Francine Shapiro Library - EMDR Bibliography Links
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1. Litt, B. (2012, October). Advanced techniques in the EMDR-based treatment of complex trauma. Presentation at the 29th annual meeting of the International Society for the Study of Trauma and Dissociation, Long Beach, CA.
Language: English
Format: Conference
Abstract:
Abstract:EMDR is an efficacious therapy for the treatment of PTSD. Increasingly, EMDR is being recognized as an important and viable therapy in the treatment of complex PTSD, including Dissociative Disorder Not Otherwise Specified, Dissociative Identity Disorder, and personality disorders that have their origins in attachment trauma. This population presents unique clinical challenges in terms of stability, affect tolerance, and accessibility to trauma resolution. While much has been written and presented about affect regulation, attachment issues, and dissociation, therapists are not often aware that these phenomena emerge and must be managed throughout all phases of EMDR therapy. This presentation will focus on advanced techniques that provide solutions to problems within phases 2,3, and 4. Clinicians will learn techniques to incorporate in the stabilization/ preparation phase and to revisit as necessary in later stages of EMDR treatment. Objectives include helping the patient effectively deal with reactions such as avoidance, freeze, hyperarousal and numbing. Techniques include ego state work and somatic interweaves.In Phase 4, (desensitization) therapists will be learn about the Zone of Optimal Arousal and learn a sequence of advanced techniques to maintain client stability and safety, and to identify when and why a patient has stopped processing.
Learning Objectives:
Participants will be able to perform a series of strategies for overcoming looping and blocking in EMDR phases three and four.
Participants will be able to utilize the Domains of Self Model to rapidly assess triggers and anticipate processing style and resolution profile.
Participants will be able to utilize the Zone of Optimal Processing model to assess problems with processing and select appropriate strategies to safely resume desensitization.
Keywords: Advanced Techniques Complex Trauma
Accuracy Verified: Yes
2. Kirsch, A., & Seidler, G. (2007). Affekt und trauma: Mimisch affektive beziehungsregulation bei gewaltopfern in der EMDR therapie [Affect and trauma: Facial affective behavior and relationship regulation in violence victims during EMDR therapy]. Zeitschrift für Psychotraumatologie, Psychotherapiewissenschaft, Psychologische Medizin (ZPPM), 5(2), 53-66.
Language: German
Format: Journal
Abstract:
Es wird davon ausgegangen, dass Patienten mit PTBS ein spezifisches Interaktionsverhalten in die Beziehung implementieren, das sich im mimisch affektiven Ausdruck und insbesondere im affektiven Mikroverhalten ausdrückt. Das mimisch-affektive Verhalten wurde mit dem Emotional Facial Action Coding System (EMFACS) analysiert. EMFACS ist ein Kodiersystem zur Erfassung von mimischen Expressionen, die den Primäremotionen zugeordnet werden. Zusätzlich wurde das Blickverhalten der Interaktanden kodiert und mit den Emotionen in Beziehung gesetzt. Patienten mit einer akuten Traumatisierung zeigen eine Reduktion der gesamten mimischen Aktivität sowie der Primäremotionen. Bezogen auf das Blickverhalten findet sich bei den PTSD-Patienten ein reduziertes beidseitiges Anblicken. Das mimisch affektive Verhalten der Patienten wurde in der ersten und der letzten EMDR-Sitzung verglichen. Es zeigte sich eine leichte Erhöhung.
It is assumed that patients with mental diseases implement a specific interaction pattern, that is expressed in the facial affective expression and particularly in facial-affective micro-behaviours. The facial affective behaviour was coded with the Emotional Facial Acting Coding System, an instrument for the registration of facial movements with emotional relevance. Afterwards these analyses were connected with gazing behaviour. Patients with an acute trauma showed a reduction of overall facial expressions and a reduced frequency of facial affects. Taking the gazing behaviour into consideration it became obvious that PTSD patients showed decreased portion of mutual gaze. Furthermore the facial affective expression of the patients' first and last EMDR session was compared. A slight increasing of facial affective expression and also an increase of the psychic complains was found. [Author Summary]
Keywords: Crime Emotional Numbing Posttraumatic Stress Disorder PSTD Survivors
Accuracy Verified: Yes
3. Krause, R., & Kirsch, A. (2006, Oktober). Auf das verhältnis zwischen traumatisierung, amnesie und symptom stress - Eine empirische pilotstudie [On the relationship between traumatization, amnesia and symptom stress - An empirical pilot study]. Zeitschrift für Psychotraumatologie und Psychologische Medizin, 52 (4), 392-405.
Language: German
Format: Journal
Abstract:
Ziele: In der vorliegenden Studie untersuchten wir mimisches Verhalten bei akut traumatisierten Patienten, EMDR-Therapie. Darüber hinaus untersuchten wir, ob eine Abnahme der emotionalen Betäubung wurde aufgrund einer Verringerung der Symptome. Amnestische Tendenzen waren als Moderator-Variable benutzt. Methode: Das mimisch affektive Verhalten wurde kodiert mit dem Emotional Facial Coding System Acting, ein Instrument zur Erfassung von mimischen mit emotionaler Bedeutung. Die Gesichts-affektive Verhalten der Patienten das erste und letzte EMDR-Sitzung wurde verglichen. Ergebnisse: Ein signifikanter Anstieg in Mitten affektive Verhalten sowie eine Zunahme der psychischen Beschwerden gefunden. Darüber hinaus hat die Reduzierung der amnestischen Tendenzen nicht zu einer Verringerung der Symptome führen. Schlussfolgerungen: Unter dem Einfluss der Behandlung ist es möglich, den Zugang zu episodische affektive Gedächtnis zu verbessern. Dennoch kann einen positiven Einfluss nicht am Ende der Behandlung bezeichnet werden.
Objectives: In the present study we examined facial affective behavior in acutely traumatized patients undergoing EMDR therapy. Furthermore, we analyzed Whether a decrease in emotional numbing was due to a reduction of symptoms. Amnestic tendencies were used as a moderator variable. Methods: The facial affective behavior was coded using the Emotional Facial Acting Coding System, an instrument for the registration of facial movements with emotional relevance. The facial affective behavior of the patient's first and last EMDR session was compared. Results: A significant increase in facial affective behavior as well as an increase in mental complaints were found. Furthermore, the reduction in amnestic tendencies did not result in a reduction of symptoms. Conclusions: Under the influence of the treatment it is possible to improve access to episodic affective memory. Nevertheless, a positive influence can not be denoted at the end of the treatment.
Keywords: Amnesia Empirical Study Facial Affective Behavior Facial Expressions Memory Quantitative Study Trauma Traumatization Treatment
Accuracy Verified: Yes
4. Kirsch, A., & Seidler, G. H. (2004). Ausdruck und erleben von emotionen bei der posttraumatischen belastungsstörung: Erste ergebnisse einer studie mit gewaltopfern [Expression and experience of emotion in patients with posttraumatic stress disorder: First result of a study with victims]. Zeitschrift für Psychotraumatologie und Psychologische Medizin, ZPPM 2(1), 45-60.
Language: German
Format: Journal
Abstract:
Emotionale Betäubung (EN) in PTSD ist ein Cluster von schwächenden Symptomen mit Problemen in der Erfahrung und dem Ausdruck von Emotionen. EN ist in drei separate diagnostischen Kriterien dargestellt: deutlich vermindertes Interesse an wichtigen Aktivitäten, Gefühle der Ablösung oder Entfremdung von anderen, und eingeschränkte Bandbreite des Affekts. Die funktionale Beziehung zwischen anderen Klassen von PTSD Symptome und EN ist nicht gut verstanden. In diesem Artikel werden verschiedene Studien diskutiert werden. Es wird davon ausgegangen, dass Patienten mit psychischen Erkrankungen eine spezifische Wechselwirkung Muster implementieren, die in der Gesichts-affektiven Ausdruck und äußerte sich vor allem in Gesichts-affektiven Mikro-Verhalten. Das Ziel der vorliegenden Pilot-Studie war die Analyse von Gesichts-affektive Verhalten von Patienten mit PTSD im Vergleich zu gesunden Personen. Erste Ergebnisse der ersten EMDR-Sitzungen auf Video aufgezeichnet von Patienten und psychodynamischen Interviews von gesunden Personen (keine psychische / psychiatrische Störungen nach ICD-10) wurden mit dem codierten Emotional Facial Coding System Acting, ein Instrument zur Erfassung von mimischen mit emotionaler Bedeutung. Danach wurden diese Analysen mit Blickverhalten verbunden. PTSD Patienten zeigten eine Verringerung der gesamten Mimik und eine verminderte Häufigkeit von Gesichts wirkt im Vergleich zu gesunden Personen. Unter dem Blickverhalten in Betracht, wurde es offensichtlich, dass PTSD Patienten zeigten Anteil sank gegenseitigen Blick im Vergleich zu gesunden Personen. Außerdem war der Gesichtsausdruck affektiven Ausdruck von vier Patienten (Eltern, die durch den gewaltsamen Tod ihrer Kinder beraubt) erste und letzte EMDR-Sitzung verglichen. Eine leichte Erhöhung des Gesichts affektiven Ausdruck gefunden wurde. [Autor Summary)
Emotional numbing (EN) in PTSD is a cluster of debilitating symptoms involving problems in the experience and expression of emotion. EN is represented in three separate diagnostic criteria: markedly diminished interest in significant activities, feelings of detachment or estrangement from others, and restricted range of affect. The functional relationship between other classes of PTSD symptoms and EN is not well understood. In this article different studies will be discussed. It is assumed that patients with mental diseases implement a specific interaction pattern, that is expressed in the facial affective expression and particularly in facial-affective micro-behaviours. The aim of the presented pilot-study was the analysis of facial-affective behaviour of patients with PTSD in comparison to healthy persons. First results of videotaped first EMDR sessions of patients and psychodynamic interviews of healthy persons (absence of mental/psychiatric disorder according to ICD-10) were coded using the Emotional Facial Acting Coding System, an instrument for the registration of facial movements with emotional relevance. Afterwards these analyses were connected with gazing behaviour. PTSD patients showed a reduction of overall facial expressions and a reduced frequency of facial affects in comparison to healthy persons. Taking the gazing behaviour into consideration, it became obvious that PTSD patients showed decreased portion of mutual gaze compared to healthy persons. Furthermore, the facial affective expression of four patients' (parents bereaved by the violent deaths of their children) first and last EMDR session was compared. A slight increasing of facial affective expression was found. [Author Summary]
Keywords: Crime Emotional Numbing Interpersonal Interaction Posttraumatic Stress Disorder Psychotherapeutic Processes PTSD Survivors
Accuracy Verified: Yes
5. Makinson, R. A., & Young, J. S. (2012, April). Cognitive behavioral therapy and the treatment of posttraumatic stress disorder: Where counseling and neuroscience meet. Journal of Counseling & Development, 90(2), 131-140. doi:10.1111/j.1556-6676.2012.00017.x .
Language: English
Format: Journal
Abstract:
There is increasing evidence to support the biological basis of mental disorders. Subsequently, understanding the neurobiological context from which mental distress arises can help counselors appropriately apply cognitive behavioral therapy and other well-researched cognitive interventions. The purpose of this article is to describe the neurobiological context underlying the formation and treatment of posttraumatic stress disorders, a mental disorder frequently encountered by counselors, from a cognitive therapy framework.
Recent changes to the Council for Accreditation of Counseling and Related Educational Programs (2009) accreditation standards include the need for counselors-in-training to understand the neurobiological basis of behavior, which marks a new direction for the training of professional counselors who have historically reacted ambivalently toward medical models for understanding client concerns and treatments. Yet recent findings in neuroscience actually support the verbally based interventions that counselors typically use in treatment; therefore, there is much to be gained by counselors and counselor educators in understanding the basics of human neurobiology and how commonly used counseling interventions intervene on these biological systems. The National Institute of Mental Health (2010) stated in a recent strategic plan that “Important discoveries in areas such as genetics, neuroscience, and behavioral science largely account for the substantial gains in knowledge that have helped us to understand the complexities of mental illnesses and behavioral disorders over the past 15 years” (“Introduction,” para. 4).
Given the increasingly biological focus of mental health research, the practicing counselor is faced with the task of understanding and using the emerging mental health treatments and explaining to clients, to reimbursing agencies, and to the broader public how counseling fits within the medically dominated mental health culture. Some counselors have long reacted ambivalently toward the pathologically oriented diagnostic categories of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV;American Psychiatric Association, 1994) system and the medication-dominated world of psychiatry. For example, the contrasting viewpoints on this issue were published in the Journal of Counseling & Development between Allen and Mary Ivey (1998, 1999) and Scott Hinkle (1999). Ivey and Ivey (1998) argued for a developmental interpretation to the DSM-IV, opposing what they called the “pathological view” (p. 334) of the manual. According to Ivey and Ivey, disorders could be viewed through a positive development tradition to lie not within the individual but within the contextual systems in which a person lives. Subsequently, disorders are viewed as a “logical response to a developmental history” (Ivey & Ivey, 1999, p. 484). By contrast, Hinkle (1999) argued that because anxiety and depressive disorders “are the most common clinical symptoms associated with presentation to counseling” (p. 475), the counseling profession is weakened if counselors shy away from direct participation in the DSM nomenclature and treatment parlance. As Hinkle indicated, “mental disorders according to the medical model describe disease processes, not people” (p. 475). Regardless of the reader's philosophical perspective, practicing counselors know participation in medical and psychiatric systems is necessary at times. Also, recent discoveries in the field of neuroscience are providing evidence that interventions often used by counselors have direct physiological impact on client neurobiology (Kennedy et al., 2007; Linden, 2006). For example, Felmingham et al. (2007) demonstrated significant differences in brain activity before and after 8 weeks of exposure therapy, which correlated with a reduction in posttraumatic stress disorder (PTSD) symptom severity. Similarly, Paquette et al. (2003) found that cognitive behavioral therapy (CBT) alters the activation and metabolism of specific brain regions following successful treatment of spider phobia. These findings, along with others (for a detailed review, see Beauregard, 2007; Frewen, Dozois, & Lanius, 2008), are significant because they support the techniques, interventions, and approaches used by counselors and provide a mechanism by which counseling positively affects brain physiology. Within the emerging physiologically based treatment milieu, counselors should be prepared to articulate how cognitive counseling interventions make measurable changes to the client. Although cognitive-behavioral-based approaches are effective in the treatment of a number of psychiatric illnesses, adult PTSD is arguably one of the best understood mental disorders from a neurological perspective. It thus presents a valuable model for exploring not only the basic tenets of neurobiology but also the mechanisms behind its successful treatment. Furthermore, PTSD is a disorder that counselors will likely encounter in practice.
PTSD is a mental disorder characterized by a sudden onset of symptoms due to environmental exposure to a psychologically stressful event such as war, natural disaster, or sexual victimization. Thus, it provides a clear example of how, even in adulthood, neurological adaptation (in this case maladaptive changes) can functionally “rewire” the brain in a short period of time, resulting in a sustained array of clinical symptoms. The diagnostic criteria for PTSD are a history of exposure to a traumatic event meeting two criteria and symptoms from each of three symptom clusters: intrusive recollections, avoidant/numbing symptoms, and hyperarousal symptoms. A fifth criterion concerns duration of symptoms and a sixth assesses functioning (American Psychiatric Association, 2000).
The National Comorbidity Survey Replication, conducted between February 2001 and April 2003 (Kessler et al., 2005), determined that the estimated lifetime prevalence of PTSD among American adults is 6.8%, with women (9.7%) twice as likely as men (3.6%) to have the disorder at some point in their lives. These findings are very similar to those of the first National Comorbidity Survey conducted in the early 1990s (Kessler, Sonnega, Bromet, Hughes, & Nelson, 1995), which was composed of interviews of a representative national sample of 8,098 Americans ages 15 to 54 years. In this earlier sample, the estimated prevalence of lifetime PTSD was 7.8% in the general population. As in the more recent survey, women (10.4%) were more than twice as likely as men (5%) to have PTSD at some point in their lives (Kessler et al., 2005; Kessler et al., 1995).
Keywords: CBT Cognitive Behavioral Therapy Neurobiological Basis of Behavior Neurobiology Posttraumatic Stress Disorder PTSD
Accuracy Verified: Yes
6. Taylor, S., Thordarson, D., Maxfield, L., Fedoroff, I., Lovell, K., & Ogrodniczuk, J. (2003, April). Comparative efficacy, speed, and adverse effects of three PTSD treatments: Exposure therapy, EMDR, and relaxation training. Journal of Consulting & Clinical Psychology, 71(2), 330-338. doi:10.1037/0022-006X.71.2.330.
Language: English
Format: Journal
Abstract:
The authors examined the efficacy, speed, and incidence of symptom worsening for 3 treatments of PTSD: prolonged exposure, relaxation training, or eye movement desensitization and reprocessing (EMDR; N = 60). Treatments did not differ in attrition, in the incidence of symptom worsening, or in their effects on numbing and hyperarousal symptoms. Compared with EMDR and relaxation training, exposure therapy (a) produced significantly larger reductions in avoidance and reexperiencing symptoms, (b) tended to be faster at reducing avoidance, and (c) tended to yield a greater proportion of participants who no longer met criteria for PTSD after treatment. EMDR and relaxation did not differ from one another in speed or efficacy (Pilots).
Keywords: Adults Empirical Study Exposure Therapy Negative Therapeutic Reaction Posttraumatic Stress Disorder PTSD Random Clinical Trial RCT Relaxation Therapy Stressors Survivors Treatment Effectiveness Witnesses
Accuracy Verified: Yes
7. Hopper, J., Spinazzola, J., Blaustein, M., Yehuda, R., van der Kolk, B. A., & Simpson, W. (2003, October-November). Differential biological outcomes of EMDR and fluoxetine for PTSD. In B. A. van der Kolk (Chair), Treatment outcome studies of PTSD. Symposium conducted at the 19th annual meeting of the International Society for Traumatic Stress Studies, Chicago, IL.
Language: English
Format: Conference
Abstract:
Treatment Outcome Studies of PTSD: This symposium presents three large carefully controlled treatment
outcome studies using four different treatment modalities (CBT,
EMDR, psychopharmacology and Cognitive Processing) and presents
data on comparative efficacy, treatment responsiveness and
resistance, effects on comorbidity, quality of life, and biological
changes that accompany symptom improvement.
Differential Biological Outcomes of EMDR and Fluoxetine for PTSD: Two major developments in PTSD research have been the development
of effective treatments and the delineation of pathophysiology.
While major gains have been made in both of these areas, they
have occurred in parallel. There is a need for investigations of possible
differential effects of different treatment modalities on biological
aspects of PTSD. In this randomized controlled trial (N = 105), we
compared the exposure treatment Eye Movement Desensitization
and Reprocessing, the serotonergic reuptake inhibitor fluoxetine,
and pill placebo for their effects on both PTSD symptoms and biological
parameters. The outcome measures were severity of reexperiencing,
avoidant/numbing, and hyperarousal symptoms; psychophysiological
reactivity to script-driven imagery; basal salivary
cortisol and dexamethasone suppression test (DST). At pre-treatment,
post-treatment and 3-month follow-up, saliva samples were
acquired at 8 a.m., 11 p.m. (immediately followed by dexamethasone)
and 8 a.m.. Participants also underwent a script-driven
imagery protocol utilizing four 30s scripts, each followed by a 60s
script imaging period and 2 minute recovery periods (fixed order:
neutral, trauma, neutral, trauma). Preliminary analyses partially support
hypothesizes concerning differential efficacies of pharmacological
and psychological treatments on different symptom clusters
and biological markers of the disorder, at post-treatment and 3-
month follow-up. Potential implications for treatment and future
research will be discussed.
Keywords: Fluoxetine Posttraumatic Stress Disorder PTSD Symposium
Accuracy Verified: Yes
8. Laliotis, D. (2009, March). Dreaming the future: Part 1 & Part 2 - Creating new possibilities with EMDR. Presentation at the Psychotherapy Networker Symposium, Washington, DC.
Language: English
Format: Conference
Abstract:
EMDR is often used to help clients access and rewire neural pathways to integrate traumatic memories and relieve dissociation, hyperarousal, and numbing. But it can also help clients move toward a better future by mentally rehearsing aspects of more positive, fulfilling lives. In this workshop, we'll describe how to use EMDR to develop alternative neural pathways freeing clients from the fears and self-doubts that keep them from developing to their fullest potential. We'll review the brain circuitry involved in moving from an internal state of disconnection and helplessness to one of integration and empowerment. Then through lecture, discussion, and videotaped examples, you'll learn guidelines for using EMDR to help clients develop new internal maps, future scenarios, and a clear sense of how to get from their present state to their future self.
Accuracy Verified: Yes
9. Raju, K. (2005). Ego strengthening and eye movement desensitization reprocessing in post traumatic stress disorder. Medical Journal Armed Forces of India, 61, 289-290.
Language: English
Format: Journal
Abstract:
Post Traumatic Stress Disorder (PTSD) is an anxiety
disorder, which occurs after exposure to
overwhelming stress like combat, rape, serious
accidents, violent crime and other catastrophic events.
The essential characteristics of the condition are
recurrent intrusive memories, images, thoughts or
dreams of the trauma, persistent arousal, emotional
numbing and avoidance of the situations reminiscent of
the trauma. 15-20% of individuals experiencing significant
trauma are known to develop PTSD [1]. Although
anxiolytic, anticonvulsant, antipsychotic and
antidepressant drugs have been tried, none have been
consistently associated with improvement [2]. Eye
Movement Desensitization Reprocessing (EMDR) is
being increasingly utilized as a valid method of treatment
for this distressing condition [3-7]. Ego Strengthening
(ES) is a sequence of simple psychotherapeutic
suggestions given under hypnosis [8]. A long standing
case of PTSD treated with EMDR and ES is reported.
Keywords: Case Report Ego Strengthening Posttraumatic Stress Disorder PTSD
Accuracy Verified: Yes
10. Sautai, G. (2011, June). EMDR intensive therapy (EMDRIT). Presentation at the annual meeting of the EMDR Europe Association, Vienna, Austria.
Language: English
Format: Conference
Abstract:
Therapeutic Process seems to be blocked for some patients with strong Developmental Disorders or exposed to Disturbing Early Life Experiences (Bessel A. van der Kolk). A specific approach during EMDR Intensive Therapy (EMDRIT) using the Case Conceptualisation (Andrew Leeds), based on the Adaptive Information Processing (AIP) model (Francine Shapiro), the Attachment Theory (John Bowlby) and the Useful and Necessary Renouncement Principe (Judith Viorst) allow those patients to progress.
As a pilot experience, we have been able to use this EMDRIT framework with 64 clients.
Their complex disorders included, for each of them, at least 3 of the following symptoms:
Anxiety, depression, primary structural dissociation, alcohol addiction, eating behaviour disorders, travel phobia, emotional numbing, affective isolation, hypochondria, phantom limb syndrome, fibromyalgia, cancer, psychological or physical abuse survivor, perpetrator of violent aggressions.
For the 25 first clients, we have used the PCL-S (pathology threshold > 44) test. Their pre-treatment average score was 70. It dropped to 28 after EMDRIT treatment, down to 26 after 3 months and stabilised at 29 after 1 year. These first results allowed us to define a target population and an adapted protocol that provides client safety, efficiency and result sustainability. For the 39 next clients, we measured a decrease of the SCL-90-R (pathology threshold > 1,5) test score from 3 before treatment down to 1,4 after treatment, 1,2 after 3 months and 1,3 after 1 year. We measure efficiency on 87% of the clients and a suppression of 80% of the symptoms after 1 year. At the same time, a control cohort of 20 people with identical pathologies saw their score drop from 3 to 2,3 with the same treatment time, using the standard EMDR protocol. From this preliminary result, we are developing some research hypothesis:
•Selection criteria for EMDRIT, based on the patient ability accessing Adaptive Memory Networks (AMN).
•The Targeting Sequence Plan, seen as an expression of the Dysfunctional Memory Networks (DMN).
•The importance of the client emotional Window Of Tolerance (WOT) for the efficiency of the Adaptive Information Processing system.
•Epigenetic show possible structural brain modifications by rehabilitation of fluid links across the 3 levels of the brain (reptilian, limbic and neo-cortical). These changes are immediate and permanent.
•Need to standardize appropriate scale for database, in order to foster international research and results sharing.
We sea AIP model as an opportunity to move from an analytic and sequential approach to a systemic and integrative approach based on Complex System for a global understanding.
Keywords: EMDR Intensive Therapy EMDRIT
Accuracy Verified: Yes
11. Lanius, U. F. (2005). EMDR processing with dissociative clients: Adjunctive use of opioid antagonists. In R. Shapiro (Ed.), EMDR solutions: Pathways to healing (pp. 121-146). New York: W W Norton & Co.
Language: English
Format: Book Section
Abstract:
Dissociative symptoms are common in traumatic stress syndromes (e.g., complex PTSD, disorder of extreme stress not otherwise specified [DESNOS], borderline personality disorder, and dissociative disorders). They commonly interfere with psychotherapy including EMDR treatment. It appears that the adaptive information processing system gets overwhelmed and shuts down, thereby barring the integration and resolution of traumatic experience and thus precluding positive treatment outcomes. A series of case studies by Ferrie and Lanius found that the administration of an opioid antagonist prior to EMDR treatment significantly reduced dissociative symptoms, somatization, and numbing, as well as aiding trauma processing. The present chapter describes the relevant scientific research, as well as a theoretical rationale and a protocol, for the use of opioid antagonists in trauma processing with EMDR. [Text, p. 121]
Keywords: Analgesic Drugs Dissociative Symptoms Posttraumatic Stress Disorder PTSD Stressors Survivors
Accuracy Verified: Yes
12. Brown, S. H., Stowasser, J. E., & Shapiro, F. (2011). Eye movement desensitisation and reprocessing (EMDR): Mental health-substance use. In D. B. Cooper (Ed.), Intervention in Mental Health-Substance Use (pp. 165-193) United Kingdom: Radcliffe Publishing Ltd .
Language: English
Format: Book Section
Abstract:
Substance use disorders remain a persistent social and medical problem. According to a
recent report,1 addiction is the number one health problem in the United States. The report
notes that when one considers the direct costs of drug-induced health problems, deaths due
to accidents, Human immunodeficiency virus (HIV), or drug-related acts of violent crime,
there are ‘more deaths, illnesses and disabilities from substance abuse than from any other
preventable health condition’.1
Most experts today agree that substance use disorders are a complex interaction
between genetics, environment, and experience. ‘Substance dependence is not a failure of
will or of strength of character, but a medical disorder that could affect any human being.
Dependence is a chronic and relapsing disorder, often co-occurring with other physical
and mental conditions’.2
The question remains - Why has it been that over the course of human history,
where people and cultures have had access to alcohol and potent mind-altering substances,
that only some become addicted while the rest are able to regulate their use?
The drugs that people experiencing substance use disorders select are not chosen
randomly, but are a result of an interaction between the psychopharmacologic action of the
drug and the dominant painful feelings with which they struggle. Edward Khantzian,
observed that opiates are often preferred because of their powerful numbing action on the
affects of rage and aggression. Cocaine has its appeal because of its ability to relieve
distress associated with depression. Although ill-fated, ‘addicts discover that the short-term
effects of their drugs of choice help them cope with distressful subjective states and an
external reality otherwise experienced as unmanageable or overwhelming’. Thus emerges a compelling hypothesis, which proposes that people use psychoactive substances in an
attempt to control painful symptoms resulting from psychological trauma. This is referred
to as ‘self-medication’.
Some studies in the United States show that more than 50% of people with mental
disorders also suffer from substance dependence compared to 6% of the general
population.2 It is from our interest in providing integrated treatment for the complex
interaction of genes, environment, trauma, and psychological pain as a driving force behind
mental health-substance use disorders, that this chapter is written.
Keywords: Substance Abuse
Accuracy Verified: Yes
13. Balk, J. L. (2001, Nov 1). Eye movement desensitization and reprocessing (EMDR) for post-traumatic stress disorder. Alternative Medicine Alert, 4, 121-124.
Language: English
Format: Newsletter
Abstract:
Post-traumatic stress disorder (PTSD) is a fairly common disorder. Roughly 8-10% of the population will suffer from PTSD at some point in their lives. For victims of violent crimes such as rape, the rate of PTSD may be 60-80%. (1) According to the DSM-IV, diagnostic criteria for PTSD include: 1) perceived or actual threat to life or physical integrity, accompanied by an emotional response of horror, helplessness, or intense fear; 2) re-experience of the trauma (e.g. flashbacks and nightmares); 3) avoidance of trauma-related stimuli and numbing of interest and affect; and 4) increased unwanted arousal, such as concentration difficulties, irritability, and insomnia. Specific criteria exist regarding the numbers of symptoms in each category that must be present.
Keywords: Posttraumatic Stress Disorder PTSD
Accuracy Verified: Yes
14. Hamner, M. B. (2007, June 1). Long-term treatment of posttraumatic stress disorder. Psychiatric Times, 24(7), 36. Retrieved from http://www.psychiatrictimes.com/display/article/10168/54861 8/9/2007.
Language: English
Format: Magazine
Abstract:
Posttraumatic stress disorder (PTSD) is an anxiety disorder that occurs after severe psychological stress,
e. g., assault, combat, natural disasters, terrorism, or other stressors. The stressor induces intense fear or
helplessness in the patient. Three symptom clusters are included in DSM-IV criteria for PTSD:
re-experiencing the traumatic event, avoidance of reminders of the event and psychological numbing,
and hyperarousal symptoms.
Keywords: Posttraumatic Stress Diorder PTSD Symptom Clusters
Accuracy Verified: Yes
15. Ehlers, A., Gene-Cos, N., & Perrin, S. (2009). Low recognition of post-traumatic stress disorder in primary care. London Journal of Primary Care, 2, 36–42.
Language: English
Format: Journal
Abstract:
Post-traumatic stress disorder (PTSD) is a common
and disabling disorder that develops as a consequence
of traumatic events and is characterised by
distressing re-experiencing of parts of the trauma,
avoidance of reminders, emotional numbing and
hyperarousal. The NICE guidelines for PTSD (2005)
recommend trauma-focused psychological therapy
as the first-line treatment. A survey of 129 GPs in
south London investigated the recognition and
treatment of PTSD in primary care. The majority
of GPs underestimated the prevalence of PTSD.
Most PTSD patients seen in GP surgeries currently
do not receive or are not referred for NICE recommended
psychological treatments. Medications,
especially SSRIs, appear to be more commonly
prescribed than recommended by NICE. Efforts to
disseminate information about PTSD and effective
treatments to both patients and GPs are needed to
increase recognition rates and prompter access to
treatment. The Improving Access to Psychological
Therapies (IAPT) programme will make the NICE
recommended treatments more widely available
and will allow self-referral by adults with PTSD to
trauma-focused psychological therapy.
Accuracy Verified: Yes
16. Arnstein, M. (1996, December). Marital therapy, EMDR, Herman's model of recovery from trauma: The journey of one woman and her family. Australian & New Zealand Journal of Family Therapy, 17(4), 212-224.
Language: English
Format: Journal
Abstract:
Judith Herman delineates a 3-stage model of recovery from trauma: (1) Safety; (2) Remembrance and Mourning; (3) Reconnection. She criticises current treatment methods for their failure to make a difference in the "constrictive symptoms of numbing and social withdrawal...and marital, social and work problems do not necessarily improve." Family therapy has been criticised often for insufficient focus on emotion and general sensations. This case analysis will illustrate how these shortcomings can be successfully addressed with the use of marital counseling and EMDR. The use of multiple treatment approaches contributed to one client's resolution of recent trauma due to a car accident, of past crises due to marital infidelity and early childhood abuse, with significant changes for her in her current family as well as in her family of origin. Theoretical implications for "family therapy" are raised. [Author Abstract]
Keywords: Adults Australians Case Report Child Abuse Family Therapy Females Marital Problems Motor Traffic Accidents Posttraumatic Stress Disorder PTSD Survivors Treatment Effectiveness
Accuracy Verified: Yes
17. Forgash, C. (2007, September). The negative impact of complex PTSD on health: an EMDR/ego state treatment plan. Presentation at the annual meeting of the EMDR International Association, Dallas, TX.
Language: English
Format: Conference
Abstract:
EMDR and Ego State integrated treatment provides a clinical model for dealing with health problems in complex trauma survivors. Health problems are made more complex by the presence of dissociative disorders and PTSD symptoms in adult survivors. This presentation will focus on the treatment of these disorders. EMDR and Ego State techniques will be utilized to help the CTS patient: a) manage triggers and avoid re-traumatization, hyperarousal and numbing; desensitize and reprocess traumatic events; b) become assertive health consumers and deal with medical/dental procedures and tests; c) learn skills such as rehearsal, identifying problems, planning visits, etc.
Keywords: Complex Posttraumatic Stress Disorder Complex PTSD C-PTSD Ego State Therapy Integrated Treatment Phased Treatment Plan
Accuracy Verified: Yes
18. Forgash, C. (2008, June). The negative impact of complex PTSD on health: An EMDR/ego state treatment plan. Presentation at the annual meeting of the EMDR International Association, London, England.
Language: English
Format: Conference
Abstract:
In this workshop, EMDR and Ego state integrated treatment will be presented as a clinical model for dealing with
current life and health problems which the presence of dissociation and PTSD exacerbates for complex trauma
survivors (CTS). There are intertwined problems that are made more complex by the presence of dissociative
disorders in adult CTS. First: there are negative sequelae of childhood abuse on the physical and mental health of
adult CTS. Second, there are specific health problems predominant in this population which often are untreated,
misdiagnosed and ignored by physicians and EMDR therapists. Third: CTS have difficulties addressing their health
needs, accessing health care, and functioning effectively as health care consumers. Preventative care and good
health care may be minimal for this population. This presentation will focus on the development of an EMDR
treatment plan to successfully work with dissociative and PTSD disorders prevalent in these patients. Specialized
Ego State techniques will be introduced in each phase of EMDR treatment to help the patient stabilize: manage
triggers and avoid re-traumatization in the health care setting; effectively deal with avoidance, freeze,
hyperarousal and numbing; desensitize and reprocess earlier traumatic events which are at the root of these
problems, (these may include iatrogenic events and specific physical problems seemingly related to current
health problems, which actually result from early trauma); and become assertive health consumers. Skills
development needed by the CTS to become empowered and competent health consumers, such as rehearsal,
identifying problems, planning visits etc will also be included in the plan. [This slide presentation has a two page "References" bibliograhy issued separately.(PDF 6065)]
Keywords: Complex Posttraumatic Stress Disorder Complex PTSD C-PTSD Ego State Therapy
Accuracy Verified: Yes
19. Herbert, J. D., & Forman, E. M. (2006). Posttraumatic stress disorder. In J. E. Fisher & W. T. O'Donohue (Eds.), Practitioner's Guide to Evidence-Based Psychotherapy (pp. 555-566). New York: Springer.
Language: English
Format: Book Section
Abstract:
What is Posttraumatic Stress Disorder?
Posttraumatic Stress Disorder (PTSD) is a syndrome characterized by persistent anxiety-related symptoms provoked by a traumatic event. These symptoms are comprised of three clusters: Re-experiencing symptoms such as recurrent intrusive thoughts about the trauma, nightmares, and flashbacks, numbing symptoms such as detachment from others and loss of interest in usual activities, and a third cluster of miscellaneous symptoms including an exaggerated startle response, sleep disturbance, and memory impairment. Estimates of the prevalence of PTSD vary widely; the National Comorbidity Survey found rates of 8.2% among men and 20.4% among women (Kessler et al., 1995). The National Vietnam Veterans Readjustment Study (NVVRS, Kulka et al., 1990) reported that 30.9% of American soldiers who served in Vietnam developed PTSD; this figure rose to 50% if subsyndromal PTSD was counted. Although these figures continue to be widely cited, the NVVRS has been widely criticized on several grounds, including reliance on undocumented, retrospective self-reports of trauma, lack of measurement of impairment, and most importantly the simple fact that only 15% of those serving in Vietnam were actually in combat units.
Keywords: Posttraumatic Stress Disorder PSTD
Accuracy Verified: Yes
20. Solomon, S. D. (1997, Winter). Psychosocial treatment of posttraumatic stress disorder. In Session: Psychotherapy in Practice, 3(4), 27-41. doi:10.1002/(SICI)1520-6572.
Language: English
Format: Journal
Abstract:
A review of the psychosocial treatment research literature indicates that several forms of therapy appear to be useful in reducing the symptoms of PTSD. Strongest support is found for the treatments that combine cognitive and behavioral techniques. Hypnosis, psychodynamic, anxiety management, and group therapies may also produce short-term symptom reduction. Still unknown is whether any approach produces lasting effects. Imaginal exposure to trauma memories and hypnosis are techniques most likely to affect the intrusive symptoms of PTSD, whereas cognitive and psychodynamic approaches may better address the numbing and avoidance symptoms cluster. Treatment should be tailored to the severity and type of presenting PTSD symptoms, to the type of trauma experience, and to the many likely comorbid diagnoses and adjustment problems. [Author Abstract]
Keywords: Adults Cognitive Therapy Drug Therapy Exposure Therapy Group Psychotherapy Hypnotherapy Posttraumatic Stress Disorder Prevention Psychoanalytic Psychotherapy PTSD Stressors Survivors
Accuracy Verified: Yes
21. McFarlane, A. (2010, June). PTSD as an information processing disorder. Keynote presented at the annual meeting of the EMDR Europe Association, Hamburg, Germany.
Language: English
Format: Conference
Abstract:
Posttraumatic stress disorder is a challenging condition, as people become captured by their past experiences and have difficulty engaging with the present. At the core of this condition is the role of traumatic memories, which orientate the individual's awareness and reactivity to reminders of the instigating traumatic event. The role of traumatic events has not been fully understood and grappled with in the full range of psychopathological conditions. This has important implications for the application of EMDR as a treatment for disorders above and beyond posttraumatic stress disorder.
However, the problems with information processing in PTSD go above and beyond the fear circuitry and reactivity to traumatic memories. Individuals with PTSD also have major difficulties with their self-orientation, which is reflected in deficits in default networks, the idling systems of the brain. These changes are indicative of problems in self-registration and free-floating reflection. Dissociative symptoms may relate to these abnormalities of individuals resting states as they reflect a sense of disconnection and integration of internal states into consciousness.
Secondly, posttraumatic stress disorder is associated with major problems in dealing with neutral environmental information. This is reflected in the symptoms of difficulty with concentration and emotional numbing. The underlying neurobiology of the working memory abnormalities in posttraumatic stress disorder will be highlighted. These studies show that, in PTSD, relatively simple attentional tasks recruit neural networks normally reserved for more demanding and higher order tasks. When confronted with more demanding challenges, individuals with PTSD do not have any further capacity to allocate to processing complex environments.
Individuals with PTSD also demonstrate a problem with switching their attentional focus from an idling to active state. The data suggests that they continue to use visio-spatial networks more than language-based systems for dealing with verbal tasks. This observation is in keeping with a broad body of literature, which suggests that there are problems with the processing of verbal memory tasks in PTSD. EMDR, as a treatment, may have an advantage, as it is not so dependent on verbal representations of traumatic experiences as other treatment approaches.
Finally, an important development in the field is a better understanding of the patterns of abnormal cortical arousal that accompany the peripheral arousal abnormalities in PTSD. Quantitative EEG has given insights into the instability of the cortical neural networks. Neurotherapy represents a treatment that can further assist clinicians in the management of these patients. It is important to consider the underlying psychosomatic aspects of posttraumatic stress disorder and ensure that treatment addresses these components as well the traumatic memories. Treatment should be thought of as a staged process where the processing of traumatic memories is only one component of a disorder that impacts on a range of information processing domains.
Keywords: Information Processing Keynote Posttraumatic Stress Disorder PTSD
Accuracy Verified: Yes
22. Knipe, J. (1995). Targeting defensive avoidance and dissociated numbing. EMDR Network Newsletter, 5(2), 6-7.
Language: English
Format: Newsletter
Abstract:
For some clients (perhaps 10-15%),I
have found that the effectiveness of
EMDR (Level I, Level I1 version) is
blocked or hindered by defensive processes
which may or may not be conscious
or voluntary, and which function
to protect the individual against
unpleasant affect. In such instances,
it has frequently been useful to use
the 0-10 scale to measure aspects of
experience other than unpleasant affect.
This is similar to the Level of
Urge (LOU) innovation designed by
Popky (1994) and used as part of his
protocol for the treatment of substance
addictions.
Accuracy Verified: Yes
23. Balibey, H., & Balikçi, A. (2013). Travma sonrası stres bozukluğu tanılı hastada göz hareketleri ile duyarsızlaştırma ve yeniden işleme (EMDR) tedavisi: Olgu sunumu ]Eye movement desensitization and reprocessing (EMDR) treatment at a patient diagnosed with post-traumatic stress disorder: Case report]. Düşünen Adam Psikiyatri ve Nörolojik Bilimler Dergisi, 26(1), 96-101. doi:10.5350/DAJPN2013260111.
Language: Turkish
Format: Journal
Abstract:
Travma sonrası stres bozukluğu tanılı hastada göz hareketleri ile duyarsızlaştırma ve
yeniden işleme (EMDR) tedavisi: Olgu sunumu
Travma sonrası stres bozukluğu (TSSB), kişinin aşırı bir travmatik stresörle karşılaşmasından, yaşamasından
veya duymasından sonra, olayların kişiye sıkıntı veren bir biçimde yeniden yaşanması, kaçınma örüntüsü,
duygulanımda küntlük ile birlikte otonomik, disforik ve bilişsel bulguların değişik derecelerde bulunması ile
belirli bir ruhsal bozukluktur.
EMDR’nin TSSB’da etkililiği kanıtlanmış psikodinamik, bilişsel, davranışsal ve danışan merkezli yaklaşımlar gibi çok
iyi bilinen farklı yaklaşımların öğelerini bir araya getiren psikolojik bir tedavi yöntemidir.
Bu yazıda geçirdiği trafik kazası sonrasında Travma sonrası stres belirtileri gösteren vakamızın Göz Hareketleri
İle Duyarsızlaştırma ve Yeniden İşleme (EMDR) yöntemi ile tedavisi süreci ve klinisyenlerce Travma sonrası
stres bozukluğu vakalarında bu yöntemin daha sık ve yaygın bir şekilde kullanılmasının gerekliliği tartışılacaktır.
Post-traumatic stress disorder (PTSD) is a psychiatric disorder that is characterised with autonomic, dysphoric and cognitive signs together with affective numbing, distressed reexperiencing and avoidance from previous traumatic events at a person who has encountered, lived or heard an excessive traumatic event. EMDR is a psychological method which has proven to be effective and it brings together elements of well established approaches such as psychodynamic, cognitive, behavioral and client-centered approaches. In this paper treatment process with Eye Movement Desensitization and Reprocessing (EMDR) of a case who shows signs of post-traumatic stress disorder after a car accident and the need for using this method by clinicians more frequent and widespread at post-traumatic stress disorder patients will be discussed.
Keywords: Case Study Posttraumatic Stress Disorder
Accuracy Verified: Yes
24. Gelinas, D. (2006, September). Treating complex PTSD with EMDR. Presentation at the annual EMDR International Association Conference, Philadelphia, PA.
Language: English
Format: Conference
Abstract:
Research has demonstrated that EMDR is
efficacious in treating PTSD. Many clinicians
however treat clients with more complicated forms
of PTSD resulting from early, repeated trauma
experiences. This workshop will provide a
framework for beating complex PTSD using EMDR.
It will first summarize the clinical picture of complex PTSD, including it's bi-phasic numbing/constricting interspersed with repetitive intrusions, chronic physiological hyperarousal, distortions of the self,
and the presence of dissociation, which includes for some clients, the presence of ego states. This
information will be used to demonstrate EMDR Case
Conceptualizations and several approaches to target selection, depending upon the characteristics of the
clinical situation. The workshop will provide a
number of EMDR methods for stabilizing clients
early in treatment then will focus on Assessment and
Desensitization. Complex PTSD frequently calls
for extensive use of cognitive interweaves because
of the significant distortions in sense of self, and so
their use will be reviewed. As they emerge in the
different phases of EMDR, different types of
dissociation present the clinician with choice points about how to proceed. The workshop will provide
sevcral ways to recognize the emergence of
dissociation during each of the 8 phases of EMDR
and the choice points this represents. It will discuss several ways to manage dissociation as it emerges, including ego states, so that EMDR can proceed productively. Present triggers and future considerations will be included. Time will be included for questions and for focused discussion.
Keywords: Complex Posttraumatic Stress Disorder Complex PTSD C-PTSD Posttraumatic Stress Disorder PTSD
Accuracy Verified: Yes
25. Kirsch, A., Krause, R., Spang, J., & Sachsse, U. (2008, August). [Childhood-onset versus acute, adult-onset traumatized patients in the light of amnestic tendencies and derealisation]. Zeitschrift für Psychosomatische Medizin und Psychotherapie, 54(3), 277-284..
Language: German
Format: Magazine
Abstract:
Ziele: In der vorliegenden Studie untersuchten wir die Gesichts-affektive Verhalten
der akuten Altersdiabetes traumatisierten Patienten versus Kindheit traumatisierten-onset
Patienten. Darüber hinaus untersuchten wir, ob eine Abnahme der emotionalen Betäubung
resultiert aus einer Verringerung der Symptome. Wir verwendeten amnestischen Tendenzen als
Moderator variabel. Methode: Das mimisch affektive Verhalten wurde kodiert mit
Die Emotional Facial Coding System Acting, ein Instrument für die
Erfassung von mimischen mit emotionaler Bedeutung. Der Gesichtsausdruck
affektive Verhalten der Patienten das erste und letzte EMDR-Sitzungen wurde
verglichen. Ergebnisse: Kindheit und akute Verlaufsform Altersdiabetes traumatisiert
Patienten zeigten die gleiche Reduktion der gesamten Gesichts-Aktivität. Wir fanden
signifikant höhere psychische Beschwerden (Global Severity Index) (SCL-90-R)
in der Kindheit einsetzende traumatisierten Patienten und keinen Unterschied in amnestische
Tendenzen (FDS) zwischen den beiden Gruppen. Childhood-onset traumatisiert
Patienten zeigten höhere Werte von Realitätsverlust (FDS). Schlussfolgerungen: Die
mimisches Reduktion bleibt über die Zeit konstant. Auch Kindheit einsetzende
traumatisierten Patienten entwickelten mehr psychische Beschwerden und mehr
derealisat.
Objectives: In the present study we examined the facial affective behaviour
of acute adult-onset traumatized patients versus childhood-onset traumatized
patients. Furthermore, we analyzed whether a decrease in emotional numbing
results from a reduction of symptoms. We used amnestic tendencies as a
moderator variable. Methods: The facial affective behaviour was coded with
the Emotional Facial Acting Coding System, an instrument for the
registration of facial movements with emotional relevance. The facial
affective behaviour of the patient's first and last EMDR sessions was
compared. Results: Childhood-onset and acute adult-onset traumatized
patients showed the same reduction of overall facial activity. We found
significantly higher psychic complaints (global severity index) (SCL-90-R)
in childhood-onset traumatized patients and no difference in amnestic
tendencies (FDS) between the two groups. Childhood-onset traumatized
patients showed higher values of derealisation (FDS). Conclusions: The
facial affective reduction remains constant over time. Also childhood-onset
traumatized patients developed more psychic complaints and greater
derealisat.
Keywords: Adult-Onset Trauma Childhood-Onset Trauma Children Derealization Facial Affective Behavior
Accuracy Verified: Yes