Francine Shapiro Library - EMDR Bibliography Links
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1. Cortés, C. (2012, June). Ayudando a desarrollar el sistema de procesamiento de la información para la reconstrucción del apego en niños adoptados [Helping to develop the adaptive information system for attachment reconstruction in adopted children]. Presentation at the annual meeting of the EMDR Europe Association, Madrid, Spain.
Language: Spanish
Format: Conference
Abstract:
EMDR
is
based
on
the
adaptive
information
system
model.
Humans
have
an
inherent
information
processing
system
that
generally
processes
the
complex
elements
of
an
experience
to
an
adaptive
state.
In
other
words,
we
have
the
innate
capacity
to
resolve
difficult
emotional
experiences
and
move
forward
in
our
lives.
There
are
cases
where,
besides
the
trauma
of
abandonment
and
lack
of
attachment,
there
has
been
no
early
stimulation,
mainly
during
the
first
year
of
life.
Sometimes
the
emotional
environment
is
so
poor
that
results
in
insufficient
attachment,
and
prevents
the
motivational
system
from
becoming
strong
enough
to
push
the
baby
to
find
and
produce
stimulation.
Other
times,
the
environment
has
been
so
negligent
that
has
not
provided
the
conditions
for
the
baby
to
adequately
cover
this
first
sensory
stimulation.
Whether
it
is
poor
emotional
environment
or
a
negligent
environment,
or
both
at
once,
the
result
is
that
we
find
children
who
have
not
had
the
opportunity
to
generate
enough
neural
connections
or
the
quality
required
for
the
reptilian
brain
to
mature.
This
phenomenon
hinders
the
brain
integration,
both
vertically
and
horizontally,
and
makes
the
processing
of
the
adaptive
information
system
difficult,
if
not
impossible.
Aiming
to
promote
and
foster
the
development
of
the
adaptive
information
system,
we
have
focused
on
a
dual
purpose:
rebuilding
attachment
and
ensuring
the
neurofunctional
reorganization
and
development
of
the
child
at
early
stages.
For
this
we
rely
on
both;
EMDR
processing,
as
well
as
sensory
integration
and
sensorimotor
therapies,
which
promote
the
integration
of
primitive
reflexes
and
the
child´s
development
at
early
years.
Given
the
baby's
phylogenetic
development
and
the
ideal
conditions
for
such
development
to
occur,
we
try
to
generate
the
same
conditions,
with
the
aim
to
facilitate
and
complete
part
of
the
child's
development
that,
so
far,
has
not
occurred
yet.
Therefore,
the
quality
of
attachment
is
what
will
define
the
self-‐regulation
capacity
and
the
child's
motivational
system.
And
in
this
sense,
the
neurofunctional
organization
and
sensory
integration
will
provide
the
child
with
the
necessary
resources
to
meet
the
challenges
of
both,
development
and
growth,
and
the
possibility
to
achieve
success
and
thus
to
obtain
the
perception
of
efficiency.
Both
aspects,
attachment
and
neurofunctional
organization,
are
interwoven
with
each
other
and
feed
the
adaptive
information
system.
Through
videos
and
clinical
material,
we
show
the
evolution
of
adopted
children
with
whom
we
have
already
intervened
from
this
dual
therapeutic
point
of
view;
generating
a
greater
vertical
and
horizontal
integration
and
a
better
attachment
consolidation.
Parents
will
play
a
key
role
in
this
intervention
and
we
prepare
them
for
it
through
both;
psycho-‐education
and
EMDR.
In
this
way,
they
can
become
proper
therapeutic
parents,
capable
to
parenthesize
their
own
children.
EMDR
está
basado
en
el
modelo
del
sistema
adaptativo
del
procesamiento
de
la
información.
El
ser
humano
posee
un
sistema
inherente
de
procesamiento
de
la
información
que
normalmente
procesa
los
elementos
complejos
de
una
experiencia
en
un
sistema
adaptativo.
En
otras
palabras,
tenemos
una
capacidad
innata
para
resolver
las
experiencias
emocionalmente
difíciles
y
seguir
adelante
con
nuestras
vidas.
Existen
casos
donde,
tras
el
trauma
de
abandono
y
la
falta
de
apego,
no
ha
existido
estimulación
temprana,
principalmente
durante
el
primer
año
de
vida.
A
menudo
el
ambiente
emocional
es
tan
pobre
que
da
como
resultado
un
apego
insuficiente,
e
impide
que
el
sistema
emocional
sea
lo
suficientemente
fuerte
para
conseguir
que
el
bebe
encuentre
y
produzca
estimulación.
En
otras
ocasiones,
el
ambiente
ha
sido
tan
negligente
que
no
proporciona
las
condiciones
adecuadas
para
que
el
bebe
cubra
su
primera
estimulación
sensorial.
Ya
sea
por
ambiente
emocional
pobre
o
un
ambiente
negligente,
o
bien
ambos,
el
resultado
es
que
encontramos
niños
que
no
tienen
la
oportunidad
de
generar
conexiones
neurales
suficientes
o
de
calidad
requeridas
por
el
cerebro
reptiliano
para
madurar.
Este
fenómeno
dificulta
la
integración
del
cerebro
vertical
y
horizontalmente
y
hace
que
el
sistema
de
procesamiento
de
la
información
sea
deficitario,
si
no
imposible.
Con
el
objetivo
de
promover
y
fomentar
el
desarrollo
del
sistema
adaptativo
del
procesamiento
de
la
información,
nos
hemos
centrado
en
un
propósito
dual:
Reconstruir
el
apego
y
asegurarnos
de
reorganizar
y
desarrollar
la
neurofuncionalidad
del
niño
en
las
etapas
tempranas
del
niño.
Para
ello
nos
apoyamos
en
el
procesamiento
del
EMDR,
así
como
en
las
terapias
de
integración
sensorial
y
sensoriomotoras,
que
fomentan
la
integración
de
los
reflejos
primitivos
y
el
desarrollo
del
niño
en
las
etapas
tempranas.
Dado
el
desarrollo
filogenético
del
niño
y
las
condiciones
ideales
para
que
dicho
desarrollo
ocurra,
intentamos
generar
las
mismas
condiciones,
con
el
objetivo
de
facilitar
y
completar
parte
del
desarrollo
del
niño
que
hasta
ahora,
no
ha
ocurrido
todavía.
Por
tanto,
la
calidad
del
apego
es
aquella
que
será
definida
por
la
capacidad
de
autorregulación
y
el
sistema
motivacional
del
niño.
Y
en
este
sentido,
la
organización
neurofuncional
y
la
integración
sensorial
promoverán
en
el
niño
los
recursos
necesarios
para
encontrarse
con
los
retos
de
desarrollo
y
crecimiento
y
la
posibilidad
de
conseguir
el
éxito
en
ambos,
además
de
obtener
la
percepción
de
eficiencia.
Ambos
aspectos,
apego
y
organización
neurofuncional,
están
entrelazados
y
alimentan
el
sistema
adaptativo
del
procesamiento
de
la
información.
A
través
videos
y
material
clínico,
mostramos
la
evolución
de
los
niños
adoptados
los
cuales
ya
han
sido
intervenidos
desde
esta
perspectiva
terapéutica
dual;
generando
una
gran
integración
vertical
y
horizontal
y
una
mejora
en
la
consolidación
del
apego.
Los
Keywords: Adoptives
Accuracy Verified: Yes
2. Landgrebe, B. (2005, Februr). Beiträge der fachtagung, diagnose, therapie und berufliche rehabilitation von jungen menschen mit traumen in der lebensgeschichte [Contributions to the symposium diagnosis, therapy and vocational rehabilitation of young people with trauma in the life history]. Berufsbildungswerk Abensberg, Deutschland.
Language: German
Format: Other
Abstract:
Bevor ich die Traumabehandlung und den Prozess der Traumabewältigung auf meiner Abteilung darstelle,
möchte ich diese für die Behandlung so wesentlichen Differenzierungen etwas aufführen.
Wir Menschen haben ein natürliches Verarbeitungssystem für traumatische Erfahrungen. Nicht
jeder Traumatisierte entwickelt eine PTSD! (nur ca. 10 – 12 %). Bei der Entstehung und Aufrechterhaltung
der Störung spielen neben dem traumatischen Ereignis auch psychologische,
biologische und soziale Faktoren eine Rolle.
Before I describe the process of trauma care and trauma to my department,
I would like to perform this treatment for something so essential distinctions.
We humans have a natural system for processing traumatic experiences. not
each developed a traumatized PTSD! (only about 10 - 12%). In the formation and maintenance
the disorder play next to the traumatic event and psychological,
biological and social factors play a role.
Keywords: Trauma Vocational Rehabilitation Young People
Accuracy Verified: Yes
3. Codina, C., & Olivia, A. M. (2012, June). Concordancia corazon y cerebro [Heart and brain concordance]. Poster presented at the annual meeting of EMDR Europe, Madrid, Spain.
Language: Spanish
Format: Conference
Abstract: Abstract:
Si bien es cierto que el EMDR tiene como objetivo el procesamiento de la información perturbadora hacia un estado adaptativo, no lo es menos que una exhaustiva y previa preparación de la persona, con el fin de asegurar sus recursos internos, facilita muchísimo el trabajo, cooperando en gran medida al éxito del mismo. Considero, por tanto, cuestión de responsabilidad terapéutica nutrir previamente al paciente con un amplio y efectivo surtido de ejercicios que refuercen su sentimiento de seguridad y confianza. En este sentido, la aportación de mi experiencia puede mostrar que: fomentar el desarrollo de la “Consciencia Psicocorpórea”(1) deviene el gran aliado no solamente de los seres humanos implicados en el proceso terapéutico, sino también del EMDR, el método terapéutico en sí. Llegué al EMDR impulsada por comprender ¿Qué ocurría? cuando en el proceso de solución, efectuando Constelaciones Familiares(2), los ojos cerrados del cliente(3) , a menudo, se movían como en la fase REM del sueño. Necesitaba una explicación. En el 2003 la encontré en un libro de David Servan-Schreiber sobre EMDR, generando un nuevo interrogante fruto del cual nace el trabajo: CONCORDANCIA CORAZÓN & CEREBRO CARMEN CODINA, EL EJERCICIO 5C.
Abstract: While the EMDR aims at disturbing information processing towards an adaptive state, the fact remains that a thorough and after preparation of the person, in order to ensure its internal resources, greatly facilitates the work, cooperating greatly to the success. I consider, therefore, a matter of responsibility to nurture therapeutic advance for patients with a wide and effective range of exercises to strengthen their sense of security and confidence. In this sense, the contribution of my experience may show that: encourage the development of "Psicocorpórea Consciousness" (1) becomes not only a great ally of the humans involved in the therapeutic process, but also of EMDR, the therapeutic method itself. I came to understand EMDR driven by What happened? when the settlement process, making Constellations (2), the closed eyes of the customer (3) often moved as in REM sleep. I needed an explanation. In 2003 I found a book by David Servan-Schreiber about EMDR, creating a new question which arises fruit of work: MATCHING HEART & BRAIN CODINA CARMEN, THE EXERCISE 5C.
Keywords: Poster
Accuracy Verified: Yes
4. Whalen, J. E. (1999, September). EMDR and hypnosis: A theoretical and clinical investigation. University of Tennessee, Knoxville, TN. AAT 9923344.
Language: English
Format: Dissertation/Thesis
Abstract:
Eye Movement Desensitization and Reprocessing (EMDR) is a controversial new treatment for anxiety disorders that is proported to evince rapid and lasting treatment gains. EMDR theorists argue that humans have an innate biological drive to process events and their memories into adaptive and useful forms. Traumatic memories become "stuck" and unprocessed, resulting in a host of psychopathological symptoms. EMDR's curative power rests primarily in the eye movements. Shapiro argues that the eye movements directly access and alter traumatic memories at a neurophysiological level. Memories are then processed down into adaptive forms, with a concomitant abatement of symptoms. Research supports the clinical efficacy of EMDR. However, there is much debate as to the actual mutative element in the EMDR protocol. Support for eye movements playing a curative role is meager and equivocal. This study examines the proposition that the primary mutative component of EMDR is response to suggestion. Specifically, this study proposes that the EMDR treatment protocol is laced with suggestion for improvement. Highly hypnotizable individuals will respond to these suggestions even though EMDR is an explicitly nonhypnotic treatment. That is, subjects will improve to the extent they respond to suggestion. Further, this study tests the viability of Shapiro's eye movement theory. An eye movement condition is compared to an eye fixation condition in terms of treatment outcome. Results indicate a positive correlation between subjects' hypnotizability and treatment outcome. In addition, eye movement conditions were as efficacious as eye fixation conditions where treatment outcome is concerned. (PsycINFO Database Record (c) 2008 APA, all rights reserved)Dissertation Abstracts International: Section B: The Sciences and Engineering. 60(3-B), Sep 1999, pp. 1319.
Keywords: Anxiety Disorder Anxiety Disorders Effectiveness Empirical Study Hypnotic Susceptibility Hypnotizability Treatment Outcomes Treatment Outcome/Clinical Trial
Accuracy Verified: Yes
5. Moura, J. G. D. (2012, Novembro). EMDR – Construção de diagnóstico comum ou acertando o alvo [EMDR - Construction of common diagnosis or hitting the target]. In temas diversos. Apresentação no II Congresso Brasileiro de EMDR, Brasília, Brasil.
Language: Portuguese
Format: Conference
Abstract:
A estabilização é o momento do processo onde recebemos o paciente construímos rapport, entendimento comum do que esta se passando, damos informações psicopedagógicas sobre o trauma e o que é EMDR e o preparamos para as próximas fases. Esta apresentação pretende focar esta primeira etapa, que seria a construção do que convencionamos chamar de setting terapêutico dentro da perspectiva do EMDR. Este é um momento fundamental para o sucesso do tratamento. Quando nos posicionamos de forma correta frente a ele construindo um entendimento comum, que também podemos chamar de diagnostico comum, emparelhamos, damos sentido e fluidez ao processo. Reproduzimos e ativamos dentro do jogo psicoterapêutico capacidade inata de nós seres humanos de mimetização e sincronização com o outro na intenção de realizar algo, aprender e melhorar nossas chances de sobreviver. Lançamos mão constantemente como terapeutas desta aptidão para resolução das equações trazidas por nossos pacientes e não raramente nos beneficiamos aprendendo mais sobre nós e o mundo. Este processo pressupõe um exercício de entrar na plástica do outro, estranhá-la e refletir
para e com ele sobre o que o aflige e suas potencialidades. Como se dá este processo? Como podemos transformar impressões em narrativa? Como construímos um diagnostico comum?
The stabilization process is the time where we get the patient build rapport, common understanding of what is going on, we psychopedagogical information about trauma and what is EMDR and prepare for the next phases. This presentation aims to address this first phase, the construction of what would conventionally call the therapeutic setting within the perspective of EMDR. This is a critical time for successful treatment. When positioned correctly in front of him building a common understanding, which we can also call common diagnosis, emparelhamos, give direction and fluidity to the process. Reproduced within the game and activate innate ability psychotherapeutic us humans to mimic and synchronize with each other in an attempt to accomplish something, learn and improve our chances of survival. We used this constantly as therapists ability to solve the equations brought by our patients and not infrequently we benefit by learning more about ourselves and the world. This process involves an exercise of plastic entering the other, her strange and reflect
and to him about what ails you and your capabilities. How is this process? How can we turn impressions into narrative? How to build a common diagnosis?
Keywords: Body Language Building Common Diagnosis Phases 1 Phase 2 Stabilization
Accuracy Verified: Yes
6. Leeds, A. M. (2010, February). Extinction or reconsolidation differences between suppression and transformation in how we recover from traumatic experiences. Author.
Language: English
Format: Other
Abstract:
Memory is central to all learned behavior, and in humans to one’s sense of identity. Sleep and memory processes are deeply entwined. Both are central to our sense of well-being.
Keywords: Adaptive Information Processing AIP Extinction, Prolonged Exposure Reconsolidation
Accuracy Verified: Yes
7. Catherall, D. R. (2003, June). How fear differs from anxiety. Traumatology, 9(2), 76-92. doi:10.1177/153476560300900202.
Language: English
Format: Journal
Abstract:
Animal models conceptualize anxiety as a response to potential danger while fear is a response to present danger. The way humans experience anxiety involves our capacity for higher thinking while the human experience of fear appears to be much the same as the animal model. This article examines these differences at both a phenomenological and neurological level and highlights implications for the treatment of conditioned fear in PTSD. The stimuli for human fear are sensory-perceptual, while the stimuli for most forms of anxiety are conceptual-linguistic. Individuals in a state of fear/terror undergo a radical shift from top-down to bottom-up processing in which access to conceptual-linguistic thought processes is severely restricted and the frontal regions of the cortex are no longer able to override impulses from brain stem and midbrain regions. Conditioned fear involves actual neurological changes in the limbic system. To overcome a traumatic memory, the individual must (1) gain some level of access to the bottom-up state in order to habituate or extinguish the conditioned fear response, and (2) also achieve access to the top-down state in order to process the fear. ]Sage Journals]
Keywords: Anxiety Fear Cognitive Neuroscience Posttraumatic Stress Disorder PTSD
Accuracy Verified: Yes
8. van der Kolk, B. A. (2006). Más allá de la cura por el diálogo: Experiencia somática, impront as subcorticales y tratamiento del trauma [Beyond dialogue cure: Somatic experience, subcortical imprints and the treatment of trauma]. Presentación en la Asociación EMDR España, Madrid.
Language: Spanish
Format: Conference
Abstract:
La investigación realizada en los laboratorios orientada a aclarar los procesos de la memoria en el hombre han mostrado de manera coherente que la memoria es un proceso activo y constructivo: la mente está reensamblando de manera constante las antiguas impresiones, agregándolas a la nueva información. Los recuerdos no son considerados como hechos precisos sino que son transformados en relatos que nos contamos a nosotros mismos y a los demás, con el fin de transmitir una narración coherente de nuestra experiencia en el mundo. En raras ocasiones genera nuestra mente imágenes, olores, sensaciones o acciones musculares precisas que reproduzcan exactamente experiencias previas. De hecho, los más renombrados investigadores de la memoria tales como Elizabeth Loftus, Dan Schachter y John Kihlstrom niegan de manera enfática que la mente sea capaz de reproducir de manera precisa las improntas de experiencias previas.
Research conducted in laboratories oriented to clarify the processes of memory in humans have consistently shown that memory is an active and constructive process: the mind is constantly reassembling the old prints, adding to the new information. The memories are not considered precise facts that are transformed into stories we tell ourselves and others, to convey a coherent narrative of our experience in the world. On rare occasions our mind creates images, smells, feelings or actions that reproduce exactly precise muscle experiences. In fact, the best known memory researchers such as Elizabeth Loftus, Dan Schachter and John Kihlstrom emphatically deny that the mind is able to accurately reproduce the imprints of past experiences.
Keywords: Neurobiology
Accuracy Verified: Yes
9. Bossini, L., Poliziotto, N., Tavanti, M., Calossi, S., Lombardelli, A., Vatti, G., & Castrogiovanni, P. (2006, Febbraio). Neuroimaging e PTSD: Dati morfovolumetrici e loro variazioni dopo trattamento [Neuroimaging and PTSD: Facts morfovolumetrici and their changes after treatment]. Presentazione al Congresso XI SOPSI (Società Italiana di Psicopatologia), Roma, Italia.
Language: Italian
Format: Conference
Abstract:
Introduzione: molti studi concordano sulla riduzione del volume ippocampale nei pazienti affetti da PTSD 1 e che tale alterazione anatomica è correlata con deficit cognitivi e
con la gravità dei sintomi. Comunque ad oggi non è stato ancora chiarito se l’atrofia ippocampale rappresenta l’esito di un effetto neurotossico del trauma o, piuttosto, una condizione
preesistente che predispone allo sviluppo di alcune patologie psichiatriche. Già da tempo studi su animali dimostrano
come lo stress causi atrofia ippocampale e inibizione della
neurogenesi, con meccanismi verosimilmente legati ai glucocorticoidi, all’increzione del fattore corticotropo, all’aumento degli aminoacidi eccitatori, all’inibizione fattore
neurotrofico cerebrale con perdita della plasticità neuronale. Nell’uomo, tuttavia, i risultati non sono così lineari. Da un
lato alcuni studi hanno individuato come fattore principale l’aumento dei glucocorticoidi 2, dall’altro tale teoria è stata fortemente criticata 3. Secondo Yehuda il meccanismo di
atrofia ippocampale è dovuto ad un’alterazione dell’asse
Ipotalamo-Ipofisi-Surrene (HPA), ma in termini di una bassa
increzione di glucocorticoidi che determina un aumento del
feedback negativo dell’asse stesso ed un’ipersensibilità recettoriale.
Indipendentemente dal meccanismo d’azione, la perdita di neuroni a livello ippocampale nei soggetti che hanno subito eventi traumatici sembra sufficientemente dimostrata e, fino a poco tempo fa, era considerata irreversibile. In realtà l’ippocampo sembra presentare una inusuale e spontanea capacità rigenerativa. Questo dato è stato individuato in molte specie animali e, in un unico studio, anche nell’uomo 4. Inoltre recenti evidenze pre-cliniche e cliniche hanno indicato che gli SSRI (Selective Serotonin Reuptake Inhibitors) promuovono la neurogenesi e riducono l’atrofia ippocampale
indotta dallo stress nell’animale 5 e nell’uomo sono in grado
di ridurre i sintomi del PTSD, incrementare le dimensioni
dell’ippocampo e ridurre i deficit mnesici tipici della patologia
6 7. Un altro fattore che sembra essere in grado di stimolare la neurogenesi negli animali sembra essere “l’ambiente arricchito” verosimilmente tramite i meccanismi molecolari dell’apprendimento che sembrano in grado di attivare la trascrizione dell’mRNA per il Brain Derived Neurotrophic Factor. Questo dato della letteratura supporta il razionale dell’efficacia della psicoterapia anche se l’unico studio
che valuta le modificazioni morfostrutturali dopo psicoterapia non ha riportato risultati positivi 8. Gli scopi di questo studio sono:
– valutare la presenza di atrofia ippocampale nei pazienti affetti da PTSD (T0-drug-free);
– valutare l’effetto della terapia: farmacologica con SSRI e
psicoterapica con EMDR (Eye Movement Desensitization and Reprocessing) sia sul piano clinico e neuropsicologico,
che sul volume ippocampale, sia sulla memoria (T1). Metodologia: abbiamo analizzato un campione di 20 pazienti, di età compresa tra i 15 ed i 65 anni, reclutati nell’ambulatorio psichiatrico del Policlinico universitario di
Siena affetti da PTSD e un gruppo di controllo di soggetti
sani appaiati per sesso, età, peso e altezza. I soggetti di entrambi
i gruppi sono stati sottoposti ad uno studio morfovolumetrico
computerizzato dell’Ippocampo tramite RM (Risonanza Magnetica). Inoltre, i diciassette pazienti con PTSD sono stati valutati tramite la somministrazione di test neuropsicologici
e scale psicometriche per approfondire il quadro
psicopatologico e valutare l’eventuale presenza di deficit cognitivi. Nei soggetti affetti da PTSD dopo un periodo di sei mesi di
terapia psicofarmacologica sono stati ripetuti i test neuropsicologici,
le scale psicometriche e l’analisi morfovolumetrica dell’ippocampo tramite RM.
Tre pazienti, dopo le valutazioni al T0, hanno effettuato un protocollo terapeutico con solo EMDR e sono stati rivalutati
dopo 8 sedute (due mesi).
Risultati: i risultati della prima parte sperimentale (T0-drug-free) evidenziano che le dimensioni dell’ippocampo di
sinistra nei soggetti affetti da PTSD sono significativamente minori rispetto ai controlli sani. Dai risultati osservati al follow-up (T1-post-terapia) è possibile
evincere che la terapia nei soggetti considerati è associata ad un miglioramento della sintomatologia e ad un aumento
dei volumi ippocampali, pari al 9,87% per l’ippocampo di destra e dell’8,37% per l’ippocampo di sinistra. Questi dati
sono concordi con i dati presenti in letteratura, anche se la percentuale di recupero su base neuroplastica nel nostro studio
risulta sensibilmente superiore rispetto ai due studi presenti in letteratura incremento pari al 4,6% 6; pari al 5% 7. I tre pazienti che hanno effettuato terapia con EMDR hanno
anch’essi mostrato al T1 un miglioramento sintomatologico (CAPS non più positiva per i criteri diagnostici) ed un aumento
medio dei volumi ippocampali pari a 338,25 mm3 per
l’ippocampo DX e 357,93 mm3 per l’ippocampo SN.
Conclusioni: la terapia nei soggetti considerati si è associata ad un aumento dei volumi ippocampali (9,87%-8,37%).
L’aumento dei volumi ippocampali appare rilevante, consistente con i dati in letteratura, sebbene quantitativamente superiore, sottolineando l’efficacia degli SSRI verosimilmente tramite il meccanismo di attivazione della neurogenesi;
è ipotizzabile che l’aumento di volume non sia da imputare ad un aumento delle cellule gliali ma ad un aumento di neuroni ippocampali visto il contemporaneo miglioramento clinico. Particolarmente interessante ci sembra il dato relativo all’efficacia clinica e sulla plasticità neurale della EMDR.
Questa osservazione su solo tre casi, necessita chiaramente di essere confermata su un campione più ampio ma rappresenta la prima evidenza in letteratura di un’azione della psicoterapia
diretta alla struttura cerebrale.
Introduction: Many studies agree on the reduction of hippocampal volume in patients with PTSD and that an anatomical alteration is correlated with cognitive deficits and the severity of symptoms. However to date has not yet been clarified whether hippocampal atrophy is the result of a neurotoxic effect of trauma or, rather, an underlying condition that predisposes to the development of some psychiatric disorders. For some time animal studies show that stress causes hippocampal atrophy and inhibition of neurogenesis, by mechanisms probably related to glucocorticoids, all'increzione corticotropo factor, increased excitatory amino acid, inhibition of brain neurotrophic factor with loss of neuronal plasticity. In humans, however, the results are not so linear. On the one hand, some studies have identified as the main factor increasing glucocorticoid two other such theory was strongly criticized 3. According to Yehuda mechanism of hippocampal atrophy is due to an alteration of hypothalamic-pituitary-adrenal (HPA), but in terms of a low secretion of glucocorticoids leading to an increase of negative feedback axis and the same receptor hypersensitivity . Regardless of the mechanism of action, loss of neurons in hippocampus in people who have suffered traumatic events seems sufficiently established and, until recently, was considered irreversible. In fact, the hippocampus appears to be an unusual and spontaneous regenerative capacity. This figure has been identified in many animal species and in one study in humans 4. Moreover, recent evidence pre-clinical and clinical studies have shown that SSRIs (Selective Serotonin Reuptake Inhibitors) promote neurogenesis and reduce stress-induced hippocampal atrophy in animals 5 and humans are able to reduce symptoms of PTSD, increase the size of the hippocampus and reduce the deficit mnesic typical of the disease 6 7. Another factor that seems to be able to stimulate neurogenesis in animals seems to be "enriched environment" probably through molecular mechanisms of learning that seem able to activate the transcription of mRNA for Brain Derived Neurotrophic Factor. This finding supports the rationale of the literature of the effectiveness of psychotherapy, even if the only study that evaluates changes morphostructural after psychotherapy has shown positive results 8. The aims of this study are: - To evaluate the presence of hippocampal atrophy in patients with PTSD (T0-drug-free) - to assess the effect of therapy: pharmacological SSRI and psychotherapy with EMDR (eye movement desensitization and reprocessing) is a clinical and neuropsychological, and on hippocampal volume, and memory (T1). Methods: We analyzed a sample of 20 patients, aged between 15 and 65, recruited nell'ambulatorio Psychiatric University Hospital of Siena with PTSD and a control group of healthy subjects matched by sex, age, weight and height. Subjects in both groups were subjected to a computerized study morfovolumetrico dell'Ippocampo using MRI (Magnetic Resonance). In addition, seventeen patients with PTSD were assessed through administration of psychometric scales and neuropsychological tests to study the psychopathological picture and evaluate the possible presence of cognitive deficits. In subjects with PTSD after a period of six months of pharmacological therapy were repeated neuropsychological tests, scales psychometric analysis morfovolumetrica hippocampus by MRI. Three patients at T0 after assessments, carried out a treatment protocol with only EMDR and were reassessed after eight sessions (two months). Results: The results of the first experiment (T0-drug-free) show that the size of the left hippocampus in patients with PTSD are significantly lower compared to healthy controls. The results observed during the follow-up (T1-post-therapy) can be inferred that therapy in patients considered to be associated with improvement in symptoms and an increase in hippocampal volume, equal to 9.87% for the right hippocampus and 8, 37% for the left hippocampus. These data are consistent with the data in the literature, although the recovery rate based on neuroplastic in our study is significantly higher than in the two studies in the literature increase of 4.6% 6; 5% 7. The three patients who have treatment with EMDR have also shown an improvement in symptoms at T1 (CAPS no longer positive for the diagnostic criteria) and an average increase in hippocampal volume amounted to 338.25 mm3 for the hippocampus and DX 357, 93 mm3 for the hippocampus SN. Conclusions: Therapy in patients considered was associated with an increase in hippocampal volume (9.87% -8.37%). The increase in hippocampal volume appear to be relevant, consistent with the literature data, although quantitatively greater, stressing the effectiveness of SSRIs probably through the mechanism of activation of neurogenesis, it is conceivable that the increase in volume is attributable to an increase glial cells but an increase of hippocampal neurons seen the simultaneous clinical improvement. Seems particularly interesting given the relative clinical effectiveness of EMDR and neural plasticity. This observation on only three cases, clearly needs to be confirmed on a larger sample but represents the first evidence in the literature of action of psychotherapy directed at brain structure.
Keywords: Posttraumatic Stress Disorder PTSD
Accuracy Verified: Yes
10. Koppel, H. (2005, Autumn/Winter). Opinion - Talking therapy and neuroscience - is there a convergence?. BNA British Neuroscience Association [BNA] Bulletin, a newsletter for members of the BNA, 52, 5-6.
Language: English
Format: Newsletter
Abstract:
Most of the effort that has been driving the increasing overlap between
talking therapy and neuroscience has come from work that is beginning
to understand the cytoarchitecture of the frontal cortex, on the one
hand, and techniques like neuroimaging on the other. Non scientists
seem to relate more easily to studies that involve humans engaged in
some kind of cerebral activity.
However, recently, therapists have begun to make what seems to be a
contribution to this overlap by developing new therapeutic techniques
for working with emotional or psychological issues; techniques that rely
less on words, suggesting that there is a neurobiological healing
process at work.
Keywords: Neurobiology
Accuracy Verified: Yes
11. 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:
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)
Keywords: Dissociative Disorders Neurobiology Trauma
Accuracy Verified: Yes
12. Matthess, H., & Yang, Y. (2010, July). Social and cultural adaptation. Presentation at the 1st EMDR Asia Conference, Bali, Indonesia.
Language: English
Format: Conference
Abstract:
We know from research that since neurobiology is the same for humans, then the reaction to stress is the same for all human
beings in the world. That is why EMDR works so well with victims of natural disasters and of adverse childhood experiences,
including sexual and physical violence and emotional neglect.
Because of cognitive functioning, e.g., creating metaphors and images for self-soothing, establishing social contact and/
or personal interpretation, or assigning meaning to stressful experiences, we have to emphasize the importance of cultural
influences.
We want to invite people from different cultures to join this open meeting to present, share, and discuss their experiences
and perhaps difficulties with cultural adaptation of trauma-therapy techniques, including EMDR. For example, we may need
to examine where and how the wording of the EMDR-protocol needs to be adapted to recognize and accommodate cultural
differences; perhaps we need to look at the language structure and its accessibility. Let us share our ideas and experiences
so that we may get new insights on how to more effectively implement our trauma-therapy techniques and spread our
knowledge about neurobiology to various cultural backgrounds.
Keywords: Social and Cultural Adaptation
Accuracy Verified: Yes
13. Johannesson, K. B. (2007). Traumatiska minnen kan behandlas effektivt med EMDR [Traumatic memories can be effectively treated with EMDR]. Läkartidningen, 104(10), 782-783.
Language: Swedish
Format: Magazine
Abstract:
Eye Movement Desensibilisering och upparbetning (EMDR) är idag en evidensbaserad och internationellt accepterade psykoterapeutisk metod för behandling av traumatiska minnen och PTSD. Jämfört med KBT-metoden har visat sig vara lika effektiva. Det är ännu inte tillräcklig förklaring till varför metoden fungerar. Ny forskning syftar till att beskriva betydelsen av ögonrörelser för aktivering minnesfunktioner och effekterna av det centrala nervsystemet. [författare sammanfattning]
Eye Movement Desensitization and Reprocessing (EMDR) is nowadays an evidence based and internationally accepted psychotherapeutic method for treatment of traumatic memories and PTSD. Compared to CBT method it has shown to be equally effective. It is not yet sufficiently explained why the method works. Recent research aims at mapping the importance of the eye movements for activating memory functions and impact of the central nervous system.[Author abstract]
Keywords: Cognitive Therapy Desensitization Eye Movements Humans Memory Post-Traumatic Therapy Psychologic Methods Stress Disorders Treatment Outcome
Accuracy Verified: Yes
14. Torun, F. (2010, Spring). Vajinismusun EMDR yöntemi ile tedavisi: İki olgu sunumu [Treatment of vaginismus with EMDR: A report of two cases]. Türk Psikiyatri Dergisi, 23(3), 243-248.
Language: Turkish
Format: Journal
Abstract:
Vajinismus kadının vajina kaslarındaki istemsiz kasılmalar nedeniyle hiçbir şekilde cinsel ilişkinin gerçekleşemediği
bir cinsel işlev bozukluğudur. Vajinismus için temel tanı kriteri vajinanın dış üçte birindeki kaslarda koitusu
engelleyecek, yineleyici bir biçimde ya da istem dışı spazmın olması olarak tanımlanmıştır. Birçok olguda ağrı ya da
ağrının olabileceğine ilişkin korku vajinismusun ortaya çıkması ve sürmesine neden olmaktadır.
Bu yazıda, çocukluk çağında geçirilmiş cinsel travmaya bağlı olarak ortaya çıkan iki vajinismus olgusunun Göz
Hareketleri ile Duyarsızlaştırma ve Yeniden İşleme (Eye Movement Desensitization & Reprocessing-EMDR) tekniği
ile tedavisi sunulacaktır. EMDR ağırlıklı olarak ruhsal travma tedavisinde kullanılan bir tedavi tekniğidir. EMDR
tekniğinin etkinliği, travma sonrası stres bozukluğu, cinsel travma mağdurları gibi birçok grupta yapılan randomize
kontrollü çalışmalarla gösterilmiştir. Her iki olguda da standart olarak sekiz aşamalı EMDR protokolü uygulanmıştır.
3 seanslık EMDR seansı sonrasında her iki olguda da hem kaygı düzeylerinde azalma, hem de cinsel ilişkiye
yönelik işlevsel olmayan düşüncelerin ortadan kalktığı görüldü ve vajinismus sorunu ortadan kalktı. Bu çalışmada
sunulan iki olgudan hareketle, travmanın neden olduğu vajinismus olgularında EMDR’nin alternatif bir tedavi
tekniği olarak etkili olabileceği söylenebilir.
Vaginismus is a type of sexual dysfunction in which spasm of the vaginal musculature prevents penetrative intercourse. The main diagnostic criterion is the presence of recurrent or persistent involuntary spasm of the musculature of the outer third of the vagina that interferes with sexual intercourse. In many cases associated pain or the fear of pain may contribute to its persistence. Herein we report 2 patients that presented with vaginismus that developed secondary to childhood sexual trauma, which was treated with the Eye Movement Desensitization and Reprocessing (EMDR) technique. EMDR is a non-pharmacologic treatment for psychological trauma. Randomized controlled trials with posttraumatic stress disorder patients and with victims of sexual abuse have shown that EMDR is effective. The standard 8-phase EMDR protocol was used in both of the presented cases. Following 3 sessions of EMDR, the patients exhibited a substantial reduction in self-reported and clinician-rated anxiety, and a reduction in the credibility of dysfunctional beliefs concerning sexual intercourse. These findings support the notion that EMDR could be an effective treatment alternative for patients with vaginismus of traumatic etiology.
Keywords: Adult Desensitization, Female Humans Psychologic Sexual Behavior Vaginismus Wounds and Injuries
Accuracy Verified: Yes
15. Gunther-Sohst, J. (2002). Zurück in die zukunft: Wie empfinden traumatisierte menschen die behandlung mit der EMDR-methode? [Back to the future - How traumatized do humans feel the treatment with the EMDR method?]. Universität, Dipl.-Arb.--Hamburg.
Language: German
Format: Dissertation/Thesis
Accuracy Verified: Yes