Francine Shapiro Library - EMDR Bibliography Links
Choose any combination of the search options below. If you do not wish to include an option in your search, leave the box blank, or select "Any."
Your Results - you searched for the keyword Instructions 31 Results
1. Waldon, A. (2008, February). Adios pensamientos y sentimientos feos, Manual de EMDR para ninos [Goodbye yucky thoughts and feelings, An EMDR workbook for children] . Lulu.com.
Language: Spanish
Format: Book
Abstract:
Translated from English by Maria Elana Aduriz, Utilizando este cuaderno, el psicoterapeuta de niño EMDR indica el cliente de niño por el protocolo de EMDR. Las ilustraciones visualmente atrayentes basadas en los dibujos de niños son utilizadas para favorecer el niño a dibujar imaginal y recursos existentes para la fuerza, para la maestría, y para el consuelo. Utilizando estos dibujos, el terapeuta prepara al niño para procesar un trauma. Entonces, después de que el niño dibuje un lugar seguro, el terapeuta utiliza el cuaderno para ayudar al niño identifica los pensamientos, las emociones, y las sensaciones del cuerpo relacionadas al trauma. El niño está entonces listo para la Fase 4, la insensibilización y volver a tratar del trauma. El cuaderno continúa ayudando al terapeuta indica el cliente de niño por las fases restantes del protocolo, terminando con un Certificado del Logro para el niño para mantener. Las instrucciones para el terapeuta y hojas de trabajo para las notas del terapeuta son incluidas.
Using this book, the child psychotherapist EMDR client indicates the child EMDR protocol. The visually appealing illustrations based on drawings by children are used to encourage the child to draw imaginal and resources for the strength, expertise, and for comfort. Using these drawings, the therapist prepares the child to process trauma. Then, after the child draw a safe place, the therapist uses the notebook to help the child identify the thoughts, emotions, and sensations of the body related to trauma. The child is then ready for Phase 4, the stunning and come back to the trauma. The book continues to help the therapist tells the client as a child for the remaining phases of the protocol, ending with a Certificate of Achievement for the child to maintain. The instructions for the therapist and worksheets for the therapist's notes are included.
Keywords: Children
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. Grant, M. (1997). Calm and confident overcome stress and anxiety with EMDR. Oakland, CA: New Harbinger Publications.
Language: English
Format: Audio
Abstract:
Two dynamic guided visualizations, soothing native Australian music, and EMDR (Eye Movement Desensitization and Reprocessing) combine top help listeners relax and feel more confident about dealing with stress and anxiety-producing situations. A 16-page instruction booklet provides complete instructions and suggested uses. September pulication date.
Keywords: Anxiety Treatment Posttraumatic Stress Disorder Psychic Trauma Treatment PTSD PSTD Treatment
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. 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
6. 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
7. 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
8. Faretta, E. (2008, Novembre). EMDR e trattamento del disturbo di panico: Un protocollo specifico integrato [EMDR and the treatment of panic disorder: a specific protocol integrated]. Presentazione le Applicazioni Cliniche del EMDR Congresso Nazionale, Milano, Italia.
Language: Italian
Format: Conference
Abstract:
Nell’ambito degli studi sulle possibilità terapeutiche offerte dall’impiego dell’EMDR in diverse patologie si sono evidenziate delle prospettive interessanti in relazione agli interventi sui disturbi di panico, in grado di fornire una possibilità di lavoro terapeutico globale e completo focalizzato non solo sulla condizione presente e quindi sulla gestione degli attacchi di panico, ma anche sulla comprensione dinamica di tale disturbo.
Facendo riferimento alla letteratura e ai resoconti che hanno supportato l’efficacia del-l’EMDR per il trattamento del Disturbo d’Attacchi di Panico (Feske & Goldstein, 1997; Goldstein & Feske, 1994; Nadler, 1996; Shapiro & Forrest, 1997) e dalla analisi ed applicazione del protocollo Whisman, è stato messo a punto, attraverso la personale pratica clinica, un preciso protocollo integrato per il trattamento del disturbo di panico secondo l’approccio EMDR.
Facendo riferimento a questi studi, l’ipotesi di intervento dalla quale sono partita è quella che si basa sulla considerazione che l’attacco di panico può rappresentare un evento traumatico di per sé e che quindi il lavoro clinico proposto, seguendo l’approccio EMDR, risulta efficace per desensibilizzare e rielaborare convinzioni, comportamenti, emozioni e sensazioni corporee legate alla paura fino a farle rientrare all’interno di un sistema di convinzioni più gestibile, in modo da permettere al paziente di affrontare le situazioni precedentemente temute e quindi evitate.
In questo workshop vengono presentate le modalità di applicazione nel disturbo panico in relazione alle 8 fasi di lavoro dell’approccio EMDR, facendo riferimento ai casi clinici e quindi ad esperienze pratiche derivanti dal personale lavoro terapeutico.
Da qui vengono fornite le linee per la strutturazione dello specifico piano di trattamento, secondo un protocollo di lavoro, appositamente elaborato, che conduce, passo dopo passo, all’applicazione del progetto terapeutico
Il protocollo di lavoro presentato si focalizza sulla rielaborazione degli attacchi di panico e quindi sulla gestione della sintomatologia caratteristica di questo disturbo.
Fornisce, inoltre, indicazioni per effettuare un’attenta anamnesi, che permetta al terapeuta di predisporre un adeguato piano di individuazione e di rielaborazione dei fattori precipitanti e delle esperienze traumatiche pregresse della storia personale del paziente sin dall’infanzia, che possono costituire la base emotiva sulla quale può instaurarsi, in particolari circostanze, la sintomatologia del DAP.
Si tratta di eventi stressanti o traumatici del passato sui quali risulta indispensabile un lavoro di rielaborazione al fine di far emergere possibili capacità e comportamenti adattivi per realizzare azioni future adeguate.
As part of studies into the therapeutic possibilities offered by EMDR in various diseases appear to be any interesting perspectives in relation to work on problems panic, unable to provide an opportunity for therapeutic work focused global and comprehensive not only on the present condition and therefore on the management of panic attacks, but also on dynamic understanding of the disorder. Referring to the literature and the reports that have supported the efficacy of on-l'EMDR the treatment of Panic Disorder (FESK & Goldstein, 1997; FESK & Goldstein, 1994; Nadler, 1996, Shapiro & Forrest, 1997) and the analysis and application of the protocol Whisman, was developed through personal clinical practice, a precise protocol integrated treatment of panic disorder according to the EMDR approach. Referring to these studies, the possibility of intervention from which game is the one based on the consideration that the panic attack can be a traumatic event in itself and therefore the clinical work proposed, following the approach EMDR, is effective for desensitize and reprocess beliefs, behaviors, emotions and body sensations associated fear until they fall within a belief system more manageable, so allow the patient to deal with situations previously feared and avoided. In this workshop presents the detailed rules in panic disorder report at 8 phases of EMDR work of the approach, referring to clinical cases and then practical experiences arising from personal therapeutic work. From here, we provide the guidelines for the structuring of a specific treatment, according a working protocol, specially developed, which leads, step by step, application
therapeutic project the protocol of work presented focuses on the recasting of panic attacks and then the management of symptoms characteristic of this disorder. Also provides instructions for making a careful medical history, which allows the therapist to
prepare an adequate plan for the identification and revision of precipitating factors and past traumatic experiences of the patient's personal history from childhood, which may form the emotional basis on which it can establish, in certain circumstances, symptoms of CAD. It is stressful or traumatic events of the past on which it is essential work of reworking in order to identify possible skills and adaptive behaviors to achieve appropriate future action.
Keywords: Panic Disorder
Accuracy Verified: Yes
9. de Roos, C., & Veenstra, S. (2009). EMDR pain control for current pain. In M. Luber (Ed.), Eye movement desensitization (EMDR) scripted protocols: Special populations (pp. 537-557). New York: Springer Publishing Co.
Language: English
Format: Book Section
Abstract:
It is estimated that approximately 30% of the population world-wide suffer
from chronic pain. In this workshop you will learn how to use EMDR in
order to treat patients who have specific forms of chronic pain e.g. phantom
limb pain, whiplash and chronic differentiation pain. Theoretical
information, practical instructions with demonstration videos of illustrative
cases and exercises or role-playing to practise yourself will all be utilised.
You will be provided with enough information and skills in order to be
confident to start treating pain patients in your own clinical practice.
This workshop will provide you with the following information:
•relevant neurobiological information about chronic pain in order to
determine whether a specific type of pain can be treated using EMDR
•the empirical status of the application of EMDR on pain and a short
review of current research and literature
•how to motivate this difficult patient group to try EMDR
•how to conceptualise a case for EMDR, the indications and contraindications
•how to choose suitable targets with pain patients
•the use of the EMDR protocol in its specific application to pain
patients and how to work with pain itself as a target
•complications you can expect and how to deal with these.
Aims:
•identify clients with chronic pain for whom EMDR may be
appropriate
•increase knowledge and understanding of the use of EMDR
in the treatment of chronic pain
•apply EMDR in the treatment of patients with chronic pain.
Target group:
EMDR trained therapists working with patients with chronic pain.
Keywords: Current Pain Pain Control Protocol
Accuracy Verified: Yes
10. Unknown. (1995, May 12). EMDR retrospective study – Instructions on completing datasheets. Unknown.
Language: English
Format: Other
Abstract:
No abstract available.
Keywords: Datasheets
Accuracy Verified: Yes
11. Shapiro, R. (2009). EMDR Solutions II: For depression, eating disorders, performance, and more. New York, NY: W. W. Norton & Co.
Language: English
Format: Book
Abstract:
A clear and comprehensive guide to using EMDR in clinical practice. This edited collection—a follow-up to Shapiro’s successful EMDR Solutions—presents step-by-step instructions for implementing EMDR approaches to treat a range of issues, written by leading EMDR practitioners. The how-to approach, mixed with ample clinical wisdom, will help clinicians excel when using EMDR to treat their clients. The units include:
A comprehensive compendium of EMDR interventions for Depression, it begins with Robin Shapiro’s Assessment, Trauma-Based and Endogenous Depression chapters, continues with Jim Knipe’s Shame-Based Depression chapter, and ends with Shapiro’s Attachment-Based chapter.
The eight chapters of the Eating Disorder unit cover all the bases. From etiology to neurology through Preparation phases and treatment strategies, you’ll learn how to work with Bulimia, Anorexia, Body Dysmorphia, Binge Eating Disorder, disorders of Desire and more. Andrew Seubert is the ring leader. The other writers are Janie Scholom, Linda Cooke, Celia Grand, DaLene Forester, Janet McGee, Catherine Lidov, and Judy Lightstone.
Performance, Coaching, and Positive Psychology unit emphasizes strengths, skills, focus, and whatever gets in the way of reaching the goal. David Grand shares his foundational 15 Strategies for Performance enhancement. Ann Marie McKelvey integrates EMDR with Coaching and Positive Psychology.
The Complex Trauma unit includes Katie O’Shea’s useful and user-friendly Preparation Methods and Early Trauma Protocol, Sandra Paulsen and Ulrich Lanius’s brilliant collaboration Integrating EMDR with Somatic and Ego State Interventions, Liz Massiah’s hair-raising Intrusive Images chapter, and Shapiro’s treatment strategies for OCPD.
Robin Shapiro gives an overview of Medically-Based Trauma and her strategies for successful treatment of Multiple Chemical Sensitivities. Katherine Davis shows us how Post-Partum “Depression” is often treatable Post-Partum PTSD.
Ronald Ricci and Cheryl Clayton tell us how to use EMDR in our work with Sex Offenders and their complete therapeutic milieu.
Martha S. Jacobi develops our “third ear” for using EMDR with Religious and Spiritually-Attuned clients.
Keywords: Depression, Eating Disorders, Performance
Accuracy Verified: Yes
12. Shapiro, F. (2012, February 27). EMDR therapy and Getting Past Your Past. Good Therapy. Retrieved from http://www.goodtherapy.org/blog/emdr-therapy-your-past-0227126/ on 6/26/012.
Language: English
Format: Other
Abstract:
The purpose of Getting Past Your Past is to help liberate readers by giving them a comprehensive understanding of why they respond to the world in ways that don’t serve them and what they can do about it. The book provides self-help procedures derived from EMDR therapy to identify the earlier memories that are the basis of the problem and other techniques to help change their reactions. Through stories, detailed descriptions, and step-by-step instructions, readers will be able to take self-exploration and healing into their own hands. Guidelines are also provided to help them decide if additional professional assistance is needed. The book is written in an easy conversational style so that it is accessible to both the general public and therapists interested in exploring a different paradigm. A wide range of luminaries in the field of psychology have highly recommended the book for both clinicians and laypeople (http://www.emdr.com/coming-soon.html). [Excerpt]
Keywords: General
Accuracy Verified: Yes
13. Karpel, M. A. (2006, September). EMDR: Targeting the repetition compulsion in couples therapy. Presentation at the annual meeting of the EMDR International Association, Philadelphia, PA.
Language: English
Format: Conference
Abstract:
EMDR constitutes a valuable tool for couples
therapists when one or both partners are stuck in
repetitive, reactive cycles. This workshop describes
the circumstances in which EMDR is most likely to
be helpful in couples therapy. It examines the
benefits of EMDR through the lens of the repetition compulsion, with pariicular emphasis on common - and often intractable - impasses in in the treatment of couples. The origins of the repetition compulsion
in early failures of attunement are described, as in
the re-enactment of these experiences in the adult
couples relationship. Working with EMDR is nested
within the context of a resource-based approach to
couples therapy, emphasizing how emotional
reactivity and defensive withdrawal impede the
expression of empathy, trustworthiness, intimacy and repair in the couples relationship. Different formats for conducting EMDR (separately with one partner; separately with both partners; conjointly with both partners; or adjunctively with another therapist) are
presented, along with indicators, advantages and
disadvantages of each format. Special
considerations (such as when to introduce EMDR,
balancing alliances, sequencing sessions and
instructions to an observing partner) and
modifications of the standard protocol when EMDR
is used in the context of couples treatment are also
clarified. Finally, circumstances in which EMDR
is unlikely to be helpful or in which it is contraindicated are examined.
Keywords: Couples Therapy Repetition Compulsion
Accuracy Verified: Yes
14. Karpel, M. A. (2005, September). EMDR: Targeting the repetition compulsion in couples therapy. Presentation at the annual meeting of the EMDR International Association, Seattle, WA.
Language: English
Format: Conference
Abstract:
EMDR can help couples in therapy when one or both partners experience distress which creates obstacles or impasses in treatment. The benetits of EMDR are
examined through the lens of the repetition compulsion and nested within a
resource~based approach to couples therapy (fostering attunement, trustworthness
and vitality). Different formats for conducting EMDR (conjointly, separarely, and
adjunctively) are presented along with their indicators, advantages and disavantages.
Special considerations (such as, when to introduce EMDR, balancing alliances, sequencing sessions and instructions to an observing partner) and modifications the standard protocol are clarified. Contraindications for EMDR in couples therapy are also examined.
Keywords: Couples Therapy Repetition Compulsions
Accuracy Verified: Yes
15. 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
16. 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
17. Waters, L. (1997, Spring). Eye movement desensitization and reprocessing treatment for combat PTSD: Commentary. Psychotherapy: Theory, Research, Practice, Training, 34(1), 99. doi:10.1037/h0087777.
Language: English
Format: Journal
Abstract:
Comments on the article by J. G. Carlson et al (see record 84-01737) regarding the use of eye movement desensitization and reprocessing treatment (EMDR) to treat posttraumatic stress disorder (PTSD) in Vietnam veterans. The author suggests that EMDR seems simplistic and lacks face validity altogether. L. Waters proposes that EMDR works because of resolute perception, a process defined by F. J. Hanna and K. Puhakka (1991) as a deliberate sustained focus of attention on an identified problem with the goal of achieving clarity, at a point when the client is ready and willing to confront and perceive. Waters suggest that a way to test whether or not EMDR works because of resolute perception would be to assign a similar group of clients to a totally different task (e.g., drawing straight lines) while giving them the same instructions as are given in EMDR regarding their memories, thoughts, and desirable cognitions. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Keywords: Commentary Combat Experience Comment Military Posttraumatic Stress Disorder PTSD Reply Veterans Vietnam War Veterans
Accuracy Verified: Yes
18. Foley, T. (1996). Eye movement desensitization and reprocessing treatment of communication anxiety: A closer look. Western Michigan University. AAT 9640073.
Language: English
Format: Dissertation/Thesis
Abstract:
The purpose of this study was to replicate the results of previous research with respect to EMD/R (eye movement desensitization and reprocessing) and of this researcher's investigation of EMD/R treatment of public-speaking anxiety (Foley & Spates, 1995). The present study, however, included components to permit more extensive analysis of the elements of treatment that contribute to therapeutic effectiveness. The study investigated the contribution of assessment speeches to treatment effectiveness by using a two factor design in which one factor featured a condition of pre-treatment/post-treatment speeches vs. a condition of post-treatment speeches only. The other factor featured two treatment conditions, permitting consideration of the contribution of the imaginal exposure component of EMD/R to treatment effectiveness. One treatment condition received EMD/R while the other condition received an alternative treatment that differed from EMD/R only in that there were no instructions to visualize the traumatic event during the eye movement component. Subjects were 32 college students who suffered from communication anxiety and had experienced a specific traumatic event related to a communication situation. The research was carried out in a two factor repeated measures design consisting of four treatment groups: EMD/R-speech condition, EMD/R-no speech condition, Alternative treatment-speech condition, Alternative treatment-no speech condition. Results showed a significant decrease from pre to post-treatment for all groups on several measures. There were no significant differences between groups; however, the results on one measure (CAI) suggests that if power were increased, the groups would differ significantly with respect to the pre-treatment behavioral assessment factor. (PsycINFO Database Record (c) 2008 APA, all rights reserved)
Dissertation Abstracts International: Section B: The Sciences and Engineering. 57(7-B), Jan 1997, pp. 4705.
Keywords: Assessment Speeches College Students With Communication Anxiety Effectiveness Evaluation Empirical Study Oral Communication Speech Anxiety Treatment Treatment Effectiveness
Accuracy Verified: Yes
19. 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:
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.
Keywords: Floatback Technique Float Foward Technique
Accuracy Verified: Yes
20. Waldon, A. P. (2004). Goodbye yucky thoughts and feelings: An EMDR workbook for children. LuLu.com and EMDRResources.com.
Language: English
Format: Book
Abstract:
Using this workbook, the child EMDR psychotherapist guides the child client through the EMDR protocol. Visually appealing illustrations based on children's drawings are used to encourage the child to draw imaginal and existing resources for strength, mastery, and comfort. Using these drawings, the therapist prepares the child for processing a trauma. Then, after the child draws a safe place, the therapist uses the workbook to help the child identify the thoughts, emotions, and body sensations related to the trauma. The child is then ready for Phase 4, desensitization and reprocessing of the trauma. The workbook continues by helping the therapist guide the child client through the remaining phases of the protocol, finishing with a Certificate of Accomplishment for the child to keep. Instructions for the therapist and worksheets for the therapist's notes are included. [EMDRResources abstract]
Accuracy Verified: Yes
21. 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:
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.
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
22. Laub, B., & Bar-Sade, E. (2009). The IMMA EMDR group protocol. In M. Luber (Ed.), Eye movement desensitization and reprocessing (EMDR) scripted protocols: Basics and special situations, (pp. 289-296). New York: Springer Publishing Co.
Language: English
Format: Book Section
Abstract:
The Imma Group Protocol is based on the Integrative Group Treatment Protocol (IGTP) by Jarero, Artigas, Alcala, and Lopez Cano (see record 2009-08399-029), the Four Elements Exercise by Elan Shapiro (see record 2009-08399-009), and the principles of group therapy work. This protocol is designed for small groups of children from the age of 5 upward. The language can, of course, be adjusted to suit the developmental level of the group. The protocol is to be used only by EMDR-trained therapists. The therapist must have the ability to react on the spot, evaluate, and provide further treatment for clients who are overwhelmed by the traumatic material. We recommend that work with this protocol include at least two group facilitators, in addition to the leader, in order to monitor the group and help the children carry out the instructions. The younger the children, the more facilitators are needed to insure that each child feels safe and emotionally supported. The appropriate scripts are provided. [PsycINFO Database]
Accuracy Verified: Yes
23. Armstrong, M. K. (2009). Integrating focusing into EMDR. Author.
Language: English
Format: Other
Abstract:
Focusing views the felt sense as the point at which we can access the
unconscious. Both Focusing and EMDR recognize the body's physical
response as the entry point into memory. Shapiro includes the body scan
in EMDR's protocol. She reminds us that the physical sensations
experienced at the time of the event are stored in the nervous system and
may constitute the dominant thread of the associative sequence (p. 79).
She instructs clinicians to ask clients to concentrate on the attendant
physical sensations while the eye movement sets are systematically altered
(p. 178). Those familiar with Focusing will find it very natural to follow
Shapiro's instructions to have clients "close their eyes and fix their entire
attention on the location of the sensation. Whatever image or thought
appears should then be targeted" (p.180). [Excerpt]
Keywords: Focusing
Accuracy Verified: Yes
24. Albers, J. (2010, July). The interplay of resourcefulness and resilience in recovery: A six session approach treating addictive behaviour, an extended EMDR protocol. Presentation at the 1st EMDR Asia Conference, Bali, Indonesia.
Language: English
Format: Conference
Abstract:
A structured six-session group therapy has been developed and approved for overcoming craving. The six session protocol
can easily be integrated to well-applied EMDR protocols (DeTur from Popky, CravEx from Haase) supported by systematic
implementation of cue exposure techniques and guided imagery. The EMDR protocol supported by cue exposure catalyses
the recovery process as follows:
At the beginning the patients are taught a set of three ideodynamic resources for coping with the urge to drink; “Rewards
of sobriety”, “Support of relatives and friends” and “Irrepressible commitment to sobriety”. The patients learn rapid activation
of these resources by the use of the “Seven Cue Word Induction–technique” and kinaesthetic bilateral stimulation (SingleblAiR).
Then they are exposed to alcohol until the urge to drink reaches it´s peak. At this moment they are taught to initialize
resourcefulness - with continued exposure to alcohol. Subsequently, the power of one ideodynamic strategy diminishes
the intensity of craving significantly. Craving symptoms finally disappear and are replaced by self-reinforcing thoughts and
feelings due to state dependent learning. In addition to this new experience the patients acquire a high level of self-efficacy
as well as greater and deeper knowledge about their personal drinking triggers. They also find out which strategy is the
most effective one for each specific trigger. After regaining self-control over triggers, the patients are more receptive to
working with their core addiction issues, which have now become easier to treat by especially using Desensitization and
Reprocessing of the Standard- EMDR protocol. Workshop participants will become acquainted with the six-session protocol
by the use of DVD-demonstrations and by practising. In addition they will receive a manual with standardised instructions.
Finally they will also be given the opportunity to participate in a cross-cultural research project proving the effectiveness of
the six-step program which starts in 2011. This approach is designed to improve the treatment of various types of addiction
and can easily be integrated into existing EMDR treatment strategies.
Keywords: Addiction Addictive Behavior Resourcefulness Resilience
Accuracy Verified: Yes
25. de Jongh, A., & ten Broeke, E. (2006, November). Masterclass EMDR. Presentatie aan de tweede congres van de Vereniging EMDR Nederland, Arnhem, The Netherlands.
Language: Dutch
Format: Conference
Abstract:
De uitvoering van EMDR kent zo zijn lastige kanten, bijvoorbeeld omdat het proces niet op gang lijkt te komen, of omdat het scherpstellen niet gemakkelijk gaat. In veel gevallen heeft dat te maken met een gebrek aan ervaring met de unieke dynamiek van EMDR als informatie-verwerkingsmethode, maar vaak ook ligt de oorzaak in het niet optimaal toepassen van het protocol.
In deze bijeenkomst wordt een overzicht gegeven van - en uitleg gegeven over - veelvoorkomende EMDR ‘fouten’ en moeilijkheden. De deelnemers krijgen tips en instructies om geblokkeerd gewaande processen weer op te starten, ook bij complexe patiëntenpopulaties. Uitgebreid wordt ingegaan op het conceptualiseren van casus voor de toepassing van EMDR, onder andere aan de hand van video-opnamen. Van de deelnemers wordt gevraagd hun eigen vragen en problemen met de EMDR procedure in te brengen om van deze masterclass een levendige bijeenkomst te maken.
The implementation of EMDR knows its tough edges, such process will not start because it seems to be, or because the focus is not easy. In many cases, this has to do with a lack of experience with the unique dynamics of EMDR as an information processing method, but often the reason lies in not fully implement the protocol.
In this session gives an overview of - and explanations are given - EMDR common 'mistakes' and difficulties. Participants receive tips and instructions for processes blocked supposed to restart, even in complex patient populations. Extensively discusses the conceptualization of case for the application of EMDR, including using video recordings. Participants are asked their own questions and problems with the EMDR procedure to bring this master of making a lively meeting.
Accuracy Verified: Yes
26. Maxfield, L. (2009). On science, orthodoxy, EMDR, and the AIP, H. Lipke, Response from the editor. Journal of EMDR Practice and Research, 3(2), 109-112. doi:10.1891/1933-3196.3.2.109.
Language: English
Format: Journal
Abstract:
The Journal ’s instructions to authors are located inside
the back cover of every issue. The relevant passage
stated, “Articles that recommend a clinical approach
that differs from EMDR’s standard protocol or its
foundational Adaptive Information Processing model
(Shapiro, 2001) should explain these differences.”The purpose of this instruction was to encourage
clarity rather than conformity. It is important for
Journal readers, some of whom have not been trained
in this method, to know whether the techniques described
are standard for eye movement desensitization
and reprocessing (EMDR) or variations on the
protocol. For example, the reader of an article describing
a technique that combines EMDR with aspects of
another psychotherapy approach such as hypnosis
could assume that hypnotic inductions were part of
standard EMDR unless it was stated clearly which elements
were adapted from that method. The request that authors also clarify points of divergence from
the adaptive information-processing (AIP) model was
similarly intended to generate clarity. It is consistent
with the recognition that a common platform for discussion
is needed, even if that platform is imperfect.
It is also consistent with Shapiro’s teaching of the AIP
model as a clinical heuristic that is subject to revision
in the face of new data or more compelling models.
Rather than thwarting discussion, the request that authors
explain points of disagreement was designed to
promote deeper consideration of the mechanisms and
models underlying EMDR.
In response to Dr. Lipke’s letter, the Journal ’s Editorial
Board engaged in a thorough review process to
examine the value of this instruction and invited responses
(see letters above) from Dr. Shapiro and the
EMDRIA’s Board of Directors to further illuminate
the process. The Editorial Board has a diverse membership,
and there were divergent opinions, including
some disagreements with the following response.
It was decided to modify the identified statement so
that it now reads, “Articles that recommend a clinical
approach that differs from EMDR’s standard protocol
or Shapiro’s (2001) Adaptive Information Processing
model should discuss these differences.”
Keywords: Adaptive Information Processing AIP Letter Orthodoxy Science
Accuracy Verified: Yes
27. Parnell, L. (2009, July). Resource tapping: Step-by step instructions for managing emotions and reducing anxiety with trauma patients . Presentation at the National Institute for the Clinical Application of Behavioral Medicine Annual Conference, Hilton Head, S.C..
Language: English
Format: Conference
Abstract:
Resource Tapping is a powerful and effective EMDR-related technique that uses imagery and bilateral stimulation to harness the power of inner resources. It is an effective, easy-to-use technique for ego strengthening, affect regulation and stress reduction in the treatment of trauma. This technique can be used to help rebalance the nervous system, activate the parasympathetic restoration cycle, and teach self-regulation. Participants will learn to interweave this mind-body technique throughout the course of treatment to help with anxiety, sleep problems, triggers, depression, and strong emotions such as fear, anger, and sadness. .
Keywords: Mind-Body Medicine Resource Tapping
Accuracy Verified: Yes
28. Forrest, M. S. (1995, June). Self-soothing and the multiple trauma survivor. Presentation at the EMDR Network Conference, Santa Monica, CA.
Language: English
Format: Conference
Abstract:
Remember the joke about the doctor who says, "The operation was a success, but the patient died"? That's how some clients feel
about EMDR. They succeed in accessing deep and important material, but find themselves extremely depressed and/or anxious in
the days afterward. For these clients, who are often survivors of multiple trauma such as long-tenn child abuse or incest, the ability
to self-soothe (both during and after an EMDR session) makes the difference between whether they regard EMDR as a useful tool or
a necessary evil.
To find out what self-control techniques work best for such clients, I interviewed EMDR clients (all women) who had experienced
long-term sexual abuse in childhood.
The first thing I learned was that for survivors of multiple trauma, the ability to feel safe starts long before EMDR is ever used.
Many women cited their relationship with their therapist as the foundation of their feeling safe with EMDR: "I trust my therapist
absolutely." One client's therapist told her he had used EMDR himself: "That made a huge difference to me," she said.
Other advance work included planning and taking preventative measures. Planning means picking the right time (and pace) for
doing EMDR: being sure the therapist and/or other support people will be available in the days after the session; not driving or
going back to work afterward (if possible); being able to have plenty of alone time; and going slowly, doing EMDR in small
increments. "I didn't expect myself to go out in the world and be social afterward. I was pretty raw for a few days, sometimes for a
whole week," B. told me.
Planning also means taking preventive measures, such as teaching the client how to find "a safe place." Most clinicians know the
importance of this, but one of the women I interviewed was emphatic that creating a safe place was very different from being able to
go to it when she was in a session and reliving the experience of being a three-year-old overwhelmed by extreme grief or terror. She
said she needed a lot of practice accessing her safe place and some special interventions (see below) to get through the intense times.
Being able to self-soothe between sets of eye movements was very difficult for most clients. "I cry all the time we do it," S. told me.
"I have to sit near the door and not have my therapist sit too close," said M. Another woman said, "We do the eye movements for a
few seconds and we talk in between."One successful intervention, especially for clients overwhelmed by the intensity of their
feelings, involved the therapist asking his client to listen to the sound of his breathing and to breathe along with him. Another
clinician has his client when she gets extremely upset ask her "inner guide or "higher power" whether it's "okay to continue;" a third
asks, "Is there more underneath or is it time to wind down?" Letting the client control the pace and progress of his/her own
processing can be an important way to teach self-trust -- especially to people for whom loss of power was endemic to their abuse.
Some clients are able to repeat special phrases or afirmations over and over between sets to calm themselves. L., a ritual abuse
survivor, said she grounds herself by silently reciting a mindfulness verse from Zen master Thich Naht Hanh in time with her inbreath
and out-breath: "In, out. Deep, slow, Calm, ease. Smile, release. In, out. Deep, slow ......
Different kinds of self-soothing techniques work best after the eye-movement sets are completed.
Immediately afterwards, while still in session, one client said she falls asleep for a few minutes -- she finds this a big help in
countering the dissociated state in which she typically concludes an EMDR session. Another said she and her therapist share a cup
of tea and talk over what happened as a way to "come down" and normalize the experience.
Some clinicians close a session by doing eye movements to reinforce the client's safe place. One woman said her therapist has her
"cement the present in place" by doing eye movements on either a present-day image, an image of her inner child in the safe place, or
a positive statement.
Francine Shapiro has often said that what happens after the EMDR session can be as important as what happens during it. The
women I interviewed felt exactly the same way. They had learned the necessity of talung exquisitely good care of themselves in the
hours and days that follow. "I take time-and time out," declared B., who often has a delayed fear reaction following EMDR.
Most clients said they go home and either curl up in bed or in a favorite rocking chair with their stuffed animals. They cry, sleep,
write in their journals, draw pictures, listen to music, look at favorite photographs, and/or call a support person. M. uses self-talk to
ease her feelings: "I say to myself, 'You know that knot of fear. I know it's only fear. I know that nothing is going to hurt me right
now'." For others, going home immediately is not the best option: D. takes a walk along the shores of Long Island Sound; C., the
mother of three young children, finds solace in a favorite bookstore.
Sometimes all the planning in the world doesn't help: the abreaction seems to launch the client back to the age she was when she
was abused - and she simply can't remember how to calm herself. To counter this, several clients said they carry a list of things
they can do to quiet themselves. S. finds reading mystery stories comforting("At the end you always find out what really happened."), but has to keep two of them on her bedside table at all times: "If they're not in full view, I forget about using them."
One interesting example of "assigned" self-soothing was given by a ritual abuse survivor who was new to EMDR. After a session
when a lot of memories came up about how her sexuality was used and degraded during the abuse, her therapist gave her very
specific instructions on how to care for herself, including buying a romantic nightgown and soaking in bath salts for 45 minutes;
listening to romantic music; and not touching or kissing her partner for 48 hours. "It worked out great!" she told me happily. "I felt
SO pretty and so safe."
The conclusion I reached about how multiple-trauma survivors learn to self-soothe in the face of the intense feelings EMDR can
trigger is not revolutionary. The recipe is: Step 1. Plan for the worst. Step 2. Let the client select the self-soothing techniques that
specifically fit for her or him. Step 3. Make sure s/he is able to use these techniques no matter how intense his/her emotions are.
Sometimes this will call for the therapist to take an active role by either leading the client in specific calming techniques or by
assigning very clear-cut homework.
If the recipe calls for planning and practicing, then the pot in which the ingredients are cooked is labeled "TRUST"-trust before
initiating EMDR, trust during the eye movements, and trust after the sets are completed. Unless the client deeply trusts the
clinician, the method itself, and his or her own capacity to go into the feelings and me out safely, the recipe for success with
EMDR can turn into a recipe for disaster.
Accuracy Verified: Yes
29. van Vliet, I. M. (2010, April). Update van de multidisciplinaire richtlijn angststoornissen [Multidisciplinary guideline update anxiety]. Presentatie op het 38ste Voorjaarscongres Nederlandse Vereniging voor Psychiatrie, Maastricht, The Nederlands.
Language: Dutch
Format: Conference
Abstract:
Een herziening van de Multidisciplinaire richtlijn Angststoornissen is nodig in verband met nieuwe wetenschappelijke kennis over effectieve interventies en wijzigingen in de organisatie van de zorg.
Doel: De belangrijkste veranderingen van de herziening van de richtlijnen Paniekstoornis met of zonder agorafobie en Posttraumatische stressstoornis worden besproken alsmede implicaties voor de praktijk.
Methoden: De wetenschappelijke literatuur met betrekking tot de paniekstoornis met of zonder agorafobie en posttraumatische stressstoornis werd vanaf 2001 verzameld, beoordeeld en verwerkt in de herziene versie van de richtlijn.
resultaten Bij de paniekstoornis met of zonder agorafobie is de grootste verandering ten opzichte van de eerste versie van de richtlijn dat de combinatiebehandeling van antidepressiva met exposure in vivo niet meer de meest effectieve behandeling is bij ernstige agorafobie. Bij korter bestaande en lichtere vormen van de aandoening gaat de voorkeur uit naar cognitieve gedragstherapie of daarop gebaseerde interventies. Bij de posttraumatische stressstoornis is de belangrijkste verandering dat cognitieve gedragstherapie en eye movement desensitization and reprocessing (emdr) nog meer dan in de eerste versie van de richtlijn geprioriteerd zijn als behandeling van eerste voorkeur. De nieuwe behandelalgoritmes worden besproken.
Conclusie: De nieuwe richtlijn geeft aanwijzingen voor een stepped-care behandeling van angststoornissen. Meer nadruk is gegeven aan niet-medicamenteuze behandelvormen. medicamenteuze behandelingen worden gereserveerd voor de meer langdurige, ernstige en voor psychotherapie resistente angststoornissen alsmede voor angststoornissen met een comorbide ernstige depressieve stoornis.
A review of the Anxiety Disorders Multidisciplinary guideline is necessary because of new scientific knowledge about effective interventions and changes in the organization of care.
Purpose: The main changes from the revision of the guidelines Panic Disorder with or without agoraphobia, and posttraumatic stress disorder are discussed and implications for practice.
Methods: The scientific literature on panic disorder with or without agoraphobia, and posttraumatic stress disorder since 2001 were collected, assessed and reflected in the revised version of the directive.
Results In the panic disorder with or without agoraphobia is the biggest change from the first version of the directive that the combination treatment of antidepressants with exposure in vivo no longer the most effective treatment for severe agoraphobia. For existing shorter and milder forms of the disease is preferable to cognitive behavioral therapy or interventions based thereon. In the post-traumatic stress disorder is the most important change that cognitive behavioral therapy and Eye Movement Desensitization and Reprocessing (EMDR) more than in the first version of the directive are prioritized for treatment of first choice. The new treatment algorithms are discussed.
Conclusion: The new directive gives instructions for a stepped-care treatment of anxiety disorders. More emphasis is given to non-pharmacological treatment modalities. drug treatments are reserved for the more prolonged, severe and resistant to psychotherapy for anxiety disorders and anxiety disorders with a comorbid major depressive disorder.
Keywords: Anxiety Multidisplinary Guideline
Accuracy Verified: Yes
30. Parnell, L. (1995, June). The use of imaginal and cognitive interweaves with sexual abuse survivors. Presentation at the EMDR Network Conference, Santa Monica, CA.
Language: English
Format: Conference
Abstract:
This hour and a half presentation addresses the use of cognitive and imaginal interweaves in the treatment of adult survivors of
sexual abuse. The overall course of treatment with EMDR is briefly outlined including a variety of interweave interventions for use
in the beginning, middle and end of EMDR sessions.
In working with sexual abuse survivors with EMDR it is important to understand the issues commonly encountered in their
treatment. These include issues of safety, trust, responsibility, choice/control, interpersonal relationships, body awareness and
image, sexuality and self esteem. A sexual abuse assessment can be taken which includes information on the perpetrator(s), severity
and frequency of abuse, type of abuse, age of onset of abuse, duration of abuse, disclosure and family response.
Sexual abuse survivors present themselves in treatment in different ways. Some clients come to treatment remembering abuse and
want to clear it with EMDR. Other clients come to treatment with no clear memories of incidents but have a "feeling" something
happened to them and have symptoms of abuse. There are clients who have no clear memories but something has triggered
flashbacks and nightmares of sexual abuse. Finally, there are clients who have no memory of abuse and come to therapy for another
reason but uncover what they believe to be sexual abuse memories with EMDR.
There are three phases of treatment in sexual abuse cases. In the beginning phase, a history is taken and there is the establishment
of a trusting relationship. The client is prepared for EMDR. In the middle phase, there is the reprocessing and working through of
traumatic memories and transference work. In the end phase of treatment there is integration of the information which has been
uncovered and preparation for life outside of therapy.
Interweaves can be utilized in the beginning, middle and end of EMDR sessions.
In the beginning of individual EMDR sessions there is a check-in with clients to see how they have been doing during the week.
What has come up for them in their dreams or daily life since the last session? Next there is the selection and development of targets
for EMDR (body sensation, memory, flashback, symptom, dream, feeling, vague sense, negative cognition or drawing).
A safe place is then established where the client can go at the beginning, middle or end of the session as needed. Along with the
safe place an inner advisor or other inner resources can be contacted and developed for use in sessions. A connection with the
client's inner child is important which can be done through the use of guided imagery, photographs and/or artwork.
Instructions on how EMDR will be used are given with attention paid to issues of safety and control (they are in control, they can
stop at any time, they can return to the safe place, they know the signal for stop). Negative and positive cognitions are established
along with the EMDR protocol.
In the middle of individual EMDR sessions there are commonly problems with looping or being "stuck." This seems to occur
frequently with sexual abuse survivors because of the intensity of the trauma and because the child self is often frozen in time
lacking access to the adult self's information. Ways to work with this include looking for the blocking beliefs (i.e., The perpetrator
can hurt me), look for blocking images, and talking to the child part (what does he/she need?).
Imaginal and cognitive interweaves can be used in a variety of different ways in the middle of EMDR sessions. Some of these
include: imagining the adult self helping the child self in the traumatic scene, bringing in inner and outer resources for help (i.e., a
powdl imaginary being, a strong loving fiend, the therapist, etc.), and reality check interweave where is the perpetrator now?, can
helshe hurt you now?) It is also important to educate the child part that his or her feelings are normal, sexual feelings are normal etc.
It can be helpful to ask the adult self to talk to the child self explaining things to the child. Another useful interweave is to have the
adult self hold the perpetrator and allow the child to beat him or her up or have the adult self beat up the perpetrator allowing anger
to be expressed safely. Asking clients if they would like to return to the safe place for a break can also be helpful if they are feeling
too overwhelmed.
There are a number of ways to end or close incomplete EMDR sessions. Often it will not be possible to completely clear a traumatic
memory in a session or the memory worked on is completed but connected to a whole network of other traumatic events. For these
cases there are a number of interweaves that can be used. Clients can be requested to have the adult self comfort the child self in the .
safe place. The client can imagine putting the scary unfinished disturbance that has been uncovered in a file folder, box, safe, leave
it in the therapist's office, etc. The client can return to the safe place where the child and adult selves can play together. The adult
can comfort the child or do whatever is needed to create safety and containment. Clients can imagine their child self being held by
protector figures repeating cognitions related to safety, responsibility and choice. They can also be asked what they learned from the
session, installing their response with eye movements.
It is helpful to give homework to clients such as journaling, artwork, walks in nature, meditation, stress reduction, group work,
exercise, nutritious diet, and restriction of drugs and alcohol. Loving Kindness or Metta Meditation is another very helpful tool for
teaching self soothihg to adult survivors of sexual abuse.
Keywords: Cognitive Interweave Imaginal Interweave Sexual Abuse Survivors
Accuracy Verified: Yes
31. Zilbergeld, B. (1995, June). Using EMDR in the treatment of sexual problems. Presentation at the EMDR Network Conference, Santa Monica, CA.
Language: English
Format: Conference
Abstract:
This presentation is based entirely on my own clinical work and discussions with a few other sex therapists who use it in their work.
I am well aware of the lack of solid research to back up my claims and to provide evidence of their generalizability to other clients,
therapists, and situations.
1. Why EMDR is used so little in treating common sexual dysfunctions and dissatisfactions.
2. Why EMDR is relevant and appropriate in treating these problems. Everything depends on how we define trauma. If
we use a broad definition - one that includes humiliations, embarrassments, anxiety, as well as hurts and wounds -the
relevance of EMDR becomes obvious.
3. The kinds of causative and maintaining issues in sex cases that EMDR can be helpful for. These include anticipatory
anxiety, unresolved early learnings about intimacy and sexuality, and current and past relationship fears and hurts.
4. Case examples of EMDR in the treatment of dysfunctions and dissatisfactions: orgasm and erection difficulties, rapid
ejaculation, and desire/frequency complaints.
5. EMDR and meditation. I have found that for some clients meditation is a valuable adjunct to EMDR. It serves as a
safe place for them and has also been helpful in bringing up issues that need work as well as a place to process and
integrate material that comes up in EMDR. No special instructions are required; the very act of meditation does the
bringing up of issues and processing on its own.
6. Litations of EMDR in dealing with cases of sexual problems. As far as I know, EMDR by itself has not resulted in
complete resolution of a presenting sexual problem While extremely helphful in many cases, EMDR has to be viewed
as one tool in a comprehensive treatment package. This means that those who use it need to have knowledge of and
experience with the tools of sex therapy and marital therapy. EMDR is also limited, as are all therapy methods, by the
dynamics of the relationship in which the sexual difficulty exists. While it can help resolve past wounds inflicted by
the partner, it will not be effective in the long run if the relationship continues to feel unsafe.
7. There is a critical need for good research to back up claims of EMDR's benefits with sexual cases and to determine
exactly how and when to use the method to maximum effect.
Keywords: Sexual Issues
Accuracy Verified: Yes