Francine Shapiro Library ~ EMDR Bibliography

Francine Shapiro Library - EMDR Bibliography Links

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Your Results - you searched for the keyword Distancing 21 Results

1. Lee, C. W., Taylor, G., & Drummond, P. D. (2006, March-April). The active ingredient in EMDR: Is it traditional exposure or dual focus of attention?. Clinical Psychology and Psychotherapy, 13(2), 97-107. doi:10.1002/cpp.479.

Language: English

Format: Journal

Abstract:
Very little is known about the mechanisms that underlie the therapeutic effectiveness of eye movement desensitization and reprocessing (EMDR). This study tested whether the content of participants' responses during EMDR is similar to that thought to be effective for traditional exposure treatments (reliving), or is more consistent with distancing, which would be expected given Shapiro's proposal of dual process of attention. The responses made by 44 participants with PTSD were examined during their first EMDR treatment session. An independent rater coded these responses according to whether they were consistent with reliving, distancing, or focusing on material other than the primary trauma. The coding system was found to have satisfactory inter-rater reliability. Greatest improvement on a measure of PTSD symptoms occurred when the participant processed the trauma in a more detached manner. Cross-lagged panel correlations suggest that processing in a more detached manner was a consequence of the EMDR procedure rather than a measure that covaried with improvement. [Author Abstract]

Keywords: Adults Attention Australians Cognitive Processes Empirical Study Mechanism of Action Posttraumatic Stress Disorder PSTD Quantitative Study Stressors Survivors Treatment Effectiveness

Accuracy Verified: Yes

2. Lee, C. (2005, September). An analysis of critical processes and components in EMDR treatment of trauma memories. Presentation at the annual meeting of the EMDR International Association, Seattle, WA.

Language: English

Format: Conference

Abstract:
Very little is known about the mechanisms that underlie the effectiveness of EMDR. Participants will be presented with information to facilitate their understanding of two competing hypotheses to account for EMDR effectiveness. Namely, because it uses similar processes found effective in traditional exposure treatments (reliving). Alternaitvely according to Shapiro's proposal of dual process of attention, the procedure may be successful because it elicits distancing responses. Participants will be able to describe how these competing hypotheses were investigated. The responses made by 44 participants with Post Traumatic Stress Disorder (PTSD) were examined during their first EMDR treatment session. Participants will be able to describe the key process variable found to be effective in EMDR treatment of trauma memories and the extent to which this process is determined by eye movement or by therapist instructions.

Keywords: Dual Attention Mechanism of Action Reliving

Accuracy Verified: Yes

3. Stein, D., Rousseau, C., & Lacroix, L. (2004, March). Between innovation and tradition: The paradoxical relationship between eye movement desensitization and reprocessing and altered states of consciousness. Transcultural Psychiatry, 41(1), 5-30. doi:10.1177/1363461504041351.

Language: English

Format: Journal

Abstract:
Eye movement desensitization and reprocessing (EMDR) is a relatively new form of psychotherapy to emerge in the West. Using both a case analysis and literature review we situate EMDR within the use of altered states of consciousness (ASCs) in psychological healing practices across times and cultures. We discuss EMDR's unique predicament as a therapy that draws upon techniques common to most therapeutic ASCs, while at the same time distancing itself from this tradition through its pseudoscientific language and technologic aesthetic. Our conclusion attempts to shed light on this paradox and raise questions for further study.

Keywords: Altered States of Consciousness Consciousness States Psychological Healing Review Transcultural Psychiatry

Accuracy Verified: Yes

4. Lee, C. (2008). Crucial processes in EMDR - More than imaginal exposure. Journal of EMDR Practice and Research, 2(4), 262-268. doi:10.1891/1933-3196.2.4.262.

Language: English

Format: Journal

Abstract:
The processes that underlie the effectiveness of eye movement desensitization and reprocessing (EMDR) are examined by evaluating the procedural differences between it and exposure therapy. Major factors include the degree of emphasis placed on reliving versus distancing in the therapies and the degree to which clients are encouraged to focus on direct trauma experiences versus experiences associated with the trauma. Research results indicate that, unlike traditional imaginal exposure, reliving responses in EMDR did not correlate with symptom improvement. Instead, consistent with an information processing model, the degree of distancing in EMDR was significantly associated with improvement. A case study is described to highlight these methodological divergences in the respective therapies relating to reliving. Finally, the research regarding the possible sources of the distancing response within EMDR was examined. The results indicate that the distancing process was more likely to be an effect produced by eye movements than by any therapist instructions. Theoretical and research evaluations indicate that the mechanisms underlying EMDR and traditional exposure therapy are different.

Keywords: Exposure Therapy Information Processing Posttraumatic Stress Disorder PTSD Reliving

Accuracy Verified: Yes

5. van Arkel, E. P. M., & Baas, A. M. (2008, Juni). De rol van het op afstand beleven en het herbeleven in eye movement desensitisation and reprocessing (EMDR) [The role of the remote experience and relive in eye movement desensitisation and reprocessing (EMDR)]. Utrecht, Nederlands: Universiteit Utrecht.

Language: Dutch

Format: Dissertation/Thesis

Abstract:
Dit onderzoek was voor ons zowel een eerste kennismaking met Eye Movement Desensitisation and Reprocessing (EMDR) als een eerste kennismaking met het klinische werkveld. Naast het leerzame traject van het onderzoek zelf, waren deze aspecten een speciale aanvulling op onze scriptie. Wij hebben dan ook met veel enthousiasme aan deze scriptie gewerkt en ons op verschillende gebieden breder ontwikkeld. Wij zijn voornamelijk blij dat wij „op de valreep van onze studie‟ nog kennis hebben mogen maken met de behandelmethode EMDR. Het is een behandelmethode die wij in onze verdere loopbaan binnen de psychologie zeker mee zullen nemen. Onze dank gaat uit naar de therapeuten en cliënten die mee wilden werken aan dit onderzoek. Zonder deze medewerking was dit onderzoek immers niet tot stand gekomen! Daarnaast willen wij graag onze begeleidster mw. dr. H.K. Hornsveld bedanken voor het overbrengen van haar enthousiasme voor EMDR en al haar op- en aanmerkingen op ons onderzoek. Mede dankzij haar is dit onderzoek goed afgerond en is ons enthousiasme gegroeid.

This study gave us both a first encounter with Eye Movement Desensitisation and Reprocessing (EMDR) as a first introduction to the clinical field. Besides the educational process of research itself, these issues were a special addition to our thesis. We also have enthusiastically worked on this paper and our wider development in various fields. We are especially pleased that we are "at the very end of our study" may even be familiar with the EMDR treatment method. It is a treatment that in our careers in psychology will certainly take it. Our thanks go to the therapists and clients who wanted participate in this study. Without this cooperation, this research was not realized! In addition, we want our companion mw. Dr. H.K. Hornsveld thanks for transferring her enthusiasm for EMDR and all her observations and comments on our research. Partly thanks to her that this study is well rounded and our enthusiasm grew.

Keywords: Desensitization, Distancing Reliving Vividness

Accuracy Verified: Yes

6. 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

7. Lee, C. W., & Drummond P. D. (2008, June). Effects of eye movement versus therapist instructions on the processing of distressing memories. Journal of Anxiety Disorders, 22(5), 801-808. doi:10.1016/j.janxdis.2007.08.007.

Language: English

Format: Journal

Abstract:
The effectiveness of components of eye movement desensitization and reprocessing (EMDR) was tested by randomly assigning 48 participants to either an eye movement or an eye stationary condition and to one of two types of therapist instructions (reliving or distancing). Participants were university students (mean age 23) who were asked to recall a personal distressing memory with measures of distress and vividness taken before and after treatment, and at follow-up. There was no significant effect of therapist's instruction on the outcome measures. There was a significant reduction in distress for eye movement at post-treatment and at follow-up but overall no significant reduction in vividness. Post hoc analysis revealed a significant reduction in vividness only for the eye movement and distancing instruction condition. The results were consistent with other evidence that the mechanism of change in EMDR is not the same as traditional exposure.

Keywords: Empirical Study Eye Movement Follow-Up Study Quantitative Study Randomized Comparison

Accuracy Verified: Yes

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

Language: English

Format: Dissertation/Thesis

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

Keywords: Posttraumatic Stress Disorder PTSD

Accuracy Verified: Yes

9. Levin, C. (1992, July). EMDR and the treatment of partners of survivors of sexual abuse. Presentation at the Fourth World Congress on Behaviour Therapy, Queensland, Australia .

Language: English

Format: Conference

Abstract:
Although there are estimated to be millions of survivors of child sexual abuse, little has been said about the partners of these survivors and the extreme difficulties which they encounter. Awe believe that these partners are “vicarious” victims of child sexual abuse themselves. As the survivor begins to deal with the issues of his/her own sexual abuse, it catalyses experiences of guilt, shame, rage, feelings of dissociation, fear, sadness, resentment, etc. The victim’s feelings towards the family or origin and the perpetrator is both emotionally draining and reoccupying to the detriment of the current relationship. The partner may be blamed for lack of understanding and caring and, almost certainly, the quality of the sexual relationship changes for the worse. Often, as the victim bombards the partner with disparaging comments and temper tantrums, the partner may begin a process of emotionally distancing. The survivor experiences this distancing as a further injury and the relationship continues a downward spiral.

Keywords: Partners of Survivors

Accuracy Verified: Yes

10. 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:
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.

Keywords: Children Earthquake

Accuracy Verified: Yes

11. Hornsveld, H. (2008, Maart). EMDR werkt! Maar hoe? [EMDR works! But how?]. Presentatie op de derde conferentie van de Vereniging EMDR Nederland, Ede, Nederland.

Language: Dutch

Format: Conference

Abstract:
Het leidt geen enkele twijfel dat EMDR een effectieve behandelvorm is. EMDR is opgenomen in de guidelines van de International Society for Traumatic Stress Studies (ISTSS) waarbij zowel EMDR als Imaginaire Exposure (IE) als ‘treatment of choice’ bij de behandeling van PTSS gelden. Ook in de Nederlandse GGZ-richtlijnen (Trimbos Instituut, 2003) worden EMDR en imaginaire exposure (IE) genoemd als superieure behandelvormen voor PTSS. Rechtstreekse vergelijking van CGt en EMDR leverde echter wisselende resultaten op. Over het geheel genomen kan worden gesteld dat wat betreft effectiviteit er geen duidelijk verschil is vastgesteld tussen CGt en EMDR. Dit is opvallend, omdat de procedures en de veronderstelde werkingsmechanismen bij IE en EMDR duidelijk verschillen. Bij IE wordt reliving essentieel geacht en bij EMDR distancing. Hier is echter nog nauwelijks expliciet onderzoek naar gedaan; het meeste onderzoek heeft zich tot nu toe gericht op de effectiviteit van EMDR en op de rol van de BLS. In deze presentatie zullen drie eigen experimenten worden besproken die worden uitgevoerd met masterstudenten van de Universiteit Utrecht naar het effect van reliving versus distancing. Het onderzoek bouwt voort op het werk van de Chris Lee en zijn collega’s. (Lee et al 2006) In het onderzoek worden 3 experimenten uitgevoerd, waarbij de variabele distancing en reliving worden gevarieerd. Verondersteld wordt (vanuit de EMDR visie) dat responses tijdens de desensitisatiefase, die getuigen van distancing leiden tot meer verbetering dan responses die getuigen van reliving. Een tweede onderzoeksvraag die wij beogen te beantwoorden is of dit verschil groter is voor narigheid uit het domein “zelfwaardering” dan voor narigheid uit het “domein controle en machteloosheid”. Een derde onderzoeksvraag betreft de vraag of een verhoogde parasympatische (arousal onderdrukkende) activiteit (een reeds aangetoond effect van BLS) samengaat met veranderingen in SUD-niveau en levendigheid van de herinneringen. De workshop is bedoeld voor therapeuten die geïnteresseerd zijn in de achtergronden van EMDR. Op zo eenvoudig mogelijke wijze zal een overzicht worden gegeven van de “state of the art” met betrekking tot de veronderstelde werkingsmechanismen. Dit zal worden geïllustreerd met bovengenoemd onderzoek en videomateriaal. Aan het eind van de workshop zal de therapeut zijn cliënten en collega’s iets meer kunnen zeggen dan “ dat EMDR de verwerking stimuleert door de linker en de hersenhelften beter te laten samenwerken, waardoor gevoel en verstand beter met elkaar verbonden raken.”

There is no doubt that EMDR is an effective form of treatment. EMDR is included in the guidelines of the International Society for Traumatic Stress Studies (ISTSS) where both EMDR and imaginal exposure (IE) as treatment of choice in the treatment of PTSD are. Also in the Dutch mental health care directives (Trimbos Institute, 2003) are EMDR and imaginal exposure (IE) identified as superior forms of treatment for PTSD. Direct comparison of CBT and EMDR yielded mixed results, however. Overall it can be stated that in terms of effectiveness there is no clear difference observed between CBT and EMDR. This is striking because the procedures and mechanisms assumed by IE and EMDR markedly different. When IE is reliving considered essential to EMDR and distancing. There is still little research has been done explicitly, most research has hitherto focused on the effectiveness of EMDR and the role of the BLS. This presentation will discuss three own experiments conducted with master students of the University of Utrecht to the effect of relieving versus distance. The research builds on the work of Chris Lee and his colleagues. (Lee et al 2006) In the study, three experiments, with variable distancing and reliving be varied. It is assumed (from the EMDR vision) that responses during desensitisatiefase, evidence of distancing lead to more improvement than responses that show reliving. A second research question we seek to answer is whether this difference is in trouble from the domain "esteem" than for trouble from the "domain control and powerlessness". A third research question concerns whether an increased parasympathetic (arousal suppressive) activity (an effect already demonstrated BLS) is associated with changes in SUD level and vividness of the memories. The workshop is designed for therapists interested in the backgrounds of EMDR. In the simplest possible manner, an overview of the state of the art "regarding the supposed mechanisms of action. This will be illustrated with the above study and video material. At the end of the workshop, the therapist will have clients and colleagues can say little more than "that EMDR stimulates the processing by the left and the brain work better together, making sense and intellect more interrelated."

Keywords: Practice Theory

Accuracy Verified: Yes

12. Gunter, R. W., & Bodner, G. E. (2009). EMDR works . . . But how? Recent progress in the search for treatment mechanisms. Journal of EMDR Practice and Research, 3(3), 161-168. doi:10.1891/1933-3196.3.3.161.

Language: English

Format: Journal

Abstract:
Eye movement desensitization and reprocessing (EMDR) is a highly scrutinized but efficacious psychotherapy commonly used in the treatment of posttraumatic stress disorder. Despite much theorizing and speculation, EMDR's mechanism of action remains unspecified. This article reviews several accounts of how EMDR works to reduce symptoms and/or aid memory reprocessing, including disruption of a traumatic recollection in working memory, increased psychological distance from the trauma, enhanced communication between brain hemispheres, and psychophysiological changes associated with relaxation or evocation of a rapid-eye-movement-like brain state. Several gaps in knowledge are also identified: The working memory account has received considerable support but has yet to be evaluated using clinical samples. How psychological distancing translates into symptomatic improvement is unclear. Psychophysiological effects of EMDR are well demonstrated but leave open the question of whether they constitute a treatment mechanism or an outcome of memory processing. Multiple mechanisms may work to produce treatment gains in EMDR; hence, an integrative model may be necessary to capture its myriad effects.

Keywords: Eye Movements Psychotherapy Treatment Mechanism

Accuracy Verified: Yes

13. van Es, A. K. & Schoen, J. M. (2008, Juni). Eye movement desensitization and reprocessing (EMDR): Effect van instructies op de verwerking van nare herinneringen [Eye movement desensitization and reprocessing (EMDR): Effect of instructions on the processing of unpleasant memories]. Utrecht, Nederlands: Universiteit Utrecht.

Language: Dutch

Format: Dissertation/Thesis

Abstract:
Op basis van eerder onderzoek door Lee en Drummond (2007), heeft dit onderzoek onderzocht de invloed van de aard van de therapeut instructies (herbeleven en afstand) op de verwerking van pijnlijke herinneringen. Bovendien, dit onderzoek onderzocht of het type van het trauma ook de manier waarop het geheugen wordt verwerkt invloeden. Het onderzoek is uitgevoerd door en onder studenten. Een gedetailleerd protocol - gebaseerd op de originele Eye Movement Desensibilisatie and Reprocessing (EMDR; Shapiro, 1989)-protocol werd gebruikt. De deelnemers (13 mannen en 23 vrouwen, gemiddelde leeftijd 22,4 jaar) werden gevraagd om een pijnlijke herinnering roepen, waarna de inhoud van het geheugen was gedesensibiliseerd herbeleven door een van beide of afstand instructies. De resultaten tonen geen verschil in effectiviteit tussen afstand en herbeleven voorwaarden. Verder werden geen verschillen gevonden tussen de condities onmacht en schuld / schaamte. Mede op basis van de gebruikte maatregelen kan worden geconcludeerd dat de manipulatie van de voorwaarden is mislukt. Voor toekomstig onderzoek wordt aanbevolen dat het protocol worden uitgebreid en de voorwaarden van het type van het trauma worden aangepast. Verder is het aangeraden om een controle conditie toe te voegen aan het onderzoek, om te bepalen of de bilaterale stimuli doeltreffend zijn en of ze invloed op de effectiviteit van de therapeut instructies.

Based on previous research by Lee and Drummond (2007), this research has examined the influence of the type of therapist instructions (reliving and distancing) on the processing of distressing memories. Furthermore, this research examined whether the type of the trauma also influences the way the memory is being processed. The research has been conducted by and among university students. A detailed protocol – based on the original Eye Movement Desensitization and Reprocessing (EMDR; Shapiro, 1989) protocol –was used. Participants (13 males and 23 females, mean age 22.4 year) were asked to recall a distressing memory, after which the content of the memory was desensitized by either reliving or distancing instructions. Results show no difference in effectiveness between reliving and distancing conditions. Furthermore, no differences were found between the conditions powerlessness and guilt/shame. Partly based on the used measures it can be concluded that the manipulation of the conditions failed. For future research it is recommended that the protocol be expanded and the conditions of the type of trauma be adjusted. Furthermore it is recommended to add a control condition to the research, in order to determine whether bilateral stimuli are effective and whether they influence the effectiveness of therapist instructions.

Keywords: Distancing Reliving Vividness

Accuracy Verified: Yes

14. Deen, M. L., & Droogendijk, J. S. (2008, Juli). Eye movement desensitization and reprocessing (EMDR): Effect van therapeutinstructies op psychologische en fysiologische maten [Eye movement desensitization and reprocessing (EMDR): Effect of therapist instructions on psychological and physiological measures]. Utrecht, Nederlands: Universiteit Utrecht.

Language: Dutch

Format: Dissertation/Thesis

Abstract:
Op basis van eerder onderzoek door Lee en Drummond (2007) heeft dit onderzoek onderzocht de invloed van de aard van de therapeut instructies (herbeleven en afstand) op de verwerking van pijnlijke herinneringen. De hypothese was dat afstand instructies, instructies ten opzichte van herbeleven, zou leiden tot een sterkere daling van subjectieve angst en nowness van het evenement. Bovendien was de verwachting dat de levendigheid van het evenement zou afnemen tijdens de sessie, ongeacht de instructies. In elke onder de sympathische en parasympathische activiteit van het zenuwstelsel wordt gemeten. Het was verondersteld dat de sympathische activiteit zou een sterkere daling in de afstand conditie moet beschikken in vergelijking met de toestand herbeleven. Een sterkere stijging werd verwacht voor de parasympathische activiteit in de afstand staat, in vergelijking met de toestand herbeleven. Bovendien, aan het begin van de zitting van de sympathische activiteit hoger zou zijn in het herbeleven conditie dan in de afstand voorwaarde dat, in tegenstelling tot de parasympathische activiteit. Het onderzoek is uitgevoerd door en onder universitaire studenten. Een gedetailleerd protocol - gebaseerd op de originele Eye Movement en Desensibilisatie Reprocessing (EMDR; Shapiro, 1989) protocol - werd gebruikt. De deelnemers (12 mannen en 24 vrouwen, gemiddelde leeftijd 22,4 jaar) werden gevraagd om een pijnlijke herinnering roepen, waarna de inhoud van de geheugen was gedesensibiliseerd door een herbeleving of afstand instructies. De resultaten tonen geen verschil in doeltreffendheid (Suds, Nowness-Scale en levendigheid) tussen afstand en herbeleven voorwaarden. Er was ook geen significant verschil gevonden in het sympathische (PEP) en parasympathische (HR-en RMSSD) activiteit. Mede op basis van de gebruikte maatregelen kan worden geconcludeerd dat de manipulatie van de voorwaarden is mislukt. Voor toekomstig onderzoek wordt aanbevolen dat het protocol worden uitgebreid en het toevoegen van een controle conditie aan het onderzoek. [Auteur abstracte]

Based on previous research by Lee and Drummond (2007) this research has examined the influence of the type of therapist instructions (reliving and distancing) on the processing of distressing memories. It was hypothesized that distancing instructions, compared to reliving instructions, would cause a stronger decrease in subjective distress and nowness of the event. Furthermore it was expected that the vividness of the event would decrease during the session, regardless of the instructions. In every subject the sympathetic and parasympathetic activity of the nervous system is measured. It was supposed that the sympathetic activity would have a stronger decrease in the distancing condition compared to the reliving condition. A stronger increase was expected for the parasympathetic activity in the distancing condition, in comparison with the reliving condition. Moreover, at the beginning of the session the sympathetic activity would be higher in the reliving condition than in the distancing condition, in contrast to the parasympathetic activity. The research has been conducted by and among university students. A detailed protocol – based on the original Eye Movement Desensitization and Reprocessing (EMDR; Shapiro, 1989) protocol – was used. Participants (12 males and 24 females, mean age 22.4 year) were asked to recall a distressing memory, after which the content of the memory was desensitized by either reliving or distancing instructions. Results show no difference in effectiveness (SUDS, Nowness-Scale and Vividness) between reliving and distancing conditions. There was also no significant difference found in the sympathetic (PEP) and parasympathetic (HR and RMSSD) activity. Partly based on the used measures it can be concluded that the manipulation of the conditions failed. For future research it is recommended that the protocol be expanded and to add a control condition to the research. [Author abstract]

Keywords: Physiological Measures Psychological Measures Therapist's Instructions

Accuracy Verified: Yes

15. 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:
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.

Keywords: Affect Theory

Accuracy Verified: Yes

16. Verstraaten, M. J., & van Vliet, E. (2009, Juni). Het werkzame mechanisme van eye movement desensitization and reprocessing (EMDR): Is dit het van een afstand bekijken of het herbeleven van een traumatische gebeurtenis? [The active mechanism of eye movement desensitization and reprocessing (EMDR): Is this the view from a distance or reliving a traumatic event?]. Utrecht, Nederlands: Universiteit Utrecht.

Language: Dutch

Format: Dissertation/Thesis

Abstract:
Dit onderzoek is een replicatie van de studie van Lee, Taylor en Drummond (2006) waarin de werkingsmechanismen beschrijft tijdens een desensibilisatie Eye Movement and Reprocessing (EMDR) behandeling. Deze studie onderzocht of er een relatie is tussen verbetering van de symptomen en de manier waarop de cliënt ziet de traumatische gebeurtenis, is dit vanuit een oogpunt van vrijstaande (afstand) of wanneer het trauma opnieuw wordt ervaren (herbeleving). De reacties van de 30 klanten tijdens een EMDR sessie, worden ingedeeld in vier categorieën volgens de classificatie van Lee et al.. (2006) (distantiëring, herbeleven, beïnvloeden en verbonden). Toegevoegd in dit onderzoek is de categorie onbeslist. De resultaten laten zien is er geen verschil in de antwoorden die tijdens een EMDR sessie en de vermindering van PTSS-symptomen (gemeten met de Nederlandse versie van de Impact of Event Scale) en van het verdriet (gemeten met de subjectieve Eenheden van Disturbance Scale). Alle reacties zijn gerelateerd aan een verbetering, ongeacht de categorie. Deze resultaten zijn niet in overeenstemming met de bevindingen van Lee et al.. (2006) die aantonen dat afstand-reacties zijn geassocieerd met een grotere vermindering van de symptomen dan herbeleven-reacties. Naast Lee et al.. (2006), de huidige studie is gebleken dat zowel de aard van het trauma (opzettelijk of niet opzettelijk) alsmede de negatieve cognitie van een cliënt (onmacht of eigenwaarde) niet zijn geassocieerd met een verbetering van de symptomen tijdens de EMDR behandeling. Toekomstig onderzoek kan bijdragen aan kennis over andere factoren die geassocieerd kan worden met de effectiviteit van EMDR.

This research is a replication of the study of Lee, Taylor and Drummond (2006) which describes the working mechanisms during an Eye Movement Desensitization and Reprocessing (EMDR) treatment. This study tested whether there is a relation between improvement in symptoms and the way the client sees the traumatic event; is this from a detached point of view (distancing) or when the trauma is re-experienced (reliving).The responses of 30 clients during an EMDR session, are classified into four categories according to the classification of Lee et al. (2006) (distancing, reliving, affect and associated). Added in this study is the category undecided. The results show there is no difference in the responses given during an EMDR session and the reduction of PTSD-symptoms (measured with the Dutch version of the Impact of Event Scale) and of the distress (measured with the Subjective Units of Disturbance Scale). All the responses are related to an improvement, regardless of the category. These results are not in line with the findings of Lee et al. (2006) that show distancing-reactions are associated with a greater reduction in symptoms than reliving-reactions. In addition to Lee et al. (2006), the current study found that both the nature of the trauma (intentional or not intentional) as well as the negative cognition of a client (powerlessness or self-esteem) are not associated with an improvement in symptoms during EMDR treatment. Future research may contribute to knowledge about other factors that may be associated with the effectiveness of EMDR.

Keywords: Distancing Reliving

Accuracy Verified: Yes

17. Lahad, M., Farhi, M., Leykin, D., & Naplansky, N. (2010, November). Preliminary study of a new integrative approach in treating post-traumatic stress disorder: SEE FAR CBT. The Arts in Psychotherapy, 37(5), 391-399. doi:10.1016/j.aip.2010.07.003.

Language: English

Format: Journal

Abstract:
SEE FAR CBT is a suggested new protocol for the treatment of anxiety disorders and post-traumatic stress disorder (PTSD) using creative form treatment based on empowerment through fantastic reality. The model emphasizes the role of fantastic reality and the use of imaginal re-narration of the traumatic event with the use of cards as a means of externalization or distancing. The treatment protocol incorporates methods of somatic memory reduction as well as CBT elements. The main objective of this study was to introduce the model and test the therapeutic efficacy of this new integrative therapeutic approach by comparing it to a well-established treatment approach; eye movement desensitization and reprocessing (EMDR). Adult PTSD patients, divided into EMDR (n = 12) and SEE FAR CBT (n = 9) groups, were assessed for traumatic symptoms at three time intervals (pre-treatment, post-treatment and 1-year follow-up). Both EMDR and SEE FAR CBT were associated with effective alleviation of traumatic symptoms, showing statistically significant decreases in their trauma symptoms over time but not differing in treatment efficacy during any of the assessment times. With some methodological limitations, results suggest further inquiry of the proposed model in clinical and experimental settings.

Keywords: Anxiety Comparative Studies Cognitive Therapy Posttraumatic Stress Disorder PTSD SEE FAR CBT Symptoms

Accuracy Verified: Yes

18. Shapiro, E., & Laub, B. (2008, May). Recent - traumatic episode protocol (R-TEP). EMDR Israel, Telaviv.

Language: English

Format: Other

Abstract:
Main Features of the R-TEP
Target selection: 1) Episode wide focus = period from the traumatic event to the present 2) Use of "Google Search" (G-Search) metaphor to identify multiple targets within the episode (sensory images/ events/ other experiences) Containment (safety): 1) 8 Phase structure parallel to Standard Protocol 2) Episode Narrative with DAS for grounding 3) Option of using distancing metaphor of TV screen 4) Option of regulation of associations by limiting associations to the image/event/ episode

Keywords: Recent-Traumatic Episode Protocol R-TEP

Accuracy Verified: Yes

19. Tofani, L. R., & Wheeler, K. (2011). The recent-traumatic episode protocol: Outcome evaluation and analysis of three case studies. Journal of EMDR Practice and Research, 5(3), 95-110. doi:10.1891/1933-3196.5.3.95.

Language: English

Format: Journal

Abstract:
This article evaluates and illustrates the application of the recent-traumatic episode protocol (R-TEP) with three diverse clients: a child with chronic illness, a woman with a significant loss, and an adolescent who self-harmed. The R-TEP is an adaptation of the Eye Movement Desensitization and Reprocessing (EMDR) protocol for early EMDR intervention. Sessions are presented in detail to highlight the shifts in information processing that occur during treatment. Observed markers used to analyze the flow of processing are identified, which include distancing from the trauma; reduction in negative affect or change in reported emotions; accessing more adaptive information; changes in the Subjective Units of Disturbance scale; and the Validity of Cognition scale and Impact of Event Scale--Revised indicating shifts in perception of the traumatic memory. Pre-post R-TEP treatment gains were noted for all clients, with changes in behavior and functioning. Theoretical underpinnings of the R-TEP are discussed with respect to the reported observations. The specific contribution of the protocol is highlighted, considering its procedural components and related plausible mechanisms of change.

Keywords: Mechanism of Action Outcome Evaluation Recent Evemts Recent Trauma R-TEP

Accuracy Verified: Yes

20. Woller, W. (2006). Traumaspezifische behandlungstechniken [Trauma-specific treatment techniques] . PiD - Psychotherapie im Dialog, 7(4), 405-407. doi:10.1055/s-2006-951833.

Language: German

Format: Journal

Abstract:
Trauma-Behandlung spezifischer Techniken verfolgen das Ziel, den traumatischen Stress-Symptomen und Stress abbauen und heben Sie die Dissoziation von traumatischen Erinnerungen. Es kann Techniken der Trauma-spezifische Stabilisierungs-und Verarbeitungstechniken von Traumata kommen angewandt. Traumaassozierten zur Verringerung der Symptome, Verbesserung der Fähigkeit, Emotionen zu regulieren und sich von traumatischen Erfahrungen Trauma-spezifische Techniken Stabilisierung Entfernung sind von großer Bedeutung. Dazu gehören Techniken Aufmerksamkeitsumfokussierung, imaginative Techniken und Distanzierung ressourcenaktivierende Techniken. Eine Integration der dissoziierten traumatischen Erinnerungen im biographischen Kontext der Lebensgeschichte erfordert den Einsatz traumabearbeitender (traumakonfrontativer) Verfahren. Verfahren mit nachgewiesener Wirksamkeit sind EMDR und kognitiv-verhaltenstherapeutischen Konfrontationstherapie. Ein traumakonfrontatives Ansatz wird durch strenge Indikationsstellung Kriterien gebunden. Äußere Sicherheit, psychologische Stabilität und eine verbesserte Fähigkeit, Emotionen zu regulieren sind wesentliche Voraussetzungen.

Trauma-specific treatment techniques pursue the goal of the traumatic stress symptoms and reduce stress and lift the dissociation of traumatic memories. It may come techniques of trauma-specific stabilization and processing techniques of trauma applied. Traumaassozierten to reduce symptoms, improve ability to regulate emotions and to distance themselves from traumatic experience trauma-specific stabilization techniques are of great importance. These include techniques Aufmerksamkeitsumfokussierung, imaginative distancing techniques and ressourcenaktivierende techniques. An integration of dissociated traumatic memories in the biographical context of the life history requires the use traumabearbeitender (traumakonfrontativer) procedures. Procedure with proven efficacy are EMDR and cognitive-behavioral exposure therapy. A traumakonfrontatives approach is bound by strict indication criteria. External security, psychological stability and an enhanced ability to regulate emotions are essential prerequisites.

Keywords: Affect Regulation

Accuracy Verified: Yes

21. Manfield, D. C. (1998). Treating a highly defended client: reworking traditional approaches. In P. Manfield (Ed.), Extending EMDR: A casebook of innovative applications, (1st ed.) (pp. 217-231). New York: Norton.

Language: English

Format: Book Section

Abstract:
Several key points emerge for consideration when treating the highly defended client with EMDR, in particular clients whose primary defenses are distancing ones. The first is to carefully gauge the client's level of functioning, the depth of therapeutic alliance, and the client's perceived sense of safety. These factors determine the appropriateness of EMDR, and presuming that, the style and directiveness of the clinician.Secondly, the use of EMDR with highly defended clients may require a directiveness that exceeds the basic protocol designed by Shapiro. Once the therapeutic alliance has been established, the clinician must balance, while being sensitive to, the client's need for control over the therapeutic process, hopefully avoiding unproductive periods of defensive distancing. This balance and sensitivity, inherent in all effective treatments and psychotherapies, is particularly important when the modality is as potent and emotionally evocative as EMDR can be. The case of William illustrates the risks in a directive approach, such as initiating EMDR too early, promoting a withdrawing or angry transference, or choosing the wrong cognitions. Knowing your client well and securing an effective working alliance is crucial to success. [Text, pp. 230-231]

Keywords: Adults Americans Anxiety Disorders Case Report Defense Mechanisms Life Experiences Male Psychotherapeutic Processes Self Concept Survivors Treatment Effectiveness

Accuracy Verified: Yes