events Scale (IES; Hmowitz, Wilner, & Alvarez, 1979), State/Trait Anxiety Inventory (STAI; Spielberger,
Gorsuch, Lushene, Vagg, & Jacobs, 1983), and the Symptom Checklist (SCL-90-R, Derogatis, 1992).
[Table 1. The Research Design,
Treatment Condition, Measurement Time:
T1 T2 T3 T4 T5;
EMDR Treatment: 01 x 02 03 04;
Delayed EMDR Treatment 01 02 x 03 04 05;
Note: T = Time of measurement; 0 = Observation; X = Treatment administered.]
II. Results:
Two analyses were performed to assess the impact of EMDR treatment at the 15-month follow up. First, in order to assess the
overall, long-term impact of EMDR, the 15-month follow-up scores were compared with the pretreatment scores. There was
significant improvement on all nine measures at the 15-month follow up: The multivariate effect was significant (Wilk's Lambda =.11, p<.0005) as were all nine of the univariate effects (all p <.0005). Second, in order to assess whether the improvement shown
immediately following EMDR treatment had been maintained over the following year the immediate posttreatment scores were
compared with, the 15-month follow-up scores. The multivariate test was nonsignificant (Wilk's lambda=.74, p=.079), indicating
the improvement shown immediately following EMDR was maintained 15 months later. The univariate analyses indicated
additional improvement for the PTSD symptoms of intrusions (IES Intrusion: F(1,56)=7.71, p=307) and avoidance (IES
avoidance: F_(1,56) -4.44, p=.040). None of the nine measures showed deterioration at the 15-month follow up. Prior to EMDR
treatment 45% (g= 9) of the responders had been diagnosed as PTSD, at the 15-month follow up only 7% (g = 4) were diagnosed
as PTSD (chi-squareo, N=61)= .72, p < .05).
III. Responders Versus Nonresponders at the 15-Month Follow up.:
At the time of writing this abstract, 75% of the participants (g=61) have responded to the 15-month follow up. In general,
measures taken prior to treatment did not differentiate responders fiom nonresponders. Responding at the 15-month follow up was
unrelated to age, gender, marital status or years of education, although the annual income of the responders (Mdn=21,500) was
higher than that of the nonresponders (Mdn = 14,750, Mann-Whitney U=372.5, p=.017). Responding or not at 15 months was
unrelated to the type of trauma experienced, whether or not the participants had been in therapy prior to EMDR treatment, or how
long ago the trauma had occurred. It was also unrelated to the severity of the trauma as measured by the pretreatment scores on the
nine dependent variables and to whether or not the participant met the PTSD diagnosis criteria prior to treatment.
A multiple regression analysis used the immediate posttreatment and 90-day posttreatment scores to predict whether or not the
participant responded at the 15-month follow up. Nonrespondents were more likely to be depressed at 90-days following treatment
than were respondents (R square=.O8, B=-.16, Beta = -.28, F_L1,71)=5.99, p=.017). No other variables entered into the
regression model. IV Discussiona and Conclusion, Tretement effects found immediately following EMDR treatment wer maintained or improved 15 months later and thee was a significant decrease in the number of participants diagnosed as PTSD at the 15 month follow up. The comparison of responders to nonresponders at the 15 month follow up showed that the nonresponders were more depressed than the responders, raising the possiblity that the present results may be favorably biased to some extent. The discussion will include the additional, subjective impressions of participants who did not respond to the follow up. Limitations of EMDR with this population will be discussed, including the influence of comorbidity, multiple traumas, retraumatization after treatment, and spontaneous recurrence of symptoms. V. References: 1) Derogatis, L. R. (1992). SCL-90: Administration Scoring and Procedures Manual II. Baltimore: Clinical Psychometric Research. 2) Horowitz, M. J., Wilmer, N. & Alverez, W. (1979). Impact of Event Scale: A Measure of Subjective Distress. Psychosomatic Medicine, 41, 209-218. 3) Shapiro, F. (1995), Eye Movement Desensitization and Reprocessing: Basic Principles, Protocols, and Procedures. 4) Speilberger, C. D., Gorsuch, R. L., Lushene, R. D., Vagg, P. R., & Jacobs, G. A. (1983). Manual for the State-Trait Anxiety Inventory, Palo Alto: Consulting Psychologists Press. 5) Wilson, S. A., Tinker, R. A., & Becker, L. A. (1994, November). Efficacy of Eye Movement Desensitization and Reprocessing (EMDR)Treatment for Trauma Victims. Paper presented at the Annual Meeting of the International Society for Traumatic Stress Studies, Chicago, IL. 6) Wilson, S. A., Becker, L. A., & Tinker, R. A. (In press), EMDR, treatment for psychologically traumatized individuals, Journal of Consulting and Clinical Psychology.
Keywords: Follow-up Traumatic Memory
Accuracy Verified: Yes
7. Sime, W., (2002). Absorption, concentration, dissociation, desensitization, flow and neurofeedback: The essence of Tiger Woods performing optimally focused "In the zone". Winter Brain Meeting.
Language: English
Format: Conference
Abstract:
The Absorption that allows an athlete, a surgeon, an astronaut or a musician to get into the Zone, i.e., to block out all distractions
unrelated to performance has been assessed by Tellegen, Csikszentmihalyi and others in self-report measures. It occurs relatively rarely at the very highest levels and is very elusive to achieve. Qualitatively speaking, it is the phenomena of being totally immersed in the activity with time moving slowly, senses being sharpened, but pain not recognized. Thoughts and images are clear and controllable while physical performance seems effortless and automatic. To measure this phenomenon accurately and completely is not possible in a dynamic state, but to shape it's appearance and to extend duration is essential in finite psychomotor skills like golf.
Physical preparation for performance is mentally grueling and fatiguing. If often results in trance-like, dis-associative and sometimes
dissociative states where depersonalization is a valuable technique to block out the intense suffering and pain associated with running, swimming or bicycling. The difficulty in sport is being able to switch in and out of full alertness for some strategic tasks while remaining in the dissociative state for endurance. The experience of flow, absorption and being in the zone is to harness power and ultimately unleash explosive yet finely titrated effort.
Concentration is the umbrella concept that also encompasses EMDR. The process of actively shifting eye focus from left to right while striving to hold an image or statement of emotionality is exceedingly difficult and ultimately beyond control. The combination of EMDR with neurofeedback is an innovative intervention that holds potential for greater impact in removing negative images of failed effort or in solidifying the recall of a successful effort. The neurofeedback serves to reinforce the development of greater mental stamina toward intensively focus comparable to zooming in a camera lens thus blocking out distractions and irrelevant stimuli. Enhanced quality of visualization is the desired outcome for the performance enhancement sport psychology consultant and his/her client.
Keywords: Absorption Concentration Dissociation Desensitization Flow Neurofeedback Performance Enhancement Tiger Woods The Zone
Accuracy Verified: No
8. Paulsen, S. L. (2006, November). ACT-AS-IF and ARCHITECTS approach to utilizing ego state therapy, somatic psychotherapy and EMDR with highly dissociative clients. Presentation at the annual meeting of the International Society for the Study of Trauma & Dissociation, Los Angeles, CA.
Language: English
Format: Conference
Keywords: Act-As-If Architects Dissociation Ego State Therapy Somatic Psychotherapy
Accuracy Verified: Yes
9. Paulsen, S. (2009). ACT-AS-IF and ARCHITECTS approaches to EMDR: Treatment of dissociative identity disorder (DID). In M. Luber (Ed.), Eye movement desensitization (EMDR) scripted protocols: Special populations (pp. 357-386). New York: Springer Publishing Co.
Language: English
Format: Book Section
Keywords: Act-As-If Architects DID Dissociative Identity Disorder Protocol
Accuracy Verified: Yes
10. Fisher, J. A. (2000, November). Adapting EMDR techniques in the treatment of dysregulated or dissociative patients. Presentation at the International Society for the Study of Dissociation Annual Meeting, San Antonio, Texas.
Language: English
Format: Conference
Abstract:
Since its inception, EMDR [Eye Movement Desensitization and Reprocessing]
has been understood by both clinicians and patients as a powerful vehicle for processing
traumatic experience but one to be undertaken only when the patient has achieved some
degree of stabilization (Shapiro, 1992). In DID and DDNOS patients, that baseline
stability is also supposed to include a level of internal communication and consensus that
would permit cooperation between parts of self about how to tolerate the memory
processing and how to re-stabilize afterward. However, as any clinician who works with
this population knows, some dissociative disorder patients never achieve that degree of
internal coherence, and some have a long, rocky, tumultuous, exhausting road to travel
before they get there. Faced with the DID or DDNOS patient who cannot tolerate affect
or associations to traumatic memories; who cannot control switching, get grounded, or
resolve internal struggles over power and control; who is unable to manage selfdestructive
impulses; who cannot differentiate past and present experience; who is even
unable to tolerate Resource Development (Korn & Leeds, 2002) or create a Safe Place
inside—is there any way that EMDR can be helpful?
Keywords: Dissociation Dysregulation
Accuracy Verified: Yes
11. Twombly, J. (2001, June). Advanced adaptations in the treatment of dissociative disorders. Presentation at the annual meeting of the EMDR International Association, Austin, TX.
Language: English
Format: Conference
Abstract:
Participants of this workshop will learn how to incorporate EMDR adaptations within treatment stages of Dissociative Disordered clients. They will also learn how to facilitate stability, present time, and height orientation, set up a protective format for processing traumatic material, and applications to ego state work.
Keywords: Dissociative Disorders
Accuracy Verified: Yes
12. Dworkin, M. (2008, September). Advanced clinical strategies for clients with complex PTSD and dissociation. Presentation at the annual meeting of the EMDR International Association, Phoenix, AZ.
Language: English
Format: Conference
Abstract:
Clients with complex PTSD and dissociation present many challenges. The neurosciences have helped us to begin to understand and deal with them through a recent clarification of mirror neurons and associated neural structures in both the clinician and client. Concepts from the Boston Change Process Study Group and ego state therapy provide methods of analyzing and intervening in the “microprocesses” that occur in treatment. Hoppenwasser’s concept of “dissociative attunement” challenges thinking about the “multiple self states” both clinician and client operate from. Her ideas push us to rethink current conceptualizations of relatedness. Participants will learn how to deal with ruptures in positive empathy that may result in the history taking, assessment, and desensitization phases. In the preparation phase, participants learn to use the therapeutic relationship as an additional resource for containment. Concepts of dyadic regulation of affect, now moments and moments of meeting will be taught to deal with ruptures to the therapeutic relationship throughout treatment. Dealing productively with countertransference ruptures poses additional challenges. Participants will learn a strategy called the “relational interweave”. Its function is to restore EMDR processing when an interpersonal “event” has temporarily derailed the work. A practicum using Dworkin’s Clinician Self Awareness Questionnaire will be held in the afternoon part of the workshop to enhance learning this strategy.
Keywords: Complex Posttraumatic Stress DIsorder Complex PTSD C-PTSD Dissociation
Accuracy Verified: Yes
13. Twombly, J. (2000, September). Advanced EMDR adaptations in the treatment of dissociative disorders. Presentation at the annual meeting of the EMDR International Association, Toronto, Ontario Canada.
Language: English
Format: Conference
Abstract:
Participants will: 1) learn how to incorporate EMDR and EMDR adaptations within the stages of treatment of Dissociative Disordered (DD) clients; 2) learn how to facilitate present time, and height orientation for clients with DDs; 3) learn how to set up a protective format for processing traumatic material with DD clients; and 4) learn how to apply EMDR adaptations in ego state work.
Keywords: Dissociative Disorders
Accuracy Verified: Yes
14. Forgash, F., & Litt, B. (2008, September). Advanced techniques in the EMDR-based treatment of complex trauma. Presentation at the annual meeting of the EMDR International Association, Phoenix, AZ.
Language: English
Format: Conference
Abstract:
EMDR is an important therapy in the treatment of complex PTSD, including dissociative disorders and certain personality disorders. This presentation will provide solutions to problems within the 8 phases of EMDR. Objectives include managing triggers and dealing with reactions such as avoidance, freeze, and hyperarousal. Techniques include ego state work and somatic interweaves. Therapists will learn readiness criteria for trauma processing (phase 4-7) and how to avoid premature interventions. In phase 4, therapists will learn about the zone of optimal arousal and a sequence of techniques to maintain client stability and to identify when and why a patient has stopped processing.
Keywords: Complex Trauma Treatment
Accuracy Verified: Yes
15. Litt, B. (2012, October). Advanced techniques in the EMDR-based treatment of complex trauma. Presentation at the 29th annual meeting of the International Society for the Study of Trauma and Dissociation, Long Beach, CA.
Language: English
Format: Conference
Abstract:
Abstract:EMDR is an efficacious therapy for the treatment of PTSD. Increasingly, EMDR is being recognized as an important and viable therapy in the treatment of complex PTSD, including Dissociative Disorder Not Otherwise Specified, Dissociative Identity Disorder, and personality disorders that have their origins in attachment trauma. This population presents unique clinical challenges in terms of stability, affect tolerance, and accessibility to trauma resolution. While much has been written and presented about affect regulation, attachment issues, and dissociation, therapists are not often aware that these phenomena emerge and must be managed throughout all phases of EMDR therapy. This presentation will focus on advanced techniques that provide solutions to problems within phases 2,3, and 4. Clinicians will learn techniques to incorporate in the stabilization/ preparation phase and to revisit as necessary in later stages of EMDR treatment. Objectives include helping the patient effectively deal with reactions such as avoidance, freeze, hyperarousal and numbing. Techniques include ego state work and somatic interweaves.In Phase 4, (desensitization) therapists will be learn about the Zone of Optimal Arousal and learn a sequence of advanced techniques to maintain client stability and safety, and to identify when and why a patient has stopped processing.
Learning Objectives:
Participants will be able to perform a series of strategies for overcoming looping and blocking in EMDR phases three and four.
Participants will be able to utilize the Domains of Self Model to rapidly assess triggers and anticipate processing style and resolution profile.
Participants will be able to utilize the Zone of Optimal Processing model to assess problems with processing and select appropriate strategies to safely resume desensitization.
Keywords: Advanced Techniques Complex Trauma
Accuracy Verified: Yes
16. Leeds, A. (2012, June). Affect phobias in EMDR therapy - developing affect tolerance capacities in client and clinician [Fobias afectivas en la terapia con EMDR -‐ El desarrollo de habilidades para la tolerancia afectiva en el cliente y el clínico]. Presentation at the annual meeting of the EMDR Europe Association, Madrid, Spain.
Language: English
Format: Conference
Abstract:
Affect phobias may also be described as psychodynamic or dissociative
defenses or as ego state conflicts. When patients present with affect phobias and
fail to progress with standard EMDR procedural interventions, EMDR therapy can
still be effective when clinicians have the conceptual knowledge and perceptual
skills to recognize these defenses, and when they can make use of a flexible set of
advanced EMDR procedural stills for responding. EMDR trained clinicians must
also confront their own affect phobias and psychodynamic conflicts as they
experience a range of responses to their work with patients including
countertransference and vicarious traumatization that can disrupt their ability to
make use of their conceptual, perceptual and procedural knowledge and skills.
This presentation provides an overview of concepts from Short-Term Dynamic
Psychotherapy (STDP: McCullough, 1997, 2003) and the Theory of Structural
Dissociation of the Personality (TSDP: van der Hart, Nijenhuis & Steele, 2006) and
identifies procedures from Knipe (1999, 2003, 2005, 2008, 2009, 2010a, 2010b,
2010c), Mosquera (2010, 2011), Mosquera and Gonzalez (2010), and Leeds
(2001), which clinicians can employ with cases involving affect phobia. We will
also consider how clinicians can be sensitive to and mitigate the potential impact
of their own affect phobias in their clinical work.
Las
fobias
al
afecto
también
se
pueden
describir
como
defensas
psicodinámicas,
disociativas
ó
como
conflictos
del
estado
del
yo.
Cuando
los
pacientes
presentan
fobias
al
afecto
y
no
avanzan
con
las
intervenciones
siguiendo
los
procedimientos
de
EMDR
habituales,
EMDR
aún
puede
ser
efectivo
cuando
los
clínicos
gozan
del
conocimiento
conceptual,
así
como
las
habilidades
perceptivas
para
reconocer
dichas
defensas
y
cuándo
puede
servirse
de
un
conjunto
flexible
de
habilidades
de
procedimiento
de
EMDR
para
responder
[ante
ellas].
Los
clínicos
formados
en
el
uso
de
EMDR
también
han
de
afrontar
sus
propias
fobias
y
conflictos
psicodinámicos
a
medida
que
pasen
por
una
variedad
de
respuestas
a
su
trabajo
con
pacientes,
incluidas
la
contra-‐transferencia
y
la
traumatización
indirecta
que
pueden
perturbar
su
capacidad
para
aprovechar
sus
conocimientos
y
habilidades
conceptuales,
perceptivos
y
habilidades.
La
presente
ponencia
ofrece
una
visión
del
conjunto
de
los
conceptos
de
Short-‐Term
Dynamic
Psychotherapy
(STDP:
McCullough,
1997,
2003)
[psicoterapia
dinámica
breve]
y
de
Theory
of
Structural
Dissociation
of
the
Personality
(TSDP:
van
der
Hart,
Nijenhuis
&
Steele,
2006)
[teoría
de
la
disociación
estructural
de
la
personalidad]
e
identifica
procedimientos
de
Knipe
(1999,
2003,
2005,
2008,
2009,
2010a,
2010b,
2010c),
Mosquera
(2010,
2011),
Mosquera
y
Gonzalez
(2010)
y
Leeds
(2001)
que
pueden
aplicar
los
clínicos
en
casos
de
fobia
al
afecto.
También
se
contemplará
cómo
los
clínicos
pueden
estar
sensibles
ante
el
impacto
potencial
de
sus
propias
fobias
al
afecto
y
cómo
mitigarlo
en
su
trabajo
clínico.
Keywords: Affect Phobias
Accuracy Verified: Yes
17. Edalatian-McCain, N. (2008, September). AIP model and treatment of clients with dissociative symptoms or disorders. Presentation at the annual meeting of the EMDR International Association, Phoenix, AZ.
Language: English
Format: Conference
Abstract:
Principles derived from Adaptive Information Processing, the theoretical basis of EMDR that are particularly relevant to working with clients with dissociation are discussed. These include principles that explain the development of dissociation, as well as those that inform treatment. Using case vignettes, these principles are applied to all phases of EMDR treatment, from case conceptualization to re-processing of traumas. It is shown how AIP informs the therapist of the prerequisites for successful trauma processing, needed resources, in-session tools, how to guide the client through reprocessing of the traumatic material in an adaptive way, and how to prevent re-traumatization.
Keywords: Adaptive Information Processing Model AIP Model Dissociative Disorders Dissociative Symptoms
Accuracy Verified: Yes
18. Seidler, G. H. (2002). Aktuelle therapieansätze in der psychotraumatologie [Psychotraumatology: Recent therapy approaches]. Zeitschrift für Psychotraumatologie und Psychologische Medizin, 48(1), 6-27.
Language: German
Format: Journal
Abstract:
Psychologische Behandlung von traumatischen Belastungsstörungen mit EMDR
Heutige Therapieansätze in der Psychotraumatologie Zentrum rund um das Problem der effektiven Zugang zu spezifischen Trauma-Symptome: Einbrüche; affektive Abstumpfung und Vermeidungsverhalten, Übererregung. Unter seinem Lager aus dem deutschen und amerikanischen Leitlinien PTSD-Therapie, skizziert der Artikel die wichtigsten Therapiemethoden und bewertet sie im Hinblick auf die relevanten Qualitätskriterien. EMDR, kognitiv-behavioralen Ansätzen, modifizierte psychodynamische Methoden und Trauma-adaptierten stationären Psychotherapie können so lange empfohlen werden, da sie in Verbindung mit stabilisierenden Elemente-Therapie eingesetzt werden. Normalerweise sind weitere therapeutische Interventionen auch notwendig, Zeichnung auf traditionelle Methoden für die Integration des Traumas in den Patienten-Biographie. [Abstract Autor]
Present-day therapy approaches in psychotraumatology center around the problem of effective access to specific trauma symptoms: intrusions; affective blunting and avoidance behaviors; hyperarousal. Taking its bearings from the German and American PTSD therapy guidelines, the article outlines the most important therapy methods and assesses them in terms of relevant quality criteria. EMDR, cognitive/behavioral approaches, modified psychodynamic methods, and trauma-adapted inpatient psychotherapy can be recommended as long as they are used in conjunction with stabilizing therapy elements. Normally, further therapeutic interventions are also necessary, drawing on traditional methods for integrating the trauma into the patient's biography. [Author Abstract]
Keywords: Posttraumatic Stress Disorder Psychotherapy PTSD Review Stressors Survivors
Accuracy Verified: Yes
19. Swedish Council on Technology Assessment (2001, April). Alert: EMDR - Psychotherapy in posttraumatic stress syndrome in young people - early assessment briefs. Swedish Council on Technology Assessment in Health Care (SBU).
Language: English
Format: Publication
Abstract:
Findings by SBU Alert,
Version: 1,
METHOD AND TARGET GROUP:
EMDR (Eye Movement Desensitization and Reprocessing) is a new psychotherapeutic method aimed at processing memories of traumatic events, thereby ameliorating the psychological consequences of these memories. EMDR involves elements from several different psychological approaches. It is uncertain which of the treatment elements are effective. Clients with post traumatic stress disorder (PTSD) are the main target group for EMDR treatment. Although both children and adults have been treated with EMDR, this document is aimed particularly at children and adolescents.
PATIENTS BENEFITS, RISKS AND SIDE EFFECTS:
Published studies of EMDR mainly cover adults with PTSD. There are two randomized and controlled studies, one of which has yet to be published, of EMDR treatment in 47 children and adolescents. One of the studies suggests that EMDR yields a better treatment outcome in the short term compared to the control treatment (active listening). In the second study, no significant difference was found between EMDR treatment in combination with standard treatment and standard treatment alone as regards reduction in avoidance and invading thoughts. However, the PTSD symptom of behavioral disorders declined significantly in the EMDR group. Furthermore, numerous case studies suggest that EMDR has a positive treatment effect in children and adolescents with PTSD. No harmful effects have been reported.
ECONOMIC ASPECTS:
There are no economic assessments of EMDR. Limited data suggest that fewer treatments are needed to achieve the desired outcome with EMDR compared to other psychotherapeutic methods. This suggests that EMDR is a potentially cost-effective method in relation to the alternatives, under the assumption that the effects of treatment are permanent.
CURRENT SCIENTIFIC EVIDENCE:
There is moderate* scientific evidence to show the benefits of EMDR treatment in children and adolescents. There is no* documentation concerning the cost-effectiveness or effects beyond 6 months.
Since the scientific documentation is limited, the effects of EMDR treatment in both the short and long term should be compared in studies with other treatment alternatives, including standard treatment. Furthermore, the cost-effectiveness of the method should be studied under Swedish conditions.
*This assessment by SBU Alert uses a 4-point scale to grade the quality and evidence of the scientific documentation. The grades indicate: (1) good, (2) moderate, (3) poor, or (4) no scientific evidence on the subject.
This summary is based on a report prepared at SBU in collaboration with Kerstin Bergh Johannesson, Lic. Psychol., Akademiska Hospital, Uppsala and has been reviewed by Prof. Mats Fredriksson, Uppsala University, Uppsala.
REFERENCES:
1.) Cahill SP, Carrigan MH, Frueh BC. Does EMDR work? And if so, why? A critical review of controlled outcome and dismantling research. J Anxiety Disord 1999;13(1-2):5-33.
2.) Chemtob CM, Nakashima J, Hamada R, Carlson J. Brief treatment for elementary school children with disaster-related PTSD: a field study. J Clin Psychol, in press.
3.) Chemtob et al. Eye movement desensitization and reprocessing. In: Foa EB, Keane TM, Friedman MJ, eds. Effective treatments for PTSD. New York: Guilford, 2000.
4.) Devilly GJ, Spence SH. The relative efficacy and treatment distress of EMDR and a cognitive-behavior trauma treatment protocol in the amelioration of posttraumatic stress disorders. J Anxiety Disord 1999;13(1-2):131-57.
5.) Lovett J. Small Wonders: Healing childhood trauma with EMDR. New York: Free Press, 1999.
6.) Macklin ML, Metzger LJ, Lasko NB, Berry NJ, Orr SP, Pitman RK. Five-year follow-up study of eye movement desensitization and reprocessing therapy for combat-related post traumatic stress disorder. Comprehensive Psychiatry 2000;41(1),24-27.
7.) Puffer MK, Greenwald R, Elrod DE. A treatment outcome study of eye movement desensitization and reprocessing (EMDR) with traumatized children and adolescents. Presented at the annual conference of the EMDR International Association, Denver, June 1996.
8.) Renfrey G, Spates CR. Eye movement desensitization and reprocessing: A partial dismantling procedure. J Behav Ther Experiment Psychiatr 1994;25:231-239.
9.) Scheck MM, Schaeffer JA, Gilette CS. Brief psychological intervention with traumatized young women: The efficacy of eye movement desensitization and reprocessing. J Trauma Stress 1998;11:25-44.
10.) Shapiro F. Eye movement desensitization and reprocessing: Basic principles, protocols and procedures. New York: Guilford Press, 1995.
11.) Stallard P, Velleman R, Baldwin S. Prospective study of post-traumatic stress disorder in children involved in road traffic accidents. BMJ 1998;317:1619-1623.
12.) Soberman GB, Greenwald R, Rule DL. A controlled study of eye movement desensitization and reprocessing (EMDR) for boys with conduct problems. J Aggression Maltreatment Trauma, in press.
13.) Tinker RH, Wilson SA. Through the Eyes of a Child: EMDR with children. New York: Norton & Co, 1999.
14.) van der Kolk B. Biological response to psychic trauma. In: Wilson JP, Raphael B, eds. International Handbook of Traumatic Stress Syndromes. New York: Plenum Press, 1993:25-33.
15.) van der Kolk B, Burbridge J, Susuki J. The psychobiology of traumatic memory; clinical implications of neuroimagery studies. Annals of the New York Academy of Sciences 1997;821:99-113.
16.) van Etten M, Taylor S. Comparative efficacy of treatments for post-traumatic stress disorder: a meta-analysis. Clin Psychol Psychother 1998;5:126-144.
17.) Wilson SA, Becker LA, Tinker RH. Fifteen-month follow-up of eye movement desensitization and reprocessing (EMDR) treatment for posttraumatic stress disorder and psychological trauma. J Consult Clin Psychol 1997;65(6):1047-1056.
18.) Wilson SA, Tinker RH, Hoff.
Alert is a joint effort by the Swedish Council on Technology Assessment in Health Care (SBU), the Medical Products Agency, the National Board of Health and Welfare, and the Federation of Swedish County Councils.
The complete report is available in Swedish only.
Keywords: Posttraumatic Stress Disorder Practice Guidelines PTSD
Accuracy Verified: Yes
20. Phillips, M. (2002, June). All for one and one for all: Integrating EMDR, ego-state therapy and energy psychology. Presentation at the annual meeting of the EMDR International Association, San Diego, CA.
Language: English
Format: Conference
Abstract:
One of the most challenging barriers to healing from past trauma is the inner conflict triggered by dissociative fragmentation. This workshop
presents several ways of synthesizing ego-state therapy, EMDR and energy psychology methods to resolve competing inner needs and reactions and
promote more integrated functioning within a comprehensive four stage model. Specific protocols incorporating ego-state work, EMDR and
meridian (energy) techniques will be demonstrated and practiced. Special emphasls will be given to the resolution of mind/body symptoms that
interface with trauma.
Keywords: Ego State Therapy Energy Psychology Meridian Therapy Mind/Body
Accuracy Verified: Yes
21. Lawrence, M. A. (2004, November). Alternating bilateral stimulation as a treatment for dissociative phenomenology. Presentation at the annual meeting of the International Society for the Study of Dissociation, New Orleans, LA.
Language: English
Format: Conference
Keywords: Bilateral Stimulation BLS Dissociation
Accuracy Verified: No
22. Staff. (2002, November/December). Alternative treatments for anxiety disorders: EMDR. Triumph Newsletter.
Language: English
Format: Newsletter
Abstract: The alternative therapy addressed in this article is Eye Movement Desensitization and Reprocessing (EMDR) developed by Francine Shapiro, Ph.D. in 1987. One day, while walking in a park, Dr. Shapiro made a connection between her involuntary eye movements and the reduction of her negative thoughts. She decided to explore this link and began to study eye movements in relation to the symptoms of Posttraumatic Stress Disorder (PTSD). PTSD is an anxiety disorder that is characterized by the development of symptoms after exposure to a traumatic event. Symptoms can include re-experiencing the event - either in flashbacks or nightmares - avoidance of reminders of the event, feeling jumpy, having difficulty sleeping, having an exaggerated startle response, and experiencing feelings of detachment.
Keywords: Anxiety Disorders General Overview
Accuracy Verified: Yes
23. O'Shea, K. (2008, June). Anger, imagination and EMDR – what EMDR has taught us about the importance of anger and how to facilitate its safe release. Presentation at the annual meeting of the EMDR Europe Assocation, London, England.
Language: English
Format: Conference
Abstract:
Jaak Panksepp’s text, Affective Neuroscience (1998), informs us of the vast amount of neurological data available
to show that, like all mammals, anger is one of our basic affective circuits. Yet it is not identified as such in the
diagnostic manual, at least here in the States. Only the destructive outcomes of angry behaviors are included.
Guiding EMDR sessions over the past 17 years has given me the opportunity to observe the nondestructive
release of anger as a protective response to harmful (traumatic) experiences. Imagination appears to provide us
with an innate ability to acknowledge the degree of harm, and to experience, at a physical level, the capability to
protect ourselves and others, if anything similar recurs. Following that release, I consistently see what I call
“Compassion-with-Protection”, spontaneously expressed. Others call it “forgiveness”. Because of their
experiences with destructive anger and our cultural avoidance of anger, clients often have difficulty allowing
their angry feelings to be felt and released during EMDR work. Letting them know they have this capability can
enable them to “just notice what happens” during trauma reprocessing. This workshop will address, via
description and case examples, how EMDR has clarified the nature of anger. It will specify how EMDR clinicians
can support their clients in releasing anger non-destructively (by clearing the anger circuit during Preparation,
teaching them how the Imagination works - for self-use and during reprocessing, - and identifying the most
efficient targeting sequences), so they can update their systems to their current level of capability and fully
experience the “Compassion-with-Protection” that naturally follows.
Keywords: Anger Imagination
Accuracy Verified: Yes
24. de Jongh, A. (2005, November). Angstjes, angsten en fobieën: Hoe pak je het simpel aan met EMDR? [Anxiety, fears and phobias: How to go about it simple with EMDR?]. Presentatie op de eerste congres van de Vereniging EMDR Nederland, Ede, Nederland.
Language: Dutch
Format: Conference
Abstract:
EMDR is een gevalideerde behandelmethode voor psychisch trauma. Maar niet altijd leidt het meemaken van een vervelende gebeurtenis tot PTSS: angsten of fobieën zullen veel vaker het gevolg zijn. In veel gevallen is de behandeling van een fobische stoornis zelfs een stuk lastiger dan van een PTSS. Dit komt omdat er meer geheugenrepresentaties moeten worden bewerkt. Een complicerende factor in de behandeling kan verder zijn dat we te maken hebben lastig, ingesleten vermijdingsgedrag (bijv. bij sociale angst) of dat een bepaalde stimulussituatie objectief vervelende kantjes heeft (bijv. bij sommige medische angsten).
In deze workshop leren de deelnemers:
- een handige manier om angsten te diagnosticeren en casuïstiek te conceptualiseren in termen van EMDR
- te beslissen in welke gevallen EMDR is aangewezen, wanneer een cognitief gedragstherapeutische aanpak (of een combinatie) beter geschikt is en hoe deze behandeling eruit ziet
- gericht angsttargets te identificeren en snel tot de juiste NCs en PCs te komen
- cliënten voor te bereiden op moeilijke of relatief onveilige stimulussituaties
Het materiaal wordt gepresenteerd aan de hand van videobeelden, demonstraties en oefeningen. De workshop is geschikt voor ervaren en minder ervaren behandelaars, zowel op het terrein van volwassenen als kinderen en jeugd.
EMDR is a validated treatment for psychological trauma but does not require the experience of an unpleasant event for PTSD: fear or phobias are more often the result. In many cases, the treatment of a phobic disorder even more difficult than one PTSD. This is because more memory representations should be modified. A complicating factor in treatment may also be that we are facing difficult ingrained avoidance behavior (e.g. social anxiety) or that a certain objective stimulussituatie nasty lace has (e.g. some medical fears).
In this workshop participants learn:
- A convenient way to diagnose anxiety and case studies to conceptualize in terms of EMDR
- To decide cases in which EMDR is appropriate when a cognitive behavioral approach (or a combination) is more suitable and how this treatment looks
- Terror targets aimed to identify and quickly correct the NCS and PCs to come
- Clients to prepare for difficult or relatively unsafe stimulussituaties
The material is presented on the video footage, demonstrations and exercises. The workshop is suitable for experienced and less experienced practitioners, both in the field of adults and children and youth.
Keywords: Anxiety Fears Phobias
Accuracy Verified: Yes
25. Lanius, U. F. (2004, September). Apego y disociacion, El papel de los opioides endógenos [Attachment and dissociation: The role of endogenous opioids]. Presentation at the annual meeting of the EMDR International Association, Montreal, Quebec Canada.
Language: Spanish
Format: Conference
Abstract:
Endogenous opiates play a major role in attachment and they are also involved in dissociative processes and somatoform dissociation. The presentation discusses the adjunctive use of opoid antagonists both during stabilization and trauma processing with EMDR and the neurobiology of opiate with regard to attachment and dissociation. It delineates the effects of effects on learning including support for a differential mechanism for EMDR as compared to Exposure treatment. It describes how to integrate EMDR processing and the use of opioid antagonists in the treatment of Complex PTSD.
Opiáceos endógenos juegan un papel importante en la adhesión y que también están involucrados en los procesos disociativos y somatomorfos disociación. La presentación trata sobre el uso complementario de los antagonistas de opoides tanto durante la estabilización y el procesamiento del trauma con EMDR y la neurobiología de los opiáceos, con lo que se refiere a la unión y la disociación. Se exponen los efectos de los efectos en el aprendizaje incluido el apoyo a un mecanismo diferencial para EMDR, en comparación con el tratamiento de la exposición. En él se describe la forma de integrar el procesamiento EMDR y el uso de antagonistas de los opioides en el tratamiento del trastorno de estrés postraumático complejo.
Keywords: Attachment Dissociation Endogenous Opioids
Accuracy Verified: Yes
26. Negadi, F., Pelissolo, A., Jouvent, R., & Allilaire, J. F. (2007, Septembre). Application de l’EMDR en sexotraumatologie: Évolution de la comorbidité psychopathologique à propos d'un cas d'agression sexuelle [EMDR applied to sexual traumatology: Evolution of psychopathological comorbidity in the case of sexual aggression]. Annales Médico-Psychologiques, Revue Psychiatrique, 165(7), 523-528. doi:10.1016/j.amp.2007.06.002.
Language: French
Format: Journal
Abstract:
L'accès thérapeutique des patients victimes d'agression sexuelle est souvent à travers une double perspective: celle du traitement de stress post-traumatique (SSPT) et d'évitement sexuel. En légère ou modérée cas de SSPT, il ya des formes complexes où la comorbidité est plus évident et le taux d'échec thérapeutique est plus important. À l'heure actuelle des méthodes de traitement actif, basé sur l'exposition, plus particulièrement EMDR (désensibilisation des mouvements oculaires et retraitement) considérée comme une thérapie brève et active, donnent de bons résultats dans le traitement de la symptomatologie traumatique. Peu d'études ont été menées sur l'évolution psychopathologique de patients ayant souffert d'agressions sexuelles et qui sont pris en charge par l'EMDR. Dans le cadre d'une étude de cas, les auteurs discutent des éléments indiquant une évolution rapide de la symptomatologie traumatique, l'évitement sexuel et de la régression de l'expression des signes de co-morbidité. [Auteur] Résumé
The therapeutic access of patients victims of sexual aggression is often through a double perspective: That of treating Post Traumatic Stress Disorder (PTSD) and of sexual avoidance. In light or moderate PTSD cases, there are complex forms in which co-morbidity is more evident and the rate of therapeutic failure is more important. At present active treatment methods based on exposure, more particularly EMDR (Eye Movement Desensitization and Reprocessing) considered as a brief and active therapy, give good results in the treatment of traumatic symptomatology. Few studies have been undertaken on the psychopathological evolution of patients having suffered from sexual attacks and who are being taken care of by EMDR. Within the framework of a case study, the authors discuss elements indicating a rapid evolution of traumatic symptomatology, of sexual avoidance and of regression of the expression of the co-morbidity signs. [Author Abstract]
Keywords: Brief Therapy Clinical Case Study Sexotherapy Sexual Trauma
Accuracy Verified: Yes
27. Paulsen, S. L. (1993). Application of EMDR in MPD. Presentation at the annual meeting of the Hawaii Psychological Association, Honolulu, HI.
Language: English
Format: Conference
Keywords: DID Dissociative Identity Disorder MPD Multiple Personality Disorder
Accuracy Verified: Yes
28. Hamilton, C. (1998, November). Application of eye movement desensitization and reprocessing (EMDR) in the treatment of dissociative disorders. Presentation at the annual conference of the international Society for the Study of Dissociation in Seattle, Washington.
Language: English
Format: Conference
Keywords: Dissociative Disorders
Accuracy Verified: Yes
29. Lansch, D. (2010, June). Application of the Four-Fields-Technique in treatment of a patient with dissociative disorder (case report). In Complex trauma. Symposium conducted at the annual meeting of the EMDR Europe Association, Hamburg, Germany.
Language: English
Format: Conference
Abstract:
The treatment of complex traumatized patients is difficult.
Especially during long term treatments it is not easy for
the chronically traumatized individuals to tolerate the exhausting
confrontation with the trauma during the EMDR standard
procedure. On the other hand they have often problems to
recognize the severity of what happened to them. Many have
problems with their compromised feelings of self-worth. Those
and other clinical problems are the reason to look for alternative
EMDR techniques. The Four-Field-Technique. one of the techniques of EMDR.
could be a good approach to solve some of these problems.
It was developed by Jarero et al, as a group protocol which
followed the 8 phases of the standard EMDR protocol (STDP).
Different from the STDP is that the moment of greatest distress
is drawn on a sheet of paper (after drawing a resource image
before and installing it with (bilateral: butterfly hugs. Different
from the group protocol patients some benefit greatly from the
individual application of the technique.
In this lecture the long term treatment of a patient with a dissociative
disorder is reported. Thereby the different phases of trauma
treatment will be demonstrated via spates of pictures. The four field-
technique itself will be explained as well as the difference to
the standard protocol of EMDR as the patient experienced.
Keywords: Case Report Dissociative Disorder Four-Fields-Technique Symposium
Accuracy Verified: Yes
30. Villa, M., & Sangiovanni, L. (2008, Novembre). Applicazione dell’EMDR ad una nuova popolazione: I pazienti posturali con dolore cronico e con deficit percettivi [Applying EMDR to a new population: Patients postural with chronic pain and perceptual deficits]. Presentazione al Applicazioni Cliniche dell'EMDR Congresso Nazionale, Milano, Italia.
Language: Italian
Format: Conference
Abstract:
Lo studio riguarda l’applicazione dell’EMDR ai Pazienti affetti da “Sindrome da deficit posturale” (Da Cuña). Il problema coinvolge il 10% della popolazione, di cui il 15% è sintomatico. È di difficile inquadramento, dato che i sintomi somatici che presenta coinvolgono tutti e tre i versanti delle regolazioni automatiche: dolori muscolo-scheletrici migranti, derivanti da disordini posturali; pseudovertigini, da deficit di localizzazione spaziale; disturbi cognitivi (fino alla dislessia), da alterata integrazione percettiva. Le modalità compensatorie a tali deficit possono investire la sfera psicologica (senso profondo di inadeguatezza, ansia, depressione...), sviluppare atteggiamenti strategici di evitamento (agorafobia da deficit di orientamento spaziale), spingere a interpretare reazioni fisiche come se fossero psicologiche (attacchi di panico, enuresi notturna…). Proprio il sottile intreccio tra aspetti somatici e psicologici rende complessa la diagnosi; può capitare infatti che un paziente con problemi di questa natura si rivolga a un terapista somatico (posturologo, osteopata…), che non coglie il problema. Abbiamo così messo a punto un sistema diagnostico che riconosca se l’aspetto psichico sia conseguenza di un vero disturbo somatico o se invece sostenga una serie di somatizzazioni tendenzialmente derivanti da traumi. Nell’uno o nell’altro caso, l’utilizzo dell’EMDR può essere risolutivo: evidentemente sul versante traumatico, ma pure per la desensibilizzazione delle convinzioni negative derivate dalle strategie psicologiche reattive al deficit somatico. Metodi. La valutazione diagnostica e le variazioni sintomatologiche sono state effettuate con DSMIV, SWAP-200, SCL90-R, TAS 20, VAS, anamnesi posturologica, kinesiologia, posturodinamica, riflessi primitivi e sensoriali, valutazione osteopatica, Maddox, stabilometria basale e con challenges). Risultati. Gli interventi su misura hanno ridotto la sintomatologia, come è rappresentato dalle rilevazioni effettuate e dai feedback dei pazienti. La conoscenza integrata, sia che il primo approccio sia psicologico o posturale, consente una diagnosi accurata e dunque una strategia terapeutica sinergica efficace che permette di sbloccare terapie cronicizzate.
The study concerns the application of EMDR in patients with "postural deficiency syndrome" (Da Cuna). The problem affects 10% of the population, of which 15% are symptomatic. It is
classification difficult, because the somatic symptoms presenting involving all three sides automatic adjustments: musculoskeletal pain migrants from postural disorders; pseudovertigini, spatial localization deficit, cognitive problems (up to dyslexia), from altered perceptual integration. The methods compensatory these deficits can invest the ball psychological (deep sense of inadequacy, anxiety, depression ...), develop attitudes strategic avoidance (agoraphobia deficit spatial orientation), push to interpret physical reactions as if they were psychological (panic attacks, nocturnal enuresis ...). Just the subtle interplay between somatic and psychological aspects makes it difficult to diagnose and can in fact happen that a patient with problems of this nature, please ask a somatic therapy (Posture, osteopath ...), who misses the problem. We have thus developed a diagnostic system that recognize if the appearance is the result of a true mental disorder or whether it supports somatic a series of somatization tendency resulting from trauma. In either case, use EMDR can be resolutely on the side obviously traumatic, but also for desensitization of the negative beliefs derived from psychological strategies responsive to deficit somatic. Methods. The diagnostic evaluation and symptom changes are were made with DSMIV, SWAP-200, SCL90-R, TAS 20, VAS, history Posture, kinesiology, posturodinamica, primitive reflexes and sensory evaluation osteopathic, Maddox, stabilometry baseline and challenges). Results. Tailored interventions have reduced symptomatology, as represented by the surveys conducted and feedback from patients. The integrated knowledge, whether the first approach is psychological or postural, allows a diagnosis accurate and therefore a therapeutic strategy that allows you to unlock synergistic effective therapies chronic.
Keywords: Chronic Pain Perceptual Deficits
Accuracy Verified: Yes
31. Sukirna, S., Sadatun, T. I., & Direzkia, Y. (2008, June). Applying EMDR for tsunami survivors with severe PTSD in a disaster region with minimum mental health facilities. Poster presented at the annual meeting of the EMDR Europe Association, London, England UK.
Language: English
Format: Conference
Abstract:
Tsunami that hit Aceh on the 26th of December 2004 taken approximately 150,000 lives has changed the region
into a devastated area. Although health services and facilities had been re-established and some NGOs started
delivering psychosocial and mental health services, only a few of them focussed on effective trauma therapy
while the number of survivors who need the treatment are enormous. Tsunami survivors in this region are more
likely to suffer from complex PTSD because of years of armed-conflict had been going on in this region. A survey
conducted by Crisis Centre of the Faculty of Psychology University of Indonesia in collaboration with Terre des
Hommes Germany showed high incidents of various psychological disorders amongst child survivors.. The
program of trauma therapy and EMDR organized by Indonesian Psychological Association and TdH Germany
funded by BMZ Germany since 2006 has treated a good number of tsunami survivors with severe PTSD. Hyperarousal,
flashbacks and bad dreams, avoidance, and somatisation are common. There has been no indication
whether there has been a natural process of recovery among those who were not treated. Starting in February
2008 a controlled study on the effectiveness of EMDR is conducted with 30 tsunami survivors with PTSD that will
be randomized into two groups of 15. The treatment group will be given EMDR therapy until April 2008 and
waitlist group will be given EMDR in May 2008. The effectiveness of EMDR will be measured using IES, HTQ, DES
pre and post treatment with EMDR. First follow up will be collected until June 2008.
Keywords: Disasters Poster Tsumani
Accuracy Verified: Yes
32. Oppenheim:, H.-P. (2013, June). Applying EMDR with dissociative disorders. Presentation at the annual meeting of the EMDR Europe Association, Geneva, Switzerland.
Language: English
Format: Conference
Abstract:
Keywords: Dissociative Disorders
Accuracy Verified: No
33. Sautai, G. (2007, Juin). Approche des patient poly-traumatisés par immersion EMDR [Approach of poly traumatised patients with EMDR immersion]. Présentation à la réunion annuelle de l'Association EMDR Europe, Paris, France.
Language: French
Format: Conference
Abstract:
Certains patients présentent "traumatisme poly» ou «empoisonnement psychique» tel que décrit par Jacques Roques dans «Guérir Avec l" EMDR. "Souvent, il s'agit d'un environnement socio culturel a commencé pendant l'enfance. Sur la base de l'hypothèse formulée par Francine Shapiro que le traumatisme peut engendrer des «bloqué les réseaux neuronaux," nous supposons une mise en forme "pourrait se produire au cours de la petite période d'apprentissage.
Exposés à un traumatisme insidieux et répétitifs, un jeune cerveau Virgin Stores réseaux neuronaux liés à la vulnérabilité des enfants en tant que mécanisme de défense. Cela pourrait être obstrué par des perturbations répétitives créer une souffrance psychologique. En tant qu'adulte, ce réseau neuronal inhibiteur, stimulée par déclenchement d'exprimer des comportements excessifs et une forte émotion que nous avons appelé le «non adapté en forme» (NAF).
Nous savons combien il est difficile de prendre ce type d'intoxication »en charge des séances de thérapie EMDR traditionnels en raison de l'interférence des composants multimodal. Habituellement, ils participent émotions mixtes liés à la sécurité, l'estime de soi et le libre choix. Par conséquent, nous avons développé une modalité particulière: EMDR immersion qui est un cours intensif de 10 jours consécutifs de traitement par le patient. «L'objectif clinique est de traiter les dimensions de la croissance personnelle et le développement ainsi que l'élimination de plus de la souffrance» (Francine Shapiro).
Notre expérience comprend 24 patients avec un niveau élevé de troubles psychologiques liés à la NAF. Seuls les patients avec expérience dissociative échelle score inférieur à 25 ont été considérés.
Nous utilisons l'approche thérapie EMDR suivant les 8 étapes du protocole standard.
Nous recevons toute l'histoire chronologique du patient, «de la naissance à aujourd'hui», permet nous permet d'identifier une moyenne de sept objectifs principaux.
Pour être capable de transmuer la NAF à une résolution d'adaptation, nous introduisons un des noms de ressources notamment l '«archaïsme», définie comme «la partie de l'être humain en charge de Live principe de préservation."
Nous l'accès au réseau d'information dysfunctionally stockée par le biais des objectifs.
Nous stimulons le système de traitement de l'information et de la maintenir en forme dynamique avec tactiles et autres additifs stimulations bilatérales. Nous passons l'information par le suivi du processus de libre-association et de lancement des procédures pour s'assurer que la cible transmue à une résolution adaptative.
Comme mesure psychométrique et méthode d'évaluation, nous utilisons l'échelle PCL-S sur les traumatismes exprimé par le patient au début de MED immersion. Le score moyen est de 70 degrés avant l'immersion elle à 28 deux mois plus tard et à 26 six mois plus tard.
En ce qui concerne les résultats encourageants, nous décidons de partager l'expérience afin de mettre à jour.
Some patients present with “poly traumatism” or “psychic poisoning” as described by Jacques Roques in “guérir avec l”EMDR.” Often it is a socio cultural environment started during childhood. Based on the hypothesis formulated by Francine Shapiro that trauma could engender “blocked neuronal networks,” we assume a “formatting” could occur during the childhood learning period.
Exposed to insidious and repetitive trauma, a virgin young brain stores neuronal networks related to the child vulnerability as defense mechanism. That could get blocked by repetitive disturbances creating psychological pain. As an adult, this blocker neuronal network, stimulated by trigger express excessive behaviors and strong emotion we called the “Non Adapted Formatting” (NAF).
We know how difficult it is to take this “poisoning” in charge with traditional EMDR sessions because of the multimodal components interfering. Usually, they involved mixed emotions related to security, self esteem and free choice. Therefore, we developed a particular modality: EMDR Immersion that is an intensive, 10 consecutive days of therapy with the patient. “The clinical goal is to address the dimensions of personal growth and development along with the elimination of over suffering” (Francine Shapiro).
Our experience includes 24 patients with a high level of psychological disturbance related to the NAF. Only patients with Dissociative Experience Scale score less than 25 were considered.
We use EMDR therapy approach following the 8 phases of the standard protocol.
We receive the complete chronological story of the patient, “from birth to now,” allows allows us to identify an average of seven main targets.
To be able to transmute the NAF to an adaptive resolution, we introduce a particular resource names “Archaism” defined as “Part of the human being in charge of Live Principle Preservation.”
We access the dysfunctionally stored information network through the targets.
We stimulate the information-processing system and maintain it in dynamic form with tactile and additive alternative bilateral stimulations. We move the information by monitoring the free-association process and initiating procedures to make sure that the target transmutes to an adaptive resolution.
As psychometric measurement and method evaluation, we use PCL-S Scale on the traumatisms expressed by the patient at the beginning of MED Immersion. The average score is at 70 before Immersion it degrees to 28 two months later and to 26 six months later.
Regarding the encouraging results, we decide to share the experiment in order to upgrade it.
Keywords: EMDR Immersion
Accuracy Verified: Yes
34. O’Rawe, B. (2005, June). Assessing dissociation in the visually impaired. Poster presented at the annual meeting of the EMDR Europe Association, Brussels, Belgium.
Language: English
Format: Conference
Abstract:
This case discussion focuses on a traumatically blinded man. Treatment
involved stabilisation using ego-state work with bilateral stimulation, followed
by trauma processing work using EMDR. The aim of this paper is to assess his
response to this approach, and to review the suitability of standard
diagnostic tools used in screening: in porticular the applicability of
Dissociation Scales -The Dissociative Experience Scale (DES) and The
Dissociative Disorders Interview Schedule (DDIS], in people suffering from
blindness
Keywords: Dissociation Poster Visual Impairment
Accuracy Verified: Yes
35. O'Rawe, B. (2005, June). Assessing dissociation in the visually impaired. Presentation at the annual meeting of the EMDR Europe Association, Brussels, Belgium.
Language: English
Format: Conference
Abstract:
This case discussion focuses on a traumatically blinded man. Treatment involved stabilisation using ego-state work with bilateral stimulation, followed by trauma precessing using EMDR. The aim of this paper is to assess his response to this approach, and to review the stability of standard diagnostic tools used in screening; in particluar the applicability of Dissociation Scales - The Dissociative Experience Scale (DES) and the Dissociative Disorders Interview Schedule (DDIS), in people suffering from blindness.
Keywords: Dissociation Visually Impaired
Accuracy Verified: Yes
36. Greenfield, R. (2010, October). The assessment and psychotherapy of a dissociateve adult man with complex PTSD. Presentation at the 27th Annual Meeting of the International Society for the Study of Trauma and Dissociation, Atlanta, GA.
Language: English
Format: Conference
Abstract:
This paper presents the assessment and four year
psychotherapy of a Hispanic man with Complex PTSD
and Dissociative Disorder NOS. The patient’s history of
childhood sexual abuse caused significant disruptions
in normative developmental processes causing what
van der Kolk (2005) posits as a Developmental Trauma
Disorder. Based on Shapiro’s (2001) adaptive information
processing paradigm, the patient’s memories of extensive
childhood sexual victimization became blocked from
resolution from adaptive memory networks, becoming
embedded in the emotional brain and activated by the 9/11
tragedy. This stimulated an array of PTSD and Dissociative symptomatology. In treatment he verbalized and chronicled
his experiences of 9/11 and memories of severe childhood
sexual abuse, establishing a narrative of victimization,
helplessness, and confusion about his sexual orientation
(Gardner, 1999). Furthermore, there were episodes of
dissociation revealing the possibility of alters. Attempts
to access adaptive networks using EMDR protocols were
thwarted by intractable defenses. The patient’s desire
to return to work was offset by his entitlement to Social
Security Disability that was initially denied. Working through
my concordant countertransference (Racker, 1968), I
ultimately accepted his wish for SSD, which he obtained
on appeal based upon my symptom-specific evaluation.
The patient transferred to a clinic that accepted SSD.
Participants will be able to :
♦♦ identify the developmental derailing
effects of childhood sexual abuse on
normative developmental processes.
♦♦ assess how childhood trauma(s) that are
repressed or dissociated are invoked by
trauma(s) in adulthood through associative
memory networks causing Complex PTSD.
♦♦ apply methods of working with patients
dissociative defenses in psychotherapy.
Keywords: Case Study Developmental Trauma Disorder
Accuracy Verified: Yes
37. Carter, A. (2007, June). Assessment and treatment of complex PTSD and dissociative disorders in childhood and adolescence, the role and use of EMDR. Presentation at the annual meeting of the EMDR Europe Association, Paris, France.
Language: English
Format: Conference
Abstract:
Damage occurs to a child’s self in the context of relationship when raised in an environment of abuse and neglect. This damage to self is manifested through disruptions in development. A child or adolescent will be unable to perform tasks a non-traumatized child or adolescent has not difficulty mastering. These tasks may be physical, emotional, intellectual, sexual, social, or spiritual. When these disruptions become manifest in the environment with which the child or adolescent is interacting, home, school, or community, conflict arises. The conflict is both internal with self and external in relationship, behavioral, and biological. This is generally when a child or adolescent is brought into therapy for intervention Caregivers are not always aware of the impact traumatic events have on a child’s life or may not want to deal with the impact and the long term implications. The therapeutic relationship is a context outside of the system where the child was traumatized that provide the potential environment and relationship which can facilitate healing for the child, adolescent, and possible, the system in which they live.
Children and adolescents with a complex PTSD will often employ the use of dissociation as a way to cope with overwhelming events or chronically dysfunctional lifestyles. The degree and way in which the child dissociates to self regulate internal systems will determine behavioural and neurological trajectories in their life such as, how the child will cope, rupture of developmental task attainment, and it will determine what type of attachment process the child experiences. Also determined are: impulse control, sleep regulation, meta cognitive functioning, neurobiological processes and the integrative processes of self. When there is no therapeutic intervention, the self which emerges as a result of these processes is a “traumatic self” organization, that is a self structural in response to traumatic experience determined to avoid the repetition of the traumatic experience “at all costs.” The biological body that emerges is the traumatized body organized for avoidance in the forms of fighting, fleeing, or freezing and submitting.
The assessment phase of therapy will map for the therapist and client where the internal dysregulation occur, what are the maladaptive response which have been developed, and what the negative beliefs are which all contribute to the construction of the “traumatic self." There are a variety of assessment tools specifically designed for this purpose.
Once the map is established, a plan can be developed to use with children and adolescents and family for therapy and for EMDR. There are a variety of models which have been developed to use with children and adolescents to process bad memories, negative cognitions and to strengthen internal resources. EMDR can also be used to facilitate state change, strengthen self regulatory capacities, and promote integrative processes of authentic self, facilitating healing throughout self, body, and relational systems.
Keywords: Adolescents Children Complex Posttraumatic Stress Disorder Complex PTSD C-PTSD Dissociative Disorders
Accuracy Verified: Yes
38. Lanius, U. F. (2004, September). Attachment and dissociation: The role of endogenous opoids. Presentation at the annual meeting of the EMDR International Association, Montreal, Quebec Canada.
Language: English
Format: Conference
Abstract:
Endogenous opiates play a major role in attachment and they are also involved in dissociative processes and somatoform dissociation. The presentation discusses the adjunctive use of opoid antagonists both during stabilization and trauma processing with EMDR and the neurobiology of opiate with regard to attachment and dissociation. It delineates the effects of effects on learning including support for a differential mechanism for EMDR as compared to Exposure treatment. It describes how to integrate EMDR processing and the use of opioid antagonists in the treatment of Complex PTSD.
Keywords: Attachment Dissociation Endogenousopoids
Accuracy Verified: Yes
39. Richman, S., & O'Connor, M. (2013, March). Attachment and trauma. Presentation at the annual workshops EMDR Association UK & Ireland and AGM, Newcastle.
Language: English
Format: Conference
Abstract:
Presents case studies of children and adults who have experienced early attachment disruptions that have adversely affected their development and relationships in childhood and later life. They will discuss the consequences of early attachment disruptions on relationships and learning and the ways in which the 8 phases of the EMDR protocol have to be adjusted to accommodate different attachment styles. They will discuss treatment strategies stemming from the eight-phase EMDR protocol for clients of all ages suffering from attachment disruptions, linking the effect of attachment trauma to dissociative symptoms and other developmental problems. They will also give attention to how the Adaptive Information Processing Theory addresses the impact of attachment trauma.
Keywords: Attachment Trauma
Accuracy Verified: Yes
40. Paulsen, S. (2012, October). Attachment repair and temporal integration: EMDR for early trauma. Presentation at the 29th annual meeting of the International Society for the Study of Trauma and Dissociation, Long Beach, CA.
Language: English
Format: Conference
Abstract:
Progress in neuroscience reveals that attachment learning, affect dysregulation, and traumatic experience are predominantly held in the right hemisphere (Schore, 2009). Therapists can access trauma and neglect held in the right hemisphere using EMDR, somatic awareness, imaginal excursions, and the therapists mirror neuronal experience. This workshop summarizes the Early Trauma approach of EMDR (O'Shea, 2009; and its variations for the dissociative client (Paulsen, in press). Of note is a new stabilization procedure that appears to work directly on the subcortical affective circuits (Panksepp, 1998).
The Early Trauma approach to EMDR processes preverbal implicit memory in sequential time periods, while attending to the nuances of somatic and affective experience as they emerge both in the clients subjective report and in the relationship field. As the infants story is told with the deciphering of these nuances, the therapy repairs developmental milestones imaginally. This enables integration from the bottom up, by time frame, called Temporal Integration (Paulsen, 2009), which contrasts with Strategic and Tactical Integration. Preliminary clinical findings are that the procedure helps repair injuries of attachment, structural dissociation, affect dysregulation and personality. The workshop will interest both EMDR and non-EMDR practitioners because of its significant implications for theory and practice
Learning Objectives:
Participants will be able to list a modification of the ET procedure for dissociative clients for each of the four steps.
Participants will be able to list the seven hardwired subcortical affective circuits described by Panksepp.
Participants will be able to name four steps of the Early Trauma procedure for non-dissociative clients.
Keywords: Attachment Repair Early Trauma Temporal Integration
Accuracy Verified: Yes
41. Shapiro, R. (2009). Attachment, affect tolerance, and avoidance targets in obsessive-compulsive personality disorder. In R. Shapiro (Ed.), EMDR Solutions II: For depression, eating disorders, performance, and more (1st Ed.) (pp. 403-411). New York, NY: W. W. Norton & Co..
Language: English
Format: Book Section
Keywords: Affect Tolerance Attachment Avoidance Targets Obsessive-Compulsive Personality Disorder
Accuracy Verified: Yes
42. El Khoury-Malhame, M., Lanteaume, L., Beetz, E. M., Roques, J., Reynaud, E., Samuelian, J. C., Blin, O., Garcia, R., & Khalfa, S. (2011, September). Attentional bias in post-traumatic stress disorder diminishes after symptom amelioration. Behavior Research and Therapy, 9(11), 796-801. doi:10.1016/j.brat.2011.08.006.
Language: English
Format: Journal
Abstract:
Background:
Avoidance and hypervigilance to reminders of a traumatic event are among the main characteristics of post-traumatic stress disorder (PTSD). Attentional bias toward aversive cues in PTSD has been hypothesized as being part of the dysfunction causing etiology and maintenance of PTSD. The aim of the present study was to investigate the cognitive strategy underlying attentional bias in PTSD and whether normal cognitive processing is restored after a treatment suppressing core PTSD symptoms.
Methods:
Nineteen healthy controls were matched for age, sex and education to 19 PTSD patients. We used the emotional stroop and detection of target tasks, before and after an average of 4.1 sessions of eye movement desensitization and reprocessing (EMDR) therapy.
Results:
We found that on both tasks, patients were slower than controls in responding in the presence of emotionally negative words compared to neutral ones. After symptoms removal, patients no longer had attentional bias, and responded similarly to controls.
Conclusion:
These results support the existence of an attentional bias in PTSD patients due to a disengagement difficulty. There was also preliminary evidence that the disengagement was linked to PTSD symptomatology. It should be further explored whether attentional bias and PTSD involve common brain mechanisms.
Keywords: Attentional Bias Posttraumatic Stress Disorder PTSD
Accuracy Verified: Yes
43. Leiner, A. S., Kearns, M. C., Jackson, J. L., Astin, M. C., & Rothbaum, B. O. (2012, January). Avoidant coping and treatment outcome in rape-related posttraumatic stress disorder. Journal of Consulting and Clinical Psychology,80(2), 317-321. doi: 10.1037/a0026814.
Language: English
Format: Journal
Abstract: Objective: This study investigated the impact of avoidant coping on treatment outcome in rape-related posttraumatic stress disorder (PTSD). Method: Adult women with rape-related PTSD (N = 62) received 9 sessions of prolonged exposure (PE) or eye movement desensitization and reprocessing (EMDR). The mean age for the sample was 34.7 years, and race or ethnicity was reported as 67.7% Caucasian, 25.8% African American, 3.2% Latina, and 3.2% other. PTSD was assessed with the PTSD Symptom Scale–Self-Report (Foa, Riggs, Dancu, & Rothbaum, 1993), and avoidant coping was assessed using the Coping Strategies Inventory–Disengagement subscale (CSI-D; Tobin, Holroyd, Reynolds, & Wigal, 1989). Results: Pretreatment avoidant coping was negatively associated with posttreatment PTSD symptom severity even when controlling for initial severity of total PTSD symptoms and when removing PTSD avoidance symptoms from the analysis to account for potential overlap between avoidant coping and PTSD avoidance symptoms: ΔR2 = .08, b = −0.31, 95% CI [−0.17, −0.01], t(60) = −2.27, p = .028. The CSI-D pretreatment mean score of 100 predicted a 96% likelihood of experiencing clinically significant change (CSC) during treatment. A CSI-D pretreatment score of 61 was associated with a 40% likelihood of experiencing CSC. Conclusions: PE and EMDR appear to be beneficial for women who frequently engage in avoidant coping responses following rape. A small subset of women with initially low levels of avoidant coping are unlikely to experience a therapeutic response from PE or EMDR. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Keywords: Rape Posttraumatic Stress Disorder PTSD
Accuracy Verified: Yes
44. Lendl, J. (2006, September). Back to basics: The positive template & affect bridge. Presentation at the annual meeting of the EMDR International Association, Philadelphia, PA.
Language: English
Format: Conference
Abstract:
One of the reasons EMDR is such a powerful
treatment method is the eight phase, three prong
protocol. The robustness of the method is not
achieved if any part of the protocol is dismissed.
Dr. Shapiro's recent trainings have emphasized
the need for the future template. The future
template is a combination of the use of imagery,
and used successfully in sport performance and health recovery, and bi-lateral stimulation. Back
fo Basics: The Positive Template is a workshop to remind participants of the importance of
positive templates in complete and incomplete
EMDR protocol sessions. The future template,
which addresses avoidance, adaptation, and
actualization, is a part of phase eight/reevaluation
and the third prong (future) of the EMDR
protocol. Preliminary research will be presented
that suggests positive templates are useful before
phase eight. Participants will learn to integrate
the positive template to help maintain skills
between sessions, encourage new skills and
practice ways to handle resistance. There will be
supervised practica for using the future template
and ESP (End Session Positive) template.
Additionally, this workshop has been expanded
to go over the Affect Bridge and practice will be
included.
Keywords: Affect Bridge Future Template Positive Template
Accuracy Verified: Yes
45. Jordan, J., Titscher, G., & Kirsch, H. (2011, September). Behandlungsmanual zur psychotherapie von akuten und posttraumatischen belastungsstörungen nach ICD-mehrfachschocks [Treatment manual for psychotherapy of acute and posttraumatic stress disorders after multiple ICD shocks]. Herzschrittmachertherapie + Elektrophysiologie, 22(3), 189-201.
Language: German
Format: Journal
Abstract:
Angesichts der steigenden Zahl implantierter Defibrillatoren in allen Industrienationen wächst auch die Zahl derjenigen Menschen, die sog. Mehrfachschocks („electrical storm“, ES) erleiden. Häufige Beschwerden sind starke und ständig wiederkehrende massive Ängste, Panikattacken, Todesangst, Hilf- und Hoffnungslosigkeit, Depressionen, Nervosität und Gereiztheit, sowie Rückzugs- und ausuferndes Vermeidungsverhalten, Intrusionen, Albträume, Flashbacks, Schlaflosigkeit und die Unfähigkeit der Gefühlsempfindung sowie eine eingeschränkte Zukunftsperspektive. Da Menschen mit einem ICD häufig körperlich (sehr) krank und nach den ICD-Mehrfachschocks zusätzlich massiv verunsichert sind, scheint es wesentlich, dass die stationäre Behandlung in einer Einrichtung durchgeführt wird, die über eine enge Anbindung an und räumliche Nähe zu einer kardiologischen Abteilung verfügt. Basis der Diagnostik ist die klinische Anamnese und die systematische Exploration der traumatischen Situation und der resultierenden Beschwerden. Als zusätzliche diagnostische Elemente sollten testpsychologische Verfahren zur Erfassung der Kernsymptomatik zum Einsatz kommen (Angst, Depression, Traumasymptome). Zur Diagnostik sollte eine testpsychologische Untersuchung gehören, damit am Ende der Behandlung auch für den Patienten sichtbar wird, welche Veränderungen eingetreten sind. Im Mittelpunkt der stationären Behandlung steht die tägliche intensive Psychotherapie. In ihrem Rahmen finden Elemente tiefenpsychologisch fundierter Psychotherapie und verhaltenstherapeutisch orientierte Angsttherapie sowie kognitive Umstrukturierung und Elemente des EMDR ihren Platz. Eine Nachuntersuchung innerhalb von 4 Monaten nach den Mehrfachschocks ist angeraten, weil PTSD Symptome zuweilen erst mit großer Latenz auftreten.
In view of the inceasing number of implanted defibrillators in all industrial nations, the number of people who have suffered so-called multiple shocks (electrical storm, ES) also increases. Common complaints are severe and continuously recurrent massive anxiety, panic attacks, fear of death, helplessness and hopelessness, depression, nervosity and irritability as well as reclusive and uncontrollable avoidance behaviour, intrusions, nightmares, flashbacks, sleeplessness and the inability to show feelings and limitation of future perspectives. Because people with an ICD are often physically (very) ill and after multiple ICD shocks are additionally very insecure, it would seem logical if the inpatient treatment would be carried out in an institution which has close connections and is also spatially close to a cardiology department. The basis of the diagnostics is the clinical anamnesis and a systematic exploration of the trauma situation and the resulting complaints. As an additional diagnostic element psychological test procedures should be implemented to determine the core symptomatic (anxiety, depression, trauma symptoms). Psychological test procedures should be included in the diagnostics so that at the end of treatment it is obvious even to the patient which alterations have occurred. The core element of inpatient treatment is daily intensive psychotherapy and includes deep psychologically well-founded psychotherapy and behavioral therapeutic-oriented anxiety therapy as well as cognitive restructuring and elements of eye movement desensitization and reprocessing (EMDR). A follow-up examination within 4 months of the multiple shocks episode is recommended because symptoms of posttraumatic stress disorder often occur after a long latent time period.
Keywords: Acute Stress Disorder Anxiety ASD Cardiology Depression ICD Shocks Internal Medicine Posttraumatic Stress Disorder PTSD Treatment Manual
Accuracy Verified: Yes
46. Blore, D. (2009, October). Blind to therapist protocol. Presentation at the 2nd EMDR Autumn Workshop Conference, Leeds, UK.
Language: English
Format: Conference
Abstract:
The Blind to Therapist (B2T) Protocol (Blore & Holmshaw 2006, 2009), is aimed at helping provide EMDR in special circumstances – particularly where the client is unwilling to describe a target image either because the client fears that the therapist will be disgusted or overwhelmed by the content - as in sexual abuse trauma, and/or where the client is reluctant to relinquish further perceived control for the purposes of conducting EMDR. In essence, the B2T protocol abandons the idea of 'client avoidance' and modifies EMDR so as to accommodate avoidance until the client is ready to identify traumatic material.
Keywords: Blind to Therapist Protocol
Accuracy Verified: Yes
47. Fisher, J. (2007, September 29). The body as a shared whole: Somatic interventions for working with trauma and dissociation. Presentation at the Quarterly Meeting Program of The New England Society for the Treatment of Trauma and Dissociation.
Language: English
Format: Conference
Abstract:
To stabilize overwhelming symptoms, integrate
memories, and overcome the terror of intimacy,
traumatized clients must establish sufficient safety in the body that they do not continue to recreate the unsafe world of childhood. Otherwise, the “child in the nightmare” from decades ago remains lost in time, demoralized
by internal critics and
terrified by the threats of
hypervigilant internal
protectors.
Because the body is the
container for all past and
present experience and for
all parts of the self,
somatically oriented
approaches can address
the intense and often
baffling reactions of these
patients in a way that is
both simple and effective.
This workshop will
demonstrate bodyoriented
interventions for
working with traumatized
and dissociative patients
drawn from Sensorimotor
Psychotherapy and easily
integrated into EMDR,
IFS, and traditional
talking therapies.
Through the use of
lecture, videotape, and
demonstration, participants will have the
opportunity to observe
somatically informed
solutions to a number of
common clinical
challenges encountered in
trauma treatment.
Capitalizing on recent
advances in the research
on attachment and trauma,
the workshop will also
provide a context for
understanding how to use
the therapeutic
relationship to provide a
safe “container” for both
patient and therapist in the
challenging work of
trauma treatment.
Keywords: Dissociation Somatic Interventions Trauma
Accuracy Verified: Yes
48. Herbert, C. (2009, June). Body staging as a method for safely assessing and working with dissociated material in severe complex trauma and DID. Presentation at the annual meeting of the EMDR Europe Association, Amsterdam, the Netherlands.
Language: English
Format: Conference
Keywords: Body Staging Complex Trauma DID Dissociative Identity Disorder
Accuracy Verified: Yes
49. Hettiarachchi, M. (2007). Brief intervention for post traumatic stress disorder with combined use of cognitive behaviour therapy and eye movement desensitisation reprocessing. Australian e-Journal for the Advancement of Mental Health, 6(1), 1-5.
Language: English
Format: Journal
Abstract:
This case study is of a 23 year old female diagnosed with Post Traumatic Stress Disorder (PTSD) in Sri Lanka, six months following the Asian Tsunami of December 2004. The intervention was conducted in a village clinic on the southern coast of the country. Treatment involved the use of Cognitive Behavioural Therapy (CBT) and Eye Movement Desensitisation Reprocessing (EMDR). The Beck Anxiety Inventory (BAI) was used to monitor levels of anxiety. The Impact of Event Scale (IES) was administered to assess level of intrusion and avoidance (Horowitz, Wilner & Alvarez, 1979). Subjective Units of Distress Scores (SUDS) were obtained to assess level of distress and the Validity of Cognition Scale (VOC) used to assess accuracy of positive beliefs (Shapiro, 2001). A significant reduction in trauma symptoms, levels of distress, intrusion and avoidance were noted at post-treatment. Treatment gains were maintained at one month and nine month follow-up. The combined treatment protocol may be an effective brief intervention to use in situations that require rapid treatments to alleviate personal psychological distress in the aftermath of large scale disasters.
Keywords: Asian Tsunami Brief Intervention Clinical Case Study Cognitive Behavior Therapy Cognitive Therapy Emotional Trauma Natural Disasters Posttraumatic Stress Disorder PTSD
Accuracy Verified: Yes
50. Khift, R. N. (1994). Building upon our foundations. Dissociation, 7(2), 79-80.
Language: English
Format: Journal
Abstract:
It is easy to become demoralized in the face of repeated
assaults on the credibility and legitimacy of our patients,
our patients' given histories and allegations of mistreatment,
and the very conditions that they suffer. As clinicians and
scientific investigators working with trauma victims and dissociative
disorder patients, we have found it difficult to withstand
withering and venomous attacks upon our professions,
our motivations, and ourselves as individuals. Although there
have been some notable exceptions, the last several months
have been remarkable for the video and print media' s love
affair with those who protest the veracity of allegations of
childhood mistreatment, and their willingness to promulgate
polarized negative representations of those who allege
childhood mistreatment and those who treat them. Since
the New Year, I have been interviewed by a large number of
reporters and journalists. Only two diverged from a rather
stereotyped and weary script in which the legitimacy of the
perspective of the False Memory Syndrome Foundation was
assumed, and this assumption colored the majority of the
dialog that transpired. I strongly suspect that matters will
get worse before they improve.
Keywords: Editorial
Accuracy Verified: Yes
51. Waters, F. S., Potgieter, R., & Yehuda, N. (2011, November). But they are too young to be traumatized!. Presentation at the 28th annual meeting of the International Society for the Study of Trauma and Dissociation, Montreal, Quebec.
Language: English
Format: Conference
Abstract:
All too often it is assumed that infants or young children are too young to remember frightening, painful, and confusing experiences, and therefore will not suffer harm because they are too young to be traumatized. Clinical experience; however, as well as research on neurobiology of trauma, child development, and attachment, tell a different story. While very often not verbalized, overwhelming early experiences are nonetheless remembered implicitly. As such they tend to find expression in a myriad of debilitating emotional and somatic symptoms across a persons life span; even into adulthood. Understanding how early trauma can affect the child developmentally, and how it might be expressed, is crucial not only to clinicians treating children but also to those working with adults. It is through understanding early traumatic markers and the subtle, often coded signs, sometimes rooted as far back as infancy, that one can begin the process of untangling these symptoms and freeing the individual from a lifetime of pain, suffering, and failed relationships. This workshop will examine the types of early traumamedical, severe neglect, all forms of abuse, disrupted attachmentand how these traumatic experiences impact the young child from birth to five years. The signs and symptoms of traumatized and dissociative children, as well as available research on the topic will be described, along with case examples. The need for careful interpretation of often convoluted and subtle symptoms will be explained. Accurate interpretation of a childs presentation relies on understanding the neurobiology of trauma and dissociation. That, as well as understanding the impact on child development and attachment is crucial for effective intervention. Strategies such as Eye Movement Desensitization Reprocessing (EMDR) and involvement of caregivers in the therapy will be described. Videoed sessions and artwork describing the young traumatized child's inner world and recovery process will augment the presentation.
Accuracy Verified: Yes
52. Bae, H., Kim, D., & Ahn, J. (2006, September). A case series of post-traumatic obsessive compulsive disorder: A six month follow-up evaluation. Journal of the Korean Neuropsychiatric Association, 45(5), 476-480.
Language: Korean
Format: Journal
Abstract:
A number of recent case reports and series indicate that obsessive compulsive disorder (OCD) can develop after traumatic experience as a comorbid conditon to post-traumatic stress disorder (PTSD). These descriptive studies consistently addressed that those patients respond poorly to treatments and had an unfavorable outcome. However, this conclusion was not supported by prospective follow up with objective measurement of symptomatology. This report presents three single trauma-related PTSD patients who developed full-blown OCD concurrently with or after the initiation of PTSD. These patients represent 10% of new PTSD outpatients at a PTSD clinic during one year period and 25% of PTSD patients who had been admitted. In all three cases compulsion seemed to distract or serve as avoidance to intrusive symptoms of PTSD. Despite Eye Movement Desensitization and Reprocessing (EMDR) and/or exposure therapy for PTSD together with at least two antidepressant trials for PTSD and OCD, at six month follow-up PTSD partially improved and OCD remained unchanged. This finding is consistent with previous reports from western literature (KoreaMed).
Keywords: Obsessive-Compulsive Disorder OCD
Accuracy Verified: Yes
53. Groenendijk, M. (2009). Casus 14 – Ik! Ben! Goed!: Een cliënte van 55 jaar met een dissociatieve identiteitsstoornis (DIS) [Case 14 - I! Am! Good!: A woman of 55 years with a dissociative identity disorder (DIS)]. In H. K. Hornsveld & S. Berendsen (Eds.), Casusboek EMDR, 25 voorbeelden uit de praktijk (1st Ed.), (pp. 205-222). Houten: Bohn Stafleu Van Loghum. doi:10.1007/978-90-313-7358-1_21.
Language: Dutch
Format: Book Section
Abstract:
Miranda is 55 jaar en getrouwd met Peter, garagehouder. Zij hebben twee volwassen kinderen (een zoon en een dochter) en twee kleinkinderen. Miranda woont in een klein dorp in het noorden van het land. Tot acht jaar geleden werkte ze als administratief medewerkster op een kantoor, maar zij kwam in de ziektewet wegens problemen op het werk en in haar huwelijk. Ze meldde zich aan voor behandeling en bij haar werd als diagnose gesteld: reactieve depressie en sociale fobie bij een persoonlijkheid met ontwijkende trekken. Na een ambulante start werd ze aangemeld voor klinische psychotherapie en gedurende deze opname kwam voor het eerst haar geschiedenis met ernstig seksueel misbruik ter sprake. Op de deeltijdbehandeling die daarop volgde, kreeg ze steeds meer last van dissociatieve klachten. Ook thuis namen deze klachten toe en kreeg ze woedeaanvallen. Ze ging's nachts geregeld zwerven. Ze werd heropgenomen en nu werd de diagnose DIS gesteld. In de kliniek werden in het kader van traumaverwerking enkele EMDR-sessies gedaan, maar dit had weinig resultaat. Miranda herinnert zich er nauwelijks iets van.
Miranda is 55 years and married to Peter, mechanic. They have two grown children (a son and a daughter) and two grandchildren. Miranda lives in a small village in the north of the country. Until eight years ago she worked as an administrative assistant at an office, but she was on sick leave due to problems at work and in her marriage. She signed up for treatment and was considered its diagnosis: reactive depression and social phobia with avoidant personality in a draw. After a patient start, she was signed up for clinical psychotherapy and during this recording first came her history with sexual abuse seriously discussed. On the day hospital treatment that followed, she was increasingly suffering from dissociative symptoms. Also took home these complaints, and she rages. She went regularly roam at night. She was re-recorded and now the diagnosis was made DIS. In the clinic under some EMDR trauma processing sessions done, but this had little effect. Miranda remembers hardly anything.
Keywords: DID Dissociative Identity Disorder
Accuracy Verified: Yes
54. Miller, P., McGowan, I., McLaughlin, D., & Paterson, M. (2010, April). Cessation of symptoms associated with dissociative schizophrenia following EMDR. Presentation at 2nd Bi-Annual International European Society for Trauma and Dissociation Conference, Belfast, Northern Ireland.
Language: English
Format: Conference
Abstract: Background: Despite over a 100 years experience with schizophrenia it is still only a minority of individuals who make a full recovery. Schizophrenia is a severe enduring mental illness (SMI) and the weight of burden falls with regard to legal problems, stigma and life expectancy: life expectancy in this group of individuals is reduced by 10 years, mostly as a consequence of suicide.
Aim: The aim of the presentation is to highlight the potential of EMDR as a treatment option in patients displaying symptoms associated with dissociative schizophrenia. Using a case study approach we will demonstrate the effectiveness of EMDR in relieving the symptoms of dissociative schizophrenia.
Case Study: In Patient ‘M’ using an EMDR paradigm integration was achieved using only outpatient therapy – 12 sessions, over the course of one year. Medication was used initially but made no impact on the psychotic phenomena; even when used within normally efficacious levels and duration. Naltrexone was used to help manage dissociation (Frewen & Lanius, 2006) and to facilitate Patient ‘M’ in engaging in EMDR. Patient ‘M’ is now nearly three years symptom free and medication free.
Conclusion: EMDR is effective in symptoms associated with dissociative symptoms.
Learning Outcomes By the end of the session participants will be able to; Gain an greater understanding of the clinical presentation of dissociative schizophrenia Discuss the potential of EMDR as a treatment option in patients displaying symptoms associated with dissociative schizophrenia
Keywords: Dissociative Schizophrenia
Accuracy Verified: Yes
55. Amen, D. G. (2003, September). Change your brain, change your life: Breakthrough information on seeing and healing the brain. Presentation at the annual meeting of the EMDR International Association, Denver, CO.
Language: English
Format: Conference
Abstract:
Utilizing the latest, most sophistcated brain imaging technology in medicine, physician and clinical neuroscientist Daniel Amen will give you an intimate look into a "working brain." Based on his brain imaging work with over
16,000 brain SPECT studies, Dr.Amen will teach you what specific parts of the brain do, and graphically show what happens when things go wrong, illustrated by many case stories and a number of the actual brain images. He
will correlate different brain patterns with specific feelings and behaviors, such as moodiness, irritability, conflict avoidance, worrying and temper outbursts, along with certain common psychiatric disorders such as depression,
attenton deficit disorder, anxiety, and substance abuse. In addition, there will be prescriptions for healing each part of the brain, including cognitive, behavioral, nutritional and medicinal strategies.
Accuracy Verified: Yes
56. Scarlata, B. (1995). Changing cognitions. EMDR Network Newsletter, 5(1), 8-9.
Language: English
Format: Newsletter
Abstract:
Linda (not her real name) is a 40-
year-old professional woman whose
avocation is healing and who is proficient
in several of the touch therapies.
She has a Dissociative Disorder with
well-defined "parts," but she has not
experienced time loss. She is not on
medication and although she is often
depressed, she is able bfunction fairly
well most of the time. As a child, she
was emotionally and sexually abused
by her father for approximately ten
years. He is bedridden now, but she is
still subject to his verbal abuse when
she visits him once a week. He has
never acknowledged his abuse, nor
has she confronted him about it (although
she has told her mother). She
said she will not feel totally safe until
he is dead. We have had ten sessions
together. EMDR was used in most of
our sessions during which she processed
specific incidents of abuse that
were very traumatic for her. She
believes that she has many dissociated
infant and child parts-each of
whom hold a memory of one of the
abusive incidents she experienced.
Keywords: Cognitions
Accuracy Verified: Yes
57. 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
58. Korn, D. (2001, June). Clinical applications of EMDR in treating adult survivors of childhood abuse and neglect. Preconference presentation at the annual meeting of the EMDR International Association, Austin, TX.
Language: English
Format: Conference
Abstract:
This workshop will focus on integrating EMDR into a phase-oriented recovery plan in treating adult survivors of childhood abuse and neglect. EMDR applications with the full range of trauma-related syndromes, including simple and complex PTSD, Borderline Personality Disorder and Dissociative Disorders, will be addressed. Treatment planning and pacing will be discussed in view of presenting problem, attachment style, defenses, and self-capacities. In recognition of clients' rigid, maladaptive schemas, poor impulse control, dissociative tendencies and limited affect tolerance, strategies for modifying and supplementing standard EMDR protocols will be explored, Significant attention will be devoted to integratring EMDR ego strengthening and resource development protocols into all phases of treatment.
Keywords: Borderline Personality Disorder Child Abuse Dissociative Disorders Ego Strengthening Neglect Posttraumatic Stress Disorder PSTD Resource Development
Accuracy Verified: Yes
59. Fine, C. G., & Berkowitz, S. A. (1999). The combined use of EMDR and hypnosis in the treatment of DID: The wreathing protocol:The imbrication of hypnosis and EMDR in the treatment of dissociative identity disorder and other dissociative responses. Presentation at the International Society for the Study of Dissociation Fall Conference, Miami FL.
Language: English
Format: Conference
Keywords: DID Dissociative Identity Disorder Hypnotherapy Posttraumatic Stress Disorder PTSD Psychotherapeutic Processes
Accuracy Verified: No
60. Cervera, M., & Acinas, P. (2012, June). Como puede la combinacion entre el EMDR y la imaginacion tartar casos con sept complejo, problemas de apego y disociacion? [How can EMDR and imagination combined, treat cases with complex PTSD, attachment and dissociative symptoms?]. Poster presented at the annual meeting of EMDR Europe, Madrid, Spain .
Language: Spanish
Format: Conference
Abstract: ABSTRACT:
La integración del EMDR con el uso de la imaginación
(See Far CBT, Lahad) como un abordaje para
el tratamiento de SEPT Complejo.
El uso de la imaginación con cartas terapéuticas
dentro de la Realidad Fantástica es una estrategia
poderosa para estos pacientes. El EMDR ha sido
ampliamente investigado y aprobado como una de
las terapias más efectivas en este campo.
ABSTRACT:
Integrate EMDR with the use of Imagination (See
Far CBT, Lahad) as an approach to treat Complex
Trauma with PTSD.
The use of Imagination with therapeutic cards
within the world of Fantastic Reality is a new powerful
coping strategy for these patients. EMDR has
been widely researched in this area.
Keywords: Attachment Dissociation Poster
Accuracy Verified: Yes
61. Taylor, S., Thordarson, D., Maxfield, L., Fedoroff, I., Lovell, K., & Ogrodniczuk, J. (2003, April). Comparative efficacy, speed, and adverse effects of three PTSD treatments: Exposure therapy, EMDR, and relaxation training. Journal of Consulting & Clinical Psychology, 71(2), 330-338. doi:10.1037/0022-006X.71.2.330.
Language: English
Format: Journal
Abstract:
The authors examined the efficacy, speed, and incidence of symptom worsening for 3 treatments of PTSD: prolonged exposure, relaxation training, or eye movement desensitization and reprocessing (EMDR; N = 60). Treatments did not differ in attrition, in the incidence of symptom worsening, or in their effects on numbing and hyperarousal symptoms. Compared with EMDR and relaxation training, exposure therapy (a) produced significantly larger reductions in avoidance and reexperiencing symptoms, (b) tended to be faster at reducing avoidance, and (c) tended to yield a greater proportion of participants who no longer met criteria for PTSD after treatment. EMDR and relaxation did not differ from one another in speed or efficacy (Pilots).
Keywords: Adults Empirical Study Exposure Therapy Negative Therapeutic Reaction Posttraumatic Stress Disorder PTSD Random Clinical Trial RCT Relaxation Therapy Stressors Survivors Treatment Effectiveness Witnesses
Accuracy Verified: Yes
62. Jaberghaderi, N., Dolatabadi, S., & Zand, S. O. (2002, Winter). A comparison of eye movement desensitzation and reprocessing and stress inoculation training (SIT) for sexually abused girls. Advances in Cognitive Science, 3(4), 16-26.
Language: English
Format: Journal
Abstract:
Fourteen sexually abused girls aged 12-13, were randomly assigned to receive either EMDR or SIT. Participants and their parents completed Child Report of Post Traumatic Symptoms (CROPS), and Parent Report of Post Traumatic Symptoms (PROPS), pre and post treatment.
Results indicated that there was significant influence only on the PROPS. But there was a significant impact on both these instrument (CROPS & PROPS), with EMDR. In evaluating CROPS and PROPS, factor analysis with SIT illustrated that, externalizing and internalizing symptoms in PROPS and avoidance thoughts and behaviors in CROPS were treated. Further the results gathered from factor analysis with EMDR, showed that internalizing and somatic symptoms in PROPS and self harm, depression feelings and also somatic symptoms in CROPS improved as well. Clinical findings also suggested that EMDR and SIT did not have any significant differences in treating posttraumatic symptoms. Factor analysis found that, EMDR was more effective than SIT in treating somatic symptoms of sexually abused girls.
Keywords: Iran Sexual Abuse SIT Stress Inocculation Training
Accuracy Verified: Yes
63. Staff. (2000). Complex PTSD in children II: Therapeutic interventions. Cavalcade Productions, Inc., Nevada City, CA.
Language: English
Format: Video
Abstract:
In this video series, Bessel van der Kolk and other clinicians from The Trauma Center, along with therapists Joyanna Silberg and Frances Waters, describe the assessment tools and therapeutic approaches that they have found most useful in working the severely traumatized in children. The clinician's role in such cases often includes working with parents or guardians as well as children, and can extend far beyond the therapy room to encompass psychoeducation and advocacy. For children with complex PTSD, safety must be established both externally and internally. Maintaining internal safety can be an especially difficult task when the child is highly dissociative. The presenters discuss ground techniques that can help a child to stay safe and stable, and describe the therapeutic modalities "play, talk, art, and group therapy" that they have found useful. Topics include controlling aggression, accessing emotions, changing the trauma story, and using EMDR.
Keywords: Children Clinical Judgment Complex Posttraumatic Stress Disorder Complex PTSD C-PTSD Intervention Posttraumatic Stress Disorder PTSD Therapeutic Processes Treatment
Accuracy Verified: No
64. Herbert, C. (2012, October). Complex trauma: Road to psychiatric dysfunction or path toward posttrauma growth?. Keynote at the 4th Autumn EMDR Workshop Conference, Sheffield, UK.
Language: English
Format: Conference
Abstract:
Healthcare service providers, as well as, mental health practitioners, frequently associate the suffering of complex trauma with pathology, mental illness, personality disorders and severe psychiatric dysfunction. Clients are perceived as difficult to treat, interventions are guided by the nature of the psychiatric diagnosis and therapy focuses on crisis management and on helping clients to achieve reductions of symptoms that account for the psychiatric diagnosis. Although symptom reduction can be of great value and importance to sufferers, sole focus on this misses the great potential to engage a person in a transformative process that can lead to considerable inner strengthening, alignment and positive growth, as a result and in spite of their early traumatic experiences. This keynote introduces a shift in perspective away from the traditional focus on psychiatric dysfunction toward a model of positive growth for clients suffering from Complex Trauma and Dissociative Identity Disorder (DID). It is proposed that development of empathic empowerment of the individual toward greater personal authenticity, honesty, accountability and compassion can open the path toward posttrauma growth. However, in order to achieve such development specific parameters must be fulfilled. These parameters, which include therapist factors, the nature of the therapeutic relationship, an underlying therapeutic framework for working with complex trauma and the guiding principles and ingredients that nurture growth rather than dysfunction, will be outlined and illustrated through the use of client vignettes.
Keywords: Complex Trauma Posttraumatic Growth
Accuracy Verified: Yes
65. de Keijser, J., Denderen, M., & Verster-Bosman, M. (2013, April). Complicated grief and PTSD after murder, etiology and treatment: Research into treatment with EMDR and CBT in relatives of murder [Complexe rouw en PTSS na moord, etiologie en behandeling: Onderzoek naar behandeling met EMDR en CGT bij nabestaanden van moord]. Presentatie op het congres EMDR Vereniging EMDR Nederland, Nijmegen, Nederland.
Language: Dutch
Format: Conference
Abstract:
Directe nabestaanden van slachtoffers van moord krijgen vaak te maken met een PTSS en gecompliceerde rouw. De Rijksuniversiteit Groningen is, met medefinanciering door het Fonds Slachtofferhulp, een onderzoek gestart naar de vraag of professionele hulp effectief is.
Het onderzoek kent twee doelstellingen:
In hoeverre draagt een behandeling bestaande uit EMDR en CGT voor familieleden en partners van een vermoord persoon bij aan het verminderen van symptomen van gecompliceerde rouw.
Daarnaast hoopt het onderzoek inzicht te krijgen in de mate waarin het effect van de behandeling met EMDR en CGT gemedieerd wordt door een afname van intrusies, vermijdingsgedrag, extreme woede en disfunctionele cognities.
In de presentatie komen drie sprekers aan het woord:
- Jos de Keijser, klinisch psycholoog/psychotherapeut en projectleider van het onderzoek, zal een theoretisch kader schetsen over gecompliceerde rouw en PTSS bij nabestaanden na moord, inclusief implicaties voor de praktijk.
- Mariette van Denderen, criminologe en promovendus, zal de resultaten van de behandelingen met EMDR en CGT tot nu (dan) toe presenteren.
- Moniek Verster, een van de behandelaren in het onderzoek, zal over de praktijk van het toepassen van EMDR en CGT bij nabestaanden van moord vertellen.
Casuïstiek komt aan bod, indien mogelijk met gebruikmaking van videofragmenten.
Immediate relatives of murder victims often have to deal with PTSD and complicated grief. The University of Groningen, with co-financing by the Fund Victim, launched an investigation into whether professional help is effective. The study has two objectives:
To what extent does a treatment consisting of EMDR and CBT for family members and partners of a murdered person to reducing symptoms of complicated grief.
Additionally this study aims to understand the extent to which the effect of the treatment with EMDR and CBT is mediated by a decrease of intrusions, avoidance behavior, extreme anger and dysfunctional cognitions.
During the presentation, three speakers to talk:
- Jos de Keijser, clinical psychologist / psychotherapist and leader of the research, a theoretical framework sketches about complicated grief and PTSD in survivors after murder, including implications for practice.
- Mariette of Denderen, criminologist and researcher, the results of the treatment with EMDR and CBT until now (then) to present.
- Moniek Verster, one of the practitioners in the study, will the practice of using EMDR and CBT in relatives of murder tell.
Casuistry is discussed, where possible using video clips.
Keywords: CBT Cognitive Behavior Therapy Complicated Grief Murder Posttraumatic Stress Disorder PTSD Violence
Accuracy Verified: Yes
66. Kluft, R. P. (1995,December). The confirmation and disconfirmation of memories of abuse in DID patients: A naturalistic clinical study. Dissociation, 8(4), 253-258.
Language: English
Format: Journal
Abstract:
The charts of 34 dissociative identity disorder (DID) patients in treatment with the author were reviewed for instances of the confirmation
or disconfirmation of recalled episodes of abuse occurring naturalistically in the course of their psychotherapies. Nineteen, or 56 %, had instances of the confirmation of recalled abuses . Ten of the 19, or 53 %, had always recalled the abuses that were ronfirrned. However, 13 of the 19, or 68%, obtained documentation . of events that were recovered in the course of therapy, usually with the use of hypnosis. Three patients, or 9%, had instances in which the inaccuracy of their recollection could be demonstrated. The forgetting oftraumatic
experiences, their reasonably accurate recovery in treatment, and the formation of pseudomemories in clinical populations were all documented in this study . This suggests that stances that are either extremely credulous of retrieved recollections or extremely skeptical of
retrieved recollections are inconsistent with clinical data, and therefore are not constructive influences on the contemporary scientifi c
study of trauma and memory. [Author Abstract]
Keywords: Abuse DID Dissociative Identity Disorder Memories
Accuracy Verified: Yes
67. Forgash, C. (2009). Constructive avoidance of present day situations: Techniques for managing critical life issues. In M. Luber (Ed.), Eye movement desensitization (EMDR) scripted protocols: Special populations (pp. 291-296). New York, NY: Springer Publishing Co.
Language: English
Format: Book Section
Keywords: Protocol
Accuracy Verified: Yes
68. Negadi, F., Jouvent, R., & Pelissolo, A. (2007, July). Contribution of EMDR's cognitive approach: A case of driving phobia. Journal International de Victimologie, 5(3), 146-152.
Language: English
Format: Journal
Abstract:
Most studies evaluating the efficacy of Eye Movement Desensitization and Reprocessing (EMDR) therapy for various problems have focused on the importance of eye movements and largely ignored the fact that EMDR is an integrative therapeutic approach in which the cognitive approach plays a large part. The case study presented here includes an evaluation of the efficacy of EMDR, on various standardised evaluation scales, for a patient with driving phobia due to a traumatic event. The treatment of this patient was largely based on a cognitive approach (cognitive interweave) and the reprocessing of dysfunctional information according to the EMDR thérapy. The outcome one month after treatment was favourable, with the absence of phobic avoidance and a marked improvement in the patient's mood.
Keywords: Cognitive Interweave Driving Phobia Dysfunctional Belief
Accuracy Verified: Yes
69. Hyer, L. A., Boudewyns, P. A., Peralme, L., Touze, J., & Kiel, A. (1995, June). Controlled treatment outcome study using EMDR on combat-related post traumatic stress disorder (PTSD). Presentation at the EMDR Network Conference, Santa Monica, CA.
Language: English
Format: Conference
Abstract:
After the status of PTSD was established, subjects were randomly assigned to one of three conditions; EMDR, exposure control (EC), and group (GT). Subjects in EMDR condition received at least five but no more than eight sessions of EMDR. EC condition subjects therapy procedure as the EMDR subjects but without the eye movements. Subjects in the GT condition received five to eight session of group therapy only.
Outcome measures were at intervals; prior to therapy, immediately following therapy and at two follow-up periods. These include: (1) self report or interview-related psychological measures (Combat Exposure scale, MMPI-2 PTSD, Veterans Adjustment Scale (VETS), Mississippi Scale, Hamilton (Depression and Anxiety); (2) behavioral outcome measures (employment, treatment seeking behavior medication therapy, and re hospitalization rate); and (3) psychophysiological response measures (skin conductance, frontalis EMG, heart rate and blood pressure). The last measures involved a change measure in psychological arousal during exposure to tape recorded scripts depicting the patients' most traumatic combat memory. In addition to these pre-, post-,
follow-up measures, measures (SUD, profile of mood scale (POMS), and impact of events scale (IOE) were taken at each therapy session.
Early results on selected outcomes show differences in positive outcome between conditions POMS EMDR>GT (p<.01); IOE Avoidance, EMDR>GT (p<.04); IOE Intrusion, EMDR>GT(p<.03); Heart Rate, EMDR>GT (p<.04). Presently, there were no other significant differences between EMDR or EC. Trends, however suggest that EMDR may be superior to EC on several of the measures.
These results indicate that EMDR may be producing greater reduction in the conditioned emotional response to traumatic memories in these patients, when compared to group therapy approach commonly used to treat these types of patients in a special VA treatment program.
Keywords: Combat Controlled Treatment Outcome Study Posttraumatic Stress Disorder PTSD
Accuracy Verified: Yes
70. Heijmans, S. (2008, Januari). Controversie rondom EMDR, Een literatuuronderzoek naar de effectiviteit van EMDR [Controversy surrounding EMDR, a literature review on the effectiveness of EMDR]. Universiteit van Tilburg, Netherlands.
Language: Dutch
Format: Dissertation/Thesis
Abstract:
Over de effectiviteit van EMDR bestaat veel controversie. Deze thesis bevat een
kritisch overzicht van de literatuur met betrekking tot de effectiviteit van EMDR. Er wordt
gekeken naar de procedure die EMDR handhaaft en er worden mogelijke verklaringen
gegeven voor de werking van EMDR. Vervolgens wordt de effectiviteit van EMDR
onderzocht bij verschillende soorten aandoeningen en vergeleken met andere
behandelingsvormen. Onderzoek laat zien dat EMDR effectief is bij de behandeling van
PTSS. Ook bij fobieën is EMDR gedeeltelijk effectief. Hier wordt echter voornamelijk een
afname geconstateerd op cognitief niveau en niet gedragsmatig. In vergelijking met
cognitieve gedragstherapie lijkt EMDR evenredig effectief te zijn. Wanneer EMDR echter
vergeleken wordt met exposure therapieën is het niet geheel duidelijk welke
behandelingsvorm het meest effectief is. Exposure therapie is effectiever in de afname van
herbeleving en vermijdingsgedrag, maar EMDR gaat efficiënter te werk. In de discussie
worden vervolgens aanbevelingen gegeven voor toekomstig onderzoek.
There is a lot of controversy about the effectiveness of EMDR. This thesis consists of
a critical overview of the literature concerning the effectiveness of EMDR. First this thesis
will look at the procedure that EMDR maintains and possible explanations for how EMDR
works will be given. Next the effectiveness of EMDR will be researched to see if it differs
between the different diseases. EMDR will also be compared to other treatments. Research
shows that EMDR is an effective treatment when treating PTSD. When treating phobias,
EMDR is partly effective. The effectiveness here is mainly a decrease on a cognitive level and
not a behavioural one. In comparison to CBT EMDR seems to be equally effective. But when
we compare EMDR to exposure treatment it is not fully clear which treatment is the most
effective. Exposure therapy is more effective when it comes to a decrease in reliving and
avoidance, but EMDR has a greater efficiency. At last there will be given recommendations
for future research.
Keywords: Literature Review
Accuracy Verified: Yes
71. Hillman, J. L. (2002). Crisis intervention and trauma, New approaches to evidence-based practice. New York, NY: Kluwer Academic/Plenum Publishers.
Language: English
Format: Book
Abstract: R
ecent findings from an American Psychological Association task force suggest that one in four therapists will experience patient suicide, and that one in eight will feel threatened by patient violence during their career. Experts from this task force have also noted that clinicians receive virtually no formal training or coursework in crisis intervention. Despite the increasing need for professional services among members of the general population, current practitioners have few texts available that provide step-by-step, detailed information about how to engage in crisis intervention, and how to integrate recent, empirical research findings into theory and practice. This volume helps bridge this critical gap by providing a theoretically advanced, yet practical guide to crisis intervention.
Particular attention is given to the role of violence within our culture, patient suicide, school and workplace violence, long-term sequelae of trauma, clinical assessment and risk management, professional boundaries and burn-out, domestic violence, and the neurophysiology of trauma, as well as the needs of typically underserved patient populations including minority group members, older adults, gays and lesbians, and children. The text also features critical reviews of controversial topics, including EMDR, critical incident stress debriefing, recovered memories, dissociative identity disorder, and alternative medicine. [Springer]
Keywords: Crisis Intervention Trauma
Accuracy Verified: Yes
72. Kluft, R. P. (2003). Current issues in dissociative identity disorder. Bridging Eastern and Western Psychiatry, 1(1), 71-87.
Language: English
Format: Magazine
Abstract:
Dissociative Identity Disorder (DID), formerly Multiple Personality Disorder (MPD), remains among the most challenging of mental disorders. It is difficult to understand, to diagnose, to treat, to discuss objectively in the face of the many controversies that swirl around it. It remains a condition that requires intensive individual psychotherapy for its satisfactory resolution.
The controversies that have surrounded DID have often obscured the progress that has been made. DID is emerging as a not uncommon consequence of overwhelming childhood events.
The major challenges facing the treatment of DID are disentangling this condition and its therapy from the controversies that swirl about them, encouraging the more widespread use of specific diagnostic approaches, educating managed care organizations to accept standards of care for DID that are based upon those treatment approaches that are effective, making specific treatments for DID more available, and continuing to develop more successful approaches for the more difficult-to-treat DID subgroups of DID patients.
Keywords: Dissociative Identity Disorder DID MPD Multiple Personality Disorder
Accuracy Verified: Yes
73. Young, W., Puk, G., & Rouanzoin, C. C. (1995, June). Current trends using EMDR in dissociative disorders. Presentation at the EMDR Network Conference, Santa Monica, CA.
Language: English
Format: Conference
Abstract:
This workshop covers the screening, diagnosis, treatment and pitfalls encountered in using EMDR in Dissociative Disorders.
The unexpected finding of dissociative disorders among trauma victims using EMDR requires therapists to be able to recogme and
screen for dissociative conditions. Under special circumstances, these patients may have negative reactions which the EMDR
therapist should be prepared to manage.
Treatment requires a strong alliance, an awareness of dissociation and the management of patients' abreactions. Treatment
guidelines have been established for using EMDR which can guide therapists as our expmence with dissociative disorders evolves.
A careful informed consent should be obtained and an assessment of the patient's inner resources made so that ffagile patients with
histories of chronic trauma are not inadvertently injured. Further, EMDR is not designed as a tool for "memory work" but for the
reduction of distress for events or experiences already known.
Lectures, discussions, handouts and video tape demonstrations show the application of EMDR in a variety of conditions.
The results of a pilot study using EMDR in 15 patients with 33 target symptoms will be presented. In this limited sample, between
50% and 60% of patients achieved significant reduction of their distress levels on selected targets. A variety of responses occurred
including fusions, generalization effects, and establishmg inner dialogue. In addition, a variety of problems arose resulting in
treatment failures or cessation of EMDR. These include such reactions as flooding, escalation of anger, paranoia and resistance to
the treatment. The implications of these findings suggest that cautious patient selection and use of EMDR has a potential use and
that as research in this population continues, strategies for overcoming problem areas can be developed.
Keywords: Dissociative Disorders
Accuracy Verified: Yes
74. Oppenheim, H.-J. (2012, March). The cutting must stop: a way out of the stabilisation versus reprocessing paradox with a DID-patient and the use of EMDR. Presentation at the 3rd Bi-Annual International European Society for Trauma and Dissociation Conference, Berlin, Germany.
Language: English
Format: Conference
Keywords: DID Dissociative Identity Disorder Stablilzation
Accuracy Verified: Yes
75. Egli-Bernd, H. (2012, Januar). Das neue EMDR dialog‐protokoll, die kognitionen und ihre zentrale bedeutung bei der EMDR arbeit mit komplexen problemstellungen [The new dialogue EMDR protocol: The cognitions and their central role in the EMDR work with complex problems]. Präsentation am Institut für Traumazentrierte Therapie und Beratung, Zürich.
Language: German
Format: Conference
Abstract:
Die Erfahrung zeigt, dass die erfolgreiche Arbeit mit EMDR häufig wesentlich von der treffenden und
emotional bedeutungsvollen Wahl der Kognitionen abhängt. Die Erfahrung zeigt aber ebenfalls, dass diese
richtige Auswahl oft zur schwierigen Hürde werden kann beim Einstieg in komplexe EMDR‐Arbeit in Phase 3,
und zwar nicht nur für AnfängerInnen, sondern auch für erfahrene EMDR TherapeutInnen.
Dies vor allem dann, wenn der Fokus der Arbeit nicht auf klar definierten klassischen traumatischen
Einzelereignissen, sondern auf komplexen, frühen Lebensthemen liegt. Das Herausarbeiten tiefgreifender,
emotional bedeutsamer Kognitionen fällt bei solchen Themen den Betroffenen oft besonders schwer. Diese
Situation erzeugt häufig Verunsicherung bei den Klienten und Therapeuten und stellt eine Herausforderung
für die erfolgreiche und effiziente Anwendung von EMDR dar.
Mittlerweile ist in der Bindungs‐ und Traumaforschung herausgearbeitet worden, dass frühe Störungen sehr
häufig eine dissoziative Struktur bei den Betroffenen zur Folge haben. Wir müssen also davon ausgehen,
dass es in diesen Fällen auch um eine „subtile“ Dissoziation geht, die sich bei der EMDR Arbeit in Phase 3 u.a.
durch Probleme mit der Erarbeitung der Kognitionen manifestieren kann.
In den letzten Jahren habe ich das EMDR Dialog‐Protokoll entwickelt, das den Umgang mit solch komplexen
EMDR Situationen in der Phase 3 wesentlich erleichtert. Im Oktober 2009 wurde eine Kurzversion meiner
Arbeit zu diesem speziellen EMDR Protokoll im deutschen EMDR Rundbrief veröffentlicht und im August
2011 wird eine englische Übersetzung im EMDR Journal for Research & Practice veröffentlicht.
Der Workshop soll einerseits die Bedeutung der Kognitionen für die erfolgreiche EMDR Arbeit nochmals
klären sowie die dazugehörigen theoretischen Grundlagen aus der Neurobiologie, der Bindungstheorie und
den Theorien der Strukturellen Dissoziation und Ego‐State Theorie zusammenfassen. Sodann wird das
Dialog‐Protokoll im Detail erläutert und mittels Fallbeispielen in der praktischen Anwendung dargestellt.
Ein praktischer Teil des Workshops ist dem Üben von Phase 3 mit dem Dialogprotokoll vorbehalten. Die
TeilnehmerInnen sollen anhand von konkreten eigenen Beispielen die Phase 3 mit Anwendung des Dialog‐
Protokolls üben, um für die Praxis eine auf Selbsterfahrung basierende praktische Erfahrung mitzunehmen.
Es geht dabei um das Erfassen von Phase 3 bis zum VOC, nicht um eine komplette Selbsterfahrung mit
EMDR. Dabei soll die emotionale Relevanz der stimmigen und tiefgreifenden Kognition erfahrbar werden.
Wenn es der zeitliche Rahmen erlaubt, können eigene Fälle zur Diskussion gestellt werden. Der Workshop
soll eine kollegiale Diskussion von Problemen in der EMDR Anwendung ermöglichen und neue Perspektiven
eröffnen helfen.
Experience shows that successful work often with EMDR significantly taken from and
emotionally meaningful choice of cognition depends. But experience shows also that these
Proper selection can often be difficult to hurdle in entering complex EMDR work in phase 3,
and not only for beginners but also for experienced EMDR therapists.
This especially when the focus of the work of non-traumatic on clearly defined classical
Individual events, but on complex, early-life subjects. Working out of profound,
emotionally meaningful cognition falls on such topics stakeholders often particularly difficult. This
Situation often creates uncertainty among clients and therapists and offers a challenge
represents for the successful and efficient use of EMDR
Meanwhile, it has been worked into the binding and trauma research that very early interference
often have a dissociative structure among those affected the result. We must therefore assume
that in these cases, a "subtle" dissociation is, among other things, at the EMDR work in phase 3
may be manifested by problems with the development of cognition.
In recent years I have developed the dialogue EMDR protocol, how to deal with such complex
EMDR situations in phase 3 easier. In October 2009, a short version of my
Work on this specific EMDR protocol in German newsletter published EMDR and in August
2011 an English translation of the EMDR Journal for Research & Practice is published.
The workshop on the one hand the importance of cognition in the successful EMDR should work again
and clarify the related theoretical principles from neurobiology, attachment theory and
summarize the theories of Structural Dissociation and ego state theory. Then, the
Dialog protocol described in detail and illustrated using case studies in practical applications.
A practical part of the workshop is reserved for the practice of dialogue with the Phase 3 protocol. The
By means of concrete examples to own participants, phase 3 of the dialogue with application-
Exercise protocol in order for the practice to bring a hands-on experience based on personal experience.
This involves having to capturing phase 3 to the VOC, not a complete self-awareness
EMDR. It is the emotional relevance of coherent and profound cognition can be experienced.
If it is the time frame allowed to own cases are presented for discussion. The workshop
should enable a collegial discussion of issues in application of EMDR and new perspectives
help open up.
Keywords: Cognitions Dialogue Protocol
Accuracy Verified: Yes
76. van Eijk, M. & ter Braak, A. (2008, Maart). De noodkreet van het lijf: Het lichaam spreekt [The cry of the body: The body speaks]. Presentatie aan de derde congres van de Vereniging EMDR Nederland, Ede, The Netherlands.
Language: Dutch
Format: Conference
Abstract:
De gevolgen van psychotrauma manifesteren zich in de meeste gevallen in de vorm van herbelevingen, vermijding, emotionele ontregeling, concentratiestoornissen en dergelijke.
Lichamelijke klachten worden inmiddels ook steeds vaker herkend als een van de gevolgen van PTSS.
In deze workshop wordt naast aandacht voor de theoretische achtergrond van psychofysiologische reacties, ingegaan op wat men als EMDR- therapeut in de praktijk kan tegenkomen: dit kan variëren van selectief mutisme tot stigmata en van verlammingsverschijnselen tot visus uitval. Een en ander wordt geïllustreerd aan de hand van voorbeelden en videomateriaal.
The effects of psychotrauma manifest themselves in most cases in the form of reexperiencing, avoidance, emotional disturbance, impaired concentration and the like.
Physical symptoms are also now increasingly being recognized as one of the effects of PTSD.
This workshop will next focus on the theoretical background of psycho-physiological responses, discuss what they like EMDR therapist in practice may encounter: this may range from selective mutism to stigmata and paralysis to vision loss. This is illustrated by examples and video material.
Keywords: Body Psychophysiological Responses Somatic
Accuracy Verified: Yes
77. Oppenheim, H.-J. (2005, November). De som der delen: EMDR bij de behandeling van een vrouw met DIS [The sum of its parts: EMDR to treat a woman with DIS]. Presentatie op het Eerste Congres van de Vereniging EMDR Nederland, Ede, Nederland.
Language: Dutch
Format: Conference
Abstract:
Er zijn, zover bekend, zeven artikelen verschenen over de toepassing van EMDR bij DIS. Young (1994) beschrijft de toepassing van EMDR gericht op de fobische symptomen bij DIS. Paulsen (1995) komt met een theoretisch model gebaseerd op neuronale netwerken voor de dissociatieve stoornissen. Volgens Paulsen zorgt EMDR voor de her-associatie van het gedisscocieerde materiaal. Zij maant echter tot behoedzaam gebruik van EMDR, zeker bij de ernstige dissociatieve stoornissen. Anderen maken melding dat, vaak aangepaste versies van, EMDR zinvol kan zijn als een beperkte toegevoegde techniek in de behandeling van DIS (Lazrove & Fine, 1996; Chemtob, Tolin, Van Der Kolk, & Pitnam, 2000; Twombly, 2000; Fine & Berkowitz, 2001). Gelinas (2003) gaat nog verder en stelt een behandeling voor waarin een gemodificeerde vorm van van EMDR wordt gecombineerd met een ‘fase georiënteerde trauma behandeling’.
In deze presentatie staat de behandeling van een 44 jarige, zeer ernstig getraumatiseerde vrouw met DIS centraal. Zij volgt sinds eind 1997 een cognitief-gedragstherapeutische therapie. In september 2004 is er gestart met EMDR. Mede aan de hand van videofragmenten wordt het half jaar durende verwerkingsproces verteld, van één van de vele trauma’s die de cliënte heeft meegemaakt. Te zien valt onder meer hoe met behulp van EMDR specifieke informatie van de diverse alters zodanig geïntegreerd wordt, dat volledige verwerking mogelijk blijkt te zijn. Er zal aandacht besteed worden aan de specifieke wijze waarop bij deze behandeling met EMDR moest worden omgegaan.
There are known to be seven articles about the use of EMDR in DIS. Young (1994) describes the application of EMDR focused on phobic symptoms in DIS. Paulsen (1995) with a theoretical model based on neural networks for the dissociative disorders. According to Paulsen EMDR allows for the re-association of the gedisscocieerde material. It urges, however, to cautious use of EMDR, especially in severe dissociative disorders. Others have reported that, often modified versions of, EMDR can be useful as a limited added technique in the treatment of CIS (Lazrove & Fine, 1996; Chemtob, Tolin, Van Der Kolk, & Pitnam, 2000, Twombly, 2000, Fine & Berkowitz, 2001). Gelinas (2003) goes further and proposes a treatment for which a modified form of EMDR is combined with a phase-oriented trauma treatment.
In this presentation, the treatment of a 44 year old woman with very severely traumatized central CIS. It follows since the end of 1997 a cognitive-behavioral therapy. In September 2004 has started with EMDR. Partly on the basis of video clips, the half-year process told by one of the many traumas that the client has experienced. Is to see how including using EMDR specific information from the various alters so integrated that complete processing proves impossible. Attention will be paid to the specific manner in which this treatment with EMDR should be handled.
Keywords: Dissociative Disorders
Accuracy Verified: Yes
78. Struik, A. (2010, April). De zes testen, een stabilisatie methode voor chronisch getraumatiseerde en dissociatieve kinderen [The six tests, a stabilization method for chronically traumatized children and dissociative]. Presentatie Aan de Vierde congres van de Vereniging EMDR Nederland, Nijmegen, The Nederlands.
Language: Dutch
Format: Conference
Abstract:
De zes testen, een stabilisatie methode voor chronisch getraumatiseerde en dissociatieve kinderen.
De stabilisatie en behandeling van deze kinderen kan gecompliceerd zijn. Vanzelfsprekend is het creëren van een veilige omgeving en een hechtingsfiguur een eerste stap. Maar wat dan? Deze kinderen functioneren soms ogenschijnlijk goed. Hun vermijdingsstrategieën zijn effectief en ze weigeren om over het trauma te praten of zeggen dat ze het vergeten zijn. Ze hebben er geen last meer van. Maar de verleiding van de therapeut om dan geen slapende honden wakker te maken is een gevaarlijke. Want onder deze ogenschijnlijk goed functionerende buitenkant, zit een constant alert, angstig en eenzaam kind. Dit kind kan zich niet hechten en dit gebrek aan veilige hechting is verwoestend voor de ontwikkeling. Dit wordt echter vaak alleen zichtbaar door er expliciet naar te zoeken.
In deze presentatie zal ik ‘De zes testen’ demonstreren, een stabilisatie methode voor kinderen en een bewerking van de drie testen (Spierings, 2008). De zes testen helpen de therapeut om te beslissen of een kind verdere stabilisatie nodig heeft en hoe dat te bereiken, voordat met EMDR gestart kan worden. Aan de hand van casuïstiek wordt dit proces en het gebruik van stabilisatietechnieken gedemonstreerd. De kinderen moeten technieken leren om emoties te reguleren en stress te verminderen. Dan wordt het hechtingssysteem geactiveerd, zodat ze stress kunnen reguleren door steun te zoeken. Zo vermindert de noodzaak tot dissociatie. Door problemen die het kind ervaart te koppelen aan ervaringen in het verleden wordt het kind gemotiveerd om naar de trauma’s te kijken en met EMDR te starten. Dan worden nog aanpassingen in het EMDR protocol besproken voor dissociatieve kinderen om ze in het desensitisatie proces te houden en wordt besproken hoe EMDR kan worden geïntegreerd in een gefaseerde behandeling.
Spierings, J. (2008). Stabilisatie, een gestructureerd programma voor taxatie en interventie. In: Ten Broeke, E. De Jongh, A., & Oppenheim, H. Praktijkboek EMDR. Amsterdam: Harcourt
The six tests, a stabilization method for chronically traumatized and dissociative children.
The stabilization and treatment of these children can be complicated. Obviously, creating a safe environment and an attachment figure is a first step. But what then? These children sometimes seem to function properly. Their avoidance strategies are effective and they refuse to talk about the trauma or say they are forgotten. They have no more trouble. But the seduction of the therapist and then to wake sleeping dogs is dangerous. For among these seemingly well-functioning exterior, is a constant alert, anxious and lonely child. This child can not attach and the lack of secure attachment is devastating for the development. This is often visible only by explicitly to search.
In this presentation I will "The six tests" demonstrate a stabilization method for children and an adaptation of the three tests (Spierings, 2008). The six tests help the therapist to decide whether a child needs further stabilization and how to reach before EMDR can be started. Using case studies this process and the use of stabilization techniques are demonstrated. The children must learn techniques to regulate emotions and reduce stress. Then the attachment system is activated, so they can be regulated by stress to seek support. Thus reduces the need for dissociation. Due to problems experienced by the child to link past experience the child is motivated to look at the trauma and EMDR to start. Then further adjustments to the EMDR protocol for dissociative children to discuss them in the desensitization process and discusses how to keep EMDR can be integrated into a phased treatment.
Spierings J. (2008). Stabilization, a structured program of assessment and intervention. In: Ten Broeke, E. De Jongh, A., & Oppenheim, H. EMDR Practice Book. Amsterdam: Harcourt
Keywords: Children Dissociation Six Tests Stabilization
Accuracy Verified: Yes
79. Peterson, G. (2009, August). Deconstructing dissociative identity disorder to guide EMDR treatment. Presentation at the annual meeting of the EMDR International Association, Atlanta, GA.
Language: English
Format: Conference
Abstract:
EMDR is known to dissolve dissociative barriers in those who have dissociative identity disorder. This occurrence can make EMDR more hazardous for clients with DID than for those in other diagnostic categories. In this program, participants will gain enthusiasm about learning more about dissociative disorders and the use of EMDR. They will learn how to distinguish the concept of self-state from ego-state and be able use this distinction in their treatment planning. Participants will recognize characteristics of dissociative structure that will lead toward or away from the use of EMDR at a particular phase of therapy.
Keywords: DID Dissociative Identity Disorder
Accuracy Verified: Yes
80. Forgash, C. A. (2005, June). Deepening EMDR treatment effects across the trauma spectrum: Integrating EMDR and ego state work. Föreningen EMDR Sverige, EMDR Tidningen, 7(2), 6-14.
Language: English
Format: Newsletter
Abstract:
The concepts, interventions, and techniques presented in this workshop are culled from theory and techniques of
working with the range of the dissociative disorders). They have proved to be an effective addition to the preparation
stage of the EMDR protocol. In other words, they can be used with clients who dissociate under certain conditions but
do not have a dissociative disorder
Most of the traumatized clients seen for EMDR treatment have a range of dissociative symptoms as well as
symptoms of PTSD. This combination of PTSD and a dissociative disorder is often labeled DDNOS. However, people
with a more complex variety of PTSD usually have experienced very early and enduring severe physical or sexual
abuse (generally perpetrated by a family member), atrocities, war, or severe environmental disruption such as
earthquakes. They are more accurately diagnosed with disorders of extreme stress (DESNOS). For these clients, the
dissociated neural networks, or dissociative fragmentation, cause serious problems in adult life.
The adaptive information processing system is on hold for these dissociated fragments or parts. They are easily
triggered by internal or external cues to which they can have extreme reactions, (flashbacks, amnesia, losing time and
place, and so forth.)
Our goal as therapists is to use EMDR to help clients (and their internal dissociated neural networks or parts) find
stability and resources to function adaptively in their present life, and then desensitize and reprocess the dissociated
trauma memories and the PTSD symptoms.
We aim to help our clients manage their symptoms. It is not our goal to eliminate dissociation, which has been a
major survival strategy, but to help the client utilize it with conscious control.
It is important to note that attachment issues are an aspect of development that are especially impacted by trauma.
The attachment styles of the family pre trauma may have already affected the client in negative ways, impacting the
client's resources and responses to trauma.
One way to look at this set of problems is to utilize two approaches in the preparation phase of EMDR. These
approaches combine the treatment of dissociative symptoms with ego state work and are an essential aspect of treating
these clients with EMDR. This work may extend the preparation phase considerably, but will add safety and structure
to the trauma processing experiences for these clients.
Keywords: Ego State Therapy
Accuracy Verified: Yes
81. Forgash, C. A., & Bergmann, U. (1999). Deepening EMDR treatment effects in the clinical treatment of dissociative disorders: Integrating EMDR techniques, ego-state therapy, and developmental blueprinting. Presentation at the annual meeting of the International Society for the Study of Dissociation Fall Conference, Miami FL.
Language: English
Format: Conference
Keywords: Dissociation Ego State Therapy
Accuracy Verified: Yes
82. Bergmann, U., & Forgash, C. (2000, November). Deepening the EMDR treatment effects in the treatment of dissociative disorders: Integrating EMDR and ego state techniques. Presentation at the annual meeting of the International Society for the Study of Dissociation Fall Conference, San Antonio, TX.
Language: English
Format: Conference
Keywords: Dissociation Ego State Therapy
Accuracy Verified: Yes
83. 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
84. Velozo, S. A. C. (2010, Noviembre). Desarrollo y procedimiento del método psicoterapéutico llamado E.M.D.R (Desensibilización y reprocesamiento por movimiento ocular) con pacientes que sufren trastorno por estrés postraumático [Procedure development and method of psychotherapy called EMDR (eye movement desentization and reprocessing) with patients suffering from posttraumatic stress disorder]. Universidad Bolivariana, Escuela de Psicologia, Santiago, Chile.
Language: Spanish
Format: Dissertation/Thesis
Abstract:
El siguiente trabajo consta de una revision bibliografica sobre el modelo psicoterapeutico llamado E.M.D.R (Desensibilizacion y Reprocesamiento por Movimiento Ocular), utilizado en patalogias psiquicas que se originan por una vivencia traumatica, esta tecnica es vilidada cientificamente y enfatiza el Sistema de Procesaiento de Informacion intrinseco del cerebro y como son almacenadas las memorias. Se identifica el problema especifico que sera el foco del tratamiento. Mediante un protocol estructuado, la informacion que estaba atrapada y aislada en la neuro-red en la que habia sido almacenada en su forma originalmente perturbadora, es procesada y desensibilizada transformandose en algo util, functional y libre de conflict. Es un metodo psicopterapeutico innovador que accelera el tratamiento en un amplio rango de patalogias de origen psicologico, como le es el Trastorno por Estres Postraumatico. Parte por una breve resena historica del concepto de truma psiquico, descripcion del cuadro de sintomas del trastorno de ester postraumatico y una revision bibliografica sobre el modelo teorico en el que se inserta principios y procedimiento de la terapia EMDR. Por ello se presentan las fases del procedimiento, que son: 1. Historica clinica y plan de tratamiento, 2. Preparacion, 3 Evaluacion/D.I.C. E.S., 4. Desensibilizacion, 5. Instalacion de la creencia positive, 6. Chequeo corporal – Escaner corporal, 7. Cierre – Conclusion, and 8. Reevaluacion/Seguimiento. Finalmente se hara una docil comparacion con las terapias del modelo convencional en base a la triada do los sintomas del Trastorno por Estres Postraumatico, vale decir: rexpermentacion, evitacion e hiperactivacion.
The following work consists of a literature review on the psychotherapeutic model called EMDR (Desensitization and Reprocessing Eye Movement), used in psychic patalogias that are caused by a traumatic experience, this technique is scientifically and emphasizes vilidada System Information Procesaiento intrinsic brain and how memories are stored. It identifies the specific problem will be the focus of treatment. Using a structured protocol, information that was trapped and isolated in the neuro-network that had been stored as originally disturbing is processed and transformed into something useful desensitized, functional and free of conflict. It is an innovative method accelerates psicopterapeutico treatment in a wide range of psychological origin patalogias, as he is Posttraumatic Stress Disorder. Party by a brief history of the concept of psychic Truma, description of box ester disorder symptoms and posttraumatic literature review on the theoretical model that is inserted in the principles and procedure of EMDR therapy. So are procedural steps which are: 1. Historical clinical and treatment plan, 2. Preparation, 3 Evaluation / D.I.C. E.S., 4. Desensitization, 5. Installation of positive belief, 6. Check body - body scanner, 7. Close - Conclusion, and 8. Reassessment / Follow-up. Finally there will be a docile compared to the conventional therapies based on the triad do the symptoms of posttraumatic stress disorder, namely: rexpermentacion, avoidance and hyperarousal.
Keywords: Posttraumatic Stress Disorder PTSD
Accuracy Verified: Yes
85. Schmidt, S. J. (2004). Developmental needs meeting strategy: A new treatment approach applied to dissociative identity disorder. Journal of Trauma and Dissociation, 5(4), 55-78. doi:10.1300/J229v05n04_04.
Language: English
Format: Journal
Abstract:
This article describes the use of the Developmental Needs Meeting Strategy (DNMS)
for the treatment of dissociative identity disorder (DID). The DNMS is an ego state
therapy which guides a client’s own internal resources to meet developmental
needs that were not met in childhood. After 17 months of DNMS treatment a client
with DID reported a near total elimination in frequency and severity of symptoms of
depression, anxiety and suicidal thoughts, her Trauma Symptom Inventory scores
indicated no trauma symptoms, and her Multidimensional Inventory of Dissociation
scores indicated she no longer meets the diagnostic criteria for DID. She was
functioning well without any medication. Further research is warranted.
Keywords: Developmental Needs Meeting Strategy
Accuracy Verified: Yes
86. Patti, M. S (2010, April). Diagnosing and treating complex PTSD: An integrated approach model - Borderline personality disorder and comorbid DID: intervening with EMDR, relational and sensorymotor psychotherapies . Symposium at the 2nd Bi-Annual International European Society for Trauma and Dissociation Conference, Belfast, Northern Ireland.
Language: English
Format: Conference
Abstract:
The paper presents a clinical case of an initial diagnosis of BPD referred to ARP by local psychiatric services where she was treated for a suicide attempt. The client presented serious affective dysregulation, impulse dyscontrol, dissociative symptoms and refused any medication. Clinical team opted for an integrated assessment which also stabilised the client. The assessment enabled to diagnose the client with structural dissociation isolating both ANP and EP aspects. Clinical intervention adopted an integrated approach using EMDR to treat specific dissociative traits, sensorymotor therapy to intervene on somatic symptoms, and relational therapy to develop therapeutic alliance. A preliminary stabilisation enabled the client to accept support from psychiatric services. This clinical case shed light on how the integration of assessment tools may detect better trauma disorders and challenged the importance of collaborative work between private practice and psychiatric services when intervening with seriously traumatized patients.
Keywords: Borderline Personalith Disorder Comorbid DID Complex Trauma
Accuracy Verified: Yes
87. Stierum, A. J., & van Heijningen, J. G. M. (2011, April). Diagnostiek en behandeling van dissociatieve stoornissen bij kinderen en jeugdigen [Diagnosis and treatment of dissociative disorders in children and adolescents]. Presentatie op het 39ste Voorjaarscongres Nederlandse Vereniging voor Psychiatrie, Amsterdam.
Language: Dutch
Format: Conference
Abstract:
Inhoud van de workshop: Dissociatie
en trauma zijn nauw met elkaar verbonden.
Dissociatieve stoornissen worden toch vaak niet
herkend en dissociatieve stoornissen bij kinderen
gelden als controversieel. Kinder- en jeugdpsychiaters
leren in de opleiding weinig over dissociatieve
stoornissen.
In de workshop wordt aandacht besteed aan
het herkennen van dissociatieve stoornissen bij
(seksueel) getraumatiseerde kinderen en aan de
behandeling ervan, geïntegreerd in de traumabehandeling.
Ernstig getraumatiseerde kinderen
hebben vaak meerdere diagnoses, zoals posttraumatische stoornissen essentieel is voor het slagen van een
goede traumabehandeling. We bespreken de
internationale richtlijnen en recente literatuur
over diagnostiek en behandeling van dissociatieve
stoornissen bij kinderen. Neurobiologische aspecten
van vroegkinderlijke traumatisering en de
gevolgen hiervan voor het kind worden behandeld.
Verschillende behandelmethoden zoals eye
movement desensitisation and reprocessing (EMDR) en
differentiatiefasetherapie worden besproken.
Vorm:
—— Aan de hand van presentaties worden de theorie
en de praktijk van de diagnostiek en het behandelen
van dissociatieve stoornissen bij kinderen
en jeugdigen besproken.
—— We tonen beeldmateriaal van diagnostiek en
behandeling van dissociatieve stoornissen bij
kinderen en jeugdigen.
—— Uitwisselen van ervaring en kennis, inbrengen
van casuïstiek en discussie.
Leerdoel:
—— Aan het einde van de workshop erkent de deelnemer
het belang van herkennen en behandelen
van dissociatieve stoornissen bij getraumatiseerde
kinderen en jeugdigen.
—— De deelnemer vergroot zijn kennis van diagnostiek
en behandeling van dissociatieve stoornissen
van kinderen en jeugdigen, waarbij hij op de
hoogte is van de recente literatuur.
stressstoornis (PTSS) en hechtingsstoornis.
Dissociatieve problematiek kan ook verward
worden met onder meer obsessieve-compulsieve
stoornissen (ODD), aandachtstekortstoornis met
hyperactiviteit (ADHD) en vele andere kinderpsychiatrische
stoornissen en zo het resultaat van
therapieën bemoeilijken. Wij gaan er daarom vanuit
dat herkennen en behandelen van dissociatieve.
Contents of the workshop: Dissociation
and trauma are closely linked.
Dissociative disorders are often not yet
recognized and dissociative disorders in children
construed as controversial. Child and adolescent psychiatrists
learning in the training little dissociative
disorders.
The workshop focuses on
recognition of dissociative disorders
(Sexual) traumatized children and the
its treatment, integrated into the trauma treatment.
Severely traumatized children
often have multiple diagnoses, such as post traumatic stress is essential for the success of a
good trauma treatment. We discuss the
International guidelines and recent literature
about diagnosis and treatment of dissociative
disorders in children. Neurobiological Aspects
of early childhood trauma and
consequences for the child to be treated.
Various treatments such as eye
Movement Desensitisation and Reprocessing (EMDR) and
phase modulation therapy are discussed.
Form:
- Based on the theory presentations
and practice of diagnosis and treatment
of dissociative disorders in children
and adolescents are discussed.
- We show footage of diagnosis and
treatment of dissociative disorders
children and adolescents.
- Share the experience and knowledge, contribute
of cases and discussion.
Objective:
- At the end of the workshop, the participant acknowledges
the importance of recognizing and treating
of dissociative disorders among traumatized
children and adolescents.
- Participants increased their knowledge of diagnosis
and treatment of dissociative disorders
of children and youth, taking on the
aware of the recent literature.
stress disorder (PTSD) and attachment disorder.
Dissociative problem can also confused
are including obsessive-compulsive
disorder (ODD), attention deficit
hyperactivity disorder (ADHD) and many other children's psychiatric
disorders and as a result of
therapies difficult. We therefore assume
that recognition and treatment of dissociative.
Keywords: Adolescents Children Dissociative Disorders Sexual Abuse
Accuracy Verified: Yes
88. Lansch, D. (2008, Januar-März). Die arbeit mit der vier-felder-technik mit komplex traumatisierten menschen [Four-fields technique with people with complex trauma]. EMDRIA Deutschland e.V. Rundbrief, 14, 14-34.
Language: German
Format: Newsletter
Abstract:
Nachfolgend zur Vorstellung der Vier-Felder-Technik im EMDRIA
Rundbrief 8 (2006) soll an Hand von Bilderserien die Anwendung der Vier-Felder-Technik bei
komplex traumatisierten Patientinnen vorgestellt werden. Insbesondere wird die Arbeit mit
unterschiedlichem Ausgangsmaterial als auch der Einsatz dieser Technik in verschiedenen
Phasen der Behandlung erläutert. Abschließend zeigen neun Bilderserien, dass auch die
Anwendung der Vier-Felder-Technik bei einer dissoziativen Patientin möglich und erfolgreich
ist. Dieser Artikel basiert und erweitert die auf den EMDRIA-Tagen 2006 + 2007 gehaltenen
Vorträge.
Following the presentation of the four-field technique in EMDRIA
Rundbrief 8 (2006) is on the basis of series of images the application of the four-field technique for
complex trauma patients are presented. In particular, working with
different source material and the use of this technology in various
Phases of treatment explained. Finally, nine images show series that also the
Application of the four-field technique with a dissociative patient possible and successful
is. This article is based and extends the hold on the EMDRIA-days 2006 + 2007
Lectures.
Keywords: Comlex Trauma Four-Fields Technique
Accuracy Verified: Yes
89. Phillips, M. (2007, September). Die Kraft einer flexiblen integrativen Traumatherapiedie Vereinigung von Ego- State-, Hypno-, Energie- und EMDRPsychotherapie [Energizing self through ego-state therapy, EMDR, and energy psychology methods]. Vortrag im Rahmen der Ersten Europäischer Kongress für Energie-Psychologie und Psychotherapie, Heidelberg, Deutschland.
Language: English
Format: Conference
Abstract:
Mit großer Freude kann ich dieses „Highlight“ mit der international führenden Spezialistin der Trauma-
Therapie, von Dissoziationsstörungen und auch der Schmerz- Therapie ankündigen. Maggie Phillips gilt ja
schon seit vielen Jahren als eine der besten und erfahrensten SpezialistInnen der Ego-State- Therapie.
Ihr "Handbuch der Hypnotherapie bei posttraumatischen und dissoziativen Störungen" (zusammen mit C.
Frederick) gilt als eines der maßgeblichsten Werke in diesem Feld.
Als einer der ersten ExpertInnen weltweit wies sie aber auch immer wieder darauf hin, dass gerade für den
Bereich multipler posttraumatischer und dissoziativer Störungen der Zugang mit einer Methode häufig
nicht ausreicht.
In beeindruckender Weise drückt ihr Werk "Finding the Energy to Heal: How EMDR, Hypnosis, TFT, &
Body Focused Therapy Can Help Restore Mindbody Health (W.W. Norton, 2000)" ihre wunderbare
Fähigkeit zum Ausdruck, unterschiedliche Konzepte zu einer sehr effektiven und flexiblen und dabei völlig
konsistenten Gesamt- Interventionsmodell für diese schwierigen Aufgaben zu integrieren.
Auch ihr neues Buch "Reversing Chronic Pain" verspricht alle Qualitäten für ein Meisterwerk.
Wer mit ihr schon einmal gearbeitet hat oder sie in ihrer Arbeit erleben durfte, kann ihre große sehr
achtungsvolle Haltung, Einfühlsamkeit und Kongruenz, gepaart mit geradezu virtuoser Fachkompetenz nur
bestätigen.
It is with great pleasure that I can highlight to the world's leading specialist in trauma-
Therapy, and also announce Dissoziationsstörungen of the pain therapy. Maggie Phillips is yes
for many years as one of the best and most experienced specialists of the ego-state therapy.
Their "Manual of hypnotherapy for post-traumatic and dissociative disorders" (with C.
Frederick) is considered one of the most authoritative works in this field.
As one of the first experts worldwide, it also repeatedly pointed out that especially for the
Multiple range post-traumatic and dissociative disorders, access to a method frequently
is not sufficient.
In impressively expresses its work, "Finding the Energy to Heal: How EMDR, Hypnosis, TFT, &
Body Focused Therapy Can Help Restore Mind Body Health (WW Norton, 2000), "her wonderful
Ability to express different concepts in a very effective and flexible and in complete
to integrate consistent overall model of intervention for these difficult tasks.
Her new book, "Reversing Chronic Pain" promises all the qualities of a masterpiece.
Anyone who has worked with her before, or could they experience in their work, may their very large
respectful attitude, empathy and congruence, coupled with an almost virtuoso expertise only
. Confirm
Keywords: Ego State Therapy Energy Psychology
Accuracy Verified: Yes
90. Wagner, F. (2004). Die wirksamkeit von eye movement desensitization and reprocessing (EMDR) bei der posttraumatischen belastungsstorung im vergleich zu kontrollbedingungen und kognitiv-behavioralen therapien: Eine metaanalytische untersuchung [Efficacy of eye movement desensitization and reprocessing (EMDR) for post-traumatic stress disorder compared with control conditions, and cognitive-behavioral therapies]. Zugl: Heidelberg. doi:volltextserver/volltexte/2005/5803 . --.
Language: German
Format: Book
Abstract:
Das Ziel der vorliegenden Metaanalyse war es, die Wirksamkeit von EMDR und kognitiv-behavioralen Therapieverfahren bei der posttraumatischen Belastungsstörung mit dem aktuellen Stand an Publikationen metaanalytisch zu untersuchen. In einer umfassenden Literaturrecherche wurden hierfür sowohl publizierte Originalarbeiten als auch unpublizierte Manuskripte recherchiert. Insgesamt gingen 32 Originalstudien in die Metaanalyse ein. 13 der Studien waren reine EMDR-Studien; 7 untersuchten sowohl eine Gruppe mit EMDR als auch eine Gruppe mit kognitiv-behavioraler Therapie. 12 Studien waren reine kognitiv-behaviorale Therapiestudien. Darüber hinaus sollte die Wirksamkeit unter dem Gesichtspunkt der verschiedenen PTSD- und komorbiden Symptomatiken betrachtet werden. In einem weiteren Schritt wurde EMDR direkt mit kognitiv-verhaltenstherapeutischen Behandlungsmethoden verglichen.
Effektstärken wurden sowohl für die PTSD-Symptomkategorien Intrusionen, Vermeidung und erhöhtes Arousal als auch für die komorbiden Symptome Angst und Depression berechnet. Die Berechnung der Effektstärken erfolgte anhand von standardisierten Mittelwertsvergleichen. Neben dem direkten Vergleich von EMDR mit kognitiv-behavioralen Therapieansätzen bzw. von EMDR und kognitiv-behavioraler Therapie mit Kontrollgruppen (Post-/Post-Vergleich) wurden auch die Veränderungen innerhalb der Behandlungsgruppen berechnet (Prä-/Post-Vergleich). In den Post-/Post-Vergleich gingen nur kontrollierte und randomisierte Originalstudien ein. In den Prä-/Post-Vergleich hingegen wurden auch Ein-Gruppen-Studien aufgenommen. Als Effektmaß wurde Hedges´d verwendet.
Die Ergebnisse legen nahe, dass sowohl EMDR als auch die kognitiv-behaviorale Therapie wirksam in der Behandlung der posttraumatischen Belastungsstörung sind. Beide Verfahren reduzieren in klinisch bedeutsamem Umfang, sowohl unmittelbar als auch lang anhaltend, die PTSD-Symptomatiken Intrusionen, Vermeidung und erhöhtes Arousal. Darüber hinaus führen beide Behandlungsmethoden auch zu einer Reduktion der komorbiden Symptomatiken Angst und Depression. Die Effektivität beider Verfahren zeigt sich hierbei sowohl im Prä-/Post-Vergleich als auch im direkten Post-/Post-Vergleich mit einer Kontrollbedingung. Darüber hinaus ergibt sich eine ähnlich hohe Wirksamkeit von EMDR und kognitiv-behavioraler Therapie, sowohl im Vergleich der Prä-/Post-Effektstärken als auch im direkten Post-/Post-Vergleich. Dennoch scheint es unterschiedliche Einflussfaktoren zu geben, welche die Therapieeffektivität sowohl bei EMDR als auch bei kognitiv-behavioraler Therapie beeinflussen. Aufgrund der geringen Studienzahl lassen sich diese Faktoren jedoch nicht näher untersuchen. Des Weitern zeichnen sich Unterschiede hinsichtlich der Effizienz der beiden Therapieformen ab: So beträgt die durchschnittliche Behandlungsdauer bei EMDR 5 Sitzungen, bei der kognitiv-behavioralen Therapie hingegen 8 Sitzungen. Darüber hinaus ist die Expositionsdosis bei den kognitiv-behavioralen Therapien höher als bei EMDR.
Die Befunde zur Wirksamkeit der bilateralen Stimulation sind hingegen weniger eindeutig. Allerdings sind Studien, welche den Versuch unternehmen, die Augenbewegungen bei Personen mit PTSD isoliert zu betrachten, oftmals von erheblichen methodischen Mängeln gekennzeichnet. Einzelne Befunde und Modellvorstellungen zur Rolle der bilateralen Stimulation beim EMDR werden im Diskussionsteil erörtert.
The aim of this meta-analysis is to examine the efficacy of EMDR and Cognitive Behavioral Therapy approaches in the treatment of Posttraumatic Stress Disorder (PTSD) on the basis of the publications relating to this issue up to the present. A large-scale search for pertinent literature came up with a total of 32 original studies. The results of these studies suggest that both the EMDR approach and Cognitive Behavioral Therapy methods are effective in the treatment of Posttraumatic Stress Disorder. Both approaches bring about immediate and sustained reduction of the PTSD symptoms intrusions, avoidance, and hyperarousal to a clinically significant degree. In addition, both treatments lead to a reduction of the comorbid symptomatologies anxiety and depression. The comparison of pre/post effect sizes and direct post/post comparison indicate that EMDR and cognitive behavioral therapy are similar in their efficacy. In terms of efficiency the EMDR method appears to have a slight advantage. However, the present meta-analytic study makes no attempt to address the issue of whether this efficiency advantage should be interpreted as having a bearing on clinical practice.
Keywords: Posttraumatic Stress Disorder PTSD Trauma
Accuracy Verified: Yes
91. [Yoshinori Fukui]. (2009, May). Discussion on the use of the dissociative experiences scale (DES): Frequency of dissociative experinces among adolescents. EMDR研究1(1)、12月23日 [Japanese Journal of EMDR Research and Practice, 1(1), 12-23].
Language: Japanese
Format: Journal
Abstract:
This research aims to look at the frequency of dissociative experiences among adolescent
population, and collect basic data. Dissociative Experiences Scale (DES) was administered to 816
university students. The results on each item were analyzed and they were very similar to those
of previous studies. I-T correlation and G-P analyses results indicate that discriminate power for each item is at best when cut-off of 25 or less is applied. Since the data was not distributed normally, test for median was performed and the same result was obtained. On top of that, to secure the normal distribution of the data, square root transformation was undertaken before the two analyses were performed. The results suggest that on G-P analysis, in order to increase
discriminate power, the cut-off needs to be less than 16. However, when false negative and positive
were taken into consideration, it was off from practical use. And when compared with other
researches, it became apparent that depending on the context of measurers used with DES, there
is a possibility of subjecrs being biased. Also it was suggested that items on DES are useful in
screening DID but they are not measuring the overall spectrum of dissociative disorder.
Keywords: Adolescence DES Dissociative Experience Dissociative Experiences Scale
Accuracy Verified: Yes
92. Draijer, N. (1996, December). Dissociation in an international perspective: The 1995 Amsterdam Papers. Dissociation, 9(4), 219-220.
Language: English
Format: Journal
Abstract:
Lazrove and Fine describe both the use of and contraindications
to EMDR (Eye Movement Desensitization and
Reprocessing) in the treatment of DID patients. This technique
is an alternate method for managing the processing
of trauma. It must be modified to conform to the principles
of fractionated trauma work. Apparently such approaches
are to be used only by clinicians highly-skilled in work with
dissociative disorder patients who are also well-trained in
EMDR.
Keywords: Editorial
Accuracy Verified: Yes
93. Forgash, C. (2010, September/October). Dissociation in the dental chair: Implications for the EMDR treatment of health issues. Presentation at the annual meeting of EMDR International Association, Minneapolis, MN.
Language: English
Format: Conference
Abstract:
EMDR treatment is effective in dealing with many health problems (exacerbated by dissociation)encountered by many complex trauma clients. The negative sequelae of abuse on the physical and mental health of these clients includes flashbacks and dissociative episodes. They are frequently avoidant of health care, which can lead to further consequences. This presentation will focus on expanding the EMDR Preparation Phase; presenting strategies to deal with dissociation, emotional issues, and PTSD symptoms. The Desensitization and Reprocessing Phase will deal with earlier traumatic events, health issues and current and past dissociative events which are frequently at the root of these problems.
Keywords: Dissociation Health Issues
Accuracy Verified: Yes
94. van der Hart, O., Nijenhuis, E. R. S., & Solomon, R. (2010). Dissociation of the personality in complex trauma-related disorders and EMDR: Theoretical considerations. Journal of EMDR Practice and Research, 4(2), 76-92. doi:10.1891/1933-3196.4.2.76.
Language: English
Format: Journal
Abstract:
As eye movement desensitization and reprocessing (EMDR) has been increasingly applied in complex trauma-related disorders, including complex dissociative disorders, and trauma-related borderline personality disorder, EMDR practice may benefit from theories developed to account for the dissociative nature of these disorders, such as the theory of structural dissociation of the personality (TSDP). TSDP postulates that the personality of traumatized individuals is unduly divided in two basic types of dissociative subsystems or parts. One type involves dissociative parts primarily mediated by daily life action systems or motivational systems. The other type involves dissociative parts, fixated in traumatic memories, primarily mediated by the defense action system. The more severe and chronic the traumatization, the more dissociative parts can be expected to exist. This article presents the basics of TSDP, and a second article will provide guidelines for the treatment of complex trauma-related disorders based on this theory.
Keywords: Complex Trauma Dissociation Dissociation of the Personality Dissociative Disorders Integration Ohase-Oriented Treatment Structural Dissociation
Accuracy Verified: Yes
95. van der Hart, O. (2011, March). Dissociation of the personality: The key to understanding chronic traumatisation and a guide to EMDR treatment. Preconference presentation at the 9th annual Conference of the EMDR UK & Ireland, Bristol.
Language: English
Format: Conference
Abstract:
There is currently consensus that the EMDR standard protocol needs to be modified
for chronically traumatized clients, such as clients with complex dissociative disorders, as it may
destabilize them. Therefore, therapists need to have a good understanding of the dissociative
personality structure that exists in these clients. Dissociation is an undue division of the personality
among two or more biopsychosocial systems or “dissociative parts” that comprise the survivor’s
personality. One or more of them function in daily life; others are fixated in traumatic experiences,
are living in trauma-time. The more severe the traumatisation, the more dissociative parts,
involving more complex trauma-related disorders, can be expected to exist. Dissociative parts have
psychobiological boundaries that are maintained, to a large degree, by different trauma-related
phobias, which are systematically resolved in phase-oriented treatment. Indeed, participants will
be able to describe structural dissociation of the personality as a specific form of integrative failure
that needs to be overcome in phase-oriented treatment, identify ways of relating dissociative
symptoms to the underlying dissociation of the personality, and identify targets such as the
dissociation-maintaining phobias, for EMDR interventions in the respective treatment phases. The
emphasis will be on the preparatory work, including how to work with dissociative parts living in
trauma-time and those perceived as being malevolent, necessary before focusing on the integration
of traumatic memories.
Keywords: Dissocation
Accuracy Verified: Yes
96. van der Hart, O. (2010, September/October). Dissociation of the personality: The key to understanding chronic traumatization and its treatment. Plenary presented at the annual meeting of EMDR International Association, Minneapolis, MN.
Language: English
Format: Conference
Abstract:
EMDR treatment of complex trauma-related disorders may benefit from a clear understanding of the dissociative nature of these disorders. Dissociation is an undue division of the personality among two or more psychobiological systems or “dissociative parts” that comprise the survivor’s personality. One or more of them function in daily life; others are fixated in traumatic experiences. The more severe the traumatization, the more dissociative parts, involving more complex trauma-related disorders, can be expected to exist. Dissociative parts have psychobiological boundaries that are maintained, to a large degree, by different trauma-related phobias, which should be systematically resolved in phase-oriented treatment. Participants will be able to describe structural dissociation of the personality as a specific form of integrative failure that needs to be overcome in phase-oriented treatment, identify ways of relating dissociative symptoms to the underlying dissociation of the personality, and identify targets for EMDR interventions in each of the three treatment phases in terms of overcoming specific phobias.
Keywords: Chronic Traumatization Plenary
Accuracy Verified: Yes
97. Lanius, U. F. (2001, June). Dissociation processes and EMDR: Staying connected. Presentation at the annual meeting of the EMDR International Association, Austin, TX.
Language: English
Format: Conference
Abstract:
Participants will: 1) learn a model, based on recent developments in neuroscience and the neurobiology of dissociation, that guides therapeutic interventions in general and EMDR treatment in particular; 2) apply effective treatment planning, target selection, and the use of both body-oriented (bottom-up processing); 3) learn to utilize interventions intended to minimize dissociative symptoms; and 4) learn techniques that aid clients in becoming reconnected, once dissociative processes have occurred.
Keywords: Dissociation
Accuracy Verified: Yes
98. Scaer, R. (2006, September). Dissociation theory and the healing of trauma. Plenary at the annual meeting of the EMDR International Association, Philadelphia, PA.
Language: English
Format: Conference
Abstract:
The early studies of trauma in late 19th century Paris
centered on the clinical phenomenon of conversion
hysteria, a dissociative disorder. Janet and Freud
wrote extensively on this topic, and actually
described many of the posttraumatic syndromes that
we are revisiting today. I will make the case that the
late syndromes of Posttraumatic Stress Disorder,
especially dissociation, are clearly the defining
symptomatic and physiological manifestations of
trauma. These syndromes all have prominent
somatic features, all of which represent posttraumatic
sornatosensory implicit memory. This unconscious,
body-based feature of the posttraumatic syndrome
presents a compelling case for the universal
application of somatically-based therapies such as
EMDR in the healing of trauma.
Keywords: Dissociation Plenary
Accuracy Verified: Yes
99. van der Hart, O. (2007). Dissociation: The key to understanding and treating traumitization. Keynote presented at the annual meeting of the EMDR Europe Association, Paris, France.
Language: English
Format: Conference
Abstract:
A precise understanding of trauma-related dissociation is
essential for clinical practice, including the use of EMDR
with traumatized patients. The existence of many conflicting
and vague definitions of dissociation that include a
mixture of constructs has obscured understanding of the
nature of dissociation. Thus, it is viewed alternately as a
process, a structure, a defense mechanism, a deficit, and
as various symptoms. Most contemporary clinicians and
researchers working with traumatized people have lost a
connection with the unifying and comprehensive theory
of trauma-related dissociation already outlined over the
course of the history of psychiatry. Thus, a return to the
original major studies on trauma-related dissociation is
essential in clarifying the concept of dissociation, in reconciling
it with contemporary science, and in realizing
its importance in treatment. The works of two Masters
will be used to highlight this basic concept: Pierre Janet
(1859-1947) and Charles Myers (1873-1947). The theory
of structural dissociation of the personality integrates
their original views on dissociation with modern findings
from clinical practice and research and developments in
the neurosciences. It emphasizes that the personality system
of the trauma survivor becomes structurally divided
into two or more self-conscious psychobiological subsystems.
Some of these subsystems, which we have called
“dissociative parts of the personality”, are engaged in
daily living and avoidance of traumatic memories, other
parts are fixated in traumatic experiences and essentially
engaged in animal defensive actions toward perceived
danger. More severe chronic traumatization leads to more
complex structural dissociation, and thus to more complex
trauma-related disorders. Although short-term, intensive
treatments such as prolonged exposure and EMDR
are appropriate for simple trauma-related disorders, a
phase-oriented treatment is the standard of care formore
complex disorders. Regardless of treatment modalities
employed, be it EMDR or other approaches, therapists
need to be skilled in the recognition of symptoms of dissociation
and in special treatment approaches that support
personality integration among dissociative parts,
particularly in working with traumatic memories.
Keywords: Dissociation Keynote
Accuracy Verified: Yes
100. Fenstermaker, D. (1992, April). Dissociative disorders. Presentation at the EMDR Network Conference, Sunnyvale, CA.
Language: English
Format: Conference
Abstract:
This paper details a protocol of Eye Movement Desensitization and Reprocessing (EMDR) in the treatment of Dissociative Disorders. EMDR replaces amytal abreactions, the numerous methods of restraint abreactions, and hypnotic abreactions.[Author absract]
Keywords: Dissociative Disorders
Accuracy Verified: Yes
101. Young, W., Puk, G., & Rouanzoin, C. C. (1993, March). Dissociative disorders. Presentation at the EMDR Network Conference, Sunnyvale, CA.
Language: English
Format: Conference
Keywords: Dissociative Disorders
Accuracy Verified: Yes
102. Fenstermaker, D. (1993, March). Dissociative disorders. Presentation at the EMDR Network Conference, Sunnyvale, CA.
Language: English
Format: Conference
Abstract:
This paper details a protocol of Eye Movement
Desensitization and Reprocessing (EMDR) in the
treatment of Dissociative Disorders. EMDR replaces
amytal abreactions, the numerous methods of restraint abreactions, and hypnotic abreactions.[Author absract]
Keywords: Dissociative Disorders
Accuracy Verified: Yes
103. Darker-Smith, S. (2012, October). Dissociative disorders and EMDR: Depersonalisation, derealisation and dissociation. Presentation at the at the 4th Autumn EMDR Workshop Conference, Sheffield, UK.
Language: English
Format: Conference
Abstract:
Within the field of dissociative disorders, EMDR clinicians are advised that there should be significant stabilisation in the preparation phase of the standard protocol. Indeed, where a client has been experiencing depersonalisation and / or derealisation for a significant period of time, there can be elements of heightened risk, such as suicidal intent caused by living in this ‘half-life’ or ‘dream-state’. For these clients, using a float-back technique to introduce body sensation as a mechanism of grounding can be, and is, highly effective in terms of stabilisation. This can enable a swifter progression to a place of stability in order to target the cause of dissociation, where it has been triggered by a natural, protective psychological avoidance to a traumatic event as well as reduce risk of suicide in clients who are experiencing significant distress at being ‘trapped’ in this ‘alternate reality’.
Keywords: Derealization Depersonalization Dissociation
Accuracy Verified: Yes
104. Rouanzoin, C. (1993, Winter). Dissociative disorders and the “spatial map”. EMDR Network Newsletter, 3(3), 11-12.
Language: English
Format: Newsletter
Abstract:
Individuals with dissociative disorders present unique therapeutic difficulties for most therapists. These clients have developed an intricate and often creative defense structure to protect themselves from painful emotions and traumatic memories. Subjectively, extensive dissociation can occur when something so terrible happens that defend against it, a person divides or splits his or her awareness into two levels or streams of consciousness.
Keywords: Dissociation
Accuracy Verified: Yes
105. Knipe, J. (2007, April). Dissociative disorders: An overview using the adaptive information processing model. Presentation at the Japanese EMDR Association Conference, Kyoto, Japan.
Language: English
Format: Conference
Keywords: Adaptive Information Processing Dissociative Disorders
Accuracy Verified: Yes
106. Beere, D. B. (2003, September). The dissociative disorders: Update, current research, and applications of EMDR. Preconference presentation at the annual meeting of the EMDR International Association, Denver, CO.
Language: English
Format: Conference
Abstract:
This workshop will focus on current advances in the dissociative disorders, emphasizing scientific information supporting the diagnosis, recent advances in assessment, and the most current advances in treatment. The application and appropriateness of EMDR will be emphasized throughout the workshop and the most current applications of EMDR with dissociative disorders presented. Data will be presented that support EMDR-interventions with dissociative disorders.
Keywords: Dissociation Dissociative Disorders
Accuracy Verified: Yes
107. Marquis, J. N., & Puk, G. (1994, November). Dissociative identity disorder: A common sense and cognitive-behavioral view. Presentation at the annual meeting of the Association for Advancement of Behavior Therapy, San Diego, CA.
Language: English
Format: Conference
Keywords: DID Dissociative Identity Disorder
Accuracy Verified: Yes
108. van der Hart, O., & Matthess, H. (2009, June). Dissociative orders and EMDR. Preconference workshop of the annual meeting of the EMDR Europe Association, Amsterdam, the Netherlands.
Language: English
Format: Conference
Abstract:
Keywords: Dissociative Disorders
Accuracy Verified: Yes
109. Lanius, U. F. (2004, September). Dissociative processes and EMDR – Staying connected. Presentation at the annual meeting of the EMDR International Association, Montreal, Quebec Canada.
Language: English
Format: Conference
Abstract:
A model is proposed, based on recent research in neuroscience and the neurobiology of dissociation and attachment, that guides therapeutic interventions in general and EMDR treatment in particular. Participants will become familiar with specific interventions intended to minimize dissociative symptoms, as well as techniques that aid clients in becoming reconnected, once dissociative processes have occurred. That is, a comprehensive therapeutic approach is described to aid clients with dissociative symptoms to stay connected, and in some cases reconnect with their healing process, thereby enhancing the likelihood of efficient information processing during EMDR treatment.
Keywords: Dissociation
Accuracy Verified: Yes
110. Zucker, M., Spinazzola, J., Blaustein, M., & van der Kolk, B. A. (2006). Dissociative symptomatology in posttraumatic stress disorder and disorders of extreme stress. Journal of Trauma and Dissociation, 7(1), 19-32. doi:10.1300/J229v07n01_03.
Language: English
Format: Journal
Abstract:
The present study was designed to assess differences in
dissociative symptoms in adults with Posttraumatic Stress Disorder
(PTSD) vs. PTSD plus Disorders of Extreme Stress Not Otherwise Specified
(DESNOS). This study was done for two reasons: (1) to better understand
the clinical profile of DESNOS clients in order to inform more
effective treatment, and (2) to further empirical research on the validity
of the DESNOS construct. To assess severity of dissociative symptoms,
the authors administered the Dissociative Experiences Scale (DES) to
155 participants with PTSD. Using the Structured Interview for Disorders
of Extreme Stress (SIDES), participants were divided into two
groups: those who also met criteria for DESNOS and those who did not.
DES means are provided for the two groups. Participants with PTSD
plus DESNOS scored higher than participants with only PTSD on the
measure of dissociative symptomatology, particularly on the DES scales that tap absorption/fantasy and depersonalization/derealization. The two
groups did not differ on the amnesia subscale of the DES. Findings support
the construct validity of the DESNOS concept and further delineate
the clinical profiles of community-based PTSD with and without DESNOS,
thus contributing to the knowledge base on the assessment of complex
adaptations to trauma. [Article copies available for a fee from The Haworth Document
Delivery Service: 1-800-HAWORTH. E-mail address:
Keywords: DES DESNOS Dissociation Dissociative Experiences Scale Posttraumatic Stress Disorder PTSD Trauma
Accuracy Verified: Yes
111. Fraser, G. A., & Welburn, K. R. (2000, November). The dissociative table technique and the integration of EMDR and ego-state therapy. Presentation at the International Society for the Study of Dissociation Fall Conference, San Antonio, TX.
Language: English
Format: Conference
Keywords: Dissociative Table Technique Ego State Therapy
Accuracy Verified: No
112. Fraser, G., & Welburn, K (1999, November). Dissociative table technique: Guided imagery strategy for PTSD with dissociation. Poster presented at the annual meeting of the International Society for Traumatic Stress Studies, Miami, FL.
Language: English
Format: Conference
Abstract:
In keeping with the theme of bridging gaps across disciplines, the
Dissociative Table Technique brings to this trauma conference a
strategy from the field of dissociative disorders. This therapeutic
adjunct has been used by many therapists over the past 10 years
for managing dissociated ego states in trauma victims who also
have dissociation as part of their clinical picture. This strategy has
been used with dissociative disorders, Ego-State therapy and more
recently in conjunction with EMDR for patients having dissociative
state alterations in addition to their PTSD. This guided
imagery strategy provides a protocol for clinical intervention in
such clients and will provide an additional therapeutic adjunct for
trauma workers when PTSD is complicated by dissociative pathology.
Based on gestalt, guided imagery and hypnosis strategies, the
Dissociative Table Technique assists the clinician to bring order to
the random dissociation which can complicate therapy in such
cases. Also clients can be taught to become aware of and integrate
dissociated ego states. This strategy must be carefully considered as
it can have a profound effect on the dissociative processes. It is
advised that it only be employed by clinicians whose fields permit
hypnosis-based therapy.The workshop will commence with a therapeutic
rationale for this technique followed by an outline of the
clinical application. Included will be a video introducing the technique
in a clinical case. The video will be followed by a second
speaker discussing possible applications to EMDR. Useful suggestions
for utilizing EMDR in this trance-prone population (those
with dissociation in addition to PTSD) will be addressed in addition
to presenting clinical examples in which the Dissociative Table
Technique was integrated with EMDR in appropriate clinical
groups.
Keywords: Dissociative Table Technique Dissociation Guided Imagery Poster Posttraumatic Stress Disorder PSTD
Accuracy Verified: Yes
113. Muret, M. (2010, April). Dissociative vs. associative techniques to treat dissociation. Presentation at the 2nd Bi-Annual International European Society for Trauma and Dissociation Conference, Belfast, Northern Ireland.
Language: English
Format: Conference
Abstract:
In the past two decades, various effective techniques have been developed for the treatment of trauma: EMDR, EMI, EFT, OEI, NLP, SE, etc. These different techniques inevitably raise the question: “Which techniques should be used for which patients? “ Because dissociative disordered patients may react to trauma work with dissociative detachment, a "low impact" technique is needed. Thus, therapeutic approaches that employ a certain degree of dissociative distancing seem to be well-suited to dissociative patients. Richard Bandler (NLP) and, more recently, Cary Craig (EFT) have developed calm, nondramatic ways to address trauma and solve problems. EMDR, a more associative method, seems better suited to stable patients who possess good resources. This workshop will present a continuum that locates techniques along a scale of increasing degrees of confrontation. Special attention will be given to EFT (Emotional Freedom Techniques), an easy-to-learn method. Techniques for reinforcing the Somatic Self during EMDR sessions will be explained. The second part of this workshop will present a conceptualization for these techniques, based on the works of Stephen Porges, Ellert Nijenhuis and Mihaly Csikszentmihalyi (Flow Theory).
Learning Outcomes The attendee will learn to consider the danger(retraumatization) of an intervention. According to the kind of patient and situation, he will be better able to choose the best available technique. For newcomers a basic methode of EFT will be taught, that can be later used in simple cases. Through a "participative" teaching the attendee will understand and integrate difficult abstracts concepts like: polyvagal model, structural dissociation, mental tension, ...
Keywords: Associative Techniques Dissociation Dissociative Technqiues
Accuracy Verified: Yes
114. Freyberger, H. J., & Spitzer, C. (2005, Juli). Dissoziative störungen [Dissociative disorders]. Der Nervenarzt, 76(7), 893-900. doi:10.1007/s00115005-1956-z .
Language: German
Format: Magazine
Abstract:
Die dissoziative Störungen und Konversion sind mit erheblichen klassifikatorischen, diagnostische und therapeutische Schwierigkeiten, die nur in den historischen Kontext der Diskussion über die Hysterie verstanden werden kann, verbunden. Auch die Einstufung in die ICD-10 und DSM-IV ist heterogen. Prävalenzraten zwischen etwa 3% in der allgemeinen Bevölkerung und bis zu 30% in klinischen Populationen, jedoch beziehen sich auf die große klinische Bedeutung. Realtraumatisierungen eine wichtige Rolle in der Pathogenese. High Komorbiditätsraten mit anderen psychischen Störungen eine Tendenz zu chronischen somatischen Erkrankung und ein Konzept (insbesondere bei Patienten mit Erkrankungen erschweren Umwandlung) der psychotherapeutischen Behandlung. Dies erlaubt die Behandlung Ziele sind sowohl psychodynamische und kognitiv-verhaltenstherapeutischen in Abhängigkeit entwickelt, möglicherweise mit den Techniken der Trauma-Therapie, wie EMDR (Springer).
The dissociative and conversion disorders are associated with significant classificatory, diagnostic and therapeutic difficulties that can be understood only in the historical context of the discussion on hysteria. Even the classification in ICD-10 and DSM-IV is heterogeneous. Prevalence rates of between about 3% in the general population and up to 30% in clinical populations, however, refer to the great clinical significance. Realtraumatisierungen have an important role in the pathogenesis. High Komorbiditätsraten with other mental disorders, a tendency to chronic somatic disease and a concept (especially in patients with conversion disorders complicate) the psychotherapeutic treatment. This allows the treatment goals are designed both psychodynamic and cognitive-behavioral dependence in, possibly with the techniques of trauma therapy such as EMDR (Springer).
Keywords: Chronicity (Disorders) Comorbidity Conversion Disorder Diagnosis Dissociative Disorders Epidemiology Etiology Psychotherapy Somatization
Accuracy Verified: Yes
115. Edalatian-McCain, N. (2009, August). Distal-proximal process interweave for treatment of sexual trauma in DID clients. Presentation at the annual meeting of the EMDR International Association, Atlanta, GA.
Language: English
Format: Conference
Abstract:
Participants will learn an extended interweave strategy to reduce the likelihood of re-traumatization in DID clients processing sexual trauma within the EMDR protocol. This strategy, Distal-Proximal Process interweave, involves an orientation phase to encourage and help the “host” to stay present during processing--even at the expense of not dealing with details of a trauma that are held in alters with limited range. The implementation phase involves using the Rescue Express Merge tactic to help the client process with empowerment. The client is helped through the trauma several times, each time handling more details until he/she can process the trauma in its entirety without needing interweaves.
Keywords: DID Dissociative Identity Disorder Distal-Proximal Process Interweave Sexual Trauma
Accuracy Verified: Yes
116. Becker, L., Todd-Overman, A., Stoothoff, W., & Lawson, P. (1998, July). Do eye movements hinder the avoidance process leading to greater accessibility of traumatic memories?. In Ironic memory, PTSD, and EMDR. Symposium conducted at the annual meeting of the EMDR International Association, Baltimore, MD.
Language: English
Format: Conference
Abstract:
Participants will: 1) learn Wegner's ironic memory process model; 2) learn how the ironic memory process model is related to the DSM-IV symptoms of PTSD; 3) learn that eye movements at different speeds interfere with and interact with the speech process; and 4) learn that eye movements can inhibit the suppression process.
Keywords: Eye Movement Ironic Memory Posttraumatic Stress Disorder PTSD Symposium Wegner
Accuracy Verified: Yes
117. Manfield, P., & Snyker, E. (2002, June). Don’t go with that!. Presentation at the annual meeting of the EMDR International Association, San Diego, CA.
Language: English
Format: Conference
Abstract:
One of the beauties of EMDR is that, in most cases, clients can simply begin each set of eye movements by focusing on their associations from
the previous set. The therapist simply says, "Go with that." This workshop will identify clients for whom "Go with that" will probably not
work, clients who use avoidance or dissociation to defend against painful affect or who associate loosely and cause targets to "pancake." We will
use video and transcripts to illustrate a variety of interventions and techniques to handle these more challenging clients and situations.
Accuracy Verified: Yes
118. Herbert, C. (2010, June). Do‘s and don‘ts in trauma therapy: Strategies for enhancing the work with trauma of different levels of complexity – a positive growth approach. Presentation at the annual meeting of the EMDR Europe Association, Hamburg, Germany.
Language: English
Format: Conference
Abstract:
Working with traumatized clients can be overwhelming
for the therapist, especially when the trauma is complex, involves
dissociative symptoms or different personality states, fragmented
memories or client affect is intense and poorly regulated. My
experience as a supervisor of EMDR practitioners has shown that
it is not uncommon for therapists, in an attempt to be helpful to
the traumatized clients, to unintentionally use strategies, which
are experienced as re-traumatizing or which lead to an increase
in their clients’' survival based coping strategies, including the
further strengthening of the ANP (Apparently Normal Personal-
~ t y- van der Hart, Nijenhuis and Steele. 2006). This workshop
highlights different therapeutic challenges, which often arise
for therapists when working with trauma and introduce strategies
that EMDR practitioners can use in their work with such
clients. This workshop embeds the principles of Positive Growth
Therapy (PGT - Herbert, 20071, which encompasses combined
knowledge from a variety of disciplines, including positive psychology,
information-processing theory, neurobiology, somatic
psychology, developmental psychology and attachment theory,
mindfulness and others. These strategies, designed to nurture
growth rather than dysfunction, are linked to specific therapeutic
factors relevant to the work with trauma, such as different types
of trauma, the nature of dissociation, the therapeutic pathway
toward integration. the concept of safety, the importance of resource
installation, individual pacing of therapy and the window
of tolerance, different types of processing, and the integration of
rational and experiential processing systems and others, which
will be explored in the course of this workshop
This workshop offers opportunities for both, EMDR therapists,
who are fairly new to the trauma field and would like to enhance
and deepen their knowledge base, and those already experienced in the trauma field who would like to use this workshop
as an opportunity to re-view, further refine or validate
their current ways of working.
The specific learning objectives for this workshop are:
1. To find out about specific therapeutic factors that is relevant
to the work with trauma.
2. To learn about strategies to avoid and strategies, which are helpful for trauma clients. 3. To increase therapist confidence in working with traumatized clients of varying levels of complexity.
This workshop is unique in the way in which it transcends specific
(and sometimes too narrowly defined) therapeutic modalities or psychiatric diagnoses and instead offers solutions to
EMDR practitioners of all modalities by providing deeper understanding of specific therapeutic factors relevant to the work with trauma of different complexities.
Accuracy Verified: Yes
119. Connell-Jones, G. (2011). Drug modulated EMDR Treatment for borderline personality disorder. Presentation at the 12th European Conference on Traumatic Stress (ECOTS), Vienna, Austria. European Journal of Psychotraumatology, Supplement 1, 189. doi:10.3402/ejpt.v2i0.7237189.
Language: English
Format: Journal
Abstract:
From my clinical work over the past 4 years a case series of 15 women patients, all detained in a secure hospital for
periods of up to 30 years discharged after EMDR therapy. Some cases discussed in depth, others factor analysed as
case series. Drug modulation permitted intensive therapy. The factors of complex stress disorder are beeing
discussed and its simlarity to borderline personality disorder. The effects of long term instititutionalisation after
detention in security. The responsible clinician as ‘‘goaler and therapist’’ as well as therapeutic pitfalls are being
explored. The psychopathology of the flashback is contrasted with the psychpathology of the alter (dissociative
identity). Prognostic factors and outcomes are being presented. The implications for personality disorder as a
diagnosis contrasted with complex PTSD will be evaluated.
Keywords: Borderline Personality Disorder BPD Drug Modulation
Accuracy Verified: Yes
120. Knipe, J. (2009). Dysfunctional positive affect: To assist clients with unwanted avoidance defenses. In M. Luber (Ed.), Eye movement desensitization (EMDR) scripted protocols: Special populations (pp. 451-452). New York: Springer Publishing Co.
Language: English
Format: Book Section
Keywords: Avoidance Defenses Dysfunctional Positive Affect Protocol
Accuracy Verified: Yes
121. Nofal, S. (2003). E.M.D.R: Método psicoterapéutico de elección [EMDR psychotherapeutic method of choice]. Psicoterapias. Presentación en: 3º Congreso Virtual de Psiquiatria.com.
Language: Spanish
Format: Conference
Abstract:
E.M.D.R.: que significa Desensibilización y Reprocesamiento con Movimientos Oculares es un método psicoterapéutico para tratar trastornos emocionales que son causadas por experiencias abrumadoras de la vida, que van desde eventos traumáticos como guerras, accidentes, violaciones y desastres naturales, hasta situaciones traumáticas originadas en la niñez. · Se pueden tratar también además del T.E.P.T. todos los trastornos de ansiedad, depresión, desórdenes disociativos, duelos, dolor crónico, adicciones, perturbaciones somáticas, etc. en niños, adolescentes y adultos.
EMDR: meaning Desensitization and Reprocessing eye movement is a psychotherapeutic method for treating emotional disorders that are caused by overwhelming experiences of life, ranging from traumatic events such as war, accidents, violations and natural disasters, to traumatic situations arising in childhood . · You can also treat PTSD plus all anxiety disorders, depression, dissociative disorders, grief, chronic pain, addiction, somatic disturbances, etc.. in children, adolescents and adults.
Keywords: Postraumatic Stress Disorder Psychotherapies PTSD Stress Trauma
Accuracy Verified: Yes
122. Grey, E. (2009, August). Earning security with EMDR. Poster presented at the annual meeting of the EMDR International Association, Atlanta, GA .
Language: English
Format: Conference
Abstract:
The experience of safety associated with a secure attachment is essential in promoting social engagement. Social engagement requires the capacity to identify, tolerate and communicate our emotional states. This poster illustrates the pathogenic role that relational trauma plays in thwarting such intrapersonal attunement necessary for interpersonal integration. In particular, disorganized attachment experiences are highlighted as small-t traumas and “touchstone memories” related to “affect phobias”. These phobias are key psychopathological agents that maintain dissociative barriers between components of internal working models of self and other involved in attachment relationships.
Internal working models related to disorganized attachment experiences include segregated information of parent/child interactions in which the parent is the “source and solution of the child’s fright”. The establishment of “trauma coded” internal working models is instrumental in the development of “extra-personal attunement”. As opposed to intrapersonal attunement, extra-personal attunement is characterized by a preoccupation with the feelings, thoughts, and behaviors of others and simultaneous dissociation of one’s own internal experience.
In the wake of such relational trauma, the adaptive information processing system within the individual becomes “corrupt”. The AIP model provides a way to understand the salience of dysfunctionally held information in the brain in thwarting interpersonal attunement and intrapersonal attunement and maintenance of a “corrupt information processing system”. Furthermore, it assists in the clinical navigation of the paths between memory, internal working models, and auto and interactive psychobiological regulation. From a clearer point of view and with an appreciation for the vulnerability of relational misattunement to be traumatic relevant EMDR processing targets can be indentified and targeted. In addition, this AIP conceptualization of relational trauma offers a parsimonious framework within which the effects of trauma can been seen in a variety of psychopathologies.
From adjustment disorders to dissociative identity disorder the feeling of “insecurity” associated with relationships reinforces extra-personal attunement and avoidance of interactive regulation necessary for social engagement. In addition, extrapersonal attunement leads to a preoccupation with the emotional states of others, avoidance of social engagement and substitution of work, play, food, and sex to regulate distress and amplify positive affect.
This poster will offer an Adaptive Information Processing model conceptualization of relational trauma and will outline the role of EMDR in reducing phobic responses to innate affect. It will also highlight the identification and processing of touchstone memories related to disorganized attachment experiences in both the standard EMDR protocol and the adapted “Ego-state specific” protocol. These interventions will be portrayed as necessary components of a comprehensive treatment plan in the treatment of relational trauma. Finally the successful treatment of relational trauma will be depicted as a relevant in promoting intrapersonal attunement necessary for interpersonal integration.
Keywords: Affect Phobias Phobias Relational Trauma
Accuracy Verified: Yes
123. Cotraccia, T. (2009, August). Earning security with EMDR - Promoting social engagement in the wake of relational trauma. Poster presented at the annual meeting of the EMDR International Association, Atlanta, GA.
Language: English
Format: Conference
Abstract:
The experience of safety associated with a secure attachment is essential in promoting social engagement. Social engagement requires the capacity to identify, tolerate and communicate our emotional states. This poster illustrates the pathogenic role that relational trauma plays in thwarting such intrapersonal attunement necessary for interpersonal integration. In particular, disorganized attachment experiences are highlighted as small-t traumas and “touchstone memories” related to “affect phobias”. These phobias are key psychopathological agents that maintain dissociative barriers between components of internal working models of self and other involved in attachment relationships.
Internal working models related to disorganized attachment experiences include segregated information of parent/child interactions in which the parent is the “source and solution of the child’s fright”. The establishment of “trauma coded” internal working models is instrumental in the development of “extra-personal attunement”. As opposed to intrapersonal attunement, extra-personal attunement is characterized by a preoccupation with the feelings, thoughts, and behaviors of others and simultaneous dissociation of one’s own internal experience.
In the wake of such relational trauma, the adaptive information processing system within the individual becomes “corrupt”. The AIP model provides a way to understand the salience of dysfunctionally held information in the brain in thwarting interpersonal attunement and intrapersonal attunement and maintenance of a “corrupt information processing system”. Furthermore, it assists in the clinical navigation of the paths between memory, internal working models, and auto and interactive psychobiological regulation. From a clearer point of view and with an appreciation for the vulnerability of relational misattunement to be traumatic relevant EMDR processing targets can be indentified and targeted. In addition, this AIP conceptualization of relational trauma offers a parsimonious framework within which the effects of trauma can been seen in a variety of psychopathologies.
From adjustment disorders to dissociative identity disorder the feeling of “insecurity” associated with relationships reinforces extra-personal attunement and avoidance of interactive regulation necessary for social engagement. In addition, extrapersonal attunement leads to a preoccupation with the emotional states of others, avoidance of social engagement and substitution of work, play, food, and sex to regulate distress and amplify positive affect.
This poster will offer an Adaptive Information Processing model conceptualization of relational trauma and will outline the role of EMDR in reducing phobic responses to innate affect. It will also highlight the identification and processing of touchstone memories related to disorganized attachment experiences in both the standard EMDR protocol and the adapted “Ego-state specific” protocol. These interventions will be portrayed as necessary components of a comprehensive treatment plan in the treatment of relational trauma. Finally the successful treatment of relational trauma will be depicted as a relevant in promoting intrapersonal attunement necessary for interpersonal integration.
Keywords: Poster Social Engagement
Accuracy Verified: Yes
124. Colosetti, S. D. (1997). Effect of relaxation training alone and relaxation training paired with EMDR on incarcerated, battered women. University of Georgia, Athens, GA. AAT 9735499.
Language: English
Format: Dissertation/Thesis
Abstract:
Every 15 seconds a woman is beaten in the U.S. Many of these women meet the criteria for a diagnosis of PTSD. Some of them end up in prison. This study used a sample of 5 battered women, incarcerated in a Southern state prison, to test the efficacy of EMDR following relaxation training. A-B-C designs were used to compare baseline assessment (Phase A), relaxation training utilizing Miller and Halpern's audiotaped instructions (Phase B), and EMDR (Phase C). A script of the worst memory of abuse was dictated by each woman during assessment and read by the researcher at the beginning of each session. The Beck Anxiety Inventory and Impact of Events Scale, measuring avoidant behaviors and intrusive thoughts, were given weekly, following the script. Client logs and measures of SUDS and VOC were taken during the EMDR phase only. A one-month follow-up was used. ANOVAs with repeated measures comparing 2 groups, E1 (n = 2) that received 3 weeks of relaxation training prior to EMDR and E2 (n = 3) that received 6 weeks of relaxation training prior to EMDR, were not statistically significant. Avoidant Behaviors scores approached significance for the main effect of treatment (F = .06) and for the group by phase interaction (F = .08). Due to intrasubject variability, blocking was used to identify trends. A distinct improvement was noted in Subject 2 -- Anxiety dropped from 36.5 to 8.0, Intrusive Thoughts 27.5 to 11.0, and Avoidant Behaviors 27.0 to 24.0. Individually graphed data and calculated mean scores by phase permit further investigation. Implications for future research include appropriate screening for dissociation and development of coping skills prior to EMDR, decreasing avoidance by having the woman read her script aloud prior to completing outcome measures, monitoring medication during treatment, continuing treatment as needed, using additional outcome measures, and employing a multi-baseline design across subjects, matching women on several demographic variables. [Author Abstract]
Dissertation Abstracts International Section A: Humanities and Social Sciences. 58(6-A), Dec 1997, pp. 2392.
Keywords: Adults Americans Battery Empirical Study Females Posttraumatic Stress Disorder Prison Inmates PTSD Relaxation Therapy Survivors Treatment Effectiveness
Accuracy Verified: Yes
125. Beere, D. B. (2009). The effectiveness of EMDR with the dissociative disorders: A research study leading to the development of an EMDR protocol for DID. Manuscript in preparation.
Language: English
Format: Journal
Keywords: DID Dissociative Disorders Dissociative Identity Disorder Research
Accuracy Verified: No
126. Nettz, S. L. (1995, August). Effects of a single session of EMDR, flooding, and a credible placebo treatment on traumatic memories in male veterans. Illinois Institute of Technology, Chicago, IL. AAT 9614404.
Language: English
Format: Dissertation/Thesis
Abstract:
This study explored the effectiveness of a single session of three different treatments for traumatic memories. Subjects were 45 adult males, randomly assigned to Eye Movement Desensitization and Reprocessing (EMDR), Flooding, or Placebo therapy (Modified Avoidance Response Conditioning [ MARC]). Self-report and physiological measures were employed to measure treatment effectiveness. Subjects completed the following pre-treatment inventories: Michigan Alcohol Screening Test, Impact of Event Scale, State-Trait Anxiety Inventory, Questionnaire on Mental Imagery, and the Treatment Credibility Questionnaire. Post-treatment measures included self-report measures (Subjective Units of Distress [ SUDs] and Treatment Credibility Questionnaire) and physiological measures (heart rate, skin conductance, and skin temperature). Treatments were rated as equally credible before and after the session. Both EMDR and Flooding produced a significant decrease in the self-report of anxiety compared to the Placebo (MARC) group. Neither heart rate or skin conductance channels showed a significant change for any of the three groups during post-treatment assessment phases. However, skin temperature was significantly lower for the Flooding group compared to the MARC group during two post-treatment phases, suggesting that the Flooding group was more physiologically aroused than Placebo (MARC) subjects. Findings suggest that during Flooding, exposure to disturbing elements of a trauma is associated with physiological arousal, which in turn leads to lessening of subjective distress. However, a different mechanism may account for EMDR treatment effects. (PsycINFO Database Record (c) 2008 APA, all rights reserved)
Dissertation Abstracts International: Section B: The Sciences and Engineering. 57(1-B), Jul 1996, pp. 0687
Keywords: Adults Emotional Trauma Empirical Study Evaluation Male Memory Military Treatment Effectiveness Treatment Outcome/Clinical Trial Veterans
Accuracy Verified: Yes
127. Hampel, J. C. (1997, November). The effects of eye movement desensitization and reprocessing (EMDR) on self-reported test anxiety in college students. Western Michigan University, Kalamazoo, MI. AAT 9732881.
Language: English
Format: Dissertation/Thesis
Abstract:
Test anxiety is a common problem among students in western culture due to the importance of academic achievement and the consequences for failure. Many consider test anxiety to be primarily an issue of poor study habits and test readiness. However, some students who appear to possess excellent study habits also appear to experience severe anxiety during tests. A recent meta-analysis of test anxiety research substantiated these claims, finding that test anxiety appeared to be an emotionally-based as opposed to a cognitively-based problem. Despite these findings, the etiologies for test anxiety remain unknown. Similar to nearly all DSM-IV diagnostic categories, test anxiety is a syndrome with no known pathognomonic sign(s) which singularly diagnose the condition. Hence, treatments for test anxiety, as for nearly all other DSM-IV mental disorders are symptomatic as opposed to strategic. Unfortunately, there are few symptomatic treatments for test anxiety that are both efficient and effective.Eye movement desensitization and reprocessing (EMDR), which was developed for the symptomatic treatment of PTSD, was chosen to treat the symptoms of test anxiety for the following essential reasons: (a) the reported efficacy of EMDR with PTSD; (b) the similarities between test anxiety and PTSD that include intrusive thoughts, inability to concentrate, behavioral avoidance, and emotional symptomatology; and (c) the need for a brief, effective symptomatic treatment for test anxiety. Using a waiting control group against which to compare the treatment group and subsequently replicate treatment effects, the results found that EMDR was highly effective for the symptomatic reduction of self-reported test anxiety as measured by all test anxiety scales. Moreover, these results also suggest that measures of study habits and attitudes are also sensitive to enhancement as a result of treatment with EMD/R. Although the current results did not suggest specific mechanism(s) by which EMDR was effective, the pattern of highly effective results across widely different types of test anxiety presentations suggests the actions of an active placebo treatment. It is suggested that future research contrast EMD/R with known active placebo protocols. [Author Abstract]
Dissertation Abstracts International: Section B: The Sciences and Engineering. 58(5-B), Nov 1997, pp. 2676.
Keywords: Anxiety Disorders College Students Empirical Study Life Experiences Posttraumatic Stress Disorder PTSD Survivors Treatment Effectiveness
Accuracy Verified: Yes
128. Hollwig, K. E. (2002). Efficacy of eye movement desensitization and reprocessing in the treatment of trauma and anxiety disorders. California State University, Long Beach, CA. AAT 1409202.
Language: English
Format: Dissertation/Thesis
Abstract:
This study evaluated the efficacy of Eye Movement Desensitization and Reprocessing for treating trauma and anxiety disorders in adult, adolescent, and child clients with or without a dissociative disorder.
Participants comprised 23 California-licensed mental health professionals who possessed at least a master's degree in the mental health field and specifically had been trained in EMDR by the EMDR Institute. Each participant completed a survey questionnaire developed specifically for this study.
Results indicated significant differences between EMDR and the other surveyed therapeutic approaches for overall level of efficacy in treating trauma in adults and adolescents. Significant differences between EMDR and two other approaches for treating child trauma were also revealed. A significant difference was found between EMDR and one other approach for overall level of efficacy in treating anxiety in adults and adolescents. No significant differences were found between therapeutic approaches for treating child anxiety. Directions for future research are discussed.
Keywords: Anxiety Disorders Trauma
Accuracy Verified: Yes
129. Paulsen, S. L. (1993, March). Ego state disorders: Dissociative but not multiple. Presentation at the EMDR Network Conference, Sunnyvale, CA.
Language: English
Format: Conference
Keywords: Dissociation Ego State Disorders
Accuracy Verified: Yes
130. Paulsen, S. L. (1994, March). Ego state disorders: Dissociative but not multiple. Presentation at the EMDR Network Conference, Sunnyvale, CA.
Language: English
Format: Conference
Abstract:
Conceptual Framework. In Ego State Disorders, moderate levels of dissociation
are present for the purpose of isolating overwhelming affect or untenable conflict from
conscious awareness. There are parts of the self'which are experienced by the host, -upon
discovery, and who experience themselves, as separate. These parts,however, do no have
the ability to take complete executive control of the body, or are not as complex and
elaborated as in Multiple Personality Disorder, which is called Dissociative Identity
Disorder in DSM-N. The closest diagnosis for describing Ego State Disorders in DSA4lV
is DDNOS, or Dissociative Disorder Not Otherwise Specified, a miscellaneous category.
Keywords: Dissociation Ego State Therapy
Accuracy Verified: Yes
131. Raju, K. (2005). Ego strengthening and eye movement desensitization reprocessing in post traumatic stress disorder. Medical Journal Armed Forces of India, 61, 289-290.
Language: English
Format: Journal
Abstract:
Post Traumatic Stress Disorder (PTSD) is an anxiety
disorder, which occurs after exposure to
overwhelming stress like combat, rape, serious
accidents, violent crime and other catastrophic events.
The essential characteristics of the condition are
recurrent intrusive memories, images, thoughts or
dreams of the trauma, persistent arousal, emotional
numbing and avoidance of the situations reminiscent of
the trauma. 15-20% of individuals experiencing significant
trauma are known to develop PTSD [1]. Although
anxiolytic, anticonvulsant, antipsychotic and
antidepressant drugs have been tried, none have been
consistently associated with improvement [2]. Eye
Movement Desensitization Reprocessing (EMDR) is
being increasingly utilized as a valid method of treatment
for this distressing condition [3-7]. Ego Strengthening
(ES) is a sequence of simple psychotherapeutic
suggestions given under hypnosis [8]. A long standing
case of PTSD treated with EMDR and ES is reported.
Keywords: Case Report Ego Strengthening Posttraumatic Stress Disorder PTSD
Accuracy Verified: Yes
132. Tripolt, R. (2012, June). EMDR in Motion. Using movement and body oriented therapeutic interweaves for complex trauma and dissociative symptoms [EMDR en movimiento. Usar el movimiento y la terapia orientada al cuerpo para traumas complejos y síntomas disociativos]. Presentation at the annual meeting of the EMDR Europe Association, Madrid, Spain.
Language: English
Format: Conference
Abstract:
"The
Body
Keeps
the
Score"
(B.
v.d.
Kolk,
1996)
Clients
who
suffer
from
traumatic
stress
are
often
afraid
about
disturbing
and
painful
somatic
symptoms.
Structural
dissociation
alienates
from
body
reactions.
Nevertheless
it
is
the
body
that
"holds"
the
discomfort
and
painful
memory
of
neglect
and
violence.
Trauma
Survivors
tend
to
perceive
their
body
as
hostile.
They
suffer
from
Alexithymia
deficiency
of
interpreting
the
meaning
of
body
reactions
and
muscle
activation.
Trauma
Survivors
are
easily
irritated
and
tend
to
react
with
rage
on
very
slight
provocations
and
freeze
when
they
are
frustrated.
Even
minor
problems
cause
fear
and
helplessness.
The
Polyvagal
Theory
(S.
Porges
2010)
proves
the
neurological
aspect
of
behavioral
patterns.
Neurozeption
describes
how
we
perceive
others
in
a
neurological
way.
Certain
behavioral
patterns
are
established
through
life
experiences.
This
research
underlines
Francine
Shapiros
AIP
model
and
confirms
the
importance
of
a
body
orientated
approach.
We
know
that
experiencing
the
effect
of
eye
movement
-‐
and
other
bilateral
stimulation,
is
a
gentle
and
powerful
way
to
bring
the
voice
of
the
body
into
the
therapeutic
space.
EMDR
helps
to
integrate
cognitive,
emotional
and
body
sensations.
Using
movement
and
body
orientated
skills
in
difficult
processes
f.e.
with
severely
and/or
early
traumatised
clients,
even
enhances
the
effect
of
EMDR.
Content
of
the
Workshop:
Short
theoretical
implications:
Polyvagal
Theory
and
AIP
Model.
Stabilisation
and
Movement
-‐
creating
a
„Moving
Container“:
How
to
create
a
safe
place
of
relationship
and
attachment
between
the
client
and
the
therapist
by
using
movement
and
bodywork?
The
body
is
the
most
powerful
resource:
How
to
use
movement
to
access
this
power.
How
to
recognize
and
dissolve
dissociation
by
body
and
movement
awareness.
EMDR
Process
and
Movement
:
How
to
widen
the
„window
of
tolerance“
by
using
movement
and
deeper
levels
of
body
consciousness.
Adding
a
fourth
level
of
attention
to
the
EMDR
process:
cognition
-‐
emotion
-‐
body
scan
-‐
movement.
Movement
and
reflex
feedback
as
interweave
technique
in
difficult
processes.
Methods
used
in
the
Workshop:
Lecture
and
Video
Presentation.
Practical
demonstration
of
some
movement
orientated
techniques.
Discussion.
“El
cuerpo
lleva
la
cuenta”
(B.
v.d.
Kolk,
1996),
los
clientes
que
sufren
de
estrés
traumático
tienen
a
menudo
miedo
sobre
sus
síntomas
somáticos
preocupantes
y
dolorosos.
La
disociación
estructural
aliena
las
reacciones
del
cuerpo,
sin
embargo
es
el
cuerpo
el
que
“mantiene”
el
disconfort
y
el
recuerdo
doloroso
de
negligencia
y
violencia.
Los
supervivientes
a
un
trauma
suelen
tender
a
percibir
su
propio
cuerpo
como
hostil.
Sufren
de
Alexitimia,
deficiencias
para
interpretar
las
señales
corporales
y
la
activación
muscular.
Son
fácilmente
irritables
y
tienden
a
reaccionar
con
ira,
con
leves
provocaciones
y
se
“congelan”
cuando
están
frustrados.
Incluso
problemas
de
fuerza
menor
causan
miedo
y
desesperanza.
La
teoría
polivagal
(S.
Porges
2010)
prueba
el
aspecto
neurológico
de
los
patrones
de
comportamiento.
La
neurocepción
describe
cómo
percibimos
a
los
otros
desde
un
punto
de
vista
neurológico.
Ciertos
patrones
de
comportamiento
están
establecidos
a
través
de
las
experiencias
vitales.
Esta
investigación
se
basa
en
el
modelo
SPIA
de
Francine
Shapiro
y
confirma
la
importancia
del
enfoque
orientado
al
cuerpo.
Sabemos
que
al
experimentar
el
efecto
de
la
estimulación
ocular,
y
otras
estimulaciones
bilaterales,
es
un
camino
poderoso
y
suave
para
traer
la
voz
del
cuerpo
dentro
del
espacio
terapéutico.
EMDR
facilita
la
integración
cognitiva
emocional
y
corporal.
Usar
el
movimiento
y
las
habilidades
orientadas
al
cuerpo
en
los
procesos
difíciles
con
clientes
traumatizados,
severamente
o
tempranamente,
incluso
amplifica
el
efecto
terapéutico
del
EMDR
Contenido
del
taller:
Implicaciones
teóricas:
Teoría
Polivagal
y
modelo
SPIA
Estabilización
y
movimiento
–
Crear
un
“recipiente
de
movimiento”
Cómo
crear
un
lugar
seguro
en
relación
al
apego
entre
el
cliente
y
el
terapeuta
usando
movimiento
y
trabajo
corporal.
El
cuerpo
es
el
recurso
más
poderoso:
Cómo
usar
el
movimiento
para
acceder
a
este
poder.
Cómo
reconocer
y
disolver
la
disociación
en
el
cuerpo
y
la
atención
al
movimiento.
Procesamiento
EMDR
y
movimiento:
Cómo
ampliar
la
"ventana
de
tolerancia"
mediante
el
uso
de
movimientos
y
niveles
más
profundos
de
la
conciencia
del
cuerpo.
Añadir
un
4
nivel
de
atención
al
procesamiento
de
EMDR:
Cognición-‐Emoción-‐
Escáner
corporal-‐movimiento.
Keywords: Body Oriented Therapeutic Interweaves
Accuracy Verified: Yes
133. Fine, C. G. (1993, March). EMDR & structured therapy for MPD. Presentation at the EMDR Network Conference, Sunnyvale, CA.
Language: English
Format: Conference
Keywords: DID Dissociative Identity Disorder MPD Multiple Identity Disorder
Accuracy Verified: Yes
134. Sack, M., & Lamprecht, F. (2004). EMDR - Ein verfahren zur behandlung dissoziativer störungen in der Folge schwerer traumatisierungen [EMDR - A method for the treatment of dissociative disorders as a result of serious trauma]. In A. Eckhardt-Henn, & S. O. Hoffmann (Hrsg.), Dissoziative Bewusstseinsstörungen: Theorie, Symptomatik, Therapie, (S 436-446) Schattauer-Verlag, Stuttgart .
Language: German
Format: Book Section
Keywords: Dissociative Disorders
Accuracy Verified: Yes
135. Roques, J. (2008, Mai). EMDR - Une révolution et un changement de paradigme thérapeutiques [EMDR – A therapeutic revolution and paradigm shift]. Présentation à la Conférence EMDR Canada, Montréal, Québec, Canada.
Language: French
Format: Conference
Abstract:
La présentation comporte trois volets. Le premier volet présente le fondement neurologique de l’EMDR qui est centré sur les réseaux neuronaux de la mémoire - ce qui permet une compréhension nouvelle des phénomènes dissociatifs et qui fait ressortir le potentiel du traitement en EMDR. Le deuxième volet aborde les applications de ce cadre théorique à l’ensemble des manifestations pathologiques : traumatismes simples et
complexes, intoxications psychiques, épisodes psychotiques brefs et même certains cas de début de schizophrénie. Le troisième volet démontre à quel point l’EMDR bouleverse notre compréhension de la pathologie et de son traitement et de ce fait, constitue un véritable changement de paradigme thérapeutique. Cette compréhension nouvelle des phénomènes neuropsychologiques sous-jacents, telle que soulevée par l’EMDR, permet de distinguer ce qui est utile de ce qui ne l’est pas dans la plupart des psychothérapies.
This opening workshop will focus on three axes :
1) The neurological basis of EMDR that focuses on the memory’s neural networks – which in turn allow a fresh understanding of dissociative phenomena and shows the potential of EMDR treatment.
2) The application of this theoretical understanding to the various expressions of psychopathology: simple versus complex PTSD – psychic poisoning – brief psychotic episodes- even certain cases of early schizophrenia.
3) As a conclusion, how EMDR shook up our understanding of pathology and its treatment, and how it provided the impetus toward a genuine paradigm shift. This new understanding of the underlying psychoneurologic phenomena brought on by EMDR helps us to determine what may be useful or not in the various psychotherapies.
Keywords: Complex Posttraumatic Stress Disorder Complex PTSD C-PTSD Dissociation
Accuracy Verified: Yes
136. Tibaldi, M. (2004, June). EMDR and analytical psychology: Imaginal use of eye movements in Jungian analysis. In psychodynamics and EMDR (B. Lilieblad, Chair). Symposium conducted at the EMDR Europe Association annual meeting, Stockholm, Sweden .
Language: English
Format: Conference
Abstract:
Among Jungian typical methodologies, one of the most interested is active imagination indeed. Carl Gustav Jung's active imagination method is a process of "lucid dream," that takes shape from observing an internal emotionally meaningful aspect - mood, image, event. When the client focuses his/her attention on these charged elements, a chain of autonomous images will be activated. The arising of such unconscious images lead consciousness to a new situation: emotional content comes into contact with the rational, can be confronted and integrated, transforming the whole personality.
Epistemologically speaking, it is interesting to point out the affinity between Jungian conscious-unconscious integration process, pursued by active imagination, and the right and left brain connecting process, gained by EMDR.
My Jungian analytical practice, on the one hand, and my EMDR therapeutic experience, on the other, gave me the opportunity to confront both Garl Gustav Jung's and Francine Shapiro's methods and paradigms, giving birth to an EMDR imaginal use, a synergic therapeutic process with interesting outcomes.
The aim of my paper is to present this form of EMDR, stressing the advantages of such integration. The paper will be accompanied by a sequence of psychic images from a client's EMDR treatment; thanks to the imaginal use of eye movements, the client got in touch with some of the unknown emotional horizons, recognized the dissociative defences that prevented him from connections his emotional and rational brain and improved his psychic well being.
Keywords: Analyitical Psychology Case Study Imagery Imaginal Jungian Analysis Mind-Body Observation Symposium
Accuracy Verified: Yes
137. Gerge, A. (2009, June). EMDR and clinical hypnosis for enhanced healing of patients with complex PTSD and DID. Presentation at the annual meeting of the EMDR Europe Association, Amsterdam, the Netherlands.
Language: English
Format: Conference
Keywords: Complex Posttraumatic Stress Disorder Complex PTSD C-PTSD DID Dissociative Identity Disorder Hypnosis
Accuracy Verified: Yes
138. Matthess, H., Vojtova, H., & Dellucci, H. (2012, March). EMDR and complex trauma. Presentation at the 3rd Bi-Annual International European Society for Trauma and Dissociation, Berlin, Germany.
Language: English
Format: Conference
Abstract:
EMDR is widely recognized as a therapy of choice in psychotraumatology. However treating clients who suffer from complex traumatization, and especially dissociative disorder, using EMDR straightaway in its standard form is very difficult.
“By far, the greatest number of reported difficulties and stories of clinical problems and potential harm through the improper use of EMDR had involved clients with dissociative disorders.” Shapiro (2001, p. 308).
Does this mean that people who have complex trauma and dissociative disorder could not benefit from EMDR?
Which adaptations of the standard protocols in the different phases of the EMDR process are crucial in order to use EMDR to enhance the clients’ capacities and diminish their suffering?
Which indicators should be considered? How can clinicians provide a safe and efficient help, without getting lost in this difficult treatment patterns, by knowing what to do and why?
This workshop is designed for practitioners familiar with EMDR. It will provide a general overview of essential modifications of the standard EMDR protocol for complex traumatized clients. The theoretical part will focus on an understanding of the underlying EMDR working mechanism as far as discussed today, on knowledge of dissociation as a result of complex traumatization, in the context of the AIP model (adaptive information processing), the attachment theory, the theory of structural dissociation and recent research findings.
The emphasis will be on practical applications of these insights into a comprehensive treatment of this group of clients. Based on the experience of the presenters, implementing use of bilateral stimulation in all phases of therapy will be shown. Important considerations according possible iatrogenic harm will be discussed. Case examples from practice will be provided, including videos.
Keywords: Complex Trauma
Accuracy Verified: Yes
139. Hofmann, A. (2001, May). EMDR and dissociation. Presentation at the EMDR Europe Association annual meeting, London, UK .
Language: English
Format: Conference
Abstract:
Patients with dissociative disorders usually are a complex traumatised population that has an
increased risk of complications during their treatment course. In treating these patients
EMDR can be one of the key treatment approaches in a therapy setting that usually needs to
include a number of other treatment modalities and an overall comprehensive treatment plan.
The objective of this presentation is to give an overview of the opportunities that EMDR
offers and to reduce risks in the course of treatment.
Keywords: Dissociation
Accuracy Verified: Yes
140. Gonzalez, A., & Mosquera, D. (2012, June). EMDR and dissociation: The progressive approach. A. I. [Amazon.co.uk].
Language: English
Format: Book
Abstract:
After the first cautions for the use of EMDR in dissociative disorders, many proposals have been done to adapt EMDR procedures to this specific population. Interesting interventions have been done for the use of EMDR in the preparation phase, but in spite of these useful proposals, EMDR is still considered by many clinicians as an intervention that is limited for the treatment of traumatic memories. From this conceptualization, which we have called the all/nothing perspective, the use of EMDR is strongly limited. Many clinicians wait years for trauma reprocessing. As a consequence of this conceptualization, many EMDR therapists do not use EMDR with most of their dissociative clients, and just use it with highly functioning patients, sometimes after years of therapy with other approaches.
In this workshop we will describe (and exemplify with clinical cases and videos) different interventions with EMDR in dissociative clients, from the preparatory phase, in what we have called a Progressive Approach. The way in which specific EMDR procedures can contribute to enhance recovery in survivors will be explained. For doing this, concepts from the different approaches and scientific knowledge about severe traumatization will be integrated with the Adaptive Information Processing Model from EMDR. The idea is to propose a holistic model for EMDR therapy in Dissociative Disorders.
The interweaving between theoretical concepts and clinical procedures, theoretical developments and video examples, will allow the audience to assimilate information and translate it to their clinical practice. Therapist from approaches different from EMDR will understand what this therapy can offer to the treatment of severely traumatized people. EMDR therapists will learn new proposals of interventions at the different phases of the treatment. We will present different examples of interventions in severely traumatized patients: DID, DESNOS, BPD and Somatoform dissociation.
Keywords: Dissociation
Accuracy Verified: Yes
141. Ostacoli, L. & Bertino, G. (2010, June). EMDR and drawing: A tool to integrate post-traumatic dissociation and overwhelming emotions. Presentation at the annual meeting of the EMDR Europe Association, Hamburg, Germany.
Language: English
Format: Conference
Abstract:
The difficulty of the management of overwhelming
emotions aid dissociative reactions are challenging for any EMUR
therapist dealing with complex traumas. As a complement
to the strategies already used in EMDR, drawing gives form to
The inner representations of the trauma, objectivizing it Thus the
person no longer relates only to something inside him/her, but
rather to something he/she can see and can concretely represent
and modify In the act of drawing, the patient makes an initial
reorganisation of the form of the trauma, and begins to differentiate
the adaptive ego, which has the tools and the ability to restructure
the experiences, and the traumatic emotional part that
suffers those experiences in a condition of Impotence and passivity
The person may rapidly access preverbal and motor-sensory
language, activating inborn creative skills. The use of this tool
enables us t0 access the traumatic material gently, limiting dissociative
reactions, bypassing avoidance and flight behaviour and
setting a distance from pan by objectivizing . A protective space
is created between the self and the part that holds the suffering.
p i n g a voice to the inner child. The patient is offered the possibility
of drawing what is occurring in the self's here and now, and given a choice of different graphic materials. At the end of the
drawing and assessment phase the person is asked to note what
has emerged, and a brief space of time may be allowed for description
without interpretation. The represented Image is treated
as the inner image in the classic protocol. To start, the patent is
asked to focus on the drawing, on the negative cognition and
on the bodily location of the emotional disorder, while bilateral
stimulation is applied. At the end of each set, the patient is asked
what he/she has noticed and the therapist verifies where the person
now is in the re-elaboration. If there is a change the person
may either work on the drawing, modifying it, or, if the change of
image is radical, may produce another drawing. After several sets,
an adaptive drawing emerge5 that may be installed as a resource.
The report presents the use of the tool in various psychopathological
conditions, with the support of video and graphic materials,
particularly focusing on how to manage dissociation.
Learning objectives:
1.To learn the use of drawing as a supplementary tool, through
graphic and video material of clinical cases.
2. To recognise the indications in which it provides added value
to the classical protocol.
3. to learn its use in various psychopathological conditions,
with particular emphasis on dissociative states.
The use of drawing as a supplementary tool within the EMDR
protocol gives form to the inner representation of the trauma, objectivising
it, and creates a bridge of communication between the
self and the blocked parts, after which it will be possible to return
to desensitizing and re-elaboration with the standard protocol.
Keywords: Dissociation Drawing Emotion
Accuracy Verified: Yes
142. Paulsen Inobe, S. L. (2003, April). EMDR and ego state therapy across the dissociative continuum. Invited faculty at the first World Congress of Ego State Therapy in Bad Orb, Germany.
Language: English
Format: Other
Keywords: Dissociation Ego State Therapy
Accuracy Verified: Yes
143. Paterson, M. (2010, April). EMDR and ego state therapy: Healing complex trauma and dissociation. Preconference presentation at the annual meeting for the European Society for Trauma and Dissociation, Belfast, Northern Ireland.
Language: English
Format: Conference
Abstract:
We all display particular patterns of thinking, feeling and acting, depending on the situation. The transition is usually seamless in well-adjusted people, but where there has been disrupted attachment or sustained early life trauma the result is often the formation of particular ego states, also known as alters, parts, or schema modes. These states perform roles usually geared towards survival, but in adulthood they can be dysfunctional. Depending upon a client’s early life experiences some ego states can be malevolent, wanting bad things for the client such as willing them to suffer in some way. These clients present us with the greatest challenges through what we know as complex trauma and dissociative disorders.
It is necessary for clients to remain stable during EMDR sessions and contained between sessions, particularly with complex trauma and dissociative disorders. There is a need, therefore, to learn techniques to work in the Preparation Phase with more difficult clients so they too can benefit from the full EMDR protocol. It is also helpful to know how to deal with blocked processing in the Desensitization Phase due to the interference of an ego-state.
This workshop initially provides an overview of dissociation and how it impacts on EMDR processing. There will be an explanation of Ego State Therapy (EST) and how it fits with EMDR to provide the stabilization clients need, as well as dealing with blocked processing. Clinical case material is used throughout to illustrate learning points. Through demonstration and practice participants will learn how to build resources for clients, access ego states in a controlled way and effect therapeutic change. In the latter part of the day, participants will see videos of live cases where EST is used effectively in the Preparation Phase of EMDR to: 1) identify the part-selves and 2) moderate the malevolence displayed by two difficult ego states.
Learning objectives
Understand how complex trauma and dissociative disorders impact EMDR processing
Understand the concept of working with part-selves as a way of preparing clients for the standard EMDR protocol.
Learn how to access ego states in a controlled way and effect therapeutic change and stability.
Learn techniques to deal with difficult ego states.
Keywords: Dissociation Ego State Therapy
Accuracy Verified: Yes
144. Peterson, M. 2010, April). EMDR and ego state therapy: Healing complex trauma and dissociation. Presentation at the 2nd Bi-Annual International European Society for Trauma and Dissociation Conference, Belfast, Northern Ireland.
Language: English
Format: Conference
Abstract:
We all display particular patterns of thinking, feeling and acting, depending on the situation. The transition is usually seamless in well-adjusted people, but where there has been disrupted attachment or sustained early life trauma the result is often the formation of particular ego states, also known as alters, parts, or schema modes. These states perform roles usually geared towards survival, but in adulthood they can be dysfunctional. Depending upon a client’s early life experiences some ego states can be malevolent, wanting bad things for the client such as willing them to suffer in some way. These clients present us with the greatest challenges through what we know as complex trauma and dissociative disorders. It is necessary for clients to remain stable during EMDR sessions and contained between sessions, particularly with complex trauma and dissociative disorders. There is a need, therefore, to learn techniques to work in the Preparation Phase with more difficult clients so they too can benefit from the full EMDR protocol. It is also helpful to know how to deal with blocked processing in the Desensitization Phase due to the interference of an ego-state. This workshop initially provides an overview of dissociation and how it impacts on EMDR processing. There will be an explanation of Ego State Therapy (EST) and how it fits with EMDR to provide the stabilization clients need, as well as dealing with blocked processing. Clinical case material is used throughout to illustrate learning points. Through demonstration and practice participants will learn how to build resources for clients, access ego states in a controlled way and effect therapeutic change. In the latter part of the day, participants will see videos of live cases where EST is used effectively in the Preparation Phase of EMDR to: 1) identify the part-selves and 2) moderate the malevolence displayed by two difficult ego states. Learning objectives Understand how complex trauma and dissociative disorders impact EMDR processing Understand the concept of working with part-selves as a way of preparing clients for the standard EMDR protocol. Learn how to access ego states in a controlled way and effect therapeutic change and stability. Learn techniques to deal with difficult ego states.
Keywords: Complex Trauma Dissociation Ego State Therapy
Accuracy Verified: Yes
145. Paulsen, S. L. (2003, September). EMDR and ego state therapy: Energizing disowned aspects of self with dissociative table technique interwoven with EMDR. Presentation at the annual meeting of the EMDR International Association, Denver, CO.
Language: English
Format: Conference
Abstract:
Ego State Therapy is a tool for EMDR practitioners seeking to resolve looping, identify early childhood targets, enhance containment, and more. Dissociative Table is an ego state approach that enables rapid visualization of disowned ego states without formal trance induction. It energizes and egotizes aspects of self so that resistance can reduced through internal education and mediation. EMDR and ego state therapy can be interwoven to manage the level of affective arousal by creating closeness to or distance from disturbing material. The workshop will also present ACT-AS-IF, a step-by-step approach to preparing dissociative clients for EMDR processing.
Keywords: Act-As-If Dissociative Table Technique Ego State Therapy
Accuracy Verified: Yes
146. Twombly, J. (2008, April). EMDR and EMDR adaptions in the treatment of dissociative disorders. Presentation at the 1st Bi-Annual European Society for Trauma and Dissociation Conference, Amsterdam, The Netherlands.
Language: English
Format: Conference
Abstract:
This workshop offers ways to incorporate Eye Movement Desensitization and
Reprocessing in the treatment of clients with Dissociative Identity Disorder, Dissociative
Disorder Not Otherwise Specified and ego state work. Used carefully, EMDR and EMDR
adaptations can accelerate the treatment process. A liability is that its incorrect use can
accelerate decompensation in clients with complex trauma and attachment disordered
histories. This workshop offers suggested uses of EMDR and EMDR adaptations to
facilitate stabilization, orientation to the present, decrease some negative transferences
and to provide a protective format for processing traumatic material.
Learning objectives:
1. Participant is able to identify stages of treatment of dissociative disordered clients
where EMDR and EMDR adaptations can be used.
2. Participant is able to use EMDR adaptations to orient dissociated parts of the mind
to present time.
3. Participant has knowledge of how to develop a controlled process of using EMDR
for trauma processing.
Keywords: Dissociative Disorders
Accuracy Verified: Yes
147. Standart, S., & Wood, C. (2011, October). EMDR and mindfullness. Presentation at the 3rd annual EMDR Autumn Workshop Conference, Durham, England.
Language: English
Format: Conference
Abstract:
A presentation of on a case series of complex Type II PTSD for early childhood and adult trauma with scores of 50+ on the Dissociative Experiences Scale (DES) and using a phased approach to EMDR with mindfulness practice prior to EMDR. Descriptions of mindfulness practice and EMDR protocol use with outcome measure on the DES, Impact of Events Scale score (IES-R) and a depression Inventory will be presented Global outcomes such as occupational and social functioning will also be described for these clients.
Working with clients with complex trauma and marked dissociation and how to develop a timely phased protocol for these difficult to engage clients. (Author abstract)
Keywords: Mindfulness
Accuracy Verified: Yes
148. Fenstermaker, D. (1991, August). EMDR and MPD. EMDR Network Newsletter, 1(1), 3.
Language: English
Format: Newsletter
Abstract:
This abstract is one portion of a panel on
Eye Movement Desensitization and Reprocessing.
It was given on Saturday,
February 23, 1991, for the California
Psychological Association Conference in
San Diego. This paper details a protocol
of Eye Movement Desensitization and
Reprocessing(EMDR) in the treatment
of Dissociative Disorders.
Keywords: MPD Multiple Personality Disorder
Accuracy Verified: Yes
149. de Jongh, A. (2008, September). EMDR and phobias: Treatment of fears and phobias with eye movement desensitization and reprocessing (EMDR)[EMDR bei angst: Und panikstörungen]. Pre-Congress presentation at the European Congress of Hypnosis, Vienna, Austria.
Language: English
Format: Conference
Abstract:
Eye Movement Desensitization and Reprocessing (EMDR) has been shown to be a structured, noninvasive, time-limited, and evidence-based treatment for the processing of memories of traumatic conditioning events and related symptomatology.
There is a growing body of evidence showing the effectiveness of EMDR for specific phobias, a group of conditions that have been found to be more prevalent than any other group of psychiatric disorders studied.
This workshop focuses on EMDR as a treatment approach for fear reactions related
to - and avoidance of - specific objects and situations. The participants will learn:
1) about the fascinating possibilities of using EMDR in their work
2) how EMDR can be applied with clients who suffer from fears and phobias
3) to assess clients with patterns of fearful avoidance and to identify strategically important memories of earlier negative learning experiences for processing
4) to integrate EMDR interventions into a general (hypno)therapeutic approach.
This will be illustrated by segments of video taped treatment sessions of clients suffering from a broad diversity of phobias (e.g., dental phobia, vomiting phobia, shark phobia).
Keywords: Phobias Dental Phobias Shark Phobias Vomiting Phobias
Accuracy Verified: Yes
150. Gelinas, D. J. (2011, August). EMDR and the phobias of structural dissociation in treating complex traumatization. Presentation at the annual meeting of the EMDR International Association, Orange County, CA.
Language: English
Format: Conference
Abstract:
Managing dissociative interference when treating individuals with early repetitive traumatization requires recognition, then direct intervention. The “phobias of structural dissociation” are especially helpful in recognizing the less readily apparent dissociative interferences. These refer to the individual’s fear and avoidance of their own internal experiencing, (e.g., thoughts, parts, memories) rather than the traditional fear of external objects or processes. They can be responsible for failures to establish the therapy or Safe Place, refusal of EMDR, looping, “stuck” NCs, etc. This presentation describes the phobias (with clinical illustrations), recognition markers, and a stepped hierarchy of EMDR interventions to manage dissociative interferences.
Keywords: Complex Trauma Phobias Structual Dissociation
Accuracy Verified: Yes
151. Hofmann, A. (2009, June). EMDR and the treatment of adult survivors of childhood abuse and neglect. Keynote presented at the annual meeting of the EMDR Europe Association, Amsterdam, the Netherlands.
Language: English
Format: Conference
Abstract:
Patients with complex PTSD and dissociative symptoms are a challenging patient population . Concepts like the Disorder of Extreme Stress (Herman et al.) and the the research on memory networks and especially structural dissociation (Nijenhuis et al.) helps to understand this patients better. In the treatment of this patients EMDR can be one of the key treatment approaches in a therapy setting that usually needs to also enclose other EMDR modalities besides the EMDR standard protocol. New developments in EMDR and an decission help when to apply them can help pacing the therapy of these patients and making it successful.
Keywords: Adults Childhood Sexual Abuse Keynote Neglect Survivors
Accuracy Verified: Yes
152. Korn, D. L. (2011, August). EMDR and the treatment of complex PTSD. Presentation at the annual meeting of the EMDR International Association, Orange County, CA.
Language: English
Format: Conference
Abstract:
This workshop will focus on integrating EMDR into an overall recovery plan in working with adult survivors of childhood abuse and neglect. Individuals with histories of chronic victimization often struggle with extreme vulnerability and shame, heightened dissociative tendencies, and limited affect tolerance. In considering their unique needs, strategies for modifying and supplementing standard EMDR protocols will be explored. Fears and blocking beliefs commonly seen in this population will be discussed, along with suggestions for effective cognitive interweave interventions. In addition, significant attention will be devoted to integrating EMDR ego strengthening and resource development protocols into all phases of treatment. This program will include lecture, videotape presentations, and case discussion.
Keywords: C-PTSD Complex Posttraumatic Stress Disorder Complex PTSD
Accuracy Verified: Yes
153. Lindsay, J. (1995, June). EMDR and the treatment of rape survivors. Presentation at the EMDR Network Conference, Santa Monica, CA.
Language: English
Format: Conference
Abstract:
The study employed single case experimental design to test the efficacy of EMDR in the treatment of rape survivors. EMDR was
introduced sequentially to five subjects by five licensed psychotherapists with Level II EMDR training. Each subject received from
4 to 6 sessions depending upon her position in the sequence. Each met criteria for PTSD prior to treatment.
The study emphasized clinical significance, and with minor exceptions, all scores meet criteria for both clinical and statistical
significance.
Independent variables were the Beck Depression Inventory (BDI), the Brief Symptom Inventory (BSI), the Dissociative Experience
Scale (DES), the State-Traft Anxiety Inventory (STAI) and the PTSD Symptom Scale, Self-Report (PSC-SR). Pre- post- and followup
scores demonstrated dramatic changes (<.O1,DES<.05).
Subjects monitored PTSD symptomotology throughout the baseline, treatment and follow-up phases. The visual analog scales
which display these graphed data provide some interesting information regarding individual response to treatment and inter- and
intra- subject variability. These quantitative data were also analyzed with respect to qualitative data from pre- and post and followup
interviews and from clinical reports.
Keywords: Rape
Accuracy Verified: Yes
154. Eimer, B. N. (1995, June). EMDR applications for pain management. Presentation at the EMDR Network Conference, Santa Monica, CA.
Language: English
Format: Conference
Abstract:
The focus of this 3-hour workshop will be on using EMDR to alleviate emotional distress attendant to coping with acute physical
pain and living with chronic pain. Participants in this workshop will learn:
(a) how to conduct a targeted assessment of the patient whose chief complaint is physical pain;
(b) a guided pain healing meditation;
(c) an EMDR protocol for installing pain relief imagery and self-care techniques;
(d) an EMDR protocol for reprocessing covert pain talk, pain behaviors and pain-related memories;
(e) how to apply A.J. Popky's EMDR protocol for reducing substance abuse (i.e., Overeating,
drinking) and dependence on pain medication in this population.
The presentation will first address how to conduct a structured assessment that identifies targets for EMDR treatment. The
dysfunctional information package associated with chronic pain (termed the "biogram")and "seven keys" to understanding chronic
pain will be discussed. Then, essential principles for designing an effective individual psychotherapy program for the pain sufferer
will be presented.
Next, use of the "seven keys for constructing a guided healing meditation (i.e., Self-care technique) for the pain patient that also
incorporates Francine Shapiro's "light stream" and "spiral" guided meditations will be demonstrated. A script for this, termed the
"C.O.M.P.I.S.S. Pain Healing Meditation," will be distributed.
The workshop will then address how to introduce EMDR to the patient whose chief complaint is physical pain. What EMDR can
do and probably cannot do for pain patients will then be discussed. Next, principles for choosing an initial tarqet for reprocessing
will be discussed.
The presentation will then cover (with clinical case examples):
(1) Red flags and cautions to consider before proceeding with EMDR-
(2) What to do and what not to do if the patient is dissociative;
(3) How to "mirror" and install with EMDR empathic responses to underlying beliefs associated with
"secondary gains" minus primary losses;
(4) Teaching the distinction between pain sensations and suffering;
(5) How to teach and install with EMDR self-care and pain coping techniques such as pain relief
imagery, mental distraction techniques, safe place imagery, and positive motivation for healthy
self-care behaviors;
(6) How to directly address with the patient the application of "cognitive psychology" and imagery
for pain reduction;
(7) EMDR reprocessing of memories around the pain's origins;
(8) EMDR reprocessing of pain-related conflicts, negative beliefs, negative past experiences,
internalized self-identifications, self-punitive tendencies and self-defeating behaviors;
(9) Eliciting core negative pain coping cognitions and suggesting preferable positive cognitions to the pain patient;
(10) EMDR reprocessing of negative cognitions associated with depression and anxiety.
(11) Use of EMDR to facilitate mental rehearsal of coping responses to pain triggers;
(12) Material that often comes up in using EMDR with pain patients;
(13) Strategically restructuring patient "resistance" with coanitive interweave;
(14) Managing narcotic and pain medication seeking behavior and substance abuse;
(15) Use of Popky's EMDR protocol for reducing medication dependence and substance abuse in
this population;
(16) Treating pain patients who also have PTSD.
Videotaped case excerpts will be shown that illustrate important points covered.
If time permits, participants may be able to briefly discuss EMDR applications to specific medical and pain patient populations.
Keywords: Chronic Pain Pain Pain Management
Accuracy Verified: Yes
155. Hamilton, C. (1996, November). EMDR applications in the treatment of DID/DDNOS. Symposia presented at the annual meeting of the International Society for the Study of Dissociation, San Francisco, CA.
Language: English
Format: Conference
Keywords: DDNOS DID Dissociative Identity Disorder Symposia
Accuracy Verified: Yes
156. Lawrence, M. A. (1998, December). EMDR as a special form of ego state psychotherapy, Part I of II. EMDRIA Newsletter, 3(4), 7, 13-15, 24-25.
Language: English
Format: Newsletter
Abstract:
Ego state therapy has become an increasingly recognized and utilized form of psychotherapy over the past 2 years although it has been used primarily by hynotherapists in the context of the treatment of dissociative disorders. The use of Eye Movement Desensitization and Reprocessing (EMDR) has also expanded extremely rapidly over the past ten years, primarily in the treatment of acute and chronic Post Traumatic Stress Disorder (PTSD). It is the thesis of this paper that EMDR can be conceptualized as a special form of ego state therapy. EMDR’s unique contribution to the ego state therapy process is in its subtle but profound, impact on the associative/dissociative process, and ego state therapy can be considered a meta model for informing EMDR therapeutic interventions, particularly with regard to impasses.
Keywords: Ego State Therapy Posttraumatic Stress Disorder PTSD
Accuracy Verified: Yes
157. Lawrence, M. A. (1999, March). EMDR as a special form of ego state psychotherapy, Part II. EMDRIA Newsletter, 4(1), 9, 14-15, 34.
Language: English
Format: Newsletter
Abstract:
Ego state therapy has become an increasingly recognized and utilized form of psychotherapy over the past 2 years although it has been used primarily by hynotherapists in the context of the treatment of dissociative disorders. The use of Eye Movement Desensitization and Reprocessing (EMDR) has also expanded extremely rapidly over the past ten years, primarily in the treatment of acute and chronic Post Traumatic Stress Disorder (PTSD). It is the thesis of this paper that EMDR can be conceptualized as a special form of ego state therapy. EMDR’s unique contribution to the ego state therapy process is in its subtle but profound, impact on the associative/dissociative process, and ego state therapy can be considered a meta model for informing EMDR therapeutic interventions, particularly with regard to impasses.
Keywords: Ego State Therapy
Accuracy Verified: Yes
158. Rougemont-Bucking, A. (2010, June). EMDR based treatment of psychotraumatic antecedents in illicit drug abusers: A report of two cases. Poster presented at the annual meeting of the EMDR Europe Association, Hamburg, Germany .
Language: English
Format: Conference
Abstract:
Background: EMDR has been recognized to be an efficacious
treatment of Posttraumatic Stress Disorder (PTSD). Other,
more recent indications comprise anxiety disorders and substance
use disorders (SUD). With regard to SUD, the application of EMDR
iS very challenging as patients frequently suffer from many
comorbidities. Another concern is the fact that the dissociative
experiencing during EMDR-sessions can potentially weaken the
patients' coping strategies and provoke relapse through activation
of intense drug craving.
General procedure. Sessions were proposed once a week. Specific
techniques like 'Safe Place', the technique of absorption, heart coherence training and ClPOS were applied prior to proposition
of the standard EMDR-protocol. Drug consumption and craving
was regularly monitored by means of the patents' self-reports
and drug craving scores. The therapist was regularly supervised
on the basis of video recordings.
Patient 1: A 49 year old man being diagnosed for PTSD and dependency
of opiates and benzodiazepines asked to benefit form
EMDR with regard to his PTSD symptoms. Patient was abstinent
from heroine consumption but consumed midazolam 3 times per
week when entering the therapy. Initial evaluation showed an
Impact of Event Scale (IES) score of 60, a Dissociative Experiences
Scale (DES) score of 39.6 and a midazolam craving score of 14.
Patient 2 :A 37 old man was diagnosed for borderline personality
disorder and for dependency of opiates. Heroine consumption occurred 1 to 3 times per month when starting the therapy
EMDR based therapy was proposed as he complained about
pertinacious insomnia due to trauma-like events during his childhood.
Initial evaluation showed a DES score of 7.8 and a heroine
craving score of 17.
Global impression: EMDR based treatment of severely affected
SUD patients appears to be a difficult and challenging endeavor
However, some beneficial effects on general comfort and on drug
consumption can be observed. A long stabilisation phase seems
to be mandatory and the standard EMDR protocol needs to be
conducted with much flexibility as patients were not able to handle
intensive emotional stress for a long time period. There was
no provocation of a prolonged psychological crisis or of relapse.
Experiencing of emotional stress could be limited to the sessions
and dissociation could be absorbed with specific techniques without
increasing permanently drug craving.
Learning objectives:
1. EMDR-based treatment is feasible in severely affected drug
abusers
2. Extensive stabilisation of the patient using flexible adaptation
of EMDR-related techniques is mandatory
3. Dissociation occurring during treatment has to be addressed
carefully as it can easily bridge into drug craving and relapse
What is unique: EMDR-based treatment may be a suitable way
to treat patients who are still abusing drugs as these interventions
focus on maladaptive associations that arise from both trauma
and substance related cues.
Keywords: Drug Abusers Heroine Psychotraumatic Antecedents
Accuracy Verified: Yes
159. Lendl, J. (2007, September). EMDR basics part II: The positive template. Presentation at the annual meeting of the EMDR International Association, Dallas, TX.
Language: English
Format: Conference
Abstract:
Requisite for the workshop is Part I. Part II will include a historical review of the Positive Template in psychotherapy and sport. Preliminary research suggests that the Positive Template is useful before the installation phase to help maintain skills between sessions, encourage new skills, and practice ways to handle resistance between sessions. Shapiro’s latest trainings emphasize the Future Template to address avoidance, adaptation and actualization as the third prong and installation and reevaluation phases. Simulation videos will demonstrate the decision making process and the use of resources in the Future Template and the End Session Positive (ESP) Template. There will be supervised practica utilizing the Positive Template to complete processing of the Part I Touchstone Event.
Keywords: Positive Template
Accuracy Verified: Yes
160. Korn, D. (2010, April). EMDR behandeling bij volwassenen met een verleden van incest en verwaarlozing. Het herstellen van ontwikkelings tekorten en het beschadigde ‘zelf’ [EMDR treatment in adults with a history of incest and neglect. Developmental deficits and restore the damaged self]. Workshop gepresenteerd aan de vierde congres van de Vereniging EMDR Nederland, Nijmegen, The Nederland.
Language: Dutch
Format: Conference
Abstract:
In deze workshop zal er worden ingegaan op het integreren van EMDR in een algemeen behandelingsplan voor volwassenen die incest en verwaarlozing in hun jeugd hebben meegemaakt.
De workshop is een verdieping van de keynote van het congres. De werkwijze zal gedetailleerd worden uitgelegd en zal worden geïllustreerd aan de hand van videopresentaties en bespreking van casuïstiek.
In eerste instantie wordt uitgelegd hoe de ontwikkelings- en hechtingsbehoeften van de cliënt onderzocht kunnen worden en hoe een betekenisvolle beschrijvende diagnose kan worden ontwikkeld om tot een geïntegreerd, logisch opgebouwd behandelingsplan te komen.
Bij deze groep cliënten, waarbij er sprake is van beperkte affect tolerantie, kwetsbaarheid voor hyper- en hypoarousal, en dissociatieve kenmerken, kan het standaard EMDR protocol worden aangepast met specifieke strategieën. Daar zal uitvoerig op worden ingegaan.
Ook zal er veel aandacht besteed worden aan het integreren van specifieke EMDR technieken, zoals diverse ego-versterkende protocollen en hulpbron installatie (RDI), in alle fasen van de behandeling.
Tevens zullen er technieken besproken worden die cliënten helpen om hun disfunctionele afweermechanismen los te laten, waardoor het veranderen van schema’s met hun kenmerkende kerngedachten en kernaffecten mogelijk wordt
Deelnemers aan deze workshop zullen leren om pathogene gevoelstoestanden, (zoals schaamte, wanhoop, onverdraagelijke eenzaamheidsgevoelens), angsten en ‘blocking beliefs’, ego state conflicten te herkennen, zodat de meest effectieve interweaves en hulpbron opties kunnen worden toegepast.
Verder zullen er strategieën voor herstel, zoals het verduidelijken van verantwoordelijkheid, het vaststellen van veiligheid en keuze, en het verwerken van rouw, verlangen en woede, worden besproken.
This workshop will address the integration of EMDR into an overall treatment plan for adult incest and neglect in childhood have experienced.
The workshop is a deepening of the keynote of the conference. The methodology will be explained in detail and will be illustrated with video presentations and discussion of case studies.
Initially, explains how the development and bonding needs of the client can be investigated and how a meaningful descriptive diagnosis can be developed into an integrated, logical plan of treatment.
In this group of clients, where there is limited affect tolerance, vulnerability to hyper-and hypoarousal and dissociative characteristics, the standard EMDR protocol to be adapted to specific strategies. As will be discussed in detail.
Also, much attention is paid to the integration of EMDR specific techniques, such as various ego-enhancing protocols and resource installation (RDI) in all phases of treatment.
Will also discuss techniques that help clients to their dysfunctional defense mechanisms to let go, so changing schedules with their distinctive core ideas and possible kernaffecten
Participants in this workshop will learn to pathogenic emotional states (such as shame, despair, unbearable loneliness feelings), and fears "blocking beliefs", ego-state conflicts to recognize that the most effective and interweaves resource options can be applied.
Moreover, through strategies for recovery, such as clarifying responsibilities, establishing security and choice, and the process of mourning, desire and anger are discussed.
Keywords: Adults Developmental Deficits Incest
Accuracy Verified: Yes
161. Hofmann, A. (2008, September). EMDR bei dissoziativen störungen [EMDR and dissociative disorders]. Presentation at Pre-Congress on EMDR auf dem European Congress of Hypnosis, Wien, Österreich.
Language: German
Format: Conference
Abstract:
Mit den zunehmenden Forschungsergebnissen im Bereich psychotraumatischer bedingter Störungen sind auch neuere erfolgreiche Zugänge zur Behandlung dieser Störungen entwickelt worden. Einer dieser neuen Ansätze ist die von Dr. Francine Shapiro in Palo Alto (Kalifornien) entwickelte und mittlerweile international anerkannte EMDR-Methode.
Diese in ihrer Effektivität gut belegte Behandlungsmethode verwendet einen
acht Phasen umfassenden Behandlungsansatz und kann in vielen Psychotherapien auch bei schwer dissoziativen PatientInnen wichtigen Beitrag zur Verarbeitung belastender Erinnerungen leisten.
Dies gilt auch für PatientInnen, die unter schwersten dissoziativen Störungen wie einer multiplen Persönlichkeitsstörung leiden. Die oft langwierige Behandlung dieser PatienInnen ist durch Methodenintegration und kann durch den Einsatz der EMDR-Methode sehr profitieren. Der diagnostische und behandlungstechnisch integrative EMDR-Ansatz bei diesen PatientInnen wird in seinen Forschungsergebnissen und klinischen Anwendungen im Einzelnen diskutiert werden.
Supervision will as well as coaching the professional competence of supervisees at the intersection of different factors: optimizing them accordingly serve the qualification, optimization and reflection of the professional action.
With the growing research in the field of psycho-traumatic disorders induced newer successful approaches to the treatment of these disorders have been developed. One of these new approaches is that of Dr. Francine Shapiro in Palo Alto (Calif.) has developed and now internationally recognized EMDR method.
This well-documented in effectiveness treatment method uses a
eight phases comprehensive approach to treatment and can afford in many psychotherapies in severely dissociative patients also important contribution to the processing of stressful memories.
This also applies to patients suffering from severe dissociative disorders, such as a multiple personality disorder. The often lengthy treatment of this PatienInnen is through integration of methods and can benefit by using the EMDR method very much. The diagnostic and treatment technique EMDR integrative approach in these patients will be discussed in its research and clinical applications in detail.
Keywords: Dissociative Disorders
Accuracy Verified: Yes
162. ten Broeke, T., & Oppenheim, H-J. (2008, Maart). EMDR bij de behandeling van complexe PTSS en ernstige dissociatie [EMDR in the treatment of complex PTSD and severe dissociation]. Presentatie aan de derde congres van de Vereniging EMDR Nederland, Ede, The Netherlands.
Language: Dutch
Format: Conference
Abstract:
Bij de behandeling van patiënten met complexe PTSS ten gevolge van type 2 trauma, wordt de behandelaar geconfronteerd met twee grote problemen: 1) hoe een overzichtelijke structuur aan te brengen in de veelheid aan traumatische gebeurtenissen, en 2) hoe om te gaan met pathologische dissociatie.
In deze voordracht wordt in eerste instantie een aanpak gepresenteerd waarmee de therapeut en patiënt kunnen komen tot een zodanige
(hiërarchische) ordening van de traumatische gebeurtenissen, dat een gefaseerde en overzichtelijke behandeling mogelijk wordt.
Vervolgens zal nader ingegaan worden op het verschijnsel dissociatie en zal worden uitgelegd welke algemene technieken toegepast kunnen worden bij dissociatieve reacties. Ten slotte zal aan de hand van videobeelden worden gedemonstreerd hoe met een aangepast EMDR basisprotocol het mogelijk is om bij mensen met secundaire en tertiaire structurele dissociatie, door activatie van een alterpersoonlijkheid, het traumatisch materiaal waardoor de alterpersoonlijkheid is ontstaan a. te ontsluiten, b. te verwerken en c.
te integreren
When treating patients with complex PTSD as a result of Type 2 trauma, the therapist faces two major problems: 1) how an organized structure to the multitude of traumatic events, and 2) how to deal with pathological dissociation .
In this lecture primarily an approach is presented that the therapist and patient can come to such a
(Hierarchical) organization of the traumatic events that a phased and orderly treatment possible.
Will then be elaborated on the phenomenon of dissociation and will explain the general techniques can be applied to dissociative reactions. Finally, using video to demonstrate how a modified EMDR basic protocol it is possible in people with secondary and tertiary structural dissociation, through activation of an alter personality, traumatic materials which alter personality created a. to access, b. processing and c. integrate.
Keywords: Complex Posttraumatic Stress Disorder Complex PTSD C-PTSD
Accuracy Verified: Yes
163. Hofmann, A. (2006, November). EMDR bij de behandeling van complexe PTSS patiënten [EMDR in the treatment of complex PTSD patients]. Keynote gepresenteerd aan de tweede congres van de Vereniging EMDR Nederland, Arnhem, The Netherlands.
Language: English
Format: Conference
Abstract:
Patiënten met complexe PTSS en dissociatieve symptomen zijn een uitdagende patiëntenpopulatie. Concepten zoals de stoornis van extreme stress (Herman et al..) En het geheugen van het onderzoek naar netwerken en vooral structurele dissociatie (Nijenhuis et al..) Helpt om dit te begrijpen patiënten beter. Bij de behandeling van deze patiënten EMDR kan een van de belangrijkste benaderingen in de behandeling een therapie instelling die gewoonlijk moet ook bijvoegen andere modaliteiten naast de EMDR EMDR standaardprotocol. Nieuwe ontwikkelingen in EMDR en een decission helpen wanneer ze toe te passen kan pacing de therapie van deze patiënten te helpen en maakt het succesvol.
Patients with complex PTSD and dissociative symptoms are a challenging patient population . Concepts like the Disorder of Extreme Stress (Herman et al.) and the the research on memory networks and especially structural dissociation (Nijenhuis et al.) help to understand these patients better. In the treatment of this patients EMDR can be one of the key treatment approaches in a therapy setting that usually needs to also enclose other EMDR modalities besides the EMDR standard protocol. New developments in EMDR and an decission help when to apply them can help pacing the therapy of these patients and making it successful.
Keywords: Complex Posttraumatic Stress Disorder C-PTSD
Accuracy Verified: Yes
164. Oppenheim, H.-J., ten Broeke, E., & de Jongh, A. (2009). EMDR bij dissociatieve stoornissen [EMDR in dissociative disorders]. In E. ten Broeke, A. de Jongh, & H.-J. Oppenheim (Red), Praktijkboek EMDR: Casusconceptualisatie en specifieke patiëntengroepen, (pp. 177-199). Amsterdam: Pearson.
Language: Dutch
Format: Book Section
Keywords: Dissociative Disorders
Accuracy Verified: Yes
165. Groenendijk, M. (2011, April). EMDR bij dissociatieve stoornissen [EMDR with dissociative disorders]. Presentatie op de 5e jaarlijkse conferentie van EMDR Vereniging, Nijmegen, Nederland.
Language: Dutch
Format: Conference
Abstract:
Na met veel succes deze workshop op de Europese congressen in Amsterdam en Hamburg te hebben gegeven, is Mariëtte gevraagd om ook op het Nederlandse congres haar kennis te delen. De workshop gaat over welke aanpassingen er nodig zijn om EMDR ook bij dissociatieve stoornissen te kunnen inzetten en aan de hand van de videoband van Maria zal getoond worden hoe dat werkt. De workshop is bedoeld voor therapeuten zijn die al werkende met getraumatiseerden bij een deel van hen stuiten op vroeger of ernstiger trauma dan ze aan het begin wisten en ook pas gaandeweg dissociatieve fenomenen ontdekken.
After this very successful workshop at the European conferences in Amsterdam and Hamburg have given, Mariette also asked the Dutch conference to share her knowledge. The workshop is about what changes are needed to EMDR also deploy and dissociative disorders on the basis of the videotape of Mary will demonstrate how that works. The workshop is intended for therapists already working with traumatized by a number of them encounter severe trauma or earlier than they did at the beginning and only gradually explore dissociative phenomena.
Keywords: Dissociative Disorders
Accuracy Verified: Yes
166. Merckelbach, H., & Muris, P. (1995). EMDR bij spinnenfobie: Twee gevalsbeschrijvingen [EMDR with spider phobia: Two case reports]. Directieve Therapie, 15(2), 64-70. doi:10.1007/BF03060109.
Language: Dutch
Format: Journal
Abstract:
Nogal wat auteurs geven hoog op van de effecten die met Eye Movement Desensitization and Reprocessing (EMDR) te behalen zijn bij de behandeling van angststoornissen. Voor een aanzienlijk deel steunen deze loftuigingen op dubieuze casuïstiek, dat wil zeggen casuïstiek waarin de werking van EMDR wordt gedocumenteerd aan de hand van subjectieve en ongevalideerde uitkomstmaten. Dit artikel beschrijft twee spinnenfobische gevallen waarbij eerst EMDR en vervolgens exposure in vivo werd uitgevoerd. Behandelingseffecten werden geëvalueerd met zowel subjectieve als objectieve maten. De resultaten laten zien dat de gunstige effecten van EMDR zich vooral afspelen op het niveau van de subjectief gerapporteerde angst en veel minder spectaculair zijn wanneer het gaat om vermijdingsgedrag. Deze observatie stelt die EMDR–critici in het gelijk die beweren dat positieve zelfrapportage–maten na EMDR niet noodzakelijkerwijze hand in hand gaan met vergelijkbare gedragseffecten.
Quite a few authors give high on the effects of Eye Movement Desensitization and Reprocessing (EMDR) can be achieved in the treatment of anxiety disorders. For a significant part in supporting these loftuigingen dubious casuistry, ie case studies where the effect of EMDR is documented by means of subjective and non-validated outcome measures. This article describes two cases where spinnenfobische first EMDR and exposure in vivo was then performed. Treatment effects were evaluated with both subjective and objective measures. The results show that the beneficial effects of EMDR mainly play at the level of subjectively reported anxiety and much less spectacular when it comes to avoidance. This observation suggests that EMDR critics were right who claim that positive self-report measures after EMDR does not necessarily go hand in hand with similar behavioral effects.
Keywords: Case Study Spider Phobia
Accuracy Verified: Yes
167. EMDR Dissociation Task Force. (1994). EMDR Dissociation Task Force position paper. EMDR Institute, Pacific Grove, CA.
Language: English
Format: Publication
Abstract:
Ths paper will offer general guidelines in the application of EMDR with the
dissociative disorders, with paramount concern for client day. The intended audience is
the established clinician who is new to the diagnosis and treatment of dissociative
disorders. The paper is not intended to define standards of care or specific training
requirements or cenfication guidelines. Further, it is not intended to supercede expert
clinical judgment, or training in dissociative disorders or hypnosis.
Keywords: Dissociation Position Paper Task Force
Accuracy Verified: Yes
168. Monteiro, A. M. (2012, Novembro). EMDR em posturas e movimento: Estados de ego e memórias não verbais [EMDR in posture and movement: Member of ego and non-verbal memories]. In EMDR e memórias. Apresentação no II Congresso Brasileiro de EMDR, Brasília, Brasil.
Language: Portuguese
Format: Conference
Abstract:
Neste trabalho serão apresentadas estratégias de exploração de postura e espaço para acesso a memórias não verbais, características de ICES incompletos e frequente expressão de Estados de Ego infantilizados, primitivos. Esses casos geralmente refletem transtornos dissociativos mais pronunciados, com desafios para terapeuta montar protocolo clássico.
In this work we will present strategies for posture and space for access to non-verbal memories, characteristics of ICES incomplete and frequent expression of Ego States childish, primitive. These cases generally reflect more pronounced dissociative disorders, with challenges to mount therapist classic protocol.
Keywords: Ego States Nonverbal Memories Posture Standard Protocol
Accuracy Verified: Yes
169. Aduriz, E. (2012, June). EMDR en niños con trastornos disociativos [EMDR in children with dissociative disorders]. En Preconferencia 2: Niños, traumatización grave y EMDR [In Pre-conference 2: Children, severe traumatization and EMDR]. Presentation at the annual meeting of the EMDR Europe Association, Madrid, Spain.
Language: Spanish
Format: Conference
Abstract:
Dr. Aduriz will show the importance of establishing
a predictable and trusting relationship between the child and her adoptive parents so that the child can repair the severe early wounds inflicted
on her by the relationship with her biological mother. She will also focus on how to help the adoptive parents attain more confidence in their
parental role.
María Elena Aduriz, expondrá a través del caso de una niña cuya traumatización es consecuencia directa de un apego desorganizado a una
madre esquizofrénica, inestable y suicida, la importancia de articular intervenciones terapéuticas con EMDR con la niña y con los padres
adoptivos. Señalará la importancia de establecer un vínculo predecible y confiable entre ellos para que la niña pueda reparar las heridas
tempranas y severas producto del vínculo con su madre biológica, y para que los padres sean capaces de generar mayor confianza en su
función parental.
Keywords: Attachment Disruptions Children
Accuracy Verified: Yes
170. Baita, S. (2012, June). EMDR en niños con trastornos disociativos [EMDR in children with dissociative disorders]. Pre-Conference presentation at the annual meeting of the EMDR Europe Association, Madrid, Spain.
Language: Spanish
Format: Conference
Abstract:
Sandra Baita will describe the case of a dissociative girl whose traumatization was a consequence of early exposure to chronic sexual abuse
by her father. In this case, Dr. Baita will explain the challenge of working with systems surrounding the child other than the family, for example,
the Justice System. She will focus on the paramount importance of the first stage of treatment and the achievement of external security when
working with severely traumatized children. Dr. Baita will offer for discussion with the attendees, the development of a treatment plan for this
dissociative girl using EMDR during the therapeutic stages of security and stability, working with traumatic memories, and integration.
Sandra Baita expondrá el caso de una niña con un trastorno disociativo en el cual la traumatización ha sido consecuencia de la exposición
temprana a abuso sexual por parte del padre. En este caso, la Dra. Baita explicará el desafío que implica trabajar con otros sistemas además
del familiar, tales como el sistema de Justicia. Ilustrará además la relevancia que adquiere la primera etapa del tratamiento y el establecimiento
de un contexto real de seguridad externa en el tratamiento de niños severamente traumatizados, y mostrará, para su discusión con los
asistentes, el desarrollo del tratamiento exhaustivo de esta niña utilizando EMDR a lo largo de las etapas de seguridad y estabilidad, trabajo
con las memorias traumáticas e integración.
Keywords: Children Dissociative Disorders
Accuracy Verified: Yes
171. Knipe, J. (2008, Maart). EMDR en sterk wordt vastgehouden psychologische verdedigingsmechanismen het voorkomen van directe toegang tot bewuste en doelgerichtheid van de post-traumatisch materiaal [EMDR and strongly held psychological defenses preventing direct conscious access and targeting of post-traumatic material]. Presentatie op het derde congres van de Vereniging EMDR Nederland, Amersfoort, The Netherlands.
Language: English
Format: Conference
Abstract:
Een specifieke EMDR procedures die nuttig is met cliënten die zich sterk hebben gehouden psychologische verweren die bewuste directe toegang te voorkomen en de gerichtheid van post-traumatische materiaal is volledig te verklaren met uitgebreid gebruik van video-materiaal met de gerichtheid van de verdedigingswerken van vermijding (bijvoorbeeld vermijden van zeer verontrustende herinneringen , vermijden van verantwoordelijkheden, te vermijden in de vorm van uitstel), idealisering van het zelf (bijv. narcistische karaktertrekken van bijzonders en het recht) en de idealisering van anderen (bv. verlangen naar een verloren geliefde, of trauma-obligatie gehechtheid aan een dader). Vaak zijn cliënten die depressief bent en anderen die te idealiseren opereren vanuit een kern eigen ego staat van schaamte, en tijdens deze zeer praktische workshop leert u hoe jammer soms kan worden opgelost met behulp van gerichte en EMDR-methoden.
A specific EMDR procedures that is useful with clients who have strongly held psychological defenses that prevent direct conscious access and targeting of post-traumatic material is fully explained with extensive use of video material showing the targeting of defenses of avoidance (e.g. avoidance of extremely troubling memories, avoidance of responsibilities, avoidance in the form of procrastination), idealization of self (e.g. narcissistic traits of specialness and entitlement) and idealization of others (e.g. longing for a lost lover, or trauma-bond attachment to a perpetrator). Often clients who are depressed and who idealize others are operating from a core self ego state of shame, and during this highly practical workshop you will learn how shame can sometimes be targeted and resolved using EMDR methods.
Keywords: Psychological Defenses Targeting
Accuracy Verified: Yes
172. Vazquez, A. G. (2007, Novembro). EMDR en trastornos disociativos [EMDR in dissociative disorders]. Apresentação no I Congresso Ibero-Americano de EMDR, Brasília, Brasil.
Language: English
Format: Conference
Abstract:
Objetivos de aprendizaje:
• Ofrecer una perspectiva de cómo enlazar el
tratamiento de trastornos disociativos y EMDR.
La disociación es un fenómeno clínico
estrechamente ligado al trauma. Todos los que
trabajamos con EMDR nos encontramos
necesariamente con ella. Sin embargo es
frecuente que los conocimientos en el área del
tratamiento de la disociación sean limitados
en muchos países. Muchas veces la información
que se nos transmite al respecto es que “es
preciso tener mucho cuidado cuando
empleamos EMDR en pacientes disociativos”.
Si bien esto es muy cierto, también lo es que
teniendo claro el esquema de tratamiento en
la disociación grave, EMDR puede utilizarse de
forma eficaz y segura en estos pacientes, y
resulta enormemente útil en el proceso
terapéutico, acortando enormemente los
tiempos de terapia.
• Acercar a los asistentes a estos tratamientos
de una forma eminentemente práctica, predominando
en la exposición la presentación
de casos clínicos, fundamentalmente en formato
de video, sobre el desarrollo teórico,
aunque se intentará engarzar ambos aspectos
de un modo coherente y comprensible.
• Crear un espacio de discusión en el que los
participantes puedan aportar sus experiencias
clínicas y compartir perspectivas. (Este trabajo también será presentado en forma
de video. Vea el horario de la Sala 4).
Learning Objectives:
• Provide an overview of how to bind the
treatment of dissociative disorders and EMDR.
Dissociation is a clinical phenomenon
closely associated with the trauma. Everyone
we work with EMDR
necessarily with it. However, it is
common knowledge in the area
dissociation treatment are limited
in many countries. Many times the information
transmitted to us in this regard is that "it is
must be very careful when
employ EMDR in dissociative patients. "
While this is very true, so is that
clear light treatment scheme
severe dissociation, EMDR can be used
effective and safe in these patients, and
is enormously helpful in the process
therapeutic, greatly shortening
days of therapy.
• Bring attendees to these treatments
of an eminently practical, predominantly
presentation in the exhibition
clinical cases, mainly in the form
Video on the theoretical development,
but will try to enshrine both aspects
in a coherent and understandable.
• Create a space for discussion where
Participants can bring their experiences
Clinical and share perspectives. (This work will also be presented as of video. See schedule of Room 4).
Keywords: Dissocative Disorders
Accuracy Verified: Yes
173. Kennedy, S. (2004, March 31). EMDR An essential “tool” for a counselor’s “toolbox”. Arizona Department of Public Safety Crime Victim Services Newsletter, 24, 1-2.
Language: English
Format: Newsletter
Abstract:
Eye Movement Desensitization
and Reprocessing
(EMDR) is quickly becoming
a valuable and soughtafter
method for treating
victims of trauma. Use of
EMDR is revolutionizing
the treatment of commonly
seen mental health problems
(such as depression,
anxiety, phobias, etc.) and
some of the most troubling
and difficult-to-treat problems
professionals deal
with in clinical settings (such as posttraumatic stress syndrome, substance abuse,
eating disorders, and dissociative
disorders).
Accuracy Verified: Yes
174. Waters, F. S., & Adler-Tapia, R. (2009, November). EMDR for children with trauma and dissociation: Case conceptualization from stabilization to integration. Presentation at the 26th annual meeting of the International Society for the Study of Trauma and Dissociation, Washington, DC .
Language: English
Format: Conference
Abstract: This workshop initially will review the 8 phase EMDR protocol for implementation with severely traumatized and dissociative children and provide advanced skills utilizing the EMDR protocol with this population. The 8 phase EMDR protocol will be described. Therapeutic challenges for therapists in implementing this protocol with young children with complex trauma will be explored with recommendations for clinicians on how to provide efficacious treatment to children. Each phase of the protocol will be discussed identifying specific goals and specialized interventions presented with linguistic sensitivity to maintain adherence to the EMDR protocol with young children. Client History and Treatment Planning Phase, and the Preparation Phase of the EMDR Protocol will be detailed. The assessment of dissociation in young children will include recommendations for specific assessment tools. Stabilization skills for helping children address the phobic response to reprocessing traumatic events with mastery and resourcing while learning self-soothing and calming techniques will be demonstrated. Innovative and creative interventions integrating play and art therapy will be presented with child friendly language using the protocol sequence for effective treatment with children. In addition, adjustments to the EMDR protocol through the trauma processing phases, including integration, will be described and demonstrated with case presentations and videos. Creatively maneuvering these phases with children who display dissociative symptoms will be explored with recommendations for the successful implementation of the protocol throughout the healing process
Keywords: Case Conceptualization Children Dissociation Stabilization Trauma
Accuracy Verified: Yes
175. Twombly, J. H. (2005). EMDR for clients with dissociative identity disorder, DDNOS, and ego states. In R. Shapiro (Ed.), EMDR solutions: Pathways to healing (pp. 88-120). New York: W W Norton & Co.
Language: English
Format: Book Section
Abstract: U
sing EMDR with clients with dissociative identity disorder (DID) and other dissociative disorders (DDs) requires careful adaptation to allow the unique benefits of EMDR to be used productively, without risking unleashing a flood of traumatic material and destabilizing the client. In this chapter I will discuss adaptations for each stage of treatment for dissociative clients. While I'll focus on work with DID (formerly multiple personality disorder) and dissociative disorder not otherwise specified (DDNOS), the EMDR adaptations and protocols taught in this chapter can be used with people with other DDs and complex PTSD, and in ego-state work. This chapter is divided into three sections, summarizing the treatment of DDs within the three stages of standard phase-oriented trauma treatment. [Text, pp. 88, 90]
Keywords: Adults Child Abuse DID Dissociative Identity Disorder Hypnotherapy Psychotherapeutic Processes Survivors
Accuracy Verified: Yes
176. Tripolt, R. (2010, Oktober). EMDR in bewegung [EMDR in motion]. EMDRIA Deutschland e.V. Rundbrief, 21, 16-23.
Language: German
Format: Newsletter
Abstract:
Im Folgenden geht es um die Möglichkeit der Erweiterung des EMDR Protokolls um die
Dimension der Bewegung: Die Ebene der Kognitionen (PK/NK, VoC), der Emotion (SUD) und
der Körperwahrnehmung (Körpertest) wird um die Reflexionsebene der Bewegung und der
Bewegungswahrnehmung ergänzt. Dieses kann die Wirkweise von EMDR verstärken und bei
dissoziativen TraumapatientInnen die unmittelbare Anwendung von EMDR oft erst
ermöglichen. Dazu wird der Einsatz von Elementen aus 5 Rhythmen Bewegungstherapie, Tanz
und körperorientierten therapeutischen Techniken vorgestellt und anhand eines Fallbeispieles
illustriert.
I now turn to the possibility of extending the EMDR protocol to the Dimension of the movemen: the level of cognition (PC/NC,VoC ), emotion (SUD )and of body awareness (body test) is the reflection plane of movement and Motion perception complements. This may enhance the mode of action of EMDR and dissociative trauma patients, the direct application of EMDR often only allow. For this purpose, the use of elements from 5 Rhythms movement therapy, dance and body-oriented therapeutic techniques and presented a case study
illustrated.
Accuracy Verified: Yes
177. Wieland, S. (2012, June). EMDR in children with dissociative disorders [EMDR en niños con trastornos disociativos]. Pre-Conference presentation at the annual meeting of the EMDR Europe Association, Madrid, Spain.
Language: English
Format: Conference
Abstract:
The effect of early interpersonal trauma on adult clients has been extensively studied and reported. Less attention has been
given to the effects of complex trauma on children. Because childhood is the time of most rapid brain development as well as the time when
children are dependent on adult caregivers, early physical, sexual, and emotional abuse, including neglect and witnessing domestic violence,
has severe effects on infants and children – disorganized attachment, affect and behavioral dysregulation, and dissociation. In this preconference
Sandra Wieland will describe how early trauma and neglect affects the infant/child’s brain, autonomic nervous system, and body
system. She will explain how dissociation is often used by children to protect themselves from the impact – both emotional and physical – of
complex trauma. Given this high level of fragmentation and fright, children are often not able to participate successfully in the standardized
EMDR protocol. Dr. Wieland will teach ways in which the EMDR protocol can be adapted in order to access more completely the child’s
fragmented internal system. She will use clinical vignettes to describe ways EMDR can assist in each of the three stages of trauma treatment
– safety/stabilization, trauma processing, and integration. Maria Elena Aduriz will describe a case of a girl whose traumatization is the direct
consequence of a disorganized attachment to a schizophrenic, unstable and suicidal mother. Through this case she will focus on the importance
of learning how to articulate EMDR interventions with the child and her adoptive parents.
Los efectos del trauma interpersonal temprano han sido extensamente estudiados y documentados. Sin embargo, se ha prestado
menos atención a los efectos del trauma complejo en niños. Debido a la etapa del desarrollo en la que se encuentran y a la dependencia
respecto de los adultos, los niños son especialmente vulnerables a la exposición a eventos traumáticos en el seno de los cuidados familiares
tales como maltrato físico, emocional y abuso sexual. Las consecuencias postraumáticas incluyen, entre otras, apego desorganizado,
desregulación afectiva y conductual, y disociación. En esta preconferencia Sandra Wieland comenzará por describir de qué forma el trauma
temprano y la negligencia afectan el desarrollo del cerebro, del sistema nervioso autónomo y del sistema corporal del niño. Explicará de qué
manera la disociación suele ser utilizada por el niño como protección contra el impacto –tanto emocional como físico- del trauma complejo.
Debido al miedo y al alto nivel de fragmentación que presentan estos niños el protocolo EMDR estándar no puede ser utilizado de manera
eficaz. La Dra. Wieland enseñará cómo el protocolo EMDR puede ser adaptado para poder acceder de manera más completa al mundo
interno fragmentado del niño. Describirá con viñetas clínicas de qué forma EMDR puede
Keywords: Developmental Trauma Disorder
Accuracy Verified: Yes
178. Gonzalez, A., Seijo, N., & Mosquera, D. (2009, August). EMDR in complex trauma and dissociative disorders. Presentation at the annual meeting of the EMDR International Association, Atlanta, GA.
Language: English
Format: Conference
Abstract:
EMDR can be safely used during the stabilization phase in a group of severely traumatized patients, not only to install positive elements, but to process dysfunctional elements (not necessarily traumatic memories, but patient-therapist relationship problems, defenses, symptoms, dissociative phobias, etc.). To postpone standard protocol until the patient has been prepared to do it in the standard way implies that the patient must resolve many of their problems without the help of EMDR processing. We will try to “think in EMDR” about severe dissociation, rather than directly apply foreign theories to EMDR work. Protocol modifications include progression, fractionation, synthesis and direction.
Keywords: Complex Trauma Dissociative Disorders
Accuracy Verified: Yes
179. Sack, M., Lempa, W., & Lamprecht, F. (2003). EMDR in der behandlung dissoziativer störungen [EMDR in the treatment of dissociative disorders]. Zeitschrift für Psychotraumatologie und Psychologische Medizin, 1 (3), 25-33.
Language: German
Format: Journal
Abstract: Keywords: Dissociative Disorders, Psychotherapeutic Processes Accuracy Verified: Yes 180. Egli-Bernd, H. (2012, Juni). EMDR in der behandlung von dissoziativen prozessen bei bindungsstörungen.
Die bedeutung und schwierigkeiten bei der wahl guter kognitionen in diesen Behandlungen.
Das dialog protokoll [EMDR in the treatment of dissociative processes in attachment disorders.
The importance and difficulty of choosing good cognition in these treatments. Dialog protocol]
. Präsentation auf EMDRIA Tag, Köln, Deutschland. Language: German Format: Conference Abstract: Keywords: Attachment Disorders Cognitions Dissociation Accuracy Verified: Yes 181. Hofmann, A. & Sack, M. (2006). EMDR in der behandlung von patienten mit chronish komplexer PTBS und schweren dissoziativen storungen [EMDR in the treatment of patients with complex PTSD and severe dissociative disorders]. In: F. Lamprecht (Hrsg.), Praxisbuch EMDR: modifizierungen für spezielle anwendungsgebiete [EMDR practice book: modifications for special areas of application] (pp. 172-194). Stuttgart: Klett-Cotta. Language: German Format: Book Section Keywords: Complex Posttraumatic Stress Disorder Complex PTSD C-PTSD Dissociative Disorders Accuracy Verified: Yes 182. Hofmann, A. (2008, September ). EMDR in der behandlung von schweren dissoziativen storungen [EMDR in the treatment of severe dissociative disorders]. Präsentation auf Precongress Workshops Vorkkongress EMDR beim Europaischen Hypnoeskongress, Wien. Language: German Format: Conference Keywords: Dissociative Disorders Accuracy Verified: Yes 183. 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: Keywords: Personality Disorders Accuracy Verified: Yes 184. Young, W. C., Rouanzoin, C., & Puk, G. (1994, March). EMDR in dissociative disorders. Presentation at the EMDR Network Conference, Sunnyvale, CA. Language: English Format: Conference Keywords: Dissociative Disorders Accuracy Verified: Yes 185. Gonzalez, A., Mosquera, D., & Seijo, N. (2011, November). EMDR in dissociative disorders: The progressive
approach. Presentation at the 26th Annual International Society for the Study of Trauma and Dissociation Conference, Montreal, QE . Language: English Format: Conference Abstract: Abstract:
After the first cautions for the use of EMDR in dissociative disorders, many proposals have been done to adapt EMDR procedures to this specific population. Interesting interventions have been done for the use of EMDR in the preparation phase, but in spite of these useful proposals, EMDR is still considered by many clinicians as an intervention that is limited for the treatment of traumatic memories. From this conceptualization, which we have called the all/nothing perspective, the use of EMDR is strongly limited. Many clinicians wait years for trauma reprocessing. As a consequence of this conceptualization, many EMDR therapists do not use EMDR with most of their dissociative clients, and just use it with highly functioning patients, sometimes after years of therapy with other approaches.
In this workshop we will describe (and exemplify with clinical cases and videos) different interventions with EMDR in dissociative clients, from the preparatory phase, in what we have called a Progressive Approach. The way in which specific EMDR procedures can contribute to enhance recovery in survivors will be explained. For doing this, concepts from the different approaches and scientific knowledge about severe traumatization will be integrated with the Adaptive Information Processing Model from EMDR. The idea is to propose a holistic model for EMDR therapy in Dissociative Disorders.
The interweaving between theoretical concepts and clinical procedures, theoretical developments and video examples, will allow the audience to assimilate information and translate it to their clinical practice. Therapist from approaches different from EMDR will understand what this therapy can offer to the treatment of severely traumatized people. EMDR therapists will learn new proposals of interventions at the different phases of the treatment. We will present different examples of interventions in severely traumatized patients: DID, DESNOS, BPD and Somatoform dissociation. Keywords: Dissociative Disorders Accuracy Verified: Yes 186. Gonzalez, A. (2013, June). EMDR in dissociative disorders: The progressive approach. Presentation at the annual meeting of the EMDR Europe Association, Geneva, Switzerland. Language: English Format: Conference Abstract: Keywords: Dissociative Disorders Progressive Approach Accuracy Verified: Yes 187. Egli-Bernd, H. (2011). EMDR in dissociative processes within the framework of personality disorders: The impact of cognitions in the EMDR Process: The “dialogue protocol“. Journal of EMDR Practice and Research, 5(3), 131-139. doi:10.1891/1933-3196.5.3.131. Language: English Format: Journal Abstract: Keywords: Attachment Childhood Abuse Dimension of Cognitions Dissociation Processing Accuracy Verified: Yes 188. Gonzalez, A., Mosquera, D., & Moskowitz, A. (2012, June). EMDR in psychosis and severe mental disorders [EMDR
en
psicosis
y
trastorno
mental
severo]. Presentation at the annual meeting of EMDR Europe Association, Madrid, Spain. Language: English Format: Conference Abstract: Keywords: Psychosis Severe Mental Disorders Accuracy Verified: Yes 189. Hamilton, C. (1999, June). EMDR in the treatment of dissociative disorders. Presentation at the annual meeting of the EMDR International Association, Las Vegas, NV. Language: English Format: Conference Abstract: Keywords: Dissociative Disorders Accuracy Verified: Yes 190. 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: Keywords: Dissociative Disorders Accuracy Verified: Yes 191. Groenendijk, M. (2010, April). EMDR in trauma-work with a patient with DID. Presentation at the 2nd Bi-Annual International European Society for Trauma and Dissociation Conference, Belfast, Northern Ireland. Language: English Format: Conference Abstract: EMDR is a powerfull technique for helping people overcoming their trauma’s. However, most of the clinical practice as well as the research has been focussed on type 1 trauma and simple PTSD. Gradually the field is expanding to complex early and chronic traumatization and dissociative problems. In this workshop I will share our experiences in this challenging field. I will start with a short introduction to EMDR, to structural dissociation and to the treatment of DID. Then I will present the case of an older woman with DID, who was treated in our residential psychotherapeutic setting. Central in this workshop is the very interesting (and moving) video-demonstration of EMDR with this DID-patient during a period of trauma-work. After reporting on the process and outcome of this therapy, the conclusion will be that EMDR can be effective for dissociative patients suffering from early and severe traumatization 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 EMDR-sessions, about adaptation of the EMDR-protocol and about integration of EMDR in the broader phase-oriented state-of-the-art treatment of DID. At the end there will be time for questions and discussion. Keywords: DID Dissociative Identity Disorder Accuracy Verified: Yes 192. Paulsen, S. L. (2004, September). EMDR master series - II: Ego state therapy and EMDR: Activating, modifying and containing dissociated neural networks. Invited master series lecture at the annual meeting the EMDR International Association, Montreal, Quebec Canada. Language: English Format: Conference Abstract: Keywords: Ego State Therapy Master Series Accuracy Verified: Yes 193. Rouanzoin, C. (2006, September). EMDR Master Series – II. Presentation at the annual meeting of the EMDR International Association, Philadelphia, PA. Language: English Format: Conference Abstract: Keywords: Accelerated Information Processing Model AIP DID Dissociation Accuracy Verified: Yes 194. Purandare, M., Bhagwagar, H., & Tank, P. (2010, July). EMDR on children affected by the earthquake. Presentation at the 1st EMDR Asia Conference, Bali, Indonesia. Language: English Format: Conference Abstract: Keywords: Children Earthquake Accuracy Verified: Yes 195. Lanius, U. F. (2005). EMDR processing with dissociative clients: Adjunctive use of opioid antagonists. In R. Shapiro (Ed.), EMDR solutions: Pathways to healing (pp. 121-146). New York: W W Norton & Co. Language: English Format: Book Section Abstract: Keywords: Analgesic Drugs Dissociative Symptoms Posttraumatic Stress Disorder PTSD Stressors Survivors Accuracy Verified: Yes 196. Beere, D. (2009). An EMDR protocol for dissociative identity disorder. In M. Luber (Ed.), Eye movement desensitization (EMDR) scripted protocols: Special populations (pp. 387-425). New York: Springer Publishing Co. Language: English Format: Book Section Keywords: Dissociative Identity Disorder DID Protocol Accuracy Verified: Yes 197. Guedalia, J., & Yoeli, F. (2006, August). EMDR protocols for ER and wards. Electronic Journal, EMDR-Israel. Language: English Format: Journal Abstract: When the patient is showing dissociative responses to the trauma, hysterical paralysis, fugue-like state, we don’t attempt EMDR. As the Patients are usually in the ER for many many hours (5-8) opportunities present themselves to assess the patients ability to communicate by various means. The EMDR-ER© Protocol is used with patients who do not seem able to move on to the ambulatory staging area (are still on gurney’s) and display difficulty in being able to re-assume normal- appropriate with the situation- physical and psychological, behavioral function Also EMDR is not used in the ER with patients who seem to have below borderline intelligence. I have used EMDR in the ER with patients whose language I didn’t know (Amharic for example), with an interpreter present with good results. Keywords: ER Recent Events Wards Accuracy Verified: Yes 198. Ross, C. (2012). EMDR se basa en un modelo trauma-disociacion de trastornos mentales [EMDR is based on a trauma-dissociation model of mental disorders]. Revista Iberoamericana de Psicotraumatología y Disociación, 3(Edicion Especial Sobre Disociacion). Language: Spanish Format: Other Abstract: Keywords: Trauma-Dissociation Model Accuracy Verified: Yes 199. Shapiro, R. (2005). EMDR solutions: Pathways to healing. New York: W W Norton & Co. Language: English Format: Book Abstract: Keywords: Anxiety Disorders Psychotherapeutic Processes Stressors Survivors Accuracy Verified: Yes 200. Gomez, A. (2012, May). EMDR therapy and adjunct approaches with children: Complex trauma, attachment, and dissociation. New York, NY: Springer Publishing. Language: English Format: Book Abstract: Keywords: Adjunct Approaches Attachment Children Dissociation Trauma Accuracy Verified: Yes 201. Matthes, H., & Hofmann, A.
(2012, June). EMDR therapy in different psychiatric diagnosis: A review of the scientific evidence [Terapia con EMDR en varias enfermedades psiquiátricas: Una revisión de la
evidencia científica]. Preconference presentation at the annual meeting of the EMDR Europe Association, Madrid, Spain. Language: English Format: Conference Abstract: Keywords: Research Accuracy Verified: Yes 202. Murray, K. (2008, September). EMDR to reduce fears of recurrence of breast cancer - Including phantom breast pain. Presentation at the annual meeting of the EMDR International Assocation, Phoenix, AZ. Language: English Format: Conference Abstract: Keywords: Breast Cancer Phantom Breast Pain Phantom Pain Accuracy Verified: Yes 203. Knipe, J. (2008, June). EMDR toolbox. Presentation at the annual meeting of the EMDR Europe Association, London, England
. Language: English Format: Conference Abstract: Keywords: Back-of-the-Head Scale BHS CIPOS Contant Installation of Present Orientation and Safety Psycholgical Defenses Targeting Accuracy Verified: Yes 204. Knipe, J. (2012, June). EMDR toolbox [La
Caja
de
herramientas
en
EMDR]. Presentation at the annual meeting of EMDR Europe Association, Madrid, Spain. Language: English Format: Conference Abstract: Keywords: EMDR Toolbox Accuracy Verified: Yes 205. Knipe, J. (2012, October). EMDR toolbox: Methods of extending EMDR to traumatized clients with significant vulnerability to dissociative abreaction and/or psychological defenses. Presentation at the 29th annual meeting of the International Society for the Study of Trauma and Dissociation, Long Beach, CA. Language: English Format: Conference Abstract: Keywords: Dissociative Abreaction Psychological Defenses Toolbox Accuracy Verified: Yes 206. Knipe, J. (2010, July). EMDR toolbox: Specific methods of treating adult clients with complex PTSD, psychological defenses and dissociative personality structure. Preconference presentation at the 1st EMDR Asia Conference, Bali, Indonesia. Language: English Format: Conference Abstract: Keywords: Complex Posttraumatic Stress Disorder Complex PTSD, C-PSTD Dissociative Personality Structure Psychological Defenses Toolbox Accuracy Verified: Yes 207. Knipe, J. (2006, June). EMDR toolbox: Video examples of methods of targeting avoidance, procrastination, affect dysregulation, the pain of being "dumped" by a lover, and a shame-based ego state in a client with a identity disorder. Presentation at the annual meeting of the EMDR Europe Association, Istanbul, Turkey. Language: English Format: Conference Abstract: Keywords: Back-of-the-Head Scale BHS CIPOS Contant Installation of Present Orientation and Safety Psycholgical Defenses Targeting Accuracy Verified: Yes 208. Ahmad, A., Larsson, B., & Sundelin-Wahlsten, V. (2007). EMDR treatment for children with PTSD: Results of a randomized controlled trial. Nordic Journal of Psychiatry, 61(5), 349-354. doi:10.1080/08039480701643464. Language: English Format: Journal Abstract: Keywords: Children Empirical Study Posttraumatic Stress Disorder PTSD Quantitative Study Random Control Trial RCT Trauma Treatment Outcome/Clinical Trial Accuracy Verified: Yes 209. Korn, D. (2010, April). EMDR treatment in adults with a history of incest and neglect. Developmental deficits and restore the damaged self. Presentation at the 4th EMDR Association Netherlands Conference, Nijmegen, The Nederlands. Language: English Format: Conference Abstract: Keywords: Adults Developmental Deficits Incest Accuracy Verified: Yes 210. Walker, N. (2005, April). EMDR treatment of complex PTSD and dissociative disorders considered in the light of the theory of structural dissociation of personality. Presentation at 3rd Annual Conference of the EMDR Association of UK and Ireland, Jordanstown, Northern Ireland . Language: English Format: Conference Keywords: Complex Posttraumatic Stress Disorder Complex PTSD C-PTSD Dissociative Disorders Structural Dissociation Theory of Personality Accuracy Verified: Yes 211. Young, W. (1994, June). EMDR treatment of phobic symptoms in multiple personality disorder. Dissociation, 7(2), 129-133. Language: English Format: Journal Abstract: Keywords: Adults Child Abuse DID Dissociative Identity Disorder Empirical Study Females Follow-up Study Incest Phobia Rape Survivors Accuracy Verified: Yes 212. Korn, D. L. (2008, May). EMDR treatment with survivors of chronic abuse and neglect: Repairing developmental deficits and
shattered selves - [Utilisation d’EMDR dans le traitement des survivants d’abus ou négligence chroniques: Réparer les déficits développementaux et les sois éclatés]. Presentation at an annual meeting of EMDR Canada, Montréal, Quebec Canada. Language: English Format: Conference Abstract: Keywords: Complex PTSD Dissociative Disorders Accuracy Verified: Yes 213. Kennert, G. (2008). EMDR und biofeedback in der behandlung von posttraumatischen belastungsstörungen [EMDR and biofeedback in the treatment of post traumatic stress disorder]. Forum Psychotherapeutische Praxis, 8(1), 45-46. doi:10.1026/1860-7357.8.1.45b. Language: German Format: Journal Abstract: rezensiert von Gabriele Kennert, In dem von Stefan Jacobs und Anna de Jong vorgestellten
Behandlungskonzept werden die kognitive Verhaltenstherapie, das EMDR-Verfahren sowie Biofeedback miteinander kombiniert, um die Angstreaktion im Rahmen traumatisierender Erinnerungen zu verringern
bzw. zu hemmen und somit auch die Symptomatik der
posttraumatischen Belastungsstörung abzubauen.
Im ersten Teil des Buches gehen die Autoren eingehend auf den theoretischen Hintergrund (Neurophysiologie, Hirnfunktionen) ein, die mit der neuronalen Bahnung von traumatisierenden Erinnerungen einhergehen. Hierbei vertreten sie die These, dass sich die neuronalen
Bahnungen der Traumata nicht löschen lassen, dass sozusagen die Angstreaktion in der Amygdalaregion im Gehirn löschungsresistent ist und es somit in der Konsequenz im Therapieziel nur um die Verringerung der Angstreaktion, bzw. Hemmung der Angstreaktion gehen könne. Konkret modifizieren die Autoren innerhalb des kognitiv,
verhaltenstherapeutischen Vorgehens das Modell
von Ehlers und Clark, ebenso das EMDR-Verfahren von
Shapiro. Das Biofeedbackverfahren nutzen die Autoren
als diagnostisches Instrument, um die subjektiven Bewertungen seitens der Patienten und Patientinnen auch objektiv überprüfbar zu machen mit Hilfe der Messung der elektrodermalen Aktivität (EDA). Im zweiten Teil des Buches beschreiben sie detailliert eine wissenschaftliche Studie an 16 Patienten und Patientinnen, die an dem Behandlungsprogramm an der Universität Göttingen teilgenommen haben. Hierbei sei bei allen Patienten und Patientinnen eine signifikante positive Symptomveränderung der PTB nachzuweisen gewesen. Im weiteren Teil des Buches stellen sie ihr ausführliches
Therapiekonzept und Behandlungsprotokoll vor.
Es wird eingehend auf die Diagnostik (psychologische
Testverfahren sowie Biofeedback eingegangen, ein wichtiger
Teil ist die Informationsvermittlung sowie Stabilisierung für die Patienten und Patientinnen. Danach erfolgt
die Traumabehandlung mit Konfrontation und Integration. Wert wird hierbei in Abgrenzung zu Shapiro auf die frühzeitige Verbindung zur positiven Kognition gelegt in Verbindung mit Hausaufgaben, die die Patienten
zwischen den Sitzungen bekommen mit eingehenden
Verhaltensübungen. Die Autoren grenzen ein, dass ihre Methode nicht für alle Patienten und Patie tinnen geeignet ist, sondern dissoziative
Störungen und Persönlichkeitsstörungen sowie Suchtproblematik explizit ausgeschlossen seien.
Die Stabilisierungsübungen werden praktisch beschrieben (Sicherer Ort, Tresor), ebenso die praktische Anwendung des Biofeedbackverfahrens sowie das Behandlungsprotokoll
für EMDR. Gegen Ende des Bandes schließen sich Fallstudien
aus der Arbeit der Autoren an, um die Praxis zu verdeutlichen.
Im Anhang gibt es Adressenverzeichnisse über den
Bezug von Tests, Biofeedbackgeräten oder Lehrfilmen.
Zusammenfassend kann man sagen, dass der Band
kurzgefasst, sehr übersichtlich und konkret sowie praxisnah das neuropsychotherapeutische Behandlungsprogramm darstellt, so dass dies hilfreich für die psychotherapeutische
Praxis in Bezug auf Traumabehandlungen erscheint.
Das Buch richtet sich an Fachleute und ist für
Laien eher weniger geeignet. Keywords: Biofeedback Posttraumatic Stress Disorder PTSD Treatment Accuracy Verified: Yes 214. Jacobs, S., Schmidt, S., Ludecke, C., & Strack, M. (2009). EMDR und biofeedback in der behandlung von substituierten traumapatienten [EMDR and biofeedback in the treatment of substituted traumatic patients]. EMDR und biofeedback in der behandlung von substituierten traumapatienten, In S. Jacobs, (Hrsg.), Neurowissenschaften und Traumatherapie. Grundlagen und Behandlungskonzepte, [Neurosciences and Trauma Therapy, Bases and treatment approaches] (pp. 107-134). Göttingen: Universitätsverlag. Language: German Format: Book Section Abstract: Prevalence of Posttraumatic Stress Disorder is alarmingly high among substanceabusing
inpatients. Although many studies have shown this problem, treatment
offered for combined trauma and substance abuse-therapy can hardly be found.
Many patients are told to initially treat their substance abuse before treating the PTSD. This study deals with the trauma-treating method EMDR and biofeedback
with substituted inpatients. 15 of these inpatients recieved questionnaires at three different point in time during their therapy, in addition nine of them during a 3-month-follow-up. Furthermore biofeedback-conductance was held within the EMDR-sets to represent the decline of the psycological affrivation, measured wit
electrodermal activity
h electrodermal activity. These data were compared to not-consuming outpatients,
who received the same treatment. Overall there were positive changes in
ratings regarding the traumaspecific variables, general psychic strain, depressivity,
somatic discomfort and dissociative symptoms. An increased satisfaction in different
areas of life could also be observed. Data associated with electrodermal activities showed only marginal differences compared to the reference data. Keywords: Biofeedback Accuracy Verified: Yes 215. Dellucci, H. (2011, February /March). EMDR using gearbox technique and letters. Presentation at the EMDR Association of India – Mumbai Chapter, Delhi, India . Language: English Format: Conference Abstract: Keywords: Gearbox Accuracy Verified: Yes 216. van Haaften, H., Muris, P., & Mayer, B. (1996, July-August). EMDR versus exposure-in-vivo bij kinderen met een spinfobie [EMDR versus exposure in vivo in children with a spider phobia]. De Psycholoog, 7, 280-285. Language: Dutch Format: Magazine Abstract: Keywords: Children Empirical Study Exposure In Vivo Spider Phobia Accuracy Verified: Yes 217. Paulsen, S. (2010, October). EMDR with dissociative clients: 17 secrets. Presentation at the 27th Annual meeting of the International Society for the Study of Trauma and Dissociation, Atlanta, GA. Language: English Format: Conference Abstract: Keywords: Dissociation Accuracy Verified: Yes 218. Bisping, V. (2011, June). EMDR with patients with dentophobia. Presentation at the annual meeting of the EMDR Europe Association, Vienna, Austria. Language: English Format: Conference Abstract: Keywords: Dentophobia Accuracy Verified: Yes 219. Mosquera, D. (2012, March). EMDR with trauma and narcissism [EMDR met trauma en narcisme]. Keynote resentatie op de 6e congres van de Vereniging EMDR Nederland, Arnghem, The Nederlands. Language: English Format: Conference Abstract: Keywords: Narcissim Accuracy Verified: Yes 220. Friberg, M. (2004, June). EMDR with two adolescents suffering from dissociative symptoms after sexual abuse: both with considerable weight-loss during treatment. In children and EMDR (R. Oras, Chair). Symposium conducted at the EMDR Europe Association annual meeting, Stockholm, Sweden . Language: English Format: Conference Abstract: Keywords: Children Dissociation Sexual Abuse Symposium Accuracy Verified: Yes 221. Johannesson, K. B. (2001, April). EMDR – psychotherapy in posttraumatic stress syndrome in young people. Swedish Council on Health Technology Assessment in Health Care (SBU), Stockholm, Sweden. Language: English Format: Other Abstract: Keywords: Posttraumatic Stress Disoder PTSD Young People Accuracy Verified: Yes 222. Bertino, G., & Ostacoli, L. (2011, June). EMDR-drawing integration in the treatment of complex PTSD and severe organic diseases. Presentation at the annual meeting of the EMDR Europe Association, Vienna, Austria. Language: English Format: Conference Abstract: Keywords: Drawing Integration Organic Disease Complex Posttraumatic Stress Disorder Complex-PTSD C-PTSD Accuracy Verified: Yes 223. Fine, C. G. (1996, June). EMDR-facilitated trauma work in patients with dissociative identity disorders. Presentation at the annual meeting of the EMDR International Association, Denver, CO. Language: English Format: Conference Keywords: DID Dissociative Identity Disorder Accuracy Verified: Yes 224. Forgash, C. A. (2002, June). EMDR/ego state work in trauma response situations: Working with survivors of the WTC 9/11 tragedy. Presentation at the annual meeting of the EMDR International Association, San Diego, CA. Language: English Format: Conference Abstract: Keywords: 9/11 Disaster Ego State Therapy September 11th Survivors World Trade Center WTC Accuracy Verified: Yes 225. Paulsen, S. L. (1993, October). EMDR: An introduction and conceptualization within BASK theory of dissociation. Presentation at the 10th annual meeting of the International Society for the Study of Dissociation, Chicago, IL. Language: English Format: Conference Abstract: Keywords: Bask Theory Dissociation Dissociative States MPD Multiple Personality Disorder Accuracy Verified: Yes 226. Paulsen, S. L. (1993). EMDR: Its use in the dissociative disorders. Presentation at the 10th annual meeting of the ISSMPD, Chicago, IL. Language: English Format: Conference Keywords: Dissociative Disorders Accuracy Verified: Yes 227. Shapiro, F., & Forrest, M. S.. (2005). EMDR: Vernieuwende therapie tegen angst, stress en trauma [EMDR: The breakthrough therapy for overcoming anxiety, stress and trauma]. Antwerpen; Apeldoorn: Garant. 287 pp.. Language: Dutch Format: Book Abstract: Accuracy Verified: Yes 228. Rouanzoin, C. C. (1994, March). EMDR: Dissociative disorders and MPD. Presentation at the 14th annual meeting of the Anxiety Disorders Association of America, Santa Monica, CA. Language: English Format: Conference Keywords: Dissociative Disorders MPD Multiple Personality Disorder Accuracy Verified: Yes 229. Hofmann, A., Fischer, G., Galley, N., & Shapiro, F. (1998). EMDR: Memory reprocessing and accelerated emotional learning. European Journal of Clinical Hypnosis, 4, 206-213. Language: English Format: Journal Abstract: Keywords: Accelerated Emotional Learning Therapeutic Integation Accuracy Verified: Yes 230. Quinn, G. (2006, August). Emergency room (ER) protocol. In Judi Guedalia & Francis Yoeli, EMDR Protocol for ER and Wards, Shaare Zedek Medical Center, Jerusalem, Israel. Language: English Format: Book Section Abstract: Keywords: Emergency Room Protocol Accuracy Verified: Yes 231. Pitman, R., Orr, S., Altman, B., Longpre, R., Poire, R., Macklin, M., Michaels, M. J., & Steketee, G. S. (1996, November-December). Emotional processing and outcome of imaginal flooding therapy in Vietnam veterans with chronic posttraumatic stress disorder. Comprehensive Psychiatry, 37(6), 409-418. doi:10.1016/S0010-440X(96)90025-5. Language: English Format: Journal Abstract: Keywords: Emotional Processing Flooding Therapy Posttraumatic Stress Disorder PTSD Vietnam Veterans Accuracy Verified: Yes 232. Grainger, R., Levin, C., Allen-Byrd, L., Doctor, R., & Lee, H. (1997, October). An empirical evaluation of eye movement desensitization and reprocessing (EMDR) with survivors of a natural disaster. Journal of Traumatic Stress, 10(4), 665-671. doi:10.1023/A:1024806105473. Language: English Format: Journal Abstract: Keywords: Adults Americans Disaster Effects Empirical Study Hurricane Andrew (1992) Hurricanes Longitudinal Study Non-Randomized Study Survivors Treatment Effectiveness Trauma Accuracy Verified: Yes 233. Ogden, P. (2004, September). Empowering the body: Somatic awareness and physical action in the treatment of trauma and dissociation. Presentation at the annual meeting of the EMDR International Assocation, Montreal, Quebec Canada. Language: English Format: Conference Abstract: Keywords: Dissociation Somatism Trauma Accuracy Verified: Yes 234. Peterson, G. (2003, September). Energy healing methods to supplement EMDR in the treatment of DID. Presentation at the annual meeting of the EMDR International Association, Denver, CO. Language: English Format: Conference Abstract: Keywords: Dissociative Disorders Energy Psychology Energy Therapies Accuracy Verified: Yes 235. Corrigan, F. M., & Jennett, J. (2004, August). Ephedra alkaloids and brief relapse in EMDR-treated obsessive compulsive disorder. Acta Psychiatrica Scandinavica, 110(2), 158. doi:10.1111/j.1600-0047.2004.00368.x. Language: English Format: Journal Abstract: Keywords: Comment Desensitization Ephedra Letter Luvoxamine Obsessive Compulsive Disorder OCD Plant Preparations Relapse Reply Review Serotonin Uptake Inhibitors Accuracy Verified: Yes 236. Gabarra, D. O. (2012, Novembro). Estados de ego e o EMDR em quadros dissociativos [Ego states and EMDR in dissociative frames]. Apresentação no II Congresso Brasileiro de EMDR, Brasília, Brasil. Language: Portuguese Format: Conference Abstract: Keywords: Advanced Management Dissociation Ego States Accuracy Verified: Yes 237. Dziegielewski, S., & Wolfe, P. (2000, September). Eye movement desensitization and reprocessing (EMDR) as a time-limited treatment intervention for body image disturbance and self-esteem: A single subject case study design. Journal of Psychotherapy in Independent Practice, 1(3), 1-16. doi:10.1300/J288v01n03_01 . Language: English Format: Journal Abstract: Keywords: Anorexia Body Image Disturbances Bulimia Clinical Case Study Eating Disorders Empirical Study Females Self-Esteem Single Subject Design Accuracy Verified: Yes 238. Renssen, M. R., & Winkel, F. W. (1999). Eye movement desensitization and reprocessing (EMDR) bij verkeersslachtoffers met chronische whiplash-klachten: Een exploratieve studie naar het verzachten va traumasymptomen [Eye movement desensitization and reprocessing (EMDR) in road casualties with chronic whiplash injuries: An exploratory study to alleviate symptoms of trauma]. Directieve Therapie, 19(4), 148-156. doi:10.1007/BF03060223. Language: Dutch Format: Journal Abstract: Keywords: Motor Vehicle Accidents Road Casualties Whiplash Accuracy Verified: Yes 239. Fine, C. G. (1994, June). Eye movement desensitization and reprocessing (EMDR) for dissociative disorders. Presentation at the Eastern Regional Conference on Abuse and Multiple Personality. Alexandria, VA. Language: English Format: Conference Keywords: Dissociative Disorders Paper Accuracy Verified: Yes 240. Balk, J. L. (2001, Nov 1). Eye movement desensitization and reprocessing (EMDR) for post-traumatic stress disorder. Alternative Medicine Alert, 4, 121-124. Language: English Format: Newsletter Abstract: Keywords: Posttraumatic Stress Disorder PTSD Accuracy Verified: Yes 241. Luber, M. (2012). Eye movement desensitization and reprocessing (EMDR) scripted protocols with summary sheets CD-ROM version: Basic and special situations. New York, NY: Springer Publishing, ISBN-13:9780826193414. Language: English Format: Book Abstract: Keywords: Scripted Protocols Special Populations Summary Sheets Accuracy Verified: Yes 242. Luber, M. (2009). Eye movement desensitization and reprocessing (EMDR) scripted protocols: Basics and special situations, (Ed.). New York, NY: Springer Publishing Co. Language: English Format: Book Abstract: Keywords: Scripted Protocols Accuracy Verified: Yes 243. Luber, M. (2009). Eye movement desensitization and reprocessing (EMDR) scripted protocols: Special populations. New York, NY: Springer Publishing Co. Language: English Format: Book Abstract: Keywords: Scripted Protocols Accuracy Verified: Yes 244. Aetna, Inc. (2005, June 28). Eye movement desensitization and reprocessing (EMDR) therapy, No. 0583 (Rev). Aetna Clinical Policy Bulletins. Language: English Format: Publication Abstract: Keywords: Practice Guidelines Accuracy Verified: Yes 245. D’Andrea, L. M., D’Andrea, L., & Detweiler, J. (2003, Spring). Eye movement desensitization and reprocessing (EMDR): A closer look at treatment outcome. Trauma and Loss: Research and Interventions, 3(1), 9-19. Language: English Format: Journal Abstract: Keywords: Adults Americans Females Stressors Survivors Treatment Effectiveness Accuracy Verified: Yes 246. Kim, D., & Choi, J. (2004, November). Eye movement desensitization and reprocessing for disorder of extreme stress: A case report. Journal of the Korean Neuropsychiatric Association, 43(6), 760-763. Language: Korean Format: Journal Abstract: Keywords: Posttraumatic Stress Disorder PTSD Accuracy Verified: Yes 247. Kelley, S. D. M., & Benbadis, S. (2007, March-April). Eye movement desensitization and reprocessing in the psychological treatment of trauma-based psychogenic non-epileptic seizures. Clinical Psychology & Psychotherapy, 14(2), 135-144. doi:10.1002/cpp.525. Language: English Format: Journal Abstract: Keywords: Clinical Case Study Comorbidity Emotional Trauma Empirical Study Epileptic Seizures Posttraumatic Stress Disorder Psychogeninic Non-epileptic Seizures Psychological Treatment Psychogenesis PTSD Qualitative Study Trauma Accuracy Verified: Yes 248. Puk, G. (1994, July). Eye movement desensitization and reprocessing in the treatment of multiple personality disorder. Presentation at the 10th annual conference of the Society for the Exploration of Psychotherapy Integration, Buenos Aires, Argentina. Language: English Format: Conference Keywords: DID Dissociative Identity Disorder MPD Multiple Personality Disorders Accuracy Verified: Yes 249. Shepherd. J., & Stein, K. (1998). Eye movement desensitization and reprocessing in the treatment of post traumatic stress disorder. Development and Evaluation Committee (Report No. 91). Bristol, UK: South and West Regional Health Authority [Southampton]: Wessex Institute for Health Research and Development. Language: English Format: Publication Abstract: Keywords: Posttraumatic Stress Disorder PTSD Therapy Accuracy Verified: Yes 250. Coleman, G. L. (1999, October). Eye movement desensitization and reprocessing in the treatment of posttraumatic stress disorder: An investigational study of the eye movement component using a within-subject design. Chicago School of Professional Psychology, Chicago, IL. AAT 9926476. Language: English Format: Dissertation/Thesis Abstract: Keywords: Avoidance Case Report Empirical Study Females Intrusive Thoughts Middle Aged PTSD Treatment Effectiveness Treatment Outcome/Clinical Trial Accuracy Verified: Yes 251. Muris, P., Merckelbach, H., van Haaften, H., & Mayer, B. (1997, July). Eye movement desensitization and reprocessing versus exposure in vivo: A single-session crossover study of spider-phobic children. British Journal of Psychiatry, 171(1), 82-86. doi:10.1192/bjp.171.1.82 . Language: English Format: Journal Abstract: Keywords: Empirical Study Exposure Therapy Phobias Spider Phobia Accuracy Verified: Yes 252. Shapiro, F. (1995). Eye movement desensitization and reprocessing: Basic principles, protocols, and procedures, 1st Ed. New York: Guilford Press. Language: English Format: Book Abstract: Keywords: Abuse Adults Assessment Child Abuse Children DID Dissociative Identity Disorder Dissociative Symptoms Incest Methodology Neurophysiology Patient Selection Posttraumatic Stress Disorder PTSD Rape Spouse Survivors Veterans Accuracy Verified: Yes 253. Shapiro, F. (2001). Eye movement desensitization and reprocessing: Basic principles, protocols, and procedures, 2nd Ed. New York: Guilford Press. Language: English Format: Book Abstract: Keywords: Adults Assessment Child Abuse Children Dissociative Identity Disorder Dissociative Symptoms Incest Methodology Neurophysiology Patient Selection Posttraumatic Stress Disorder PTSD Rape Spouse Abuse Survivors Veterans Accuracy Verified: Yes 254. Eckley, T. L. (2002, August). Eye movement desensitization and reprocessing: Efficacy with residential latency-age children. Alliant International University, Fresno, CA. AAT 3042989. Language: English Format: Dissertation/Thesis Abstract: Keywords: Depressive Disorders Dissociative Symptoms Empirical Study Posttraumatic Stress Disorder PTSD School Age Children Stressors Survivors Treatment Effectiveness Accuracy Verified: Yes 255. Paulsen, S. L. (1993, October). Eye movement desensitization and reprocessing: Its role in the treatment of dissociative disorder. Multiple personality/dissociative states: Dissociation: the next ten years. International Society for the Study of Dissociation Fall Conference, Chicago, IL. Rush University. Language: English Format: Conference Abstract: Keywords: Dissociative Disorder Accuracy Verified: Yes 256. Foster, S., & Lendl, J. (1995, September). Eye movement desensitization and reprocessing: Initial application for enhancing performance in athletes. Presentation at the annual meeting of the Association for the Advancement of Applied Sport Psychology, New Orleans, LA.. Language: English Format: Conference Abstract: Keywords: Athletes Performance Enhancement Accuracy Verified: Yes 257. Paulsen, S. L. (1995, March). Eye movement desensitization and reprocessing: Its cautious use in the dissociative disorders. Dissociation: Progress in the Dissociative Disorders, 8(1), 32-44. Language: English Format: Journal Abstract: Keywords: Adults Crisis Intervention Dissociative Disorders Females Stressors Survivors Treatment Effectiveness Accuracy Verified: Yes 258. Paulsen, S. L., Vogelmann-Sine, S., Lazrove, S., & Young, W. (1993, October). Eye movement desensitization and reprocessing: It’s role in the treatment of dissociative disorders. Symposium conducted at the 10th annual meeting of the International Conference on Multiple Personality/Dissociative States, Chicago, IL. Language: English Format: Conference Keywords: Dissociative Disorders Symposium Accuracy Verified: Yes 259. Rose, B. K. (2004). Eye movement desensitization reprocessing (EMDR): A treatment protocol for addicted inmates with traumatic histories. Carlos Albizu University, Miami, FL. AAT 3102092. Language: English Format: Dissertation/Thesis Abstract: S Keywords: Comorbidity Drug Abuse Prison Inmates Psychiatric Disorders Stressors Survivors Therapeutic Community Accuracy Verified: Yes 260. Foster, S. (1995, September). Eye movement desensitization reprocessing: Initial application for enhancing performance in athletes. In (Doug Asher, Presider) Non-traditional Interventions for Performance Enhancement. Colloquium presented at the 10th Annual Conference of the Association for the Advancement of Applied Sport Psychology, New Orleans, LA. Language: English Format: Conference Abstract: Keywords: Athletes Colloquium Performance Enhancement Accuracy Verified: Yes 261. Alatalo, G. L. (1994). Eye-movement desensitization and reprocessing: A new treatment for trauma. Spalding University, Louisville, KY. AAT 9522299. Language: English Format: Dissertation/Thesis Abstract: Keywords: Americans Avoidance Cognitive Impairment Empirical Study Intrusive Thoughts Longitudinal Study Self Concept Stressors Survivors Treatment Effectiveness Treatment Outcome/Clinical Trial Accuracy Verified: Yes 262. McDonnell, F. (2012, October). Facilitating EMDR with Ericksonian hypnosis. Presentation at the at the 4th Autumn EMDR Workshop Conference, Sheffield, UK. Language: English Format: Conference Abstract: Keywords: Ericksonian Hypnosis Accuracy Verified: Yes 263. Browning, C. (1999). Flotar hacia atrás y flotar hacia delante: Técnicas para ligar el pasado, Presente y futuro [Floatback and Float Forward: Techniques for the Tie Past, Present and Future]. Presentation at EMDRIA Latinoamericana. Language: Spanish Format: Conference Abstract: Keywords: Floatback Technique Float Foward Technique Accuracy Verified: Yes 264. Hartung, J. G., & Philbrick, P. (1997, July). Forensics applications of EMDR with traumatized, personality disorders, and dissociative persons. Presentation at the annual meeting of the EMDR International Association, San Francisco, CA. Language: English Format: Conference Keywords: Personality Disorders Accuracy Verified: Yes 265. Martin, K. (2010, September/October). Fraser's dissociative table technique: A phase 2 strategy. Presentation at the annual meeting of EMDR International Association, Minneapolis, MN. Language: English Format: Conference Abstract: Accessing, identifying, and communicating with internal ego states are necessary for effective treatment of complex trauma and dissociation. To facilitate this, clinicians establish an imaginary internal meeting place where all parts of the client’s personality can gather. This gathering place provides a means to identify, stabilize, negotiate with, and prepare ego states for trauma reprocessing. In this workshop, Fraser’s Dissociative Table Technique will be taught and demonstrated as a Phase 2 strategy for stabilization and preparationfor Phase 4 trauma reprocessing. Using Fraser’s Dissociative Table Technique when Phase 4 reprocessing is stopped due to dissociation will also be demonstrated. Keywords: Fraser's Dissociative Table Technique Accuracy Verified: Yes 266. Martin, K. (2013, May). Fraser’s dissociative table: When and how to use
it to identify and heal emotional parts of the
personality. Presentation at the Western Massachusetts EMDRIA Regional Network 9th Annual Spring Conference, Amherst MA. Language: English Format: Conference Abstract: Keywords: Dissocation Fraser's Dissociative Table Accuracy Verified: Yes 267. Adler-Tapia, R., & Settle, C. (2010, September/October). From sandboxes to the classroom: EMDR for the treatment of trauma and dissociation in children. Presentation at the annual meeting of EMDR International Association, Minneapolis, MN. Language: English Format: Conference Abstract: Keywords: Children Dissociation Trauma Accuracy Verified: Yes 268. Fine, C., Paulsen, S., Rouanzoin, C., Luber, M., Puk, G., & Young, W. (2001). A general guide to the use of EMDR in the dissociative disorders: A task force report. In F. Shapiro, EMDR: Basic principles, practices and procedures, 2nd Ed. (pp. 365-369). New York, NY: Guilford Press. Language: English Format: Book Section Abstract: Keywords: Dissociative Disorders Task Force Report Accuracy Verified: Yes 269. Fenstermaker, D. (1991, December). A general practice screen for dissociative disorders. EMDR Network Newsletter, 1(2), 13-17. Language: English Format: Newsletter Abstract: Keywords: Dissociative Disorders Accuracy Verified: Yes 270. Nardo, D., Hogberg, G., Looi, J. C., Larsson, S., Hallstrom, T., & Pagani, M. (2010, May). Gray matter density in limbic and paralimbic cortices is associated with trauma load and EMDR outcome in PTSD patients. Journal of Psychiatric Research, 44(7), 477-485. doi:10.1016/j.jpsychires.2009.10.014. Language: English Format: Journal Abstract: Keywords: Limbic Cortex Posterior Cingulate Posttraumatic Stress PTSD Accuracy Verified: Yes 271. Pagani, M. (2010, June). Gray matter density is associated with EMDR outcome in PTSD patients. In Research. Symposium conducted at the annual meeting of the EMDR Europe Association, Hamburg, Germany. Language: English Format: Conference Abstract: Keywords: Gray Matter Posttraumatic Stress Disorder PTSD Research Symposium Accuracy Verified: Yes 272. International Society for Study of Trauma and Dissociation. (2011, March). Guidelines for treating dissociative identity disorder in adults, third revision. Journal of Trauma & Dissociation, 12, 115–187. doi:10.1080/15299732.2011.537247. Language: English Format: Journal Abstract: Keywords: Adults DID Dissociation Dissociative Identity Disorder Practice Guidelines Trauma Treatment Accuracy Verified: Yes 273. Forgash, C. A. (2005, September). Healing the heart of complex trauma through EMDR, ego state and somatosensory work. Presentation at the annual meeting of the EMDR International Association, Seattle, WA. Language: English Format: Conference Abstract: Keywords: Challenging Clients Dissociation Ego State Therapy Master Series Somatosensory Therapy Accuracy Verified: Yes 274. Forgash, C. (2004, June). Healing the heart of trauma: Restoring connections and stability. Presentation at the annual meeting of the EMDR Europe Association, Stockholm, Sweden . Language: English Format: Conference Abstract: Keywords: Affect Theory Accuracy Verified: Yes 275. Tudor, T. (1994). Healing the heart: EMDR in post-unification MPD therapy. EMDR Network Newsletter, 4(1), 8-9. Language: English Format: Newsletter Abstract: M Keywords: Post-Unification MPD Therapy Accuracy Verified: Yes 276. 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: Keywords: Sexual Abuse Sexual Issues Accuracy Verified: Yes 277. Steele, S. L. (2003). Healing trauma: Creating a theoretical structure for nonverbal and expressive therapies in the treatment of trauma. Chicago School of Professional Psychology, Chicago, IL. AAT 3093612. Language: English Format: Dissertation/Thesis Abstract: Keywords: Alexithymia Body Psychotherapy Cognitive Processes Dance Therapy Dissociative Disorders Expressive Psychotherapy Posttraumatic Stress Disorder Psychotherapeutic Processes PTSD Stressors Somatic Symptoms Accuracy Verified: Yes 278. Brodeur, E. (1995). Heaven’s barbecue. EMDR Network Newsletter, 5(1), 2-3. Language: English Format: Newsletter Abstract: Accuracy Verified: Yes 279. Giamp, J. S. (2003). Honoring their voice: Eye movement desensitization and reprocessing through the eyes of inmates with developmental disabilities. Walden University, Minneapolis, MN. AAT 3119790. Language: English Format: Dissertation/Thesis Abstract: Keywords: Americans Empirical Study Mentally Retarded Posttraumatic Stress Disorder Prison Inmates PTSD Quantitative Study Self Esteem Treatment Effectiveness Accuracy Verified: Yes 280. Martin, K. M. (2012). How to use Fraser's Dissociative Table Technique to access and work with emotional parts of the personality. Journal of EMDR Practice and Research, 6(4), 179-186. doi:10.1891/1933-3196.6.4.179. Language: English Format: Journal Abstract: Keywords: ANP Apparently Normal Part of the Personality EMD Dissociative Table Emotional Part of the Personality EP Eye Movement Desensitization Meeting Place Accuracy Verified: Yes 281. Cook, A. (1994). Ideas for using EMDR with dissociative states. EMDR Network Newsletter, 4(3), 5. Language: English Format: Newsletter Abstract: Keywords: Dissociation Accuracy Verified: Yes 282. Occhi, S., Albiol, L. M., & Cicognani, E. (2007). Il disturbo post-traumatico da stress: Una rassegna [Post-traumatic stress disorder: A review]. Psicoterapia Cognitiva e Comportamentale, 13(3), 323-344. Language: Italian Format: Journal Abstract: Keywords: Posttraumatic Stress Disorder PTSD Review Accuracy Verified: No 283. Shusta-Hochberg, S. R. (2003). Impact of the World Trade Center disaster on a Manhattan psychotherapy practice. Journal of Trauma Practice, 2(1), 1-16. doi:10.1300/J189v02n01_01. Language: English Format: Journal Abstract: Keywords: 9/11 Americans DID Dissociative Identity Disorder Personal Narrative Posttraumatic Stress Disorder Psychologists PTSD September 11 Survivors Terrorism Terrorist Attacks Accuracy Verified: Yes 284. Leeds, A. (2007, June). Improving self-regulation and social functioning for survivors of early emotional neglect and abuse with positive affect tolerance and integration protocol: A case series. Poster presented at the annual meeting of the EMDR Europe Association, Paris, France. Language: English Format: Conference Abstract: Keywords: Affect Tolerance Poster Self-Regulation Social Functioning Accuracy Verified: Yes 285. Forgash, C. A. (2003, September). Improving survivor’s health with integrated EMDR and ego state treatment. Presentation at the annual meeting of the EMDR International Association, Denver, CO. Language: English Format: Conference Abstract: Keywords: Ego State Therapy Accuracy Verified: Yes 286. Magirena, S. (2009, Julio 7). Incorporación de EMDR en la terapia sexual. Caso clínico de vaginismo [Incorporating EMDR in sex therapy. Case report of vaginismus]. DePsicoterapias S.R.L. Retrieved from http://www.depsicoterapias.com/articulo.asp?IdArticulo=454 om 1/4/2009. Language: Spanish Format: Journal Abstract: Keywords: Sex Therapy Vaginismus Accuracy Verified: Yes 287. Twombly, J. H. (2000). Incorporating EMDR and EMDR adaptations into the treatment of clients with dissociative identity disorder. Journal of Trauma and Dissociation, 1(2), 61-81. doi:10.1300/J229v01n02_05. Language: English Format: Journal Abstract: Keywords: Dissociative Identity Disorder Psychotherapeutic Processes Stressors Survivors Accuracy Verified: Yes 288. Twombly, J. (2004, September). Incorporating EMDR and EMDR adaptations into the treatment of dissociative disorders. Presentation at the annual mmeting of the EMDR International Association, Montreal, Quebec Canada. Language: English Format: Conference Abstract: Keywords: Dissociative Disorders Accuracy Verified: Yes 289. Twombly, J. H. (2001, December). Incorporating EMDR and EMDR adaptations into the treatment of dissociative disorders. Presentation at the International Society for the Study of Dissociation Fall Conference, New Orleans, LA. Language: English Format: Conference Abstract: Keywords: Dissociation Accuracy Verified: Yes 290. Frustaci, A., Pozzi, G., Aurigemma, C., La Rosa, C., Lanza, G., Fernandez, I., & Ruggeri, G. (2006, Febbraio). Indicatori di cambiamento in pazienti
con disturbi da eventi stressanti: Impiego
della heart rate variability [Indicators of change in patients with disorders of stressful events: Use of heart rate variability]. Poster presentato al XI Congresso SOPSI (Società Italiana di Psicopatologia), Roma, Italia. Language: Italian Format: Conference Abstract: Keywords: Heart Rate Variability Poster Stress Disorders Accuracy Verified: Yes 291. Paulsen, S. (2009, August). Infant alters and conversion seizures: EMDR with ego-state and somatic interweaves. Presentation at the annual meeting of the EMDR International Association, Atlanta, GA. Language: English Format: Conference Abstract: Keywords: Conversion Seizures Ego-State Interweaves Infant Alters Somatic Interweaves Accuracy Verified: Yes 292. Fenstermaker, D. (1991). An innovative abreactive process for dissociative disorders: Eye movement desensitization and reprocessing (EMDR). Presentation at the California Psychological Association Annual Conference, San Diego, CA. Language: English Format: Conference Keywords: Dissociative Disorders Accuracy Verified: Yes 293. Litt, B. K., Forgash, C., & Twombly, J. (2002, November). Integrating ego state therapy and EMDR in the assessment and treatment of dissociative disorders. Presentation at the International Society for the Study of Dissociation Fall Conference, Baltimore, MD. Language: English Format: Conference Keywords: Dissociative Disorders Ego State Therapy Accuracy Verified: Yes 294. Forgash, C., & Knipe, J. (2008). Integrating EMDR and ego state treatment for clients with trauma disorders. In C. Forgash & M. Copeley (Eds), Healing the heart of trauma and dissociation with EMDR and ego state therapy (pp. 1-59) New York, NY: Springer Publishing Co. Language: English Format: Book Section Abstract: Keywords: Egp State Therapy Dissociative Disorders Trauma Accuracy Verified: Yes 295. Forgash, C., & Knipe J. (2012). Integrating EMDR and ego state treatment for clients with trauma disorders. Journal of EMDR Practice and Research, 6(3), 120-128. doi:10.1891/1933-3196.6.3.120. Language: English Format: Journal Abstract: Keywords: C-PTSD Complex Posttraumatic Stress Disorder Complex PTSD Dissociative Disorders Ego State Therapy Accuracy Verified: Yes 296. Whisman, M., & Keller, M. (1999, June). Integrating EMDR in the treatment of obsessive compulsive disorder. Presentation at the annual meeting of the EMDR International Association, Las Vegas, NV. Language: English Format: Conference Abstract: Keywords: Cognitive Interweave Obsessive Compulsive Disorder OCD Resource Installation Accuracy Verified: Yes 297. Gelinas, D. (2003). Integrating EMDR into phase-oriented treatment for trauma. Journal of Trauma and Dissociation, 4(3), 91-135. doi:10.1300/J229v04n03_06. Language: English Format: Journal Abstract: Keywords: Dissociative Identity Disorder Posttraumatic Stress Disorder Psychotherapeutic Processes PTSD Stressors Survivors Accuracy Verified: Yes 298. Bergmann, U. (2003, May). Integrating EMDR into specific therapeutical approaches - Personality disorders as variants of dissociative phenomena: Treatment with an integration of the EMDR and ego state work. Presentation at the annual meeting of the EMDR Europe Association, Rome, Italy. Language: English Format: Conference Abstract: Keywords: Dissociation Ego State Therapy Personality Disorders Accuracy Verified: Yes 299. Peterson, G. (2002, November). Integrating EMDR with energy healing in the treatment of DID. Presentation at the International Society for the Study of Dissociation Fall Conference, Baltimore, MD. Language: English Format: Conference Keywords: DID Dissociative Identity Disorder Energy Psychology Energy Therapies Accuracy Verified: Yes 300. Paulsen-Inobe, S. L. (2001, December). Integrating EMDR, ego state therapy, and dissociative table: A cartooning psychologist's glimpse into the mind's eye. Presentation at the annual meeting of the International Society for the Study of Dissociation, New Orleans, LA. Language: English Format: Conference Keywords: Dissociative Table Ego State Therapy Accuracy Verified: Yes 301. Foster, S. (2012). Integrating positive psychology applications into the EMDR peak performance protocol. Revue Européenne De Psychologie Appliquée/European Review of Applied Psychology, 62(4), 213-217. doi:10.1016/j.erap.2012.04.005. Language: English Format: Journal Abstract: Keywords: Performance Enhancement Positive Psychology Accuracy Verified: Yes 302. Keenan, L. (2010, June). The integration and progression of EMDR
within a generic primary care mental health
service. In Trainiing issues. Symposium conducted at the annual meeting of the Europe Association, Hamburg, Germany. Language: English Format: Conference Abstract: Keywords: Generic Primary Care Symposium Training Issues Accuracy Verified: Yes 303. Rouanzoin, C. (2007, September). The integration of EMDR in the treatment of
dissociative clients. Presentation at the annual meeting of the EMDR International Association, Dallas, TX. Language: English Format: Conference Abstract: Keywords: Dissociation Dissociative Disorders Accuracy Verified: Yes 304. Woller, W. (2011, June). Integration von EMDR in tiefenpsychologische therapien [Integration of EMDR in deep psychological therapies]. Presentation at the annual meeting of the EMDR Europe Association, Vienna, Austria. Language: German Format: Conference Abstract: Keywords: Posttraumatic Stress Disorder PTSD Psychodyamic Therapy Accuracy Verified: Yes 305. Korn, D. (1995, June). Integrative and strategic utilization of EMDR in treating survivors of sexual abuse. Presentation at the EMDR Network Conference, Santa Monica, CA. Language: English Format: Conference Abstract: Keywords: Sexual Abuse Survivors Accuracy Verified: Yes 306. Wade, T., & Wade, D. (2001, January-April). Integrative psychotherapy: Combining ego-state therapy, clinical hypnosis, and eye movement desensitization and reprocessing (EMDR) in a psychosocial developmental context. American Journal of Clinical Hypnosis, 43(3-4), 233-245. doi:10.1080/00029157.2001.10404279. Language: English Format: Journal Abstract: Keywords: Clinical Hypnosis Ego Ego-State Therapy Hypnotherapy Integrative Psychotherapy Review Multimodal Treatment Approach Psychosocial Development Psychosocial Developmental Context Accuracy Verified: Yes 307. Stergiopoulos, E., Cimo, A., Cheng, C., Bonato, S., & Dewa, C. S. (2011, October). Interventions to improve work outcomes in work-related PTSD: A systematic review. BMC Public Health, 11(1), 838. doi:10.1186/1471-2458-11-838. Language: English Format: Journal Abstract: Keywords: Employees Posttraumatic Stress Disorder PTSD Workers Accuracy Verified: Yes 308. Snyder, M. (1996, December). Intimate partners: A context for the intensification and healing of emotional pain. Women and Therapy, 19(3), 79-92. doi:10.1300/J015v19n03_08. Language: English Format: Journal Abstract: Keywords: Adults Americans Case Report Child Abuse Family Therapy Females Homosexuals Incest Interpersonal Interaction Psychiatric Disorders Rape Survivors Accuracy Verified: Yes 309. Barach, P. (2000, September). Introduction to the diagnosis and treatment of dissociative disorders: Learning the ropes, avoiding the pitfalls. Presentation at the annual meeting of the EMDR International Association, Toronto, Ontario Canada. Language: English Format: Conference Abstract: Keywords: Diagnostic Instruments Dissociation False Memory Interview Questions Pacing Recovered Memory Therapeutic Boundaries Accuracy Verified: Yes 310. Lytle, R. A. (1993). An investigation of the efficacy of eye-movement desensitization in the treatment of cognitive intrusions related to memories of a past stressful event. Pennsylvania State University. AAT 9334778. Language: English Format: Dissertation/Thesis Abstract: Keywords: Biologic Markers College Students Intrusive Thoughts Negative Therapeutic Reaction Posttraumatic Stress Disorder PTSD Stressors Survivors Treatment Effectiveness Witnesses Accuracy Verified: Yes 311. de Jongh, A. (2008, September). Is EMDR mogelijk bij mensen met borderline of DIS [Is EMDR possible in people with borderline or DIS]. Psychologie Magazine. Retrieve January 23, 2013 from http://www.psychologiemagazine.nl/. Language: Dutch Format: Magazine Abstract: Keywords: Dissociative Identity Disorder Accuracy Verified: Yes 312. Munaro, D., Anchisi, R., Bossa, R., & Guzzi, R. (2001, October). Is orienting reflex in EMDR successful?. In International CIANS Conference (CIANS: Collegium Internationale Activitatis Nervosae Superioris; International Association for Integrative Nervous Functions, Neurobiology of behaviour and Psychosomatics, (pp 149-158) Palermo, Italy. Language: English Format: Conference Abstract: Keywords: Orienting Reflex Accuracy Verified: Yes 313. 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: Keywords: Personality Disorders Symposium Trauma Accuracy Verified: Yes 314. Knipe, J. (1998). It was a golden time...: Treating narcissistic vulnerability. In P. Manfield (Ed.), Extending EMDR: A casebook of innovative applications, (1st ed.) (pp. 232-255), New York: Norton. Language: English Format: Book Section Abstract: Keywords: Adults Americans Case Report Defense Mechanisms Life Experiences Males Posttraumatic Stress Disorder PTSD Self Concept Survivors Treatment Effectiveness Accuracy Verified: Yes 315. Fine, C.& Berkowitz, A. (2008, April). The joint use of EMDR and hypnosis in the treatment of DID, DDNOS and complex
PTSD. Presentation at the 1st bi-annual European Society for Trauma and Dissociation Conference, Amsterdam, The Netherlands. Language: English Format: Conference Abstract: Keywords: Complex PTSD DDNOS DID Dissociative Identity Disorder Dissociative Disorder Not Otherwise Specified Hypnosis Accuracy Verified: Yes 316. Hull, T. (1999, June). Jungian “active imagination” and EMDR: A synergistic therapy convergence. Presentation at the annual meeting of the EMDR International Association, Las Vegas, NV. Language: English Format: Conference Abstract: Keywords: Active Imagination Jungian Accuracy Verified: Yes 317. Becher, M. (2002, Mai). Kasuistik einer patientin mit dissoziativer identitätsstörung [Case report of a female patient with dissociative identity disorder]. Vortrag auf der Jahrestagung der EMDR Europe Association, Frankfurt, Deutschland. Language: German Format: Conference Abstract: Keywords: DID Dissociative Identity Disorder Accuracy Verified: Yes 318. Miti, G., & Onofri, A.
(2011, Guigno). La psicoterapia dei disturbi dissociativi: Dalle tecniche cognitivo-comportamentali all'approccio EMDR [Psychotherapy of dissociative disorders: From cognitive-behavioral techniques to the EMDR approach]. Cognitivismo Clinico, 8(1), 73-91 . Language: Italian Format: Journal Abstract: Keywords: Dissociative Disorders Accuracy Verified: Yes 319. Bruno, T. (2006, Maggio). Le emozioni dei terapeuti nel lavoro con persone vittime di traumi interpersonali [The emotions of therapists working with victims of interpersonal trauma]. Presentazione alla Conferenza Nazionale, Associazione per l'EMDR in Italia, Firenza, Italia. Language: Italian Format: Conference Abstract: Keywords: Interpersonal Trauma Accuracy Verified: Yes 320. Yoeli, F. R. (2002, May/June). Life in the shadow of anxiety; The mask of OCD:
and EMDR. Presentation at the annual meeting of the EMDR Europe Association, Frankfurt, Germany. Language: English Format: Conference Abstract: Keywords: Obsessive Compulsive Disorder OCD Accuracy Verified: Yes 321. Solvey, R. (2003, Febrero). Lineamientos generales para el tratamiento de los trastornos disociativos [General guidelines for the treatment of dissociative disorders]. Presentación en: 4º Congreso Virtual de Psiquiatría. Language: Spanish Format: Conference Abstract: Keywords: Dissociative Disorders Psychotherapy Accuracy Verified: Yes 322. Hamner, M. B. (2007, June 1). Long-term treatment of posttraumatic stress
disorder. Psychiatric Times, 24(7), 36. Retrieved from http://www.psychiatrictimes.com/display/article/10168/54861 8/9/2007. Language: English Format: Magazine Abstract: Keywords: Posttraumatic Stress Diorder PTSD Symptom Clusters Accuracy Verified: Yes 323. Paulsen, S. L. (2010, February). Looking through the eyes: EMDR & ego state therapy across the dissociative continuum. Presentation at the 3rd World Congress of Ego State Therapy, Sun City, South Africa. Language: English Format: Conference Abstract: There are two workshops that are similar, in that they describe ways to work with dissociative clients in the phased approach recommended by the Treatment Guidelines of the International Society for the Study of Trauma and Dissociation, to which Dr. Paulsen contributed for the Third Revision That phased approach emphasizes stabilization and containment before conducting EMDR, and then using a measured approach to pace the use of EMDR for maximal safety for dissociative clients. The first workshop teaches the ego state methods to do this, and this second workshop describes somatic methods as well as ego state methods.
[The second workshop ”Looking Through the Eyes: EMDR & Ego State and Somatic Therapies Acrosss the Dissociative Continuum” with its own entry describes somatic methods as well as ego state methods, making that workshop very full indeed.]
This first workshop will elaborate on the key phase of stabilization, before ever conducting EMDR for a dissociative client. It will describe ways to increase affect tolerance, employ somatic resourcing, and other somatic methods to reconfigure ego states, use a two-step containment strategy for traumatic material and for ego states. A key focus is on working directly with perpetrator introjects or other “monstrous” disowned or shameful parts, to minimize resistance and internal conflict. Leading edge methods for resetting affective circuits and clearing very early attachment trauma will be touched upon.
Participants will be able to: 1. Explain why and when to assess every client for degree of dissociation prior to doing EMDR and choose an appropriate protocol, 2. Utilize a phased approach to therapy, including EMDR when and where appropriate, for complex dissociative clients, 3. List six tactics for stabilizing clients, prior to doing EMDR for dissociative clients to increase rapport, increase soma tolerance, contain affect, orient to present circumstances, reduce inner conflict, and build coping resources, 4. Prepare for EMDR processing using ego state and other methods to clarify roles and plan the work, 5. Structure EMDR sessions using imagery, ego state interventions (and somatic methods, for the second workshop) for pacing, fractionating and trouble shooting the work, and 6.For the somatic version of the workshop, list several somatic interventions to assist with various phases work with dissociative clients.
Keywords: Dissociative Continuum Ego State Therapy Accuracy Verified: Yes 324. Paulsen, S. L. (2009). Looking through the eyes: EMDR, Ego state & somatic therapies across the dissociative continuum. Presentation at the Bainbridge Institute for Integrative Psychology, Bainbridge Island, Washington
. Language: English Format: Other Abstract: Keywords: Dissociative Continuum Ego State Therapy Somatic Resourcing Accuracy Verified: Yes 325. Knipe J. (2008). Loving eyes: Procedures to therapeutically reverse dissociative processes while preserving emotional safety. In C. Forgash and M. Copeley, (Eds.) Healing the heart of trauma and dissociation with EMDR and ego state therapy (pp. 181-225). New York, NY: Springer Publishing Co. Language: English Format: Book Section Abstract: Keywords: Dual Attention Accuracy Verified: Yes 326. Ehlers, A., Gene-Cos, N., & Perrin, S. (2009). Low recognition of post-traumatic stress
disorder in primary care. London Journal of Primary Care, 2, 36–42. Language: English Format: Journal Abstract: Accuracy Verified: Yes 327. Lambin, M. (2012, April). L’écran, un outil clinique en EMDR [The screen, a clinical tool in EMDR]. Presentation at the annual meeting of the EMDR Canada, Montreal, Canada. Language: French Format: Conference Abstract: Il est fréquent que des clients avec lesquels nous utilisons l’EMDR présentent des symptômes de dissociation au cours de la séance, particulièrement si les émotions deviennent très intenses ou si le souvenir du trauma est réactivé de façon très aigue. Parmi les stratégies que l’on peut utiliser à ce moment pour aider le client à rester dans l’expérience, l’écran s’avère un outil clinique extrêmement efficace.
Le but de cet atelier est d’amener le clinicien à découvrir et expérimenter l’utilisation de l’écran dans le traitement en EMDR. Ainsi, lors de l’application du protocole en 8 étapes, si des symptômes dissociatifs apparaissent, l’écran permet une stabilisation et favorise la poursuite du traitement adaptatif de l’information.
Le déroulement de cet atelier de 3 heures comporte un grand volet pratique pour permettre l’expérimentation et les échanges chez les participants. Ce qui favorise l’intégration des connaissances actuelles en EMDR ainsi que l’expérience clinique à partir d’un cas précis. L’apprentissage de cet outil donne accès aux ressources du client. Keywords: Dissociation Screen Accuracy Verified: Yes 328. Giannantonio, M. (2001, Ottobre). L’eye movement desensitization and reprocessing (E.M.D.R.) negli adulti e adolescenti abusati sessualmente in età infantile [The eye movement desensitization and reprocessing (EMDR) in adults and adolescents sexually abused in childhood]. Congresso AIAMC, Palermo, Italia. Language: Italian Format: Conference Abstract: Keywords: Adolescents Adults Postttraumatic Stress Disorder PTSD Sexual Abuse Accuracy Verified: Yes 329. Giannantonio, M. (2008, Novembre). L’integrazione possible: accedere alle emozioni con strategie imaginative e corporee [Integration impossible: Access to emotions with imaginative and corporeal strategies]. Presentazione Le applicazioni cliniche del EMDR Congresso Nazionale, Milano, Italia. Language: Italian Format: Conference Abstract: Keywords: Imaginative Strategies Somatic Interventions Accuracy Verified: Yes 330. Gauvreau, P. (2013, Mai). L’utilisation de la table dissociative dans la Phase 2 préparation [The use of the dissociative table in preparation for Phase 2]. Presentation at the annual EMDR Canada Conference, Banff, Alberta CAN. Language: French Format: Conference Abstract: n Keywords: Dissociation Table Structural Dissociatio Accuracy Verified: Yes 331. Yordy, J. (2013, May). Making the brain/body connection: Using brain gym techniques to enhance child EMDR processing. Presentation at the annual EMDR Canada Conference, Banff, Alberta CAN. Language: English Format: Conference Abstract: Accuracy Verified: Yes 332. Litt, B. K. (2006, September). The marriage of EMDR and ego state theory in couples therapy. Presentation at the annual meeting of the EMDR International Association, Philadelphia, PA. Language: English Format: Conference Abstract: Keywords: Couples Therapy Ego State Therapy Accuracy Verified: Yes 333. Egli-Bernd, H. (2009, October). MDR bei dissoziativen prozessen im rahmen von persönlichkeitsstörungen ; Zur Bedeutung der kognitionen im EMDR-prozess, Das „Dialog-Protokoll“ [EMDR in dissociative processes within the framework of Personality Disorders; On the importance of cognitions in EMDR process, The "dialogue protocol"]
. EMDR Deutschland e.V. Rundbrief, 19, 20-34. Language: German Format: Newsletter Abstract: Keywords: Cognitions Dialogue Protcol Dissociation Personality Disorders Accuracy Verified: Yes 334. Darker-Smith, S. (2007, June). Mindfulness as a stabilisation tools for trauma processing. Poster presented at the annual meeting of the EMDR Europe Association, Paris, France. Language: English Format: Conference Abstract: Keywords: Mindfulness Poster Stabilization Accuracy Verified: Yes 335. Darker-Smith, S. (2007, June). Mindfulness meditation to enable attenuation on imagined exposure in PTSD - A single case study. Poster presented at the annual meeting of the EMDR Europe Association, Paris, France. Language: English Format: Conference Abstract: Keywords: Attenuation Case Study Imagined Exposure Mindfulness Poster Posttraumatic Stress Disorder PTSD Accuracy Verified: Yes 336. Beere, D. (2009). Modified resource development and installation (RDI) procedures with dissociative clients. In M. Luber (Ed.), Eye movement desensitization (EMDR) scripted protocols: Special populations (pp. 281-290). New York: Springer Publishing Co. Language: English Format: Book Section Keywords: Dissociation Protocol RDI Resource Development and Installation Accuracy Verified: Yes 337. 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: Keywords: Narcissistic Personality Disorder Accuracy Verified: Yes 338. Amendolia, R. D. (1998). A narrative constructivist perspective of treatment of posttraumatic stress disorders with Ericksonian hypnosis and eye movement desensitization and reprocessing. Trauma Response, 13-14. Language: English Format: Journal Abstract: Keywords: Eriksonian Hypnosis Narrative Constructionist Accuracy Verified: Yes 339. Gersons, B., Schnyder, U., Rothbaum, B., & McFarlane, A. (2006, November). The need for new directions in psychotherapy
for PTSD. Panel presentation at the 22nd annual meeting of the International Society for Traumatic Stress Studies Fall Conference, Hollywood, CA. Language: English Format: Conference Abstract: Keywords: CBT Cognitive Behavioral Therapy Panel Accuracy Verified: Yes 340. Forgash, C. (2007, September). The negative impact of complex PTSD on health:
an EMDR/ego state treatment plan. Presentation at the annual meeting of the EMDR International Association, Dallas, TX. Language: English Format: Conference Abstract: Keywords: Complex Posttraumatic Stress Disorder Complex PTSD C-PTSD Ego State Therapy Integrated Treatment Phased Treatment Plan Accuracy Verified: Yes 341. Forgash, C. (2008, June). The negative impact of complex PTSD on health: An EMDR/ego state treatment plan. Presentation at the annual meeting of the EMDR International Association, London, England. Language: English Format: Conference Abstract: Keywords: Complex Posttraumatic Stress Disorder Complex PTSD C-PTSD Ego State Therapy Accuracy Verified: Yes 342. van Dijke, A. (2011, April). The Netherlands centre for chronic early childhood
traumatisation: Adults. Presentatie op het 39ste Voorjaarscongres Nederlandse Vereniging voor Psychiatrie, Amsterdam. Language: English Format: Conference Abstract: Keywords: Childhood Traumatization Accuracy Verified: Yes 343. Bergmann, U. (2012). Neurobiological foundations for EMDR practice. New York, NY: Springer Publishing Company. Language: English Format: Book Abstract: Keywords: Neurobiology Accuracy Verified: Yes 344. Paulsen, S., & Lanius, U. (2011, November). Neurobiology and dissocation: Information processing and the embodied self. Presentation at the 28th annual meeting of the International Society for the Study of Trauma and Dissociation, Montreal, Quebec. Language: English Format: Conference Abstract: Keywords: Dissociation Embodies Self Information Processing Neurobiology Accuracy Verified: Yes 345. Lanius, U. (2008, September). The neurobiology of dissociation: Current findings and treatment approaches. Presentation at the annual meeting of the EMDR International Association, Phoenix, AZ. Language: English Format: Conference Abstract: Keywords: Dissociation Neurobiology Accuracy Verified: Yes 346. Ferrie, R. K., & Lanius, U. F. (2002, June). The neurobiology of opiates: Opoid antagonists and EMDR. Presentation at the annual meeting of the EMDR International Association, San Diego, CA. Language: English Format: Conference Abstract: Keywords: Neurobiology Opiates Accuracy Verified: Yes 347. Kluft, R. P. (1995, March). A new kid on the block and miscellaneous reflections. Dissociation, 8 (1), 1-2. Language: English Format: Journal Abstract: Keywords: Editorial Accuracy Verified: Yes 348. Krause, R., Sachsse, S., & Spang, J. (2008, April). Nonverbal behavior in traumatized patient: Comparison between childhood onset versus acutely adult onset trauma. Presentation at the European Society for Trauma and Dissociation First Bi-Annual Conference, Amsterdam, the Netherlands. Language: English Format: Conference Abstract: Keywords: Nonverbal Behavior Accuracy Verified: Yes 349. Yoeli, F. R., & Prattos-Spongalides, T-A. (2004, June). OCD: Anxiety, rituals, co-morbidity or altered state? Treatment outcomes with EMDR. In anxiety disorders and EMDR (A. de Jongh, Chair). Symposium conducted at the annual meeting of th EMDR Europe Association, Stockholm, Sweden . Language: English Format: Conference Abstract: Keywords: Altered States Anxiety Disorders Co-morbidity Obsessive Compulsive Disorder OCD Rituals Symposium Treatment Outcomes Accuracy Verified: Yes 350. Holm, O. (2012, October). On the path of shame affect: Its management in traumatized and dissociative patients with the compass of shame and EMDR special interventions and/or IFS ego states. Presentation at the 29th annual meeting of the International Society for the Study of Trauma and Dissociation, Long Beach, CA. Language: English Format: Conference Abstract: Keywords: Compass of Shame Dissociation IFS Ego States Shame Affect Accuracy Verified: Yes 351. Becker-Fritz, T., Carson, S., Donovan, L., Froning, M., Heiman, M., Peterson, G., & Packwood, B. (2003, September). Open forum to share clinical uses of EMDR with child/adolescent population - Facilitated by the EMDRIA Child/Adolescent Special Interest Group Chairs. Open formum presented at the annual EMDRIA Conference, Denver, CO. Language: English Format: Conference Abstract: Keywords: Adolescents Children Open Forum Accuracy Verified: Yes 352. Denny, N. (1995, March). An orienting reflex/external inhibition model of EMDR and thought field therapy. Traumatology, 1(1), 1-6, Article 1. doi:10.1177/153476569500100101. Language: English Format: Journal Abstract: Keywords: Conditioned Emotional Responses Cognitive Processes TFT Thought Field Therapy Accuracy Verified: Yes 353. Armstrong, M., & Vaughan, K. (1996, March). An orienting response model of eye movement desensitization. Journal of Behavior Therapy and Experimental Psychiatry, 27(1), 21-32.
doi:10.1016/0005-791(95)00056-9. Language: English Format: Journal Abstract: Keywords: Conditioned Emotional Responses PTSD Treatment Effectiveness Accuracy Verified: Yes 354. Vaughan, K., & Armstrong, M. (1995, June). An orienting response model to EMDR. Presentation at the EMDR Network Conference, Santa Monica, CA. Language: English Format: Conference Abstract: Keywords: Orienting Response Accuracy Verified: Yes 355. Shapiro, F., Solomon, R., Kaufman, T., & Fenstermaker, D. (1991). Origins and update; Origins of EMDR with critical incidents; Preliminary research and results; Clinical use of EMDR with dissociative patients. Presentation at the International Society for Traumatic Stress Studies Fall Conference, Washington, DC. Language: English Format: Conference Keywords: Critial Incidents Dissociative Disorders Recent Events Accuracy Verified: No 356. Bergmann, U. (2004, June). Personality disorders as a variant of dissociative phenomena. Treatment with an integration of EMDR and ego-state work in the healing of self. Presentation at the annual meeting of the EMDR Europe Association, Stockholm, Sweden
. Language: English Format: Conference Abstract: Keywords: Complex Trauma Dissociation Ego State Therapy Personality Disorders Accuracy Verified: Yes 357. Bergmann, U. (2004, November). Personality disorders as variants of dissociative phenomena: Treatment with an integration of ego-state work and EMDR. Presentation at the annual meeting of the International Society for the Study of Dissociation Fall Conference, New Orleans, LA. Language: English Format: Conference Abstract: Keywords: Dissociation Ego State Therapy Personality Disorders Accuracy Verified: Yes 358. Bergmann, U. (2004, June). Personality disorders as variants of dissociative phenomena: Treatment with an integration of the EMDR and ego state treatment. Presentation at the annual meeting of the EMDR Europe Association, Stockholm, Sweden. Language: English Format: Conference Abstract: Keywords: Dissociation Ego State Therapy Personality Disorders Accuracy Verified: Yes 359. Bergmann, U. (2002, November). Personality disorders as variants of dissociative phenomena: Treatment with an integration of ego-state therapy and EMDR. Presentation at the annual meeting of International Society for the Study of Dissociation Fall Conference, Baltimore, MD. Language: English Format: Conference Abstract: Keywords: Dissociation Ego State Therapy Personality Disorders Accuracy Verified: Yes 360. Bergmann, U. (2003, November). Personality disorders as variants of dissociative phenomena: Treatment with an integration of EMDR and ego state treatment. Presentation at the annual meeting of the International Society for the Study of Dissociation Fall Conference, Chicago, IL. Language: English Format: Conference Abstract: Keywords: Dissociation Ego State Therapy Personality Disorders Accuracy Verified: Yes 361. Bergmann, U. (2003, September). Personality disorders as variants of dissociative phenomena: Treatment with an integration of EMDR and ego state work in the repair of the self. Presentation at the annual meeting of the EMDR International Association, Denver, CO. Language: English Format: Conference Abstract: Keywords: Dissociation Ego State Therapy Personality Disorders Accuracy Verified: Yes 362. Bergmann, U. (2004, September). Personality disorders as variants of dissociative phenomena: Treatment with an integration of EMDR and ego-state work. Presentation at the annual meeting of the EMDR International Association, Montreal, Quebec Canada. Language: English Format: Conference Abstract: Keywords: Personality Disorders Dissociation Ego State Therapy Accuracy Verified: Yes 363. Sandstrom, M., Wiberg, B., Wikman, M., Willman, A. K., & Hogberg, U. (2008, March). A pilot study of eye movement desensitization and reprocessing treatment (EMDR) for post-traumatic stress after childbirth. Midwifery, 24(1), 62–73. doi:10.1016/j.midw.2006.07.008. Language: English Format: Journal Abstract: Keywords: Adults Childbirth Females Longitudinal Study Posttraumatic Stress Disorder PTSD Survivors Swedes Treatment Effectiveness Accuracy Verified: Yes 364. Calero, M., Cutinella, L., Duarte, G., Frontini, M. D., Garcia, S. Garcia, V., F., & Yoo, I. (2012). Policinca para el tratamiento del trauma [Policinca for the treatment of trauma]. Revista Iberoamericana de Psicotraumatología y Disociación, 4(1). Language: Spanish Format: Other Abstract: Keywords: Police Trauma Treatment Accuracy Verified: Yes 365. Calero, M. (2010, Octubre/Noviembre). Policlinica para el tratamiento del trauma con modelo EMDR en pacientes graves en el Hospital Psiquátrico Vilardebó de Montevideo, Uruguay [Poli-clinical treatment for trauma with EMDR in severe patients in a psychiatric hospital (Vilardebo) in Montevideu, Uruguay]. Presentada en el II Congreso Iberoamericano de EMDR y Psicotrauma, Quito, Ecuador. Language: Spanish Format: Conference Abstract: Keywords: Hospital Trauma Montevideu, Uruguay Accuracy Verified: Yes 366. McLean, P. D., & Woody, Sheila, R. (2001). Posttraumatic stress disorder. In P. D. McLean & S. R. Woody (Eds.), Anxiety disorders in adults: An evidence-based approach to psychological treatment (pp. 205-241). New York: Oxford University Press. Language: English Format: Book Section Abstract: Keywords: Adults Evidence Based Treatment Posttraumatic Stress Disorder Psychotherapy PTSD Accuracy Verified: Yes 367. van der Kolk, B. A. (2000). Posttraumatic stress disorder and the nature of trauma. Dialogues in Clinical Neuroscience, 2(1), 7-22. Language: English Format: Journal Abstract: Keywords: Etiology Historical Account Posttraumatic Stress Disorder PTSD Accuracy Verified: Yes 368. Phillips, M. (2001, January-April). Potential contributions of hypnosis to ego-strengthening procedures in EMDR. American Journal of Clinical Hypnosis, 43(3-4), 247-262. doi:10.1080/00029157.2001.10404280. Language: English Format: Journal Abstract: Keywords: Hypnotherapy Posttraumatic Stress Disorder Psychotherapeutic Processes PTSD Review Treatment Treatment Effectiveness Accuracy Verified: Yes 369. Lamprecht, F. (2006). Praxisbuch EMDR: Modifizierungen für spezielle anwendungsgebiete [Practice book EMDR: Modifications for special applications]. Stuttgart: Klett-Cotta. Language: German Format: Book Abstract: Accuracy Verified: Yes 370. Yoeli, F. R., & Prattos-Spongalides, T.-A. (2003, November). Pre-war anxiety, embedded traumata, dissociative behavior and proactive treatment with EMDR to prevent complex PTSD. Presentation at the International Society for the Study of Dissociation Fall Conference, Chicago, IL. Language: English Format: Conference Keywords: Anxiety Complex Posttraumatic Stress Disorder Complex PTSD C-PTSD Dissociation Accuracy Verified: Yes 371. Lazrove, S. (1997, July). Problems, problems. Treating dissociative identity disorder. If it isn’t one thing, it’s another. Presentation at the annual meeting of the EMDR International Association, San Francisco, CA. Language: English Format: Conference Keywords: DID Dissociative Identity Disorder Accuracy Verified: Yes 372. Veerbeek, H. (2013, June). Processing anger and revenge with EMDR. Presentation at the annual meeting of the EMDR Europe Association, Geneva, Switzerland. Language: English Format: Conference Abstract: Accuracy Verified: Yes 373. Gonzalez, A., Mosquera, D., & Seijo, N. (2010, April). Processing dissociative phobias with EMDR. Presentation at the 2nd Bi-Annual International European Society for Trauma and Dissociation Conference, Belfast, Northern Ireland. Language: English Format: Conference Abstract: The standard EMDR protocol (SP) was designed for the treatment of simple PTSD, and when it´s used on this cases, EMDR is a very powerful therapy. But when SP is applied on complex trauma and dissociative disorders 20% of patients may become de-compensated. The importance of the stabilization phase has been remarked by different authors. The existent proposals are to use interventions coming from different approaches sometimes enhanced with bilateral stimulation. Standard procedures used for simple PTSD must be adapted and modified for working with dissociative disorders. To do this is important to understand from recent research work what we know about the effects of EMDR therapy. We will try to dynamically integrate these features with conceptualizations coming from the EMDR Adaptive Information Processing Model (AIP) and the Theory of the Structural Dissociation of the Personality (TSDP) TSDP emphasizes the importance of working with dissociative phobias prior to trauma work. In the stabilization phase the work on the phobia of dissociative parts and of attachment (and the attachment with the therapist) is the most important one. We will show with clinic cases the effect of this intervention on improving internal communication and collaboration and overcoming therapist-patient relationship problems. Keywords: Phobias Accuracy Verified: Yes 374. Woodward, C. L. (2001). Processing trauma: studies into posttraumatic stress disorder, eye movement desensitisation and reprocessing and posttraumatic growth. University of Warwick. Language: English Format: Dissertation/Thesis Abstract: Keywords: Posttraumatic Growth Posttraumatic Stress Disorder PTSD Accuracy Verified: Yes 375. Matthess, H. (2007, June). Profits from the benefit of structural dissociation on the application with EMDR for
complex-traumatized clients. Presentation at the annual meeting of the EMDR Europe Association, Paris, France. Language: English Format: Conference Abstract: Keywords: Complex Trauma Dissociation Accuracy Verified: Yes 376. Giannantonio, M. (2002, Settembre). Psicoterapia ipnotica e eye movement desensitization and reprocessing (EMDR): Sinergie e integrazioni nella psicoterapia dei disturbi post-traumatici e dell'attaccamento (EMDR) [Hypnotic psychotherapy and eye movement desensitization and reprocessing (EMDR): Synergies and integration in psychotherapy with post-traumatic stress and attachment]. IX Congresso della Società Europea di Ipnosi: L'ipnosi e gli altri modelli terapeutici nel nuovo millennio, Roma, Italia. Language: Italian Format: Conference Abstract: Keywords: Attachment Posttraumatic Stress Accuracy Verified: Yes 377. Sack, M., & Matthess, H. (2005, November). Psychobiological studies and practical implications of the use of EMDR with dissociative clients. Presentation at the International Society for the Study of Dissociation Fall Conference, Toronto, Ontario Canada. Language: English Format: Conference Keywords: Dissociation Psychobiology Accuracy Verified: Yes 378. Ross, C. (2010, Septembrer/October). Psychobiology of dissociation. Plenary presented at the annual meeting of EMDR International Association, Minneapolis, MN. Language: English Format: Conference Abstract: Keywords: Dissociation Plenary Psychobiology Accuracy Verified: Yes 379. van der Kolk, B. A., Burbridge, J. A., & Suzuki, J. (1997, June). The psychobiology of traumatic memory: Clinical implications of neuro imaging studies. Annals of the New York Academy of Sciences, 821, 99-113. doi:10.1111/j.1749-6632.1997.tb48272.x
. Language: English Format: Journal Abstract: Keywords: Brain Imaging Dissociative Amnesia Etiology Literature Review Neuroanatomy Neuroendocrinology Psychobiology PTSD Stressors Survivors Treatment Effectiveness Accuracy Verified: Yes 380. Tarquinio, C., Fayard, A., & Mousel, P. (2008, June). Psychological consequences of family violence act in a small group of women victims
and EMDR therapy: Preliminary results. Presentation at the 9th annual meeting of the EMDR Europe Association, London, England. Language: English Format: Conference Abstract: Keywords: Family Violence Act Accuracy Verified: Yes 381. Solomon, S. D. (1997, Winter). Psychosocial treatment of posttraumatic stress disorder. In Session: Psychotherapy in Practice, 3(4), 27-41. doi:10.1002/(SICI)1520-6572. Language: English Format: Journal Abstract: Keywords: Adults Cognitive Therapy Drug Therapy Exposure Therapy Group Psychotherapy Hypnotherapy Posttraumatic Stress Disorder Prevention Psychoanalytic Psychotherapy PTSD Stressors Survivors Accuracy Verified: Yes 382. Miti, G. (2003, May). Psychotherapy of dissociative disorders: New strategies and new techniques in a new perspective. In Dissociation and theoretical methods. Symposium conducted at the annual meeting of the EMDR Europe Assocation, Rome, Italy. Language: English Format: Conference Keywords: Dissociation Symposium Accuracy Verified: Yes 383. Calero, M. (2011, November). Psychotraumatologic unit for the treatment of severe psychiatric patients in a public hospital in Uruguay. Presentation at the 28th annual meeting of the International Society for the Study of Trauma and Dissociation, Montreal, Quebec. Language: English Format: Conference Abstract: Keywords: Psychotraumatologic Unit Posttraumatic Stress Disorder PTSD Public Hospitals Uruguay Accuracy Verified: Yes 384. McFarlane, A. (2010, June). PTSD as an information processing disorder. Keynote presented at the annual meeting of the EMDR Europe Association, Hamburg, Germany. Language: English Format: Conference Abstract: Keywords: Information Processing Keynote Posttraumatic Stress Disorder PTSD Accuracy Verified: Yes 385. St-André, E. (2007, June). PTSD secondary to Fournier's grangrene: 1-Comparison of two eye modalities, 2-Legal and ethical issues. Presentation at the annual meeting of the EMDR Europe Association, Paris, France. Language: English Format: Conference Abstract: Keywords: Case Report Ethical Issues Fournier's Gangrene Legal Issues Accuracy Verified: Yes 386. Fay, D., & Fisher, J. A. (2003, November). Rebuilding the self after trauma: A skills building model for dissociative disorder patients. Presentation at the International Society for the Study of Dissociation Fall Conference, Chicago, IL. Language: English Format: Conference Keywords: Dissociative Disorders Accuracy Verified: Yes 387. Young, W. C. & Young, L. J. (1997). Recognition and special treatment issues in patients reporting childhood sadistic ritual abuse; Appendix A: Informed consent regarding the treatment of traumatic and dissociative disorders. In G. A. Fraser (Ed.), The Dilemma of Ritual Abuse: Cautions and Guides for Therapists (Clinical Practice, No. 41) (1st ed.) (pp. 65-93, 95-100). Washington, DC: American Psychiatric Press. Language: English Format: Book Section Abstract: Keywords: Adults Child Abuse Dissociative Amnesia Dissociative Identity Disorder Drug Therapy Etiology False Memory Hypnotherapy Posttraumatic Stress Disorder Psychotherapeutic Processes PTSD Ritual Abuse Survivors Treatment Effectiveness Accuracy Verified: Yes 388. Spokes, T., Hofmeyr, M., & Hopkinson, P. (2011, August). Reducing distress following assault in the workplace. Nursing Times, 107, Online Issue 9; Nursing Times.Net. Retrieved from http://www.nursingtimes.net/reducing-distress-following-assault-in-the-workplace/5033506.article on August 9, 2011. Language: English Format: Journal Abstract: Keywords: Mental Health Post-Incident Support Workplace Assault Accuracy Verified: Yes 389. Giovannozzi, G.
(2012, June). Regulated eye contact activation and installation protocol [Regulación
de
la
activación
del
contacto
ocular
y
protocolo
de
instalación]. Presentation at the annual meeting of the EMDR Europe Association, Madrid, Spain. Language: English Format: Conference Abstract: Keywords: Installation Protocol Regulated Eye Contact Activation Accuracy Verified: Yes 390. Colosetti, S., & Thyer, B. A. (2000, October). The relative effectiveness of EMDR versus relaxation training with battered women prisoners. Behavior Modification, 24(5), 719-739. doi:10.1177/0145445500245006 . Language: English Format: Journal Abstract: Keywords: Adults African American Anxiety Disorders Avoidance Battery Drug Abuse Effectiveness Empirical Study European Americans Females Intrusive Thoughts Quantitative Study Posttraumatic Stress Disorder Prison Inmates PTSD Rape Relaxation Therapy Survivors Treatment Outcome/Clinical Trial Treatment Spouse Abuse Accuracy Verified: Yes 391. 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: Keywords: Neoteric Trauma Treatments Practice Guidelines Accuracy Verified: Yes 392. Twombly, J. H. (2001, December). Safe place imagery: Handling intrusive thoughts and feelings. EMDRIA Newsletter, 6(Special Edition), 35-38. Language: English Format: Newsletter Abstract: Keywords: Dissociative Disorders Safe Place Imagery SPI Accuracy Verified: Yes 393. Carvalho, E. (2012, June). Sanando la pandilla que vive adentro [Healing the folks who live inside]. Presentation at the annual meeting of the EMDR Europe Association, Madrid, Spain. Language: Spanish Format: Conference Abstract: Accuracy Verified: Yes 394. Lanius, U. (2012, October). Science & practice: Attachment, dissociation and EMDR. Presentation at the 29th annual meeting of the International Society for the Study of Trauma and Dissociation, Long Beach, CA. Language: English Format: Conference Abstract: Keywords: Attachment Dissociation Accuracy Verified: Yes 395. Gerge, A. (2012, June). Seven ways to extend the EMDR-protocol based in clinical hypnosis for clients with complex dissociative disorders
[Siete
maneras
de
extender
el
protocolo
EMDR
basadas
en
hipnosis
clínica
para
pacientes
con
trastornos
disociativos
complejos]. Presentation at the annual meeting of the EMDR Europe Association, Madrid, Spain. Language: English Format: Conference Abstract: Keywords: Dissociative Disorders Hypnosis Accuracy Verified: Yes 396. Gerge, A. (2012, June). Seven ways to extend the EMDR-protocol based in clinical hypnosis for clients with complex dissociative disorders [Siete maneras de extender el protocolo EMDR basadas en hipnosis clínica para pacientes con trastornos disociativos complejos]. Presentation at the annual meeting of the EMDR Europe Association, Madrid, Spain. Language: English Format: Conference Abstract: Keywords: Dissociative Disorders Hypnosis Accuracy Verified: Yes 397. Gerge, A. (2012, March). Seven ways to extend the EMDR-protocol from the tradition of clinical hypnosis for clients with complex dissociative disorders. Presentation at the 3rd Bi-Annual International European Society for Trauma and Dissociation Conference, Berlin, Germany
. Language: English Format: Conference Keywords: Dissociative Disorders Hynopisis Accuracy Verified: Yes 398. Strenge, H. (2005). Sexuelle traumata und ihre behandlung mit EMDR [Sexual traumas and their treatment with EMDR]. In G. Nissen, H. Csef, W. Wolfgang, & F. Badura (Eds.), Sexualstörung: Ursachen - Diagnose- Therapie (pp. 147-155). Darmstadt: Steinkopff. doi:10.1007/3-7985-1600-6_12. Language: German Format: Book Section Abstract: Keywords: Sexual Trauma Accuracy Verified: Yes 399. Bergmann, U. (2008). She's come undone: A neurobiological exploration of dissociative disorders. In C. Forgash and M. Copeley (Eds.), Healing the heart of trauma and dissociation with EMDR and ego state therapy (pp. 61-89). New York, NY: Springer Publishing Co. Language: English Format: Book Section Abstract: Keywords: Dissociative Disorders Neurobiology Trauma Accuracy Verified: Yes 400. Taylor, S., Adminson, G., Gordon, J. G., & Carolton, R. N. (2006). Simple versus complex PTSD: A cluster analytic investigation. Journal of Anxiety Disorders, 20(4), 459-472. doi:10.1016/j.janxdis.2005.04.003. Language: English Format: Journal Abstract: Keywords: Adults Canadians Complex Posttraumatic Stress Disorder Complex PTSD C-PTSD Dissociative Symptoms Exposure Therapy Nosology Personality Disorders Random Clinical Trial RCT Relaxation Therapy Somatic Symptoms Stressors Survivors Treatment Effectiveness Accuracy Verified: Yes 401. Struik, A. (2011, April). Slapende honden? Wakker maken! Een stabilisatie methode voor vroegkinderlijk, chronisch getraumatiseerde kinderen [Dogs? Wake up! A stabilization method for early, chronic traumatized children]. Presentatie op de 5e jaarlijkse conferentie van EMDR Vereniging, Nijmegen, Nederland. Language: Dutch Format: Conference Abstract: Keywords: Children Dissociative Disorders Posttraumatic Stress Disorder PTSD Accuracy Verified: Yes 402. Struik, A. (2011, Févrieri). Sleeping dogs: Stabilisation et EMDR pour enfants et adolescents avec traumatismes complexes
[Sleeping dogs: Stabilizing and EMDR for children and adolescents with complex trauma]. Avc de l' UPC KULeuven, Campus Kortenberg, Belgium. Language: Dutch Format: Other Abstract: Keywords: Adults Children Complex Trauma Accuracy Verified: Yes 403. 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: Keywords: Counter-transference Dissociative Disorders Transference Accuracy Verified: Yes 404. 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: Keywords: Countertransference Transference Accuracy Verified: Yes 405. 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 406. Parker, C., Doctor, R. M., & Selvam, R. (2008, September). Somatic therapy treatment effects with tsunami survivors. Traumatology, 14(3). 103-109. doi:10.1177/1534765608319080. Language: English Format: Journal Abstract: Keywords: IES Impact of Event Scale Posttraumatic Stress Post-Tsunami
Symptoms PTSD Somatic Therapy Somatic Experiencing Therapy Accuracy Verified: Yes 407. Vaughan, K. (1992, July). The specificity of symptom change in post-traumatic stress disorder treated with eye movement desensitisation. Presentation at the Fourth World Congress on Behaivour Therapy, Queensland, Australia . Language: English Format: Conference Abstract: Accuracy Verified: Yes 408. Kayal, H. (2013, June). Stabilisation techniques in preparation for trauma focused interventions with refugees. Presentation at the 13th annual conference for the European Society for Traumatic Stress Studies (ESTSS), Bologna, Italy. Language: English Format: Conference Abstract: Keywords: Refugees Stablilization Accuracy Verified: Yes 409. Struik, A. (2009, June). Stabilization and EMDR treatment of young dissociative children. Presentation at the annual meeting of the EMDR Europe Association, Amsterdam, the Netherlands. Language: English Format: Conference Keywords: Children Dissociation Stablization Treatment Accuracy Verified: Yes 410. Struik, A. L. (2010, June). Stabilization and EMDR treatment of young dissociative children, the use of the six tests, a stabilization model. Presentation at the annual meeting of the EMDR Europe Association, Hamburg, Germany. Language: English Format: Conference Abstract: Keywords: Children Dissociation: Six Tests Accuracy Verified: Yes 411. Leutner, S., & Cronauer, E. (2010, June). Stabilizing while processing - Integration of resources into the EMDR protocol (RIT). Preconference presentation at the annual meeting of the EMDR Europe Association, Hamburg, Germany. Language: English Format: Conference Abstract: Accuracy Verified: Yes 412. Knipe, J. (1999, June). Strengthening affect tolerance and adult perspective through construction of imagined dissociative avoidance. EMDRIA Newsletter, 4(2), 10, 25. Language: English Format: Newsletter Abstract: Keywords: Affect Tolerance Dissociative Avoidance Accuracy Verified: Yes 413. Lopez, G. (2007, Juin). Stress vs trauma/Stress vs trauma [Stress vs. trauma / stress vs. srauma]. Présentation à la réunion annuelle de l'Association EMDR Europe, Paris, France. Language: French Format: Conference Abstract: Accuracy Verified: Yes 414. Flood, B. (1999, June). Stroke induced dissociative states and traumatic memory recall. Presentation at the annual meeting of the EMDR International Association, Las Vegas, NV. Language: English Format: Conference Abstract: Keywords: Dissociative States Stroke Traumatic Memory Recall Accuracy Verified: Yes 415. Fullam, P. (2007, August). Successful EMDR in conditions of patient avoidance: To seek or not to seek the negative cognition. EMDR Practitioner. Retrieved from http://www.emdr-practitioner.net on 12/27/2008. Language: English Format: Other Abstract: Keywords: Avoidance Negative Cognition Accuracy Verified: Yes 416. Gambuzza, C. A. (2010, June). Supervision, EMDR and ego state therapy. Poster presented at the annual meeting of the EMDR Europe Association, Hamburg, Germany
. Language: English Format: Conference Abstract: Keywords: Ego State Therapy Supervision Accuracy Verified: Yes 417. Schwarz, R. (1997, January). The supportive use of EMDR in working with patients with dissociative identity disorder. EMDRIA Newsletter, 2(3), 21-23. Language: English Format: Newsletter Abstract: Keywords: DID Dissociative Identity Disorder Accuracy Verified: Yes 418. Abbott, G. (2013, May). Tactical integration in the conference room: A
Safer, more efficient path to healing structural
dissociation of the personality with EMDR. Presentation at the Western Massachusetts EMDRIA Regional Network 9th Annual Spring Conference, Amherst MA. Language: English Format: Conference Abstract: Keywords: Conference Room Dissociation Structural Dissociation Accuracy Verified: Yes 419. Knipe, J. (1995). Targeting defensive avoidance and dissociated numbing. EMDR Network Newsletter, 5(2), 6-7. Language: English Format: Newsletter Abstract: Accuracy Verified: Yes 420. Knipe, J. (2005). Targeting positive affect to clear the pain of unrequited love, codependence, avoidance, and procrastination. In R. Shapiro (Ed.). EMDR solutions: Pathways to healing (pp. 189-212). New York: W W Norton & Co. Language: English Format: Book Section Abstract: Keywords: Life Experiences Psychotherapeutic Processes Survivors Accuracy Verified: Yes 421. Walker, N. (2012, October). Temporal sequencing as a multipurpose aid in preparing for and facilitating EMDR with complex trauma or severe PTSD. Presentation at the at the 4th Autumn EMDR Workshop Conference, Sheffield, UK
. Language: English Format: Conference Abstract: Keywords: Complex Trauma Posttraumatic Stress Disorder PTSD Temporal Sequencing Accuracy Verified: Yes 422. van der Hart, O., Solomon, R., & Gonzalez, A. (2010, September/October). The theory of structural dissociation as a guide for EMDR treatment of chronically traumatized clients. Presentation at the annual meeting of EMDR International Association, Minneapolis, MN. Language: English Format: Conference Abstract: Keywords: Chronic Traumatization Structural Dissociation Accuracy Verified: Yes 423. Tarquinio, C., Fayard, A., & Tarquinio, P. (2007, Juin). Thérapie EMDR chez des vicimes d'accident d'automobile: Une suivi de 6 mois [A 6 month follow-up if victims of automobile accidents undergoing EMDR therapy]. Présentation à la réunion annuelle de l'Association EMDR Europe, Paris, France. Language: French Format: Conference Abstract: Keywords: Automobile Accident Motor Vehicle Accident Accuracy Verified: Yes 424. Dellucci, H. (2010, Novembre). Thérapie EMDR et troubles dissociatifs [EMDR and dissociative disorders]. Presentation a la Pré-programme du colloque: Second séminaire Universitaire de recherche sur
les dimensions intégratives dans la thérapie EMDR, Universite Paul Verlaine - METZ, France. Language: French Format: Conference Abstract: Keywords: Dissociative Disorders Research Accuracy Verified: Yes 425. Knipe, J. (2002, June). A tool for working with dissociative clients. EMDRIA Newsletter, 7(2), 14-15. Language: English Format: Newsletter Abstract: Keywords: Dissociation Accuracy Verified: Yes 426. Nilsson, D., & Jonsson, M. (2010, April). Towards healing of a trauma that led to conversion-dissociation. Presentation at the 2nd Bi-Annual Internatinal European Society for Trauma and Dissociation Conference, Belfast, Northern Ireland. Language: English Format: Conference Abstract: Keywords: Conversion Disorder Dissociation Accuracy Verified: Yes 427. Sanfiz, J., Luque, M. J. S., & Pardos, R. Q. (2007, Novembro). Trabajo con reacciones disociativas durante una sesión de EMDR [Working with dissociative reactions during an EMDR session]. Apresentação no I Congresso Ibero-Americano de EMDR, Brasília, Brasil. Language: Spanish Format: Conference Abstract: No abstract available. Keywords: Dissociative Disorders Accuracy Verified: Yes 428. Mielnik, G. M. (2008). Trastornos disociativos y EMDR [Dissociative disorders and EMDR]. In P. Solvey & R. C. Ferrazzano de Solvey (Eds.), Terapias de avanzada [Advanced therapies]: Vol. 5, Abordajes en EMDR: Trauma y disociacion – Ninos y adolescentes – Fertilidad, inferitilidad, y esterilidad - Psicoprofilaxis, quiruigica, adicciones [Approaches in EMDR: Trauma and dissociation – Children and adolescents – Fertility, infertility, and sterility – Psychoprofilaxis, Surgery, Addictions] (1st ed) (pp. 115-124). Buenos Aires: TdeA Ediciones. Language: Spanish Format: Book Section Abstract: N Keywords: Dissociative Disorders Accuracy Verified: Yes 429. Giannini, A. M., & Segat, I. (2002, Junio). Trastornos disociativos, deteccion, diagnosticos diferenciales y tratimiento con EMDR [Dissociative disorders, screening, diagnosis and differential treatment with EMDR]. Mesa redonda de discusión presentada en El II Congreso Internacional de Trauma y Psiquico y Estres Traumatico, Buenos Aires. Language: Spanish Format: Conference Keywords: Dissociative Disorders Roundtable Accuracy Verified: Yes 430. Ferrazzano de Solvey, R. C. (2008). Tratamiento de los trastornos disociativos de la identidad [Treatment of dissociative disorders of identity – three clinical cases]. In P. Solvey & R. C. Ferrazzano de Solvey (Eds.), Terapias de avanzada [Advanced therapies]: Vol. 5, Abordajes en EMDR: Trauma y disociacion – Ninos y adolescentes – Fertilidad, inferitilidad, y esterilidad - Psicoprofilaxis, quiruigica, adicciones [Approaches in EMDR: Trauma and dissociation – Children and adolescents – Fertility, infertility, and sterility – Psychoprofilaxis, Surgery, Addictions] (1st ed) (pp.125-166). Buenos Aires: TdeA Ediciones. Language: Spanish Format: Book Section Abstract: Keywords: Dissociative Disorders Accuracy Verified: Yes 431. Gimenez, A., Bonet, M. D., Gonzalez, L., & Santos, L. (2011, Julio). Tratamiento preventivo con EMDR del trastorno por estres postraumatico y el duelo patologico: caso clinico [Preventive treatment with EMDR of posttraumatic stress disorder and pathological grief: Case report]. En Casos clínicos: varios. Simposio realizado en el IX Congreso Nacional de Psicología Clínica, San Sebastián, España. Language: Spanish Format: Conference Abstract: Keywords: Pathological Grief Posttraumatic Stress Disorder Preventive Treatment PTSD Symposium Accuracy Verified: Yes 432. Siracusano, A., & Niolu, C. (2006, Settembre-Dicembre). Trattamento farmacologico del - Disturbo post-traumatico da stress [Drug treatment of - post-traumatic stress disorder]. NÓOς, 12(3), 243-276. Language: Italian Format: Journal Abstract: Keywords: Acute Stress Disorder ASD Cognitive-Behavioral Therapy Comorbidity Hypnosis Peritraumatic Dissociation Psychological Debriefing Trauma Accuracy Verified: Yes 433. Mastronardi, C. (2007). Trauma da abuso e EMDR: Presentazione di una ricerca in corso [Abuse trauma and EMDR: A presentation of current research]. Universita Degli Studi di Milano, Italia. Language: Italian Format: Dissertation/Thesis Abstract: Accuracy Verified: Yes 434. Lupo, W. (2007, Novembro). Trauma e trastorno disociativo: Estudio de caso [Trauma and dissociative disorder: Case study]. Apresentação no I Congresso Ibero-Americano de EMDR, Brasília, Brasil. Language: Spanish Format: Conference Abstract: Keywords: Case Study Dissociation Accuracy Verified: Yes 435. van der Kolk, B. (2012, June). Trauma in different mental disorders [El trauma en los distintos trastornos mentales]. Preconference presentation at the annual meeting of the EMDR Europe Association, Madrid, Spain. Language: English Format: Conference Abstract: Keywords: Mental Disorders Trauma Accuracy Verified: Yes 436. Balsamo, S. (2012, June). Trauma medico y su impacto en niños y adultos [Medical trauma and its impact in kids and adults]. Presentation at the annual meeting of the EMDR Europe Association, Madrid, Spain. Language: Spanish Format: Conference Abstract: Keywords: Adults Children Medical Trauma Accuracy Verified: Yes 437. de Roos, C., & van Rood, Y. R. (2011, August-September). Trauma treatment (EMDR) as part of CBT for
body dysmorphic disorder. In Case conceptualization
and treatment of body dysmorphic disorder. Symposium conducted at the 41st EABCT annual congress, Reykjavík, Iceland. Language: English Format: Conference Abstract: Keywords: Body Dysmorphic Disorder CBT Cognitive Behavioral Therapy Symposium Accuracy Verified: Yes 438. Fisher, J. (2012, June). Trauma, body and neurobiology EMDR and sensorimotor psychotherapy in treatment of dissociative disorders [Trauma,
neurobiología
y
el
cuerpo:
EMDR
y
la
psicoterapia
sensoriomotriz
en
el
tratamiento
de
los
trastornos
disociativos]. Presentation at the annual meeting of EMDR Europe Association, Madrid, Spain. Language: English Format: Conference Abstract: Keywords: Dissociative Disorder Neurobiology Accuracy Verified: Yes 439. Moskowitz, A. (2012, June). Trauma, dissociation and psychosis [Trauma,
disociación y psicosis]. Presentation at the annual meeting of the EMDR Europe Association, Madrid, Spain. Language: English Format: Conference Abstract: Keywords: Dissociation Psychosis Trauma Accuracy Verified: Yes 440. Diseth, T. H., & Christie, H. J. (2005, September). Trauma-related dissociative (conversion) disorders in children and adolescents – An overview of assessment tools and treatment principles. Nordic Journal of Psychiatry, 59(4), 278-292. doi:10.1080/08039480500213683. Language: English Format: Journal Abstract: Keywords: Adolescents Children Conversion Disorders Empirical Study Quantitative Study Accuracy Verified: Yes 441. Luber, M. (1992, Winter). Trauma/abuse memories with a client diagnosed with MPD. EMDR Network Newsletter, 2(3), 6-8. Language: English Format: Newsletter Abstract: Keywords: Abuse Memories MPD Multiple Personality Disorder Accuracy Verified: Yes 442. Balibey, H., & Balikçi, A. (2013). Travma sonrası stres
bozukluğu tanılı hastada göz
hareketleri ile duyarsızlaştırma
ve yeniden işleme (EMDR)
tedavisi: Olgu sunumu ]Eye movement desensitization and reprocessing (EMDR) treatment at a patient diagnosed with post-traumatic stress disorder: Case report]. Düşünen Adam Psikiyatri ve Nörolojik Bilimler Dergisi, 26(1), 96-101. doi:10.5350/DAJPN2013260111. Language: Turkish Format: Journal Abstract: Keywords: Case Study Posttraumatic Stress Disorder Accuracy Verified: Yes 443. Forgash, C. A. (2007, June). Treating complex trauma with integrated EMDR and ego state therapy. Pre-conference presentation at the annual meeting of the EMDR Europe Association, Paris, France. Language: English Format: Conference Abstract: Keywords: Ego State Therapy Integrated Phased Treatment Accuracy Verified: Yes 444. Peterson, G. (2003, November). Treating DID with energy psychotherapies. Presentation at the 20th International Society for the Study of Dissociation Fall Conference, Chicago, IL. Language: English Format: Conference Keywords: DID Dissociative Identity Disorder Energy Psychology Energy Therapies Accuracy Verified: Yes 445. Settle, C., & Bolte, C. S. (2012, October). Treating dissociation, ritual abuse and mind control from an attachment perspective. Presentation at the annual meeting of the EMDR International Association, Arlington, VA. Language: English Format: Conference Abstract: Keywords: Attachment Dissociation Mind Control Ritual Abuse Accuracy Verified: Yes 446. Puk, G. (2002, May). Treating dissociative disorders. An invited pre-conference presentation at the annual meeting of the EMDR Europe Association, Frankfurt, Germany. Language: English Format: Conference Keywords: Complex Dissociative Disorders Accuracy Verified: Yes 447. Paulsen, S. (2008). Treating dissociative identity disorder with EMDR, ego state therapy, and adjunct approaches. In C. Forgash and M. Copeley, (Eds.) Healing the heart of trauma and dissociation with EMDR and ego state therapy (pp. 141-179). New York, NY: Springer Publishing Co. Language: English Format: Book Section Abstract: Keywords: Dissociation Ego State Therapy Accuracy Verified: Yes 448. Puk, G. (2011, May). Treating highly traumatized clients with EMDR. Presentation at the EMDR Canada Advanced Clinical Applications Workshop, Montreal, Quebec, Canada. Language: English Format: Conference Abstract: Keywords: Dissociation Accuracy Verified: Yes 449. Muris, P., Merckelbach, H., Holdrinet, I., & Sijsenaar, M. (1998, February). Treating phobic children: Effects of EMDR versus exposure. Journal of Consulting & Clinical Psychology, 66(1), 193-198. doi:10.1037/0022-006X.66.1.193. Language: English Format: Journal Abstract: Keywords: Adolescents Children Empirical Study Phobia Treatment Effectiveness Accuracy Verified: Yes 450. Muris, P., & Merckelbach, H. (1995, September-October). Treating spider phobia with eye-movement desensitization and reprocessing: Two case reports. Journal of Anxiety Disorders, 9(5), 439-449. doi:10.1016/0887-6185(95)00023-H. Language: English Format: Journal Abstract: Keywords: Arachnida Clinical Case Study Empirical Study Phobias Spider Phobia Accuracy Verified: Yes 451. Muris, P., & Merckelbach, H. (1997, January). Treating spider phobics with eye movement desensitization and reprocessing: A controlled study. Behavioural and Cognitive Psychotherapy, 25(1), 39-50. doi:10.1017/S1352465800015381. Language: English Format: Journal Abstract: Keywords: Control Study Empirical Study Spider Phobias Accuracy Verified: Yes 452. Forgash, C. A. (2003, November). Treating survivors of overwhelming trauma who present with pre-existing PTSD and dissociative disorders: An EMDR/Ego State approach. Presentation at the International Society for the Study of Dissociation Fall Conference, Chicago, IL. Language: English Format: Conference Keywords: Dissociative Disorders Posttraumatic Stress Disorder PTSD Accuracy Verified: Yes 453. Nelson, W. F. (2006, June). A treatment assisted recovery model for victims of prostitution and trafficking. Presentation at the Stockholm Criminology Symposium, Stockholm, Sweden. Language: English Format: Conference Abstract: Keywords: Prostitution Accuracy Verified: Yes 454. Honda, M. (2005, February). Treatment of a PTSD victim of attempted murder-robbery by eye movement desensitization and reprocessing (EMDR): A case report. Japanese Journal of Traumatic Stress, 3(1), 91-106. Language: English Format: Journal Abstract: Keywords: Case Report Posttraumatic Stress Disorder Psychotherapeutic Processes PTSD Robbery Survivors Accuracy Verified: Yes 455. de Jongh, A. (2006, June). Treatment of anxiety and phobias with EMDR: Rapid conceptualization: Effective procedures and proposals for changes of the protocol. Presentation at the annual meeting of the EMDR Europe Association, Istanbul, Turkey. Language: English Format: Conference Abstract: Accuracy Verified: Yes 456. Adler-Tapia, R. (2012, October). Treatment of attachment trauma and the dissociative sequelae: A developmentally grounded approach to case conceptualization with EMDR. Presentation at the annual meeting of the EMDR International Association, Arlington, VA. Language: English Format: Conference Abstract: Keywords: Attachment Case Conceptualization Dissociation Accuracy Verified: Yes 457. Omaha, J. (2000, September). Treatment of bulimia and binge eating disorder using the Chemotion/EMDR protocol. Presentation at the annual meeting of the EMDR International Assocation, Toronto, Ontario Canada. Language: English Format: Conference Abstract: Keywords: Bulimia Nervosa Binge Eating Chemotion Dissociation Hypnosis Ingestive Disorder Accuracy Verified: Yes 458. de Jongh, A., & ten Broeke, E. (1998). Treatment of choking phobia by targeting traumatic memories with EMDR: A case study. Clinical Psychology and Psychotherapy, 5(4), 264-269. doi:10.1002/(SICI)1099-0879(199812). Language: English Format: Journal Abstract: Keywords: Adults Report Females Medical Procedures Multiple Traumatic Events Phobia Survivors Treatment Effectiveness Accuracy Verified: Yes 459. Tarrier, N., & Sommerfield, C. (2004). Treatment of chronic PTSD by cognitive therapy and
exposure: 5-year follow-up. Behavior Therapy, 35, 231-246. Language: English Format: Journal Abstract: Keywords: Cognitive Therapy Exposure Therapy, Posttraumatic Stress Disder PTSD Accuracy Verified: Yes 460. Cohen, A. (2009). Treatment of dissociation with EMDR when war interrupts the process: The integration of EMDR with e-mail therapy. Journal of EMDR Practice and Research, 3(1), 50-56. doi:10.1891/1933-3196.3.1.50. Language: English Format: Journal Abstract: Keywords: Dissociative Disorder Dissociation E-Mail Not Otherwise Specified War Writing Accuracy Verified: Yes 461. Barre, K. (2010, June). Treatment of dissociative amnesia after vehicle
accident with EMDR. In Accident victims. Symposium conducted at the annual meeting of the EMDR Europe Association, Hamburg, Germany. Language: English Format: Conference Abstract: Keywords: Accident Victims Dissociative Amnesia Symposium Traffic Accidents Accuracy Verified: Yes 462. Barre, K. (2008, October). Treatment of dissociative amnesia with EMDR . In A. C. McFarlane & Yuchuan Yang (Conveners) Psychological trauma: Diagnosis and treatment – State of the Art. Symposium presented at the 5th World Congress for Psychotherapy, Beijing, China . Language: English Format: Conference Keywords: Dissociative Amnesia Trauma Accuracy Verified: Yes 463. Barre, K. (2008, April). Treatment of dissociative amnesia with EMDR. Presentation at the annual meeting for the European Society for Trauma and Dissociation, Belfast, Ireland. Language: English Format: Conference Keywords: Dissociative Amnesia Accuracy Verified: No 464. de Jongh, A. (2010; June). Treatment of fears and phobias with EMDR: Assessment, conceptualization and effective treatment strategies. Preconference presentation at the annual meeting of the EMDR Europe Association, Hamburg, Germany. Language: English Format: Conference Abstract: Keywords: Fear Phobias Treatment Strategies Accuracy Verified: Yes 465. Whisman, M. (2000, May 6). Treatment of obsessive compulsive disorder (OCD) with EMDR. Presentation at the annual meeting of the EMDR Europe Association, Utrecht, Netherlands. Language: English Format: Conference Abstract: Keywords: Obsessive Compulsive Disorder OCD Accuracy Verified: Yes 466. Whisman, M. (2000, May 6). Treatment of panic disorder with EMDR. Presentation at the annual meeting of the EMDR Europe Association, Utrecht, Netherlands. Language: English Format: Conference Abstract: Keywords: Panic Disorder Accuracy Verified: Yes 467. Oras, R., de Ezpeleta, S. C., & Ahmad, A. (2004, June). Treatment of traumatized refugee children with eye movement desensitization and reprocessing in a psychodynamic context. Nordic Journal of Psychiatry, 58(3), 199-203. doi:10.1080/08039480410006232. Language: English Format: Journal Abstract: Keywords: Children Comorbidity Depressive Disorders Empirical Study Posttraumatic Stress Disorder PTSD Quantitative Study Refugees School Age Children Adolescents Stressors Survivors Trauma Treatment Effectiveness Accuracy Verified: Yes 468. Cohena, J. A., Mannarino, A. P., & Rogal, S. (2001, January). Treatment practices for childhood posttraumatic stress disorder. Child Abuse and Neglect, 25(1), 123-135. doi:10.1016/S0145-2134(00)00226-X. Language: English Format: Journal Abstract: Keywords: Adolescents Arousal Avoidance Children Drug Therapy Mental Health Personnel Reexperiencing Posttraumatic Stress Disorder PTSD Treatment Effectiveness Accuracy Verified: Yes 469. Vidal, C., Santed, A., Sánchez, S., Mattioli, G., & Serrano, M. J. (2006, Febrero). Un caso clínico de trastorno de identidad disociativo (TID) tratado con EMDR e ICV: Una cierta integración (que para la paciente ha representado una experiencia vitalizante mayúscula) [A clinical case Dissociative Identity Disorder (DID) treated with EMDR and ICV: A certain integration has been reached (which for the patient has represented a major revitalizing experience)]. Comunicación presentada en: 7º Congreso Virtual de Psiquiatría, Barcelona, Spain. Language: Spanish Format: Conference Abstract: Keywords: DID Dissociation Dissociative Identity Disorder MPD Multiple Personallity Disorder Psychological Trauma Psychotherapy, VCI Psychotherapy Accuracy Verified: Yes 470. Yoeli, F. R. (2001, December). Uncovering the dissociative ego states under the mask of OCD. Presentation at the annual meeting of the International Society for the Study of Dissociation Fall Conference, New Orleans, LA. Language: English Format: Conference Keywords: Dissociation Ego States Obsessive Compulsive Disorder OCD Accuracy Verified: No 471. Mosquera, D. (2012, June). Understanding
and
treating
narcissistic
and
antisocial
personalities
with
EMDR [Personalidades
narcisistas
y
antisociales.
Comprensión
y
abordaje
desde
EMDR]. Presentation at the annual meeting of EMDR Europe Association, Madrid, Spain. Language: English Format: Conference Abstract: Keywords: Antisocial Personality Disorder Narcissistic
Personality Disorder Accuracy Verified: Yes 472. Mosquera, D., Gonzalez, D., & Seijo, N. (2010, September/October). Understanding "dissociative language". Presentation at the annual meeting of EMDR International Association, Minneapolis, MN. Language: English Format: Conference Abstract: Keywords: Dissociation Accuracy Verified: Yes 473. Mosquera, D., & Gonzalez, A. (2010, June). Understanding dissociative language. Presentation at the annual meeting of the EMDR Europe Association, Hamburg, Germany. Language: English Format: Conference Abstract: Keywords: Dissociation Accuracy Verified: Yes 474. Pessina, C (2007, June). The use and adaptation of EMDR technique with sexually abused children. Presentation at the annual meeting of the EMDR Europe Association, Paris, France. Language: English Format: Conference Abstract: Keywords: Children Sexual Abuse Accuracy Verified: Yes 475. Dodds, J. (2003, September 13). Use of EMDR and associated techniques in dissociative disorders: A clinical perspective. Presentation at the International Conference on Trauma, Attachment and Dissociation, Melbourne, Australia . Language: English Format: Conference Keywords: Dissociative Disorders Accuracy Verified: Yes 476. Suokas-Cunliffe, A., Matthess, H.,
& van der Hart, O. (2008, April). The use of EMDR and guided synthesis in the treatment of chronically traumatized patients. Proceedings of the 1st Bi-Annual International European Society for Trauma and Dissociation Conference, Amsterdam, the Netherlands. Language: English Format: Conference Abstract: Keywords: Guided Synthesis Trauma Accuracy Verified: Yes 477. Klaus, P. H. (1995, June). The use of
Psychologische Behandlung von traumatischen Belastungsstörungen mit EMDR. Die EMDR-Behandlung ist nach unserer Erfahrung eine sehr effektive Technik zur Behandlung von traumatischen Erinnerungen bei Patienten mit dissoziativen Störungen. Das Ziel der Traumabehandlung bei dissoziativen Patienten zusätzlich zu der Verringerung der Belastung von posttraumatischen Symptomen, Aussetzen der zuvor abgespaltenen Erinnerungen im Sinne einer Integration von dissoziierten Erfahrung liegt. Die EMDR-Behandlung dissoziativer Patienten brauchen, wenn nötig. durch Ändern der Standard-Protokoll auf den einzelnen Elastizität eingestellt werden. Da dissoziative Speicher Barrieren durch eine EMDRBehandlung sehr schnell untergraben werden kann, kombiniert mit dem Risiko der Übererflutung durch aversive Reize, sollte dies nur von entsprechend erfahrenen Therapeuten und mit Sorgfalt im Rahmen einer umfassenden Traumatherapie eingesetzt werden.
Psychological treatment of traumatic stress disorders with EMDR. The EMDR treatment is, in our experience a very effective technique for the treatment of traumatic memories in patients with dissociative disorders. The aim of trauma treatment in dissociative patients in addition to reducing the burden of post-traumatic symptoms, exposing the previously split-off memories in the sense of an integration of dissociated experience content. The EMDR treatment of dissociative patients need, if necessary. be adjusted by modifying the standard protocol on the individual resilience. Since dissociative memory barriers through a EMDRBehandlung may be undermined very quickly, combined with the risk of Übererflutung by aversive stimuli, this should only be used by suitably experienced therapists and with care in the context of a comprehensive trauma therapy.
Es geht im Workshop um die Rolle der Kognitionen im EMDR bei der Bearbeitung früher und komplexer Themen aus dem Bereich der Bindungsstörungen. Durch die Aktivierung von Egostates respektive subtiler dissoziativer Prozesse in der Phase 3 der EMDR-Behandlung kommt es häufig zu Schwierigkeiten bei der Herausarbeitung bedeutungsvoller und hilfreicher Kognitionen. Das Dialog-Protokoll stellt eine Möglichkeit dar, diese Schwierigkeiten zu vermeiden. Durch die Wahl hilfreicher Kognitionen in einer dialogischen Formulierung zwischen zwei involvierten Selbstteilen wird der dissoziative Prozess aufgehoben und der Verarbeitungsprozess im Sinne der interaktiven Vernetzung von Vergangenheit und Gegenwart affektiv und kognitiv intensiviert und beschleunigt. Das Dialog Protokoll kann als die direkte und effiziente Verbindung von EMDR und Egostate-Arbeit angesehen werden. Im Workshop werden theoretische Grundlagen der Vorgehensweise vermittelt, eine kurze life Demonstration und/oder ein Video sollen die konkrete Anwendung des Dialogprotokolls anschaulich näherbringen.
[It's in the workshop on the role of cognitions in EMDR in the treatment earlier and complex topics in the field of attachment disorders. By activating Egostates respectively subtle dissociative processes in phase 3 of the EMDR treatment often leads to difficulties in the elaboration of meaningful and helpful cognitions. The dialog protocol provides a way to avoid these difficulties. By choosing more helpful cognitions in a dialogical formulation between two self-involved parts of the dissociative process is canceled and the manufacturing process in terms of the interactive network of past and present affective and cognitive intensified and accelerated. The dialog protocol can be used as direct and efficient connection of EMDR and egostate work are considered.
During the workshop, theoretical foundations of the approach gives a brief demonstration of life and / or a video to bring closer the actual application of the Protocol dialog clearly.]
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.
After the first cautions for the use of EMDR in dissociative disorders, many proposals have been done to adapt EMDR procedures to this specific population. Nevertheless EMDR is still considered by many clinicians as an intervention that is limited to the treatment of traumatic memories in highly functioning dissociative clients, after a long preparation phase. From this conceptualization the use of EMDR is strongly limited, and many trauma survivors cannot benefit of it.
In this workshop a comprehensive model for EMDR therapy in Dissociative Disorders (the Progressive Approach) will be proposed. From this extended framework, different interventions with EMDR in dissociative clients will be described, including procedures to prepare and stabilize these clients. The integration of these specific EMDR procedures into a group therapy for trauma survivors will be described. The interweaving between theoretical developments, clinical procedures and video examples will allow the audience to assimilate information and translate it to their clinical practice.
Learning objectives:
Propose a comprehensive model to approach dissociative clients from the EMDR perspective, connecting theoretical developments and clinical procedures;
Identify difficult situations in EMDR therapy of severely traumatized people and describe EMDR procedures for dissociative clients, all along the different phases of treatment;
Illustrate the “progressive approach” for the treatment of dissociative disorders with clinical examples and video fragments of individual and group sessions so EMDR therapists can understand when, where and how to apply these procedures in their clinical practice.
A theoretical analysis of the psychodynamic dimension of cognitions in the eye movement desensitization and reprocessing (EMDR) protocol can be beneficial in addressing the specific issues affecting the choice of appropriate cognitions in working with clients with personality disorders. This group of patients share the biographic commonality of emotional-narcissistic abuse and neglect in childhood by primary attachment figures and significant others in their lives. Arising from these experiences, a subtle dissociation (in childhood) can cause the development of parts of self with an emotional and cognitive fixation on a self-image. This is defined by the child's attachment figures and other significant people, and has subsequently been internalized by the child themselves. In such cases, the actual goal of treatment is not primarily the event on which the EMDR session is initially focused, but rather the complex emotional and cognitive significance that the event has on the client's self-perception and self-evaluation.
Interactions between trauma and biology, dissociation and psychosis are
complex. Some cases could be more biologically based, and traumatic events may
trigger a psychotic episode or contribute to the low-response to usual
interventions. But traumatic experiences could also influence neurodevelopment
and brain structure. In some cases past adverse events may be a main factor in the
development of psychotic psychopathology. The treatment of psychotic disorders
with a specifically trauma-oriented therapy as EMDR, can help us to evaluate the
relative contribution of these different factors from clinical results. The empirical
research about the application of EMDR will be also reviewed.
A relevant point for EMDR therapy in psychotic disorders is the complex
relationship between dissociation and psychosis. Patients presenting with the
belief of being controlled by an external force, intrusive thoughts and hallucinatory
voices that comment on one's thoughts or actions or that have a conversation with
other hallucinated voices, are easily diagnosed as schizophrenic or psychotic but
can often be best understood and approached as dissociative symptoms. These
patients can be treated with EMDR, but the procedures present relevant
modifications in relation with the standard EMDR procedure for PTSD.
In this workshop we will briefly describe how EMDR can be applied in different
examples of psychotic patients, and based on these clinical examples (presented a case-descriptions or videos, we will reflect on the previously described aspects.
Las
interacciones
entre
trauma
y
biología,
disociación
y
psicosis
son
complejas.
Algunos
casos
pueden
estar
más
basados
en
el
ámbito
biológico,
y
los
eventos
traumáticos
pueden
ser
disparadores
de
un
episodio
psicótico
o
contribuir
a
la
baja
respuesta
ante
las
intervenciones
usuales.
Pero
las
experiencias
traumáticas
pueden
también
influenciar
el
neurodesarrollo
y
la
estructura
cerebral.
En
Algunos
casos
eventos
adversos
del
pasado
pueden
ser
el
principal
factor
para
desarrollar
psicosis
o
una
psicopatología.
El
tratamiento
de
los
trastornos
psicóticos
con
un
terapia
orientada
al
trauma
como
el
EMDR
nos
ayudan
a
evaluar
la
contribución
relativa
de
distintos
factores
a
los
resultados
clínicos.
La
investigación
empírica
acerca
de
la
aplicación
del
EMDR
también
será
revisada.
Un
punto
relevante
de
la
Terapia
EMDR
en
trastornos
psicóticos
es
el
resultado
complejo
de
la
relación
entre
disociación
y
psicosis.
Los
pacientes
que
presentan
creencias
de
control
por
fuerzas
externas,
pensamientos
intrusivos
y
voces
alucinatorias
que
comentan
las
acciones
o
pensamientos
o
tienen
una
conversación
con
otras
voces
alucinatorias,
normalmente
son
diagnosticadas
como
esquizofrenia
y
psicosis
pero
en
algunas
ocasiones
estarían
mejor
entendidas
desde
un
enfoque
que
las
considerara
síntomas
disociativos.
Estos
pacientes
pueden
ser
tratados
con
EMDR,
pero
los
procedimientos
presentan
modificaciones
referentes
al
procedimiento
estándar
de
EMDR
para
el
TEPT.
Participants will: 1) increase their confidence in deciding how, when, and where to use EMDR in the context of long term therapy with dissociative disorders; 2) increase their skills in being able to structure safe and contained EMDR sessions with clients with dissociative disorders; 3) increase their ability to adapt the EMDR protocol to the specific needs of specific clients with dissociative disorders; and 4) increase their knowledge of both the potential risks and potential benefits of using EMDR with dissociative clients.
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.
Learning Outcomes 1. How to integrate EMDR in the phase-oriented treatment of DID 2. Inspiration for finding creative solutions for the problems that can occur during the session (e.g. dissociation, reliving traumatic experiences, acting-out) 3. Witnessing the effect of EMDR 4. Encouraging collegue’s to indicate EMDR for complex trauma (under specific conditions).
Chronic childhood trauma may lead to chronic dissociation which in turn produces a highly conflicted self-structure. Since conflicted self systems may not process smoothly in EMDR, it behooves practitioners to assess for degree of dissociation and other “red flag” indicators prior to EMDR. To work with clients with conflicted selves, the practitioner needs a means to access disowned parts of self. Although Ego State Therapy (EST) is based upon psychoanalytic theory, it is not slow as psychoanalytic treatment is. EST is a way to rapidly access internal structures, mediate conflicts, navigate around defenses and mobilize resources. Therefore EST is ideal as either: 1) a cognitive interweave in EMDR looping; or 2) as part of a preparation for clients in the high end of the dissociative continuum (the ACT-AS-IF approach). This workshop will illustrate case formulation and EMDR preparation and processing using the concepts above.
Dissociation is a normal human process. We all
dissociate. Some individuals are so severely and
chronically traumatized that, in order to survive,
they split their awareness into at least two levels
or streams of consciousness - one level being the
participant in the abuse drama and the other level
being an observer watching as if the abuse was
happening to someone close. This defense mechanism, which allows severely abused individuals to survive, can become an obstacle to
the reprocessing of their traumatic memories. This
presentation will discuss dissociative process from the Accelerated Informational Processing Model of EMDR. It will cover: the implications and
complications of clinical treatment with
dissociative process; the nature of dissociative
process; screening for dissociation and the 'Red
Flags' of treatment concerns; the differential
diagnoses of dissociation - from dissociation
found in diagnostic categories other than
Dissociative Disorders (e.g., Mood Disorders,
Anxiety Disorders, PTSD) to DDNOS (ego states
work) and DID; the use of EMDR in the treatment
of dissociation in relation to trauma; therapist
attributes that help contribute to the successful
treatment of dissociative patients. Participants will
be encouraged to share their own insights and
difficulties in working with this very traumatized
population of individuals.
Efficacy of EMDR on Children Affected by Earthquake: The aim of the study was to investigate the efficacy of EMDR as an
intervention technique for trauma victims. A sample of 50 students, studying in 10th grade, age ranging from 14 to 16 years
were selected. The Impact of Event Scale (IES) was administered to measure the intensity of trauma experienced. A pre-post
test research design was used in the study. The results were in the predicted direction. EMDR was found to be effective in
reducing avoidance, intrusion and hyper arousal as well as overall impact of trauma.
“Group EMDR With Earthquake Survivors”
The current study is an attempt to understand the impact of a specific traumatic events and its expression in children i.e. the
earthquake that occurred in Gujarat, Western India in January 2001.
This study was a part of the therapy work conducted with the survivors of the earthquake by the group of 40 practitioners
from Mumbai and was over 4 months.
The paper will present the following aspects:
1. The symptoms seen among the children depicting PTSD as per DSM IV criteria. Signs of Hyper-arousal, Avoidance and
Intrusion were clearly seen especially in children
2. The process used. This was a modified version of the standard 8 phase protocol appropriate for use with group work.
Butterfly hugs were used as BLS. Stages of EMDR for this group:
3. Observations and a few unique experiences
These include blocking of trauma image, difficulty in safe place visualizing, difficulty in distancing and using creative
techniques for soothing and relaxation.
4. Impact of the EMDR intervention with this group
More than 16000 children from about 30 schools were seen. based on observations and reports by teachers during the
follow up showed reduction in anxiety, reports of life resembling pre-earthquake, improved attention and concentration,
better sleeping patterns and lowering of somatic complaints.
Impact and expression of trauma in children exposed to the earthquake: The current study is an attempt to understand
the impact of a specific traumatic event and its expression in children i.e. the earthquake that occurred in Gujarat, western
India in January 2001. The Butterfly hug technique for bilateral stimulation was used following 8 steps of EMDR. Drawings
of children were used as their expressions during different phases of EMDR. Drawings during “ Assessment phase” depicted
feelings of insecurity, a sense of vacuum and emptiness, low energy levels, a desire for contact and help, feelings of guilt, poor
body image, hypersensitivity was noticed almost universally and even during therapy. Drawings, following the processing
and installation phases indicated the facial expression changed to a smile. Tears which were present in almost all drawings
were not noted Positive cognitions were reflected in terms of the growth and freshness e.g. the newly growing grass. In spite
of the various symptoms of post traumatic stress disorder, no gross disintegration of personality had been noted.
Dissociative symptoms are common in traumatic stress syndromes (e.g., complex PTSD, disorder of extreme stress not otherwise specified [DESNOS], borderline personality disorder, and dissociative disorders). They commonly interfere with psychotherapy including EMDR treatment. It appears that the adaptive information processing system gets overwhelmed and shuts down, thereby barring the integration and resolution of traumatic experience and thus precluding positive treatment outcomes. A series of case studies by Ferrie and Lanius found that the administration of an opioid antagonist prior to EMDR treatment significantly reduced dissociative symptoms, somatization, and numbing, as well as aiding trauma processing. The present chapter describes the relevant scientific research, as well as a theoretical rationale and a protocol, for the use of opioid antagonists in trauma processing with EMDR. [Text, p. 121]
El autor presenta una serie de argumentos del porque el reprocesamiento y desensibilización a través del movimiento ocular (EMDR por sus siglas en inglés: Eye Movement Desenstization and Reprocessing) se basa en un modelo trauma-disociación de trastornos mentales. El modelo de EMDR es consistente con las teorías trauma-disociación de Pierre Janet, el modelo BASK de disociación de Braun y la teoría de disociación estructural, la cual es una elaboración reciente de las ideas de Janet. Los procedimientos terapéuticos del EMDR son consistentes con los modelos de tres etapas de psicoterapia para trauma, y EMDR puede utilizarse en el tratamiento de trastornos disociativos complejos sin modificaciones significativas. El autor sugiere que la literatura con los resultados del tratamiento con EMDR puede considerarse como literatura sobre el tratamiento de la disociación inducida por trauma.
The author presents a series of arguments for why desensitization and reprocessing through eye movement (EMDR for short English: Desenstization and Reprocessing Eye Movement) is based on a trauma-dissociation model of mental disorders. The model is consistent with EMDR trauma-dissociation theory of Pierre Janet, the BASK model of dissociation of Braun and the theory of structural dissociation, which is a recent development ideas Janet. EMDR therapeutic procedures are consistent with models of three stages of psychotherapy for trauma, EMDR can be used in the treatment of complex dissociative disorders without significant modifications. The author suggests that literature with the results of EMDR therapy can be considered as literature on the treatment of trauma-induced dissociation
This book is a manual for doing EMDR with diverse client populations. [Text, P. 3]TOPICS TREATED: The strategic developmental model for EMDR; Integrating resource development strategies into your EMDR practice; EMDR for clients with dissociative identity disorder, DDNOS, and ego states; EMDR processing with dissociative clients: adjunctive use of opioid antagonists; The phantom limb pain protocol; The two-hand interweave; DeTUR, an urge reduction protocol for addictions and dysfunctional behaviors; Targeting positive affect to clear the pain of unrequited love, codependence, avoidance, and procrastination; The reenactment protocol for trauma and trauma-related pain; EMDR with cultural and generational introjects; Exiting the binge-diet cycle; Utilizing EMDR and DBT techniques in trauma and abuse recovery groups; Using EMDR in couples therapy; EMDR with clients with mental disability; Treating anxiety disorders with EMDR; Affect regulation for children through art, play, and storytelling. [Pilots]
This is the first book to provide a wide range of leading-edge, step-by-step strategies for clinicians using EMDR therapy and adjunct approaches with children with severe dysregulation of the affective system. Written by an author internationally known for her innovative work with children, the book offers developmentally appropriate and advanced tools for using EMDR therapy in treating children with complex trauma, attachment wounds, dissociative tendencies, and compromised social engagement. The book also presents the theoretical framework for case conceptualization in EMDR therapy and in the use of the Adaptive Information Processing (AIP) model with children.
Principles and concepts derived from the Polyvagal Theory, affective neuroscience, attachment theory, interpersonal neurobiology, developmental neuroscience and the neurosequential model of therapeutics, which can greatly support and expand our understanding of the AIP model and complex trauma, are presented. The text also offers an original and pioneering EMDR therapy-based model to working with parents with abdicated caregiving systems. The model is directed at assisting parents in developing the ability for mentalization, insightfulness, and reflective capacities linked to infant's development of attachment security.
A unique and innovative feature of this book is the masterful integration of strategies from other therapeutic approaches, such as Play therapy, Sandtray therapy, Sensorimotor psychotherapy, Theraplay and Internal Family Systems (IFS), into a comprehensive EMDR treatment maintaining appropriate adherence to the AIP model and EMDR therapy methodology.
Key Features:
•Provides creative, step-by-step, "how-to" information about the use of EMDR therapy with children with complex trauma from an internationally known and innovative leader in the field
•Explores thoroughly the eight phases of EMDR therapy in helping children with attachment wounds, dissociative tendencies and high dysregulatio
•Incorporates adjunct approaches into a comprehensive EMDR therapy while maintaining fidelity to the AIP model and EMDR therapy methodology
•Contains an original EMDR therapy-based model for helping parents with abdicated caregiving systems to develop metalizing and reflective capacities
Abstract: Scientific studies of EMDR have shown that it is one of the most effective
tools to treat posttraumatic stress disorder. One of the lesser known properties of
EMDR is that it also seems to be an effective psychotherapy method in a number of
disorders that have part of their origins in dysfunctional implicit memory
structures. Some of these disorders are complex trauma based disorders like
dissociative disorders and some patients with symptoms of borderline disorder
others are traumatized offenders, some forms of substance dependencies and
depressive disorders.
Many of these patients are challenging populations and some of the direct EMDR
approaches may only be partly successful.
In this workshop an overview of the new areas for the application of EMDR will be
given and participants will hear where and how EMDR can be used in a treatment
plan. Also the research status of these new approaches will be reported.
If time permits cases can be discussed too.
Los estudios científicos de EMDR han comprobado que es una de las
herramientas más efectivas en el tratamiento del trastorno por estrés
postraumático. Una de las propiedades menos conocidas de EMDR es que también
parece suponer un método de psicoterapia efectivo en varios trastornos que se
originan parcialmente en estructuras disfuncionales de la memoria implícita.
Algunos de estos trastornos son trastornos basados en el trauma complejo, como
los trastornos disociativos y algunos casos de trastorno límite de la personalidad;
también se pueden incluir agresores traumatizados, algunas formas de
dependencias de sustancias y trastornos depresivos.
Muchos de estos pacientes suponen poblaciones de especial dificultad y algunos de
los abordajes directos con EMDR pueden tener un éxito únicamente parcial.
Este taller ofrecerá una perspectiva global de las nuevas áreas de aplicación de
EMDR y se les explicará a los participantes en qué casos y cómo se puede utilizar
EMDR en un plan terapéutico. También se informará respecto al estado de la
investigación de estos nuevos planteamientos.
Si hay tiempo, también se podrán presentar algunos casos.
Distress and fears of recurrence following breast cancer treatment are viewed through the lens AIP. Through review of research and case presentation of one stage III client, participants will be able identify traumatic stress symptoms in women with breast cancer and the factors that predict distress; describe how intrusion, hyperarousal and avoidance can impact cancer treatment and quality of life, including fears of recurrence; apply research on the use of EMDR with phantom limb pain to the phantom sensations experienced by many women following mastectomy; and identify treatment considerations in the use of the eight phases of EMDR to improve quality of life and decrease fears of recurrence.
It is clear from over 17 published studies that the EMDR method is highly effective in assisting clients in resolving PTSD (Maxfield and Hyer, 2002). However, most clients who enter therapy do not have a simple problem of a single disturbing memory, but a complex history. Typically, clients come to therapy with a mixed presentation, of not only emotional disturbance, but also mental structures and actions which function to soothe, contain, avoid or dissociate from emotional disturbance. Thus, the initial presentation of most clients is complex and often ambivalent. In this workshop, examples will illustrate Adaptive Information Processing methods of targeting and resolving psychological defenses, such as avoidance, ambivalence, and idealization. Also, the BHS/CIPOS (Back-of-the-Head Scale/Constant Installation of Present Orientation and Safety) method will be described. This method is a set of procedures that can be used during the EMDR Desensitization Phase to therapeutically reverse dissociative processes while preserving emotional safety. Video segments from therapy sessions will be shown to illustrate each of these methods.
EMDR
has
had
a
profound
positive
impact
on
the
lives
of
many
clients
and
has
been
shown
in
more
than
seventeen
published
trials
to
be
effective
in
the
treatment
of
PTSD
(Maxfield
&
Hyer,
2002).
However,
the
DSM
IV
definition
of
PTSD
is
focused
on
the
single
traumatic
incident,
and
many
clients
seeking
relief
in
therapy
have
a
damaging
traumatic
history
that
extended
over
repeated
events
or
over
long
periods
of
time.
The
term,
Complex
PTSD
(Herman,
1992,
van
der
Kolk,
2005)
has
been
proposed
to
describe
a
pattern
of
negative
effects
of
prolonged
and
extreme
stress,
particularly
during
childhood.
The
focus
of
this
workshop
is
to
describe
a
theoretical
framework,
and
specific
therapy
“tools”
which
may
be
useful
in
providing
effective
therapy,
within
the
EMDR
Adaptive
Information
Processing
Model,
to
individuals
suffering
with
Complex
PTSD.
Important
concepts
and
particular
interventions
will
be
illustrated
through
video
examples
and
transcripts
from
therapy
sessions.
Dr.
Knipe
will
present
methods
for
identifying
and
treating
specific
dissociative
symptoms
with
accompanying
evidence
from
available
research
or
case
studies.
He
will
offer
EMDR
“tools”
that
can
be
used
to
make
the
healing
power
of
EMDR
more
available
to
clients
who
are
avoidant,
and/or
highly
vulnerable
to
dissociative
abreaction,
chronic
shame,
and
unrealistic
idealization
of
self
or
of
others.
He
will
discuss
the
primary
characteristics
of
clients
with
Complex
PTSD,
including
problems
with
disrupted
attachment
and
inappropriate
psychological
defenses.
He
will
illustrate
how
to
identify
various
Ego-‐States
and
work
with
these
within
the
Adaptive
Information
Processing
Therapy
Approach.
Time
will
be
available
for
participants
to
discuss
difficult
EMDR
cases.
EMDR
ha
tenido
un
profundo
efecto
sobre
la
vida
de
muchos
clientes
y
ha
demostrado
en
más
de
diecisiete
ensayos
publicados,
ser
eficaz
para
el
tratamiento
del
TEPT
(Maxfield
&
Hyer,
2002).
Sin
embargo,
la
definición
del
DSM
IV
del
TEPT
está
centrada
en
el
incidente
traumático
único,
mientras
que
en
muchos
de
los
clientes
que
buscan
el
alivio
a
través
de
la
terapia
su
historial
traumático
incluye
episodios
traumáticos
repetidos
o
que
se
extienden
a
lo
largo
de
períodos
prolongados
de
tiempo.
Se
ha
propuesto
el
término
TEPT
complejo
(Herman,
1992,
van
der
Kolk,
2005)
para
describir
un
patrón
de
efectos
negativos
derivados
una
situación
de
estrés
prolongado
e
intenso
que
ha
aparecido
principalmente
en
la
infancia.
Este
taller
estará
centrado
en
describir
el
marco
teórico
y
las
“herramientas”
terapéuticas
específicas
que
pueden
ser
necesarias
para
proporcionar
,
dentro
del
modelo
de
procesamiento
adaptativo
de
la
información
de
EMDR,
una
terapia
eficaz
a
los
individuos
que
sufran
de
un
cuadro
de
TEPT
complejo.
Los
conceptos
importantes
y
las
intervenciones
concretas
que
se
realizan
serán
ejemplificadas
mediante
ejemplos
en
vídeo
y
mediante
transcripciones
de
sesiones
de
terapia.
El
Dr.
Knipe
presentará
diversos
métodos
que
permitan
identificar
y
tratar
los
síntomas
disociativos
específicos,
los
cuales
irán
acompañado
de
la
evidencia
de
que
se
dispone
procedente
de
la
investigación
existente
o
de
los
estudios
de
casos.
Ofrecerá,
además,
aquellas
“herramientas”de
EMDR
que
pueden
ser
empleadas
para
que
el
poder
sanador
del
EMDR
esté
más
disponible
para
aquellos
clientes
con
comportamientos
evitativos
y/o
que
son
extremadamente
sensibles
a
experimentar
abreacciones
disociativas,
vergüenza
crónica
o
conceptos
idealizados
de
sí
mismos
o
de
los
demás
no
realistas.
Comentará
también
cuales
son
las
características
principales
de
los
pacientes
que
padecen
de
TEPT
complejo,
entre
los
que
se
incluyen
los
vínculos
afectivos
perturbados
y
los
mecanismos
de
defensa
psicológica
inadecuados.
Ilustrará,
igualmente,
cómo
poder
identificar
los
diversos
estados
del
ego
que
se
producen
y
cómo
trabajar
con
ellos
en
el
marco
del
procesamiento
adaptativo
de
la
información.
Se
dispondrá
de
un
tiempo
adicional
para
comentar
con
los
participantes
los
casos
difíciles
que
se
presenten
con
EMDR.
Abstract:The focus of this workshop will be to describe a theoretical framework, and specific EMDR-related therapy tools which may be useful during Janets Phase 2, the Phase of trauma processing, for multiply-traumatized clients with Complex PTSD. Points of similarity and difference will be described between the EMDR Adaptive Information Processing Model, and two other models of dissociation treatment: the Theory of Structural Dissociation of the Personality and the Internal Family Systems model. EMDR variations will be described which increase emotional safety, and thereby extend the use of EMDR to clients who might otherwise be vulnerable to the intrusion of overwhelming post-traumatic memory material. Through transcript and video examples, the Loving Eyes method (for safely accessing a traumatized Part), the Back-of-the-Head Scale (for measuring the degree of dissociative experience, moment-to-moment, in a therapy session), and the method of Constant Installation of Present Orientation and Safety (for maintaining emotional safety during the processing of a traumatic memory) will be presented. In addition, the structure and treatment of psychological defenses will be conceptualized within the Adaptive Information Processing Model.
Learning Objectives:
1. Describe the Loving Eyes method of developing a co-consciousness between an adult Part and a traumatized child Part.
2. Describe the clinical situations in which the use of the Back-of-the-Head Scale and the method of Constant Installation of Present Orientation and Safety would be likely to be helpful to a traumatized client.
3. Describe how psychological defense may be conceptualized within the Adaptive Information Processing model, and how defenses may be safely released, so that underlying post-traumatic material may be processed.
EMDR has had a profound positive impact on the lives of many clients and has been shown in more than
twenty randomized, peer-reviewed trials to be effective in the treatment of PTSD. However, the DSM IV
definition of PTSD is focused on the single traumatic incident, and many clients seeking relief in therapy
have a damaging traumatic history that extended over repeated events or over many years. The term,
Complex PTSD (Herman, 1992, van der Kolk, 2005) has been proposed to describe a pattern of negative
effects of prolonged and extreme stress, particularly during childhood. The focus of this workshop
is to describe a theoretical framework, and specific therapy “tools” which may be useful in providing
effective therapy, within the EMDR Adaptive Information Processing Model, to individuals suffering with
Complex PTSD. Methods will be described that can make the healing power of EMDR more available to clients who are
avoidant, defensive, and/or highly vulnerable to dissociative abreaction, chronic shame, and unrealistic idealization of self or
of others. Important concepts and particular interventions will be illustrated through video examples and transcripts from
therapy sessions.
It is clear from over 17 published studies that the EMDR method is highly effective in
assisting clients in resolving PTSD (Maxfield and Hyer, 2002). However, most clients
who enter therapy do not have a simple problem of a single disturbing memory, but a
complex history. Typically, clients come to therapy with a mixed presentation, of not
only emotional disturbance, but also mental structures and actions which function to
soothe, contain, avoid or dissociate from emotional disturbance. Thus, the initial
presentation of most clients is complex and often ambivalent. In this workshop,
examples will illustrate Adaptive Information Processing methods of targeting and
resolving psychological defenses, such as avoidance, ambivalence, and idealization.
Also, the BHS/CIPOS (Back-of-the-Head Scale/Constant Installation of Present
Orientation and Safety) method will be described. This method is a set of procedures
that can be used during the EMDR Desensitization Phase to therapeutically reverse
dissociative processes while preserving emotional safety. Video segments from therapy
sessions will be shown to illustrate each of these methods.
The objective of the study was to examine the efficacy of EMDR treatment for children with post-traumatic stress disorder (PTSD) compared with untreated children in a waiting list control group (WLC) participating in a randomized controlled superiority trial (RCT). Thirty-three 6-16-year-old children with a DSM-IV diagnosis of PTSD were randomly assigned to eight weekly EMDR sessions or the WLC group. The Posttraumatic Stress Symptom Scale for Children (PTSS-C scale) was used in interviews with children to evaluate their symptoms and outcome. Post-treatment scores of the EMDR group were significantly lower than the WLC indicating improvement in total PTSS-C scores, PTSD-related symptom scale, and the subscales re-experiencing and avoidance among subjects in the EMDR group, while untreated children improved in PTSD-non-related symptom scale. The improvement in re-experiencing symptoms proved to be the most significant between-group difference over time. The results of the present exploratory study including a limited number of children with PTSD are encouraging and warrant further controlled studies of larger samples of children suffering from PTSD. [Author Abstract]
This workshop will address the integration of EMDR into an overall treatment plan for adult incest and neglect in childhood have experienced.
The workshop is a deepening of the keynote of the conference. The methodology will be explained in detail and will be illustrated with video presentations and discussion of case studies.
Initially, explains how the development and bonding needs of the client can be investigated and how a meaningful descriptive diagnosis can be developed into an integrated, logical plan of treatment.
In this group of clients, where there is limited affect tolerance, vulnerability to hyper-and hypoarousal and dissociative characteristics, the standard EMDR protocol to be adapted to specific strategies. As will be discussed in detail.
Also, much attention is paid to the integration of EMDR specific techniques, such as various ego-enhancing protocols and resource installation (RDI) in all phases of treatment.
Will also discuss techniques that help clients to their dysfunctional defense mechanisms to let go, so changing schedules with their distinctive core ideas and possible kernaffecten
Participants in this workshop will learn to pathogenic emotional states (such as shame, despair, unbearable loneliness feelings), and fears "blocking beliefs", ego-state conflicts to recognize that the most effective and interweaves resource options can be applied.
Moreover, through strategies for recovery, such as clarifying responsibilities, establishing security and choice, and the process of mourning, desire and anger are discussed.
Two multiple personality disorder patients with severe, persistent phobias were treated using Eye Movement Desensitization/Reprocessing (EMDR). Both patients achieved significantly beneficial results with a single session in one patient and two sessions in another. Each patient confronted the previously phobic object successfully showing an objective measure of success and results were maintained at six months follow-up. Caution should be exercised from generalizing the use of EMDR for specific target symptoms to using it as a total treatment technique. Further research is needed to determine the efficacy of EMDR as a treatment procedure in general and its role in the overall treatment of dissociative conditions. [Author Abstract]
Cet atelier d’une journée met l’accent sur l’intégration de l’EMDR à l’intérieur d’un plan thérapeutique. Nous aborderons l’utilisation d’EMDR pour traiter le Stress post-traumatique complexe, de même que d’autres syndromes cliniques d’origine traumatique, tels que le Trouble de personnalité limite et les Troubles
dissociatifs. Des modifications et/ou additions au protocole EMDR seront proposées afin de tenir compte des capacités limitées à tolérer les affects, des défenses rigides, de la sur-utilisation des stratégies d’évitement, des conflits entre les états du moi, des tendances à la dissociation ou des dérégulations émotionnelles
importantes.
Nous aborderons l’évaluation des aspects développementaux et des besoins d’attachement du client, l’établissement d’une bonne compréhension de la situation clinique et le développement d’un plan de traitement intégré avec des objectifs atteignables et réalisables. On portera plus particulièrement notre attention sur l’intégration de l’EMDR comme moyen de renforcer l’Ego et le développement des ressources au
cours des différentes étapes du traitement.
This full-day workshop will focus on integrating EMDR into an overall recovery plan. The use of EMDR in treating complex PTSD as well as other trauma-related syndromes such as borderline personality disorder and dissociative disorders will be addressed. In recognition of clients’ limited affect tolerance, rigid defenses,
overdeveloped avoidance patterns, ego state conflicts, dissociative tendencies, and extreme emotional dysregulation, strategies for modifying and supplementing standard EMDR protocols will be explored.
Assessing the developmental and attachment needs of the client, establishing a useful case conceptualization, and developing an integrated treatment plan with achievable goals will be discussed. Considerable attention will be devoted to integrating EMDR ego strengthening and resource development protocols into all phases of treatment.
In the presented text by Stefan Jacobs and Anna de Jong, the treatments approached are the cognitive-behavioral therapy,
the EMDR method and biofeedback
combined to the fear reaction Framework to reduce traumatic memories
or to inhibit and thus the symptoms of
reduce post-traumatic stress disorder.
In the first part of the book, the authors detail
to the theoretical background (neurophysiology,
Brain functions, a), the facilitation of the neuronal accompanied by traumatic memories.
Here, they argued that the neuronal
Facilitations of trauma can not be cleared, so to speak, that the fear response in the Amygdalaregion Brain is resistant to extinction and thus in consequence the goal of therapy just to reduce the fear response, and inhibiting the fear response could. Specifically, the authors modify within the cognitive, behavioral approach, the model
by Ehlers and Clark, as well as the method of EMDR
Shapiro. The biofeedback method, the authors use
as a diagnostic tool for the subjective evaluation
on the part of the patients also
making objectively verifiable by measuring
electrodermal activity (EDA).
In the second part of the book they describe in detail a scientific study of 16 male and female patients, where the treatment program at the University Göttingen participated. Here is at
all patients, and patients had a significant positive Detect symptom change the PTB have been.
In another part of the book they put their detailed Therapeutic approach and treatment protocol first. It will detail the psychological diagnosis (
Test procedures and biofeedback received an important
Part is to communicate information and stabilization for male and female patients. Thereafter the confrontation with trauma treatment and integration. Value in this case in contrast to Shapiro on down early connection to the positive cognition in conjunction with homework, the patients who get between meetings with incoming Behavioral exercises.
The authors of a frontier that their method is not for All male and female patients is appropriate, but dissociative And personality disorders and addiction are explicitly excluded.
The stabilization exercises are described practically
(Safe Place, Safe), as well as the practical
Application of biofeedback procedure and the treatment protocol for EMDR. Towards the end of the tape to close case studies from the work of the authors in order to clarify the practice.
In the appendix, there are records of the address
Terms of testing, biofeedback devices or educational films. In summary, one can say that the band concise, very clear and concrete and practical the neuro-psychological treatment program represents, so this is helpful for the psychotherapeutic Practice in relation to trauma treatment appears. The book is aimed at professionals and is for Lay less suitable.
The new protocol has been likened to the gears of a vehicle where on each speed a certain amount of work is done to deal with the trauma in a gradual fashion.
Speed zero deals with stabilization;
speed 1 deals with desensitizing future fears;
speed 2 touches upon desensitizing emotions or body sensations without touching on the actual trauma. At speed 3 the client works on early imprints (any issues from the age of birth to 3 years). Speed 4 deals with desensitizing present triggers and speed 5 deals with use of EMDR on past events. Helene will also be teaching how she also ingeniously uses LETTER WRITING(from the future or standard) with bilateral stimulation. The above protocol is useful even for dissociative or complex trauma clients
Helene has summarized her therapy by saying: “Different clients evolve at different speeds, as a function of many parameters that we often are not able to control as therapists. Our basic assumption is that clients go as fast as they can, given their particular situation.
If they slow down, it is because they have good enough reasons, whether conscious or not.
What we try to avoid is them slowing down because of the therapist. Our motto is to progress as fast as possible, as long as the road and the weather permit it, and go as slowly as necessary to keep the journey secure.”
Uitgevoerd een cross-over studie van de werkzaamheid van EMDR en in vivo exposure bij de behandeling van spinangst bij kinderen en adolescenten. Human Ss: 22 Nederlandse school-kinderen en adolescenten (leeftijd van 10-14 jaar) (spinangst). Ss werden getest, en hun galvanische huid reactie werd gemeten. Tests die worden gebruikt: De korte vorm van de Spider Phobia Questionnaire for Children (M. Kindt et al., 1996), de Self Assessment oefenpop (RL Hodes et al., 1985) en de gedragsmatige Vermijden Test. Behandelingen: alle SS werden behandeld met 1 sessie van in vivo blootstelling en 1 sessie van EMDR. (Engels abstract) (PsycINFO Database Record (c) 2008 APA, alle rechten voorbehouden)
Conducted a cross-over study of the efficacy of EMDR and in vivo exposure in the treatment of spider phobia in children and adolescents. Human Ss: 22 Dutch school-age children and adolescents (aged 10-14 yrs) (spider phobia). Ss were tested, and their galvanic skin response was measured. Tests used: The short form of the Spider Phobia Questionnaire for Children (M. Kindt et al, 1996), the Self Assessment Manikin (R. L. Hodes et al, 1985) and the Behavioral Avoidance Test. Treatments: All Ss were treated with 1 session of in vivo exposure and 1 session of EMDR. (English abstract) (PsycINFO Database Record (c) 2008 APA, all rights reserved)
Unmodified EMDR can harm dissociative clients if it prematurely breaches dissociative barriers overwhelming
the client’s capacity and resources. Practitioners must
screen for dissociation and use special procedures to safely
use EMDR with these clients. The workshop will cover critical guidelines and techniques to pace and troubleshoot
EMDR with dissociative clients within the phased
treatment model, for clients ranging from DDNOS to DID.
Assessment and stabilization are key to preparing clients
for trauma work. The workshop offers methods to increase
affect tolerance, establish a two-step containment habit, and
orient personalities to person place and time. Other topics
include: increasing tolerance of body sensation and affect,
and enhancing compassion for self and others, directly
working with introjects or other “monstrous” shame-laden
parts, essential to reducing internal conflict and resistance
to therapy. The workshop instructs in specific ego state
strategies and imagery to provide sufficient resources,
maintain an observing ego. Rooted in the hypnotic tradition,
stabilization methods to pace and fractionate the work
within EMDR while interspersing trauma work with sessions
that consolidate gains. The workshop also describes the
conference room method and means to trouble-shoot
stuck processing. Finally, the workshop describes the final
phases of therapy, skills building, integration and fusion.
Participants will be able to :
♦♦ explain why and when to assess every client for degree
of dissociation and choose an appropriate protocol.
♦♦ list six tactics for stabilizing clients, prior to doing
EMDR for dissociative clients, to increase rapport,
contain affect, orient to present circumstances,
reduce inner conflict, and build coping resources.
♦♦ structure EMDR sessions using imagery
and ego state interventions for pacing,
fractionating and trouble-shooting the work.
An appointment at the dentist’s is not what most people look forward to. For some people, however, even the mere thought of having to undergo dental treatment causes them to feel extreme fear and panic. Between 5 and 15% of the world population suffer from such a pathological form of dental fear, called dental phobia. Dentally anxious individuals commonly avoid necessary dental procedures for many years despite deteriorating oral health, agonizing pain and severe psychosocial problems. The majority of individuals with dental phobia recall a traumatic event as cause for the onset of their fear. Interestingly, nearly 50% of them even suffer from posttraumatic stress symptoms, such as intrusive memories, nightmares, hyperarousal and avoidance behavior. EMDR can be a very useful instrument to help dentally anxious people to cope with past traumatic experiences and to prepare them for future confrontations with phobic stimuli.
The 90-minute workshop will give background information to the problem of pathological dental fear and present evidence from research showing that EMDR is an effective treatment method for dentophobia. The main focus will be on the practical procedure, which will be illustrated using video sequences of patient sessions.
Learning objectives:
This workshop will provide you with the following information:
•a short review of current research and literature
•the use of the EMDR protocol in its specific application to dentally anxious patients, with special emphasis on preparing the patient for future confrontations
by working with flashforwards, future template and video check
•ways of combining EMDR with other cognitive, behavioral and imagery techniques in the treatment of dental phobia.
The devaluation of self and others is a relevant issue in the field of trauma and dissociation but therapy usually focuses on a victim-abuser perspective where we tend to pay attention to victims and their symptoms, and when narcissistic features are described, they tend to be considered as characteristics of the abusive figure. From this perspective, victims are described as depressed, submissive, vulnerable and usually trapped in learned helplessness. Although this picture describes some situations related to maltreatment and abuse, it can be simplistic and minimize or overlook internalization of some abuser features by victims (e.g., the presence of perpetrator-imitator parts in DID). Narcissistic features can be a cause and consequence of traumatization and can be treated effectively with EMDR. Targeting the roots of the symptoms is crucial for an adequate case conceptualization.
A core characteristic of narcissism is lack of empathy. While empathy issues can be present in many people with personality disorders, there are two personality disorders that are more related with lack of empathy, and a (sometimes only apparent) lack of concern about the suffering that they can cause in other people: narcissist and antisocial personality disorder. Both types of personalities share this self-centered profile.
A description of different profiles characterized by self-centerness, selfish attitude and lack of empathy will be described in this presentation. These aspects may be present in abusers and victims, in overt or subtle presentations.
To conceptualize EMDR therapy in these cases it is important to understand the pathway from early experiences to present problems. Narcissism and antisocial features can be final outcomes of a neglecting environment, chronic abuse or excessive appraisal. Different attachment disturbances with primary caregivers can lead to lack of empathy and self-centerness. In some cases, structural dissociation is underlying narcissistic or antisocial features that can characterize some dissociative parts of the personality. All these aspects and the complexity of therapeutic relationship in narcissistic and antisocial personalities will be reviewed in this presentation.
Clinical case-presentation of EMDR-treatment of a boy and a girl, sixteen and eighteen years of age respectively, both with a history of different dissociative symptoms. Both were sexually abuse and both had a considerable weight-loss during EMDR-treatment. Symptoms prior to my contact with the body was pseudo-epileptic fits with shaking, cramps, eyes turning “inside out” and sometimes turning quite blue. After he could be spoken to, he could drink and seemed oriented in time and space, but later had total amnesia of the dissociative episode that could last for several hours. He also had pain in one leg and got the diagnosis “Sympatic Dystrophia” and “Complex Regional Pain Syndrome.” Memory of the sexual abuse was completely hidden behind a screen memory of being abuse physically by a schoolmate until very late in EMDR-treatment. The girl had family relations problems, eating disturbance, suicidal behavior and intense sways in temper and server conflicts with her mother. The sexual abuse by a relative was known and the dissociation was not diagnosed before screening with DES>
Both had different kinds of somatic and/or psychological long treatment, with little success, before entering EMDR-treatment. Both had an EMDR-treatment period of almost one-year and both were given the Putnam DES-scale before, during, and eight months after treatment.
In both cases, there was decline from very high Putnam DES scores to normal. At the eight month follow-up, the boy’s results persisted and weight was regained. The girl us just about to end treatment so there are no follow-up results. However, her weight is back to normal.
Is weight loss during EMDR-treatment noticed by other EMDR-therapists?
EMDR (Eye Movement Desensitization and Reprocessing) is a new psychotherapeutic method aimed at processing memories of traumatic events, thereby ameliorating the psychological consequences of these memories. EMDR involves elements from several different psychological approaches. It is uncertain which of the treatment elements are effective. Clients with post traumatic stress disorder (PTSD) are the main target group for EMDR treatment. Although both children and adults have been treated with EMDR, this document is aimed particularly at children and adolescents.
Patient Benefits, Risks, and Side Effects
Published studies of EMDR mainly cover adults with PTSD. There are two randomized and controlled studies, one of which has yet to be published, of EMDR treatment in 47 children and adolescents. One of the studies suggests that EMDR yields a better treatment outcome in the short term compared to the control treatment (active listening). In the second study, no significant difference was found between EMDR treatment in combination with standard treatment and standard treatment alone as regards reduction in avoidance and invading thoughts. However, the PTSD symptom of behavioral disorders declined significantly in the EMDR group. Furthermore, numerous case studies suggest that EMDR has a positive treatment effect in children and adolescents with PTSD. No harmful effects have been reported.
As a complement to the strategies already used in EMDR, drawing gives form to the inner representations of the trauma, objectivising it. Thus the person no longer relates only to something inside him/her, but rather to something he/she can see and can concretely represent and modify. In the act of drawing, the patient makes an initial reorganisation of the form of the trauma, and begins to differentiate the adaptive ego, which has the tools and the ability to restructure the experiences, and the traumatic emotional part that suffers those experiences in a condition of impotence and passivity. The person may rapidly access preverbal and motor-sensory language, activating inborn creative skills. The use of this tool enables us to access the traumatic material gently, limiting dissociative reactions, bypassing avoidance and flight behaviour and setting a distance from pain by objectivising it. A protective space is created between the self and the part that holds the suffering.
The patient is offered the possibility of drawing what is occurring in the self’s here and now, and given a choice of different graphic materials. At the end of the drawing and assessment phase the person is asked to note what has emerged, and a brief space of time may be allowed for description without interpretation. The represented image is treated as the inner image in the classic protocol. To start, the patient is asked to focus on the drawing, on the negative cognition and on the bodily location of the emotional disorder, while bilateral stimulation is applied. At the end of each set, the patient is asked what he/she has noticed and the therapist verifies where the person now is in the re-elaboration. If there is a change the person may either work on the drawing, modifying it, or, if the change of image is radical, may produce another drawing. After several sets, an adaptive drawing emerges that may be installed as a resource.
The workshop focuses on the treatment of two clinical conditions, complex PTSD and severe medical diseases, with the support of video and graphic materials. It includes a practical experience of the Technique
Learning objectives:
To learn the use of drawing as a supplementary tool, through graphic and video material of clinical cases.
To recognise the indications in which it provides added value to the classical protocol.
To learn its use in various psychopathological conditions, with particular emphasis on dissociative states and severe medical diseases.
The use of drawing as a supplementary tool within the EMDR protocol gives form to the inner representation of the trauma, objectivising it, and creates a bridge of communication between the self and the blocked parts, after which it will be possible to return to desensitising and re-elaboration with the standard protocol.
Therapists who respond to massive trauma find that some clients (i.e., people who escaped the WTC Towers, rescue workers, firefighters, and those who have lost family members) may be triggered into reexperiencing earlier traumas and may present with a dissociative disorder. Integration of EMDR and Ego State Therapy provides a safer approach. Unresolved trauma necessitates dealing with ego states that hold earlier memories/symptoms to prevent poor response to standard EMDR. This presentation emphasizes practical, safety focused innovations; planing for longer EMDR treatment; developing resources, stability and readiness; container and imagery exercises to help clients deal with triggering stressful situations. This workshop will provide handout and bibliography; case illustrations and slides of clients treated in the aftermath of disaster.
EMDR staat voor "Eye Movement Desensitization and Reprocessing" en is een kortdurende, geprotocolleerde en cliëntgerichte behandelmethode om schokkende ervaringen te verwerken. Ook kan het helpen tegen angst en stress.
EMDR integreert verschillende succesvolle elementen van andere therapieën in combinatie met een afleidende stimulus. Deze stimulus kan zijn: het met de ogen volgen van de handen van de therapeut, bi-laterale audiostimulatie, of bi-laterale handstimulatie. Hierdoor wordt "het informatie-verwerkings-systeem in de hersenen" gestimuleerd. Met EMDR is het niet nodig om jarenlang te praten over het verleden. Wel worden, door het stimuleren van het informatie-verwerkings-systeem, in een relatief korte tijd therapeutische doelen bereikt. Hierbij veroorzaakt EMDR herkenbare veranderingen die ook na langere tijd blijven bestaan. De volgende gebeurtenissen kunnen, bij kinderen en volwassenen, leiden tot verwerkingsproblematiek: een (auto)ongeval, brand, diagnose van een ernstige ziekte, getuige van geweld, mishandeling, misbruik, natuurramp, overval, verkrachting of aanranding, verlies van een baan, ziekte of een ziekenhuisbezoek/opname etc.
De volgende soorten klachten kunnen kinderen en volwassenen hebben na een schokkende ervaring: herbelevingen van de ervaring, vermijdingsgedrag m.b.t. de ervaring, verhoogde arousal (opgewonden, overdreven alertheid), stress, schaamte of schuldgevoel, slecht humeur, depressie, zich zorgen maken, angsten, slecht zelfbeeld, paniek, slaapproblemen, relatieproblemen, onverklaarbare lichamelijke klachten etc. Voor meer informatie verwijs ik naar www.emdr.nl.
EMDR stands for Eye Movement desensitization and Reprocessing "is a short, recorded and client-centered treatment approach to shattering experience to process. It can also help reduce anxiety and stress. EMDR integrates various successful elements of other therapies in combination with a distracting stimulus. This incentive can be: with the eyes following the hands of the therapist, bi-lateral audio stimulation, or bi-lateral hand stimulation. This is the "information-processing system in the brains" encouraged. With EMDR is no need for years to talk about the past. Well, either by stimulating the information processing system in a relatively short time therapeutic goals. This caused EMDR recognizable changes even after long period of time. The following events may, in children and adults, leading to processing problems: a (car) accident, fire, diagnosis of a serious illness, witnessing violence, maltreatment, abuse, natural disaster, robbery, rape or sexual assault, job loss, illness or a hospital visit / recording etc. The following types of complaints, children and adults after a shocking experience: reliving the experience, avoidance of the Experience, increased arousal (excited, exaggerated alertness), stress, shame or guilt, bad mood, depression , worry, anxiety, low self-esteem, panic, sleep problems, relationship problems, unexplained physical complaints, etc. For more information I refer www.emdr.nl
A number of recent controlled studies has shown that EMDR (Eye Movement Desensitization and Reprocessing) can reprocess disturbing memories and bring them to therapeutic resolution whether or not patients fulfil the DSM (or ICD)- criteria of post-traumatic stress disorder (PTSD). The method can be integrated into treatment plans of different therapeutic approaches and integrates aspects of a number of the major treatment orientations. Clinical experience and EEG research show that the reprocessing in EMDR is not a trance-related phenomenon (Nicosia, 1995). However, EMDR blends well with hypnotic techniques in specific cases, especially with severe complex traumatised and dissociative patients. In addition, EMDR seems to help stabilise and generalise positive self-referencing beliefs as well as positive images, such as "a safe place", and accelerates future projectionsof new orientations and behaviours. In this sense, EMDR can be viewed not only as a method for the treatment of traumatic memories, but as a method of accelerated emotional learning.
This section EMDR treatment immediately after a traumatic event. The treatment combines shock treatments with ingredients
From EMDR. This treatment protocol is not official yet and would like to bring a summary of our experience in treating victims of terrorism in the ICU. Representative of the protocol has been formulated so far (it probably will take some developments) as well as a case study illustrates the use of the protocol. Nurse in the ICU is Dr. Judy Gedalia receiving immediate training. Yoeli Francis on line. SCREENING
When the patient is showing dissociative responses to the trauma, hysterical paralysis, fugue-like state, we don’t attempt EMDR. As the Patients are usually in the ER for many many hours (5-8) opportunities present themselves to assess the patients ability to communicate by various means.
The EMDR-ER© Protocol is used with patients who do not seem able to move on to the ambulatory staging area (are still on gurney’s) and display difficulty in being able to re-assume normal- appropriate with the situation- physical and psychological, behavioral function Also EMDR is not used in the ER with patients who seem to have below borderline intelligence. I have used EMDR in the ER with patients whose language I didn’t know (Amharic for example), with an interpreter present with good results.
This study examined emotional processing and outcome in 20 Vietnam veterans with chronic posttraumatic stress disorder (PTSD) who underwent imaginal flooding therapy. Results supported the occurrence of emotional processing, as manifest in significant activation, within-session habituation, and partial across-session habituation of physiologic and self-reported process variables. The flooding therapy produced only modest overall improvement, which was statistically significant for avoidance symptomatology measured by the Impact of Events Scale (TOES) and number of intrusions per day recorded by the subject in a log. Symptomatic improvement appeared to generalize from a treated to an untreated experience. Heart rate activation during the first flooding session predicted a decrease in daily number of intrusive combat memories across the therapy. Otherwise, there was little association between extent of emotional processing and therapeutic outcome. The results provide limited support for the notion that mobilization of phychophysiologic arousal during exposure therapy predicts improvement. [Author Abstract]
Controlled studies of treatments effective with victims of natural disasters are almost nonexistent. This is a small study conducted under difficult conditions to test the effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) in treating trauma related reactions following Hurricane Andrew. The results were positive in that EMDR produced significant improvement over wait list controls in perceived posttraumatic avoidance behaviors and thoughts as measured by changes in the Impact of Event Scale and significant improvement in subjective aversive reactions to representative experiences of the hurricane. These results suggest and support other studies that EMDR can be an effective therapeutic intervention for trauma reactions. [Author Abstract]
The repetitive traumatic patterns our clients come to us to change are not only psychological but somatic, clearly reflected in posture, energy level, movement, regulation of arousal and other physical attributes. Changing these patterns cannot be accomplished by insight alone. The procedural memory that keeps such behaviors and dissociative patterns in in place must be addressed. A body-oriented approach is indicated that facilitates new actions and addresses dissociative symptoms, including somaticcomponents of traumatic memories (e.g., pain, analgesia, and motor inhibitions) and avoidance-related symptoms such as bodily anesthesia. Sensorimotor Psychotherapy emphasizes practicing new actions and building other somatic resouces to mitigate symptoms and develop a somatic sense of self. In this workshop, somatic interventions that can be integrated into existing clinical skills will be taught and illustrated through excerpts of videotaped therapy sessions and brief experiential exercises.
Eye movement desensitization and reprocessing treatment (EMDR) is a powerful method for the treatment of PTSD. Therapists may uncover a
covert dissociative disorder in the course of applying EMDR. The presentation will compare the major components of EMDR and energy psychotherapy techniques. Both of these treatment methods have in common 1) focusing on (attuning to) a disturbing problem, issue, or event; 2) applying a prescribed set of procedures to resolve the disturbance or imbalance. Participants will grasp the indications/risks/contraindications of use of EMDR and energy methods with DID. They will understand how energy healing methods can support EMDR.
Letter to the editor commenting on an article by E. Ernst (see record 2003-05653-002). We report the case of a patient who was effectively treated for severe obsessive compulsive disorder but relapsed briefly following ingestion of herbal products containing ephedra alkaloids that she bought to facilitate weight loss. The patient was a 29-year-old woman with a 10-year history of obsessive compulsive disorder who was referred for Eye Movement Desensitisation and Reprocessing (EMDR) when her condition had not responded to cognitive behavior therapy nor to various medications including Fluoxetine, Paroxetine, Clomipramine and Amitriptyline. Her score on the Dissociative Experiences Scale was low and there was nothing in the clinical history to suggest major dissociative disorder, so after preparation with mindfulness, relaxation and safe place imagery she proceeded to treatment with EMDR. Nine months later she reported a relapse into increased anxiety with a partial return to compulsive thoughts and behaviours after she had obtained a herbal health product sold to promote weight loss. (PsycINFO Database Record (c) 2008 APA, all rights reserved)
O objetivo da oficina é abordar como os processos de dissociação consciente de papéis ou estados de ego podem ser utilizados para potencializar a reintegração psíquica dos pacientes dissociativos. Pacientes dissociativos sempre foram um dos grandes temores dos terapeutas em EMDR para o uso da fase 3 em diante. Geralmente esses quadros requerem um grande tempo de preparação além de um manejo mais avançado e interventivo durante o reprocessamento. Entretanto, entre pacientes com alto grau dissociativo é comum encontrarmos pessoas com grande fragilidade psíquica, acesso a um pobre histórico de recursos, uma grande dificuldade em se expressar, perceber e nomear seus sentimentos além de grande dificuldade em relatar seus traumas. Então, como avançar no protocolo de EMDR com pessoas tão fragilizadas e que quase não nos dão dicas do conteúdo de seus traumas? Alguns critérios hipotéticos auxiliam a instrumentalizar tanto o profissional quanto o paciente a enfrentarem o reprocessamento. Primeiramente, (a) se diante de uma história de traumas intensos a pessoa sobreviveu e chegou até você, é porque ela tem recursos importantes, mesmo que tenha dificuldade de acessá-los. Um desses recursos é o próprio quadro dissociativo que a protege da intensidade dos traumas e possibilita a vida “apesar de...”. (b) Se essas partes estão tão distantes uma da outra, é porque elas tiveram um motivo para isso, mas talvez esse motivo já esteja no passado, e hoje podemos caminhar para uma conversa. (c) Sendo todos esses papéis ou egos são partes do eu, certamente eles querem algo de positivo para esse eu, mesmo que aparentemente seja difícil perceber isso. Essas hipóteses ou crenças positivas a respeito do paciente devem ser checadas com dados de realidade para que possam ser fortalecidas, mas, mais do que isso, é fundamental que elas "transpirem por todos os poros do corpo do terapeuta". Identificados os estados de ego presentes no evento traumático parece ser mais fácil seguir com a etapa do reprocessamento de deforma menos interventiva, principalmente quando não se tem o conteúdo do evento em questão. Obviamente que todo esse processo deve levar todo o tempo necessário e seguido de todos os
cuidados que a aplicação do EMDR demanda.
The goal of the workshop is to discuss how the processes of conscious dissociation of roles or ego states can be used to enhance the reintegration of the psychic dissociative patients. Dissociative patients have always been one of the great fears of EMDR therapists for use in phase 3 onwards. Generally these paintings require a great preparation time plus a more advanced and interventional management during reprocessing. However, among patients with high dissociative is common to find people with great fragility psychic, poor access to a historical resource, a great difficulty in expressing themselves, perceive and name their feelings besides great difficulty in reporting their trauma. So, how to advance the EMDR protocol with people so fragile and hardly give us hints of the contents of their trauma? Some hypothetical criteria help to equip both the professional and the patient to face the reprocessing. First, (a) in front of a history of severe trauma the person survived and came to you, it is because it has important features, even if you have difficulty accessing them. One of these features is the very dissociative disorder that protects the intensity of the trauma and allows life "although ...". (B) If these parties are so far apart, it's because they had a reason for that, but maybe that reason is already in the past, and today we can walk into a conversation. (C) Since all these roles and egos are part of me, surely they want something positive to me, although apparently it is difficult to realize this. These positive beliefs or assumptions about the patient be checked against data from reality so that they can be strengthened, but more than that, it is crucial that they "transpire from every pore of the body of the therapist." Identified ego states present at the traumatic event seems to be easier to follow with step of reprocessing deforms less interventionist, especially when you do not have the content of the event in question. Obviously, this entire process should take all the time necessary and followed by all
care that the application of EMDR demand.
This single subject case study implemented in the private practice setting examined body-image disturbance and self-esteem. Eye movement desensitization and reprocessing (EMDR) is the treatment modality. The Self-Esteem Rating Scale and the Body Image Avoidance Questionnaire are pre and post tested. A self-developed Daily Body Satisfaction Log is used throughout the 43-day observation period. Scores on subjects' self-esteem and body image avoidance showed clinical improvement over the treatment period. Based on this clinical examination, eye movement desensitization and reprocessing appears to be a promising time-limited treatment intervention that merits further research for application to eating disorder symptoms such as body image disturbance and low self-esteem. Suggestions for future research are provided.
Dit onderzoek bij verkeersslachtoffers met whiplash-klachten maakte deel uit van een omvangrijker studie naar de kwaliteit van hulpverlening aan slachtoffers van verkeersongevallen, in het kader van het Achmea-project ‘Kwaliteit Slachtofferhulp’. Gerapporteerd wordt een viertal gevalsbeschrijvingen van patiënten met chronische whiplash-klachten. Vier vrouwen die gemiddeld 22 maanden geleden bij een auto-ongeval betrokken waren, werden tweemaal anderhalf uur behandeld met Eye Movement Desensitization and Reprocessing (EMDR). Voor en na de behandeling werden de Symptom Checklist 90 (SCL-90) en de Schokverwerkingslijst (SVL) afgenomen. Vergelijking van voor- en nameting toonde een duidelijke afname van klachten, onder meer op Herbeleving en Vermijding (SVL) en Somatisatie, Angst, Depressie, Slaapproblemen, Wantrouwen en Interpersoonlijke Sensitiviteit (SCL-90). Deze resultaten zijn hoopgevend: EMDR bleek bij te dragen aan een verzachting van traumasymptomen. In verder onderzoek zouden de effecten en onderliggende mechanismen van emdr bij een grotere groep chronische whiplash-patiënten bestudeerd moeten worden.
This study of road accident victims with whiplash injuries was part of a larger study on the quality of assistance to victims of traffic accidents, as part of the Achmea project 'Quality Victim'. Reported four case reports of patients with chronic whiplash injuries. Four women who averaged 22 months ago in a car accident, were two and a half hours with Eye Movement Desensitization and Reprocessing (EMDR). Before and after treatment were the Symptom Checklist 90 (SCL-90) and Shock Treatment List (SVL) decreased. Comparison of pre-and post-test showed a significant reduction of complaints, including the re-experiencing and Avoidance (IES) and Somatization, Anxiety, Depression, Insomnia, Distrust, and Interpersonal Sensitivity (SCL-90). These results are encouraging: EMDR appeared to contribute to an alleviation of trauma symptoms. In further research, the effects and underlying mechanisms of EMDR in a larger group of chronic whiplash patients should be studied.
Post-traumatic stress disorder (PTSD) is a fairly common disorder. Roughly 8-10% of the population will suffer from PTSD at some point in their lives. For victims of violent crimes such as rape, the rate of PTSD may be 60-80%. (1) According to the DSM-IV, diagnostic criteria for PTSD include: 1) perceived or actual threat to life or physical integrity, accompanied by an emotional response of horror, helplessness, or intense fear; 2) re-experience of the trauma (e.g. flashbacks and nightmares); 3) avoidance of trauma-related stimuli and numbing of interest and affect; and 4) increased unwanted arousal, such as concentration difficulties, irritability, and insomnia. Specific criteria exist regarding the numbers of symptoms in each category that must be present.
These scripted protocols and summary sheets in a fill-in PDF format offer the EMDR practitioner an adjunct to the chapters of Eye Movement Desensitization and Reprocessing (EMDR) Scripted Protocols: Basics and Special Situations. The excerpted digitalized scripts give the clinician a unique opportunity to record data on the computer or as a hard copy. In addition, there are new summary sheets for each chapter to condense the data collected, allowing for quick retrieval. These digital scripts and summary sheets assist in protocol information retrieval for different populations, and facilitate the gathering and organization of important client data, as well as case conceptualization. These forms are available as a digital download or on a CD-ROM and are compatible with any computer or device that supports PDF.
Special populations addressed include children, adolescents, couples, and clients suffering from complex posttraumatic stress disorder, dissociative disorders, anxiety, addictive behaviors, and severe pain.
Key Features:
•Available in an expandable and editable digital format for easy access and customized tailoring
•Provides concise summary sheets for quick information retrieval and case conceptualization
•Facilitates gathering and organization of protocol and client data
•Assists in the formulation of concise and clear treatment plans
•Offers select scripts and summary sheets customized for client populations
•Includes templates for repeat use
EMDR has become an important tool in the use of treating trauma. As therapists have worked with this methodology, EMDR has been used in many different areas of human suffering such as addictions, anxiety, pain, dissociative disorders, and many other issues.
Eye Movement Desensitization and Reprocessing (EMDR) Scripted Protocols serves as a one-stop resource where therapists can access a wide range of protocols, including the past, present, and future templates, as well as any auxiliary information. The book sets forth a template for therapists and researchers to use so that the form of working in the EMDR idiom is consistent, valid, and reliable. Written in an easy-to-use manual style, the book is replete with detailed techniques, exercises, and scripts as developed by recognized EMDR experts.
EMDR has become an important tool in the use of treating trauma. As therapists have worked with this methodology, EMDR has been used in many different areas of human suffering such as addictions, anxiety, pain, dissociative disorders, and many other issues.
Eye Movement Desensitization and Reprocessing (EMDR) Scripted Protocols serves as an authoritative, one-stop resource where therapists can access the full protocols, including the past, present, and future templates, as well as any auxiliary information. The book sets forth a template for therapists and researchers to use so that the form of working in the EMDR idiom is consistent, valid, and reliable. Written in an easy-to-use manual style, the book is replete with detailed techniques, exercises, and scripts as developed by recognized EMDR experts.
Policy: Aetna considers eye movement desensitization and reprocessing (EMDR) therapy medically necessary for the treatment of post-traumatic stress disorder (PTSD).
Aetna considers EMDR experimental and investigational for the prevention of PTSD or for the treatment of other psychiatric and behavioral disorders including anger, guilt, phobias, dissociative disoders, eating disorders, as well as panic and anxiety disorders other than PTSD because its effectiveness for these indications has not been established.
EMDR therapy, using bilateral audio-tones as the stimulus, was given to 30 women for two to six sessions (the number determined by the individual). Results from the Impact of Event Scale (IES) and the State-Trait Anxiety Inventory (STAI) suggested that treatment was moderately successful for the study sample. Analysis of pre- and post-treatment item responses suggested individuals who benefited from EMDR had significant reductions in intrusion and avoidance behaviors. The need to look beyond sample-mean comparisons and focus on scale-item analysis is discussed. [Author abstract]
A chronic psychological disorder is often encountered in adult survivors of severe and repeated child abuse. We report a case of successful Eye Movement Desensitization and Reprocessing (EMDR) treatment in a multiply traumatized survivor whose previous treatments with psychotropic medication and supportive psychotherapy were unsuccessful. A series of consecutive six weekly sessions of EMDR were given. The patient completed Symptom Checklist-90-Revised. Dissociative Experiences Scale. State and Trait Anxiety Inventory, Beck Depression Inventory and Impact of Event Scale-Revised at four points; at two months and a week before EMDR, a week and six months after EMDR. After EMDR, the patient improved on all the measures of scales. These gains were maintained at six months after the termination of treatment. This case suggests a possible application of EMDR with for chronic difficult-to-treat post traumatic conditions.
Little is known about the types of mental health treatment that are most effective for psychogenic non-epileptic seizure (PNES) patients who have high rates of comorbid post-traumatic stress disorder (PTSD) and dissociation. Eye movement desensitization and reprocessing (EMDR) has proved to be effective in the treatment of PTSD, anxiety states, dissociative symptoms and somatoform disorders. This study, which utilized a non-controlled qualitative multiple revelatory case design, integrates EMDR into the psychological treatment of PNES patients with confirmed trauma experiences. With EMDR targeting trauma and dissociative symptoms in three patients, PNES were extinguished in two. Those patients have remained seizure-free for 12-18 months. Copyright © 2007 John Wiley & Sons, Ltd.
Objective/Purpose: Eye Movement Desensitization and Reprocessing (EMDR) is a relatively new form of psychotherapy designed to alleviate symptoms of anxiety, depression, avoidance of trauma related thoughts and intrusive memories associated with Post Traumatic Stress Disorder (PTSD). Under therapist instruction, the patient makes rhythmic eye movements while imagining the traumatic event, designed to facilitate cognitive reprocessing to alleviate stress. Methods: Electronic searching of Medline, PsyClit, Health Star, CCTR, The National Research Register and a range of other databases was conducted. Once trials had been identified, data were extracted and methodological quality assessed. Cost-utility was estimated indirectly through consultation with expert clinicians. Costs per Quality Adjusted Life Year (QALY) gained were also calculated. Results: 12 randomised controlled trials (RCTs) were identified, comparing EMDR to alternative psychotherapy treatments; variants of EMDR; and to delayed treatment groups in various combinations. The trials are generally small, with partial blinding of outcome assessors, and in some cases with high attrition. Results suggest the EMDR may be effective at reducing symptoms up to 3 months after treatment in comparison to delayed treatment groups. Two studies suggest that EMDR is as effective as other psychotherapy treatments for PTSD, and 3 claim greater effectiveness. Cost per QALY ranged from Pounds 983 to Pounds 20,568. CONCLUSIONS: Further trials are needed with larger samples, and longer post-intervention measurement to assess maximum length of treatment effect, as well as to ascertain the effectiveness of different treatment components.
Eye movement desensitization and reprocessing (EMDR) is a recently developed psychotherapy treatment procedure which combines imaginal exposure with eye movements and is reported to dramatically reduce negative symptoms associated with trauma related psychological disturbances and memories. The author reviewed and analyzed the current literature regarding EMDR, and conducted a within-subject design investigating the importance of the eye movement component in the EMDR treatment protocol by comparing the efficacy of an eye movement treatment condition, with two non-eye movement treatment conditions. The use of two different control conditions allowed comparisons of the eye movement condition (EMDR), which involved bilateral stimulation of the brain, with exposure to memory of the trauma without eye movements (Eye-Focus Desensitization), which served as a placebo, and exposure to memory of the trauma with a competing motor activity (Single Hand Tapping), which represented unilateral stimulation of the brain. This study also employed a delayed treatment condition to investigate the overall effectiveness of EMDR in treating PTSD. The subject was a 53-year-old Caucasian female who met DSM-IV criteria for PTSD. Dependent variables included a diagnostic instrument, which was the Structured Interview for Posttraumatic Stress Disorder (SI-PTSD); global instruments, which included the Beck Anxiety Inventory (BAI), Impact of Events Scale (IES), and Subjective Units of Distress scale (SUDs); process measures, which included the Subjective Units of Distress scale (SUDs) and Validity of Cognition (VOC) scale; and a self-report measure of overall improvement, which was the Image Desensitization Rating Scale (IDRS).Results demonstrated support for the superiority of an eye movement condition over that of both a no-eye movement condition (EFD), and a competing motor activity of single hand tapping (SHT) on process variables (SUDs and VOC), but not on weekly global measures (IES, BAI, and SUDs) in the single subject studied. Also, this study found support for the effectiveness of EMDR (delayed treatment phase) in reducing symptoms of anxiety, intrusiveness and avoidance, and subjective distress related to memory of trauma as measured by BAI, IES, and SUDs, and also in alleviating DSM-IV symptoms of Posttraumatic Stress Disorder for this subject. Experimental single-subject studies, as well as group designs, need to investigate possible neurological and theoretical explanations for the effectiveness of EMDR in future research. [Author Abstract]
Dissertation Abstracts International: Section B: The Sciences and Engineering. 60(4-B), Oct 1999, pp. 1846.
Background: Eye movement desensitisation and reprocessing (EMDR) is a relatively new therapeutic technique that has been proposed as a treatment for post-traumatic stress disorder and other anxiety complaints. Method: We compared the efficacy of EMDR with that of exposure in vivo in the treatment of a specific phobia. Twenty-two spider-phobic children who met the DSM-III-R criteria for specific phobia participated in the study. Children were treated with one session of exposure in vivo and one session of EMDR in a crossover design. Treatment outcome was evaluated by self-report measures, a behavioural avoidance test and a physiological index (skin conductance level). Results: Results showed positive effects of EMDR, but also suggest that it is especially self-report measures that are sensitive to EMDR. Improvement on a behavioural measure was less pronounced, and exposure in vivo was found to be superior in reducing avoidance behaviour. With regard to skin conductance level, EMDR and exposure in vivo did not differ. Conclusions: EMDR has no additional value in treatment of this type of animal phobia, for which exposure in vivo is the treatment of choice.
This book reviews research and development; discusses theoretical constructs and possible underlying mechanisms; and presents protocols and procedures for treatment of adults and children with a range of complaints. Among the many clinical populations for whom the material is this volume is applicable are victims of sexual abuse, violence, combat, grief, and phobias.To assist the learning process, detailed descriptions and transcripts guide the clinician through every stage of therapeutic treatment, ranging from the safety issues necessary for appropriate client selection through the administration of EMDR and its integration within a comprehensive treatment plan. Only licensed mental health professionals, or those under direct supervision of licensed clinicians, should use the procedures and protocols in this book. The book has been written with four kinds of readers in mind: academicians, researchers, clinicians, and clinical graduate students. [Adapted from Text]
This book reviews research and development; discusses theoretical constructs and possible underlying mechanisms; and presents protocols and procedures for treatment of adults and children with a range of complaints. Among the many clinical populations for whom the material is this volume is applicable are victims of sexual abuse, violence, combat, grief, and phobias. To assist the learning process, detailed descriptions and transcripts guide the clinician through every stage of therapeutic treatment, ranging from the safety issues necessary for appropriate client selection through the administration of EMDR and its integration within a comprehensive treatment plan. Only licensed mental health professionals, or those under direct supervision of licensed clinicians, should use the procedures and protocols in this book. The book has been written with four kinds of readers in mind: academicians, researchers, clinicians, and clinical graduate students. [Adapted from Text of 1st Edition]
This archival study examined the efficacy of EMDR with residential latency-age children. Participants in the study were the records of 5 children who completed a 10-week EMDR treatment protocol, and 4 children who were in a control group. Treatment included art therapy, play therapy, drama therapy, and talk therapy. EMDR was included as a component of the overall treatment for the experimental group. Pre- and post-measures were assessed using the Behavior Assessment Scale for Children (BASC) and the Trauma Symptom Checklist for Children (TSCC). Three versions of the BASC were used in this study: the Parent Rating Scale (PRS), the Teacher Rating Scale (TRS), and the Self Report of Personality (SRP).Paired-sample t tests demonstrated significant differences on the BASC-SRP and the TSCC for the experimental group at pre- and post-measures. For the BASC-SRP, the children in the experimental group endorsed significantly fewer items for Atypicality, Locus of Control, Social Stress, and Anxiety at the conclusion of the study as compared to initial results. For the experimental group, three of the six scales on the TSCC were significantly lower at the end of the study than at the beginning of the study. The children endorsed significantly fewer symptoms of PTSD, Depression, and Dissociation at the end of treatment as compared to the beginning of treatment. Because of the numerous limitations of this study, generalizability is inevitably limited. However, the outcome of this research indicates that EMDR can be effective to reduce overall symptomology of severely traumatized children. [Author Abstract]
Dissertation Abstracts International: Section B: The Sciences and Engineering. 63(2-B), Aug 2002, pp. 1021.
Eye Movement Desenitization and Reprocessing (EMDR) is a procedure which uses saccadic eye movements as part of a protrocol to detoxify disturbing memories. EMDR has attracted significant attention because of its claims to facilitate recall of repressed material and to relieve the anxiety rapidly. Some patients are able to recall and resolve a disturbing memory during a single session of EMDR, although complex memories require longer. Shapiro (1989, 1991) first described the use of EMDR in patients with Post Traumatic Stress Disorder, and other case studies have described similar results (Wolpe and Abrams, 1991; Kleinknecht & Morgan, 1992). Prelimary studies in larger groups have been reported (Solomon, 1993; Daniels, 1993; Wilson, 1993). This session will discuss the use of EMDR in patients with dissociative disorders.
This session will present the use of EMDR in three areas of the treatment of dissociative disorders: 1) accessing dissociated BASK elements, 2) crisis management, and 3) abreaction. This will be followed by a discussion involving two senior clinicians, Dr. Walter Young, MD, and Richard Lowenstein, MD. A general question and answer will follow.
1. Sandra Paulsen, PhD., will open the session with a general introduction to EMDR and an overview of the general principles of treatment. Following this, she will present a conceptual framework for understanding the use of EMDR insociative disorders using Braun's BASK model. A videotape will be presented which demonstrates the reassociation, one at a time, of BASK elements.
2) Silke Vogelmann-Sine, PhD, will present cases illustrating the use of EMDR in the management of patients in crisis. It will be suggested that the relief provided by EMDR is long-lasting and that EMDR is a cost-effective way to prevent hospitalizations.
3) Steven Lazrove, MD, will discuss the use of EMDR in abreaction. It is proposed that EMDR allows the abreactive work to progress quiickly without traumatizing the patient. This hyposesis will be supported by the presentation of a case including a videotape of the patient's initial EMDR session.
The purpose of this symposium is to expose clinicians to the use of EMDR in dissociative disorders, only. It is not intended to substitute for formal training in use of EMDR.
The Eye Movement Desensitization and Reprocessing (EMDR) procedure, developed
by Francine Shapiro, PhD, was introduced as a new rapid treatment for anxiety and
related traumata. In a controlled study (Shapiro, 1989), rape victims and Vietnam
veterans experienced a significant decrease in distressing symptoms--flashbacks,
ruminating, sleep disturbance, and uncomfortable physiological arousal. Additional
outcomes were the subjects cognitive restructuring of what had happened to them.
Subsequent research studies reported therapeutic outcomes with a variety of disorders-
phobias (Kleinknecht, 1993), panic disorder (Goldstein, 1992), dissociative disorder
(Paulsen et el, 1993) and PTSD (Wilson et al, In press). The first author was the first
EMDR-trained clinician to apply EMDR in performance enhancement work,
beginning with sales professionals. The authors have now used EMDR with nearly
sixty Individual athletes ranking from amateur to Olympic hopeful, across several
different sports. Their single case findings suggest that EMDR amplifies and
accelerates the benefits of standard mental training. Their data indicates EMDR
speeds psychological recovery from sport injury and coming back from a loss, adds
in working through difficulties with past coaches, reduces fears about competition,
and improves overall athletic performance.
Eye Movement Desensitization and Reprocessing (EMDR) is described in terms of clinical phenomena, the need for appropriate training in EMDR, and the consistency of neural network theory with BASK theory of dissociation. EMDR treatment failures occur in dissociative disorder patients when EMDR is used without making diagnosis of the underlying dissociative condition and without modifying the EMDR procedure to accommodate it. Careful informed consent and the use of the dissociative table technique can allow EMDR to move successfully to completion in a dissociative patient. Certain "red flags" contraindicate the use of EMDR for some dissociative patients. A protocol for EMDR with dissociative patients is offered, for crisis intervention (rarely appropriate), abreactive trauma work, and integration/fusion. The safety and effectiveness of EMDR's use in the dissociative disorders requires adequate preparation and skillful trouble-shooting during the EMDR. [Author Abstract]
ubstance Abuse is the use and abuse of mood and mind altering substances often having undesired effects on the lives of those addicted, and having a negative impact on the lives of others. Those addicted may expose themselves and others to physical and psychological harm; may create forensic problems; cause disintegration of the family, and problematic interpersonal relationships. Underlying reasons for addictive behavior include but are not limited to: genetic predisposition, psychosocial involvement, psychobiological complications, developmental conditions, and pre-existing psychological and environmental events. Some deficits found in those addicted include: poor coping skills, inability to problem solve, inability to function in difficult situations, and may use cognitive avoidance as a means of coping with life. The idea that children might be negatively impacted by exposure to substance abuse using parents is not a new revelation. However, the degree of damage done to these children is severe, and more is being learned about the severity of that damage. Children often are enmeshed with their dysfunctional families, and many problems arise involving their inability to maintain intimate relationships with others. Attachment issues may develop in infancy and early stages of maturation, and adversely affect children's ability to function as adults. Abusive pasts and traumatic incidents often may hinder the psychological growth and maturity of those who have experienced trauma and abuse.Eye Movement Desensitization Reprocessing (EMDR) is a fairly new concept of treatment. It was first designed to address therapy with those who had been exposed to trauma. However, over the past 22 years since its inception, it has been adapted to treat many other types of Axis I disorders. It has been determined that EMDR is useful in addressing substance abuse and other Axis I diagnoses, especially PTSD. Hiller, Knight, and Simpson completed a study with 161 persons who resided at a residential halfway house for newly released inmates. Their results found: 80% of the sample of had psychological problems; 72% had significant drug abuse problems; 58% had concurrent psychopathology and drug abuse problems. Research indicates prison confinement is increasing, and the idea of therapy in the forensic setting is gaining in popularity. Thus, the purpose of this dissertation is to design a substance abuse program to address the difficulties of substance abuse treatment for the dual diagnosed clients. The data collected from this program will help provide much needed information in order to further research and increase our understanding of the needs of this underserved population. [Author Abstract]
The Eye Movement Desensitization and Reprocessing (EMDR) procedure, developed by Francine Shapiro, PhD, was introduced as a new rapid treatment for anxiety and
related traumata. In a controlled study (Shapiro, 1989), rape victims and Vietnam
veterans experienced a significant decrease in distressing symptoms--flashbacks,
ruminating, sleep disturbance, and uncomfortable physiological arousal. Additional
outcomes were the subjects cognitive restructuring of what had happened to them.
Subsequent research studies reported therapeutic outcomes with a variety ofdisorders-
phobias (Kleinknecht, 1993), panic disorder (Goldstein, 1992), dissociative disorder
(Paulsen et el, 1993) and PTSD (Wilson et al, In press). The first author was the first
EMDR-trained clinician to apply EMDR in performance enhancement work,
beginning with sales professionals. The authors have now used EMDR with nearly
sixty Individual athletes ranking from amateur to Olympic hopeful, across several
different sports. Their single case findings suggest that EMDR amplifies and
accelerates the benefits of standard mental training. Their data indicates EMDR
speeds psychological recovery from sport injury and coming back from a loss, adds
in working through difficulties with past coaches, reduces fears about competition,
and improves overall athletic performance.
Eye-movement desensitization and reprocessing (EMDR) has been hailed as a new experimental treatment for survivors of trauma that can provide rapid relief from the debilitating symptoms associated with PTSD. EMDR's efficacy reportedly stems from the use of eye-movements that are postulated to stimulate physiological changes in brain activity to produce cognitive restructuring and desensitization of emotional discomfort. This novel procedure has become more prominent with reported benefits for an increasing range of clinical applications. Since there is minimal controlled research, especially in a civilian population, on psychological methods to treat the ill effects of trauma and because EMDR has limited empirical support, further controlled investigation was warranted to supplement this limited body of scientific knowledge.Consequently, the specific goals of this controlled study were to evaluate (1) the efficacy of EMDR in the treatment of civilian trauma survivors, (2) whether or not eye-movements are instrumental to the therapeutic process, and (3) the treatment impact on intrusive and avoidant symptoms. It was hypothesized that (1) an EMDR treatment group would demonstrate greater efficacy when compared to an Alternative group which followed the same treatment protocol except for the substitution of deep breathing for the eye-movements, (2) both the EMDR and Alternative treatments would show significant improvement over a Control group, and (3) there would be similar changes in intrusive and avoidant symptoms. Findings at two month follow-up indicated the EMDR group had significant reductions in intrusive/avoidant symptoms (using the Impact of Event Scale), decreased emotional discomfort related to traumatic memories (rated by Subjective Units of Distress), and improvements in positive self-evaluations (measured by the Validity of Cognition Scale). There were similar results in the Alternative group with the exception of no significant improvement in self-evaluation. This latter finding provides some support for the hypothesis that eye-movements facilitate a cognitive restructuring. Comparisons between the EMDR and Alternative treatments, however, found no significant differences on any of the dependent measures. That is, both treatments appeared to produce comparable positive results which implied eye-movements were no more effective than deep breathing. In addition, both treatments were found to be more effective in easing intrusive symptoms. Other similarities included observable relaxation reactions in both treatments. These overall findings imply a similar change mechanism. Therefore, the efficacy of EMDR may stem more from reciprocal inhibition rather than a cognitive restructuring induced by the eye-movements. If this is valid, then EMDR may be a variant of systematic desensitization. [Author Abstract]
Dissertation Abstracts International: Section B: The Sciences and Engineering. 56(3-B), Sep 1995, pp. 1690
The spirit and principles of Ericksonian Hypnosis work well with other therapies and can be integrated effectively with the eight-phase EMDR protocol. The workshop will introduce some key concepts and elements of Ericksonian trance work.
Conversational Ericksonian Hypnosis provides an elegant method for using metaphors and doing “parts work”, which can be combined with other interweaves. The application is particularly relevant where avoidance, ambivalence and blocking beliefs are an issue in treatment.
El protocolo estándar de EMDR requiere enfocar los orígenes de la perturbación, los gatillos del presente y crear un patrón de conductas adecuadas para el futuro (Shapiro). Algunos pacientes, sin embargo pueden tener dificultades para conectar su problema actual con acontecimientos del pasado. Así también, otros pacientes pueden tener dificultades para crear patrones positivos para el futuro, especialmente si ensayar conductas nuevas los pone ansiosos. Para estos problemas las técnicas de "Flotar hacia atrás" y "Flotar hacia delante" desarrolladas por William Zangwill Ph. D., entrenador del Instituto EMDR, son métodos efectivos para ligar el pasado, presente y futuro en un ámbito terapéutico y proveen al terapeuta de instrumentos para abordar eficientemente ambos temas.
LA TÉCNICA DE FLOTAR HACIA ATRÁS
Abordar recuerdos tempranos asociados con el material perturbador es fundamental para EMDR. Shapiro dice que ayudar al paciente a encontrar un recuerdo temprano "debe ser una de las primeras opciones que debe considerar al terapeuta..." (Shapiro, 1995). La Técnica de Flotar hacia atrás es un camino eficiente y poderoso para llegar a esta meta, permitiendo al terapeuta asistir al paciente a llevar a cabo sus propias asociaciones con acontecimientos del pasado. Su uso es muy apropiado cuando el terapeuta sospecha que una perturbación que el paciente experimenta en el presente, tiene sus raíces en experiencias del pasado; especialmente cuando preguntas como "Cuál es su recuerdo más temprano en relación a lo que se siente ahora? no ha tenido éxito en ayudar al paciente a conectar con eventos del pasado. También cuando un paciente presenta un tema o experiencia recurrente, la Técnica de Flotar hacia Atrás es ideal para ayudar al paciente a identificar un target para el reprocesamiento. Muchos pacientes se ponen en contacto con los problemas actuales con relativa facilidad. Por ejemplo, una paciente que se queja que se siente abandonada cuando su marido se va de viaje de negocios, probablemente pueda recordar sus problemas actuales con facilidad. Entonces el terapeuta puede aplicar la Técnica de Flotar hacia Atrás para ayudarle a la paciente a recordar un acontecimiento del pasado con rapidez y eficiencia.
Para usar la Técnica de Flotar hacia Atrás, arme el protocolo con el problema actual, utilizando los pasos que figuran en el Manual de Entrenamiento del Nivel I y del Nivel II (Shapiro, 1994) incluyendo la imagen, la cognición negativa (CN), la cognición positiva (CP), la validación de la cognición (VoC), emociones, Unidad Subjetiva de Perturbación (SUD) y sensación corporal. Sin embargo, no incide todavía el procesamiento (es decir, movimientos oculares u otra estimulación). En vez de eso, diga a su paciente: "Fíjese en la imagen de... y esas palabras (repita la imagen perturbadora del paciente y su cognición negativa), fíjese que emociones le vienen y donde las siente en el cuerpo. Ahora cierre los ojos y deje que su mente flote hacia atrás a un período anterior en su vida, no busque, simplemente deje que su mente flote a una época donde usted pensaba cosas similares... (repita las emociones que dijo el paciente) en ...(repita los lugares del cuerpo donde el paciente sintió las sensaciones). Cuando esté listo abra los ojos y dígame lo primero que le viene a la mente".
Utilice esta experiencia más temprana como target, completando todos los items del protocolo: imagen, CN, CP, VoC, emociones, SUD y ubicación de las sensaciones corporales y comience a procesar con movimientos oculares u otro estímulo bilateral. Una vez que se ha procesado este material, vuelva al target original del material actual. Muy a menudo se generaliza el trabajo realizado sobre el material más temprano y ya no hace falta procesar el material actual.
Es importante usar términos generales cuando se le dan al paciente las instrucciones de la Técnica de Flotar hacia Atrás, es decir, pedir un recuerdo temprano y no el más temprano. Hay varias razones que avalan esto. Primero, muchas veces es el peor recuerdo y no el primero que funciona como el mejor target para el reprocesamiento,. Además, usar términos generales es una ayuda para los pacientes más compulsivos y perfeccionistas que de otra manera estarían demasiado preocupados en no equivocarse y encontrar exactamente la primera asociación. Finalmente, la flexibilidad que permite la utilización de términos generales más que términos específicos aumenta la posibilidad de éxito del paciente de conectarse con el pasado que es la meta de esta técnica.
El rasgo esencial de la Técnica de Flotar hacia Atrás es usar las preguntas del protocolo para conectar los problemas del presente con eventos del pasado. Pasar las preguntas como fueron desarrolladas por Shapiro es un potente método para ayudar a los pacientes a sintonizar con todos los aspectos de su experiencia del problema. El material perturbador se vuelve más vívido y actual para el paciente y posibilita recordar experiencias similares. Se supone, como hipótesis, que al haber desarrollado el protocolo con todas las preguntas sobre el problema actual, estimula la red neuronal de asociaciones y posibilita casi sin esfuerzo el "flotar hacia atrás" a asociaciones tempranas.
Además, el vínculo paciente-terapeuta es realzado porque el terapeuta valida la experiencia del paciente (la perturbación actual) al empezar el trabajo desde el punto en el que se encuentra el paciente. Las asociaciones son del paciente, eliminando el tema de la resistencia a cualquier idea o interpretación introducida por el terapeuta. El paciente se da cuenta vivencialmente de la conexión del presente con el pasado usando la Técnica de Flotar hacia Atrás, pudiendo esquivar la evitación y otras defensas.
LA TÉCNICA DE FLOTAR HACIA DELANTE
Mientras que la Técnica de Flotar hacia Atrás posibilita muy a menudo que los pacientes vean y sientan la conexión entre el problema actual y los eventos pasados, la Técnica de Flotar hacia delante permite que el paciente identifique y reprocese la ansiedad anticipatoria y desarrolle patrones positivos para el futuro. Es un método que puede ser utilizado en cualquier momento del proceso terapéutico para solucionar bloqueos, renuencias y en algunos casos, resistencias o temas de beneficios secundarios o pérdidas. Es especialmente útil para trabajar con el miedo del paciente a hacer EMDR.
Para ponerlo en práctica, primero pida al paciente que imagine lo peor que le puede pasar si hace "X" (por ej. probar una nueva conducta, testear una nueva habilidad, empezar una experiencia nueva). ¿Qué es lo peor que le puede pasar si hace EMDR? Que es lo peor que le puede pasar si soluciona este problema? ¿Qué es lo peor que le puede pasar si le pone límites a su jefe respecto a la cantidad de trabajo que espera que usted haga? El paciente puede necesitar ayuda para identificar la peor escena. Algunas sugerencias incluyen el miedo a perder el control de sus emociones, el miedo a perder el control de sus funciones corporales como el control de esfínteres, miedo a tener un ataque de pánico, y no poder manejar su vida emocional entre las sesiones.
Una vez que el paciente ha identificado el incidente, pregunte por la peor parte de esa escena y utilícelo como el target de EMDR, armando el protocolo con las preguntas estándar, pero con una leve modificación: pregunte por la imagen que representa la peor parte del peor incidente, por ej. "Cuando usted ve una imagen de si mismo/a haciendo......, que es lo peor que puede pasar?"
Después siga con el resto de las preguntas estándar, es decir, CN, CP, VoC, emociones, SUD, y ubicación de la sensación corporal. Estimule el procesamiento del paciente con movimientos oculares u otro estímulo bilateral.
Si el desarrollo de la peor escena del paciente le provoca un miedo racional, puede que se tengan que tomar medidas prácticas para solucionar estas preocupaciones. Por ejemplo, usando la técnica de flotar hacia delante con un chico de 13 años que estaba en un hogar adoptivo transitorio, la peor escena evocada por él fue: "Me van a devolver al Hogar si esta adopción no resulta". Durante el procesamiento, el SUD se redujo de 8 a 3 con bastante rapidez pero de ahí no bajaba. El paciente comentó que no bajaba porque esta "peor escena" podría sucederle realmente y le había sucedido en el pasado. Paramos los movimientos oculares, charlamos un rato y elaboramos un plan para: a) una sesión con sus padres adoptivos para hablar sobre la permanencia de la adopción y b) una llamada en conferencia a su asesor legal para clarificar sus derechos y opciones. Volviendo al target después de esto, le fue posible reducir el SUD a 1 con unos pocos sets de movimientos oculares.
Al utilizar la Técnica de Flotar hacia delante para reprocesar la peor escena, el paciente tiene una oportunidad para resolver la ansiedad anticipatoria. Durante la instalación de la cognición positiva, el paciente está creando patrones positivos para acciones en el futuro. Una mujer cuyo hermano fue verbalmente abusivo con ella en la infancia y en la actualidad la intimidaba, armó una "peor escena" con: "Va a ser igualmente abusivo cuando lo vea la próxima vez". La paciente había hecho mucho EMDR, reprocesando incidentes de la infancia relacionados con el abuso verbal del hermano. Sin embargo, sin un referente positivo vivencial, seguía ansiosa cada vez que interactuaba con él. Pidiéndole que "flote hacia delante" y usando EMDR sobre una de las peores escenas, alivió su ansiedad respecto a una fiesta familiar que tenía pendiente. Instalando una CP de "Ahora estoy más fuerte" le permitió crear una imagen de si misma manejando a su hermano con humor y sintiéndose segura.
A aplicar las Técnicas de Flotar hacia Atrás y hacia Delante y ocuparse así del pasado, presente y futuro, el terapeuta de EMDR puede sanar mejor a su paciente. Es más, las Técnicas de Flotar hacia Atrás y hacia Delante están basadas en EMDR. Las dos incorporan las preguntas del protocolo standard y le dan al terapeuta y al paciente la oportunidad de manejarse más fluidamente con dicho protocolo.
EMDR standard protocol requires a focus of the origins of the disturbance, the triggers of this and create a pattern of behaviors appropriate to the future (Shapiro). Some patients, however, may have difficulty connecting the current problem with past events. Also, other patients may have difficulty creating positive patterns for the future, especially if you try new behaviors makes them anxious. For these problems the techniques of "float back" and "Float forward" developed by William Zangwill Ph.D., EMDR Institute trainer, are effective methods to link the past, present and future in a therapeutic area and provide the therapist tools to effectively address both issues.
THE ART OF FLOATING BACK
Addressing early memories associated with foreign material is essential to EMDR. Shapiro said that helping the patient to find early memory "must be one of the first options to consider when therapist ..." (Shapiro, 1995). Floating Technique back is a powerful and efficient way to reach this goal, allowing the therapist to assist the patient to carry out their own associations with past events. Its use is most appropriate when the clinician suspects that a disturbance that the patient is experiencing at present, is rooted in past experiences, especially when questions like "What is your earliest memory in relation to what you feel now? Not been successful in helping patients to connect with past events. Also when a patient has a recurrent theme or experience, the Backward Floating Technique is ideal for helping the patient to identify a target for reprocessing. Many patients come into contact with the current problems with relative ease. For example, a patient who complains that she feels abandoned when her husband goes on a business trip, you can probably recall their current problems with ease. Then the therapist can apply the technique Float Backwards to help the patient to remember a past event quickly and efficiently.
To use the technique to back float, arm the protocol to the current problem, using the steps listed in the Training Manual Level I and Level II (Shapiro, 1994) including the image, negative cognition (NC) positive cognition (PC), validation of cognition (VoC), emotions, Subjective Unit of Disturbance (SUD) and bodily sensation. However, it still affects the processing (ie, eye movements or other stimulation). Instead, tell your patient: "Look at the picture ... and those words (repetition of the disturbing image of the patient and negative cognition), note that emotions come from and where you sit on the body. Now close eyes and let your mind float back to an earlier period in your life, look no further, just let your mind float to a time when you thought things like ... (repeat the emotions that said the patient) .. . (repeat parts of the body where the patient felt the sensation). When you are ready open your eyes and tell me the first thing that comes to mind. "
Use this early experience as a target, completing all protocol items: image, CN, CP, VoC, emotions, SUD and location of bodily sensations and begin processing with eye movements or other bilateral stimulation. Once this material has been processed, return to the original target of the current material. Very often we generalize the work done on the earlier material and no longer have to render the current material.
It is important to use general terms when the patient is given instructions Technique Float Backwards, ie a memory request early and not earlier. There are several reasons that support this. First, it is often the worst memory and not the first that works as the best target for reprocessing. In addition, using general terms is an aid for compulsive and perfectionistic patients who otherwise would be too concerned with avoiding failure and find exactly the first association. Finally, the flexibility that allows the use of general rather than specific terms increases the likelihood of success of the patient to connect with the past that is the goal of this technique.
The essential feature of the technique is to use Float Backwards questions of protocol to connect the problems of the present with past events. Skip the questions and were developed by Shapiro is a powerful method to help patients to tune into all aspects of their experience of the problem. The foreign material becomes more vivid and present to the patient and possible recall similar experiences. It is assumed, arguendo, that having developed the protocol with all the questions about the current problem, the neural network encourages and facilitates partnerships almost effortlessly "float back" early associations.
In addition, the patient-therapist relationship is enhanced because the therapist validates the patient's experience (current disruption) to start work from the point where the patient is. Partnerships are the patient, eliminating the issue of resistance to any idea or interpretation introduced by the therapist. The patient realizes experientially connecting the present with the past by using the technique Float Backwards, can avoid the avoidance and other defenses.
THE ART OF FLOATING FORWARD
While technology enables Float Backwards often patients to see and feel the connection between the current problem and past events, the forward float technique allows the patient to identify and reprocess anticipatory anxiety and develop positive patterns the future. It is a method that can be used at any time of the therapeutic process to troubleshoot crashes, reluctance and in some cases, resistance or topics of ancillary benefits or losses. It is especially useful for working with the patient's fear to do EMDR.
To put this into practice, first ask the patient to imagine the worst that can happen if you "X" (eg. Try a new behavior, test a new skill, start a new experience.) What's the worst that can happen if you EMDR? That's the worst that can happen if you solve this problem? What's the worst that can happen if you put your head limits on the amount of work expected to do? The patient may need help to identify the worst scene. Some suggestions include fear of losing control of his emotions, fear of losing control of their bodily functions such as bowel and bladder control, fear of having a panic attack and can not manage their emotional life between sessions.
Once the patient has identified the incident, ask for the worst part of that scene and use it as the target of EMDR, setting up the protocol with the standard questions, but with a slight modification: ask for the image that represents the worst of worst incident, eg. "When you see a picture of him / herself by ......, it's the worst that can happen?"
Then follow with the rest of the standard questions, ie, CN, CP, VoC, emotions, SUD, and location of bodily sensation. Stimulate the processing of patients with eye movements or other bilateral stimulation.
If the development of the patient's worst scene provokes a rational fear, you may have to take practical steps to address these concerns. For example, using the technique of floating forward with a boy of 13 who was in a temporary foster home, the worst scene evoked for him was: "I will return home if this adoption is not." During processing, the LDS was reduced from 8 to 3 fairly quickly but it does not down. The patient said he did not go down because the "worst scene" could really happen and had happened in the past. Eye movements stopped, we chatted a while and developed a plan for: a) a meeting with her adoptive parents to discuss the permanence of the adoption and b) a conference call to his legal adviser to clarify your rights and options. Returning to the target after that, it was possible to reduce the LDS-1 with a few sets of eye movements.
Using Floating Technique forward to reprocess the worst scenario, the patient has an opportunity to resolve the anticipatory anxiety. During the installation of the positive cognition, the patient is creating positive patterns for future action. A woman whose brother was verbally abusive to her children and now intimidated, put together a "worst stage" with: "It will be equally unfair when I see him next time." The patient had done much EMDR reprocessing childhood incidents related to verbal abuse of his brother. However, without a positive reference experiential, still anxious every time I interacted with him. Asking him to "float forward" and using EMDR on one of the worst scenes, relieved her anxiety about a family party that was pending. Installing a CP of "I'm stronger now allowed him to create an image of herself driving her brother with humor and feeling safe.
To apply the techniques to float back and forth and deal well past, present and future, the EMDR therapist can heal your patient better. Moreover, techniques to float back and forth are based on EMDR. Both incorporate the standard protocol questions and give the therapist and the patient the opportunity to be managed more smoothly with this protocol.
This introductory workshop will teach the
8 steps of Fraser’s Dissociative Table Technique and
how to incorporate it into the EMDR Standard Protocol.
Case examples and video clips will be used to demonstrate
the power of this technique to identify and work
with emotional parts of the personality throughout the
healing process.
Recognizing and treating symptoms of attachment trauma and dissociation are imperative clinical skills for effective treatment throughout the eight Phases of the EMDR Protocol with clients of any age. The presentation will review AIP theory and the eight-phase EMDR treatment protocol, the three-phase Dissociative Theory treatment, and tools for assessing dissociation in children and adolescents. Once evaluated, therapists will need to continue to assess emerging symptoms that can continue to arise and impede EMDR treatment. Clinical skills including grounding techniques, visualizations, identifying and integrating ego states, and mirroring and nurturing techniques, will be described and demonstrated for participants to implement throughout the EMDR Protocol.
No abstract available.
Media descriptions, popular magazine articles, novels and television programs, dissociaparticularly
talk shows, present a variety of
human conditions to the public. These accounts are often portrayed to represent the general condition when, in fact, they represent highly stylized, idiosyncratic variations of a general class. Over the last ten
years, many accounts of dissociative somedisorders,
most specifically multiple personality disorder (MPD), have been presented in the media in exactly that sensationalizing fashion. The public, as well as many mental health practioners, have been inundated with largely believable, but exceptionally rare, accounts of how patients with these disorders function, (e.g., what they are like in their day to day living and how they are likely to present themselves in treatment). These conditioned descriptions lead inadvertently to unrealistic expectations about how to recognizesignsand symptoms that would lead to an accurate diagnosis of dissociative disorders.
There is converging evidence of gray matter (GM) structural alterations in different limbic structures in Post-Traumatic Stress Disorder (PTSD) patients. The aim of this study was to evaluate GM density in PTSD in relation to trauma load, and to assess the GM differences between responders (R) and non-responders (NR) to EMDR therapy. Magnetic Resonance Imaging (MRI) scans of 21 subjects exposed to occupational trauma, who developed PTSD (S), and of 22 who did not (NS), were compared by means of an optimized Voxel-Based Morphometry (VBM) analysis as implemented in SPM. Within S, further comparisons were made between 10 R and 5 NR. A regression analysis between GM density and the Traumatic Antecedents Questionnaire (TAQ) was also performed on all 43 subjects. Results showed a significantly lower GM density in S as compared to NS in the left posterior cingulate and the left posterior parahippocampal gyrus. Moreover, NR showed a significantly lower GM density as compared to R in bilateral posterior cingulate, as well as anterior insula, anterior parahippocampal gyrus and amygdala in the right hemisphere. Regression analysis showed that GM density negatively correlated with trauma load in bilateral posterior cingulate, left anterior insula, and right anterior parahippocampal gyrus. In conclusion, a GM lower density in limbic and paralimbic cortices were found to be associated with PTSD diagnosis, trauma load, and EMDR treatment outcome, suggesting a view of PTSD characterized by memory and dissociative disturbances.[Pubmed]
There is converging evidence of gray matter (GM) structural alterations in different limbic structures in Post-Traumatic Stress Disorder patients. Eye Movement Desensitization Reprocessing (EMDR) is currently used to treat PTSD but its neurobiological implications are still unknown. The aim of this study was to evaluate GM density in PTSD relation to trauma load, and to assess the GM differences between responders (R) and non-responders (NR) to EMDR therapy.
Structured clinical interviews for DSM-IV Axis I Disorders were carried out before and after EMDR treatment. Those who no longer fulfilled the DSM-IV criteria for PTSD were classified as R and those who still met the diagnostic criteria of PTSD after treatment were classified as NR. Two scales 0f self-related Trauma Antecedent Questionnaire (‘trauma and neglect’ TAQ-, and ‘resilience factors’ TAQ+), were administered to assess lifelong trauma load and resilience. Magnetic Resonance Imaging (MRI) scans 10 R and of 5 NR were compared before therapy by means of an optimized Voxel-Based Morphometry (VBM) analysis as implemented in SPM. For group analysis, a threshold of p<0.05 corrected for multiple comparisons at cluster level and an uncorrected threshold of p <0.001 at voxel-level were used.
NR subjects showed no significant differences nor in TAQ- scores neither in TAQ+ as compared to R(t=0.140, p+0.891). The contract R>NR exhibited a significant GM lower density in NR as compared to R in three different cluster: the first bilaterally located over posterior cingulate (Brodmann Areas, Bas 23 and 31); the second centered over the left precentral (BA 4), middle and medial frontal gyri (BA 6); the third including anterior insula (BA 13), and the complex anterior parahippocampal gyrus/amygdala, over the right hemisphere.
To our knowledge, this is the first study investigating GM alterations with a VBM approach in a sample of PTSD patients respond and non responding to EMDR therapy. Posterior cingulate, parahippocampal and insular lower GM concentrations have been found to relate to responsiveness to EMDR therapy suggesting a high vulnerability of these structures to the effects of stress and trauma. These regions are well known to be implicated in processes such as: integration, encoding and retrieval of autobiographical and episodic memories; emotional processing, interoceptive awareness and sefl-referential conscious experience. Thus, our study supports lower GM densities in limbic and paralimbic cortices as a potential structural basis for memory and dissociative dysfunction in PTSD. Using such methodological approach can contribute to better understand the neurostructural basis for traumatic responses and their treatment.
The goals for the audience are: 1. To understand the methodological research principles; 2. To be updated on neurobiological research in EMDR; 3. to be informed on the neural basis of EMDR.
The International Society for the Study of Dissociation (ISSD), the former
name of the International Society for the Study of Trauma and Dissociation
(ISSTD), adopted the Guidelines for Treating Dissociative Identity Disorder
(Multiple Personality Disorder) in Adults in 1994. However, the Guidelines
must be responsive to developments in the field and require ongoing review.
The first revision of the Guidelines was proposed by the ISSD’s Standards
of Practice Committee1 and was adopted by the ISSD Executive Council
in 1997 after substantial comment from the ISSD membership. The second
revision of the Guidelines was requested and approved in 2005 based on the
expertise of a task force of expert clinicians and researchers.2 The current revision was undertaken by a new task force3 in 2009 and 2010 after input
from an open-ended survey of the membership.
The current revision of the Guidelines focuses specifically on the
treatment of dissociative identity disorder (DID) and those forms of dissociative
disorder not otherwise specified (DDNOS) that are similar to DID.
It is intended as a practical guide to the management of adult patients
and represents a synthesis of current scientific knowledge and informed
clinical practice. There is a separate Guidelines for the Evaluation and
Treatment of Dissociative Symptoms in Children and Adolescents (ISSD,
2004) available through the ISSTD and published in the Journal of Trauma
& Dissociation. The American Psychiatric Association (2004) has published
Practice Guidelines for the Treatment of Patients with Acute Stress Disorder
(ASD) and Posttraumatic Stress Disorder (PTSD), which may be relevant to
the treatment of DID.
EMDR is increasingly being utilized to treat highly challenging clients with a
variety of diagnoses including complex PTSD, DESNOS, and a range of
dissociative disorders. The dissociative processes commonly described as
part of the PTSD spectrum, are also predicted by early attachment difficulties
and losses. These clients may present with elements of several disorders (i.e.,
Borderline PD). Without considerable stabilization work, they may be unable
to process information safely. This presentation, through lecture, experiential
work and case presentation, will provide clinicians with a model that enables
them to provide EMDR treatment effectively with this population.
Participants will become familiar with specialized treatment planning that begins with detailed and complex history taking and pays particular attention to an extensive individualized preparation phase. They will learn how and when to integrate ego state work, somatosensory work and disociative treatment strategies in this phase and throughout EMDR protocol work. This systemic work will be understood to help patients resolve internal conflicts, deal with stabilization, affect regulation, triggering, overwhelm, dissociation, and resistance.
When trauma victims enter therapy, they generally seek help for symptoms of PTSD, depression and anxiety. However, additional trauma responses may lead the client to encounter difficulty in dealing with the trauma and also with the trauma and also with relationships in their life. These responses also include the inability to love, nurture and bond with other individuals (even those currently in relationship to victim). These clients often experience feeling internally fragmented, detached, alienated and fearfully isolated. Gathering this information is an important part of history taking and becomes crucial to treatment planning. The aim of this presentation is to help clinicians learn to implement strategies that help traumatized clients to experience reconnection, stability, and then, trauma processing. Integrating ego state strategies with the preparation phase of the EMDR protocol results in a safety/stability focused therapeutic approach necessary for these clients to resolve the sequelae of trauma.
Emphasis is placed on the sequential formulation of guided imaginal and somatosensory exercises (enhanced with DAW) that provide stability for the dissociated aspects of the self unable to cope with symptoms and current stresses. The central work includes the development of an internal Home Base, Workplace, and a positive body resource that compliments the standard safe place/stress reduction work. Stabilizing exercises include constructive avoidance, distancing, grounding, containment as well as affect and dissociative symptom management techniques. When stabilized, client’s access and work with their ego state system to resolve conflicts, develop resources, reconnect and then successfully desensitize and reprocess trauma.
Learning objective include: the importance of including information in the history taking about an inability to love, loss of connections, fragmentation, detachment and alienation; defining the ego state strategies that help such client s successfully process traumas with the EMDR protocol; learning the preparation exercises for managing affect and dissociative symptoms. Participants will select the appropriate interventions to help trauma clients reconnect with dissociated, disconnected parts and employ this sequential method in their practice with traumatized clients.
ultiple Personality Disorder (MPD)
represents the most severe form of
the Dissociative Disorders. The predominant
symptoms are disturbances
in the normally integrative functions
of identity and memory (American
Psychiatric Association, 1987). There
has been an explosion of interest in
the disorder since about 1984
Putnam, 1989; Ross, 1989), with many
articles focusing upon phenomena,
diagnosis, and treatment. The treatment
articles have focused primarily
upon thechallengingissues that have
to be dealt with prior to the eventual
unification ofthe mind, as represented
by the fusions of the various alter
personalities. Relatively little has
been written about the post-unification
phase of treatment, except that
treatment does not end with unification
(Kluft, 1988).
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.
Expressive and nonverbal therapies are increasingly being used in the treatment of trauma. This paper provides a theoretical structure that explains the mechanisms of therapeutic action so that empirical investigations can be conducted to determine the effectiveness of these modalities. Trauma, PTSD, memory, dissociation, alexithymia, and somatization are discussed. Donnel B. Stern's conceptualization of unformulated experience and David Kreuger's discussion of the body self and psychological self are explored and integrated with the neuropsychological research of Bessel A. van der Kolk and others. Finally, these concepts and research findings are integrated with expressive and nonverbal treatment approaches, including Eye Movement Desensitization and Reprocessing, Somatic Experiencing, Sensorimotor Psychotherapy, and Dance/Movement and Voice Movement therapies. [Author Abstract]
The client is a 27-year-old woman
known to me from her first psychiatric
hospitalization 2 1/2 years ago,
during which she was diagnosed with
Major Depression with psychotic features.
She also had dissociative syrnptoms
including well-defined "parts,"
though she did not experience time
loss. She had tried about 20 different
psychoactive medications prior to her
first EMDR session, and had also received
outpatient electroconvulsive
therapy (ECT) 18 months earlier.
During ECT, she maintained a
straight-A average in her course work
to obtain a second degree in nursing.
This study examined the efficacy of eye movement desensitization and reprocessing (EMDR) on inmates with developmental disabilities (DD) who were incarcerated in a special needs correctional facility in the southwestern United States. Cognitively, these inmates ranged from borderline intellectual functioning (BIF) to mild mental retardation (MMR), and all suffered from PTSD-like symptoms. A repeated measure pre- and postanalysis design with one sample group was utilized. The Emotional Problem Scales (EPS), Impact of Events Scales - 8 Items (IES-8), Validity of Cognition Scales (VOCS), and Subjective Units of Disturbance Scales (SUDS) were used to gather quantitative data on the 17 volunteer participants. Baseline and outcome data were collected by an independent assessor. The T-Test was incorporated to analyze the data and determine significance. Due to the small sample of convenience, the data were skewed, so the researcher also used the nonparametric Wilcoxon Signed Rank Test. Descriptive data on EMDR were collected and analyzed.As measured by the SUDS, IES-8, and VOCS, the statistical findings revealed self-reported reductions in levels of distress, avoidance, and intrusiveness of the traumatic memory, and an increase in self-esteem and the believability of positive cognitions about self and the event after the application of EMDR. However, the clinical scales from the Self-Report Inventory (SRI) of the EPS did not reveal any changes after the application of EMDR. Staff familiar with the study volunteers also reported a significant decrease in clinical pathology and an increase in prosocial behavior, as measured by the Behavior Rating Scale (BRS) of the EPS. Findings suggest that the utilization of EMDR with persons having developmental disabilities may have clinical utility. Thus, further research in this area is warranted. [Author Abstract]
Dissertation Abstracts International: Section B: The Sciences and Engineering. 65(1-B), 2004, pp. 436.
This Clinical Q&A article responds to a question about what process to use to access and identify ego states when working with complex trauma. The procedure for implementing Fraser's Dissociative Table Technique is explained and detailed in 8 clearly defined steps. The author builds on Fraser's original instructions and adds several innovations for use by EMDR therapists. Tips on implementing this technique are given. The article then concludes with a session transcript to illustrate the use of this powerful tool.
I have been using EMDR with many
of my clients a number of whom had
been sexually assaulted as children
and have suffered other childhood
trauma. While it is very helpful for
most clients, I have found that some,
who had suffered repeated and early
abuse, are overwhelmed with the material
that they uncovered using
EMDR in its original form. I have
tried a couple of techniques for altering EMDR which have been very helpful
to some clients. Interestingly,
many clients can return to the original
version once their anxiety levels
have been lowered.
Questo articolo presenta una rassegna aggiornata teorico del Post-Traumatico da Stress Disorder (PTSD) concetto, un disturbo mentale che può comparire dopo essere stato esposto direttamente o indirettamente, ad un evento traumatico. L'articolo inizia con una descrizione della sintomatologia, suddivisi in: rivivere l'evento traumatico, evitamento, ottundimento reattività generale e ipervigilanza. Questo è seguito da una presentazione dei più recenti studi che indicano la presenza di disordine da stress post-traumatico nella popolazione, sia nella popolazione generale e nei soggetti direttamente coinvolti in un evento traumatico. Post-traumatico da stress sintomi del disturbo sono identificati mediante questionari specifici descritti nella sezione riferimento a strumenti di indagine. Lo studio delle basi biologiche per il PTSD è diventata particolarmente significativo negli ultimi anni, e abbiamo analizzato questo contesto in modo più approfondito per questo motivo, con particolare riferimento al ruolo dell'asse ipotalamo-ipofisi-surrene. Un impulso importante dello studio del PTSD è dovuto alla crescente importanza dato alla prevenzione, intesa come riduzione dell'impatto dei disturbi psichiatrici che concentrandosi su Eye Movement Desensibilizzazione e ritrattamento (EMDR), il trattamento psicologico, con il supporto di tecniche che riguarda la terapia cognitivo comportamentale e il trattamento farmacologico che prevede l'uso di inibitori della ricaptazione della serotonina selettiva, quali siano le forme più studiate. (PsycINFO record del database (c) 2008 APA, tutti i diritti riservati)
This article presents an updated theoretical review of the Post-Traumatic Stress Disorder (PTSD) concept, a mental disorder that can appear after being exposed directly or indirectly to a traumatic event. The article begins with a description of the symptomatology, divided in: re-living the traumatic event, avoidance, dulling general reactivity and hyperarousal. This is followed by a presentation of the most recent studies which indicate the presence of post-traumatic stress disorder in the population, both in the general population and in subjects directly involved in a traumatic event. Post-traumatic stress disorder symptoms are identified by using specific questionnaires described in the section referring to investigation instruments. The study of the biological bases for PTSD has become particularly significant in recent years, and we analysed this context in greater detail for this reason, with particular reference to the role of the hypothalamo-pituitary-adrenocortical axis. An important boost of the study of PTSD is due to the increasing importance placed on prevention, understood as a reduction of the impact of psychiatric disorders which focusing on Eye Movement Desensitisation and Reprocessing (EMDR), on psychological treatment, with the support of techniques that concerns cognitive behavioral therapy and pharmacological treatment that involves the use of serotonin selective reuptake inhibitors, which are the forms studied most. (PsycINFO Database Record (c) 2008 APA, all rights reserved)
On September 11, 2001, when two hijacked planes destroyed the World Trade Center, the world changed. As a clinical psychologist practicing in Manhattan, and specializing in trauma, the author has found the event's impact upon her work to be profound. For most of her patients, in particular the severely dissociative, this event triggered the deepest feelings of vulnerability, fear and rage. She describes the varied trauma responses of her patients, effective interventions, and her own experiences as a psychologist and a New Yorker both on and since September 11. [Author Abstract]
Survivors of early emotional neglect experience pervasive difficulties including vulnerability to adult psychiatric disorders and inability to regulate emotional states (Schore, 1996, 1997, 2000, 2001a, 2001b; Teicher, 2000, 2002; Teicher et al, 1993; Teicher et al., 1997). Their inability to regulate emotional states is not solely linked to effects of adverse events, but is significantly linked to insufficient exposure to normal, developmental attachment sequences that foster capacities for self-regulation.
A subset of adult survivors of early, pervasive, emotional neglect who meet full or partial criteria for posttraumatic stress disorder also present with comorbid Cluster C Axis II symptoms (Avoidant, Dependent, Obsessive-Compulsive) and meet criteria for dismissing (or fearful) insecure attachment (Cassidy & Shaver, 1999; Main, 1996).
Clinical assessment reveals these patients have low tolerance for positive interpersonal emotions and engage in defensive strategies to dismiss, minimize, deny or subtly avoid experiencing and assimilating this positive emotional states into their internal model of self. These strategies include overt and covert behavioral avoidance as well as dissociate defenses. Paradoxically, these patients may show superficial characteristics or competence, interpersonal skills, or emotional stability which on closer examination prove to be fragile or which collapse in the face of social stressors.
The general theoretical base for the Positive Affect Tolerance and Integration (PAT) protocol is related to McCullough’s (1996, 2003) model of affect phobia and recognizes McCullough’s emphasis on an anxiety regulating, titrated approach to developing tolerance for adaptive affect and associated coping behaviors. Putnam’s (1997) discrete behavioral states model provides an important conceptual framework for understanding these patients’ needs to gradually develop new discrete behavioral (psychophysiological and affective) states and new pathways (schemes and scripts) fostering access to these shared positive states often as a crucial early phase of treatment to help resolve their impairments in emotional self-regulation.
This presentation describes the use of standard EMDR procedural steps in a treatment plan that postpones the standard three pronged (past, present, future) PTSD protocol, but which is consistent with the consensus model for Complex PTSD (Brown, Scheflin & Hammond, 1998; Chu, 1998; Courtois, 1999; Hart, Nijenhuis, Steele, 2006) and other EMDR approaches focused initially on improving response to current stimuli (Hoffman, 2004; Leeds & Korn, 1998; Leeds & Shapiro, 2000) before attempting to target childhood traumatic memories. Targets for PAT are recent experiences in which the patient was exposed to positive, shared, interpersonal emotional states. The purposes for applying PAT to these targets are: to decrease defensive avoidance; dissociation and anxiety about shared positive emotional states; to increase capacity to tolerate and enjoy these shared positive emotional states; and to integrate these shared positive emotional states into positive schemas and self-concepts. Observed clinical gains following PAT included: improved mood and resilience, and decreased depersonalization during subsequent use of EMDR to reprocess traumatic memories.
The goal in presenting this “Positive Affect Tolerance and Integration Protocol” case series is to encourage research to evaluate the clinical effectiveness of this application of the standard EMDR procedures for a clinical subpopulation generally considered challenging to treat.
This workshop will present an EMDR and Ego State integrated approach dealing with the health problems of child sexual abuse survivors (CSAS). These problems are exacerbated by dissociative and PTSD symptoms and may have affected clients accessing health care. These complex clients require tri-phased treatment approach which includes an extended preparation phase (to help CSAS manage triggers and avoid retraumatization in the healthcare setting) desensitization and reprocessing of earlier trauma, including both sexual abuse and medical situations, and the future template phase where consumer skills development will be planned, rehearsed and installed. The workshop will include handouts, bibliography, and a slide presentation.
El vaginismo es una de las causas más frecuentes de matrimonio no consumado y fobia al coito.
Es preciso diferenciar el vaginismo de la evitación fóbica del acto sexual y también de cualquier causa orgánica que pueda obstruir la entrada de la vagina. Por lo tanto es imprescindible el examen ginecológico de la paciente.
A pesar del desarrollo y relativa proliferación de los tratamientos psicológicos para las disfunciones sexuales desde los trabajos pioneros de Masters y Johnson (1970), y a pesar del convencimiento de los psicólogos clínicos de la eficacia de estos tratamientos, la verdad es que existen pocos tratamientos empíricamente validados.
En el caso de las mujeres el panorama no ha sido muy alentador, salvo el empleo de terapia hormonal en los trastornos del deseo, no es mucho lo que se ha avanzado.
Vaginismus is one of the most common causes of unconsummated marriage and sex phobia.
We must distinguish vaginismus phobic avoidance of sexual intercourse and also any organic cause that may prevent the entrance of the vagina. Therefore it is essential to the gynecological examination of the patient.
Despite the development and proliferation on psychological treatments for sexual dysfunction from the pioneering work of Masters and Johnson (1970), despite the belief of clinicians of the effectiveness of these treatments, the truth is that there are few treatments empirically validated.
For women the situation has not been very encouraging, but the use of hormone therapy in disorders of desire, not much progress has been made.
This paper offers ways to incorporate Eye Movement Desensitization and Reprocessing (EMDR) in the treatment of clients with Dissociative Identity Disorder (DID). Uses of EMDR detailed can be applied to Dissociative Disorder, Not Otherwise Specified (DDNOS) and ego state work. EMDR is a therapeutic method using alternating bilateral stimulation (ABS) that integrates traumatic memories with adaptive reasoning and the patient's own resources, resulting in accelerated information processing and healing. DID is a complex disorder suffered by clients who have often experienced multiple childhood traumas. They live with what Kluft terms a "multiple reality disorder," and describes as living in "...several parallel but incompletely over-lapping constructions of the world and of life experience." An asset with EMDR is that it can accelerate the treatment process. A liability is that its incorrect use can accelerate decompensation for fragile clients, e.g., those with complex trauma histories or DID. This paper offers suggested uses of EMDR and EMDR adaptations to facilitate learning, intervene in multiple reality disorder, decrease some negative transferences, and to provide a protective format for processing traumatic material. [Author Abstract]
This workshop offers ways to incorporate Eye Movement Desensitization and Reprocessing in the treatment of clients with Dissociative Identity Disorder (DID). Dissociative Disorder Not Otherwise Specified (DDNOS) and ego state work. DID and DDNOS are complex disorders suffered by clients who have often experienced multiple childhood traumas. Used carefully. EMDR and EMDR adaptations can accelerate the treatment process. A liability is that its introject use can accelerate decompensation. This workshop offers suggested uses of EMDR and EMDR adaptations to facilitate Stabilization, orientation to the present, decrease some negative transferences and to provide a protective format far processing traumatic material.
Introduzione: i pazienti traumatizzati presentano alterazioni sintomatiche quali intrusività, evitamento ed aumentato arousal, che ostacolerebbe la possibilità di elaborazione/integrazione
delle tracce mnesiche, oltre ad esprimersi a livello periferico. Tecniche specifiche di trattamento sembrano promuovere
l’elaborazione/integrazione delle memorie traumatiche, tra cui la Eye Movement Desensitization and Reprocessing
(EMDR). Nella ricerca valutativa è quindi necessario affiancare alle scale psicologiche un appropriato indicatore
biologico di attivazione neurovegetativa. La variabilità della frequenza cardiaca (Heart Rate Variability – HRV) esprime
l’integrità funzionale del sistema neurovegetativo in risposta
allo stress e può essere misurata nei domini di tempo o di frequenza. Lo studio della HRV è stato applicato in psichiatria ai disturbi
d’ansia (panico, DOC, PTSD) e dell’umore (depressione unipolare) in ricerche trasversali (confronto con controlli sani) e longitudinali di trattamento farmacologico (triciclici,
SSRIs) ma in pochi casi a trattamenti psicoterapici. Gli AA. valutano l’impiego della HRV come indicatore biologico nel trattamento psicoterapeutico di pazienti con Disturbo dell’adattamento erdurante da oltre un mese dopo l’esposizione ad eventi vitali stressanti (EVS). Metodi: sono stati reclutati 6 soggetti (M/F = 1/5, età 40,5 ± 11,0) esposti ad EVS ed avviati a ciclo di trattamento psicoterapico
breve (4-6 sedute a cadenza settimanale) di tipo
specifico (EMDR) o generico (colloqui supportivi). Costituivano criteri di esclusione: età < 18 o > 65 anni; comorbilità psichiatrica, neurologica e cardiologica; uso di farmaci interferenti. Le valutazioni psicopatologiche sono state eseguite al reclutamento
(TBASE: colloquio anamnestico, MINI, Brief
COPE), a inizio e fine ciclo di trattamento (TINI, TFINE: IES, SCL-90-R), a uno e tre mesi di follow-up (T30, T90: IES, SCL-90-R, Brief COPE). Le registrazioni Holter sono state effettuate ad ogni intervallo valutativo coprendo: 60 min. attività libera, 10 min. tilt-test, 3-5 min. ascolto dell’evento traumatico, 30-45 min. seduta psicoterapica. Sono stati impiegati test statistici non parametrici per l’analisi
delle correlazioni (Spearman) e delle differenze
(Wilcoxon). Risultati preliminari: vengono valutate le correlazioni a TINI e le variazioni T90 vs. TINI. Sono significative le seguenti correlazioni: ansia fobica SCL e SDNN (dev. standard intervalli R-R) [r = + 0,9; p = ,037]; collera-ostilità
SCL e SDNN [r = -0,95; p =.014]; depressione SCL e
r-MSSD (radice media somma quadrati diff. R-R) [r = + 0,9; p = ,037]; sint. intrusivi IES e LF (basse frequenze) [r
= -0,9; p = ,037]. Sono risultate statisticamente significative le seguenti variazioni:
IES totale [Z = -1,99; p = ,046], sintomi intrusivi IES [Z = -2,21; p = ,027], sintomi di evitamento IES [Z = -1,99; p = ,046], ideazione paranoide SCL [Z = -2,21; p = ,027]; R-R, LF e LF/HF (rapporto basse/alte frequenze) durante ascolto evento [Z = -2,02; p = ,043].
Discussione: a livello basale gli indicatori HRV di distress vegetativo correlano positivamente con collera-ostilità e sintomi intrusivi, negativamente con ansia e depressione. Anche dopo tre mesi dalla fine del trattamento gli interventi psicoterapeutici tendono a ridurre i punteggi sintomatici, e migliorano il bilancio simpato-vagale durante il riascolto dell’evento traumatico.
Introduction: trauma patients have symptomatic changes such as intrusiveness, avoidance and increased arousal, which hampers the development / integration
of memory traces, as well as speak at the peripheral level. Specific techniques of treatment seem to promote
the formulation and integration of traumatic memories, including eye movement desensitization and reprocessing
(EMDR). In evaluation research is therefore necessary to combine psychological scales appropriate indicator
organic autonomic activation. The heart rate variability (Heart Rate Variability - HRV) expresses
functional integrity of the autonomic nervous system in response
stress and can be measured in time or frequency domains. The study of HRV has been applied in psychiatric disorders
anxiety (panic, DOC, PTSD) and mood (unipolar depression) in cross-disciplinary (compared with healthy controls) and longitudinal drug treatment (tricyclic
SSRIs), but in a few cases in psychotherapeutic treatment. The AA. evaluate the use of HRV as a biological indicator in the psychotherapeutic treatment of patients with adjustment disorder erdurante more than a month after exposure to stressful life events (EVS). Methods: 6 subjects were recruited (M / F = 1 / 5, age 40.5 ± 11.0) exposed to EVS and initiated treatment cycle psychotherapeutic
short (4-6 sessions weekly) type
specific (EMDR) or generic (hearing supported). Exclusion criteria were: age <18 or> 65 years, psychiatric comorbidity, neurological and cardiological, use of drugs interfering. Psychopathological assessments were performed at recruitment
(TBASE: anamnestic interview, MINI, Brief
COPE) at the beginning and end of treatment cycle (TINI, TFINE: IES, SCL-90-R) in a three-month follow-up (T30, T90: IES, SCL-90-R, Brief COPE). Holter recordings were made at each interval evaluation covering: 60 min. free activity, 10 min. tilt-test, 3-5 min. listening to the traumatic event, 30-45 minutes. psychotherapy session. Were used nonparametric statistical tests for analysis
correlations (Spearman) and differences
(Wilcoxon). Preliminary results: the correlations are evaluated and changes TINI vs. T90. TINI. Significant correlations are the following: SCL phobic anxiety and SDNN (standard dev. RR intervals) [r = + 0.9, p =, 037]; anger-hostility
SCL SDNN [r = -0.95, p =. 014]; SCL depression
r-mssd (root mean square sum diff. RR) [r = + 0.9, p =, 037]; sint. IES intrusive and LF (low frequency) [r
= -0.9, P =, 037]. Were statistically significant, the following changes:
IES total [Z = -1.99, p =, 046], IES intrusive symptoms [Z = -2.21, p =, 027], symptoms of avoidance IES [Z = -1.99, p =, 046] , SCL paranoid [Z = -2.21, p =, 027], RR, LF and LF / HF ratio (low / high frequencies) while listening event [Z = -2.02, p =, 043].
Discussion: At baseline HRV indicators of distress correlated positively with growing anger-hostility, and intrusive symptoms, negatively with anxiety and depression. Even after three months of the end of psychotherapeutic treatment interventions aimed at reducing symptom scores and enhance sympathetic vagal balance during the playback of the traumatic event.
The recent literature on conversion seizures suggests that they are not only traumatic but dissociative in nature. In two cases, the presenter has found conversion seizures to be manifestations of infant alters. The presentation will convey, by lecture and videotape, the treatment of a remarkable client and how EMDR, Ego-State Therapy, and somatic interweaves were seminal in treating conversion seizures to remission. The video illustrates AIP and Porges polyvagal theories’ expression in infant trauma and will illustrate how the therapeutic relationship and increased compassion between parts of self are avenues for the transformation of attachment injury in EMDR.
In this chapter, we will introduce what we have termed the "cross-training model," an approach that integrates several lines of psychotherapy theory, practice, and research in order to assist clients with complex presentations. This model consists of EMDR (Eye Movement Desensitization and Reprocessing), ego state therapy, and dissociative disorder treatment methods. We believe that this model will enable therapists to extend the scope of treatment beyond trauma resolution to include the extensive life issues often faced by clients with complex disorders (Wachtel, 2002) and to have the opportunity to develop mastery and competence in treating these challenging clients. (PsycINFO Database Record (c) 2008 APA, all rights reserved)
This article is an excerpt from Healing the Heart of Trauma and Dissociation with EMDR and Ego State Therapy (edited by Carol Forgash and Margaret Copeley, 2007, pp. 1-59). The preparation phase of eye movement desensitization and reprocessing (EMDR) is very important in the therapy of multiply traumatized clients with complex posttraumatic stress disorder (PTSD) and dissociative symptoms. EMDR clinicians who treat clients with complex trauma will benefit from learning specific readiness and stabilization interventions that are inherent to Phase 1 of a well-accepted phased trauma-treatment model. Extending the preparation phase of EMDR by including these interventions provides sequential steps for the development of symptom-management skills and increased stability. Additional focus is placed on helping clients work with their ego state system to develop boundaries, cooperative goals, and healthier attachment styles. Following an individually tailored preparation phase, the processing of long-held traumatic memory material becomes possible.
Participants will: 1) learn the model of understanding and educating the client about OCD; 2) gain an understanding of biological, cognitive, behavioral, and affective theoretical orientations as they apply to OCD; 3) learn the eight stages of treatment, modification of the standards model, cognitive interweave, and resource installation; 4) learn of the foundation of success of EMDR and OCD treatment, information processing, avoidance of emotions, and the development of self; 5) be able to define a successful treatment, therapeutic stance, similarities in processing to trauma processing; and 6) learn about fear, superstition, ridigity, and control within the family context.
Originally introduced a century ago by Pierre Janet, phase-oriented treatment has been independently proposed by many authors and is now widely considered by trauma specialists to be the treatment of choice for PTSD and other posttraumatic disorders. Much more recently, introduced by Francine Shapiro in 1989, Eye Movement Desensitization and Reprocessing (EMDR) has also become available for the treatment of PTSD and other trauma-based disorders. EMDR has become widely accepted by clinicians and has received strong support regarding its efficacy from a wide range of empirical studies. However, with a very few exceptions (highlighted in this paper), these two major approaches for treating trauma have developed largely independently. The present paper integrates the major EMDR developments with the different stages of the phase-oriented approach to assess if such an integration is conceptually and clinically useful. The EMDR developments integrated into the phases of trauma treatment include: Shapiro's prototypic protocol for PTSD and the protocols for other trauma-based disorders, safety protocols, Leeds' and Korn's work with Resource Development and Installation, and Kitchur's Strategic Developmental Model for EMDR. The usefulness of integrating phase-oriented treatment and EMDR is then assessed. These approaches were found to strongly complement each other in their clinical strengths and weaknesses, while sharing many underlying theoretical and structural elements. [Author Abstract]
The integration of EMDR with Ego State therapy will be presented as a comprehensive approach to the treatment of the wide spectrum of
personality disorders. The histories of these clients often include early repeat experiences of abuse, deprivation, abandonment, and parental
coldness. Historically, the treatment of personality disorders has been described as difficult, if not impossible; manifested by a rigid character armor, defensive resistance. This presentation will propose that the presence of untreated dissociation accounts for these failures and will highlight the use of ego-mapping, exploration, interweaves and the
utilization of ego-state-specific EMDR protocols to facilitate robust processing.
Introduction:
This article describes an innovative Eye Movement Desensitization and Reprocessing (EMDR) protocol which applies the standard EMDR protocol, with modifications, to the reduction of performance anxiety and enhancement of skillful performance in higher functioning clients.
Objective:
The intention was to compare a modified version of the standard EMDR protocol for the reduction of performance anxiety and the enhancement of performance.
Method:
The method was applying the special EMDR protocol for peak performance with higher functioning clients. A further enhancement applied three empirically valid techniques drawn from the subfield of positive psychology.
Results:
Published case studies suggest that this special EMDR protocol aided an experienced commercial pilot in overcoming his avoidance and returning to the flight simulator following a failed proficiency check, and assisted an executive in managing his sense of failure following a significant business setback. Athletes preparing for competition have also found the protocol assists them in managing precompetition anxiety. A further enhancement is the application of three techniques drawn from positive psychology which the empirical research in this subfield of psychology suggests can further enhance the benefits of this protocol.
Conclusion:
Limitations are discussed and recommendations for future research are outlined.
In 2007 the Department of Health (DoH. UK) published
"Improving Access to Psychological Therapies" (IAPT). This meant
that primary care mental health services (PCMHS) had to seriously
consider the mode, method and efficacy of their service delivery.
This paper will consider one such service, critically reflecting on the
integration of EMDR as a mainstream therapeutic intervention.
The service utilises therapists from various therapeutic paradigms,
counselors, graduate workers, cognitive behavioural psychotherapists,
cognitive analytical psychotherapists, clinical psychologists
and registered mental nurses. Clients are referred with a wide range of psychological issues such as Depression, anxiety disorders,
OCD, and PTSD. Following a further EMDR training initiative in 2007 (Birmingham University), the service now boasts,
One EMDR Consultant/Facilitator, three accredited practitioners,
three level three trained therapists and two clinicians at level two.
This paper will present a brief history of the development of EMDR
within the PCMHS, exploring how EMDR has been utilised
not only in the treatment of PTSD (NIHCE 20051, but also in the
treatment of other psychological pathologies. The paper will highlight
the number of clients treated with EMDR (retrospectively
over a twelve month period), the average number of sessions per
client and the therapeutic outcomes as measured by the Patients
Health Questionnaire [PHQ-9) (Kroenke & Spitzer, 2002) and the
Generalized Anxiety Disorder Questionnaire (CAD-7) ( Spitzer et
al 2006). The Dissociative Experience Scale is used when considering
EMDR as an intervention strategy and the Impact of Events
Scale- Revised (WEISS et al 2004) when appropriate. The paper
will conclude with a brief analysis of qualitative data from clinicians
as to the impact EMDR has had on their clinical practice.
Learning Outcomes:
By the conclusion of the presentation the participants will:
1. Be able to discuss the application of EMDR in the treatment
of psychopathologies other than PTSD.
2. To consider the integration of EMDR with other psychotherapeutic
paradigms.
3. To critical consider the treatment outcomes and in particular
the cost effectiveness of EMDR as a psychotherapeutic tool in a
generic primary care setting.
4. Be aware of the ethical and political considerations of integrating
EMDR into a generic primary care mental health service.
Innovation: This work is innovative as it focuses on how EMDR
can be utilised within generic mental health services. It critically
reflects on the phenomenology of integrating EMDR into
a PCMHS and it has encouraged the training of other EMDR
clinicians outside of the primary care mental health team.
This workshop will focus on the use of EMDR in the treatment of patients who span the dissociative spectrum. The participants will learn how to understand dissociative process from simple to complex dissociation and how to utilize EMDR in their treatment. This presentation will discuss dissociative process from the Adaptive Information Processing Model of EMDR. It will cover: the implications and complications of clinical treatment with dissociative process; the nature of dissociative process; screening for dissociation and the ‘Red Flags’ of treatment concerns; the differential diagnoses of dissociation – from dissociation found in diagnostic categories other than Dissociative Disorders (e.g., Mood Disorders, Anxiety Disorders, PTSD) to DDNOS (ego states work) and DID; the use of EMDR in the treatment of dissociation in relation to trauma; and therapist attributes that help contribute to the successful treatment of dissociative patients. Participants will be encouraged to share their own insights and difficulties in working with this highly traumatized population of individuals.
Der Workshop beschäftigt sich mit Fragen der Integration von EMDR in ein psychodynamisches Therapiesetting. Zum einen kann EMDR sinnvoll mit psychodynamischer Therapie kombiniert werden, wenn bei komplexen posttraumatischen Belastungsstörungen Symptome einer PTSD zusammen mit depressiven, dissoziativen, somatoformen und anderen Symptomen auftreten. Daneben finden sich verschiedene andere Anwendungsmöglichkeiten von EMDR im Rahmen psychodynamischer Therapien, bspw. wenn dysfunktionale Erinnerungsnetzwerke die Wirkungsweise klarifizierender, konfrontierender und deutender Interventionen blockieren. Dies gilt für Anpassungsstörungen ebenso wie fixierte, aber verhaltenssteuernde negative Selbstkognitionen und für psychosomatisch abgewehrte implizite Emotionen im Rahmen somatoformer Störungen. Schließlich können ressourcenaktivierende Interventionen im Rahmen des EMDR den Aufbau von Ich-Funktionen bei Strukturpathologien unterstützen.
The workshop will focus on integration of EMDR in a psychodynamic therapy setting. First, EMDR can be usefully combined with psychodynamic therapy, which may arise in complex post-traumatic stress disorder symptoms of PTSD with depressive, dissociative, somatoform and other symptoms. In addition, various other applications of EMDR in related psychodynamic therapies, for example, if dysfunctional memory block the operation of networks klarifizierender, confrontational and interpretive interventions. This applies for adjustment disorders as well as fixed, but behavior-controlling negative self-cognitions and psychosomatic thwarted emotions implicit in the context of somatoform disorders. Finally, support resource-activating interventions of EMDR the development of ego functions in structural pathologies.
This presentation will focus on integrating EMDR into an overall treatment plan and utilizing EMDR in conjunction with other
cognitive behavioral approaches. Strategic utilization of EMDR to move clients through the various stages of recovery will be
discussed.
1) In the first stage of treatment, safety, stabilization, coping, and development of a strong therapeutic relationship are emphasized.
Treatment focuses on decreasing (1) suicidal and parasuicidal behavior, (2) treatment - interfering behavior, and (3) quality-of-life-interfering behavior (Linehan, 1993). Efforts are made to assist the client in developing a repertoire of cognitive-behavioral coping
skills; relevant skills address grounding, trigger awareness, basic self - care, mindfullness, distress tolerance, affect regulation,
assertiveness, relaxation, self - monitoring, stress inoculation, and cognitive restructuring. At this stage, EMDR can be used to shift
negative cognitions which interfere with commitment to treatment, skill development, and the restoration of hope. The following are
examples of negative cognitions whlch interfere with first stage stabilization goals:
- I will only get acknowledgment of my pain if I act out. - I don't deserve to feel better.
- If I take care of myself, no one will know I hurt. - I'm pathetic, a failure.
- I will die/go crazy fiom these feelings. - I can never do anything right.
- I can't stand this feeling. I must cut myself. - Don't trust anyone or anything.
Newly learned information about coping can be reinforced and further integrated in the course of an EMDR session. Clients can be
encouraged to notice their ability to tolerate affect and to practice their assertiveness skills, grounding skills, mindfulness skills, etc.
2) In the second stage of treatment, the focus is on processing traumatic memories and decreasing behaviors related to post-traumatic
stress. EMDR interventions can be designed to assist clients with specific recovery tasks or issues:
- fear/terror and associated avoidance
- sense of powerlessnesshelplessness
- responsibility/accountability
- safety - self, others, environment
- self-esteem/self as bad, defective, unlovable
- lack of individuation
- dependency
- anger
- grief/mouming
- trust/mistrust
- fear of abandonment
- guilt/self-blame
- shame/self-loathing
With regard to each of these issues, maladaptive schemas can be addressed via effective cognitive interweave strategies. Ideas for
supplementing EMDR work with written assignments, imagery exercises, recovery rituals, and planned in vivo exposure will be
discussed. Strategies for handling possible problems, obstacles, or resistance at this stage will also be noted. Finally, the role of ongoing
assessment and data collection in making decisions about EMDR targets will be addressed.
3) In the third stage of treatment, the emphasis is on personal development and increased connection with others. Recovery tasks and
issues addressed via EMDR include:
- Increasing intimacy and healthy connections - Increasing self-esteem
- Increasing self-efficacy and sense of mastery - Reclaiming sexuality
- Increasing self-efficacy and sense of mastery - Identity exploration and development
- Establishing goals, initiating new projects, and taking reasonable risks
At this stage, EMDR can be useful in detecting remnants of shame, fear, etc. In addition, EMDR can be used to reduce anxiety and
increase confidence as a client sets his/her sights on the future and prepares to face new and challenging situations. EMDR can aid
in the generalization of skills and adaptive schemas across time and place. It can facilitate the integration of a new, more positive
and vital self-image.
The presentation will conclude with a videotape case presentation highlighting relevant recovery tasks and issues in applying
EMDR at a specific stage of treatment.
The principles of this conceptual framework are: (1) personality organization is
dissociative as well as associative, consisting of ego states, and progresses through
stages of psychosocial development; (2) inappropriately activated ego states cause
dysfunction, which is habitual or due to the intense affect of disrupted development
or unresolved grief or trauma; (3) completely overcoming dysfunction requires
therapy with both individual ego states and the personality system; (4) clinical
hypnosis provides techniques to enhance accessing ego states; and (5) EMDR
combines ego-state therapy with eye movements (EMs) to produce a powerful
psychotherapy method. During assessment, ego states responsible for
dysfunctional emotional reactions and behavior are identified together with those
that could be appropriate instead. Included in the treatment protocol, EMs and
clinical hypnosis promote: (1) corrective developmental experiences; (2) resolution
of grief and trauma; (3) acquisition of skills and abilities; (4) co-consciousness;
and (5) negotiation among ego states. The outcome is an integrated “family of
self” that has effectively overcome developmental crises, grief, and trauma, is
aware of essential inner resources, and can consciously activate appropriate ego
states. [Author Abstract]
Background:
Posttraumatic stress disorder acquired at work can be debilitating both for workers and their employers. The disorder can result in increased sick leave, reduced productivity, and even unemployment. Furthermore, workers are especially unlikely to return to their previous place of employment after a traumatic incident at work because of the traumatic memories and symptoms of avoidance that typically accompany the disorder. Therefore, intervening in work-related PTSD becomes especially important in order to get workers back to the workplace.
Methods:
A systematic literature search was conducted using Medline, PsycINFO, Embase, and Web of Science. The articles were independently screened based on inclusion and exclusion criteria, followed by a quality assessment of all included articles.
Results:
The systematic search identified seven articles for inclusion in the review. These consisted of six research articles and one systematic review. The review focused specifically on interventions using real exposure techniques for anxiety disorders in the workplace. In the research articles addressed in the current review, study populations included police officers, public transportation workers, and employees injured at work. The studies examined the effectiveness of EMDR, cognitive-behavioural techniques, and an integrative therapy approach called brief eclectic psychotherapy. Interestingly, 2 of the 6 research articles addressed add-on treatments for workplace PTSD, which were designed to treat workers with PTSD who failed to respond to traditional evidence-based psychotherapy.
Conclusions:
Results of the current review suggest that work-related interventions show promise as effective strategies for promoting return to work in employees who acquired PTSD in the workplace. Further research is needed in this area to determine how different occupational groups with specific types of traumatic exposure might respond differently to work-tailored treatments.
A case of a lesbian couple is presented in which one partner experienced early sexual abuse and the other a series of major losses (beginning with the death of her mother) in early childhood. The first partner developed an alcohol addiction and the second a high level of emotional lability and some practices of self-harm. Both partners developed dissociative patterns. The couple is now in a committed relationship and have continued in therapy for the last 9 months, with sessions gradually becoming less frequent. The therapeutic work has included the "externalization" of the problem(s), some individual work within the couple session using Eye Movement Desensitization and Reprocessing (EMDR), and a strong emphasis on the development of empathic skill through the technique of "becoming" the other person. The case reveals the way in which a primary relationship often surfaces intense unresolved feelings and dysfunctional relationship practices, and also the way in which emotional commitment and a structure for the couple becoming therapeutic agents to each other allows for a deep level of healing. The couple comments on their relationship process and the therapeutic process as part of the article. [Author Abstract]
EMDR is not the focus of this program.
Participants will: 1) become acquainted with interview questions and diagnostic instruments that access for the presense of a dissociative disorder; 2) learn current thinking concerning the etiology of dissociative disorder; and 3) learn how to use therapeutic boundaries and pacing to structure a treatment plan for dissociative clients that helps maintain daily functionality; 4) understand the basic issues in the false memory/recovered memory controversy; and 5) understand some of the common traps and errors in the treatment of this population.
A novel clinical technique, referred to as "eye-movement desensitization," has recently been reported to rapidly achieve significant reductions in the frequency and intensity of the two primary symptoms of PTSD; cognitive intrusions and the behavioral and emotional avoidance of trauma related fear cues. The current study was intended to provide an experimentally controlled replication of this procedure. The 45 students with the highest scores on a self-report questionnaire were selected for participation in the study and randomly assigned to one of three treatment conditions. These conditions included "eye-movement desensitization," "eye-fixation desensitization," and a non-directive control condition.Sessions One and Three consisted of pretest and posttest assessment respectively, administered by questionnaire and behavioral measures of cognitive intrusions relating to the reported trauma. Session Two, consisted of immediate pretest and posttest assessment of information regarding subjective discomfort, perceived validity of adaptive cognitions, and vividness of images related to the reported trauma. The results of this experiment indicated that treatment-related pretest to posttest change was limited to (a) a relative reduction in cognitive intrusions for the eye-fixation group compared to the other treatment conditions, and (b) initial superiority of both desensitization techniques in immediately reducing subject distress, vividness of the initial image (and for eye-fixation, improved validity of an adaptive cognition) in comparison to the non-directive condition. The latter condition, however, then achieved equivalent gains by one-week follow-up. It was concluded that: (a) the relative efficacy of the eye-movement desensitization technique, was not supported in this non-clinical population, (b) to the degree that the outcomes resulting from the two desensitization conditions were at variance from those of the more traditional non-directive technique, those differences appear to have been predominantly transient in character, and (c) the induction of saccadic eye-movements did not demonstrably function as an active component of treatment within this experimental context. It was additionally concluded that further research will be required to satisfactorily resolve the discrepant findings of experimentation and case reports regarding the efficacy of this technique. Specific suggestions for further research were presented. [Truncated Author Abstract] [Pilots]
Kan iedereen gebruik maken van EMDR? Ik heb namelijk ergens gelezen dat het niet goed zou zijn voor mensen met borderline en mensen met DIS (een dissociatieve identiteitsstoornis), alhoewel bij deze mensen ook vaak sprake is van PTSS (een posttraumatische stress-stoornis).
Kunt u mij eventueel ook vertellen waarom dit niet goed zou zijn. Kent u een andere goede therapie voor deze mensen als EMDR niet wenselijk is?
Can anyone use EMDR? Because I have read somewhere that it would not be good for people with borderline and those with CIS (dissociative identity disorder), although these people are often given of PTSD (post traumatic stress disorder).
Can you tell me possibly why this would not be good. Do you know of another good therapy for them as EMDR is not appropriate?
We tried to “dissect” the EMDR method in the component desensitization through rapid eye movement (EMD), that is also the original part, to explain the neurophysiological functioning, Charney et al, say that a lot of persistent symptoms of PTSD are caused by an elevate arousal of NVS, particularly due to the increase of norepinephrine. Others hypothesize, again, that EMDR method is rapid because it is based on Classic Conditioning. Pavlov found that every stimulus of environment causes to the organism (animal or human) an immediate orienting response due to the arousal of the Autonomic Nervous System. In this situation the animal begins to look around moving its eyes laterality (as it happens during ocular movements of EMD); if it perceives a danger in the environment it stimulates a visceral negative response (hyperactivation that means fear) that leads an an avoidance behaviour (stiffening) and/or fighting. In other cases it causes a visceral positive response (de-arousal process that means reassurance) that leads to an approach behaviour through interaction or exploration.
The EMD should produce an orienting reflex in the patient in a protective sitaution like a psychotherapeutic setting; that means an important reduction of neuro-vegetative nervous system activity (dearousal) and some visceral positive response. We propose an experimental design with a single subject (ABACADA) by interruption treatment and by monitoring Neurophysiological functions through biofeedback instruments to test this neurophyiological hypothesis.
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.
This chapter focuses on EMDR-enhanced therapeutic protocols to treat individuals whose painful life experience is separated from consciousness by complex defensive structures, particularly those associated with narcissistic and avoidance defenses.In many of the clients I have worked with, the healing power of EMDR is prevented or impaired by unresolved positive feelings that block the client's full awareness of the negative experience associated with trauma. This can occur when the overall complex of posttraumatic images, self-defeating cognitions, unpleasant feelings and sensations (what Francine Shapiro calls the unprocessed "memory network") contains embedded strong positive affect that is highly valued by the client. In the case of a person with narcissistic defenses, the positive material may block awareness of negative memories, especially if the positive experience occurred in the larger context of trauma and neglect. In such instances the positive part of the experience is idealized through selective memory and strengthened in intensity, because it serves as a defense against the core PTSD. The negative part of the memory is partially or wholly dissociated and is thus less accessible to processing. [Adapted from Text, pp. 232, 233-234]
Dissociative Identity Disorder (DID), a chronic childhood onset posttraumatic stress
disorder (PTSD), is currently recognized as a treatable condition. It is considered the
paradigmatic dissociative disorder and carries with it extreme posttraumatic
symptomatology which lends itself to be an apt target for treatment combining the use of
EMDR and hypnosis. Therapists skilled in the treatment of DID and Dissociative Disorder
Not otherwise specified (DDNos) have augmented their therapeutic arsenal with the fluent
uses of hypnosis for stabilization, affect management, building a safe place and
grounding. EMDR, which has come to the forefront of clinical awareness in the last fifteen
years, seems well suited for the treatment of trauma, but can be destabilizing. The
presenters recommend a protocol, called Wreathing Protocol, for the imbricated use of
EMDR and hypnosis in the treatment of not only DID, but also DDNOS and complex
chronic PTSD. The Wreathing Protocol is useful to advanced clinicians skilled in both
modalities independently. This workshop will explain and illustrate with a clinical vignette
the sequential steps of the Wreathing Protocol; it will describe the required contextual
treatment frame for its safe use. The presenters will explore the consequences of the
premature uses of EMDR and offer planful structured responses to a disequilibrated
treatment and a destabilized patient. The clinical implications of the use of the Wreathing
Protocol will be discussed.
Learning objectives:
1. Name three prohibitions to the use of EMDR in the treatment of dissociative
disorders.
2. Exemplify one target symptom of the BASK model of dissociation in the clinical
example presented and relate a different one in one of your own patients.
3. Describe a potential multistep Wreathing Protocol sequence from selection of
target to resolution of at least one microsymptom in a patient of your choice.
Participants will: 1) understand the similarities between "active imagination" and EMDR dissociative processing; 2) appreciate the therapeutic/personal value of EMDR-linked "active imagination;" 3) have a personal experience of EMDR-linked "active imagination;" 4) be able to use this theoretical construct and therapy technqiue with her/his clients/patients/analysands.
Chairs: Meusers, M. & Freiha, T.
Gli Autori illustrano i princìpi fondamentali nel trattamento dei Disturbi Dissociativi, nell’ottica della psicoterapia cognitivo-evoluzionista. Descrivono la cosiddetta “Terapia per fasi”, caratterizzata dalla iniziale ricerca della stabilizzazione del paziente e da una riduzione sintomatologica; quindi da una fase centrale di elaborazione dei traumi relazionali e complessi considerati frequentemente alla base degli stati dissociativi; infine dalla integrazione e ricerca di una “crescita post-traumatica”. Gli Autori prendono in esame le diverse strategie e tecniche più frequentemente utilizzate, da quelle legate al lavoro terapeutico sul corpo ai gruppi di mutuo aiuto, dalla psicofarmacologia all’ipnosi. Una parte significativa dell’articolo è dedicata all’uso dell’approccio EMDR nel trattamento degli stati dissociativi.
The Authors show the fundamental principles in the treatment of the Dissociative Disorders, in the perspective of the Cognitive-Evolutionary Psychotherapy. They describe the so called “Staged Therapy”, characterized by a starting phase toward the stabilization of the patient and the symptomatology’s reduction; by a central phase of processing of the relational and complex traumas often grounding the dissociative states; and then by an integration and a “post-traumatic growing”. The Authors examine the different strategies and techniques, most frequently used, from the therapeutical body work till self-help groups, from psychopharmacology till hypnosis. A significant part of the article show the importance of the EMDR approach in the treatment of dissociative states.
Quando ascoltiamo storie di devastazione, terrore, impotenza e di tradimento della fiducia, come naturale conseguenza, le nostre sicurezze più profonde possono essere messe in crisi. Applicando l’EMDR, a volte, possiamo essere messi di fronte alla “realtà del trauma” inaspettatamente, senza parole: il/la paziente “torna là” rivive l’esperienza col corpo e noi assistiamo e “viviamo il suo trauma”. Le emozioni (paura, schifo, terrore, rabbia, senso di paralisi ecc.) possono irrompere nello spazio sicuro della stanza di terapia e sfidare il nostro senso di “invulnerabilità” e prevedibilità. Rispetto all’impatto del materiale traumatico sul terapeuta quando si trova come testimone di eventi terribili e delle loro conseguenze ci possono essere risposte quali senso di paralisi, paura, desideri sadici e di vendetta, fino a “violazioni del setting”. Nel lavoro sul trauma possiamo agire in un continuum che va da risposte di evitamento con sentimenti di rifiuto e rabbia verso risposte di iper identificazione con la vittima. Esiste un rapporto circolare fra aspetti controtransferali e traumatizzazione secondaria negli operatori. Possono emergere problemi esistenziali e spirituali, sentimenti aggressivi e di giudizio, orrore, rabbia, senso di vulnerabilità, dolore-pena e sintomi classici del Disturbo da Stress Post Traumatico. La conoscenza, la consapevolezza e la gestione di questo processo all’interno della relazione terapeutica è fondante rispetto alla riparazione del danno nelle vittime e alla salute mentale dei terapeuti. Nel corso della presentazione ci sarà una focalizzazione sugli aspetti del ciclo del controtranfert e della traumatizzazione secondaria nel terapeuta e si forniranno elementi di protezione per i terapeuti.
When we hear stories of devastation, terror, helplessness and betrayal of trust, as a natural result, our securities may be made deeper into crisis. Applying EMDR, sometimes, we may be confronted with the "reality of trauma" unexpectedly, without words, it/the patient "back there" relive the experience with the body and we are seeing and "live her trauma." Emotions (fear, disgust, fear, anger, sense of paralysis, etc.) can break into the safe space of the therapy room and challenge our sense of "invulnerability" and predictability. Compared to the impact of traumatic material when the therapist is as a witness to terrible events and their consequences there may be responses such as sense of paralysis, fear, desires and sadistic revenge, to "violations of the setting." In work on trauma, we can act on a continuum ranging from avoidance responses with feelings of rejection and anger responses of hyper identification with the victim. There is a circular relationship between trauma and countertransference issues in the secondary players. Existential and spiritual problems can arise, aggressive feelings and judgments, horror, anger, sense of vulnerability, pain and pain-classic symptoms of Post Traumatic Stress Disorder. Knowledge, awareness and management of this process within the relationship Therapeutic compliance is fundamental to repairing the damage in the victims and mental health therapists. During the presentation there will be a focus on aspects of the cycle controtranfert and secondary traumatization in the therapist and will give protection elements for therapists.
Chairs: Sack M. & Spector J.
My focus today is on the etiology of the trauma-based predisposition to OCD.
I would like to demonstrate how the obsessive-compulsive disorder serves the dissociative adult as a MASK thereby maintaining the hidden status of both the traumatic memories, and the dissociation;
and finally I would like to demonstrate how EMDR can be used to target the OCD as an ego state to uncover the dissociated parts, the anxiety and the original trauma.
I would like to share with you some thoughts and examples from my clinic in the form of these goals, which you will find in your handouts:...[Author abstract]
En este trabajo se desarrollan los lineamientos y criterios generales para el tratamiento de los trastornos disociativos. Dichos tratamientos, entre los que se destaca el EMDR, presetan una serie de características particulares, que serán reseñados.
In this paper we develop guidelines and criteria for the treatment of dissociative disorders. Such treatments, among which stands out the EMDR present a number of features which will be outlined.
Posttraumatic stress disorder (PTSD) is an anxiety disorder that occurs after severe psychological stress,
e. g., assault, combat, natural disasters, terrorism, or other stressors. The stressor induces intense fear or
helplessness in the patient. Three symptom clusters are included in DSM-IV criteria for PTSD:
re-experiencing the traumatic event, avoidance of reminders of the event and psychological numbing,
and hyperarousal symptoms.
There are two workshops that are similar, in that they describe ways to work with dissociative clients in the phased approach recommended by the Treatment Guidelines of the International Society for the Study of Trauma and Dissociation, to which Dr. Paulsen contributed for the Third Revision That phased approach emphasizes stabilization and containment before conducting EMDR, and then using a measured approach to pace the use of EMDR for maximal safety for dissociative clients. The first workshop ["Looking Through the Eyes: EMDR & Ego State Therapy Across the Dissociative Continuum” with its own entry] teaches the ego state methods to do stabilization and containment. This second workshop describes somatic methods as well as ego state methods, making that workshop very full indeed. This workshop will elaborate on the key phase of stabilization, before ever conducting EMDR for a dissociative client. It will describe ways to increase affect tolerance, employ somatic resourcing, and other somatic methods to reconfigure ego states, use a two-step containment strategy for traumatic material and for ego states. A key focus is on working directly with perpetrator introjects or other “monstrous” disowned or shameful parts, to minimize resistance and internal conflict. Leading edge methods for resetting affective circuits and clearing very early attachment trauma will be touched upon.
Partipants will be able to: 1. Explain why and when to assess every client for degree of dissociation prior to doing EMDR and choose an appropriate protocol, 2. Utilize a phased approach to therapy, including EMDR when and where appropriate, for complex dissociative clients, 3. List six tactics for stabilizing clients, prior to doing EMDR for dissociative clients to increase rapport, increase soma tolerance, contain affect, orient to present circumstances, reduce inner conflict, and build coping resources, 4. Prepare for EMDR processing using ego state and other methods to clarify roles and plan the work, 5. Structure EMDR sessions using imagery, ego state interventions (and somatic methods, for the second workshop) for pacing, fractionating and trouble shooting the work, and 6. For the somatic version of the workshop, list several somatic interventions to assist with various phases work with dissociative clients.
Dual attention (simultaneous awareness of both the disturbing material and a neutral or safe aspect of the present situation) is an essential element of the effectiveness of EMDR (Shapiro, 2001). That is, in EMDR therapy, the therapist assists the client in keeping "one foot in the present, one foot in the past." Metaphorically, "two feet in the past" would simply be emotionally reliving the trauma, and not therapeutic. For those clients with highly dissociated and intense affect, there is a danger with standard EMDR that uncontrolled emotion may intrude into consciousness in a way that undermines this important balance between present and past. In this chapter, several methods are described that seem to be useful in empowering clients with dissociated ego states to stay oriented to the present while processing unfinished disturbing memories. Specifically, these EMDR variations seem to enable the client to maintain the balance between emotional safety and the controlled emergence of unresolved affect, so as to avoid dissociative abreaction and make possible the healing and eventual integration of separate parts of the self. (PsycINFO Database Record (c) 2008 APA, all rights reserved
Post-traumatic stress disorder (PTSD) is a common
and disabling disorder that develops as a consequence
of traumatic events and is characterised by
distressing re-experiencing of parts of the trauma,
avoidance of reminders, emotional numbing and
hyperarousal. The NICE guidelines for PTSD (2005)
recommend trauma-focused psychological therapy
as the first-line treatment. A survey of 129 GPs in
south London investigated the recognition and
treatment of PTSD in primary care. The majority
of GPs underestimated the prevalence of PTSD.
Most PTSD patients seen in GP surgeries currently
do not receive or are not referred for NICE recommended
psychological treatments. Medications,
especially SSRIs, appear to be more commonly
prescribed than recommended by NICE. Efforts to
disseminate information about PTSD and effective
treatments to both patients and GPs are needed to
increase recognition rates and prompter access to
treatment. The Improving Access to Psychological
Therapies (IAPT) programme will make the NICE
recommended treatments more widely available
and will allow self-referral by adults with PTSD to
trauma-focused psychological therapy.
Objectifs d’apprentissage:
1. Approfondir les connaissances pour mieux cibler l’intervention en EMDR (facteurs facilitants et écueils rencontrés)
2. Reconnaître les manifestations des symptômes dissociatifs en cours de traitement EMDR
3. Faire l’apprentissage de l’écran comme outil clinique dans le traitement adaptatif de l’information
4. Privilégier l’accès du client à ses ressources
5. Favoriser le mouvement et la stabilisation de la personne par l’utilisation de cet outil dans le cadre des 8 étapes pour poursuivre le traitement EMDR.
It is common for clients with whom we use EMDR with symptoms of dissociation during the session, especially if emotions become intense or if the memory of the trauma was reactivated very acute. Among the strategies that can be used at this time to help the client to remain in the experiment, the screen is an extremely effective clinical tool.
The purpose of this workshop is to bring the clinician to explore and experiment with using the screen in the EMDR treatment. Thus, when applying the protocol in 8 steps, if dissociative symptoms appear, the screen allows a stabilization and promotes the pursuit of adaptive processing of information.
The course of this 3 hour workshop includes a large practical component to allow experimentation and exchanges among participants. Which promotes the integration of existing knowledge in EMDR and clinical experience from a case. Learning this tool provides access to client resources.
Learning Objectives:
1. Deepen the knowledge to better target intervention in EMDR (facilitating factors and pitfalls)
2. Recognize the manifestations of dissociative symptoms during treatment EMDR
3. Make learning the screen as a clinical tool in the adaptive processing of information
4. Preferred customer access to its resources
5. Encourage movement and stabilization of the person through the use of this tool as part of the 8 steps to continue the EMDR treatment.
L’Eye Movement Desensitization and Reprocessing (EMDR) nasce come
interevento elettivo nella terapia del Disturbo Post-traumatico da Stress
(PTSD) e, in particolar modo nelle fasi iniziali del suo consolidamento
clinico e teoretico, ha calibrato il proprio protocollo di intervento standard sul
PTSD generato da combattimenti bellici, catastrofi naturali e provocate
dall’uomo. L’abuso sessuale, soprattutto se avvenuto nell’infanzia, in modo
prolungato ed all’interno di un contesto familiare (ovvero il tipo di abuso
sessuale sul quale concentrerò ora la mia attenzione), è un tipo di evento
traumatico che può presentare caratteristiche peculiari: elementi dissociativi
da marcati ad assenti, alterazioni mnestiche e codifiche mnestiche statodipendenti,
massicci meccanismi di repressione operanti anche per decenni,
condizionamento negativo dell’evoluzione del sistema comportamentale
dell’attaccamento, presenza di memorie somatiche di difficile gestione da
parte del paziente, disturbi sessuali, difficoltà nell’instaurazione e nel
mantenimento della relazione terapeutica. L’abuso sessuale intrafamiliare si
accompagna abitualmente alla trascuratezza emotiva ed alla violenza
psicologica, in alcuni casi anche a quella fisica. Di fronte ad un quadro
2
clinico così complesso (laddove la presenza di PTSD è semplicemente uno
dei possibili esiti psicopatologici, e con ogni probabilità non il più
frequente), l’intervento con l’EMDR richiede modificazioni rispetto al
protocollo standard di intervento per il PTSD ma, soprattutto, l'inserimento
all'interno di un intervento clinico di respiro decisamente più ampio rispetto
all’impiego di algoritmi terapeutici ridotti all’essenziale. Il sottoscritto ritiene
che, al momento attuale, lo studio più approfondito sull’argomento sia una
pubblicazione di Laurel Parnell del 1999. Personalmente, ed in modo
concorde con quest’ultimo autore, ho verificato la notevole efficacia
nell’operare con l'EMDR - anche molto direttivamente - sulla storia di
attaccamento del paziente al fine di colmarne le falle evolutive o eliminare gli
ostacoli per il conseguimento di questo fondamentale obiettivo terapeutico.
The eye movement desensitization and reprocessing (EMDR) is born as
interevento elective in the treatment of Posttraumatic Stress Disorder
(PTSD) and, especially in the early stages of its consolidation
clinical and theoretical, has calibrated their intervention protocols for the standard
PTSD generated by fighting wars, natural disasters and caused
man. Sexual abuse, especially if done in childhood, so
Prolonged and within a family context (ie the type of abuse
which focus on sex now my attention) is a type of event
trauma that may have special characteristics: elements dissociative
to be marked absent, changes in mnemonic and mnemonic encodings statodipendenti,
massive repression mechanisms operating for decades
negative evolution of behavioral conditioning system
attachment, presence of somatic memories of unmanageable
the patient's sexual problems, difficulty in establishing and
maintaining the therapeutic relationship. Sexual abuse is intrafamilial
usually accompanies the emotional neglect and violence
psychological, in some cases to physical. Faced with a framework
2
clinical as complex (where the presence of PTSD is simply a
possible outcomes of psychopathology, and probably not the most
frequent), intervention with EMDR requires changes compared to
standard protocol of intervention for PTSD but, more importantly, the inclusion
within a clinical intervention to breath much larger than
use of therapeutic algorithms reduced to essentials. My opinion
that, at present, more thorough study on the subject is a
Published by Laurel Parnell in 1999. Personally, and so
agreed with this page, I checked the remarkable effectiveness
in working with EMDR - very directly - on the history of
attachment of the patient in order to bridge the evolutionary gaps or eliminate
obstacles to achieving this important therapeutic target.
Il modello paradigmatico di intervento clinico al quale l’EMDR si ispira è di non interferenza all’interno dell’elaborazione adattiva prodotta autonomamente dal paziente, stimolato da una ottimale relazione terapeutica e dalla stimolazione bilaterale all’interno di un campo di attenzione duale. Nondimeno, è esperienza abituale del clinico come tale modello incappi regolarmente all’interno di stalli rielaborativi che impediscono una adeguata desensibilizzazione e rielaborazione degli eventi stressanti o francamente traumatici. Per tale motivo, l’EMDR può massimizzare la sua efficacia psicoterapeutica attraverso l’impiego di specifiche strategie di “intervento cognitivo integrativo”, finalizzate all’implementazione adattiva ed ecologica delle risorse inattingibili da parte del paziente. In questa comunicazione, che prende in parte ispirazione dalle domande e dalle difficoltà emergenti nei colleghi durante l’attività di supervisione, attraverso numerose esemplificazioni cliniche si intenderà mostrare l’impiego flessibile ed euristico di strategie immaginative e corporee come interventi integrativi di particolare efficacia. In particolare, verrà posta una specifica attenzione nei confronti degli stalli integrativi dovuti principalmente a meccanismi dissociativi che possono causare difficoltà anche notevoli all’attività dello psicoterapeuta. Fenomeni dissociativi massicci, infatti, possono mostrarsi sin dall’inizio (in particolare qualora l’evento abbia suscitato una dissociazione peritraumatica), rendendo apparentemente non affrontabile il ricordo del paziente, in quanto non evocatore di alcuna risonanza emotiva; diversamente, la gestione dissociativa dei ricordi comparirà tra una seduta e l’altra, oppure all’interno del processo elaborativo condotto con l’EMDR. Verrà mostrato come la dissociazione, che può rendere impossibile l’elaborazione, possa essere gradualmente ridotta iperassociando il paziente nei confronti dei propri ricordi, di volta in volta privilegiando attività rivolte nei confronti delle immagini mentali oppure attraverso l’adozione di posture corporee finalizzate alla rottura delle barriere dissociative.
The paradigmatic model of clinical intervention in which EMDR is based is not interference in preparing adaptive generate themselves from the patient, stimulated by optimal therapeutic relationship and the bilateral stimulation within a field of attention dual. Nevertheless, it is habitual experience of the clinician how this model regularly encountering processed within stalls that prevent a adequate desensitization and reworking frankly stressful or traumatic events. Therefore, EMDR can maximize its effectiveness through the use of specific psychotherapeutic strategies, "Integrative cognitive intervention, aimed at the implementation of adaptive and ecological resources unattainable by the patient. In this communication, which takes some inspiration, the questions and difficulties emerging in the colleagues during the supervisory activities through numerous clinical examples to show you will understand the use of flexible, heuristic imaginative strategies and body as supplementary measures, particularly effective. In particular, specific attention will be paid in respect of the stalls due mainly to additional dissociative mechanisms that can cause considerable difficulties although the activity of psychotherapist. Dissociative phenomena massive, in fact, can show the beginning (in particularly if the event has generated a dissociation peritraumatica), making apparently not face the memory of the patient, because not suggestive of any resonance emotional, otherwise the management dissociative memories appear between sessions and one or within the computational process conducted with EMDR. Will be shown as the dissociation which may make it impossible to process, can be gradually reduced iperassociando
the patient against their own recollections, each time focusing on activities aimed respect of mental images or through the adoption of body postures designed to rupture of dissociative barriers.
Lorsque nous travaillons avec des clients souffrant de TSPT Complexe, il est souvent fort utile des les aider à
accéder et identifier les différents états du moi, ces parties émotionnelles qui portent les réseaux de mémoires
contenant les souvenirs traumatiques/matériel dysfonctionnel. Cet atelier vise à présenter la Table dissociative
de Fraser comme outil de travail. Ce “lieu de rencontre interne” devient un endroit sécuritaire où les états du moi/
parties émotionnelles peuvent communiquer entre elles, facilitant la stabilisation, le renforcement de l’égo et la
préparation au travail de retraitement EMDR. Cette présentation se fera par le biais de matériel didactique et de
démonstrations video.
Objectifs d’apprentissage:
• Introduction aux principes généraux de la dissociation structurelle dans les cas de traumas complexes
• Apprendre un scripte afin de mettre en pratique la table dissociative
• Apprendre à mettre en place des stratégies de préparation et stabilisation via la table dissociative
When we work with clients with complex PTSD, it is often useful to help
access and identify the different ego states, those parts that carry the emotional memory arrays
containing traumatic memories / equipment dysfunctional. This workshop aims to present the dissociative Table
Fraser as a working tool. This "internal meeting place" becomes a safe place for ego states /
emotional parts can communicate with each other, facilitating stabilization, strengthening the ego and the
job readiness EMDR reprocessing. This presentation will be through educational materials and
video demonstrations.
Learning Objectives:
• Introduction to general principles of structural dissociation in the case of complex trauma
• Learn a script to put into practice the dissociative table
• Learn to develop preparedness strategies and stabilization via the dissociative table
This workshop is a presentation which encompasses the Triune Brain Theory, Educational Kinesiology and recent
research on trauma and how it effects brain development and functioning. Information will be presented on the
Triune Brain Theory and how “bottom up” processing can block EMDR from working with traumatized children.
A description of the energy blockages in the brain and how they can be detected and then eliminated through
Brain Gym exercises will comprise the second part of this educational workshop. The difference between hyper
arousal and dissociative responses and which brain centers are involved will be explained in order to understand
the adaptive, evolutionary response of the brain when the child/adult is experiencing trauma. Throughout the
workshop will be experiential Brain Gym exercises. This format is designed to encourage greater understanding
of the whole brained effects of the exercises as participants learn these tools. Several other exercises which
reduce stress and connect the three levels of the brain for efficient, whole-brained processing will also be
incorporated. Several case examples will be shared to illustrate how the Brain Gym exercises become part of the
child’s coping resources and eventually facilitate the processing of his/her traumaLearning Objectives:
• The participants will be able to demonstrate and describe the benefits of a Brain Gym Warm Up to create full
brain activation and a relaxed processing state.
• Participants will be able to describe the Triune Brain Theory and how trauma creates “bottom up” processing
instead of “top down” processing.
• Participants will be able to demonstrate specific exercises for reducing stress/trauma within the Central
Nervous system thus enhancing a child’s sense of safety.
• Participants will be able to identify 5 brain/energy imbalances and how they block EMDR processing.
• Participants will be able to identify and explain the Brain Gym exercises which correct each of the 5 brain/
body/energy imbalances.
Great strides have been made in applying EMDR
to different populations with a variety of
diagnoses. Integrating this powerful treatment
into couples therapy is relatively new and very
promising. By augmenting EMDR with the
explanatory power and clinical inventiveness of
ego state theory, couples therapy can be brought to new levels of efficacy. Through didactic
presentation and case illustration, participants will
understand the relational nature of the Self,
psychobiological and psychodynamic mechanisms of attachment, the structure of the
relational self, and the challenges of individuation/differentiation. In addition, all participants will learn and be able to access the intergenerational pathogenesis of ego fragmentation, and will be
able to identify clinical manifestations of ego state
conflict in conjoint sessions, including the doublebind,
split loyalty, and reenactments. Participants
will be able to use this learning to diagnose the
interlock of negative cognitions in their client
couples, and implement strategies to contract for
individually-focused EMDR therapy. Participants
will be able to explain to clients the risks and
benefits of conjoint EMDR, and understand the
contraindications for conjoint EMDR. Participants will learn a model of EMDR
treatment planning that includes target selection
and salience, and will be able to utilize a
progressive sequence of techniques for facilitation
EMDR processing with dissociative clients who
are blocked, looping, or at risk of abreaction.
Spezifische Schwierigkeiten bei einer Gruppe von KlientInnen mit Persönlichkeitsstörungen bei der Wahl adäquater Kognitionen erfordern eine theoretische Auseinandersetzung mit der psychodynamischen Bedeutung der Kognitionen im EMDR-Protokoll. Die biographische Gemeinsamkeit dieser Patientengruppe ist der emotional-narzisstische Missbrauch in der Kindheit sowie Vernachlässigung durch primäre Bindungs- und Beziehungspersonen. Diese Lebenserfahrungen haben zur Folge, dass durch eine subtile Dissoziation (kindliche) Selbstteile entstehen, die emotional und kognitiv auf dasjenige Selbstbild fixiert sind, welches von den Bindungs- und Beziehungspartnern definiert und vom Kind verinnerlicht wurde. Das Ziel der Bearbeitung mit der EMDR-Methode ist in diesen Fällen nicht primär das anvisierte Ereignis, sondern dessen komplexe emotionale und kognitive Bedeutung für die Selbstwahrnehmung und -bewertung.
Im vorliegenden Artikel wird vorgeschlagen, bei der EMDR-Bearbeitung dieser spezifischen Foki während der Bewertungsphase 3 sich der subtilen dissoziativen Struktur bewusst zu sein und sich ihrer, falls nötig, explizit zu bedienen. Dies geschieht durch die Fokussierung auf die gleichzeitige „Aktivierung“ zweier neuronaler Netzwerke (Selbstteile,) nämlich des „betroffenen (kindlichen) Selbst“ (Traumanetzwerk) und des erwachsenen „Gegenwarts-Selbst“ (Alltagsnetzwerk). Die Formulierung des schlimmsten Momentes (Bild), der Negativen Kognition sowie Affekt und Körperlokalisierung obliegen dem „betroffenen Selbst“, welches das zu bearbeitende verzerrte Selbstbild verinnerlicht hat. Die Positive Kognition hingegen soll vom „Gegenwarts-Selbst“ als eine dialogische, alternative Sichtweise aus der Gegenwartsperspektive formuliert und in den EMDR Prozess als direkte Anrede in der 2.Person Einzahl eingebracht werde n („du bist…“ etc.)
Specific difficulties in a group of clients with personality disorders in the choice of adequate cognition require a theoretical discussion of the psychodynamic significance of cognitions in EMDR protocol. The biography of this common group of patients is the emotional and narcissistic childhood abuse and neglect through primary attachment and relationship people. These life experiences have the effect that, due to a subtle dissociation (childish) Auto Parts, which are fixed to that of emotional and cognitive self-image, which was defined by the attachment and relationship partners and internalized by the child. The goal of treatment with the EMDR method in these cases is not primarily the targeted event, but the complex emotional and cognitive meaning for the self-perception and assessment.
In this article it is proposed to be in the EMDR treatment of these specific foci during the evaluation phase 3 is aware of the subtle dissociative structure of her, if necessary, to use explicitly. This is done by focusing on the simultaneous "activation" of two neural networks (auto parts,) namely, the "concerned (children's) self" (Trauma Network) and the adult "present-self '(everyday network). The wording of the worst moment (picture), the negative cognition and affect and body localization is responsible for the "self-interested", which has internalized the distorted self-image to be processed. The positive cognition on the other hand will be the "present-self," formulated as a dialogical, alternative view from the present perspective, and placed in the EMDR process as a direct address to the 2nd person singular ("you are ..." etc.).
Both EMDR and Trauma-Focused CBT are the two main recommended treatments for symptoms of trauma meeting diagnostic criteria for Post Traumatic Stress Disorder.
In accordance with current literature, contrasting the use of Trauma-Focused CBT with EMDR, it has been found in practise by the author that overall, clients using EMDR experience significantly less long-term distress and appears to process much more quickly than clients engaging in trauma-focused CBT. However, the effect of bodily sensations does not tend to differ between the two groups nor does flashbacks or dissociative tendencies.
Specifically, dissociation is not uncommon in traumatised clients and in clients with a diagnosis of post traumatic stress disorder. The existence of dissociative tendencies can pose a realistic problem in effectively processing traumatic memories, regardless of whether the method being used is trauma-focused cognitive-behavioural exposure-based methods or EMDR.
Mindfulness has been utilised by the Author as a stabilisation method for reducing dissociation in clients, prior to trauma processing (CEP conference – Darker-Smith, 2005) and has since been found to reduce dissociation on the DES scale, when measured pre and post teaching clients the basics of the MBSR programme (taught on a 1-to-1 basis).
Equally, the level of flashbacks and bodily reactions subside dramatically when Mindfulness is taught prior to trauma processing, compared with clients who engage in trauma processing without any form of stabilisation.
The author has not found any evidence that the use of Mindfulness body-scan increases traumatic body memory in trauma survivors.
The purpose of this workshop is to explore the application of mindfulness, through experiencing aspects of the Mindfulness programme. Case studies will be presented to demonstrate the application of mindfulness as a stabilisation took, paying specific attention to clients with dissociative tendencies and personality disorders evolving from trauma.
In addition, role plays between participants will be used to practise the skills of mindfulness in relation to stabilisation prior to trauma processing.
Mindfulness mediation (based on Buddhist meditative techniques) has previously been advocated for depression relapse prevention and chronic pain reduction in former research trials (Teasdale; Kabat-zinn, etc.). Because the practice of mindfulness relates to body scans and focusing attention upon the body, it has been advised that it may cause problems in using such a method for sexual abuse and rape survivors, although no research appears to have been carried out in this area. In a single case study of child-sexual-abuse adult survivor who frequently dissociated and experienced “flashbacks” during clinical sessions, the methods of Mindfulness Mediation were introduced to her, in an attempt to keep an awareness of her surroundings whilst doing imagined exposure in for PDSD (post duress stress disorder). From dissociative phases, flashbacks and cognitive avoidance of stimuli, the client became able to focus on the traumatic information being presented and to emotionally relate and process trauma memories, which previously she had been unable to do. Her ability to attenuate upon traumatic information was increased, habituation was easier from a clinical perspective, her anxiety levels decreased (BAI) and her depression levels eased (BDI). (N.B. The client’s improved anxiety and depression scores may have been due to Mindfulness Mediation practices or to the processing of highly emotive information).
Conclusion: Mindfulness Meditation can be a useful adjunct to trauma processing when imagined exposure is being implemented for PTSD/PDSD for processing of un-integrated traumatic information, where dissociation, cognitive avoidance or flashbacks occur within the context of treatment, creating a barrier to habituation from traumatic information. [Two statistical charts which accompanied this abstract in the Conference Program entry have not been included here.]
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.
In a trauma survivor, physiological responses are exacerbated when the affect-laden memories stored in associative networks are triggered by environmental sensory inputs or cues and activate the autonomic nervous system. Recovery from trauma involves not only amelioration of physiological and dissociative symptoms, but also the cognitive rebuilding of a viable assumptive world view which integrates the realms of vulnerability, meaning and self-esteem. This world view is contextualized in cultural idioms and values.
From an Ericksonian perspective, persons are usually attempting to problem-solve, even in a dissociative date. A symptom such as an intrusive recollection or recurrent dream of a traumatic event is therefore construed as a request for help in problem-solving. Hypnosis is a structured dissociation which facilitates cognitive flexibility; that is, the broadening of choices of the client' s belief system, rather than direct work on changing affect or behaviors. The goal of Ericksonian hypnosis is to recontextualize the traumatic memory, the affect of fear, and the physiological hyperarousal cued by the traumatic memory. This occurs within a broader context of pride, mastery and courage, and within a context inclusive of other memories and affects, which are positive for the client.
Eye Movement Desensitization and Reprocessing (EMDR), similarly has as its goal the facilitation of a transfer of traumatic data from the cortical right hemisphere to the left hemisphere. EMDR also utilizes the attainment of a state of heightened awareness, or collaborative structured dissociation, in order to facilitate the orientation of the traumatized client's conscious mind toward "revisiting" traumatic memories.
Both interventions can facilitate the self-narrative reconstruction process of trauma survivors by simultaneously modulating the person's hyperarousal while attending to the culturally significant metaphors which form the building blocks of a person' s world of meanings.
[AAETS]
The trauma field can be proud of having evidence-based effective
psychotherapy protocols for PTSD. Especially CBT and EMDR have
been recognized as first choice treatments (NICE Guidelines 2005).
However, having these protocols available new questions that need
to be answered are emerging. There is no large scale evidence yet on
phase 4 implementation showing its effectiveness. Too many patients
drop out of treatment. Many patients suffer from comorbid conditions.
The question on how research outcomes on the biology of
PTSD should be translated into different psychotherapeutic
approaches is a rather new one. Especially, is habituation still the
correct fundament of exposure in PTSD, or should it be replaced by
the concept of extinction? A third question is the mixed feeling in
many societies about the concept of PTSD and it´s consequences in
the need for treatment. Especially after disasters, but also after
domestic violence, treatment can be seen as the avoidance of society
to punish the responsible ones or to ask for material compensation.
These questions will lead to find new directions for the psychotherapy
protocols, for the combination with biological routes of intervention
and for the societal acceptance of treatment for PTSD.
EMDR and Ego State integrated treatment provides a clinical model for dealing with health problems in complex trauma survivors. Health problems are made more complex by the presence of dissociative disorders and PTSD symptoms in adult survivors. This presentation will focus on the treatment of these disorders. EMDR and Ego State techniques will be utilized to help the CTS patient: a) manage triggers and avoid re-traumatization, hyperarousal and numbing; desensitize and reprocess traumatic events; b) become assertive health consumers and deal with medical/dental procedures and tests; c) learn skills such as rehearsal, identifying problems, planning visits, etc.
In this workshop, EMDR and Ego state integrated treatment will be presented as a clinical model for dealing with
current life and health problems which the presence of dissociation and PTSD exacerbates for complex trauma
survivors (CTS). There are intertwined problems that are made more complex by the presence of dissociative
disorders in adult CTS. First: there are negative sequelae of childhood abuse on the physical and mental health of
adult CTS. Second, there are specific health problems predominant in this population which often are untreated,
misdiagnosed and ignored by physicians and EMDR therapists. Third: CTS have difficulties addressing their health
needs, accessing health care, and functioning effectively as health care consumers. Preventative care and good
health care may be minimal for this population. This presentation will focus on the development of an EMDR
treatment plan to successfully work with dissociative and PTSD disorders prevalent in these patients. Specialized
Ego State techniques will be introduced in each phase of EMDR treatment to help the patient stabilize: manage
triggers and avoid re-traumatization in the health care setting; effectively deal with avoidance, freeze,
hyperarousal and numbing; desensitize and reprocess earlier traumatic events which are at the root of these
problems, (these may include iatrogenic events and specific physical problems seemingly related to current
health problems, which actually result from early trauma); and become assertive health consumers. Skills
development needed by the CTS to become empowered and competent health consumers, such as rehearsal,
identifying problems, planning visits etc will also be included in the plan. [This slide presentation has a two page "References" bibliograhy issued separately.(PDF 6065)]
In the
mental health care system adequate treatment for
a large group of children and adults suffering
under the consequences of chronic early childhood
traumatisation is not available. The Netherlands
centre for chronic early childhood traumatisation
(lcvt) is aiming to enhance the treatment
services available with a nationwide offering of
tertiary referral psychotherapy, innovation,
research and education. The LCVT was formed in
2008 with eleven tertiary referral trauma centres
(TRTC), which are affiliated with mental health
care institutions. LCVT affiliated services use a
unique client-monitoring system as ‘sampling
frame’ in order to monitor the progress and results of all TRTC treatments. At the TRLCS information
is gathered systematically at regular intervals
from all patients on clinical symptoms, personality,
day-to-day functioning, quality of life, use of
health care system and social functioning. Evaluation
diagnostics give answers to what degree
treatment goals are realized.
format Workshop.
aim To provide the participants with
information on:
—— Management and implementation of TRTC and
monitoring system; —— Eye movement desensitisation and reprocessing
(emdr) and dissociative identity disorder (DID):
innovative psychotherapy possibilities;
—— Therapy effects of imaginaire exposure versus
imaginaire rescripting versus dramarescripting;
—— Trauma-related inhibitory and excitatory regulation styles.
This volume introduces the most current research about the neural underpinnings of consciousness and EMDR (eye movement desensitization and reprocessing) in regard to attachment traumatic stress and dissociation. It is the first book to comprehensively integrate new findings in information processing, consciousness, traumatic disorders of information processing, chronic trauma and autoimmune compromises, and EMDR's underlying mechanisms of action.
The text examines online/wakeful information processing, including sensation, perception, somatosensory integration, cognition, memory, language and motricity, and off-line/sleep information processing, such as slow wave sleep and cognitive memorial processing, as well as REM/dream sleep and its function in emotional memory processing. The volume also addresses disorders of consciousness, including coma, anesthesia, and other neurological disorders, particularly disorders of Type 1 PTSD, complex PTSD/dissociative disorders, and personality disorders. It delves into chronic trauma and autoimmune function, especially in regard to diseases of unknown origin, and examines them from the perspective of autoimmune compromises resulting from the unusual neuroendocrine profile of PTSD sufferers. The final section integrates all material to illustrate the ability of EMDR's bilateral neural stimulation to impact, mediate, and change the functioning of neural circuitry, thereby facilitating repair in the linking and binding of neural networks.
Neuroscience research can guide trauma treatment including EMDR, ego state, somatic, and attachment therapies (Lanius, Paulsen & Corrigan, in press). Traumatic memories tend to be encoded somatically and affectively in implicit memory. Lower brain structures, particularly basic affective circuits and the periaqueductal gray (PAG) (Panksepp, 1998), are essential to understanding of both traumatic memory and and dissociation. The polyvagal nervous system (Porges, 2001) is key to understanding the activation of different affective circuits, including the interplay between social engagement and connection, fight/flight and dissociation. A model is proposed that links alterations in consciousness to failure of integration and ultimately to structural dissociation (van der Hart et al., 2006). It is suggested that attachment trauma contributes to the failure of horizontal integration of the columnar organization of affective states, which, over time, become the foundation of discontinuous self-states: Discontinuity of self-states, amnesia barriers and dissociative state switching develop in lieu of smooth state transitions. Somatic interventions can enable sensory integration and personification (Janet, 1929), prior to trauma processing with EMDR that engages brain processing inter-hemispherically and across cortical and subcortical levels. The workshop will highlight implications of recent neurobiological findings for clinical practice.
Learning Objectives:
Articulate the role of the periaqueductal gray (PAG) in the expression and experience of emotion.
Identify two brain structures implicated in integrating affective and sensory information.
Name three branches of the polyvagal nervous systems described by Porges.
Current research in neuroscience and the neurobiology of dissociation is discussed and its connection to a wide variety of traumatic stress syndromes and attachment related disorders. Dissociation is a normal and adaptive response to overwhelming experience. At the same time, dissociative symptoms interfere with mindfulness and the continuity of self. Moreover, information processing becomes compromised or shut down, thus barring the integration and resolution of the traumatic experience. Thus, dissociation interferes with effective psychotherapeutic intervention. Therefore, addressing dissociative symptoms is essential for positive treatment outcomes. A neurobiological model is described that guides therapeutic interventions and integrates diverse approaches that include not only EMDR, but also mindfulness, body therapy approaches, ego-state interventions, sensory integration, as well as neurobiologically based interventions. Participants will become familiar with interventions that reduce dissociative symptoms, as well as when and how to use them to maximize treatment effects.
Endogenous opiates not only play a major role in attachment, but are also involved in dissociative processes and somatoform dissociation. We
present a series of case studies of severely dissociative clients. In our sample administration of an opioid antagonist significantly enhanced
EMDR processing. Possible caveats and contraindications are discussed.
Findings support the notion of a differential mechanism for EMDR as
compared to exposure treatment.
A few years ago I witnessed a curious series of events.
David H. Cleaves, Ph.D., a young psychologist doing postgraduate
work at The Institute of Pennsylvania Hospital,
became curious about Eye Movement Desensitization and
Reprocessing (EMDR), Francine Shapiro, Ph.D.'s novel
approach to the treatment of post-traumatic symptoms. He
began to apply these techniques to several dissociative disorder
patients he was seeing under the supervision of
Catherine G. Fine, Ph.D. Dr. Fine became interested in the
technique and sought out instruction in EMDR.
Objective: In the present study we examined the facial affective behavior of acutely adult
onset traumatized patients in comparison to childhood onset traumatized patients.
Furthermore we analyzed as a moderator variables psychic complains, amnesia and
derealization.
Methods: The facial affective behavior was coded with the Emotional Facial Acting Coding
System, an instrument for the registration of facial movements with emotional relevance.
The facial affective behavior of the patient’s first and last EMDR session was videotaped
and compared. The first 5 min of each session were coded by an independent rater
(certified FACS user). The psychic complains were measured with the SCL-90-R
(German version of Symptom Checklist-90-R), amnesia and derealization with the FDS
(German version of the Dissociative Experiences Scale).
Results: Childhood onset and acutely adult onset traumatized patients showed the same
reduction of overall facial activity. We found significantly higher psychic complains (global
severity index) (SCL-90-R) in childhood onset traumatized patients and no difference in
amnesia (FDS) between the two groups. Childhood onset traumatized patients showed
higher values of derealization (FDS).
Conclusions: Acutely adult onset traumatized patients showed the same facial affective
reduction as childhood onset traumatized patients in comparison to a healthy control
group. Additionally childhood onset traumatized patients showed more psychic complains
and derealization.
Trauma-generated OCD repeats the trauma through its own ritual behavior patterns. This altered state re-traumatizes the core personality through the repetition of rituals similar to the original trauma. The presenters hypothesize that trauma-based OCD is an altered state not co-morbid with diagnosis for dissociative disorders. This OCD persona served the dissociative adult cope with traumatic memories changing and influencing reactions to ongoing trauma, life choices, and other behavior patterns.
This aim of this workshop is to focus on the development of trauma-based, anxiety-motivated dissociative states. Life in the shadow of chronic anxiety stemming from living under constant and consistent life-threatening conditions produces a (sub)-population of persons suffering from PTS/D. The anxiety and fear from elements of unprocessed traumatic events are retained and embedded in the body and are repeatedly triggered in daily life. This PTSD population dissociates into anxiety-based altered states ranging along a continuum from mild tension to phobias, panic attacks, denial, PCD, aggression, indifference and apathy and finally full blown trauma generated OCD.
The presenters provide cross-cultural examples demonstrating how ongoing threat of man-made or natural disasters often leads to a dissociative OCD state. Case examples are explored which demonstrate how processing with EMDR effectively enables resolution and change. EMDR is particularly useful in processing the “anxiety” via current behavior patterns.
Objectives: 1) to examine the co-morbidity aspects of trauma-based OCD and dissociation 2) to present the parallel continuums of types of stress and anxiety (on the intensity and severity axis 3) to compare the differences and similarities in behavioral patterns in different cultures under the stress of constant threat of annihilation (man-made vs. natural threats) 4) to demonstrate the effectiveness of EMDR on trauma induced OCD, through case illustration and discussion.
Five traumatized patients grouped this way: 2 males, 2 females, one boy of 11. The two men had received treatment with CBT, 1 of females Gestalt therapy, the other female with EMDR, and the 11 years old boy with IFS; they had come to a point of stuck in their therapy because of the therapists not being able to manage Shame Affect during trauma confronting; also, when alters appeared during some therapy sessions in one of the adult females. Four of the patients had already worked on some traumatic memories with previous therapists. According to Compass of Shame 2 of the male patients had a rather high urge to enter into Attacking others pole with rage, and one of them, also, into Avoidance pole with drug abuse, compulsive sex and gamble; two females were more urged to enter into Attack self pole and in 1 of the females, her alter and patient described herself as being very upset and paralyzed with Shame. The 11 years old boy was stuck in Withdrawn pole; a highly Shamed Negative Part was so paralyzed that the Integrating Strategy was stopped until the child Ego state was released from Shame.
Learning Objectives:
EMDR/and not EMDR participants will able to perform interventions characterized by working with Shame or preparing patients to tolerate Shame.
Participants will be able to define the scripts inside each pole of the Compass
Participants will be able to identify the different poles of Compass of Shame.
Many clinicians who work with children and adolescents struggle with applying the basic protocol for EMDR for this population. It can feel
overwhelming for the clinician to be creative within their own practice without support for what they are doing, or suggestions on other strategies that may be more effective. This conversation hour session, lasting 3
hours, will provide a panel of professionals from different fields of expertise to lead a discussion of clinical applications of EMDR when treating chlldren and adolsecents. Topics that will be presented and followed with audience discussion include use of EMDR with the following: attachment disorders, children and adolescents in residential treatment, dissociative disorders, sexually reactive kids, children with AD/HD, and unresolved grief issues. The members of the panel are the current chairs of the Child/Adolescent SIG who will share their expertise with the audience.
The clinical phenomena of the conduct of EMDR and Thought Field Therapy were interpreted in light of concepts in the field of classical conditioning with emphasis on the orienting reflex and its external inhibiting effects on conditioned responses. A model was proposed using the temporary suppression through external inhibition of the fear and avoidance conditioned responses to disturbing memories. The clinically helpful effect proposed is the emergence of previously suppressed competing responses to the troublesome memories. Those newly emerged responses are responsible for spontaneous cognitive restructuring of the meaning attribution of the memories, thus lowering SUDS ratings. [Author Abstract]
Dyck's conditioning model of EMD provides a useful description of failure of habituation in PTSD, but may not account for some common EMD phenomena. An alternative model proposes that the therapist's waving hand -- in the presence of a trauma-related cortical set -- triggers an intense orienting response (OR). Intrinsic effects of the OR facilitate continuing attention to the memory without avoidance, and provide for effective input of new trauma-related information. The person's neuronal model of the trauma alters to reflect his survival and current safety -- as true outcome of the trauma -- and associated conditioned responses extinguish. Proposals for experimental evaluation of the model are described. [Author Summary]
The authors reviewed the literature of EMDR and consulted their own clinical experiences to establish the characteristic
phenomenology of EMDR. Dyck's (1993) conditioning model of eye movement desensitization provides a useful account of failure
and habituation in post-traumatic stress disorder (PTSD), but does not account for some of these common EMDR phenomena. The
authors propose an alternative model in which the therapist's waving hand-- in the presence of a trauma-related cortical set-triggers
an intense orienting response (OR). Intrinsic effects of the OR facilitate continuing attention to the memory without avoidance, and
provide for effective input of new trauma-related information. The person's neuronal model of the trauma alters to reflect their
survival and current safety -- as true outcome of the trauma - and associated conditioned responses extinguish. Some proposals for
experimental evaluation of the model are described.
The integration of EMDR with Ego State Therapy will be presented as a comprehensive approach to treatment of the wide spectrum of personality disorders. These diagnostic categories include individuals manifesting character pathology, borderline personalities, antisocial and sociopathic tendencies as well as addictive behaviors. These clients have often been seen as poor candidates for EMDR or even nonresponders. They are often mandated for treatment or come at the behest of others. Their histories often include early repeated experiences of abuse, deprivation, abandonment, and parental coldness. The hallmarks of personality disorders are rigid, intractable defenses, difficulty relating and empathizing with others, as well as acting out behavior. Historically, the treatment of personality disorders has been described as the symptoms of personality disorders be viewed as aspects of dissociation and will examine the applications of ego state concepts and techniques to all phases of the EMDR protocol in order to facilitate the treatment of these clients. Central to this approach is the conceptualization of self and object rcpresentations, self-objects or schemas as ego-states. Discussion will include how to use a developmental approach to assessment and will review the identification, mapping, and accessing of ego-states as well as how to promote ego-state-specific EMDR targets, facilitating the enhancement of EMDR processing.
The integration of EMDR with Ego State therapy will be presented as a comprehensive approach to the treatment of the wide spectrum of personality disorders. The histories of these clients often include early repeat experiences of abuse, deprivation, abandonment, and parental coldness. Historically, the treatment of personality disorders has been described as difficult, if not impossible; manifested by a rigid character armor, defensive resistance. This presentation will propose that the presence of untreated dissociation accounts for these failures and will highlight the use of ego-mapping, exploration, interweaves and the utilization of ego-state-specific EMDR protocols to facilitate robust processing.
The integration of EMDR with Ego State therapy will be presented as a comprehensive approach to the treatment of the wide spectrum of personality disorders. The histories of these clients often include early repeat experiences of abuse, deprivation, abandonment, and parental coldness. Historically, the treatment of personality disorders has been described as difficult, if not impossible; manifested by a rigid character armor, defensive resistance. This presentation will propose that the presence of untreated dissociation accounts for these failures and will highlight the use of ego-mapping, exploration, interweaves and the utilization of ego-state-specific EMDR protocols to facilitate robust processing.
The integration of EMDR with Ego State therapy will be presented as a comprehensive approach to the treatment of the wide spectrum of personality disorders. The histories of these clients often include early repeat experiences of abuse, deprivation, abandonment, and parental coldness. Historically, the treatment of personality disorders has been described as difficult, if not impossible; manifested by a rigid character armor, defensive resistance. This presentation will propose that the presence of untreated dissociation accounts for these failures and will highlight the use of ego-mapping, exploration, interweaves and the utilization of ego-state-specific EMDR protocols to facilitate robust processing.
The integration of EMDR with Ego State therapy will be presented as a comprehensive approach to the treatment of the wide spectrum of personality disorders. The histories of these clients often include early repeat experiences of abuse, deprivation, abandonment, and parental coldness. Historically, the treatment of personality disorders has been described as difficult, if not impossible; manifested by a rigid character armor, defensive resistance. This presentation will propose that the presence of untreated dissociation accounts for these failures and will highlight the use of ego-mapping, exploration, interweaves and the utilization of ego-state-specific EMDR protocols to facilitate robust processing.
The integration of EMDR with Ego State therapy will be presented as a comprehensive approach to the treatment of the wide spectrum of
personality disorders. The histories of these clients often include early repeat experiences of abuse, deprivation, abandonment, and parental
coldness. Historically, the treatment of personality disorders has been described as difficult, if not impossible; manifested by a rigid character armor, defensive resistance. This presentation will propose that the presence of untreated dissociation accounts for these failures and will highlight the use of ego-mapping, exploration, interweaves and the
utilization of ego-state-specific EMDR protocols to facilitate robust processing.
The integration of EMDR with Ego State therapy will be presented as a comprehensive approach to the treatment of the wide spectrum of personality disorders. The histories of these clients often include early repeated experiences of abuse deprivation, abandonment and personal coldness. Historically, the treatment of personality disorders has been described as difficult, if not impossible; manifested by a rigid, character-armor, defensive resistance. This presentation will propose that the presence of untreated dissociation accounts for these failures and will highlight the use of ego-state mapping, exploration, interweaves and the utilization of ego-state-specific EMDR targeting to facilitate robust processing.
Objective: To explore the possibility of using eye movement desensitisation and reprocessing (EMDR) to treat women who have experienced post-traumatic stress after childbirth. Design: The pilot study consisted of a "before and after" treatment design combined with follow-up measurements 1-3 years after EMDR treatment. Quantitative data from questionnaires (Traumatic Event Scale [TES]) were collected. In addition, qualitative data from individual interviews with the participants were collected as well as data from the psychotherapist's treatment notes of the EMDR treatment sessions. Setting: The north of Sweden. Participants: 4 women with PTSD after childbirth (1 pregnant and 3 non-pregnant). Findings: All participants reported reduction of post-traumatic stress after treatment. After 1-3 years, the beneficial effects of EMDR treatment remained for 3 of the 4 women. Symptoms of intrusive thoughts and avoidance seemed most sensitive for treatment. Implications for Practice: EMDR might be a useful tool in the treatment of non-pregnant women severely traumatised by childbirth; however, further research is required. [Author Abstract]
La falta de alternativas de tratamiento para pacientes graves y el reconocimiento de situaciones traumáticas como factores etiológicos o coadyuvantes de sus patologías, ha generado la necesidad de nuevas respuestas terapéuticas para esta población.
Se instrumentó una Policlínica para el tratamiento del Trauma con el Modelo EMDR en el Hospital Psiquiátrico Vilardebó de Uruguay que da atención tanto a pacientes internados con patologías psiquiátricas severas como a pacientes ambulatorios con TEPT.
Los pacientes atendidos son del sector público, de bajos recursos, algunos de los cuales presentan también causas judiciales por cometer hechos delictivos asociados a Trastornos Disociativos.
Se presenta esta experiencia, la forma en que se instrumenta, el equipo que la forma, y la necesidad que se repliquen instancias similares en otros sectores de atención.
The lack of alternative for treatment with grave patients and the acknowledgment of traumatic situations as etiological or aggravating factors in their pathologies has generated the need for therapeutic responses to this population. This Poli-Clinic was trained in trauma treatment using EMDR in this Hospital that gives attention to residential patients with severe psychiatric pathologies as well as outpatients with PTSD. The patients were from the public sector, low income, some of whom presented with legal situations due to crimes committed associated to Dissociative Disorders. The experiment will be presented, how the training was administered, the instruments used and the need for replication of results in other sectors of attention.
La falta de alternativas de tratamiento con pacientes graves y el reconocimiento de situaciones traumáticas como factores etiológicos o coadyuvantes de sus patologías, ha generado la necesidad de respuestas terapéuticas para esta población.Se instrumentó una Policlínica para el tratamiento del Trauma con el Modelo EMDR en el Hospital Psiquiátrico Vilardebó de Uruguay que da atención tanto a pacientes internados con patologías psiquiátricas severas como a pacientes ambulatorios con TEPT. Los pacientes atendidos son del sector público, de bajos recursos, algunos de los cuales presentan también causas judiciales por cometer hechos delictivos asociados a Trastornos Disociativos.Se presentará esta experiencia, la forma en que se instrumenta, el equipo que la forma, y la necesidad que se repliquen instancias similares en otros sectores de atención.
The lack of alternative for treatment with grave patients and the acknowledgment of traumatic situations as etiological or aggravating factors in their pathologies has generated the need for therapeutic responses to this population. This Poli-Clinic was trained in trauma treatment using EMDR in this Hospital that gives attention to residential patients with severe psychiatric pathologies as well as outpatients with PTSD. The patients were from the public sector, low income, some of whom presented with legal situations due to crimes committed associated to Dissociative Disorders.
The experiment will be presented, how the training was administered, the instruments used and the need for replication of results in other sectors of attention.
Description and conceptualization (phenomenology; diagnostic trends; prevalence and course); Theoretical perspectives; Assessment (diagnosis; assessment of symptoms; assessing contextual factors: social support, cognitive distortions, avoidant coping, multiple trauma history, occupational adjustment, physical history/pain/litigation; case formulation); Treatment models and guidelines (cognitive behavioral therapy for PTSD: education, exposure, cognitive control, cognitive restructuring, relaxation training; specific types of trauma: sexual assault, motor vehicle accident, combat; pharmacological treatment for PTSD; eye movement desensitization and reprocessing [EMDR]; client-treatment matching; minimal vs. optimal interventions; common problems: noncompliance due to fear and avoidance, comorbidity, medical and litigation complications; treatment outcome evaluation and life planning). [Pilots]
The role of psychological trauma (e.g., rape, physical assaults, torture, motor vehicle accidents) as an etiological factor in mental disorders, anticipated as early as the 19th century by Janet, Freud, and Breuer, and more specifically during World War I and II by Kardiner, was "rediscovered" some 20 years ago in the wake of the psychlogical traumas inflicted by the Vietnam war and the discussion "in the open" of sexual abuse and rape by the women's liberation movement. 1980 marked a major turning point, with the incorporation of the diagnostic construct of PTSD into DSM-III and the definition of its main diagnostic criteria (reexperiencing of the traumatic event, avoidance of stimuli associated with the trauma, and symptoms of increased arousal). Initially described as resulting from a onetime severe traumatic incident, PTSD has now been shown to be triggered by chronic multiple traumas as well. This "state-of-the-art" article discusses past and current understanding of the disorder, with particular emphasis on the recent explosive developments in neuroimaging and other fields of the neurosciences that have highlighted the complex interrelationships between psychological, psychiatric, biological, and neuroanatomical components of the disorder, and opened up entirely new therapeutic perspectives on how to help the victims of trauma overcome their past. [Author Abstract]
This paper explores how hypnotic principles can be systematically incorporated into the standard EMDR protocol to enhance various ego strength capacities during EMDR treatment. Expanding these skill areas can widen the therapeutic window of possibility for clients with a variety of complex clinical issues, including posttraumatic, dissociative or personality disorders, anxiety symptoms, and depressive difficulties. Clinical case examples are used to illustrate ways of integrating hypnotic principles within a proposed EMDR protocol to promote ego strengthening and facilitate therapeutic change. [Author Abstract]
Kurzbeschreibung
Weiterentwicklung der erfolgreichen EMDR-Methode Mit EMDR steht nicht nur eine wirksame Vorgehensweise bei der Traumaverarbeitung zur Verfügung. Der Band zeigt, wie auch traumabedingte Ängste, Schmerzen, Depressionen, Suchtverhalten und dissoziative Störungen mit diesem effektiven Ansatz behandelt werden können. Klappentext
EMDR (Eye Movement Desensitization and Reprocessing) ist als Behandlungsform für traumatisierte Menschen in ihrer Wirkweise von der neurologischen Forschung umfassend bestätigt: Traumatisierungen verursachen häufig eine dysfunktionale Informationsverarbeitung im Gehirn, die zu quälenden Wiederholungen des traumatischen Ablaufs ohne Verarbeitungsmöglichkeiten führt. Dieser Kreislauf kann mit der »Augenbewegungstechnik«, die immer in eine sorgfältige psychotherapeutische Behandlung einzubinden ist, unterbrochen werden.
Summary of development of the successful EMDR with EMDR method is not only an effective approach in the trauma processing. The book shows how even traumatic anxiety, pain, depression, addictions and dissociative disorders with effective this approach can be treated. Blurb EMDR (Eye Movement Desensitization and Reprocessing) is evidenced by fully as treatment for traumatized people in their mode of action of the neurological research: trauma often cause a dysfunctional information processing in the brain that leads to agonizing repetition of the traumatic process without processing facilities. This cycle can "with the" eye movement technique, which is always involved in a careful psychotherapeutic treatment to be interrupted.
Until now, best practise regarding treatment of anger seems to be mostly focused on improving control over angry outbursts. The treatment as usual is cognitive and behaviour oriented. For trauma related internalizing symptoms (anxiety, panic, nightmares, avoidance, intrusions), we know that EMDR is much more effective than a standard cognitive behavioural approach. Anger, embitterment and revenge are, more often than we think, also trauma-related symptoms and can be viewed as externalizing reactions to severe maltreatment, powerlessness and/or humiliation. A lot of our veterans have to deal with a permanent elevated arousal and an aggressive response style after they return from war. These externalizing symptoms can have devastating effects on marriage, work and daily live. In trauma-literature, there has been a lack of attention to this debilitating and externalizing side of PTSD.
In the workshop, after a brief review of the literature on anger and revenge, a new perspective will be presented in understanding anger and revenge. An EMDR-based protocol will be demonstrated, which can be used as a cognitive interweave and also as a “stand-alone” tool to process anger- and revenge symptoms. Extensive video footage will be used to illustrate the effect of this treatment on a patient with severe, dangerous and obsessive revenge symptoms. The question, when this add-on tool can be used and when it will be preferable to stick to the standard EMDR protocol, will be discussed. In conclusion, questions from the audience will hopefully lead to an inspiring discussion.
Learning objectives:
Being able to apply the theoretical framework of Posttraumatic Anger in understanding anger symptoms in clients;
Being able to detect which experiences en people from the past contributed to current anger – and anxiety symptoms and know when to apply the standard EMDR protocol or the Rage, Resentment and Revenge Protocol; and
Being able to apply the Rage, Resentment and Revenge Protocol to process and resolve the anger symptoms.
Learning Outcomes For those who are not EMDR therapists this workshop will help to understand how EMDR conceptualizes the work in structural dissociation from the Adaptive Information Processing Model (AIP). For people who are not expertise on Theory of Structural Dissociation of the Personality (TSDP) a brief description of dissociative phobias and their importance in the work with dissociative disorders will be put forward. The assistants will watch videos of therapies with different patients, in which EMDR is applied using dissociative phobias as targets. Differences with ego states therapy without introducing bilateral stimulation and with standard EMDR protocol will be observable in the case-examples and will be explained in detail. This work represents a different way of using EMDR to stabilize the patient and prepare her/him for future traumatic memory processing.
While PTSD results in various symptomatology, key characteristics concern a sense of being "stuck" on the trauma which keeps the person reliving it through thoughts, feelings and images and a need to avoid anything which reminds them of the trauma. Such avoidance is suggested to prevent the opportunity for processing and integrating the distressing material. One key clinical question is how to help the person work through their trauma without them becoming overwhelmed by trauma symptoms? Eye Movement Desensitisation and Reprocessing (EMDR) is a relatively new technique that has been reported to help PTSD sufferers reduce the intensity and intrusiveness of traumatic thoughts and images. Despite the growing clinical evidence of the effectiveness of EMDR, a strong debate exists within the research literature regarding its empirical and theoretical validity. One aspect of this dissertation is an experimental study looking at the role of eye movements in Eye Movement Desensitisation and Reprocessing and testing a working memory model of "distress reduction". Of course not everyone who experiences a traumatic event will go on to develop PTSD. An often neglected area of trauma investigation is how some individuals experience positive change and personal growth as a result of their traumatic experiences. This is an area that is now beginning to receive some attention and has been termed Posttraumatic Growth (PTG). The move away from looking exclusively at the impact of trauma to consider how people who have experienced trauma might construct a more positive understanding of themselves in the light of the trauma forms the main section of this dissertation. This exploratory study uses personal experience narratives of posttraumatic growth.
Clients with chronic and complex Posttraumatic Stress
Disorder (PTSD) caused by severe traumata in childhood,
are often still treated inadequately, especially when they
developed additional dissociative symptoms or a Dissociative
Disorder.
There is a current consensus about the need tomodify the
EMDR standard protocol in the treatment of complex
traumatized and dissociative clients. From the theoretical
background of structural dissociation theory and Janet’s
system of action systems, the therapist has not only to recognize
clients’ deficits but also to address action tendencies
in the client’s inner system that could ameliorate
coping strategies in solving problems in daily life.
With the help of bilateral stimulation, blending of parts
of the personality containing different information can
be promoted often resulting in remarkable changes in the
behavior and resource activation. The main principles
that need to be regarded treating complex and dissociative
clients with bilateral stimulation will be explained
and basic rules for treatment plans including the use of
EMDR will be developed.
English subtitled video examples demonstrate the proposed modification
of the EMDR standard protocol and will
be discussed in detail. I will present shortly recent research
findings on autonomic nervous system alterations
during EMDR. These results help to define special
working mechanisms of our modified EMDR protocol in
clients with dissociative disorders.
L’incremento costante di interesse nei confronti dei disturbi post-traumatici sta
portando non soltanto ad un costante e rapido approfondimento delle conoscenze in questo
campo, ma anche ad una continua riscoperta della psicoterapia ipnotica e ad un suo
raffinamento come approccio psicoterapico. La psicoterapia ipnotica, infatti, non solo è la
più antica delle psicoterapie, ma anche la prima ad essere stata in grado di trattare con
successo gli esiti di esperienze traumatiche o altamente stressanti e ad attribuire ad esse
una adeguata rilevanza in seno ad una comprensione trasversale della psicopatologia tutta.
Nonostante l’evidente esistenza di frequenti esperienze traumatiche nel corso della vita
delle persone, con ogni probabilità, però, solo le conseguenze sociali drammatiche di
continui coinvolgimenti bellici (insieme alla rivoluzione della cultura femminista) hanno
portato definitivamente al centro dell’attenzione la presenza di esperienze reali come
implicate nello sviluppo di stati di sofferenza (Hacking, 1995). La rinascita del cosiddetto
“modello traumatico” di Pierre Janet ha portato ad una iniziale riscoperta dei traumi
secondo una concezione di essi come di esperienze discrete, circoscrivibili, rilevanti
essenzialmente per la loro grandezza oggettiva; una tale visione, infatti, viene ufficializzata
dalla pubblicazione della terza edizione del manuale Diagnostico e Statistico dei Disturbi
Mentali (DSM-III; American Psychiatric Association, 1980) e progressivamente diventa la
concezione dominante in tema di Disturbo Post-traumatico da Stress (PTSD). Il progresso
delle conoscenze, però, sta portando sempre più in luce che nella comprensione dei disturbi
post-traumatici sono necessari modelli molto più complessi e non lineari (Pennati, 1995,
2001; Pennati, Grecchi, 2001), valutativi di un insieme di condizioni cliniche molto più
vasto ed articolato di quello previsto dal DSM-IV (Wilson, Friedman, Lindy, 2001),
pienamente immersi nei molteplici e affatto secondari fattori di rischio: psicologici,
genetici, neurologici, biochimici, interpersonali, sociologici (per una rassegna: Yehuda,
1999). Oltre a ciò, anche nei confronti del più studiato e prototipico dei disturbi post2
traumatici, ovvero il Disturbo Post-traumatico da Stress, vengono sempre più decisamente
sollevate obiezioni concettuali che renderebbero quantomeno parzialmente discutibili le
ricerche sull’efficacia delle psicoterapie nel loro trattamento. Infatti, sebbene la quasi
totalità della ricerca si concentri sulla valutazione testistica dei sintomi di intrusione,
evitamento ed iperattivazione, nondimeno sembra opportuno pensare che il PTSD sia
costituito anche da alterazioni del sistema motivazionale dell’attaccamento, delle strategie
interpersonali e della strutturazione del Sé (Wilson, Friedman, Lindy, 2001) (Tabella 1).
The steady increase of interest in the post-traumatic stress is leading not only to a constant and rapid advancement of knowledge in this field, but also to a continuous rediscovery of hypnotic psychotherapy and its refinement as a psychotherapeutic approach. The hypnotic psychotherapy, in fact, not only is the oldest of psychotherapy, but also the first to be able to successfully treat the sequelae of traumatic or highly stressful experiences and to give them a proper understanding of relevance within a transverse all of psychopathology. Despite the apparent existence of frequent traumatic experiences in people's lives, in all likelihood, however, only the social consequences of dramatic escalation continues (along with the feminist revolution of culture) have finally brought to light the presence of real experiences as involved in the development of states of suffering (Hacking, 1995). The rebirth of the "trauma model" by Pierre Janet has led to a rediscovery of the initial trauma according to a conception of them as experiences of discrete constrained, mainly relevant for their size objective, such a vision, in fact, be formalized by publication of third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III, American Psychiatric Association, 1980) and gradually became the dominant view in terms of Posttraumatic Stress Disorder (PTSD). The advancement of knowledge, however, is bringing more and more light in the understanding of post-traumatic stress models are needed much more complex and nonlinear (Penn, 1995, 2001; Pennati, Grecchi, 2001), evaluation of a set of conditions Clinical much more vast and that provided by the DSM-IV (Wilson, Friedman, Lindy, 2001), not fully immersed in multiple and secondary risk factors: psychological, genetic, neurological, biochemical, interpersonal, sociological (for a review: Yehuda, 1999). Moreover, even against the most studied and prototypical post2 traumatic disorder, or Posttraumatic Stress Disorder, are decidedly more conceptual objections that would make at least partially questionable research on the effectiveness of psychotherapy in their treatment. Although almost all of dissertation research focuses on evaluation of symptoms of intrusion, avoidance and hyperactivity, however, it seems appropriate to suggest that PTSD is also consist of changes in the motivational system of attachment, interpersonal strategies and structuring of the self ( Wilson, Friedman, Lindy, 2001) (Table 1).
The session will: explain four different meanings of the word “dissociation" and clarify which ones are relevant to the psychobiology of dissociation; review the structural model of dissociation and how it unifies the dissociative disorders and PTSD; and describe examples of dissociations between declarative and procedural memory from neurology and experimental cognitive psychology. Most of the session will focus on existing and future research on the biology of dissociation from a trauma perspective. Data on hippocampal volume reduction, the hypothalamic-pituitary-adrenal axis and other biological systems will be reviewed.
Whereas most patients with PTSD construct a narrative of their trauma over time, it is a characteristic of PTSD that sensory elements of the trauma itself continue to intrude as flashbacks and nightmares, altered states of consciousness in which the trauma is relived, unintegrated with an overall sense of self. Because traumatic memories are so fragmented, it seems reasonable to postulate that extreme emotional arousal leads to failure of the central nervous system (CNS) to synthesize the sensations related to the trauma into an integrated whole. Earlier models for a biological substrate of these phenomena have become rapidly outdated with the availability of new information derived from neuroimaging studies of patients with PTSD. The emerging body of knowledge from these studies has stimulated a gradual shift in emphasis away from the neurochemicals involved in the organisms' response to overwhelming threat to a focus on the neuronal filters concerned in the interpretation of sensory information: the interactions between the various parts of the CNS that process and interpret the meaning of incoming information, such as the amygdala, hippocampus, corpus callosum, anterior cingulte, and prefrontal cortex. [Text, p. 99]
Review Article: 58 references. This volume of the Annals was published as "Psychobiology of posttraumatic stress disorder," edited by Rachel Yehuda and Alexander C. McFarlane (New York: New York Academy of Sciences, 1997; ISBN 1-57331-078-6). These papers are the result of a conference entitled "Psychobiology of Posttraumatic Stress Disorder" sponsored by the New York Academy of Sciences, New York, 1996 September 7-10.
Objective: The present study would expose first results of a study about the consequences of family
violence act in a small group of women victims treated by EMDR therapy. Subjects: All of the victims
underwent EMDR therapy for seven 90-minute sessions. The subjects were included in the
therapeutic project for 12 months and were followed for 6 month after the end of the therapy.
Procedure: The victims (n=9) were referred by different associations of victims to consult with two of
the authors who took charge of all of the treatments. We have constructed a control group (n=9) with
the same characteristics (age, study level,...). After the first consultation a proposal was made to the
subjects to be part of a research protocol. The subjects then had to answer questions from Horowitz’s
Revised Impact Event Scale (Horowitz & al., 1979) and the State-Trait Anxiety Inventory –STAI-
(Spielberger & al. 1983). In the framework of therapeutic protocol, the subjects had to do a SUDS
evaluation. These different measures were administered to all of the subjects before beginning the
therapy (T1), after the seven sessions of EMDR (T2), and six months later (T3). Main results: Because
of the small size of the sample and a non-normal distribution, the data were processed with nonparametric
tests. We show differences between victims and non victims in the beginning of therapy.
The victims have higher scores in the IES-R and STAI than the control subjects. Difference continues
for the all duration of the experimentation, but the assessments after seven sessions and after six
months show fewer differences. It’s important to note that the differences between the pre-test, the
postest and the evaluation after six months are shown to be equally very significant, indicating a very
positive effect with EMDR on the reduction of intrusive symptoms and avoidance.
A review of the psychosocial treatment research literature indicates that several forms of therapy appear to be useful in reducing the symptoms of PTSD. Strongest support is found for the treatments that combine cognitive and behavioral techniques. Hypnosis, psychodynamic, anxiety management, and group therapies may also produce short-term symptom reduction. Still unknown is whether any approach produces lasting effects. Imaginal exposure to trauma memories and hypnosis are techniques most likely to affect the intrusive symptoms of PTSD, whereas cognitive and psychodynamic approaches may better address the numbing and avoidance symptoms cluster. Treatment should be tailored to the severity and type of presenting PTSD symptoms, to the type of trauma experience, and to the many likely comorbid diagnoses and adjustment problems. [Author Abstract]
In Uruguay, South America, in a public psychiatric hospital unit, a clinic has been developed for the treatment of patients with simple and complex PTSD with promising results. As an example, we can mention a patient with a diagnosis of brain injury with a poor outcome who turned out to have a severe dissociative disorder, and who had a favorable evolution with the right treatment. The population treated is very poor and heterogeneous. Some patients are hospitalized for crimes commited during psychiatric decompensation (theft, murder, rape). This paper will present the basics for creating such unit in a psychiatric treatment setting and describe the work with such difficult hospital inpatients and outpatients. In South American countries it is very hard to develop specific psychiatric care units in public hospitals because patients psychological problems also have serious social and economic problems. The theorical approach in the clinic is cognitive behavioral and EMDR, based on the fact that psychotraumatology is a discipline that has had a rapid development in recent years and its knowledge has become indispensable for the treatment of severe psychiatric illness.
Posttraumatic stress disorder is a challenging condition, as people become captured by their past experiences and have difficulty engaging with the present. At the core of this condition is the role of traumatic memories, which orientate the individual's awareness and reactivity to reminders of the instigating traumatic event. The role of traumatic events has not been fully understood and grappled with in the full range of psychopathological conditions. This has important implications for the application of EMDR as a treatment for disorders above and beyond posttraumatic stress disorder.
However, the problems with information processing in PTSD go above and beyond the fear circuitry and reactivity to traumatic memories. Individuals with PTSD also have major difficulties with their self-orientation, which is reflected in deficits in default networks, the idling systems of the brain. These changes are indicative of problems in self-registration and free-floating reflection. Dissociative symptoms may relate to these abnormalities of individuals resting states as they reflect a sense of disconnection and integration of internal states into consciousness.
Secondly, posttraumatic stress disorder is associated with major problems in dealing with neutral environmental information. This is reflected in the symptoms of difficulty with concentration and emotional numbing. The underlying neurobiology of the working memory abnormalities in posttraumatic stress disorder will be highlighted. These studies show that, in PTSD, relatively simple attentional tasks recruit neural networks normally reserved for more demanding and higher order tasks. When confronted with more demanding challenges, individuals with PTSD do not have any further capacity to allocate to processing complex environments.
Individuals with PTSD also demonstrate a problem with switching their attentional focus from an idling to active state. The data suggests that they continue to use visio-spatial networks more than language-based systems for dealing with verbal tasks. This observation is in keeping with a broad body of literature, which suggests that there are problems with the processing of verbal memory tasks in PTSD. EMDR, as a treatment, may have an advantage, as it is not so dependent on verbal representations of traumatic experiences as other treatment approaches.
Finally, an important development in the field is a better understanding of the patterns of abnormal cortical arousal that accompany the peripheral arousal abnormalities in PTSD. Quantitative EEG has given insights into the instability of the cortical neural networks. Neurotherapy represents a treatment that can further assist clinicians in the management of these patients. It is important to consider the underlying psychosomatic aspects of posttraumatic stress disorder and ensure that treatment addresses these components as well the traumatic memories. Treatment should be thought of as a staged process where the processing of traumatic memories is only one component of a disorder that impacts on a range of information processing domains.
G. G., a man in his mid 30s was brought to medico-legal service to assess fitness to stand trial, and criminal responsibility, after a brief appearance in court: He was charged with death threats.
G. G. was quite angry about his situation, and argumentative against health and justice systems. Physically, he was short stature, extremely lean, his body was leaning forward.
He was living alone, has a girl of thirteen, which he saw once in a while.
He was not working for few years, after two major events; he lost his garage after a huge fire (from which he escaped alive and safe), and was few months earlier, found almost dead by a neighbor. Brought to the hospital, he had more than ten surgeries in a few days, to lance many wound, as he as suffering of Fournier’s disease. He was left with his body leaning forward about 45 degrees, 4 cm thick scar around his abdomen, a severely deformed genitalia, and chronic pain. Another surgery was performed later which permitted the man to be less leaned forward.
Before those events, he wasn’t known from psychiatry. He had a life that he considered, “okay,” even though he was separated. He has his own garage, a social life. He admitted some alcohol and drugs use in the past. After the illness and the fire, he was seen more often in psychiatry. Specialists concluded from time to time to chronic adjustment disorder, and drug addiction, and oriented him to resources for his problem. No follow-up in psychiatry.
G. G. was so much in pain that he took cocaine repeatedly for few minutes’ relief.
With this story and symptoms description, severe PTSD diagnosis was made and treatment initiated accordingly, with introduction of ISRS, and later, seroquel, to decrease dissociative episode he was still experimenting. With informed consent, we had three sessions of EMI, which helped him in various ways; The nightmares decreased of 50%, after the first treatment, he was less angry and afraid of hospital and care, and was more in control of dissociative episodes. Sleep improved, so did his mood. He was eve able to go for correction of his deformed genitalia. Even though still on medication, he felt that the therapy helped him much to recover. After his discharge and end of court process, he was able to go back home. We were at the time unable to do more treatments, as he was involved in his physical rehabilitation. He had at least 2 other reconstructive surgeries.
This case allows discussion about similarities, pros and cons of EMI and EMDR, in their theories and practice. More importantly, this case raises important ethical and legal questions about adequate diagnosis and treatment of PTSF which include powerful tools as EMDR. This tool is yet relatively unknown from general population, and available mainly (in Quebec, Canada) through private facilities. From ethical standpoint, it should be more readily available – without fees – in public services.
The purpose of this chapter is to review reports of the Sadistic Ritual Abuse (SRA) phenomenon, to discuss credibility of the accounts, and to describe current issues in its treatment, including preparation for treatment, general treatment issues, management of cultic or satanic alters, pharmacological treatment, and controversy over historical accuracy. Controversial trends in the etiology and treatment of SRA cases are also discussed. It should be kept in mind that the controversy surrounding SRA continues to heighten. Actual clinical interpretations may be considerably different if scientific data should support patients' accounts or, from an opposing viewpoint, if a socially contagious, media-influenced syndrome is shown to run its course among dissociative, suggestible individuals. [Text, p. 68]
Background: Nurses working in inpatient mental health settings report high rates of assault and psychological morbidity. Psychological debriefing is the main form of post-incident support, yet its efficacy has been widely questioned.
Aim: To determine whether eye-movement desensitisation and reprocessing (EMDR) therapy is effective in reducing the psychological distress experienced by nurses after an assault at work.
Method: Four participants experiencing post-traumatic stress symptoms following a workplace assault completed between three and five sessions of EMDR. A multiple-baseline, case series design was used, and quantitative and qualitative outcome data were collected.
Results: The results showed a clinically significant reduction in the level of emotional distress associated with traumatic memories, avoidance and intrusion symptoms between the pre and post-treatment data collection points for all participants. There was also an increase in the strength of belief in positive coping cognitions concerning the event following EMDR therapy in all participants. These improvements were maintained at one-month follow-up for three of the four participants. The study results did not show a reduction in general psychological distress.
Conclusion: The value of EMDR as a form of post-incident support lies in its alleviation of specific post-traumatic stress symptoms, rather than in improving general psychological wellbeing. The data must be interpreted with caution, but the positive outcomes suggest the need for further case series research, or a more controlled design with a larger sample.
Porges’
polyvagal
theory
provides
a
plausible
explanation
for
the
covariation
between
psychiatric
and
behavioral
disorders
and
the
atypical
regulation
of
the
Autonomic
Nervous
System
(ANS).
Porges
himself
associated
this
phenomenon
with
the
failed
maturation
of
the
ventrovagal
circuit,
as
well
as
with
the
child’s
failure
to
learn
the
ability
to
modulate
the
so-‐called
“vagal
break”
which
keeps
the
heart-‐rate
low
and
inhibits
the
influence
of
the
SNS,
allowing
the
modulation
of
the
facial
and
head
muscles
and,
therefore,
the
social
engagement
function,
often
impaired
in
psychiatric
pathologies.
From
a
psychotherapy
standpoint,
Porges’
finding
that
the
maturation
of
the
ventrovagal
circuit
and
of
its
associated
braking
function
occurs
ontogenetically
later
than
that
of
other
ANS
branches
(last
months
of
pregnancy
and
first
year
of
life)
and
that
a
good
relation
with
the
caregiver
is
essential
for
its
development
is
of
significant
importance.
In
this
dyad
–
with
the
cortical-‐bulbar
pathway,
sufficiently
myelinated
at
birth,
regulating
face
and
head
muscles
and
allowing
signals
exchange
with
the
caregiver
–
children
learn
to
confront
their
internal
states
and
the
environment
as
well
as
regulate
their
emotions,
regulating
an
adaptive
neuroception
with
the
consequent
possibility
of
a
good
social
involvement.
This
focus
on
the
first
year
of
life
and
the
caregiver
–
child
dyad,
in
terms
of
time
and
place
for
the
construction
of
biologically
based
behaviors
common
to
all
human
beings,
paves
the
way,
as
anticipated
by
Porges
himself,
for
new
possible
intervention
models
in
psychotherapy
directly
acting
on
the
missed
or
impaired
steps
in
this
first
phase
of
the
psycho-‐physiological
development
process,
without
disregarding
its
psychobiological
quality.
Clinical
Application
Since
I
believe
that
the
inter-‐brain
perspective
is
the
most
efficient
not
only
for
the
etiological
explanation
but
especially
for
the
restoration
of
relational
impairments
occurred
during
brain-‐brain
interactions,
I
chose
eye
contact
(EC),
because,
according
to
several
scholars,
it
is
a
privileged
communication
channel,
in
particular
between
mother
and
child.
Several
scholars
agree
that
all
forms
of
psychopathology
share
a
failure
in
emotional
regulation,
which
can
be
mostly
traced
back
to
the
failure
in
the
child-‐
caregiver
adaptive
tuning
and
therefore
to
the
impairment
of
their
inter-‐brain
communication.
An
intervention
on
the
EC
shifts
the
therapy
focus
on
this
dysregulation
to
restore
its
functions.
The
EMDR
AIP
approach
relies
on
the
brain
adaptive
processing
ability.
EMDR
has
proved,
in
appropriate
conditions
(good
therapeutic
alliance,
client
stabilization,
compliance
with
the
EMDR
protocol),
our
brain
can
repair
traumatic
injuries,
i.e.,
reacquire
and
use
information
dysfunctionally
stored
after
a
trauma.
Successful
use
of
EMDR
on
target
not
directly
traceable
to
a
traumatic
event
(e.g.,
defenses,
chronic
pain,
etc.)
allows
for
the
possibility
to
use
this
processing
tool
in
increasingly
broad
fields
and
refines
its
resources.
Thanks
to
its
three-‐pronged
approach
to
dysfunctionally
stored
information
in
the
brain
(EMDR
works
on
the
cognitive,
emotional
and
somatic
level),
the
inter-‐brain
quality
of
its
scope
(the
therapeutic
alliance
is
part
of
the
healing
process)
and
for
its
focus
on
the
present
(EMDR
works
on
the
present,
i.e.,
on
the
current
and
active
components
of
the
pathogenetic
memory,
bypassing
all
mediations
and
interpretation),
EMDR
seemed
the
most
appropriate
therapeutic
tool
to
intervene
on
the
EC
dysregulation
found
in
several
psychiatric
pathologies.
Conclusion
An
EMDR
protocol
for
the
exploration
and
modulation
of
the
EC
is
proposed.
This
protocol
proved
particularly
useful
with
depressed
or
severely
dissociative
clients.
After
making
clients
aware
of
their
difficulty
in
maintaining
the
EC,
they
are
retrained
to
use
this
contact
first
on
objects,
then
on
animals
(excellent
mediators
of
a
primitive
form
of
social
contact)
until
they
are
able
to
achieve
eye
contact
with
the
therapist.
During
this
training,
clients
are
encouraged
to
become
aware
of
their
body
sensations,
emotions
and
beliefs,
and
the
positive
ones
are
installed
with
BLS.
Memories
of
relational
situations
where
clients
identify
an
impaired
EC
are
identified
and
these
are
targeted
with
the
standard
protocol.
The
focus
then
shifts
to
present
and
future
situations.
The
regulation
purpose
of
this
protocol
affects
the
application
mode:
interventions
must
never
be
dysregulating,
therapists
must
proceed
slowly.
Clients
must
be
rigorously
kept
within
their
window
of
tolerance,
must
be
trained
to
recognize
it
and
able
of
staying
within
its
boundaries
with
respect
to
the
microregulation
of
the
EC.
La
teoría
polivagal
de
Porges
proporciona
una
explicación
plausible
para
la
covariación
entre
los
trastornos
psiquiátricos
comportamentales
y
la
regulación
atípica
del
sistema
nervioso
autónomo
(ANS).
El
propio
Porgues
asoció
este
fenómeno
con
el
fallo
de
maduración
del
circuito
ventrovagal,
por
tanto
el
niño
falla
al
aprender
una
habilidad
también
llamada
“bloqueo
vagal”,
que
mantiene
la
tasa
cardiaca
baja
e
inhibe
la
influencia
del
SNS,
permitiendo
la
modulación
de
los
músculos
faciales
y
la
cabeza,
y
por
tanto,
la
función
optima
del
compromiso
social,
a
menudo
emparejada
con
patologías
psiquíatricas.
Partiendo
desde
un
punto
de
vista
psicoterapéutico,
Porges
encontró
que
la
maduración
del
circuito
ventrovagal
y
su
asociación
con
la
función
de
frenado
ocurre
ontogenéticamente
después
que
otras
ramas
del
sistema
nervioso
autónomo
(Los
últimos
meses
del
embarazo
y
los
primeros
años
de
vida)
y
que
una
buena
relación
con
el
cuidador
es
esencial
para
su
desarrollo
es
significativamente
importante.
En
esta
línea
–
con
vía
córtico-‐bulbar,
lo
suficientemente
mielinizada
en
el
nacimiento,
regulando
los
músculos
de
la
cara
y
la
cabeza
y
permitiendo
señales
de
intercambio
con
el
cuidador-‐
Los
niños
aprenden
a
estar
cómodos
con
sus
estados
internos
y
con
un
ambiente
que
también
regula
sus
emociones,
regular
una
neurorecepción
con
la
consecuente
posibilidad
de
una
buena
integración
social.
Centrándonos
en
el
primer
año
de
vida
del
niño
y
el
cuidador
–
La
pareja
de
niños,
en
términos
de
tiempo
y
lugar
para
la
construcción
biológica
fundamentada
y
basada
en
todos
los
seres
humanos,
allana
el
camino,
como
anticipó
Porges,
para
nuevos
modelos
de
intervención
en
psicoterapia,
actuando
directamente
con
el
paso
perdido
o
afectado
de
esta
primera
fase
del
proceso
de
desarrollo
psicofisiológico,
sin
tener
en
cuenta
su
calidad
psicobiológica.
Aplicación
Clínica.
Desde
que
creó
que
la
perspectiva
del
cerebro
interior,
continúa
siendo
la
más
eficiente
no
solo
para
desarrollar
explicaciones
etiológicas,
también
para
la
restauración
de
los
desajustes
relacionados
ocurridos
durante
las
interacciones
cerebro-‐cerebro.
Escogí
contacto
visual
(ECE),
porque,
de
acuerdo
con
numerosos
investigadores,
es
un
privilegiado
canal
de
comunicación,
particularmente
eficaz
entre
una
madre
y
su
hijo.
Numerosos
profesionales
afirman
que
todas
las
formas
de
psicopatología
comparten
una
fallo
en
la
regulación
emocional,
que
solo
puede
crear
un
error
en
el
la
comunicación
interna
del
cerebro.
Esta
intervención
en
el
EC
modifica
la
terapia
y
la
centra
en
la
desregulación
y
la
restauración
de
funciones.
El
enfoque
EMDR
SPIA
está
basado
en
la
habilidad
de
procesamiento
de
la
información
relevante,
EMDR
ha
sido
probado
en
condiciones
idóneas
(buena
alianza
terapéutica,
estabilización
de
la
queja
del
cliente
disgustado
con
el
EMDR.).
5 women prisoners with a history of being battered and who met the DSM-IV criteria for PTSD were assessed (A phase) and provided with structured relaxation training (RT) (B phase, or placebo treatment), followed by eye movement desensitization and reprocessing (EMDR) therapy (C phase). Using the Beck Anxiety Inventory and the Impact of Events Scale's avoidance behavior and intrusive thoughts subscales as outcome measures, RT alone did not result in any clinical improvements. The subsequent provision of EMDR did not improve upon this lack of success with 4 of the 5 participants; 1 did improve on anxiety and intrusive thoughts. The apparent ineffectiveness of EMDR with these participants may be attributed to several explanations. Foremost perhaps is the hypothesis that EMDR is not sufficient to ameliorate the effects of chronic abuse. [Author 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.
This paper will expand on the EMDR protocol of Safe Place Imagery (SPI) making it useful to a wider range of clients. Clients with overt and covert trauma histories will frequently experience traumatic intrusions in to the Safe Place or not be able to find one. Knowledge of trance both explains these phenomena and informs the process of teaching these clients to block out intrusions. Use of SPI with clients with complex ego states and Dissociative Disorders will also be discussed.
Role
theory/therapy
was
developed
almost
one
hundred
years
ago,
and
one
of
its
greatest
innovators
was
Jacob
Moreno,
the
founder
of
Psychodrama
and
Group
Psychotherapy.
This
workshop
will
present
the
use
of
eight-‐phase
EMDR
treatment
approach
as
a
form
of
role
therapy.
It
will
help
therapists
identify
the
inner
roles
that
all
clients
present,
how
the
roles
can
be
treated
with
EMDR
and
integrated
towards
a
personality
whole.
This
is
an
innovative
and
creative
alternative/adjunct
to
ego-‐state
therapy
for
clients
with
less
dissociative
symptomatology
and
the
more
“everyday”
client
that
psychotherapists
tend
to
see
in
their
offices.
La
teoría/terapia
de
rol
fue
desarrollada
hace
casi
100
años,
y
uno
de
sus
grandes
innovadores
fue
Jacob
Moreno,
el
fundador
del
psicodrama
y
la
terapia
de
grupo.
Este
taller
presentará
el
uso
de
un
tratamiento
EMDR
de
8
fases
en
forma
de
terapia
de
rol.
Esto
ayudara
a
los
terapeutas
a
identificar
los
roles
interiores
que
todos
los
clientes
presentan,
como
los
roles
deben
ser
tratados
con
EMDR
e
integrados
hacia
un
todo
en
la
personalidad.
Esta
es
una
alternativa
innovadora
y
creativa
a
la
terapia
de
Estados
del
Ego
para
los
clientes
con
poca
sintomatología
disociativa
y
orientada
al
cliente
más
común
de
“a
pie”
que
normalmente
tiende
a
acudir
a
la
consulta.
EMDR is a powerful integrative psychotherapeutic intervention. However, in the case of disrupted attachment and significant dissociative symptoms EMDR can be destabilizing if used early on in treatment. That is, fragmentation of self and dissociative symptoms commonly interfere with information processing, thus barring the integration and resolution of the traumatic experience through EMDR. Dissociation interferes with clients sense of their own body, their ability to experience emotion, their capacity for emotional regulation and their sense of self. Addressing dissociative symptoms prior to proceeding with EMDR treatment is essential for positive treatment outcomes.
A neurobiological model is described that guides therapeutic interventions and integrates diverse approaches that include not only EMDR and relevant target selection, but also mindfulness, body therapy approaches, ego-state interventions, sensory integration, as well as neurobiologically based interventions. Such interventions can be used both in the preparation phase but can also form useful interweaves during EMDR information processing.
Using a neurobiologically informed approach, the case is made for the use of somatic and ego-state interventions when dissociation is a significant part of the clinical presentation. Specific focus is on different ego-state and body therapy interventions to increase awareness of the self and ones body. Body therapy and somatic interventions are distinguished from other psychotherapeutic interventions in that they are expressed in markedly slowed-down time, in order to give clients ample time to experience the felt sense of their bodies. Similarly ego-state work can be utilized to titrate information processing, as well as provide clients with internal resources that aid in enhanced information processing.
Attendees will gain knowledge about possible underlying neurobiological processes with regard to attachment, dissociation and adaptive information processing and how this relates to EMDR treatment. The workshop will teach specific interventions intended to stabilize clients, create safety, help the client stay connected or get reconnected and therefore minimize dissociative symptoms and their effect. Participants will learn how to effectively integrate different somatic and ego-state interventions in the treatment of attachment and trauma related syndromes and dissociative disorders, as well as how to enhance information processing during the EMDR treatment. The workshop also will discuss innovative use of opioid antagonists in the treatment of dissociative symptoms with a particular focus on EMDR.
Learning Objectives:
Attendees will gain knowledge about possible underlying neurobiological processes with regard to attachment, dissociation and adaptive information processing and how this relates to EMDR treatment.
Participants will learn how to effectively integrate different somatic and ego-state interventions in the treatment of attachment and trauma related syndromes and dissociative disorders, as well as how to enhance information processing during the EMDR treatment.
The workshop will teach specific interventions intended to stabilize clients, create safety, help the client stay connected or get reconnected and therefore minimize dissociative symptoms and their effect.
Clients
with
complex
dissociative
disorders
usually
are
in
trauma-‐
induced
wake
trance-‐states.
Due
to
this,
they
might
thrive
from
treatment-‐
strategies,
where
skills
in
clinical
hypnosis,
from
the
side
of
the
therapists,
are
added
to
the
treatment
model.
Clinical
hypnosis
also
offers
excellent
tools
for
working
with
attachment
traumas
and
reinstalls
the
neuroception
of
safety.
This
workshop
highlights
seven
strategies
for
extending
the
EMDR
standard
protocol,
mainly
built
on
clinical
hypnosis.
They
consist
of:
(1)
Formal
hypnotic
induction
of
safe
place/safe
state
BEFORE
introducing
EMDR
under
phase
I
treatment
(2)
Informal
hypnotic
induction
for
ongoing
activation
of
the
social
engagement
system
when
clients
are
in
trance
(3)
Using
hyper-‐empirical
trance
inductions
under
exposure
phase
(ie
helping
the
clients
to
stay
present
with
dual
awareness
by
continuously
inducing
trance,
thus
helping
them
to
titrate
the
trauma-‐material
(4)
Addressing
ego-‐states
that
react
as
if
they
still
are
bound
in
trauma-‐time
(5)
Addressing
resource-‐rich
ego-‐states
and
parts
of
the
self,
f
ex
ISH
(internal
self-‐
helper),
thus
helping
the
client
to
begin
to
metabolize
the
trauma
material
(6)
Installation
of
hope
and
the
“memory
of
the
future”
(7)
Using
post-‐hypnotic
suggestions
for
enhancing
the
neuroception
of
safety
between
sessions.
Learning
objectives:
Demonstrate
how
to
use
EMDR
and
hypnosis
for
stabilization
and
work
with
parts
within
phase
II
work,
addressing
the
special
needs
of
continuous
stabilization
for
this
population.
Develop
an
understanding
of
how
to
enhance
the
integrative
capacity
during
trauma-‐work
with
DD-‐clients.
Apply
structured
techniques
and
rationales
for
calming
and
soothing
patients
related
to
their
integrative
capacity
during
extended
EMDR-‐work.
Los
clientes
con
trastornos
disociativos
complejos
normalmente
se
encuentran
en
estados
de
trance
despierto
inducido
por
el
trauma.
Debido
a
esto,
pueden
crecer
rápidamente
de
estrategias
de
tratamiento,
donde
estrategias
de
hipnosis
clínica
se
añaden
al
modelo
de
tratamiento
por
parte
del
terapeuta.
La
hipnosis
clínica
ofrece
también
excelentes
herramientas
para
trabajar
con
traumas
de
apego
y
reinstalar
la
neurocepción
de
seguridad.
Este
taller
subraya
siete
estrategias
para
extender
el
protocolo
estándar
de
EMDR,
principalmente
basadas
en
la
hipnosis
clínica.
Consisten
en:
(1) Inducción
hipnótica
formal
del
lugar
seguro/
estado
de
seguridad
ANTES
de
introducir
la
fase
I
de
tratamiento
de
EMDR
(2) Inducción
hipnótica
informal
para
la
activación
continuada
de
los
sistemas
de
compromiso
social
cuando
los
clientes
están
en
trance
(3) Uso
de
inducciones
al
trance
hiper-‐empíricas
en
la
fase
de
exposición
(ej,
ayudar
a
los
clientes
a
estar
presentes
con
conciencia
dual
mediante
la
inducción
continua
al
trance,
por
tanto
ayudándoles
a
valorar
el
material
traumático.
(4) Dirigirse
a
los
estados
del
ego
que
reaccionan
como
si
aún
estuviesen
atados
al
tiempo
traumático
(5) Dirigirse
a
estados
del
ego
ricos
en
recursos
y
a
partes
del
yo,
por
ejemplo,
al
ISH
(en
inglés
yo-‐interno
ayudante),
por
tanto
ayudando
al
cliente
a
empezar
a
metabolizar
el
material
traumático
(6) Instalación
de
esperanza
y
la
“memoria
de
futuro”
(7) Usando
sugestión
post-‐hipnótica
para
fomentar
la
neurocepción
de
seguridad
entre
sesiones.
Objetivos
de
aprendizaje:
Demostrar
cómo
usar
EMDR
e
hipnosis
para
estabilizar
y
trabajar
con
las
partes
en
el
trabajo
de
la
fase
II,
dirigiéndonos
a
las
necesidades
especiales
de
estabilización
continua
para
esta
población.
Desarrollar
un
entendimiento
de
cómo
fomentar
la
capacidad
integrativa
cuando
se
trabaja
el
trauma
con
clientes-‐DD.
Aplicación
de
técnicas
estructuradas
y
racionales
para
calmar
y
tranquilizar
a
los
pacientes
en
relación
con
su
capacidad
integrativa
durante
trabajo
extendido
con
EMDR.
Clients with complex dissociative disorders usually are in trauma-induced wake trance-states. Due to this, they might thrive from
treatment-strategies, where skills in clinical hypnosis, from the side of the therapists, are added to the treatment model. Clinical hypnosis also
offers excellent tools for working with attachment traumas and reinstalls the neuroception of safety.
This workshop highlights seven strategies for extending the EMDR standard-protocol, mainly built on clinical hypnosis. They consist of:
1. Formal hypnotic induction of safe place/safe state BEFORE introducing EMDR under phase I treatment.
2. Informal hypnotic induction for ongoing activation of the social engagement system when clients are in trance.
3. Using hyper-empirical trance inductions under exposure phase (ie helping the clients to stay present with dual awareness by
continuously inducing trance, thus helping them to titrate the trauma-material.
4. Addressing ego-states that react as if they still are bound in trauma-time.
5. Addressing resource-rich ego-states and parts of the self, f ex ISH (internal self-helper), thus helping the client to begin to metabolize
the trauma material.
6. Installation of hope and the “memory of the future”.
7. Using post-hypnotic suggestions for enhancing the neuroception of safety between sessions.
Learning objectives:
Demonstrate how to use EMDR and hypnosis for stabilization and work with parts within phase II work, addressing the special needs of
continuous stabilization for this population.
Develop an understanding of how to enhance the integrative capacity during trauma-work with DD-clients. Apply structured techniques and
rationales for calming and soothing patients related to their integrative capacity during extended EMDR-work.
Los clientes con trastornos disociativos complejos normalmente se encuentran en estados de trance despierto inducido por el
trauma. Debido a esto, pueden crecer rápidamente de estrategias de tratamiento, donde estrategias de hipnosis clínica se añaden al modelo
de tratamiento por parte del terapeuta. La hipnosis clínica ofrece también excelentes herramientas para trabajar con traumas de apego y
reinstalar la neurocepción de seguridad.
Este taller subraya siete estrategias para ampliar el protocolo estándar de EMDR, principalmente basadas en la hipnosis clínica. Consisten en:
1. Inducción hipnótica formal del lugar seguro / estado de seguridad ANTES de introducir la fase I de tratamiento de EMDR.
2. Inducción hipnótica informal para la activación continuada de los sistemas de compromiso social cuando los clientes están en trance.
3. Uso de inducciones al trance hiper-empíricas en la fase de exposición (ej, ayudar a los clientes a estar presentes con conciencia dual
mediante la inducción continua al trance, por tanto ayudándoles a valorar el material traumático.
4. Dirigirse a los estados del ego que reaccionan como si aún estuviesen atados al tiempo traumático.
5. Dirigirse a estados del ego ricos en recursos y a partes del yo, por ejemplo, al ISH (en inglés yo-interno ayudante), por tanto
ayudando al cliente a empezar a metabolizar el material traumático.
6. Instalación de esperanza y la “memoria de futuro”.
7. Usando sugestión post-hipnótica para fomentar la neurocepción de seguridad entre sesiones.
Objetivos de aprendizaje:
Demostrar cómo usar EMDR e hipnosis para estabilizar y trabajar con las partes en el trabajo de la fase II, dirigiéndonos a las necesidades
especiales de estabilización continua para esta población.
Desarrollar un entendimiento de cómo fomentar la capacidad integrativa cuando se trabaja el trauma con clientes-DD. Aplicación de técnicas
estructuradas y racionales para calmar y tranquilizar a los pacientes en relación con su capacidad integrativa durante trabajo extendido con
EMDR.
Die EMDR-Therapie mit sexuell traumatisierten Patienten erfordert psychotraumatologische Behandlungserfahrung (Peichl 2000). Auf unbewusste Blockierungen während des Prozesses, Affektdysregulation, chronische Übererregung oder dissoziative Zustände ist zu achten und angemessen zu reagieren, beispielsweise mit geleiteten Imaginationen oder differenzierten Einwebtechniken (Shapiro 1995; Parnell 2003). Der Sicherheitsaspekt spielt eine große Rolle, vor allem bei Patienten aus inzestuösen Familien, die häufig nur im Alleinsein ausreichend Schutz und Sicherheit empfanden. Jede neue Beziehung, auch in der Therapie, muss daher im Vorfeld einen Glaubwürdigkeitstest bestehen und für den Patienten eine klare Unterscheidung zwischen Fürsorglichkeit und ausbeutender Sexualität ermöglichen. Dabei erscheint unentbehrlich, dass sich der Therapeut seiner Wertvorstellungen und Überzeugungen hinsichtlich der zahlreichen Aspekte von sexueller Gewalt bewusst wird. EMDR bei sexuell Traumatisierten stellt erhöhte Anforderungen an die Stabilisierungsbedürfnisse der Patienten und die therapeutische Flexibilität des Therapeuten. Die frühzeitige Erkennung und therapeutisch angemessene Bewertung von spontan auftauchenden dissoziativen Symptomen, Körpersensationen ohne visuelle Erinnerungen und starken Abreaktionen stellen besondere therapeutische Herausforderungen dar. Hierbei entscheidet sich, ob der Therapeut vom Patienten als empathisches, gegenwärtiges und angstfreies Objekt erlebt und geschätzt werden kann.
The EMDR therapy with sexually traumatized patients requires psychotraumatological treatment experience (Peichl 2000). blockages at the unconscious during the process, Affektdysregulation, chronic hyperarousal or dissociative states to respect and respond appropriately, for example with guided imagery or differentiated Einwebtechniken (Shapiro 1995, Parnell 2003). The security aspect plays an important role, especially in patients from incestuous families, often felt only in being alone sufficient protection and security. Each new relationship, even in therapy must, therefore run in a credibility test for the patient there and make a clear distinction between caring and exploitative sex. It seems essential that the therapist's values and beliefs regarding the many aspects of becoming aware of sexual violence. EMDR for sexually traumatized places increased demands on the stabilization needs of patients and the therapeutic flexibility of the therapist. The early diagnosis and therapeutic proper assessment of spontaneously arising dissociative symptoms, body sensations without visual memories and strong abreaction provide special therapeutic challenge this will determine whether the therapist can be experienced by the patient as empathic, present, and fear-free object and appreciated.
Life is often an enduring struggle for people who have been chronically traumatized. Their suffering essentially recounts a horrifying and anguished past that haunts them, incessantly. As clients attempt to hide their sorrow beneath a veneer of normality, therapists often feel beleaguered by their many symptoms and never-ending pain. Van der Kolk and McFarlane (1996) note that "experiencing trauma is an essential part of being human; history is written in blood" (p. 3). Centuries of wars, famines, pogroms, holocausts, slavery, dictatorship, and colonization brought every type of horror and abuse into the homes of our ancestors. Some found ways to adapt, but many succumbed to the horror and despair. Despite the capacity of humans to survive and adapt, traumatic experiences tend to alter their biological, psychological, and social equilibrium to such a vast extent that the memory and interpretation of their traumas wash over and taint all other experiences, contaminating the present and future (van der Kolk & McFarlane, 1996). (PsycINFO Database Record (c) 2008 APA, all rights reserved)
A cluster analytic investigation was conducted on measures of PTSD associated features (e.g., personality pathology, dissociative tendencies) to investigate whether empirically-defined clusters correspond to Herman's distinction between simple and complex PTSD. Results from a sample of 60 PTSD patients were broadly consistent with this distinction, although some inconsistencies were observed. Treatment outcome generally did not differ between the two clusters. Implications for classifying and treating PTSD are discussed. [Author Abstract]
De stabilisatie en behandeling van deze kinderen kan gecompliceerd zijn. Vanzelfsprekend is het creëren van een veilige omgeving en een hechtingsfiguur een eerste stap. Maar wat dan? Deze kinderen functioneren soms ogenschijnlijk goed. Hun vermijdingsstrategieën zijn effectief en ze weigeren om over het trauma te praten of zeggen dat ze het vergeten zijn. Ze hebben er geen last meer van, of ze weten er niks meer van omdat ze een dissociatieve stoornis hebben. Maar de verleiding van de therapeut om dan geen slapende honden wakker te maken is een gevaarlijke. Want onder deze ogenschijnlijk goed functionerende buitenkant, zit een constant alert, angstig en eenzaam kind. Dit kind kan zich niet hechten en dit gebrek aan veilige hechting is verwoestend voor de ontwikkeling. Dit wordt echter vaak alleen zichtbaar door er expliciet naar te zoeken, zeker als er sprake is van dissociatie.
In deze presentatie zal ik toelichten hoe je deze stabilisatiemethode, welke een bewerking is van De drie testen (Spierings, 2008), kunt gebruiken en met name bij dissociatieve stoornissen. Deze methode helpt de therapeut om te beslissen of een kind verdere stabilisatie nodig heeft en hoe dat te bereiken, voordat met EMDR gestart kan worden. Deze workshop is anders dan de presentatie van vorig jaar omdat de focus meer ligt op het toepassen van de methode en dan met name bij dissociatie.
Allereerst begin je natuurlijk met diagnostiek van dissociatie. Door dan de problemen die het kind ervaart te koppelen aan ervaringen in het verleden wordt het kind gemotiveerd voor behandeling. Dan worden de zes stappen van de stabilisatiemethode (veiligheid, rust in het dagelijks leven, hechting verbeteren, emotieregulatie, zelfbeeld en notendop) toegelicht. Dan wordt besproken hoe EMDR kan worden geïntegreerd in een gefaseerde behandeling voor deze kinderen en wat aanpassingen zijn bij dissociatieve stoornissen.
The stabilization and treatment of these children can be complicated. Obviously, creating a safe environment and an attachment figure is a first step. But what then? These children sometimes seemingly functioning properly. Their avoidance strategies are effective and they refuse to talk about the trauma or say they forgot it. They have no more trouble, they know nothing more because they have a dissociative disorder. But the seduction of the therapist and then to wake sleeping dogs is dangerous. For, by this seemingly well-functioning without, is a constant alert, anxious and lonely child. This child can not stick and this lack of secure attachment is devastating for the development. This is often visible only by explicitly to look for, especially when there is dissociation.
In this presentation I will explain how this stabilization method, which is a reworking of the three tests (Spierings, 2008), can use and in particular in dissociative disorders. This method helps the therapist to decide whether a child needs further stabilization and how to reach before EMDR can be started. This workshop is different than the presentation of last year because the focus is more on applying the method and especially for dissociation.
First you start with diagnostics course of dissociation. By then the problems the child experiences to link past experiences, the child is motivated for treatment. Then the six steps of the method of stabilization (safety, peace in everyday life, improve adherence, emotion regulation, and self nutshell) explained. Then discusses how EMDR can be integrated into a phased treatment for these children and what changes in dissociative disorders.
Stabiliser et traiter les enfants traumatisés et souvent dissociés peut être compliqué. En apparence, ils peuvent sembler fonctionner relativement bien. Leurs stratégies d'évitement paraissent efficaces et ils refusent de parler du trauma ou disent qu'ils l'ont oublié. Cela ne les perturbe plus. Mais le désir du thérapeute de laisser les chiens dormir tranquillement est une stratégie dangereuse. Sous cette apparence de bon fonctionnement extérieur l'enfant est terrifié, constamment en alerte et seul, incapable de trouver le réconfort. Cet enfant ne peut s'attacher et ce manque d'attachement sécure peut dévaster son développement futur. Cependant, ce n'est que par une anamnèse détaillée réalisée par les soignants et les instituteurs que ces problèmes souvent cachés peuvent être révélés.
Arianne expliquera les principes de base de la dissociation et de la dissociation structurelle chez les enfants dans le but d'aider à les traiter.
Dans ce workshop, elle fera une démonstration du "6 tests", un nouveau modèle unique de stabilisation pour enfants. La stabilisation inclut la motivation, la psycho-éducation, la création d'un lieu sûr, l'activation du système d'attachement, des outils d'auto-régulation, des changements cognitifs, etc . Le "6 tests" aide le thérapeute à décider si l'enfant a besoin de stabilisation supplémentaire et comment l'établir avant de commencer l'EMDR.
Stabilize and treat traumatized children and often dissociated can be complicated. Outwardly, they may appear to function relatively well. Their avoidance strategies seem effective and they refuse to talk about the trauma or say they have forgotten. That does not disturb more. But the therapist's desire to let the dogs sleep in peace is a dangerous strategy. Under the appearance of functioning outside the child is terrified, alone and constantly alert, unable to find comfort. This child can not concentrate and lack of secure attachment can devastate its future development. However, it is only through a detailed history completed by caregivers and teachers that these often hidden problems can be revealed.
Arianne will explain the basic principles of unbundling and structural separation of children in order to help address them.
In this workshop she will demonstrate the "6 tests," a new model for stabilization of single children. Stabilization includes motivation, psycho-education, creating a safe place, the activation of attachment system, tools for self-regulation, the exchange
In this workshop she will demonstrate the "6 tests," a new model for stabilization of single children. Stabilization includes motivation, psycho-education, creating a safe place, the activation of attachment system, tools for self-regulation, cognitive changes, etc.. "6 test" helps the therapist to decide if the child requires additional stabilization and how to prepare before starting EMDR.
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.
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 .
This is an uncontrolled field study of the outcome effects
of a somatically based therapy with tsunami victims in
southern India. One hundred and fifty (150) participants,
prescreened for trauma symptoms, received 75
minutes of somatic therapy and training in affect modulation
and self-regulation. The results indicate a reliable
and significant treatment effect at immediate, 4-week, and
8-month follow-up assessments. At the 8-month follow-up,
90% of participants reported significant improvement or
being completely free of symptoms of intrusion, arousal,
and avoidance. The results support the effectiveness and
reliability of this modified version of Somatic
Experiencing Therapy in working with trauma reactions
and invite future controlled trials of this therapy.
Since official recognition of post-traumatic stress a number of ways. These include intrusive recollections, indicated by nightmares or “flashbacks” to the event, avoidance of stimuli associated with the trauma, and increased arousal (DSM-III-R, 1987). Behavioural approaches have been somewhat successful in treatment (e.g.., Cooper & Clum, 1989; Keane & Kalouped, 1982) however, such methods have been time consuming, require intense effort by the patient, and symptom improvement can be slow.
A phased model of treatment is recommended for the treatment of people who have experienced repeated and multiple traumas and who may still be facing ongoing stress and threat. Establishing a sense of safety and stability is the first stage of treatment before any exposure work can begin. This can be particularly challenging when treating refugees with complex PTSD presentations. This interactive workshop will explore treatment approaches to establishing a sense of safety and stability in preparation for trauma focused therapy. Case examples of torture survivors, victims of trafficking and domestic abuse will be presented to illustrate some of the difficulties in this stage of treatment and interventions.
The workshop will promote an understanding of:
•Complex PTSD presentations in refugees and asylum seekers
•Stabilisation and symptom management in preparation for trauma focused interventions
•Managing dissociative flashbacks, dissociative seizures and sensory/physical flashbacks
•Cognitive techniques for managing shame, guilt and self blame which may be barriers to exposure work
•How best to work with trauma memories and when to use NET, CBT or EMDR
•Cultural considerations
•Managing vicarious traumatisation and self care
The stabilization and treatment of young dissociative
children can be complicated. Providing the child with a safe
environment and attachment figure is obviously the first step.
But what's next? They can appear to function relatively well.
Their avoidance strategies seem effective and they refuse to
talk about trauma or say they forgot about it. It doesn't bother
them anymore. But the temptation of the therapist to let sleeping
dogs lie is a dangerous one.
Underneath this apparently well-functioning outside the child
is terrified, constantly alert, and lonely, unable to find comfort,
This child cannot attach and this lack of safe attachment is devastating
for future development. However, only detailed history
taking from caregivers and schoolteachers will often reveals
these otherwise often hidden problems.
In this presentation 1 will demonstrate. The six tests, a new and
unique stabilization model for children. The six tests help therapy
is to decide whether a child needs further stabilization and
how to establish this stabilization, before starting with EMDR. I
will present some cases to illustrate this process and the use of stabilization techniques. The children need to learn self-regulation
skills to reduce stress. Then we activate the attachment
system, so they car, reduce stress by seeking comfort. In this
way the need to dissociate reduces. By relating present problems
to past experiences their motivation increases to look into
their traumas and start EMDR, (but only on their request). Finally,
I will discuss adjustments in the EMDR protocol for these
dissociative children in order to keep them in the desensitization
process and how to integrate the use of EMDR Into the complete
phase-orientated treatment.
Learning objectives:
-The basic tenets of the six tests
-The ability to critically consider whether a child needs further
stabilization or can start EMDR.
- Understanding which techniques to utilize for particular conditions, through case presentations and questions.
New and unique: This model is an adjustment for children of
The tree test (Spieling, 2008) for adults, which is unique and
new. Up until now, many EMDR therapists don't treat these children,
because they are afraid to destabilize them or don't know
how to do it. With this model I hope they start to treat these
children who need EMDR the most.
In EMDR, as in Pyschotrauma Therapy in general, it is important neither to ask too much of the client, which leads to re-traumatization and a breakthrough of necessary dissociative barriers, nor to ask too little of the client, which in turn could increase avoidance.
Specialists should be able to tailor their interventions well, in accordance with the needs of the clients. Resource activation and trauma processing should be in an appropriate balance, keeping in mind that the most important thing is to let the client be in charge and "keep out of the way" of his or her process as much as possible.
The neurological background of balancing work with traumatic memories and resources lies in promoting effective and permanent links between the neuronal trauma network and one or more corresponding resource networks.
A process-oriented model will be shown during the workshop, which does just that, as well as taking the different stages of trauma treatment with EMDR into consideration. An experimental EMDR-Protocol will be explained and practiced, which directly connects resource activation and processing of trauma in accordance with the AIP Model.
It is the presenter's goal to clearly show how the integration of resources can greatly accelerate processing. It is imperative, however, that the use of these resources is not random, but oriented towards the specific needs of the client at that specific point in time while giving attention to how much resource or trauma is activated.
Some clients, because of very difficult life experience, have low affect tolerance; that is, they are unable to endure, even briefly, their own intensely disturbing post-traumatic images and affect. For these clients, the therapeutic benefits of EMDR are blocked because of an automatic response of overwhelming terror or disorientation, often accompanied by a loss of objectivity or adult perspective. For these individuals, the experience is not so much one of remembering, but of emotionally reliving their trauma. Understandably, when this occurs, the client may being to “numb out,” dissociate, or consciously avoid thinking of the material.
La notion de Stress figure en tant qu’Etat de stress post-traumatique (F43-1) et Réaction aiguë (F43-0) dans la nomenclatures diagnostiques internationales des troubles mentaux, comme le DMS IV ou la CIM-10. Pourtant, l’expérience clinique indique que la pathologie psychotraumatique ne peut se limiter à un Etat de stress post-traumatique (ESPT) avec ou sans Trouble dissociatif (F44), ni méme à un ESPT complexe ou DESNOS (Disorder of Extreme Stress Not Otherwise Specified).
Le rôle de l’impact tramatique discrimine la pathologie consécutive au stress et la pathologie psychotruamatique qui est << une réponse differée our prolongée a une situation ou à un evénemént stressant (de courte ou de longue durée) exceptionnellement menaçant ou catastrophique et qui provoquerait des symptômes évidents de détresse chez la plupart des individus […]>> selon la CIM-10.
Cette intervention fait le point des recherches, sur la fonctionnement du systéme limbique notamment, et des connaissances cliniques recéntes concernant le rôle del la dissociation périttraumatique et des troubles dissociatifs ultérieurs dans la pérnnisation des troubles psychotraumatiques.
The concept of stress is as a state of posttraumatic stress disorder (F43-1) and acute reaction (F43-0) in the international diagnostic classifications of mental disorders, such as the DMS-IV or ICD 10. However, clinical experience indicates that the pathology psychotraumatic can not be limited to a Posttraumatic Stress Disorder (PTSD) with or without dissociative disorder (F44), or even a complex PTSD or DESNOS (Disorder of Extreme Stress Not Otherwise Specified).
The role of impact tramatique discriminates consecutive stress pathology and pathology psychotruamatique is "a delayed response o prolonged a situation or a stressful event (short or long term) of an exceptionally threatening or catastrophic nature and cause of obvious symptoms of distress in most people [...]>> ICD-10.
This intervention provides an update on research on the functioning of the system including limbic, and recent clinical knowledge regarding the role périttraumatique del dissociation and dissociative disorders later in pérnnisation psychotraumatic disorders.
Participants will be able to: 1) analyze how stroke effects brain function particularly in regards to dissociative disorders and traumatic memory recall; 2) assess the appropriate use of EMDR with a stroke victim; and 3) evaluate whether or not the reduction of traumatic intrusion is assisting in the recovery of the stroke.
The willingness of a victim to re-experience trauma through the use of words and felt emotion, to approach rather than avoid the experience under conditions of safety, is generally associated with the resolution of the trauma (Van der Kolk 2002, Harbour & Pennebaker, 1992). This is usually considered an essential prerequisite for successful therapy. In this paper I would like to consider two associated areas, those of control and the role of semantic processing as they relate to the conduct of brief therapy under adverse conditions in cases where there remain high levels of avoidance.
The aim of this paper is to illustrate a self-reparation
model within the framework of a supervision conducted my me.
a therapy plan was defined for my colleague whose patent’s
traumatic experience brought to light her own unresolved traumatic
material.
This innovative approach is not limited to the parallel therapy involving
both patient and therapist, but is an intervention model.
a syncletic approach integrating the standard EMDR protocol and
other contributions: the attachment theory. Freud's and Bion's
'dream-work', A, van der Kolk's and 0,van der Hart's dissociative
disorders treatment, Forgash's and Knipe's Ego States Therapy, A.
Shore's affection regulation and self-repair therapy, Eigen's vision
of damaged bonds.
Maternal abandonment was the common traumatic event. The
patient's mother abandoned him at birth in hospital, where
he remained for a year before being institutionalized and then
adopted. My colleague was abandoned by her mother when she
was one year old. The transition from supervision to EMDR was
facilitated by the vast dream material produced by my colleague;
her dreams represented targets for EMDR.
According to Eigen, dream-work addresses the damage inflicted
on the self, thus the traumas experienced, and plays a major role
in digesting the impact of events and in metabolizing emotions:
through the dreams we try to make the indigestible digestible.
Dream-work constantly reveals states of the self: dreams evolve
within damaged bonds and express the psyche's attempts to undo
the damage or to get the best from it.
EMDR shares the same objectives and tools same as dreams.
At an operational level, EMDR made it possible to analyze the
dream material and to integrate the dissociated dream material
related to the traumatic, catastrophic abandonment induced
damage. The Ego States Therapy allowed my colleague to talk
with her dissociated Ego States, to negotiate with the States a
higher behavioural model, and to free her Ego States held hostage
by others.
At the end of this journey, a dream expresses Ego States integration.
Work on the future using EMDR is concluded with these
thoughts "I want to thank you because the supervision, albeit
not therapy, was an important experience that opened up a new
space for me: the space of perspective. The beam of light crossing
the two sheaves in the dream gives a meaning to the supervision,
supervision has created a third dimension in me: the dream within
the dream. It is the vehicle, the skill to perceive this dialogue
space, intersubjective and intrasubjective, where things change.
It alleviates the feeling of being impotent. The dialectical position
enables me to speak. I am very grateful for that."
My colleague's dreams were incorporated in a dream network
and indicate the phases of EMDR induced mental digestion. My
colleague has rebuilt herself in a supervision scenario.
This study demonstrates the effectiveness of EMDR in hitherto
unthought-of areas, i.e., within the framework of supervision.
When working with a client with Dissociative Identity Disorder (DID), how does the therapist know when an EMDR protocol will lead a client through a trauma to relative safety vs. precipitate an overwhelming abreaction because of all of the trauma linked up in the associative chain?
EMDR This
advanced workshop covers six hindrances to using
EMDR with dissociative disorders and an integrated set
of solutions. Hindrances include: sudden loss of ability
to defend against dissociated memories during processing
and a tendency to over-access with insufficient
skill to express affect, etc. Safe resolutions lie in
the integration of a tactical integrationist approach to
the introduction of EMDR, plus concepts from the
structural theory of dissociation of the personality and
the clinical tool of the conference room. The workshop
will include lecture, case vignettes, sculpted role plays
with participants, and discussion.
For some clients (perhaps 10-15%),I
have found that the effectiveness of
EMDR (Level I, Level I1 version) is
blocked or hindered by defensive processes
which may or may not be conscious
or voluntary, and which function
to protect the individual against
unpleasant affect. In such instances,
it has frequently been useful to use
the 0-10 scale to measure aspects of
experience other than unpleasant affect.
This is similar to the Level of
Urge (LOU) innovation designed by
Popky (1994) and used as part of his
protocol for the treatment of substance
addictions.
Most clients who enter therapy do not have a simple problem of a single disturbing memory. More typically, clients come to therapy with a mixed presentation, of not only emotional disturbance, but also a history of conscious or unconscious choices about how best to soothe, contain, or avoid that disturbance. When the client has a problem that includes positive and negative affective components, we could say (in the language of Shapiro's Adaptive Information Processing Model) that the chain of experiential associations -- the dysfunctionally stored memory network -- has positively valued experience at the entry point into the network and disturbing material at other, less accessible places. Clients often experience this situation as one of conflicting ego states. Specifically, one ego state may be positively emotionally invested in an outcome that is an obstacle to the person's larger life goals. When this happens and the usual EMDR method of targeting negative affect is stalled, it may be useful to target the positive side of the issue, that is, an image that has a positive emotional valence. Such clients are asked to hold in mind the enjoyable aspects of a problematic wish or identity while engaging in Dual Attention Stimulation (DAS). In this way, they can process these positive aspects, "disinvest" from the problem, and go on to resolve the conflict. Several session transcripts illustrate how this approach can work in practice. [Adapted from Text, pp. 189-190]
This workshop describes the various uses of chronological autobiographical memory cues (temporal sequencing) to restore the sense of ‘continuity of being’ disrupted by trauma:
1. To facilitate readiness for EMDR processing when a client is avoidant to accessing memory, or is likely to become hyper-aroused, by creating felt distance in time from the time of the trauma to the present.
2. To securely close an incomplete EMDR session.
3. To improve the clients’ present groundedness both in the session, and to improve their general level of groundedness, making them less vulnerable to intrusions and avoidance.
4. To build sufficient ego-strength and empowerment for secure processing and integration of traumatic memory.
Chronically traumatized clients with complex dissociative disorders need careful preparation. There is currently consensus that the EMDR standard protocol needs to be modified for chronically traumatized clients, as it may destabilize them. Thus, the therapist needs to have a good understanding of the dissociative personality structure that exists in their clients, the dissociative parts, their strengths and deficits, and their interrelationships. Using the framework of phase-oriented treatment and the theory of structural dissociation of the personality, this workshop will help participants understand the preparatory work necessary before integrating traumatic memories and discuss important procedural considerations for each phase of EMDR.
Objectif: présenter les résultats d'une étude réalisée dans le cadre du traitement des victimes de la route. Nous avons fait la distinction entre les sujets qui ont présenté un (complet n = 16) ou une forme partielle (n = 8) du syndrome de stress post-traumatique (définie par la présence de grappes A et B et l'un des groupes C ou D ).
Sujets: Toutes les victimes (âge moyen: 34,3, s = 4,19; 17 hommes et 7 femmes) ont subi une thérapie EMDR pour quatre séances de 90 minutes. Les sujets ont été inclus dans le projet thérapeutique de 18 mois et ont été suivis pendant 6 mois après la fin de la thérapie.
Procédure: Les sujets ont été envoyées par différentes associations de victimes de consulter l'un des auteurs qui ont pris en charge tous les traitements, après la première consultation, une proposition a été faite au sujet de faire partie d'un protocole de recherche. Après des explications ont été données au diagnostic (complet vs partielle SSPT) a été faite par les deux autres co-auteurs qui ont également participé à l'évaluation des différentes phases.
Les sujets devaient ensuite répondre aux questions de l'échelle d'impact de l'événement d'Horowitz (Horowitz et al, 1979) et la State-Trait Anxiety Inventory - STAI (Spielberger et al 1983). Dans le cadre du protocole thérapeutique, les sujets devaient faire une évaluation SUDS (Wolpe, 1990) qui mesure l'état de détresse concevable par le patient, évalué sur un formulaire échelle de 0 (aucun) à 10 (le pire). Ces différentes mesures ont été administrés à tous les sujets avant de commencer le traitement (T1), après quatre séances de l'EMDR (T2), et six mois plus tard (T3).
Principaux résultats: En raison de la petite taille de l'échantillon et une distribution non normale, les données ont été traitées avec des tests non paramétriques (Mann et Whitney pour les groupes indépendants et de Wilcoxon pour les mesures appariées). [Tableau 1 de l'étude des données du Programme de la conférence originale abstraite ne figurent pas ici.]
Les différences entre le prétest, post-test et l'évaluation après six mois sont montrés également très importante, indiquant un effet très positif avec l'EMDR sur la réduction des symptômes intrusifs et d'évitement. Les effets positifs du traitement sur l'anxiété de la victime peuvent également être des notes, ainsi que sur la réduction de la mousse.
Objective: To present the results of a study carried out in the framework of treating road victims. We have made the distinction between the subjects who presented a complete (n=16) or a partial form (n=8) of post-traumatic stress disorder (defined by the presence of clusters A and B and one of the clusters C or D).
Subjects: All the victims (mean age: 34.3, s=4.19; 17 men and 7 women) underwent EMDR therapy for four 90 minute sessions. The subjects were included in the therapeutic project for 18 months and were followed for 6 months after the end of the therapy.
Procedure: The subjects were sent by different associations of victims to consult with one of the authors who took charge of all of the treatments, After the first consultation, a proposal was made to the subject to be part of a research protocol. After explanations were given the diagnosis (complete vs. partial PTSD) was made by the other two co-authors who also participated in evaluations of the different phases.
The subjects then had to answer questions from Horowitz’s Impact Event Scale (Horowitz et al, 1979) and the State-Trait Anxiety Inventory – STAI (Spielberger et al 1983). In the framework of therapeutic protocol, the subjects had to do a SUDS evaluation (Wolpe, 1990) which measures the state of distress conceivable by the patient, evaluated on a scale form 0 (none) to 10 (the worst). These different measures were administered to all of the subjects before beginning the therapy (T1), after four sessions of EMDR (T2), and six months later (T3).
Main results: Because of the small size of the sample and a non-normal distribution, the data was processed with non-parametric tests (Mann and Whitney for the independent groups and Wilcoxon for the paired measures). [Table 1 of study's data from the original Conference Program abstract not included here.]
The differences between the pretest, the posttest and the evaluation after six months are shown to be equally very significant, indicating a very positive effect with EMDR on the reduction of intrusive symptoms and avoidance. The positive effects of the treatment on the victim’s anxiety can also be notes, as well as on the reduction of the SUDS.
La dissociation c’est… définition
Definition du DSM-IV-TR (APA 2000): « une rupture des fonctions
habituellement intégrées de la conscience, de la mémoire, de l’identité
ou de la perception de l’environnement »
Ne contient pas d’éléments somatoformes, comme des fonctions de
contrôle moteur ou de sensations physiques
Moreau de Tours (1845): dissociation comme un phénomène de
désagrégation psychique
Pierre Janet (1907): « …une maladie de la synthèse personnelle. » « Une
forme de dépression mentale caractérisée par la rétraction du champ de
la conscience et une tendance à la dissociation et à l’émancipation des
systèmes d’idées et des fonctions que constitue la personnalité. »
19e siècle: concepts de dissociation de la personnalité et dissociation de
conscience sont utilisés conjointement
Van der Hart, Nijenhuis & Steele (2006): il s’agit d’un « manque
d’intégration parmi deux ou plusieurs sous-systèmes psychobiologiques
de la personnalité, comme système entier, ces sous-systèmes endossant
chacun au moins un sens de Soi rudimentaire. » [Extrait]
The separation is ... Definition Definition of DSM-IV-TR (APA 2000), "a breakdown in the usually integrated functions of consciousness, memory, identity or perception of the environment" Do not contain any somatoform, as functions of motor control or physical sensations Moreau de Tours (1845): dissociation as a phenomenon of psychic disintegration Pierre Janet (1907): "... a disease of personal synthesis. "" A form of mental depression characterized by retraction of the field of consciousness and a tendency to dissociation and emancipation of the systems of ideas and functions that constitute personality. " 19th century concepts of dissociation of the personality and dissociation of consciousness are used in conjunction Van der Hart, Nijenhuis & Steele (2006): This is a" lack of integration among two or more subsystems psychobiological personality, as the entire system, these subsystems endorsing each at least a rudimentary sense of self. "[Excerpt]
For those clients who are suffering from Complex PTSD, especially those whose condition originates in childhood abuse or neglect,
dissociation is likely to be part of the presenting clinical picture. To the extent that dissociation is occurring, the healing power of EMDR
may be blocked, and more importantly, the use of the standard EMDR protocol may put the client at risk for a non-therapeutic dissociative
abreaction.
This is a case study of a 17 year old adolescent who came in contact with Child and adolescent psychiatry at an inward basis, screening for dissociation gave very high dissociative symptom on Dis-Q-Sweden; 3.6 total scale, 3.88, 4.00, 2.64 and 3.5 on the subscales, she also had high scores on Trauma Symptom Checklist for Children. After screening a SCID- interview was done and she had symptoms of amnesia, derealizaition, depersonalization and identity confusion.
We will describe the psychotherapy with this adolescent girl, different stages of therapy individual work – with tf-cbt- EMDR and symboldrama-, family work with much work with not before worked with traumatic experiences. In the presentation we will connect to attachment theories of dissociation, dissociation in a generational perspective and theories of multimodal approach to dissociation.
o abstract available.
No abstract available.
Introducción:
La desensibilización y reprocesamiento por movimientos oculares (EMDR) es un
abordaje psicoterapéutico que acelera el tratamiento de diversas patologías fóbicas y
traumáticas, especialmente del Trastorno por estrés postraumático (TEPT). En el abordaje
de duelos traumáticos , derivados de una situación excepcionalmente impactante para el
paciente, puede prevenir el desarrollo de un TEPT grave. Se pretende realizar una investigación sobre cómo una intervención temprana y
breve con EMDR en un caso de síndrome por estrés agudo reactivo a duelo puede paliar
los síntomas característicos del TEPT y complicaciones psicológicas del duelo. Permitiendo
la elaboración temprana de la situación traumática para que no devenga patológica en el
futuro.
Material y métodos
Paciente de 50 años diagnosticada de estrés agudo reactivo a duelo que acude a
consulta de salud mental por muerte brusca de su pareja en una situación violenta y muy
traumática.
Método: 2 sesiones de EMDR en dos semanas (sesiones de 90 minutos).
Instrumentos: Escala de gravedad del TEPT (Echeburúa), Escala de depresión de
ZUNG y Escala de ansiedad‐estado (STAI).
Resultados:
Se observa mejoría significativa en Escala de gravedad del TEPT, con disminución en
síntomas de reexperimentación, evitación y aumento de la activación. Se aprecia un leve
incremento en síntomas ansioso‐ depresivos más característicos de un proceso de duelo
normal.
Conclusiones:
Con el tratamiento con EMDR podemos reducir los síntomas del TEPT, así como la
prevención de un duelo patológico. Que el paciente sea derivado tempranamente a la
unidad de salud mental, y que se intervenga con esta herramienta, puede ser un recurso
muy valioso, rápido y breve con unos beneficios importantes para su salud.
Introduction:
Desensitization and reprocessing eye movement (EMDR) is a
psychotherapeutic approach that accelerates the treatment of various diseases and phobic
traumatic, especially posttraumatic stress disorder (PTSD). In dealing with traumatic grief, derived from an exceptionally impressive to the patient, can prevent the development of severe PTSD.
It aims to conduct research on how early intervention and
EMDR brief in a case of acute stress syndrome, reactive to grief may alleviate the characteristic symptoms of PTSD and psychological complications of grief. Allowing early development of the trauma accrues not to be pathological in the future.
Material and methods:
50 year old patient diagnosed with acute stress reactive to grief that comes to
mental health consultation sudden death of his partner in a violent situation and very traumatic.
Method: 2 sessions of EMDR in two weeks (90 minute sessions).
Instruments: Scale of severity of PTSD (Echeburúa), Scale for Depression
Zung scale and state anxiety (STAI).
Results: Observed significant improvement in PTSD severity scale, with a decrease in
symptoms of reexperiencing, avoidance and increased arousal. It shows a slight
increase in anxiety-depressive symptoms more characteristic of a grieving process
normal.
Conclusions:
With EMDR therapy can reduce symptoms of PTSD and the
prevention of pathological mourning. That the patient be referred to early
mental health unit, and to intervene with this tool, you can be a resource
very valuable, quick and short with significant benefits to your health.
Complesso caratteristiche sintomatologiche del disturbo. Qui troviamo, mescolati tra loro, i sintomi
di ansia, panico, depressione, dissociazione, evasione, deterioramento della memoria. La Società per traumatica
Stress Studies (ISTSS) le linee guida suggeriscono alcuni passi: da un debriefing psicologico top
e la terapia cognitivo-comportamentale (CBT), seguita dal trattamento farmacologico e di alcuni altri
approcci: tecniche psico-sociale e riabilitativo, il movimento degli occhi desensibilizzazione e rielaborazione
(EMDR), ipnosi, psicoterapia di coppia e di gruppo, psychothery psicoanalitico. Nel
ultimi anni, molti dati dalla ricerca fornire consulenza per l'avvio forte CBT e farmacologiche
trattamento subito dopo il trauma (entro 72 ore) solo per gestire dissociazione peritraumatico, ad alto rischio
fattore per lo sviluppo di PTSD. Inoltre, quando si avvicina al trattamento del PTSD, è
importante prendere in considerazione altre comorbidità con asse I e II e con disturbi abuso di sostanze.
Complex symptomatological features of the disorder. Here we find, mixed up together, symptoms
of anxiety, panic, depression, dissociation, avoidance, memory impairment. The Society for Traumatic
Stress Studies (ISTSS) guidelines suggest some steps: on the top psychological debriefing
and cognitive-behavioral therapy (CBT), followed by pharmacological treatment and some other
approaches: psychosocial and rehabilitative tecniques, eye movement desensitization and reprocessing
(EMDR), hypnosis, couple and group psychotherapies, psychoanalitic psychothery. In the
last years, many data from the research give strong advice for starting CBT and pharmacological
treatment soon after trauma (within 72 hours) just to manage peritraumatic dissociation, high risk
factor for the development of PTSD. Moreover, when approaching to the treatment of PTSD, it’s
important to consider comorbidity with other axis I and II disorders and with substance abuse.
La tesi “Trauma da abuso e EMDR: presentazione di una ricerca in corso” mira ad
esplorare il trauma in un’ottica sia psicologica che neurobiologica. Recenti ricerche
dimostrano che i sopravvissuti affetti da Disturbo Post-traumatico da Stress (PTSD) non
solo manifestano dei sintomi post traumatici – come intrusività, evitamento ed arousal – ma
hanno anche livelli più bassi di cortisolo rispetto ai sopravvissuti senza Disturbo Posttraumatico
da Stress. In questa tesi viene riportato uno studio su un caso singolo nel quale
sono stati misurati i livelli di cortisolo urinario pre e post-trattamento EMDR (Eye
Movement Desensitization and Reprocessing) in una ragazzina di quindici anni affetta da
Disturbo Post-traumatico da Stress. L’obiettivo è determinare se il trattamento produce un
decremento dei sintomi, misurati attraverso una valutazione testistica, e se a questo
decremento è associato un aumento dei livelli di cortisolo urinario. I risultati indicano una
diminuzione dei sintomi che ha comportato una remissione del PTSD. Questo
miglioramento è confermato anche da un aumento dei livelli di cortisolo urinario. Questi
risultati confermano l’efficacia dell’EMDR (trattamento evidence-based) per la cura del
Disturbo Post-traumatico da Stress e suggeriscono l’utilità di includere misurazioni
neuroendocrine nella valutazione dei risultati.
The thesis “Trauma da abuso e EMDR: presentazione di una ricerca in corso” aims at
exploring the trauma from a psychological and neurobiological point of view. According to
the latest studies, trauma survivors with posttraumatic stress disorder (PTSD) have been
shown to have not only posttraumatic symptoms - as Avoidance, Intrusion and Arousal -
but also lower basal cortisol levels than in trauma survivors without PTSD. In this thesis a
single case study, in which pre and post–Eye Movement Desensitization and Reprocessing
(EMDR) treatment urinary cortisol levels have been measured in a 15-year old female with
PTSD, has been reported. The aim of this study is the assessment of the EMDR treatment
effectiveness in symptom reduction measured with psychological instruments; besides, the
assessment of the changes in the urinary cortisol levels following the symptom reduction.
Results show a symptom reduction with a PTSD remission associated with higher urinary
cortisol levels. These results confirm the EMDR treatment effectiveness with PTSD and the
utility of including neuroendocrine measures in the assessment of treatment outcome in
PTSD.
Resumen del trabajo: Trata de una paciente
mujer, de 38 años de edad, en tratamiento desde
el mes de abril de este año. Había realizado tres
tratamientos psicoterapéuticos en los últimos
años, considera que su psicoterapia actual está
estancada y quiere hacer EMDR para trabajar sus
síntomas y traumas del pasado que afectan la
relación con su marido e hijas.
Summary of work: It is about a patient
women 38 years of age, treated from
April this year. He had made three
psychotherapeutic treatments in the past
years, sees his current therapy is
stuck and want to do EMDR to work their
symptoms and past traumas that affect
relationship with her husband and daughters.
Scientific studies of EMDR have shown that it is one of the most effective
tools to treat posttraumatic stress disorder. One of the lesser known properties of
EMDR is that it also seems to be an effective psychotherapy method in a number of
disorders that have part of their origins in dysfunctional implicit memory
structures. Some of these disorders are complex trauma based disorders like
dissociative disorders and some patients with symptoms of borderline disorder
others are traumatized offenders, some forms of substance dependencies and
depressive disorders.
Many of these patients are challenging populations and some of the direct EMDR
approaches may only be partly successful.
In this workshop an overview of the new areas for the application of EMDR will be
given and participants will hear where and how EMDR can be used in a treatment
plan. Also the research status of these new approaches will be reported.
If time permits cases can be discussed too.
Los estudios científicos de EMDR han comprobado que es una de las
herramientas más efectivas en el tratamiento del trastorno por estrés
postraumático. Una de las propiedades menos conocidas de EMDR es que también
parece suponer un método de psicoterapia efectivo en varios trastornos que se
originan parcialmente en estructuras disfuncionales de la memoria implícita.
Algunos de estos trastornos son trastornos basados en el trauma complejo, como
los trastornos disociativos y algunos casos de trastorno límite de la personalidad;
también se pueden incluir agresores traumatizados, algunas formas de
dependencias de sustancias y trastornos depresivos.
Muchos de estos pacientes suponen poblaciones de especial dificultad y algunos de
los abordajes directos con EMDR pueden tener un éxito únicamente parcial.
Este taller ofrecerá una perspectiva global de las nuevas áreas de aplicación de
EMDR y se les explicará a los participantes en qué casos y cómo se puede utilizar
EMDR en un plan terapéutico. También se informará respecto al estado de la
investigación de estos nuevos planteamientos.
Si hay tiempo, también se podrán presentar algunos casos.
Either
in
acute
or
chronic
diseases,
medical
interventions,
in
adults
and
kids,
might
be
potentially
traumatic.
This
can
be
named
"Medical
Trauma".
In
kids
this
can
disrupt
attachment
process.
Frequently,
psychotherapists
must
take
part
of
interventions
and
decisions
in
a
short
time.
Clinical
cases,
in
adults
and
kids,
following
EMDR
model
will
be
presented
considering:
•
Medical
Trauma
definition
and
its
vulnerability.
Attachment
disruption.
Dissociative
symptoms.
•
EMDR
intervention
model
(presentation
the
protocol)
•
Therapeutic
bond
•
Incidents
in
therapist
in
these
situations.
Resources
and
obstacles.
Tanto
en
enfermedades
agudas
o
crónicas,
las
intervenciones
medicas
en
niños
y
adultos,
pueden
ser
potencialmente
traumáticas.
Esto
puede
ser
llamado
como
“Trauma
Medico”
De
esta
forma
puede
perturbar
el
proceso
de
apego.
Frecuentemente,
los
psicoterapeutas
deben
tomar
decisiones
rápidas
como
parte
de
la
intervención.
Casos
clínicos,
en
niños
y
adultos,
siguiendo
el
modelo
de
EMDR
serán
presentados
considerando:
• Una
definición
de
trauma
médico
y
sus
riesgos.
Perturbación
del
Apego.
Síntomas
disociativos
• Modelo
de
intervención
EMDR
(Presentación
del
protocolo)
• Lazo(relación)
terapéutico/a
• Incidentes
de
los
terapeutas
ante
estas
situaciones.
Recursos
y
obstáculos.
Eye Movement Desensitization and Reprocessing (EMDR) is a
widely used and acknowledged treatment modality for PTSD but
is still in its experimental phase for other disorders, such as BDD.
With EMDR, the vividness and emotionality of unpleasant mental
representations, which resulted from one or more traumatic
events can be, reduced (Günter & Bodner, 2008). BDD patients
often report traumatic events preceding the development of BDD
and intrusive images referring to these events (Osman, et al.,
2004). Brown et al., (1997) were the first to treat BDD patients
for their traumas, using EMDR. The results of their case series
were promising but lacked a theoretical base. The learning
theoretical model of BDD provides a strong base for the selection
of interventions for individual patients and the application of
EMDR. This presentation outlines how to select the essential
target memories for EMDR treatment in BDD patients. One way is
to order etiological and/or aggravating events meaningfully on a
time line and select those memories for processing which
preceded an increase in BDD symptoms. The other way is to select
targets related tot anxious expectations and avoidance behaviour.
Video fragments illustrate the EMDR process in a BDD patient.
Although
most
patients
respond
well
to
EMDR
treatment,
those
with
dissociative
disorders
often
become
more
fragmented:
they
experience
flooding
of
memory,
or
they
become
disconnected
and
numb.
Faced
with
the
dissociative
patient
who
cannot
tolerate
emotions,
who
cannot
manage
self-‐destructive
impulses,
differentiate
past
and
present,
or
create
a
Safe
Place—is
there
any
way
that
EMDR
can
be
helpful?
The
answer
is,
“Yes.”
With
an
understanding
of
post-‐traumatic
neurobiology
and
the
Structural
Dissociation
model,
the
responses
of
dissociative
disorder
patients
to
EMDR
become
logical
rather
than
surprising.
If
we
understand
their
purpose
and
meaning,
we
can
better
address
the
responses
that
interfere
with
successful
EMDR
processing.
Then
if
we
use
simple
body-‐centered
interventions
drawn
from
Sensorimotor
Psychotherapy
that
modulate
autonomic
arousal
and
address
the
needs
and
fears
of
each
part
of
the
personality,
EMDR
treatments
can
help
even
our
most
de-‐stabilized
and
dissociative
clients.
This
workshop
will
introduce
a
neurobiological
model
for
understanding
how
and
when
EMDR
treatments
can
be
effective
even
with
dysregulated
and
dissociative
clients
and
offer
an
introduction
to
Sensorimotor
Psychotherapy,
a
body-‐centered
therapy
developed
specifically
to
treat
post-‐traumatic
symptoms.
Participants
will
be
taught
simple,
body-‐centered
interventions
that
can
be
woven
into
both
trauma
processing
and
Resource
Development
protocols.
Using
lecture,
videotape,
session
demonstration
and
actual
practice,
participants
will
have
an
opportunity
to
integrate
these
simple
but
effective
techniques
into
their
EMDR
practice.
Si
bien
la
mayoría
de
los
pacientes
responden
bien
al
tratamiento
con
EMDR,
con
frecuencia
aquellos
que
sufren
trastornos
disociativos
se
vuelven
más
fragmentados:
sienten
una
inundación
de
la
memoria
o
se
vuelven
desconectados
y
“anestesiados”.
Ante
el
paciente
disociativo
que
no
es
capaz
de
tolerar
las
emociones,
que
no
puede
gestionar
los
impulsos
auto-‐destructivos,
distinguir
entre
pasado
y
presente
o
crear
un
Lugar
Seguro,
¿existe
alguna
manera
en
la
cual
puede
resultar
útil
EMDR?
La
respuesta
es,
“Sí.”
Con
una
comprensión
de
la
neurobiología
post
traumática
y
del
modelo
de
disociación
estructural,
las
respuestas
de
los
pacientes
con
trastorno
disociativo
a
EMDR
se
vuelven
lógicas
en
lugar
de
sorprendentes.
Si
entendemos
su
propósito
y
significado,
estaremos
mejor
situados
para
abordar
las
respuestas
que
interfieren
con
el
éxito
del
procesamiento
con
EMDR.
De
ahí,
si
aplicamos
intervenciones
sencillas
centradas
en
el
cuerpo
derivadas
de
la
psicoterapia
sensoriomotriz
que
modulan
la
excitación
autonómica
y
abordan
las
necesidades
y
miedos
de
cada
parte
de
la
personalidad,
los
tratamientos
con
EMDR
pueden
ayudar
a
nuestros
clientes,
incluso
a
los
más
desestabilizados
y
disociativos.
Este
taller
introducirá
un
modelo
neurobiológico
para
comprender
el
cómo
y
cuándo
los
tratamientos
basados
en
EMDR
pueden
resultar
efectivos
aún
en
los
clientes
desregulados
y
disociativos
y
ofrece
una
introducción
a
la
psicoterapia
sensoriomotriz,
una
terapia
que
se
centra
en
el
cuerpo
desarrollada
específicamente
para
tratar
los
síntomas
post-‐traumáticos.
Se
les
enseñará
a
los
participantes
intervenciones
sencillas
y
centradas
en
el
cuerpo
que
pueden
entretejerse
en
los
protocolos
tanto
de
procesamiento
del
trauma
como
de
desarrollo
de
recursos.
Mediante
la
conferencia,
vídeos,
demostraciones
de
sesiones
y
prácticas
reales,
los
participantes
tendrán
la
oportunidad
de
integrar
estas
técnicas
sencillas
a
la
vez
que
efectivas
en
su
ejercicio
de
EMDR.
What
is
the
relationship
between
trauma,
dissociation
and
psychosis?
In
this
talk,
I
will
discuss
links
between
the
historical
concept
of
schizophrenia
and
dissociation,
the
meaning
of
‘psychosis’,
and
interpretations
of
psychotic
symptoms
from
a
trauma/dissociation
perspective.
It
is
proposed
that
auditory
verbal
hallucinations
or
‘voices’
are
dissociative
in
nature,
and
that
other
psychotic
symptoms
may
be
related
to
traumatic
experiences
in
a
variety
of
ways.
¿Cuál es la relación entre
trauma,
disociación
y
psicosis?
En
esta
charla
se
abordarán
los
puntos
de
conexión
entre
el
concepto
histórico
de
esquizofrenia
y
disociación,
el
significado
de
‘psicosis’
y
las
interpretaciones
de
los
síntomas
psicóticos
desde
una
perspectiva
de
trauma/disociación.
Se
propone
que
las
alucinaciones
auditivas
verbales
o
‘voces’
son
de
naturaleza
disociativa
y
que
otros
síntomas
psicóticos
pueden
estar
relacionados
de
distintas
maneras
con
experiencias
traumáticas.
A high proportion of patients in child and adolescent psychiatry with significant dissociative symptomatology after early childhood traumatization may go undiagnosed, be wrongly diagnosed and/or inappropriately treated. The diagnostics and treatment of dissociative disorders have been limited by lack of comprehensive, reliable and valid instruments and the ongoing polarization and fierce controversy regarding treatment. However, recent neurobiological findings of neurochemical, functional and structural cerebral consequences of early stressful childhood experiences point out a need for active, early and effective identification and treatment interventions. We present an update on assessment tools available in the Nordic countries, and an overview of different appropriate therapeutic intervention models for children and adolescents. A systematic overview of studies of dissociation in children and adolescent published over the last decade disclosed a total of 1019 references. The 465 papers describing aspects of assessment tools and/or treatment were studied in detail. Reliable and valid screening questionnaires and diagnostic interviews for children and adolescents now allow for effective early identification of dissociative disorders. A combination of individual psychotherapy, pharmacotherapy and family therapy are often required to handle dissociative disorders in children and adolescents. Cognitive-behavioural therapy, hypnotherapy, Eye-Movement Desensitization-Reprocessing (EMDR), psychodynamic therapy and an integrated approach are the main described psychotherapeutic approaches, but treatment of dissociation in children and adolescent does not require allegiance to any one particular treatment model. However, achievement of physical safety by providing a safe environment is a primary goal that supersedes any other therapeutic work. Assessments tools are now available, and appropriate therapeutic intervention models may hopefully contribute to reduce the risk of wrong diagnoses and inappropriate treatment of dissociative symptomatology in children and adolescents. However, controlled clinical trials of the various interventions and longitudinal outcome studies are needed.
Dissociation is the result of overwhelming trauma. The major feature of patients with Dissociative Disorders is a disturbance or alteration in the normally integrative functions of identity, memory, or consciousness (American Psychiatric Association, 1987). “The task of psychotherapy is to re-associate disrupted memory patterns, to restore a continuity of consciousness, and to assimilate the patient’s identity into a unified whole” (Steele, 1988, p. 151).
Travma sonrası stres bozukluğu tanılı hastada göz hareketleri ile duyarsızlaştırma ve
yeniden işleme (EMDR) tedavisi: Olgu sunumu
Travma sonrası stres bozukluğu (TSSB), kişinin aşırı bir travmatik stresörle karşılaşmasından, yaşamasından
veya duymasından sonra, olayların kişiye sıkıntı veren bir biçimde yeniden yaşanması, kaçınma örüntüsü,
duygulanımda küntlük ile birlikte otonomik, disforik ve bilişsel bulguların değişik derecelerde bulunması ile
belirli bir ruhsal bozukluktur.
EMDR’nin TSSB’da etkililiği kanıtlanmış psikodinamik, bilişsel, davranışsal ve danışan merkezli yaklaşımlar gibi çok
iyi bilinen farklı yaklaşımların öğelerini bir araya getiren psikolojik bir tedavi yöntemidir.
Bu yazıda geçirdiği trafik kazası sonrasında Travma sonrası stres belirtileri gösteren vakamızın Göz Hareketleri
İle Duyarsızlaştırma ve Yeniden İşleme (EMDR) yöntemi ile tedavisi süreci ve klinisyenlerce Travma sonrası
stres bozukluğu vakalarında bu yöntemin daha sık ve yaygın bir şekilde kullanılmasının gerekliliği tartışılacaktır.
Post-traumatic stress disorder (PTSD) is a psychiatric disorder that is characterised with autonomic, dysphoric and cognitive signs together with affective numbing, distressed reexperiencing and avoidance from previous traumatic events at a person who has encountered, lived or heard an excessive traumatic event. EMDR is a psychological method which has proven to be effective and it brings together elements of well established approaches such as psychodynamic, cognitive, behavioral and client-centered approaches. In this paper treatment process with Eye Movement Desensitization and Reprocessing (EMDR) of a case who shows signs of post-traumatic stress disorder after a car accident and the need for using this method by clinicians more frequent and widespread at post-traumatic stress disorder patients will be discussed.
This workshop will focus on the integration of EMDR and
Ego State Work in the treatment of highly traumatized
clients with complex diagnoses, including dissociative
disorders and complex PTSD. People suffering with these
problems often require an extensive preparation phase to
develop a therapeutic relationship and deal with stabilization,
affect regulation, dissociative symptoms and resistance.
Integrating Ego state work with EMDR in this expanded
protocol achieves more extensive goals than merely elimination
of PTSD and dissociative symptoms
Working from a position of empathy and understanding
of the legacies of trauma, loss and attachment disruption,
we help our patients resolve their critical issues and develop
a blueprint for living.
Clear theoretical basics, technical innovation and practical
strategies for incorporating EMDR and Ego StateWork
will be provided through lecture, demonstration, experiential
work/practicum and case presentations.
Participants will learn:
1. The relationship of Ego State Theory to the Adaptive
Information Processing Model.
2. The rationale for an EMDR/Ego State Integrated Phased
Treatment Model in the treatment of complex trauma.
4. Specific stabilization strategies to help clients manage
dissociation and affect dysregulation throughout the
treatment.
5. Advanced techniques and interweaves that promote resolution
within the EMDR trauma processing phase.
Using EMDR as an integrative therapeutic approach from an attachment and developmental trauma lens, this presentation will give practical strategies for treating clients with Dissociative Identity Disorder (DID) symptoms who have experienced Ritual Abuse and Mind Control (RA/MC). Infant disorganized attachment is an important precursor to adult dissociation and perhaps even more of a predictor of Post Traumatic Stress Disorder (PTSD) than severe trauma alone (van der Kolk). RA/MC programming will be explained so the clinician understands the layers of complexity in treating these dissociative symptoms and ego states.
Therapists who choose to work with clients with dissociative identity disorder (DID) enter into the complex, confusing worlds of some of the most wounded clients they will ever encounter. For that very reason, they are the people who are most in need of our best personal and professional resources: our deepest compassion, our most enduring patience, our courage, and our best technical strategies--offered to not just one personality, but many parts of the psyche within a single individual. Those parts are at war with one another, and it is up to the therapist to show the way to peace. This chapter shares three case studies examining using EMDR, ego state therapy, and adjunct approaches to treat DID. (PsycINFO Database Record (c) 2008 APA, all rights reserved)
Patients exhibiting chronic dissociative symptoms are among the most complicated patients to be treated in psychotherapy. Their treatment tends to be a multi-faceted approach of which EMDR is only one part, albeit, a very important component.
The objective of this course is to assist the treating clinician in identifying the chronic dissociative patient, conceptualizing and implementing an effective treatment plan for the patient. This will include integrating the traditional three-stage model (stabilization, trauma work and integration) of working with patients with dissociative symptoms using the EMDR Eight Phase Treatment Model. Emphasis will be placed on stabilization and pacing the trauma work with individual patients.
This workshop format will include lecture and presentation of clinical case material. Participants are encouraged to bring clinical cases to the workshop for discussion.
Workshop Objectives:
Assess and identify clients presenting with dissociative symptoms;
•Formulate case conceptualization,
•Treatment planning to include EMDR based trauma processing,
•Integrate the 8 phases of EMDR with traditional treatment for trauma,
•Identify when clients with dissociative symptoms are ready for EMDR treatment,
•Pace the treatment, shifting between stabilization trauma reprocessing and relational work,
•Manage therapeutic complications that arise during treatment.
This study examined the efficacy of eye movement desensitization and reprocessing (EMDR) and exposure in the treatment of a specific phobia. 26 spider phobic children were treated during 2 treatment phases. During the first phase, which lasted 2.5 hr, children were randomly assigned to either (a) an EMDR group (n = 9), (b) an exposure in vivo group (n = 9), or (c) a computerized exposure (control) group (n = 8). During the 2nd phase, all groups received a 1.5 hr session of exposure in vivo. Therapy outcome measures (i.e., self-reported fear and behavioral avoidance) were obtained before treatment, after Treatment Phase 1, and after Treatment Phase 2. Results showed that the 2.5 hr exposure in vivo sesson produced significant improvement on all outcome measures. In contrast, EMDR yielded a significant improvement on only self-reported spider fear. Computerized exposure produced nonsignficant improvement. Furthermore, no evidence was found to suggest that EMDR potentiates the efficacy of a subsequent exposure in vivo treatment. Exposure in vivo remains the treatment of choice for childhood spider phobia. [Author Abstract]
Two spider phobics were first treated with Eye-Movement Desensitization and Reprocessing (EMDR) and then received an exposure in vivo session. Results showed positive effects of EMDR, but also suggest that it is especially self-report measures that are sensitive to EMDR. Improvement on a behavioral measure was less pronounced and exposure was necessary to eliminate residual avoidance behavior. This observation confirms the position of those EMDR critics who point out that EMDR effects should be documented with objective and standardized evaluation instruments (Pilots).
Two spider phobics were first treated with Eye-Movement Desensitization and Reprocessing (EMDR) and then received an exposure in vivo session. Results showed positive effects of EMDR, but also suggest that it is especially self-report measures that are sensitive to EMDR. Improvement on a behavioral measure was less pronounced and exposure was necessary to eliminate residual avoidance behavior. This observation confirms the position of those EMDR critics who point out that EMDR effects should be documented with objective and standardized evaluation instruments.
Women engaged in prostitution either domestically or in the course of being trafficked experience
trauma reflected in symptoms of Post-Traumatic Stress Syndrome (PTSD) along with other
psychological manifestations which may include significant dissociative functioning, depression
and drug addiction along with physical impairments. The author describes the psychological damage and a programmed approach which has successfully produced a more productive
lifestyle.
Reports both in Japan and in the U.S. indicate that Eye Movement Desensitization and Reprocessing (EMDR) can be effective for the treatment of PTSD and traumatic memory. This report summarizes the treatment of an attempted murder-robbery victim using EMDR. Although she responded rather poorly to the medications, the patient showed a rapid improvement with the introduction of six 90-minute EMDR sessions, as measured by the Impact of Event Scale - Revised (IES-R) and Clinician Administered PTSD Scale (CAPS). Of particular interest was that the intrusion and hyperarousal symptoms disappeared in the early stage of the treatment; in contrast, the avoidance symptoms needed several sessions for management. Given the current controversies surrounding EMDR for the treatment for PTSD, more empirical evidence is needed to establish its efficacy. [Author Abstract]
Fears and phobias associated with EMDR situations where a single event for the well-structured, and short-term treatment is not compelling. Exposure in vivo EMDR'ın cognitive behavioral interventions, such as advantages, the fear-inspiring re-creation of the situation, situation (eg, sexuality, illness or death-related moments, situations) or phobic stimuli (eg, aircraft, mouse, snake) real life should be revived. However, inspiring fear and phobia on the basis of the number of lives to be in that situation, the phobic anxiety reactions to certain situations people may continue to give. Therefore EMDR'la fear and / or while working with phobias, anxiety-fear may danışanalr work preparing for the future status should not be terminated. This adaptive coping mechanisms to obtain, provide relief to improve the mental strategies in the future will need to be placed in a behavioral patterns and behavioral experiments can be done. EMDR'ın with fear and phobia clinical applications focusing on this at the end of the study group participants: 1) consult those who fear, avoidance of situations of mold assessment, 2) in terms of EMDR cases quickly formulated, 3) for those who need counseling EMDR protocol creative format can be adapted, and 4 ) EMDR intervention for their general treatment approach (cognitive-behavioral) to integrate aims to provide skills to develop.
When earliest relationships are traumatic, attachment injuries can significantly change the trajectory of one’s life. Bonding and attachment are neurobiologically driven survival mechanisms; but when irreconcilable conflict exists within the innate mechanisms of survival and attachment, individuals can experience extreme distress leading to mental health disorders and physical disease. Although these conditions may begin in infancy, if untreated they can endure for a lifetime. Through the lens of AIP, this workshop will teach a developmentally grounded approach to treating attachment issues in clients of all ages by integrating EMDR with Erikson’s stages and the re-organization of the three-pronged approach in a Reverse Protocol (Adler-Tapia, 2012).
Participants will: 1) learn that in Bulimia Nervosa (BN) and Binge Eating Disorder (BED), food, the abused substance, provides the means for reenactment of childhood emotional trauma and how food facilitates a re-experiencng of unresolved affects assembled with the trauma; 2) learn the Chemotion/EMDR protocol; 3) learn how to apply the Chemotion/EMDR protocol to identify what affects are being re-experienced and what traumas are being reenacted through the ingestive disorder; 4) learn how to apply the Chemottion/EMDR protocol to develop resources to tolerate the affects being vicariously reenacted through the ingestive disorder; 5) learn how to apply Chemotion/EMDR protocol to desensitize and reprocess the traumas being reenacted through the ingestive disorder; 6) learn how to recognize the presence of a dissociative component in BN and BED; and 7) learn how to combine hypnosis and EMDR to treat the dissociative component in BN and BED.
Choking phobia is a specific phobia characterized by fear and avoidance of swallowing foods and liquids. It often develops following an episode of choking on food. A prospective case study of a 30-year-old woman with a phobia of choking, acquired after a series of traumatic incidents 5 years previously, demonstrates the usefulness of an approach that is aimed at processing the disturbing memories of a traumatic event. Two therapy sessions of Eye Movement Desensitization and Reprocessing (EMDR) produced a lasting decrease in symptomatology. [Author Abstract]
Patients who had taken part in a randomized clinical trial of the treatment of chronic
PTSD by either cognitive therapy or imaginal exposure were reassessed after 5
years. At 5-year follow-up a clear superiority of cognitive therapy over imaginal exposure
emerged, although there had been no difference between the two treatment
groups up to 12 months posttreatment. The cognitive therapy group showed significant
differences on the primary outcome measures: total PTSD symptoms on the
CAPS and percentage of PTSD cases. At 5 years no patients who received cognitive
therapy were diagnosed with full PTSD compared to 29% of those who received
imaginal exposure. All secondary outcomes showed lower scores for cognitive therapy,
of which 3 were significant. Those who were not assessed at 5 years scored significantly
higher on assessment measures, especially avoidance, at posttreatment.
This article describes the integration of e-mail correspondence with EMDR treatment for a woman with a fear of driving and a diagnosis of dissociative disorder, not otherwise specified (DDNOS). When the client first presented for treatment, her diagnosis was unrecognized, and treatment showed limited success. With recognition of the DDNOS diagnosis, the treatment contract was renegotiated, with the focus of therapy shifting to addressing her dissociative experiences. Therapeutic progress was being made when the course of the treatment was interrupted by war in the north of Israel, and regular meetings became impossible. Communication was maintained by e-mail correspondence. When face-to-face sessions recommenced, the e-mail therapy continued because writing had become a powerful therapeutic tool. Therapy concluded with the successful treatment of both the dissociative disorder and the fear of driving. Cautions regarding the use of e-mail therapy are provided.
There is doubt if dissociative amnesias, the forgetting
of traumatic memories, are a helpful condition for a patient or
not. Clinically especially difficult is the situation if amnesias occur
after an accident, where the condition is possibly organically
based (like in a brain injury). Often the problems that these
patients face in rehabilitation are difficult to understand and
often the interventions that usually work with brain injuries are
only partially effective.
These situation will be illustrated by two cases of severe post accident
amnesias (10 weeks and 10 months) and their treatment.
Video documentation of the cases and their EMDR treatment
will be shown and discussed. Usually effective treatments had
been ineffective in both. Both however lost their symptoms and
remember the incidents fully after trauma-specific treatment.
Both patients have been stable for a year after the termination
of treatment.
Specific phobias are more prevalent than any other group of psychiatric disorders. Given that specific phobias and PTSD share a number of important features, and that a wide array of controlled studies support EMDR's effectiveness with treatment for unprocessed events and related conditions, EMDR has also been claimed to be an effective treatment for specific fears and phobias.
This workshop focuses on EMDR as a treatment approach for a wide variety of fears and phobias. Participants will learn how: 1) to assess clients with patterns of fearful avoidance, 2) to rapidly conceptualize cases in terms of EMDR, 3) to adequately identify core targets and cognitions, 4) to use creative adaptations of the EMDR protocol for difficult clients, and 5) to integrate EMDR interventions into a general treatment approach. Many of these approaches will be illustrated by segments of video taped treatment sessions.
This presentation will focus on key factors believed to contribute to the development and maintenance of OCD: a damaged, diffuse sense of self; a perceived inadequacy to function, to meet the vicissitudes of life; and an elaborate defence system designed to offer the illusion of safety and control (avoidance of affect and action). Given the prominence of cognitive distortions and avoidance of affect in OCD, and the impact of EMDR on such phenomena as exhibited in the literature about EMDR treatment with PTSD, Whisman believes EMDR has the potential to be quite beneficial in the treatment of OCD. EMDR seems to allow the OCD client to hold a dual focus: the illusion of the disorder and the reality of the self; and to tolerate the affect accompanying this processing. Bridging past experience and present behavior, EMDR appears to allow new connections to be made that offer the client a distance form the disorder and a strengthening of the self. A model for educating the client about OCD will be presented a model whcih develops a "language" between therapist and client and bridges self and disorder; changes in the standard EMDR protocol will be presented and demonstrated via videotape; and EMDR components such as targeting, cognitive interweaves, and resource installation will be addressed. Clinical observation and client self-report are pointing to EMDR as an effective treatment component for OCD.
This presentation will focus on incorporating EMDR into the treatment of panic and phobia. Emphasis will be given to the preparation phase of EMDR: an educational model will be presented which is a necessary prerequisite to processing. A three-level approach to processing will be presented, targeting different cognitions and affect at each level. Level three includes the behavioral aspect of overcoming phobia avoidance. It is Whisman’s experience that a panic disorder can be its own origin (i.e., panic from on overdose of caffeine perpetuates itself because the client does not have the knowledge that s/he experienced a caffeine/adrenaline reaction, not symptoms of impending mental or physical catastrophe); however, panic and phobia can also be symptoms of underlying trauma, acute stress disorder, or PTSD. These distinctions will be discussed and relevant case material will be offered. Targeting, negative and positive cognitions, cognitive interweaves, and resource installation will be addressed as each level is discussed. A videotaped session will be shown: the client enters this session experiencing anxiety, dissociation, and trauma response. Clinical observation and client self-report are demonstrating that EMDR can be an effective treatment component for panic/phobia.
This study examines the effects of a psychodynamic approach of Eye Movement Desensitization and Reprocessing (EMDR) in treatment of traumatized refugee children. Among a child psychiatric outpatient refugee team, 13 children with post-traumatic stress disorder (PTSD), were treated by EMDR incorporated in a traditional psychodynamic therapeutic approach. The Posttraumatic Stress Symptom Scale for Children (PTSS-C) and the Global Assessment of Functioning (GAF) were administered before and after the treatment, to measure the effects. After treatment, a significant improvement was noticed in the functioning level and all PTSS-C scales, mostly in re-experiencing and least in the avoidance symptoms. The improvement in the functioning level was significantly correlated with the reduction of the PTSD-non-related and the depression, but not with that of the PTSD-related symptoms. Used in a psychodynamic context, EMDR is suggested to be effective treatment for traumatized refugee children. Our findings support the hypothesis of child-specific criteria for PTSD.
Objective: This study surveyed practices in treating childhood PTSD among child psychiatrists and non-M.D. therapists with self-identified interest in treating traumatized children. Method: An anonymous survey was mailed to 207 child psychiatrists ("medical") [members of the American Academy of Child and Adolescent Psychiatry] and 460 nonphysician ("non-medical") therapists [members of the International Society for Traumatic Stress Studies] inquiring about current interventions used to treat children with PTSD. Results: 247 responses were received: of 77 medical and 82 nonmedical respondents who currently treat children with PTSD, a wide variety of modalities are used. Most preferred modalities among medical responders were pharmacotherapy, psychodynamic, and cognitive-behavioral therapy. Most preferred modalities among nonmedical respondents were cognitive-behavioral, family, and nondirective play therapy. 95% of medical respondents used pharmacotherapy for this disorder; most preferred medications to treat childhood PTSD were selective serotonin reuptake inhibitors and alpha-adrenergic agonists. Several significant differences between medical and nonmedical practices were identified. Conclusions: There is little clinical consensus regarding the effectiveness of the many modalities used to treat traumatized children who have PTSD symptoms; empirical research is particularly needed to evaluate the efficacy of pharmacotherapy and EMDR. [Author Abstract]
Se aborda el caso de una paciente que sufre un TID (como consecuencia de una infancia traumática). Se presentan las principales características del caso y de los cambios que se fueron produciendo en las sesiones del tratamiento (EMDR e ICV básicamente). Se comparan los resultados con las referencias más relevantes y recientes de los trastornos disociativos y por estrés postraumático. Se discute acerca de que el TID es un diagnóstico mucho más frecuente de lo que se pensaba, instrumentos de valoración, y terapias específicas que están ofreciendo algunos resultados. Se extraen algunas conclusiones acerca de las particularidades del abordaje de este tipo de casos.
The paper addresses the clinical case of a patient suffering from DID (following a traumatic childhood). It also examines the main features of the case and the changes produced in the patient during the course of the sessions of the treatment (basically, EMDR and ICV). We correlate our results with the most recent and relevant references on dissociative and posttraumatic stress disorders. We discuss about the possibility that DID is a much more frequent diagnosis than it was believed to be; instruments of evaluation, and that new specific therapies are offering some results. Some conclusions are extracted about the peculiarities of the handling of this type of cases.
The
DSM-‐IV
description
of
narcissistic
personality
disorder
focuses
on
the
“overt”
qualities
of
narcissism
(grandiosity,
exploitation,
arrogance,
interpersonal
problems
and
rage)
while
omitting
the
less
obvious
and
more
subtle
“covert”
characteristics
(tendency
to
be
shame
sensitive,
introverted,
vulnerable,
inhibited
and
anxiety-‐prone).
A
core
characteristic
of
narcissism
is
lack
of
empathy.
While
empathy
issues
can
be
present
in
many
people
with
personality
disorders,
there
are
two
personality
disorders
that
are
more
related
with
lack
of
empathy,
and
a
(sometimes
only
apparent)
lack
of
concern
about
the
suffering
that
they
can
cause
in
other
people:
narcissist
and
antisocial
personality
disorder.
Both
types
of
personalities
share
this
self-‐centered
profile.
People
characterized
by
lack
of
empathy
and
selfishness
are
usually
considered
difficult
to
treat
and
poor
candidates
for
psychotherapy
(even
untreatable)
but
many
cases
can
be
treated
effectively
with
EMDR.
Targeting
the
roots
of
the
symptoms
is
crucial
for
an
adequate
case
conceptualization.
A
description
of
different
profiles
characterized
by
self-‐centerness,
selfish
attitude
and
lack
of
empathy
will
be
described
in
this
presentation.
These
aspects
may
be
present
in
abusers
and
victims,
in
overt
or
subtle
presentations.
To
conceptualize
EMDR
therapy
in
these
cases
it
is
important
to
understand
the
pathway
from
early
experiences
to
present
problems.
Narcissism
and
antisocial
features
can
be
final
outcomes
of
a
neglecting
environment,
chronic
abuse
or
excessive
appraisal.
Different
attachment
disturbances
with
primary
caregivers
can
lead
to
lack
of
empathy
and
self-‐centerness.
In
some
cases,
structural
dissociation
is
underlying
narcissistic
or
antisocial
features
that
can
characterize
some
dissociative
parts
of
the
personality.
All
these
aspects
and
the
complexity
of
therapeutic
relationship
in
narcissistic
and
antisocial
personalities
will
be
reviewed
in
this
presentation.
La
descripción
de
la
DSM-‐IV
del
trastorno
de
personalidad
narcisista
se
centra
en
las
cualidades
“externas”
del
narcisismo
(grandiosidad,
explotación
de
otros,
arrogancia,
problemas
interpersonales
y
rabia)
mientras
que
omite
las
características
“internas”
menos
obvias
y
más
sutiles
(tendencia
a
ser
sensitivos
a
la
vergüenza,
introvertidos,
vulnerables,
inhibidos
y
tendentes
a
la
ansiedad.
Una
característica
central
del
narcisismo
es
la
falta
de
empatía.
Mientras
que
los
problemas
de
empatía
pueden
estar
presentes
en
muchas
personas
con
trastornos
de
personalidad,
hay
dos
trastornos
de
personalidad
más
relacionados
con
la
falta
de
empatía
y
la
falta
de
preocupación
(en
ocasiones
tan
sólo
de
modo
aparente)
sobre
el
sufrimiento
que
pueden
causar
en
otras
personas:
el
trastorno
de
personalidad
narcisista
y
el
antisocial.
Ambos
tipos
de
personalidad
comparten
un
perfil
egocéntrico.
Las
personas
que
se
caracterizan
por
una
falta
de
empatía
y
egoísmo,
normalmente
son
consideradas
difíciles
de
tratar
y
malos
candidatos
para
psicoterapia
(incluso
intratables)
pero
muchos
casos
pueden
ser
tratados
de
manera
efectiva
con
EMDR.
Entender
la
raíz
de
los
síntomas
es
crucial
para
una
adecuada
conceptualización
del
caso.
En
esta
presentación
se
realizará
una
descripción
de
diferentes
perfiles
caracterizados
por
egocentrismo,
actitud
egoísta
y
falta
de
empatía.
Estos
aspectos
pueden
estar
presentes
en
agresores
y
víctimas,
de
forma
evidente
o
sutil.
Para
realizar
una
adecuada
conceptualización
de
estos
casos
desde
EMDR
es
importante
comprender
cómo
las
experiencias
tempranas
influyen
en
la
problemática
actual.
Los
rasgos
narcisistas
y
antisociales
pueden
ser
el
resultado
de
un
entorno
negligente,
de
abuso
crónico
o
de
un
exceso
de
elogio
y
refuerzo.
Los
diferentes
problemas
de
apego
con
los
cuidadores
principales
pueden
generar
una
falta
de
empatía
y
una
actitud
egocentrista.
Todos
estos
aspectos
y
la
complejidad
de
la
relación
terapéutica
en
las
personalida
In order to get a complete and comprehensive case conceptualization in Phase 1 of the EMDR protocol, it is important to explore dissociative symptomatology. In consultation a therapist often presents a “complex case” and this “complexity” has to do with dissociation. This presentation will show the many different ways dissociation can be manifested during EMDR sessions. Another goal is to give practical examples of interventions with dissociative patients during EMDR processing. Many examples of subtle manifestations (“dissociative language”) will be illustrated with video cases.
In order to get a complete and comprehensive case
conceptualization in Phase 1 of the EMDR protocol, it is important
to explore dissociative symptomatology. But the cinicai
picture of dissociation may be difficult to identify for inexperienced clinicians; some symptoms can be difficult to observe
even for experienced therapist who haven't seen severe cases.
in consultation we often find therapist who bring a 'complex
case' for supervision and quite frequently this 'complexity' has
to do with dissociation. Our goal with this presentation is to
show the many different ways dissociation can be manifested
during EMDR sessions. Another goal is to give practical examples
of interventions with dissociative patients during EMDR
processing. Many examples of subtle manifestations (what we
call 'dissociative language') will be illustrated with video cases.
Severely traumatized people don't communicate in a direct and
clear way, they have their 'own language' and in order to understand
the patient's inner world, we need to understand the
silences, the somatic symptoms the subtle (and not so subtle)
intrusions; all of these are frequent symptoms that the patient
can't detect, understand or disclose to us (not directly).
It is widely known that EMDR clinicians must be careful when
dealing with dissociative patients; techniques that can be used
during the stabilization phase have been developed for the
treatment of dissociative disorders (Knipe, Forgash .......). These
techniques are complementary to the basic protocols and are
very useful but the problem arises when therapists are not able
to identify and/or understand what we call the 'dissociative
language'.
We must keep in mind that most dissociative patients have
grown in an early environment where their needs were not taken
into account. Many never had the possibility to express their
feelings openly. For this, it is important to focus and under^
stand the indirect, complex and ambivalent communication of
these people especially during an EMDR session. The approach
to these difficulties is not only a question of protocol modifications.
but a complex learning from the therapist of the 'dissociative
language'. Several examples from videos of therapy
sessions and case descriptions will be presented.
Thanks to a European Equal project the sexually abused children who came to our Center for therapy have been treated with EMDR. We will illustrate, through the use of clinical examples, the main therapeutic issues, the difficulties and strategies in order to exceed them. In particular, we will address the following topics: the use of "menus,” the use of positive installations, how to identify targets, how to exceed the use of psychological defenses, mainly dissociative, etc. We will then highlight the advantages of using EMDR with those children.
The treatment of traumatic memories in the therapy of chronically
traumatized patients who have complex dissociative disorders needs
careful preparation and the utmost care. The standard EMDR protocol is
not sufficient for memory work with these patients, and can destabilize
them. Thus, the therapist needs to have a good understanding of the
dissociative personality structure that exists in these patients, including
dissociative parts, their strengths and deficits, and their
interrelationships. Using the framework of phase-oriented treatment and
the theory of structural dissociation of the personality, this workshop will
help participants understand essential preparatory work which has to be
completed before working through traumatic memories with EMDR, and
become more knowledgeable about using modified EMDR approaches
to work with traumatic memories in these complicated cases. The theory
of structural dissociation helps the therapist become aware of which
dissociative parts of
the personality (and their interrelationships) need to be included in the
preparation phase, which deficits need to be recognized and treated,
and which resources need to be developed for the treatment of traumatic memories to be
successful. Attention is also given to a comparative approach, i.e., guided synthesis. Both
approaches need largely the same preparation. A modified protocol of EMDR for complex
dissociation will be presented. Videos of EMDR and guided synthesis will be shown in the
workshop.
Learning objectives:
1. Participants will be able to: Describe structural dissociation and why
understanding of this phenomenon is needed for adequate treatment of traumatic
memories.
2. Apply specific modified EMDR protocols for the treatment of traumatic memories
in complex dissociation.
3. Describe the guided synthesis approach and how it differs from the EMDR
approach.


