Francine Shapiro Library ~ EMDR Bibliography

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1. van der Kolk, B. A. (1994, January). The body keeps the score: Memory and the evolving psychobiology of posttraumatic stress. Harvard Review of Psychiatry, 1(5), 253-265. doi:10.3109/10673229409017088.

Language: English

Format: Journal

Abstract:
Ever since people's responses to overwhelming experiences have been systematically explored, researchers have noted that a trauma is stored in somatic memory and expressed as changes in the biological stress response. Intense emotions at the time of the trauma initiate the long-term conditional responses to reminders of the event, which are associated both with chronic alterations in the physiological stress response and with the amnesias and hypermnesias characteristic of posttraumatic stress disorder (PTSD). Continued physiological hyperarousal and altered stress hormone secretion affect the ongoing evaluation of sensory stimuli as well. Although memory is ordinarily an active and constructive process, in PTSD failure of declarative memory may lead to organization of the trauma on a somatosensory level (as visual images or physical sensations) that is relatively impervious to change. The inability of people with PTSD to integrate traumatic experiences and their tendency, instead, to continuously relieve the past are mirrored physiologically and hormonally in the misinterpretation of innocuous stimuli as potential threats. Animal research suggests that intense emotional memories are processed outside of the hippocampally mediated memory system and are difficult to extinguish. Cortical activity can inhibit the expression of these subcortically based emotional memories. The effectiveness of this inhibition depends, in part, on physiological arousal and neurohormonal activity. These formulations have implications for both the psychotherapy and the pharmacotherapy of PTSD.[MLM MEDLINE]

Keywords: Neurobiology Posttraumatic Stress Disorder Practice PTSD Theory

Accuracy Verified: Yes

2. Haour, F. (2009, June). Brain source imaging of the alpha rhythm in PTSD patients using the MEG technique. In K. Zaal (Chair), Research). Symposium conducted at the annual meeting of the EMDR Europe Association, Amsterdam, the Netherlands.

Language: English

Format: Conference

Abstract:
In anxiety disorders, such as PTSD, brain imaging has demonstrated local modifications of functional activities using various techniques. In the present study the direct neuronal activities were measured in delta, theta and beta frequencies, using Magnetoencephalagraphy (MEG) which provides very fast temporal response. The technique is neither invasive nor stressful for the patients. Nineteen female volunteers with DSM-IV PTSD were included in the study. The protocol was a script-driven imagery provocation test, achieved with the patients sitting in the MEG apparatus. The scenarios, specific for ach patient, were composed of 4 active conditions: neutral image (N) traumatic memory (T), traumatic memory suppression (TS) and positive image (P) corresponding to 3 minutes where the patient had to imagine the corresponding sequence with eyes closed Measures of heat rate and subjective disturbance (SUD) were measured during the recoding. The MEG data were analysed in the source domain using a spatial filtering approach. Measurement of electrophysiological waves of various rhythms: delta: 1-4 Hetz (Hz), theta: 4.8-5.8 Hz, alpha: 8-12 Hz and beta: 12-25 Hz was obtained. Anatomical information was from MRI imaging. Signal of activation during trauma recall (T-N) were limited to the delta and theta waves and mainly found in the left hemisphere (visual, orbitofrontal and dorsolateral prefrontal and temporal gyrus (BA 8-9-10-11, 18-19, 22, 28) and in the right supra marginal gyrus (Wernicke BA 40). Signal of inhibition during trauma recall (T-N) were found mainly in the left hemisphere, in the delta, alpha and beta waves (visual, orbitofrontal, dorsolateral prefrontal and temporal gyrus (BA 8-9-10-11, 18-18, 22, 28), cingular cortex (BA 23-24, 31, 32), insula (BA 13) and Broca visual cortex (BA 18-19, 43-44). In conclusion trauma recall mainly induces a hypoactivation in the ventromedial prefrontal cortex and in the cingular cortices, structures linked to the experience and regulation of emotions.

Keywords: Alpha Rhythm Brain Imaging MEG Technique Posttraumatic Stress Disorder PTSD Research Symposium

Accuracy Verified: Yes

3. Haour, F. (2010, June). Brain source imaging using magnetoencephalography (MEG): Modifications in various rhythms during memory recall, in PTSD patients. In Research. Symposium conducted at the annual meeting of the EMDR Europe Association, Hamburg, Germany.

Language: English

Format: Conference

Keywords: Magnetoencephalography MEG Memory Recall Posttraumatic Stress Disorder PTSD Research Rhythms Symposium

Accuracy Verified: Yes

4. Oh, D., & Choi, J. (2004). Changes in the regional cerebral perfusion after EMDR: A SPECT study of two cases. Journal of the Korean Society of Biological Psychiatry, 11(2), 173-180.

Language: Korean

Format: Journal

Abstract:
Over the last decade, EMDR(Eye Movement Desensitization and Reprocessing) has emerged as a promising new treatment for trauma and other anxiety-based disorders. However, neurobiological mechanism of EMDR has not been well understood. Authors report SPECT findings of two patients of PTSD before and after EMDR.Brain 99mTc-ECD-SPECT was performed before and after EMDR treatment. To evaluate the significance of changes in the regional cerebral perfusion, t-test was conducted on the resulting images using SPM99 . In addition, clinical scales(CAPS, CGI, STAI) were employed to asses the changes in the clinical symptoms of the patients. After EMDR treatment, each showed significant improvement in clinical symptoms. The cerebral perfusion increased in bilateral dorsolateral prefrontal cortex, and decreased in the temporal association cortex. The differences in the cerebral perfusion between patients after treatment and normal controls decreased. These changes appeared mainly in the limbic area the and the prefrontal cortex.These results suggest that EMDR may show the therapeutic effect through 1) improvement in the emotional control by increased activity in the prefrontal cortex, 2) inhibited hyperstimuli on amygdala by deactivation of the association cortex, 3) inhibition on past trauma related memory, and 4) keeping the functional balance between the limbic area and the prefrontal cortex. This case report needs further replication from studies with larger sample. [Author Abstract]

Keywords: Brain Imagining Adults Females Koreans Motor Vehicle Accidents Neurophysiology Posttraumatic Stress Disorder Psychiatric Inpatients PTSD: Rape SPECT Survivors Treatment Effectiveness

Accuracy Verified: Yes

5. Lendl, J., & Foster, S. (2009). EMDR performance and enhancement psychology protocol. In M. Luber (Ed.), Eye movement desensitization and reprocessing (EMDR) scripted protocols: Basics and special situations, (pp. 377-396). New York: Springer Publishing Co.

Language: English

Format: Book Section

Abstract:
The EMDR Performance Enhancement Psychology Protocol (EMDR-PEP) addresses performance anxiety, self-defeating beliefs, behavioral inhibition, posttraumatic stress, and psychological recovery from injury for creative and performing artists, workplace employees, and athletes. The EMDR-PEP can be very useful with everyday nonpathological complaints such as procrastination, fear of failure, setbacks, and life transitions. Note: Clinicians, working with athletes require rigorous training in Sport Psychology and Sociology of Professional Sport. The EMDR-PEP encompasses a full spectrum viewpoint (body, mind, and spirit) regarding optimal functioning at work and in life. This perspective inspires clients to identify their strengths as well as areas to improve and to prioritize their work accordingly. The EMDR-PEP approach draws upon Maslow's (1971) Human Potential Movement and Positive Psychology (Amen, 2002; Buss, 2000; Csikzentmihalyi, 1990; Seligman, 1998; Taylor, Kemeny, Reed, Bower, & Gruenwald, 2000), as well as Sport Psychology Research and Principles (levleva & Orlick, 1991; Kohl, Ellis, & Roenkerm, 1992; Mamassis & Doganis, 2004; Martin, Moritz, & Hall, 1999; Nideffer, 1976; Short & Short, 2005; Simons, 2000; Unestahl, 1982), and Health Psychology (Graham, 1995; Levine, 1991; Simonton & Creighton, 1982; Whiting & den Brinker, 1982). The first single subject series (Foster & Lendl, 1996) reported promising findings with four diverse work-related situations and was republished in APA's seminal coaching papers in Consulting Psychology, The Wisdom of Coaching (Foster & Lendl, 2007). Reduced anxiety and increased self-confidence were reported for mature performing artists launching an existing repertoire into a new arena (Foster, 2000) and in a controlled study of master swimmers (Linebarger, 2005). Note: The Linebarger study included the Brief Intervention Focusing Protocol; the paper does not include inner advisor and mental room. Special attention is given to performance elements such as ability, focus, and motivation. The EMDR Performance Enhancement Psychology protocol Forms and Script are included. [PsycINFO Database]

Keywords: Performance Enhancement Protocol

Accuracy Verified: Yes

6. Jacobs, S., de Jong, A., & Strack, M. (2007). EMDR und biofeedback in der therapie posttraumatischer belastungsstörungen: Evaluation eines neuropsychotherapeutischen behandlungsprogramms [EMDR and biofeedback in the therapy of posttraumatic stress disorder: Evaluation of a neuropsychotherapeutic intervention]. VPP - Verhaltenstherapie & Psychosoziale Praxis, 39(4), 855-876.

Language: German

Format: Journal

Abstract:
Eine neu entwickelte multimodale, neuropsychotherapeutic Programm für die Behandlung der Posttraumatischen Belastungsstörung (PTBS) wurde ausgewertet. Ausgehend von neueren Erkenntnissen in der Forschung neuroscienctific, so dass eine Dissoziation zwischen impliziter und expliziter Trauma-Speicher die wichtigste Grundlage der PTBS ist, verschiedene Module wurden im Rahmen der Behandlung integriert anzuzeigen. Die vereinigten Komponenten sind: spezifische Hintergrundinformationen über die Unordnung und typische PTSD-Symptome, eine pädagogische Film für Patienten, spezifische kognitive Verhaltenstherapie und Biofeedback-Techniken unterstützte Eye Movement Desensitization and Reprocessing (EMDR). Das Ziel der Biofeedback-Sitzungen während EMDR ist es, den Patienten eine direkte Rückmeldung über die implizite Prozesse während der Trauma-Exposition. Darüber hinaus Erfassung der physiologischen Daten über Biofeedback ermöglicht das Testen, ob es eine Korrelation zwischen dem Grad der subjektiven Belastung durch traumatische Erinnerungen ausgelöst (quantifiziert mit der SUD-Skala), und messbare physiologische Erregung. Elektrodermale Aktivität (EDA; Hautleitfähigkeit) wurde als eine physiologische Parameter gemessen. Die Ergebnisse einer durchgeführten Pilot-Studie (16 Patienten auf der Grundlage, mit einem wartenden Gruppe als Kontrollgruppe) zeigen verschiedene EDA-Muster während EMDR-desensitivation (fad und assoziative Wiederaufbereitung). Ein offensichtlich Reduktion der PTBS-Symptome gefunden (d = 2,27) sein, die stärker ist als in anderen Behandlungen. Die traumatischen Erinnerungen mit EMDR behandelt wurde weniger Anstrengung, die ebenfalls reflektiert in der Physiologie (verminderte autonome Erregung) und in der subjektiven Belastung fühlte sich durch die Patienten. Die Kürzungen der Erregung (d = 1,01) und subjektive Belastung (d = 2,55) zeigen, dass eine effektive Hemmung der Aktivierung der Amygdala-und damit der Angstreaktion selbst-aufgrund der Intervention geschaffen. Mit EMDR reduziert die Amygdala physiologische Erregung. Wir vermuten, dass aus diesem Grund den medialen präfrontalen Kortex und im Hippocampus kann eine kortikale Inhibition, die erfolgreich reduziert die Angst-Reaktion (Grawe, 2004) zu etablieren. Die berichteten Ergebnisse wurden durch einen dreimonatigen Follow-up-Bewertung bestätigt. Mit einer durchschnittlichen Dauer von 16 Sitzungen und einer nicht vorhandenen Drop-out-Rate (0%), die Intervention erwiesen sich ebenfalls als sehr effizient. (PsycINFO Database Record (c) 2010 APA, alle Rechte vorbehalten)

A newly developed multimodal, neuropsychotherapeutic program for the treatment of posttraumatic stress disorder (PTSD) was evaluated. Starting from recent findings in the neuroscienctific research, which indicate that a dissociation between implicit and explicit trauma-memory is the main basis of PTSD, different modules were integrated within the treatment. The combined components are: specific background information regarding the disorder and typical PTSD-symptoms, an educational movie for patients, specific cognitive behavioral intervention techniques and biofeedback-supported Eye Movement Desensitization and Reprocessing (EMDR). The aim of using biofeedback during EMDR sessions is to give patients a direct feedback about the implicit processes during trauma-exposition. In addition, recording the physiological data via biofeedback allows testing if there is a correlation between the level of subjective strain, triggered by traumatic memories (quantified with the SUD-scale), and measurable physiological arousal. Electrodermal activity (EDA; skin conductance) was measured as a physiological parameter. The results of a conducted pilot-study (based on 16 patients, with a waiting group as a control group) show different EDA-patterns during EMDR-desensitivation (bland and associative reprocessing). An evident reduction of the PTSD-symptoms could be found (d = 2.27), which is stronger than in other treatments. The traumatic memories treated with EMDR became less straining, which reflects likewise in physiology (decreased autonomous arousal) and in the subjective strain felt by the patients. The reductions of arousal (d = 1.01) and subjective strain (d = 2.55) indicate that an effective inhibition of the amygdala activation—and thereby of the anxiety reaction itself—is created due to the intervention. Using EMDR reduces the amygdala induced physiological arousal. We suppose that for this reason the medial prefrontal cortex and the hippocampus can establish a cortical inhibition, which successfully reduces the anxiety reaction (Grawe, 2004). The reported results were confirmed by a three month follow-up evaluation. With an average duration of 16 sessions and a non-existing drop-out rate (0%), the intervention also proved to be very efficient. (PsycINFO Database Record (c) 2010 APA, all rights reserved)

Keywords: Biofeedback PTSD

Accuracy Verified: Yes

7. Meignant, I. (2011, June). EMDR with couples in the context of family therapy [EMDR mit paaren im kontext der familientherapie]. Presentation at the annual meeting of the EMDR Europe Association, Vienna, Austria.

Language: English

Format: Conference

Abstract:
The use of both Mony Elkaïm’s systemic model and the AIP model is a new perspective for couples’therapy and for EMDR target plan and further in individual therapy where relational problems are involved. This workshop will teach present a way to do a target plan for relational problem treatment. Focusing on couples’therapy the workshop will show how to do an EMDR case conceptualization integrating the systemic model. It will propose clinical question/answer that will help to decide to use EMDR or not in the couple session, choosing the position of the other member of the couple during the reprocessing phases. It will show the use of individual safe places as a safe place for the couple during the session and at home. What we propose here is that the understanding of Mony Elkaïm’s Systemic model for a couple in crisis guides us to find where to work on the past of each member to heal the couple in the EMDR target plan. We imagine that this understanding can be of help to build a bridge between any 2 parts of a relation: 2friends, 2 colleagues, 2 persons from different culture or religion. The presentation will illustrate how the systemic model created by Mony Elkaïm for understanding couple crisis can be useful in the EMDR treatment of couples, EMDR case conceptualization and EMDR target plan. This model insists on the double bind in which each member of the couple is torn between his/her Official Program and his/her World View. For example: "I want to be loved" (O.P) and" if someone loves me he will leave me" (W.V.). These world views are creating repetitive cycles which are trapping the members of the couple or of any people in interaction. The aim of the EMDR practitioner is to treat the dysfunctional stored memories connected with these world views and give them flexibility to free the members of the couple from the vicious circle in which they are caught. In this presentation we propose to show how making hypothesis about the World view of each member of the couple and verifying them will guide us to the individual target that will be the Gordian knot in the present problem the couple is dealing with, hence helping the system to evolve from a situation of crisis to a situation of equilibrium. Using EMDR will help to give flexibility to the world view of each member. Using it within Mony Elkaïm’s systemic model will help the couple. Following each phase of the EMDR model eight-phases protocol, we will show how it will be applied to couple therapy with case studies and practice example. We will see how this target plan can apply to any dyad or system in crisis in family therapy, couple therapy and individual therapy. Learning objectives: •Understand how to use the systemic model, reciprocal double bind, to find the individual targets that are involved in the couple or any relational present problem in an EMDR target plan. •Being able to do the installation of EMDR safe place as a resource for the couple. •Evaluate more clearly whether and when to use EMDR in the couple therapy session. •Knowing specifications of each of the 8 phases EMDR protocol with couple.

Keywords: Couples Family Therapy

Accuracy Verified: Yes

8. Wilson, D. L., Silver, S. M., Covi, W. G., & Foster, S. (1996, September). Eye movement desensitization and reprocessing: Effectiveness and autonomic correlates. Journal of Behavior Therapy and Experimental Psychiatry, 27(3), 219-229. doi:10.1016/S0005-7916(96)00026-2.

Language: English

Format: Journal

Abstract:
18 subjects distressed by memories of a specific traumatic event were randomly assigned to a single session of 1 of 3 conditions: Eye Movement Desensitization and Reprocessing (EMDR), a Time Interval Condition (TIC), or Tapping Alternate Phalanges (TAP). All subjects treated in the EMDR group showed desensitization as monitored by SUDs, which correlated with the physiological data and cessation of pronounced symptomatology. Only 1 subject in a control group showed desensitization. Compared to TIC and TAP, autonomic measures showed distinct changes during EMDR: (1) respiration synchronized with the rhythm of the eye movements in a shallow, regular pattern; (2) heart rate slowed significantly overall; (3) systolic blood pressure increased during early sets, invariable declined during abreactions, and decreased overall; (4) finger tip skin temperature consistently increased; and (5) the galvanic skin response consistently decreased in a clear "relaxation response." This relaxing effect of the eye movements suggests that at least one of the mechanisms operating during EMDR is desensitization by reciprocal inhibition, by pairing emotional distress with an unlearned or "compelled" relaxation response. [Author Summary]

Keywords: Adults Arousal Empirical Study European Americans Longitudinal Study Posttraumatic Stress Disorder PTSD Random Clinical Trial RCT Stressors Survivors Treatment Effectiveness

Accuracy Verified: Yes

9. Alatalo, G. L. (1994). Eye-movement desensitization and reprocessing: A new treatment for trauma. Spalding University, Louisville, KY. AAT 9522299.

Language: English

Format: Dissertation/Thesis

Abstract:
Eye-movement desensitization and reprocessing (EMDR) has been hailed as a new experimental treatment for survivors of trauma that can provide rapid relief from the debilitating symptoms associated with PTSD. EMDR's efficacy reportedly stems from the use of eye-movements that are postulated to stimulate physiological changes in brain activity to produce cognitive restructuring and desensitization of emotional discomfort. This novel procedure has become more prominent with reported benefits for an increasing range of clinical applications. Since there is minimal controlled research, especially in a civilian population, on psychological methods to treat the ill effects of trauma and because EMDR has limited empirical support, further controlled investigation was warranted to supplement this limited body of scientific knowledge.Consequently, the specific goals of this controlled study were to evaluate (1) the efficacy of EMDR in the treatment of civilian trauma survivors, (2) whether or not eye-movements are instrumental to the therapeutic process, and (3) the treatment impact on intrusive and avoidant symptoms. It was hypothesized that (1) an EMDR treatment group would demonstrate greater efficacy when compared to an Alternative group which followed the same treatment protocol except for the substitution of deep breathing for the eye-movements, (2) both the EMDR and Alternative treatments would show significant improvement over a Control group, and (3) there would be similar changes in intrusive and avoidant symptoms. Findings at two month follow-up indicated the EMDR group had significant reductions in intrusive/avoidant symptoms (using the Impact of Event Scale), decreased emotional discomfort related to traumatic memories (rated by Subjective Units of Distress), and improvements in positive self-evaluations (measured by the Validity of Cognition Scale). There were similar results in the Alternative group with the exception of no significant improvement in self-evaluation. This latter finding provides some support for the hypothesis that eye-movements facilitate a cognitive restructuring. Comparisons between the EMDR and Alternative treatments, however, found no significant differences on any of the dependent measures. That is, both treatments appeared to produce comparable positive results which implied eye-movements were no more effective than deep breathing. In addition, both treatments were found to be more effective in easing intrusive symptoms. Other similarities included observable relaxation reactions in both treatments. These overall findings imply a similar change mechanism. Therefore, the efficacy of EMDR may stem more from reciprocal inhibition rather than a cognitive restructuring induced by the eye-movements. If this is valid, then EMDR may be a variant of systematic desensitization. [Author Abstract] Dissertation Abstracts International: Section B: The Sciences and Engineering. 56(3-B), Sep 1995, pp. 1690

Keywords: Americans Avoidance Cognitive Impairment Empirical Study Intrusive Thoughts Longitudinal Study Self Concept Stressors Survivors Treatment Effectiveness Treatment Outcome/Clinical Trial

Accuracy Verified: Yes

10. Lipke, H. (1996 June). A four activity model of psychotherapy and its relationship to eye movement desensitization and reprocessing and other methods of psychotherapy. Traumatology, 2(2), 1-8. doi:10.1177/153476569600200201 .

Language: English

Format: Journal

Abstract:
This paper presents a general, information processing, model of psychotherapy based on Shapiro's EMDR, that includes both recently developed and traditional psychotherapy methods. It is posited that methods of psychotherapy can be conceptualized as employing up to four categories of activity to promote adaptive functioning. These activities include: (1) accessing of information already acquired; (2) introduction of new information; (3) facilitation of the processing of information; (4) inhibition of accessing. The third category, facilitation of processing, includes abstract activity, and represents a relatively new development in psychotherapy. [Author Abstract]

Keywords: Cognitive Processes Psychotherapeutic Processes

Accuracy Verified: Yes

11. Meignant, I. (2009, August). Healing the couple within a systemic EMDR approach. Presentation at the annual meeting of the EMDR International Association, Atlanta, GA.

Language: English

Format: Conference

Abstract: Using both Mony Elkaïm’s reciprocal double-bind systemic model and the AIP model, we demonstrate a new perspective for couple therapy. This presentation will consider how to choose to do EMDR or not in the couple session, using the other member of the couple as a co-therapist, and using individual safe places as a safe place for the couple during the session and at home. The workshop will also include how understanding the reciprocal double-bind can be a guide in the EMDR target plan in determining where to work on the past of each client to heal the couple in couple or individual therapy.

Keywords: Couples Therapy Mony Elkaïm Reciprocal Double-Bind Systemic Model

Accuracy Verified: Yes

12. Flumeri, F., Salmaso, D., & Pagani, M. (2008, 26-28 Settembre). Impatto dell'EMDR sulle fuzioni e sulla neurobiologia cerebrali [Impact on EMDR and neurobiological brain functions]. In T. Farma (Chair), Simposio, Il modello psicotraumatologico: Un ponte tra indicatori neurobiologici e Psicoterapia. VII Congresso SPR Italia, Modena.

Language: Italian

Format: Conference

Abstract:
Introduzione:negli ultimi anni il numero di studi condotti nell’ambito dei disturbi causati da eventi traumatici ha subito una forte accelerazione rilevando l’esistenza di alterazioni fisiologiche e morfologiche in specifiche aree cerebrali associate sia alla risposta emotiva al trauma che alla insorgenza dei sintomi della sindrome da stress post-traumatico (PTSD). L’impiego delle tecniche di neuroimmagine ha consentito di fare luce sui correlati neurali della psicoterapia, rivelando i suoi effetti neurobiologici sulla funzione cerebrale. Nell’ambito dei diversi approcci psicoterapeutici, l’EMDR (Eye Movement Desensitization and Reprocessing therapy) è emerso come promettente risorsa per il trattamento del trauma e di altri disturbi d’ansia, sebbene ancora non sia stata completamente chiarita la sua modalità di azione sui circuiti neurali. Molte ricerche sono state effettuate per valutare l’efficacia dell’EMDR, ma solo un numero esiguo di esse ha indagato il substrato neurobiologico di questa psicoterapia. Le metodiche di neuroimmagini utilizzate finora per studi sull’EMDR sono la Single Photon Emission Computed Tomography (SPECT) e la Magnetic Resonance Imaging (MRI). La prima raccoglie dati sull’attivita’ cellulare cerebrale mentre la seconda riporta dati anatomici strutturali. Gli studi funzionali condotti con SPECT consentono di identificare le variazioni del metabolismo e del flusso ematico cerebrale, suggerendo un ruolo specifico per ciascuna area cerebrale coinvolta nel complesso meccanismo che sottende il processamento delle emozioni; la MRI consente invece di rilevare la presenza di variazioni morfologiche e volumetriche di specifiche strutture cerebrali. Negli ultimi anni, studi SPECT e MRI, volti ad esaminare gli effetti dell’EMDR sulla fisiopatologia cerebrale in pazienti affetti da disturbi d’ansia, hanno riscontrato sostanziali variazioni del flusso ematico ed alterazioni strutturali di alcune regioni cerebrali in seguito a terapia. L’efficacia dell’EMDR nel trattamento del PTSD è stata confermata da uno studio SPECT su sei soggetti ( Lansing et al.) (1) che ha evidenziato dopo terapia una diminuzione del flusso ematico nel lobo occipitale bilateralmente e nel lobo parietale sinistro e un aumento di flusso nel giro frontale inferiore sinistro. Sempre utilizzando la SPECT Oh e Choi (2) hanno riportato una significativa modificazione del flusso cerebrale in seguito ad EMDR, prevalentemente riscontrabile nell’area limbica e nella corteccia prefrontale. Un recente studio con utilizzo di MRI (3) ha inoltre messo in evidenza un aumento di volume dell’ippocampo in seguito a trattamento con EMDR, aumento invece non riportato in un lavoro di Lindauer et al. su 9 soggetti con PTSD, nonostante il successo clinico della psicoterapia eclettica eseguita (4). Obiettivi: il nostro gruppo ha studiato gli effetti a breve e lungo termine dell’EMDR (5, 6) dimostrando la sua efficacia nel trattamento di soggetti traumatizzati sul lavoro, e una stabilità del miglioramento clinico ottenuto in risposta alla terapia, ancora presente a distanza di tre anni. Nell’ambito dello stesso progetto sono state anche studiate le variazioni del flusso ematico cerebrale e della volumetria di alcune strutture cerebrali in relazione alla terapia con EMDR. Un primo studio SPECT ha analizzato la variazione della distribuzione di flusso in 11 soggetti guariti clinicamente da PTSD in seguito a EMDR messi a confronto con 5 soggetti nei quali la terapia non ha avuto effetto (7). Risultati: è stato evidenziato nei soggetti con remissione sintomatologica significative differenze di flusso in 4 aree corticali, alla disfunzione delle quali sono ascrivibili alcuni sintomi presenti in corso di PTSD. Diminuzioni di flusso post-terapia sono state registrate nell’ippocampo, nella corteccia parieto-occipitale e nella corteccia visiva primaria. L’ippocampo e’ sede della memoria a breve termine; la corteccia parieto-occipitale processa il riconoscimento di volti, dei corpi e delle parole; la corteccia visiva primaria custodisce la memoria visiva degli eventi. La mancata inibizione e/o l’iperattivita’ di queste regioni nel PTSD sono responsabili della rivisitazione patologica dell’evento traumatico e della presenza di flashback ed immagini allucinatorie. Inoltre la corteccia frontale dorsolaterale ha dimostrato un aumento di flusso nei soggetti che hanno risposto positivamente alla terapia. Questa regione chiave oltre ad essere deputata ad inibire la risposta patologica a stimoli che ricordano l’evento traumatico e’ essenziale per i processi di attenzione e di autostima, diminuiti in corso di PTSD e recuperati in seguito alla remissione della malattia. In ulteriori studi che combinano indagini funzionali e strutturali utilizzando SPECT e MRI abbiamo messo in evidenza il valore predittivo delle dimensioni dell’ippocampo riguardo all’efficacia della terapia con EMDR (Pagani et al. sottomesso). Conclusioni: gli effetti della terapia con EMDR sono risultati, unitamente ad un consistente miglioramento della sintomatologia e ad una riduzione della iperreattività a stimoli di carattere emotivo, in una normalizzazione funzionale di alcune aree specifiche e in un aumento del volume ippocampale probabilmente ascrivibile a neo-neurogenesi. Questi risultati sono in linea con la pregressa letteratura e con le attuali conoscenze sul PTSD e suggeriscono basi neurobiologiche dell’effetto terapeutico dell’EMDR confermandone l’impatto funzionale su strutture cerebrali coinvolte in patologie ansiogene. Bibliografia: 1. Lansing et al. (2005). J Neuropsych Clin Neurosci;17(4):526-532. 2. Ho DH and Choi J. (2007). J EMDR Pract Res;1(1):24-30. 3. Bossini et al. (2007). J Neuropsych Clin Neurosci; 19(4):475-476. 4. Lindauer et al. (2005). Psychol Med ; 35 :1-11. 5. Hogberg et al. (2007). Nord J Psych; 61(1):54-61. 6. Hogberg et al. (2008). Psych Res; doi:10.1016/j.psychres.2007.10.019. 7. Pagani et al. (2007). Nuc Med Comm; 28(10):757-65. [Pagani abstract]

Introduction In recent years the number of studies in disorders caused by traumatic events has been greatly accelerated by detecting the existence of morphological and physiological changes in specific brain areas associated with both the emotional response to trauma to the onset of symptoms Post-traumatic stress syndrome (PTSD). The use of neuroimaging techniques has allowed to shed light on the neural correlates of psychotherapy, revealing the neurobiological effects on brain function. Under the different psychotherapeutic approaches, EMDR (eye movement desensitization and reprocessing therapy) has emerged as a promising resource for the treatment of trauma and other anxiety disorders, although still not been fully elucidated its mode of action on neural circuits. Many studies have been carried out to assess the effectiveness EMDR, but only a small number of them have investigated the neurobiological substrate of this psychotherapy. The methods used so far for neuroimaging studies on EMDR are Single Photon Emission Computed Tomography (SPECT) and Magnetic Resonance Imaging (MRI). The first collects data on 'brain cells while the second contains structural anatomical data. The functional studies performed with SPECT to identify changes in metabolism and cerebral blood flow, suggesting a specific role for each brain area involved in the complex mechanism underlying the processing of emotions, instead of MRI allows detection of morphological changes and volume of specific brain structures. In recent years, MRI and SPECT studies, aimed to examine the effects of EMDR on brain pathophysiology in patients with anxiety disorders, have found substantial variations in blood flow and structural alterations of some brain regions after treatment. The effectiveness of EMDR in the treatment of PTSD was confirmed by a SPECT study in six subjects (Lansing et al.) (1) showed that after treatment reduced blood flow in the occipital lobe bilaterally and in left parietal lobe and a increase of flow in left inferior frontal gyrus. Always using SPECT Oh and Choi (2) reported a significant change of cerebral blood flow after EMDR, mainly found in limbic and prefrontal cortex. A recent study using MRI (3) has also highlighted an increase in volume of the hippocampus after treatment with EMDR, but no increase in reported work of Lindauer et al. on 9 subjects with PTSD, despite the clinical success of eclectic psychotherapy performed (4). Objectives: Our group has studied the effects of short and long term EMDR (5, 6) demonstrating its effectiveness in treating traumatized individuals at work, and stability of clinical improvement obtained in response to therapy, yet this distance three years. Within the same project were also studied changes in cerebral blood flow and volume of certain brain structures in relation to treatment with EMDR. A first SPECT study analyzed the change in flow distribution in 11 subjects clinically recovered from PTSD after EMDR compared with 5 subjects in whom treatment had no effect (7). Results: It was shown in patients with symptomatic remission, significant differences in flow in 4 cortical areas, which are attributable to dysfunction of some symptoms of PTSD being present. Flow decreases post-treatment were recorded in the hippocampus, cortex parietal-occipital and primary visual cortex. The hippocampus and 'seat of short-term memory, the parietal-occipital cortex processes the recognition of faces, bodies and words, the primary visual cortex preserves the visual memory of events. The lack of inhibition and / or 'hyperactivity' of PTSD in these regions are responsible for the pathological review of the traumatic event and the presence of flashbacks and hallucinatory images. Moreover, the dorsolateral frontal cortex showed an increase in flow in subjects who responded positively to therapy. This key region in addition to being appointed to inhibit the pathological response to stimuli that recall the traumatic event and 'essential for the processes of attention and self-esteem, decreased in the course of PTSD and recovered following the remission of the disease. In further studies that combine functional and structural investigations using SPECT and MRI have shown the predictive value of the size of the hippocampus on the effectiveness of EMDR therapy (Pagani et al. Submitted). Conclusion: the effects of EMDR therapy were coupled with a significant improvement in symptoms and a reduction of hyperreactivity to stimuli, emotional, functional in a normalization of some specific areas and an increase in hippocampal volume probably due to neo- neurogenesis. These results are consistent with previous literature and with current knowledge about PTSD and suggest a neurobiological basis of therapeutic EMDR confirming the functional impact on brain structures involved in anxiety-disorders. Bibliography: 1. Lansing et al. (2005). J Neuropsych Clin Neurosci, 17 (4) :526-532. 2. I DH and J. Choi (2007). J EMDR pract Res, 1 (1) :24-30. 3. Bossini et al. (2007). J Neuropsych Clin Neurosci, 19 (4) :475-476. 4. Lindauer et al. (2005). Psychol Med, 35 :1-11. 5. Högberg et al. (2007). Nord J Psych, 61 (1) :54-61. 6. Högberg et al. (2008). Psych Res, doi: 10.1016/j.psychres.2007.10.019. 7. Pagani et al. (2007). NUC Med Comm, 28 (10) :757-65. [Pagani abstract]

Keywords: Brain Functions Neurobiology

Accuracy Verified: Yes

13. Harford, P. M. (2010). The integrative use of EMDR and clinical hypnosis in the treatment of adults abused as children. Journal of EMDR Practice and Research, 4(2), 60-75. doi:10.1891/1933-3196.4.2.60.

Language: English

Format: Journal

Abstract:
The potential benefits of the use of a permissive style of clinical hypnosis as a therapeutic medium to enhance eye movement desensitization and reprocessing (EMDR) trauma treatment are explored. A comparative review of hypnosis and EMDR is provided, including putative psychophysiological mechanisms for both. A rationale for integrating clinical hypnosis with EMDR treatment is presented. It is suggested that hypnosis primarily enhances the accessibility of traumatic information while EMDR primarily enhances the reprocessing of traumatic information and that accessibility and reprocessing are reciprocal features. The relative and combined merits of hypnosis and EMDR for resource development are discussed. The author proposes that clinical hypnosis may be incorporated into EMDR without necessarily modifying the eight-stage EMDR protocol apart from modifications that are indicated for special conditions. Three case vignettes are used to illustrate the integrative use of clinical hypnosis and EMDR in the treatment of adults who experienced childhood abuse.

Keywords: Abuse ACC Adolescents Children Clinical Hypnosis Complex PTSD Complex Posttraumatic Strress Disorder C-PTSD Integrative Use VMPFC

Accuracy Verified: Yes

14. Lazzari, D. (2008, Novembre). L'EMDR in ottica PNEI (interazione corpo-mente) [EMDR in optical PNEI (interaction body-mind)]. Presentazione le Applicazioni Cliniche del EMDR Congresso Nazionale, Milano, Italia.

Language: Italian

Format: Conference

Abstract:
In questi anni l’EMDR si è affermata come trattamento di evidenza nel più classico e più grave dei disturbi direttamente legati allo stress, cioè il PTSD (Bisson & Andrew, 2007) e sono stati evidenziati i suoi effetti sul SNC. Nonostante questo ed il suo progressivo impiego in una ampia varietà di situazioni sono ancora poche le riflessioni sull’EMDR dal punto di vista dell’integrazione mente-corpo, in particolare utilizzando i dati offerti dal campo di ricerca della PNEI. Nel presente lavoro ci soffermeremo su alcuni di questi aspetti per evidenziare come l’EMDR rappresenta una delle terapie più rispondenti alle nuove evidenze scientifiche ed alle esigenze di una scienza integrata della salute. Tre gli elementi salienti offerti dalla ricerca: 1. La vita ha plasmato nel percorso evolutivo strutture altamente integrate, descrivibili come sistemi complessi a rete in retroazione continua con il contesto. In particolare i sistemi nervoso, endocrino ed immunitario costituiscono nel network psicocorporeo un “super-sistema” di relazione e regolazione in grado di assicurare gli equilibri adattativi incorporando l’esperienza e gestendo la dinamica mantenimento-cambiamento (“regolazione allostatica”). Quindi l’organismo non è una macchina fatta di parti autonome tra loro assemblate, ma una realtà che parte dall’unità (zigote) e mantiene tale carattere unitario in tutte le sue articolazioni. 2. Lo stress non è qualcosa di per sé eccezionale e patologico, deve invece essere visto – all’opposto – come l’espressione di un insieme di processi (un sistema) che modulano la regolazione individuo-contesto a fini adattativi. In sostanza il sistema dello stress è sempre attivo e solo in situazioni di eccesso o di carenza (acute o croniche) produce effetti progressivamente dannosi per l’individuo. Le attività legate allo stress producono un “carico allostatico” (peso biologico, energetico) che – in relazione a fattori soggettivi ed esterni – può divenire “sovraccarico” innescando una catena di successive alterazioni nel funzionamento dell’organismo. Parallelamente vi è un “carico” ed un “sovraccarico psicologico” legati al primo da processi circolari. 3. Nel network corporeo e nel sistema dello stress, ovvero nei processi di regolazione generale interni e individuo-contesto, la mente svolge un ruolo cruciale di modulazione come dimensione nella quale i segnali (interni ed esterni) vengono trasformati in informazioni (assegnazione di significati) in base ai percorsi ed alle esigenze individuali di adattamento. La mente rappresenta così la più alta espressione dell’evoluzione della vita e delle sue strategie adattative e ciò spiega il suo ruolo rispetto al funzionamento complessivo dell’organismo. Le recenti acquisizioni delle neuroscienze hanno mostrato l’interdipendenza tra attività psichica, espressione genica e plasticità cerebrale che rende possibile il ruolo della mente. Il sovraccarico allostatico e psicologico legati allo stress dipendono in gran parte dall’attività mentale e costituiscono il principale fattore di rischio per la salute nelle società occidentali, antecedenti accertati delle patologie più diffuse. Se guardiamo a quanto detto sinora nell’ottica dello sviluppo individuale (fase intrauterina, processi di attaccamento, eventi significativi successivi) possiamo avere una idea di come mente, corpo e contesto interagiscono nella strutturazione dell’individuo ed il ruolo condizionante e de-strutturante delle situazioni e degli eventi che provocano una alterazione da stress. Le ricerche sul rapporto tra stress e sviluppo psicobiologico, tra modalità di attaccamento, strutturazione dei circuiti cerebrali, o tra queste e salute, confermano tali assunti (Lazzari, 2007). Venendo più da vicino all’EMDR, gli studi sulla psicobiologica del PTSD stanno mostrando che siamo di fronte sostanzialmente ad una manifestazione (particolarmente complessa ed accentuata) degli effetti dello stress sul network psicocorporeo (Iribarren et al., 2005). La ricerca sul PTSD (e gli altri disturbi da stress del DSM) deve incrociare necessariamente i filoni di studio sopra richiamati ed utilizzare la cornice concettuale che ne scaturisce. Gli effetti psicobiologici dello stress estremo e del trauma vanno inquadrati nell’ambito delle interazioni mente-corpo e della regolazione allostatica (carico vs sovraccarico allostatico). A nostro avviso, al di là degli specifici effetti sul SNC, l’EMDR si è mostrata efficace nel PTSD in relazione alla sua caratteristica generale di ricercare ed utilizzare come “target” non singoli aspetti di una esperienza, bensì l’esperienza nei suoi diversi aspetti: cognitivi, emotivi, fisiologici e relazionali. Il lavoro dell’EMR va a recuperare una integrazione perduta e lavora su questa. Si deve tenere presente infatti che, in via generale e preminente, lo stress compromette i livelli di integrazione, coerenza e flessibilità del sistema: lo stress cronico per processi progressivi di disregolazione, quello acuto per “rotture”, blocchi e sconnessioni. Pertanto l’elaborazione dell’informazione (e delle conseguenze) legata ad eventi e situazioni stressanti passa attraverso una re-integrazione di tutti gli aspetti psicobiologici correlati per giungere ad una ristrutturazione. Il livello di “penetrazione” (efficacia) di un approccio terapeutico è molto legato alla sua omogeneità con la realtà su cui interviene,cioè al fatto di parlare lo stesso linguaggio. E questo è un punto di forza notevole per l’EMDR. I dati disponibili sono coerenti con quanto enunciato: l’EMDR modifica i parametri fisiologici riducendo ed annullando l’attivazione da stress, spostando la bilancia dall’inibizione simpatica all’attivazione parasimpatica (Sack et al. 2007) e risulta associata l’abbassamento dell’arousal fisiologico, cioè con pattern di attività regolari e trofiche (Sack et al. 2008), mostrando similarità con quanto accade durante il sonno REM (Elofsson et al., 2008). L’EMDR incide altresì su disturbi fisici legati al sistema dello stress, come ad esempio hanno mostrato ricerche su patologie dermatologiche (Gupta, 2002).

In recent years, EMDR has established itself as the treatment of evidence in the most classical and most serious of disorders directly related to stress, that is, PTSD (Bisson & Andrew, 2007) and were highlighted its effects on the CNS. Despite this and its progressive use in a wide variety of situations are still few reflections from the perspective sull'EMDR mind-body integration, in particular using data provided by the search of PNEI. In this work we will focus on some of these issues to highlight how EMDR is one of the therapies are more responsive to new scientific evidence and the needs of an integrated science of health. Three main elements of research are: 1. Life has shaped the evolutionary highly integrated structures, we describe how systems complex feedback network continues with the context. In particular, the nervous, endocrine immune network and provide psycho in a "super-system" of relationship and adjustment able to ensure the balance incorporating adaptive expertise and managing the dynamic maintenance-change ( "regulation allostatica"). Then the body is a machine made of autonomous parts, assembled together, but a reality that leaves the unit (zygote) and maintains that unitary in all its joints. 2. Stress is not something in itself exceptional and pathological, but must be seen - in contrast -- as the expression of a set of processes (a system) that modulate the individual-regulation framework for adaptive. In essence, the system of stress is always on and only in situations of excess or deficiency (acute or chronic) effects progressively damaging to the individual. The Stress-related activity produces a "load allostatico" (weight biological energy) that -- relation to subjective factors and external - can become "overloaded" by triggering a chain of subsequent alterations in the functioning of the organism. In parallel there is a "load" and a "Overload psychological" processes related to the first round. 3. In the network system and body of stress, or in the process of setting general internal and individual-context, the mind plays a crucial role as a dimension of modulation in which signals (internal and external) are transformed into information (assigning meanings) depending on the paths and individual needs of adaptation. The mind is so the highest expression of the evolution of life and its adaptive strategies, which explains its role in relation to the overall functioning of the organism. The recent acquisitions of neuroscience have shown the interdependence of psychic activity, gene expression and plasticity brain that makes the role of the mind. Overload allostatico and psychological stress-related depend in large part by activism mental and constitute the main risk factor for health in Western societies, antecedents established disease spreading. If we look to the foregoing view of personal development (stage intrauterine attachment process, significant events later) we can have an idea of how mind, body and environment interact in the structuring the individual and the role conditioning and de-structuring of situations and events that cause an alteration by stress. Research on the relationship between stress and psychobiological development, including mode of attachment, structure of brain circuits, or between them and health, confirmation of these given (Lazzari, 2007). Coming closer all'EMDR, psychobiological studies of PTSD are showing that we are dealing essentially an event (especially complex and pronounced) the effects of stress on the network psycho (Iribarren et al., 2005). Research on PTSD (and other stress disorders DSM) must necessarily cross the strands study mentioned above and use the conceptual framework that arises. Psychobiological effects of extreme stress and trauma should be classified within mind-body interactions and regulation allostatica (load vs. overload allostatico). In our view, beyond the specific effects on the CNS, EMDR has been shown effective in PTSD in connection with his characteristic broad research and use as a "target" rather than individual aspects of an experience, but experience in its different aspects: cognitive, emotional, physiological and relational. Work dell'EMR goes to retrieve a lost and working on this integration. It should be remembered that, in general, and prominent, stress affects the levels of integration, consistency and flexibility of the system: chronic stress for progressive process of dysregulation, the acute "broken", blocks and disconnections. Therefore processing information (and consequences) related to events and stressful situations through a re-integration of all aspects related to psychobiological reach a restructuring. The level of "penetration" (effectiveness) of a therapeutic approach is very attached to his homogeneity with the reality on which it operates, namely the fact of speaking the same language. And this is a great asset for EMDR. The available data are consistent with the statement: EMDR change physiological parameters reducing and canceling the activation by stress, shifting the balance from the inhibition nice parasympathetic activation (Sack et al. 2007) and is associated with lowering dell'arousal physiological, ie regular patterns of activity and trophic (Sack et al. 2008), showing similarities with what happens during REM sleep (Elofsson et al., 2008). EMDR also impacts on physical ailments related to the system of stress, such as have Show searches on dermatological (Gupta, 2002).

Keywords: Body-Mind Interaction PNEI

Accuracy Verified: Yes

15. Meignant, I. (2012, April). L’approche systémique et l’EMDR: Soigner le couple [The systems approach and EMDR: Treating the couple]. Présentation à la réunion annuelle de l'EMDR Canada, Montréal, Québec, Canada.

Language: French

Format: Conference

Abstract:
L’utilisation conjointe du modèle systémique du double lien réciproque de Mony ElKaïm et du modèle du Traitement Adaptatif de l'Information (TAI) d’EMDR est une nouvelle perspective pour la thérapie de couple. L'utilisation des deux approches permet de développer un plan de traitement en EMDR qui tient compte et respecte les systèmes relationnels ex : couple, homme /femme, parent/enfant, employé/employeur. Lors de cette présentation les participants apprendront quand et comment travailler avec un membre du couple comme co-thérapeute ; comment un lieu sûr sur le plan individuel peut aussi s’appliquer au niveau du couple et être utilisé durant la session et à la maison ; comment déterminer les cibles dans un plan de traitement EMDR et systémique qui soit guidées par la compréhension systémique du double lien réciproque et finalement comment adapter les 8 phases du protocole EMDR auprès du couple en se basant sur le modèle systémique.
Objectifs d'apprentissage: 1. Déterminer lorsqu’il est approprié d’utiliser l’EMDR en thérapie de couple 2. Pouvoir faire l’installation d’un lieu sûr afin que cela soit une ressource pour le couple 3. Comprendre comment utiliser le modèle systémique du double lien réciproque afin d’identifier les cibles individuelles qui contribuent aux difficultés actuelles du couple 4. Comprendre les particularités de chacune des 8 phases du protocole EMDR lorsque utilisés auprès du couple.

Using both the systemic model of the double reciprocal link Mony Elkaim and model of the Adaptive Information Processing (ADP) EMDR is a new perspective for couple therapy. The use of both approaches can develop a treatment plan that considers EMDR and respects relational systems eg couple, man / wife, parent / child, employee / employer. During this presentation participants will learn when and how to work with a member of the couple as co-therapist; how a safe place at the individual level can also be applied to the couple and used during the session and at home, how identify targets in a treatment plan that is systemic and EMDR guided by the systemic understanding of the double reciprocal link and finally how to adapt the eight phases of EMDR protocol with the torque based on the systemic model.
Learning Objectives: 1. Determine when it is appropriate to use EMDR in couples therapy 2. Able to install a safe place so that this is a resource for the couple 3. Understand how to use the systemic model of the double reciprocal link in order to identify individual targets that contribute to the current difficulties of the couple 4. Understand the particularities of each of eight phases of EMDR protocol when used with the couple.

Keywords: Couples

Accuracy Verified: Yes

16. Corrigan, F. (2002). Mindfullness, dissociation, EMDR and the anterior cingulate cortex: A hypothesis. Contemporary Hypnosis, 19(1), 8-17. doi:10.1002/ch.235.

Language: English

Format: Journal

Abstract:
Hypotheses on the neurobiology of a mindfulness-dissociation continuum are presented. Crucial to the hypotheses are the observations of a reciprocal interaction between the cognitive and affective subdivisions of the anterior cingulate cortex and the unilateral activation of right anterior cingulate in hypnotic dissociation and in post-traumatic syndromes. It is proposed that the unilateral activation can cause a loss of the reciprocal relationship between the subdivisions and that in the case of peri-traumatic dissociation the subsequent syndrome responds to eye movement desensitization and reprocessing (EMDR) through restoration of the bilateral activation and reinstatement of the reciprocal relationship between the subdivisions. Bilateral activation of the cognitive subdivisions is proposed to underlie the attentional state of concentration mindfulness in which affect is well regulated. Copyright © 2002 British Society of Experimental and Clinical Hypnosis

Keywords: Anterior Cingulate Cortex Bilateral Activation Dissociation Emotional Trauma Gyrus Cinguli Hypnosis Hypnotic Dissociation Mindfulness Posttraumatic Syndromes Reciprocal Interaction

Accuracy Verified: Yes

17. Cartoni, A., Gaudin, M., Astori, M. G., Mannatrizio, A., & Brunati, E. (2012, June). Mistakes to not repeat: When the child´s body talks of the mother´s traumatic past (case) [Errores a no repetir: Cuando el cuerpo del niño habla del pasado traumático de la madre (caso)]. Presentation at the annual meeting of the EMDR Europe Association, Madrid, Spain.

Language: English

Format: Conference

Abstract:
Following Siegel’s model (2005), the authors present a single case that undergone a therapeutic intervention with EMDR aimed to reprocess infantile traumatic memories reactivated in the parenting. A 4 year old child came to our Child Neuropsychiatric Unit because she presented a toe walking in absence of neurological signs. She undergone periodic physiatrist visits for one year without any symptoms regression. She was then seen from a Child Neuropsychiatrist and a Psychomotor Therapist who evaluated the importance of observations by a psychologist. Method: The psychologist observed a general anxiety state in the child characterized by perfectionism, inhibition and hypervigilance to the environment demand. The mother's life story was that of a child with an alcoholic father who she wished to save with her love and who died for cirrhosis. It was clear how the parenting experience reactivated infantile traumatic memories. It was proposed a treatment with EMDR. The child treatment was addressed to install resources and to reprocess stressing interactions with the mother. The mother treatment was aimed to reprocess infantile traumatic experience and to look at the present triggers in the interaction with the daughter who reactivated traumatic memories and cause emotion dysregulation. Results: The treatment brought to a resolution of the child symptoms and a reorganization of the interaction between the child and the mother. Conclusions: This single case report highlights the importance to understand well the psychological origin of somatic symptoms and gives an evidence of the efficacy of the treatment with EMDR following Siegel’s model.

Antecedente Teórico: La desensibilización y reprocesamiento por el movimiento ocular (EMDR) es una reconocida primera línea para el tratamiento del trauma psicológico. Sin embargo sus bases neurobiológicas no han sido descifradas todavía. Método: La electroencefalografía ha sido usada por primera vez para monitorizar completamente la activación neuronal durante sesiones enteras de EMDR incluyendo el guión autobiográfico. 10 Clientes con traumas psicológicos mayores fueron investigados durante la primera sesión de EMDR y durante la última después del procesamiento del trauma raíz. Las comparaciones entre los EEG de la última y primera sesión y las de EEG de los clientes en la primera sesión y 10 controles realizando el mismo procedimiento de EMDR fueron realizadas. Resultados: Durante ambos procesos, la escucha y la estimulación bilateral, el EEG mostró una actividad significativamente mayor en el córtex límbico prefontral (Brodmann Areas, BA 9-‐10) al principio comparadas con la última sesión de EMDR. La comparación opuesta muestra un cambio en la actividad fundamental entre las regiones corticales temporal, parietal y occipital (BAs 20, 21, 22, 37, 17, 18, 19) con lateralizaciones hacia la izquierda. La comparación entre los 10 clientes y los controles confirman la activación máxima de la corteza límbica en los clientes antes de procesar el trauma. Conclusiones: La metodología usada hizo posible visualizar la neuroimagen por primera vez de las activaciones cerebrales asociadas con las acciones terapéuticas que acontecen en el EMDR. Los hallazgos sugieren que el procesamiento cognitivo de los eventos traumáticos seguidos de una terapia EMDR exitosa apoyan la evidencia de un patrón neurobiológico diferenciado en las activaciones del cerebro durante la estimulación ocular bilateral asociados con una acumulación un experiencias emocionales negativas.

Keywords: Body

Accuracy Verified: Yes

18. Bossini, L., Poliziotto, N., Tavanti, M., Calossi, S., Lombardelli, A., Vatti, G., & Castrogiovanni, P. (2006, Febbraio). Neuroimaging e PTSD: Dati morfovolumetrici e loro variazioni dopo trattamento [Neuroimaging and PTSD: Facts morfovolumetrici and their changes after treatment]. Presentazione al Congresso XI SOPSI (Società Italiana di Psicopatologia), Roma, Italia.

Language: Italian

Format: Conference

Abstract:
Introduzione: molti studi concordano sulla riduzione del volume ippocampale nei pazienti affetti da PTSD 1 e che tale alterazione anatomica è correlata con deficit cognitivi e con la gravità dei sintomi. Comunque ad oggi non è stato ancora chiarito se l’atrofia ippocampale rappresenta l’esito di un effetto neurotossico del trauma o, piuttosto, una condizione preesistente che predispone allo sviluppo di alcune patologie psichiatriche. Già da tempo studi su animali dimostrano come lo stress causi atrofia ippocampale e inibizione della neurogenesi, con meccanismi verosimilmente legati ai glucocorticoidi, all’increzione del fattore corticotropo, all’aumento degli aminoacidi eccitatori, all’inibizione fattore neurotrofico cerebrale con perdita della plasticità neuronale. Nell’uomo, tuttavia, i risultati non sono così lineari. Da un lato alcuni studi hanno individuato come fattore principale l’aumento dei glucocorticoidi 2, dall’altro tale teoria è stata fortemente criticata 3. Secondo Yehuda il meccanismo di atrofia ippocampale è dovuto ad un’alterazione dell’asse Ipotalamo-Ipofisi-Surrene (HPA), ma in termini di una bassa increzione di glucocorticoidi che determina un aumento del feedback negativo dell’asse stesso ed un’ipersensibilità recettoriale. Indipendentemente dal meccanismo d’azione, la perdita di neuroni a livello ippocampale nei soggetti che hanno subito eventi traumatici sembra sufficientemente dimostrata e, fino a poco tempo fa, era considerata irreversibile. In realtà l’ippocampo sembra presentare una inusuale e spontanea capacità rigenerativa. Questo dato è stato individuato in molte specie animali e, in un unico studio, anche nell’uomo 4. Inoltre recenti evidenze pre-cliniche e cliniche hanno indicato che gli SSRI (Selective Serotonin Reuptake Inhibitors) promuovono la neurogenesi e riducono l’atrofia ippocampale indotta dallo stress nell’animale 5 e nell’uomo sono in grado di ridurre i sintomi del PTSD, incrementare le dimensioni dell’ippocampo e ridurre i deficit mnesici tipici della patologia 6 7. Un altro fattore che sembra essere in grado di stimolare la neurogenesi negli animali sembra essere “l’ambiente arricchito” verosimilmente tramite i meccanismi molecolari dell’apprendimento che sembrano in grado di attivare la trascrizione dell’mRNA per il Brain Derived Neurotrophic Factor. Questo dato della letteratura supporta il razionale dell’efficacia della psicoterapia anche se l’unico studio che valuta le modificazioni morfostrutturali dopo psicoterapia non ha riportato risultati positivi 8. Gli scopi di questo studio sono: – valutare la presenza di atrofia ippocampale nei pazienti affetti da PTSD (T0-drug-free); – valutare l’effetto della terapia: farmacologica con SSRI e psicoterapica con EMDR (Eye Movement Desensitization and Reprocessing) sia sul piano clinico e neuropsicologico, che sul volume ippocampale, sia sulla memoria (T1). Metodologia: abbiamo analizzato un campione di 20 pazienti, di età compresa tra i 15 ed i 65 anni, reclutati nell’ambulatorio psichiatrico del Policlinico universitario di Siena affetti da PTSD e un gruppo di controllo di soggetti sani appaiati per sesso, età, peso e altezza. I soggetti di entrambi i gruppi sono stati sottoposti ad uno studio morfovolumetrico computerizzato dell’Ippocampo tramite RM (Risonanza Magnetica). Inoltre, i diciassette pazienti con PTSD sono stati valutati tramite la somministrazione di test neuropsicologici e scale psicometriche per approfondire il quadro psicopatologico e valutare l’eventuale presenza di deficit cognitivi. Nei soggetti affetti da PTSD dopo un periodo di sei mesi di terapia psicofarmacologica sono stati ripetuti i test neuropsicologici, le scale psicometriche e l’analisi morfovolumetrica dell’ippocampo tramite RM. Tre pazienti, dopo le valutazioni al T0, hanno effettuato un protocollo terapeutico con solo EMDR e sono stati rivalutati dopo 8 sedute (due mesi). Risultati: i risultati della prima parte sperimentale (T0-drug-free) evidenziano che le dimensioni dell’ippocampo di sinistra nei soggetti affetti da PTSD sono significativamente minori rispetto ai controlli sani. Dai risultati osservati al follow-up (T1-post-terapia) è possibile evincere che la terapia nei soggetti considerati è associata ad un miglioramento della sintomatologia e ad un aumento dei volumi ippocampali, pari al 9,87% per l’ippocampo di destra e dell’8,37% per l’ippocampo di sinistra. Questi dati sono concordi con i dati presenti in letteratura, anche se la percentuale di recupero su base neuroplastica nel nostro studio risulta sensibilmente superiore rispetto ai due studi presenti in letteratura incremento pari al 4,6% 6; pari al 5% 7. I tre pazienti che hanno effettuato terapia con EMDR hanno anch’essi mostrato al T1 un miglioramento sintomatologico (CAPS non più positiva per i criteri diagnostici) ed un aumento medio dei volumi ippocampali pari a 338,25 mm3 per l’ippocampo DX e 357,93 mm3 per l’ippocampo SN. Conclusioni: la terapia nei soggetti considerati si è associata ad un aumento dei volumi ippocampali (9,87%-8,37%). L’aumento dei volumi ippocampali appare rilevante, consistente con i dati in letteratura, sebbene quantitativamente superiore, sottolineando l’efficacia degli SSRI verosimilmente tramite il meccanismo di attivazione della neurogenesi; è ipotizzabile che l’aumento di volume non sia da imputare ad un aumento delle cellule gliali ma ad un aumento di neuroni ippocampali visto il contemporaneo miglioramento clinico. Particolarmente interessante ci sembra il dato relativo all’efficacia clinica e sulla plasticità neurale della EMDR. Questa osservazione su solo tre casi, necessita chiaramente di essere confermata su un campione più ampio ma rappresenta la prima evidenza in letteratura di un’azione della psicoterapia diretta alla struttura cerebrale.

Introduction: Many studies agree on the reduction of hippocampal volume in patients with PTSD and that an anatomical alteration is correlated with cognitive deficits and the severity of symptoms. However to date has not yet been clarified whether hippocampal atrophy is the result of a neurotoxic effect of trauma or, rather, an underlying condition that predisposes to the development of some psychiatric disorders. For some time animal studies show that stress causes hippocampal atrophy and inhibition of neurogenesis, by mechanisms probably related to glucocorticoids, all'increzione corticotropo factor, increased excitatory amino acid, inhibition of brain neurotrophic factor with loss of neuronal plasticity. In humans, however, the results are not so linear. On the one hand, some studies have identified as the main factor increasing glucocorticoid two other such theory was strongly criticized 3. According to Yehuda mechanism of hippocampal atrophy is due to an alteration of hypothalamic-pituitary-adrenal (HPA), but in terms of a low secretion of glucocorticoids leading to an increase of negative feedback axis and the same receptor hypersensitivity . Regardless of the mechanism of action, loss of neurons in hippocampus in people who have suffered traumatic events seems sufficiently established and, until recently, was considered irreversible. In fact, the hippocampus appears to be an unusual and spontaneous regenerative capacity. This figure has been identified in many animal species and in one study in humans 4. Moreover, recent evidence pre-clinical and clinical studies have shown that SSRIs (Selective Serotonin Reuptake Inhibitors) promote neurogenesis and reduce stress-induced hippocampal atrophy in animals 5 and humans are able to reduce symptoms of PTSD, increase the size of the hippocampus and reduce the deficit mnesic typical of the disease 6 7. Another factor that seems to be able to stimulate neurogenesis in animals seems to be "enriched environment" probably through molecular mechanisms of learning that seem able to activate the transcription of mRNA for Brain Derived Neurotrophic Factor. This finding supports the rationale of the literature of the effectiveness of psychotherapy, even if the only study that evaluates changes morphostructural after psychotherapy has shown positive results 8. The aims of this study are: - To evaluate the presence of hippocampal atrophy in patients with PTSD (T0-drug-free) - to assess the effect of therapy: pharmacological SSRI and psychotherapy with EMDR (eye movement desensitization and reprocessing) is a clinical and neuropsychological, and on hippocampal volume, and memory (T1). Methods: We analyzed a sample of 20 patients, aged between 15 and 65, recruited nell'ambulatorio Psychiatric University Hospital of Siena with PTSD and a control group of healthy subjects matched by sex, age, weight and height. Subjects in both groups were subjected to a computerized study morfovolumetrico dell'Ippocampo using MRI (Magnetic Resonance). In addition, seventeen patients with PTSD were assessed through administration of psychometric scales and neuropsychological tests to study the psychopathological picture and evaluate the possible presence of cognitive deficits. In subjects with PTSD after a period of six months of pharmacological therapy were repeated neuropsychological tests, scales psychometric analysis morfovolumetrica hippocampus by MRI. Three patients at T0 after assessments, carried out a treatment protocol with only EMDR and were reassessed after eight sessions (two months). Results: The results of the first experiment (T0-drug-free) show that the size of the left hippocampus in patients with PTSD are significantly lower compared to healthy controls. The results observed during the follow-up (T1-post-therapy) can be inferred that therapy in patients considered to be associated with improvement in symptoms and an increase in hippocampal volume, equal to 9.87% for the right hippocampus and 8, 37% for the left hippocampus. These data are consistent with the data in the literature, although the recovery rate based on neuroplastic in our study is significantly higher than in the two studies in the literature increase of 4.6% 6; 5% 7. The three patients who have treatment with EMDR have also shown an improvement in symptoms at T1 (CAPS no longer positive for the diagnostic criteria) and an average increase in hippocampal volume amounted to 338.25 mm3 for the hippocampus and DX 357, 93 mm3 for the hippocampus SN. Conclusions: Therapy in patients considered was associated with an increase in hippocampal volume (9.87% -8.37%). The increase in hippocampal volume appear to be relevant, consistent with the literature data, although quantitatively greater, stressing the effectiveness of SSRIs probably through the mechanism of activation of neurogenesis, it is conceivable that the increase in volume is attributable to an increase glial cells but an increase of hippocampal neurons seen the simultaneous clinical improvement. Seems particularly interesting given the relative clinical effectiveness of EMDR and neural plasticity. This observation on only three cases, clearly needs to be confirmed on a larger sample but represents the first evidence in the literature of action of psychotherapy directed at brain structure.

Keywords: Posttraumatic Stress Disorder PTSD

Accuracy Verified: Yes

19. Denny, N. (1995, March). An orienting reflex/external inhibition model of EMDR and thought field therapy. Traumatology, 1(1), 1-6, Article 1. doi:10.1177/153476569500100101.

Language: English

Format: Journal

Abstract:
The clinical phenomena of the conduct of EMDR and Thought Field Therapy were interpreted in light of concepts in the field of classical conditioning with emphasis on the orienting reflex and its external inhibiting effects on conditioned responses. A model was proposed using the temporary suppression through external inhibition of the fear and avoidance conditioned responses to disturbing memories. The clinically helpful effect proposed is the emergence of previously suppressed competing responses to the troublesome memories. Those newly emerged responses are responsible for spontaneous cognitive restructuring of the meaning attribution of the memories, thus lowering SUDS ratings. [Author Abstract]

Keywords: Conditioned Emotional Responses Cognitive Processes TFT Thought Field Therapy

Accuracy Verified: Yes

20. Tryon, W. W. (2005, January). Possible mechanisms for why desensitization and exposure therapy work. Clinical Psychology Review, 25(1), 67-95. doi:10.1016/j.cpr.2004.08.005.

Language: English

Format: Journal

Abstract:
Rosen and Davison [Rosen, G.M. and Davison, G.C. (2003). Psychology should list empirically supported principles of change (ESPs) and not credential trademarked therapies or other treatment packages. Behavior Modification, 27, 300–312] recommended that empirically supported principles be listed instead of empirically supported treatments because the latter approach enables the creation of putatively new therapies by adding functionally inert components to already listed effective treatments. This article attempts to facilitate inquiry into empirically supported principles by reviewing possible mechanisms responsible for the effectiveness of systematic desensitization and exposure therapy. These interventions were selected because they were among the first empirically supported treatments for which some attempt was made at explanation. Reciprocal inhibition, counterconditioning, habituation, extinction, two-factor model, cognitive changes including expectation, self-efficacy, cognitive restructuring, and informal network-based emotional processing explanations are considered. Logical problems and/or available empirical evidence attenuate or undercut these explanations. A connectionist learning-memory mechanism supported by findings from behavioral and neuroscience research is provided. It demonstrates the utility of preferring empirically supported principles over treatments. Problems and limitations of connectionist explanations are presented. This explanation warrants further consideration and should stimulate discussion concerning empirically supported principles.

Keywords: Systematic Desensitization Exposure Therapy Learning-Memory Mechanism

Accuracy Verified: Yes

21. Mosquera, D., Gonzalez, A., & Seijo, N. (2010, April). Relational problems in severely traumatized patients. Presentation at the 2nd Bi-Annual International European Society for Trauma and Dissociation Conference, Belfast, Northern Ireland.

Language: English

Format: Conference

Abstract:
A practical workshop focused on frequent clinical situations in therapy. Its main goal is help the participants to identify relational patterns based on reciprocal role procedures, in order to be able to overcome therapist-patient difficulties. A brief therapeutic exposure about different theoretical sources will be presented: Cognitive-Analytic Therapy, Adaptive Information Processing Model and EMDR, Theory of Structural Dissociation of the Personality, Attachment Theories, psychodynamic transference-countertransference conceptualizations, and therapies focused on relational issues (systemic family therapy, psychodramatic group therapy, etc) Vignettes of frequent reciprocal role procedures in therapeutic relationship with severely traumatized people will be presented, explained the different kinds of presentation. The linking of these vignettes with the traumatic history will be developed. Short video-cases will illustrate these situations and some interventions to overcome them. Modified EMDR interventions will be described and showed.
Learning Outcomes Therapeutic relationship problems are main issues in severely traumatized people. Different authors coming from different theoretical orientations have presented thoughtful approaches to these situations and how to overcome them. In this workshop we will review many of these contributions, but we will base our theoretical development on the concept of reciprocal role procedures from the Cognitive Analytic Therapy (Ryle). From this concept we will summarize frequent relationship problems in therapy, how we conceptualize them from the Adaptive Information Processing model from EMDR and how we work on these issues using EMDR methodology. An additional learning outcome of this workshop is that the participants will review their own experience with their patients through a specific evaluation, and will have the opportunity to share their experiences.

Keywords: Relationship Issues Trauma

Accuracy Verified: Yes

22. Kaye, B. (2008). Reversing reciprocal suppression in the anterior cingulated cortex: A hypothetical model to explain EMDR effectiveness. Journal of EMDR Practice and Research, 2(1), 88-99. doi:10.1891/1933-3196.1.2.88.

Language: English

Format: Journal

Abstract:
A theoretical model is proposed to explain desensitization during Eye Movement Desensitization and Reprocessing (EMDR) as resulting from the reversal of reciprocal suppression of cognitive processing in the anterior cingulate cortex (ACC). Dual-attention and error monitoring are known to activate dorsal regions of the ACC that mediate metacognitive processing. Neuroimaging research has produced evidence that cognitive areas in the upper ACC may reciprocally suppress affective processing in the lower areas and vice versa. It is therefore proposed that the original eye-to-finger tracking task of EMDR may achieve its therapeutic effect by using error monitoring to reverse suppression of the upper ACC by the lower ACC. Contributions to EMDR effectiveness from resource installation and novelty-driven orienting reflexes may also influence ACC functioning. A distraction effect is proposed to be a negative and potentially disruptive by-product of very interactive stimulation tasks. A semantic priming procedure is suggested to limit distraction effects during more interactive forms of stimulation. [Author Abstract]

Keywords: Anterior Cingulate Cognitive Processes Neurotransmitters Reciprocal Suppression Semantic Priming

Accuracy Verified: Yes

23. Chang, S. H. (2007, September). Role of EM and stimulus valence presentation order in the return of fear: Possible implications for the therapeutic mechanism. Presentation at the annual meeting of the EMDR International Association Conference, Dallas, Texas. (NSC 93-2413-H-002-002-).

Language: English

Format: Conference

Abstract:
Research background & aims: This study examined possible therapeutic mechanisms of eye movements in Eye Movement Desensitization and Reprocessing (EMDR; Shapiro, 1989, 1995, 2001) in terms of exposure and information processing model. While exposure model contended process of extinction and response habituation, Stickgold (2002) proposed that sleep induced change in associative memory via activation of weak association during REM state and EM functioned as REM sleep to integrate the episodic memory of trauma into general semantic memory. In this study, the effect of EM compared to that of Exposure-Only (non-EM) on process measures of SUDs, ratings of cockroach phobia across sessions, along with outcome measures were examined. Specifically, the degree of return of fear and response habituation was explored. Methods: Thirty-six college students with cockroach phobias were recruited as participants and invited after informed consent for 4 1-week interval treatment sessions and a 1 month follow-up session. The instruments for outcome measures included Cockroach Phobia Questionnaire, fear ratings of cockroach slides, FSS, STAI-S, BDI, short form of SCL-90, the Revised Thought-Action Fusion Questionnaire, White Bear Suppression Inventory, and cognitive tasks for measuring strength of associations. The SUDs, credibility and therapeutic relationship rating, and physiological measures such as HR, HRV, EOG, served as process measures. Due to space limitations, the results of cognitive task and physiological measures were reported elsewhere. The participants were randomly assigned to one of the four groups: EM condition (EM vs. Non-EM exposure only) × block order of cockroach theme presentation (negative cognition first vs. positive cognition first). A 2 (EM condition) × 2 (order of valence presentation) × 9 (time: pre-assessment and post-assessment for each of the 4 sessions plus 1 month follow-up assessment) mixed factorial design was performed, with time serving as within Ss factor and the other two variables serving as between Ss factors. There were 20 trials in each therapeutic session. The duration of each trial was 30s for both the EM and Exposure-Only conditions. Results: After preliminary analyses for group differences on pretreatment variables, credibility-relationship ratings, and outcome variables were explored, the 2 (EM condition) × 2 (order of valence presentation) × 9 (time) ANOVA on SUDs showed that the main effects of time and EM were both significant (p < .001 and p < .034). Subsequently, two 2 (order of valence presentation) × 9 (time) ANOVAs were performed for EM condition and Exposure-Only condition, respectively. The results showed that for EM condition, only time effect was significant (p < .006); while for Exposure-Only condition, there were a significant time effect (p < .001) and an approaching significant valence presentation order effect (p < .065), with the SUDs being higher in negative cognition presented first condition compared to positive cognition presented first condition; whereas the effect was not significant for the EM condition. Using trend analyses and inspection of time effect showed that significant within session SUDs reduction for Exposure-Only conditions. Notwithstanding, the pairwise comparisons for the 9 time points indicated salient phenomena of return of fear among several of the 5 sessions for this condition when comparing the pre-assessment of each session with post-assessment of its previous session. Whereas for EM condition the return of fear between sessions was small and the trend analysis showed a reduction with linear trend. Conclusions & Discussion: Compared to Exposure-Only, EM resulted in less degree of sufferings while participants encountering negative theme which in turn might facilitate further processing of negative memory. In addition, EM might add something beyond the mechanism of pure exposure. The less return of fear indicating that information processing in addition to response inhibition might take place between sessions. The results echoed Shapiro’s Adaptive Information Processing model and Stickgold’s REM-sleep dependent memory reprocessing model, suggesting that EM in EMDR might reflect a shift in associative memory systems by activating different strength of associations of negative semantic nodes for different semantically related words. Given that previous research showed that EM decreased emotionality and also generate greater amount of associations for negative stimuli, the implications of the present results from theoretical and therapeutic point of views and future research possibilities are discussed.

Keywords: Adaptive Information Processing Model REM-Sleep Dependent Memory Reprocessing Model Saccadic Eye Movement Semantic Association

Accuracy Verified: Yes

24. Chang, S. H. (2009). Role of EM and stimulus valence presentation order in the return of fear: Possible implications for the therapeutic mechanism. National Taiwan University, Taipei, Taiwan.

Language: English

Format: Dissertation/Thesis

Keywords: Adaptive Information Processing Model REM-Sleep Dependent Memory Reprocessing Model Saccadic Eye Movement Sematic Association

Accuracy Verified: Yes

25. Pagani, M. (2008, Novembre). Sub-strato neurobiologico della sindrome da stress post-traumatico e relativo impatto funzionale e strutturale della terapia con EMDR [Neurobiological substrate of post-traumatic stress syndrome and impact on functional and structural therapy with EMDR]. Presentazione le Applicazioni Cliniche del EMDR Congresso Nazionale, Milano, Italia.

Language: Italian

Format: Conference

Abstract:
Recenti studi hanno dimostrato come la sindrome da stress post-traumatico (PTSD) possa causare nel cervello cambiamenti sia strutturali che funzionali. Studi di imaging funzionale tramite tomografia ad emissione di fotone singolo (SPECT) e ad emissione di positrone (PET) hanno evidenziato significative variazioni del flusso cerebrale in pazienti con PTSD durante la rivisitazione del trauma. A questo proposito sono stati riportati aumenti e diminuzioni di flusso nell’ippocampo, nell’amigdala, nella corteccia prefrontale mediale, nel cingolo anteriore e posteriore e nella corteccia temporale. Il modello prevalente collega i sintomi del PTSD ad una mancata inibizione dell’ amigdala, iperattivata dalla sensazione di incombente minaccia, da parte della corteccia prefrontale. E’ stato anche proposto che i cambiamenti strutturali dell’ippocampo e del cingolo anteriore rivelati dalla risonanza magnetica strutturale (RM) siano causati dalla risposta neuronale allo stress. L’obiettivo delle nostre ricerche e’ stato quello di analizzare la risposta funzionale e le variazioni strutturali in due gruppi di soggetti esposti a trauma occupazionale che hanno sviluppato (S=sintomatici, n=20) o no (NS=non sintomatici, n=27) il PTSD. Una parte dei S (n=16) è stata trattata con EMDR. La diagnosi di PTSD prima e dopo la terapia è stata basata sia sui criteri del DSM-IV sia su vari test neuropsicologici mirati. La SPECT (n=47) e la RM (n=33) sono state eseguite da 3 mesi a sei anni dal trauma e la prima è stata ripetuta dopo EMDR. I sintomi sono stati provocati da uno script individualizzato che ha riportato alla memoria il trauma e durante il quale è stato iniettato il tracciante di flusso cerebrale. Le analisi eseguite hanno mostrato differenze significative tra S e NS nella risposta del flusso cerebrale allo script. Nei 33 soggetti in cui sono state eseguite sia la SPECT che la RM sono state trovate differenze significative sia funzionali che strutturali nella corteccia temporo-parietale sinistra e nell’ippocampo, regioni nelle quali gli score dei test neuropsicologici correlano significativamente con il flusso cerebrale. Nei soggetti con remissione sintomatologica dopo EMDR (R; n=11) sono state trovate rispetto ai soggetti che non hanno risposto alla terapia (NR; n=5) significative differenze di flusso in 4 aree corticali che processano funzioni deteriorate in corso di PTSD. Diminuzioni di flusso dopo la terapia sono state registrate nei R rispetto ai NR nell’ippocampo, nel giro fusiforme (corteccia parieto-occipitale) e nella corteccia visiva primaria. L’ippocampo è sede della memoria episodica ed autobiografica; il giro fusiforme processa il riconoscimento di volti, dei corpi e delle parole; la corteccia visiva primaria custodisce la memoria visiva degli eventi. La mancata inibizione e/o l’iperattività di queste regioni nel PTSD sono responsabili della rivisitazione patologica figurata e somatica dell’evento traumatico e della presenza di flashback ed immagini allucinatorie. Viceversa la corteccia frontale dorsolaterale ha mostrato un aumento di flusso nei R. Questa regione oltre ad essere deputata ad inibire nel sistema limbico la risposta patologica a stimoli che ricordano l’evento traumatico è essenziale per i processi di attenzione e del “senso di sé”, diminuiti in corso di PTSD e recuperati in seguito alla remissione della malattia. In questi soggetti la RM ha inoltre messo in evidenza il valore predittivo delle dimensioni dell’ippocampo rispetto all’efficacia della terapia con EMDR. I nostri risultati confermano il coinvolgimento della corteccia temporo-parieto-occipitale nel PTSD e sottolineano il valore delle neuroimmagini sia nello svelare gli effetti neurobiologici dell’EMDR che determinare il valore delle indagini strutturali nel predirne l’efficacia.

Recent studies have shown that the post-traumatic stress syndrome (PTSD) may result in both structural and functional brain changes. Imaging studies using functional Single photon emission tomography (SPECT) and positron emission tomography (PET) shown significant changes in cerebral blood flow in patients with PTSD during revisiting the trauma. In this regard have been reported increases and decreases in flow hippocampus, amygdala, medial prefrontal cortex, the anterior cingulate and posterior and temporal cortex. The dominant model linking the symptoms of PTSD to a no inhibition of 'amygdala hyperactivity disorder by the sense of impending threat by the prefrontal cortex. E 'was also proposed that the structural changes of the hippocampus and anterior cingulate revealed by structural magnetic resonance imaging (MRI) are caused by the response neuronal stress. The aim of our research and 'was to analyze the response functional and structural variations in two groups of subjects exposed to occupational trauma that have developed (S = symptomatic, n = 20) or not (NS = non-symptomatic, n = 27) PTSD. Part of S (n = 16) was treated with EMDR. The diagnosis of PTSD before and after the therapy was based on both DSM-IV has on several neuropsychological tests targeting. SPECT (n = 47) and MRI (n = 33) are were performed from 3 months to six years from the trauma and the first was repeated after EMDR. Symptoms were caused by a script individual who reported to the memory of the trauma and during which were injected with a tracer of cerebral blood flow. The analysis performed showed significant differences between S and NS in the response of flow brain to the script. In the 33 subjects in which they were performed both SPECT and MRI were found significant differences in both functional and structural temporo-parietal cortex left hippocampus, regions in which the scores of neuropsychological tests correlate significantly with the flow in the brain. In subjects with symptomatic remission after EMDR (R; n = 11) were found compared with subjects who did not respond to therapy (NR, n = 5) significant differences in flow in 4 cortical areas that process functions deteriorated in the course of PTSD. Decreases in flow after treatment were recorded in R than NR hippocampus, within fusiform (parieto-occipital cortex) and in the primary visual cortex. The hippocampus is the seat of episodic memory and autobiographical, and the processes around the fusiform recognition of faces, bodies and words, the primary visual cortex preserves the memory visual events. The non-inhibition and / or 'hyperactivity of these regions in PTSD are responsible for pathological figured revisiting the traumatic event and physical and presence of flashbacks and hallucinatory images. Contrast, the dorsolateral frontal cortex has showed an increase of flow in R. This region in addition to being deputies to inhibit the system limbic response to pathological stimuli that recall the traumatic event is essential for processes of attention and the "sense of self, decreased in the course of PTSD and recovered following remission. In these subjects, MRI has also highlighted the predictive value the size of the hippocampus compared the efficacy of EMDR therapy. Our results confirm the involvement of the temporo-parietal-occipital cortex in PTSD and emphasize the value of neuroimaging in revealing both the neurobiological effects of EMDR that determine the value of the structural surveys in predicting effectiveness.

Keywords: Neurobiology Posttraumatic Stress Disorder PTSD

Accuracy Verified: Yes

26. Meignant, I. (2012, April). The systemic EMDR approach: Healing the couple. Presentation at the annual meeting of EMDR Canada, Montreal, Quebec, Canada.

Language: English

Format: Conference

Abstract:
Combining Mony Elkaim's Reciprocal Double Bind Systemic Model with the EMDR Adaptive Information Processing (AIP) model is a new perspective for couple therapy. This combination of approaches can be used to develop an EMDR treatment plan that incorporates and respects the relational systems, e.g., spouses and intimate partners, parent/child, employer/employee. In this presentation, participants will learn how and when it is appropriate to work with the one member of a couple as a co-therapist; how individual safe places can be applied to develop a safe place for the couple, both during the session and at home; how to develop a systemic EMDR targeting plan, guided by the understanding of the Reciprocal Double Bind, and finally, how to apply the 8 phases EMDR protocol to couple work, based on a Systemic Model.
Learning objectives: 1.Evaluate when to use EMDR in couple therapy session 2.Be able to do the installation of EMDR safe place as a resource for the couple 3.Understand how to use the systemic model, reciprocal double bind, to find the individual targets that are involved in the couple’s current issues and presenting problems. 4.Learn to apply the specifications of each of the 8 phases EMDR protocol with a couple.

Keywords: Couples Therapy

Accuracy Verified: Yes

27. Lipke, H. (1995, June). Theoretical understanding of EMDR: Examples from treatment of veterans. Presentation at the EMDR Network Conference, Santa Monica, CA.

Language: English

Format: Conference

Abstract:
The rapidity and thoroughness of EMDR therapeutic effectiveness, compared to more traditional methods of psychotherapy, calls for a general reconceptualization of the field. As EMDR and, perhaps, other new methods continue to demonstrate what Francine Shapiro has referred to as "accelerated information processing" these new therapeutic effects will undoubtedly become better understood. In an initial effort to systematically integrate EMDR with other methods of treatment, the following four categories of psychotherapeutic activity are proposed: 1. Accessing of present associative networks - the bringing forward of information (distressing, dysfunctional, comforting, adaptive, etc.) already stored in both procedural and non-procedural systems. 2. Introduction of new information - the teaching of facts and skills, which form new or add to old associative networks. 3. Inhibition of information accessing - the tuming of attention away from dysfunctional information, with the goal of decreasing arousal, such as with relaxation training. 4. Facilitation of the processing of information - abstract activity that makes it more likely information networks will connect in an adaptive way, leading to the dissipation of unwarranted negative emotion and the attainment of adaptive understanding. Methods of psychotherapy may be distinguished by the ways in which they use or don't use activities in each of these categories. EMDR like other methods can be so distinguished. While the proposed categorization system can be used to clarify the differences and similarities among the various methods of psychotherapy, more relevantly to clinical practice, this conceptualization may promote more efficient intervention choices when progress during therapy sessions has slowed or stopped. Examples of the theoretical and clinical value of the proposed model are offered, especially in the treatment of combat related psychological trauma.

Keywords: Veterans

Accuracy Verified: Yes

28. van der Vleugel, B. M., van den Berg, D. P. G., & Staring, A. B. P. (2012, March-April). Trauma, psicosi, disturbo da stress post-traumatico e l’utilizzo dell’EMDR [Trauma, psychosis, post-traumatic stress disorder and the application of EMDR]. Rivista di Psichiatria, 47(Supplement 1), 33S-38S. doi:10.1708/1071.11737.

Language: Italian

Format: Journal

Abstract:
In questo articolo descriveremo tre interazioni tra trauma, disturbo da stress post-traumatico (PTSD) e psicosi: 1. molti pazienti con disturbi psicotici hanno subito esperienze di vita traumatiche che giocano un ruolo fondamentale nell’insorgenza e nel dar forma al contenuto della loro psicosi; 2. sia l’esperienza psicotica sia il suo trattamento psichiatrico possono causare la sintomatologia da stress post-traumatico; 3. nel caso in cui la psicosi ricorra assieme ad un PTSD, vi è un rischio sostanziale che i due quadri clinici si rinforzino reciprocamente in maniera negativa, oltre a un potenziale protrarsi della traumatizzazione. Sebbene queste interazioni siano clinicamente molto rilevanti, raramente vengono tenute in considerazione durante la pratica clinica di routine. Le tre interazioni verranno illustrate attraverso un caso singolo e una descrizione di un trattamento con EMDR. In conclusione raccomandiamo di prestare attenzione, durante la pratica clinica di routine, alla traumatizzazione e a una co-diagnosi di un PTSD nei casi che presentano un disturbo piscotico, oltre che offrire un trattamento a questi pazienti.

In this article we describe three interactions between trauma, post-traumatic stress disorder (PTSD) and psychosis: 1. many patients with psychotic disorders suffered from traumatic life experiences that play an important role in the onset and content of their psychosis; 2. the experience of psychosis as well as its psychiatric treatment may result in post-traumatic stress symptoms; 3. if psychosis and PTSD occur simultaneously, there is a substantial risk for reciprocal negative reinforcement of both symptom groups as well as for potentially ongoing traumatization. Although these interactions are highly relevant from a clinical perspective, they usually remain unattended in routine care. The three interactions will be illustrated by a case history as well as an impression of the psychological treatment including EMDR. We recommend to pay attention to traumatization and comorbid PTSD in routine care for people with psychosis, as well as to offer them treatment.

Keywords: Posttraumatic Stress Disorder PTSD Psychosis Schizophrenia Trauma

Accuracy Verified: Yes

29. Lovett, J. (2000). The trauma-attachment tangle: Let's help children and parents out of the bind. The Children's Group Therapy Association Newsletter. Retrieved from http://www.cgta.net/newsletters/play_therapy.html November 16, 2011.

Language: English

Format: Newsletter

Abstract:
What does help children and adults who have had experiences that ruptured their trust in the world and who have been unable to develop close, reciprocal, loving relationships? 1. Experiences of being safe for an extended period of time. 2. EMDR to desensitize and reprocess upsetting memories. 3. Development of healthy “inner parents” who nurture, encourage, and offer guidance. 4. Children benefit from nurturing cuddle time with parents – and alternating bilateral stimulation to reinforce positive experiences of safety, care, tenderness, and attunement. 5. Adults benefit from imagination exercises to help them experience nurturing. 6. Children and adults need a cohesive life story that is developmentally appropriate and explains and reframes what happened to them and offers trauma resolution and hope for the future. 7. EMDR to target confusion, so that uncertainty (necessary for approaching new experiences and learning) does not trigger anxiety. 8. Grief work, to deal with loss and find ways to be loyal to more than one person or family. 9. Creative opportunities for healing. Art, play therapy, drama, sandtray work can be used to express feelings, as well as provide targets for desensitizing and reprocessing traumatic experiences. Fortunately, children can resolve trauma even when EMDR is used to help the action figure, the baby doll, or the toy horse resolve a challenging situation. 10. Work with parents (or refer them) to understand and desensitize their own triggers for reactivity. Children who are fearful, angry, needy, or sad need mature parents who can stay objective and help them contain their strong emotions. 11. While the work of resolving trauma and developing trust can be slow, EMDR can facilitate the process. The rewards are sweet and well worth the effort. [Excerpt]

Keywords: Adults Attachment Children Trauma Treatment

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