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1. Swedish Council on Technology Assessment (2001, April). Alert: EMDR - Psychotherapy in posttraumatic stress syndrome in young people - early assessment briefs. Swedish Council on Technology Assessment in Health Care (SBU).
Language: English
Format: Publication
Abstract:
Findings by SBU Alert,
Version: 1,
METHOD AND TARGET GROUP:
EMDR (Eye Movement Desensitization and Reprocessing) is a new psychotherapeutic method aimed at processing memories of traumatic events, thereby ameliorating the psychological consequences of these memories. EMDR involves elements from several different psychological approaches. It is uncertain which of the treatment elements are effective. Clients with post traumatic stress disorder (PTSD) are the main target group for EMDR treatment. Although both children and adults have been treated with EMDR, this document is aimed particularly at children and adolescents.
PATIENTS BENEFITS, RISKS AND SIDE EFFECTS:
Published studies of EMDR mainly cover adults with PTSD. There are two randomized and controlled studies, one of which has yet to be published, of EMDR treatment in 47 children and adolescents. One of the studies suggests that EMDR yields a better treatment outcome in the short term compared to the control treatment (active listening). In the second study, no significant difference was found between EMDR treatment in combination with standard treatment and standard treatment alone as regards reduction in avoidance and invading thoughts. However, the PTSD symptom of behavioral disorders declined significantly in the EMDR group. Furthermore, numerous case studies suggest that EMDR has a positive treatment effect in children and adolescents with PTSD. No harmful effects have been reported.
ECONOMIC ASPECTS:
There are no economic assessments of EMDR. Limited data suggest that fewer treatments are needed to achieve the desired outcome with EMDR compared to other psychotherapeutic methods. This suggests that EMDR is a potentially cost-effective method in relation to the alternatives, under the assumption that the effects of treatment are permanent.
CURRENT SCIENTIFIC EVIDENCE:
There is moderate* scientific evidence to show the benefits of EMDR treatment in children and adolescents. There is no* documentation concerning the cost-effectiveness or effects beyond 6 months.
Since the scientific documentation is limited, the effects of EMDR treatment in both the short and long term should be compared in studies with other treatment alternatives, including standard treatment. Furthermore, the cost-effectiveness of the method should be studied under Swedish conditions.
*This assessment by SBU Alert uses a 4-point scale to grade the quality and evidence of the scientific documentation. The grades indicate: (1) good, (2) moderate, (3) poor, or (4) no scientific evidence on the subject.
This summary is based on a report prepared at SBU in collaboration with Kerstin Bergh Johannesson, Lic. Psychol., Akademiska Hospital, Uppsala and has been reviewed by Prof. Mats Fredriksson, Uppsala University, Uppsala.
REFERENCES:
1.) Cahill SP, Carrigan MH, Frueh BC. Does EMDR work? And if so, why? A critical review of controlled outcome and dismantling research. J Anxiety Disord 1999;13(1-2):5-33.
2.) Chemtob CM, Nakashima J, Hamada R, Carlson J. Brief treatment for elementary school children with disaster-related PTSD: a field study. J Clin Psychol, in press.
3.) Chemtob et al. Eye movement desensitization and reprocessing. In: Foa EB, Keane TM, Friedman MJ, eds. Effective treatments for PTSD. New York: Guilford, 2000.
4.) Devilly GJ, Spence SH. The relative efficacy and treatment distress of EMDR and a cognitive-behavior trauma treatment protocol in the amelioration of posttraumatic stress disorders. J Anxiety Disord 1999;13(1-2):131-57.
5.) Lovett J. Small Wonders: Healing childhood trauma with EMDR. New York: Free Press, 1999.
6.) Macklin ML, Metzger LJ, Lasko NB, Berry NJ, Orr SP, Pitman RK. Five-year follow-up study of eye movement desensitization and reprocessing therapy for combat-related post traumatic stress disorder. Comprehensive Psychiatry 2000;41(1),24-27.
7.) Puffer MK, Greenwald R, Elrod DE. A treatment outcome study of eye movement desensitization and reprocessing (EMDR) with traumatized children and adolescents. Presented at the annual conference of the EMDR International Association, Denver, June 1996.
8.) Renfrey G, Spates CR. Eye movement desensitization and reprocessing: A partial dismantling procedure. J Behav Ther Experiment Psychiatr 1994;25:231-239.
9.) Scheck MM, Schaeffer JA, Gilette CS. Brief psychological intervention with traumatized young women: The efficacy of eye movement desensitization and reprocessing. J Trauma Stress 1998;11:25-44.
10.) Shapiro F. Eye movement desensitization and reprocessing: Basic principles, protocols and procedures. New York: Guilford Press, 1995.
11.) Stallard P, Velleman R, Baldwin S. Prospective study of post-traumatic stress disorder in children involved in road traffic accidents. BMJ 1998;317:1619-1623.
12.) Soberman GB, Greenwald R, Rule DL. A controlled study of eye movement desensitization and reprocessing (EMDR) for boys with conduct problems. J Aggression Maltreatment Trauma, in press.
13.) Tinker RH, Wilson SA. Through the Eyes of a Child: EMDR with children. New York: Norton & Co, 1999.
14.) van der Kolk B. Biological response to psychic trauma. In: Wilson JP, Raphael B, eds. International Handbook of Traumatic Stress Syndromes. New York: Plenum Press, 1993:25-33.
15.) van der Kolk B, Burbridge J, Susuki J. The psychobiology of traumatic memory; clinical implications of neuroimagery studies. Annals of the New York Academy of Sciences 1997;821:99-113.
16.) van Etten M, Taylor S. Comparative efficacy of treatments for post-traumatic stress disorder: a meta-analysis. Clin Psychol Psychother 1998;5:126-144.
17.) Wilson SA, Becker LA, Tinker RH. Fifteen-month follow-up of eye movement desensitization and reprocessing (EMDR) treatment for posttraumatic stress disorder and psychological trauma. J Consult Clin Psychol 1997;65(6):1047-1056.
18.) Wilson SA, Tinker RH, Hoff.
Alert is a joint effort by the Swedish Council on Technology Assessment in Health Care (SBU), the Medical Products Agency, the National Board of Health and Welfare, and the Federation of Swedish County Councils.
The complete report is available in Swedish only.
Keywords: Posttraumatic Stress Disorder Practice Guidelines PTSD
Accuracy Verified: Yes
2. von Knorring, L., Thelander, S., & Pettersson, A. (2005, November 21-27). Behandling av angestsyndrom. En systematisklitteraturaversikt. SBUs sammanfattning och slutsatser [Treatment of anxiety syndrome: A systematic literature review. Summary and conclusions by the SBU]. Lakartidningen, 102(47), 3561-3562, 3565-3566, 3569.
Language: Swedish
Format: Magazine
Abstract:
En rapport frĺn det svenska rĺdet för medicinsk utvärdering (SBU) har gĺtt igenom, klassificeras och utvärderas den vetenskapliga litteraturen om behandling av panik-syndrom, specifika fobier, social fobi, tvĺngssyndrom syndrom (OCD), generaliserat ĺngestsyndrom (GAD) och posttraumatiskt stressyndrom (PTSD). Översynen ingĺr behandling av barn, ungdomar och vuxna. Rapportens slutsats är att det finns effektiv behandling tillgänglig för alla ĺngest syndrom. Men i allmänhet, är effekten ofta mĺttliga och symtomen ĺterkommer när behandlingen perioden avbryts. För vuxna, stödjer vetenskapliga bevis användning av paroxetin och sertralin för alla syndrom utom specifika fobier. För övriga SSRI-preparat Det finns ocksĺ bevis för användning av Fluoxetin i OCD och PTSD, för fluvoxamin i social fobi och tvĺngssyndrom och för escitalopram i social fobi. Andra antidepressiva läkemedel med ett starkt vetenskapligt stöd är venlafaxin i social fobi och GAD, imipramin i panik syndrom och chlomipramine i panik syndrom och tvĺngssyndrom. Bland de psykologiska behandlingar, det finns vetenskapliga bevis för kognitiv beteendeterapi (KBT) för behandling av panik-syndrom, specifika fobier, social fobi, PTSD och GAD. Exponering, med eller utan andra psykoterapeutiska interventioner har vetenskapligt stöd för effekt vid paniksyndrom (bĺde i termer av antalet panikattacker och agorafobi för), specifika fobier, tvĺngssyndrom och PTSD. Användning av ögonrörelser desensibilisering och upparbetning (EMDR) har vetenskapligt stöd för behandling av PTSD.
A report by the Swedish Council on Technology Assessment in Health Care (SBU) has reviewed, classified and evaluated the scientific literature on treatment of panic syndrome, specific phobias, social phobia, obsessive-compulsive syndrome (OCD), generalized anxiety syndrome (GAD) and post-traumatic stress disorder (PTSD). The review included treatment of children, adolescents and adults. The report concludes that there is effective treatment available for all anxiety syndromes. However in general, the effect is often moderate and symptoms reappear when the treatment period is discontinued. For adults, scientific evidence supports the use of paroxetine and sertraline for all syndromes except specific phobias. For the other SSRI's there is also evidence for the use of fluoxetin in OCD and PTSD, for fluvoxamine in social phobia and OCD and for escitalopram in social phobia. Other antidepressant drugs with a strong scientific support is venlafaxin in social phobia and GAD, imipramin in panic syndrome and chlomipramine in panic syndrome and OCD. Among psychological treatments, there is scientific evidence for cognitive behavior therapy (CBT) for treatment of panic syndrome, specific phobias, social phobia, PTSD and GAD. Exposure, with or without other psychotherapeutic interventions, has scientific support for efficacy in panic disorder (both in terms of number of panic attacks and for agoraphobia), specific phobias, OCD and PTSD. Use of eye movement desensitization and reprocessing (EMDR) has scientific support for treatment of PTSD.
Keywords: Review
Accuracy Verified: Yes
3. Korn, D. (2001, June). Clinical applications of EMDR in treating adult survivors of childhood abuse and neglect. Preconference presentation at the annual meeting of the EMDR International Association, Austin, TX.
Language: English
Format: Conference
Abstract:
This workshop will focus on integrating EMDR into a phase-oriented recovery plan in treating adult survivors of childhood abuse and neglect. EMDR applications with the full range of trauma-related syndromes, including simple and complex PTSD, Borderline Personality Disorder and Dissociative Disorders, will be addressed. Treatment planning and pacing will be discussed in view of presenting problem, attachment style, defenses, and self-capacities. In recognition of clients' rigid, maladaptive schemas, poor impulse control, dissociative tendencies and limited affect tolerance, strategies for modifying and supplementing standard EMDR protocols will be explored, Significant attention will be devoted to integratring EMDR ego strengthening and resource development protocols into all phases of treatment.
Keywords: Borderline Personality Disorder Child Abuse Dissociative Disorders Ego Strengthening Neglect Posttraumatic Stress Disorder PSTD Resource Development
Accuracy Verified: Yes
4. Leeds, A. (2006, September). The consensus model. In criteria for assuring appropriate clinical use and avoiding misuse of resource development & installation when treating complex posttraumatic stress syndromes (A. Leeds). Presentation at the annual meeting of the EMDR International Association, Philadelphia, PA.
Language: English
Format: Conference
Abstract:
The consensus model of treatment for patients with complex posttraumatic syndromes emphasizes assuring adequate stabilization before and during uncovering and resolving of traumatic memories. Resource Development and Installation (RDI) has been reported to be a potentially effective intervention for enhancing patient & stabilization. There are now several published descriptions and case reports of RDI including a summary in the standard reference text on EMDR. The growing use of RDI by EMDR trained clinicians has been followed by reports indicating that a significant number of patients with posttraumatic stress syndromes who meet standard EMDR readiness criteria for ego strength and stability have been offered RDI without being offered standard EMDR reprocessing. This presentation will review specific criteria for identifying: for which patients and clinical situations the use of RDI is indicated; for which patients and clinical situations RDI should be offered cautiously, if at all, but alternate stabilization methods should be considered; and for which patients RDI should not be offered but where standard EMDR reprocessing should be offered without delay. An overview of RDI procedural steps will be presented to clarify its use. Strategies will be offered to address technical, clinical and countertransference issues that may be associated with misuse of RDI. Clinical vignettes will be presented to illustrate appropriate clinical use, clinical cautions and misuse of RDI.
Keywords: Complex PTSD Complex Posttraumatic Stress Disorder C-PSTD Consensus Model Resource Development & Installation RDI Treatment Criteria
Accuracy Verified: Yes
5. Leeds, A. (2006, September). Criteria for assuring appropriate clinical use and avoiding misuse of Resource Development & Installation when treating complex posttraumatic stress syndromes. Presentation at the annual meeting of the EMDR International Association, Philadelphia, PA.
Language: English
Format: Conference
Abstract:
The consensus model of treatment for patients with complex posttraumatic syndromes
emphasizes assuring adequate stabilization before
and during uncovering and resolving of traumatic memories. Resource Development and Installation
(RDI) has been reported to be a potentially
effective intervention for enhancing patient & stabilization. There are now several published
descriptions and case reports of RDI including a
summary in the standard reference text on EMDR.
The growing use of RDI by EMDR trained
clinicians has been followed by reports indicating
that a significant number of patients with
posttraumatic stress syndromes who meet
standard EMDR readiness criteria for ego strength
and stability have been offered RDI without being offered standard EMDR reprocessing. This presentation will review specific criteria for identifying: for which patients and clinical
situations the use of RDI is indicated; for which
patients and clinical situations RDI should be
offered cautiously, if at all, but alternate
stabilization methods should be considered; and
for which patients RDI should not be offered but
where standard EMDR reprocessing should be
offered without delay. An overview of RDI
procedural steps will be presented to clarify its
use. Strategies will be offered to address technical,
clinical and countertransference issues that may
be associated with misuse of RDI. Clinical
vignettes will be presented to illustrate appropriate clinical use, clinical cautions and misuse of RDI.
Keywords: Consensus Model RDI Resource Development and Installation Treatment Criteria
Accuracy Verified: Yes
6. Leeds, A. M. (2007, June). Criteria for assuring appropriate clinical use and avoiding misuse of resource development and installation when treating complex posttraumatic stress syndromes. Presentation at the annual meeting of the EMDR Europe Association, Paris, France.
Language: English
Format: Conference
Abstract:
The consensus model of treatment for patients with complex posttraumatic syndromes emphasizes assuring adequate stabilization before and during uncovering and resolving of traumatic memories (Brown, Scheflin, & Hammond, 1998; Chu, 1998; Courtois, 1999; Hart, Nijenhius, Steele, 2006). Resource Development and Installation (RDI) has been described in a series of published case reports as an effective stabilizing intervention for adult survivors of adverse childhood experiences (Korn & Leeds, 2202; Leeds, 1997, 1998, 2001b; Leeds & Shapiro, 2000; Popky, 2005). These clinical case reports of RDI have been described observed decreases in intense shame, depersonalization, angry outbursts, self-injurious behaviors, compulsive eating, obsessive self-critical thoughts, persistent negative emotional states (misery), sexual acting out, and substance abuse. There are now several published procedural descriptions (Korn & Leeds, 2002; Leeds, 2001; Leeds & Shapiro, 2000) and a summary in the standard reference text on EMDR (Shapiro, 2001).
The growing use of RDI by EMDR trained clinicians has been followed by reports indicating that a significant number of patients with post traumatic stress syndromes who meet standard EMDR readiness criteria for ego strength and stability have been persistently offered RDI without being offered standard EMDR reprocessing. EMDR has been shown to produce stable, enduring treatment effects for symptoms of posttraumatic stress disorder. RDI has not. Until recently (Korn et al, 2004; Leeds, 2005, 2006; Shapiro, 2004) little attention has been given to assuring appropriate use and avoiding misuse of RDI. This presentation will describe serious clinical and professional issues in continuing to offer RDI over repeated treatment sessions to patients with posttraumatic stress syndromes who meet or achieve readiness criteria for standard EMDR reprocessing and in failing to offer or in excessively delaying EMDR reprocessing.
This presentation will clarify and review specific criteria for identifying: for which patients (1) and clinical situations (2) the use of RDI is indicated; for which patients and clinical situations (3) RDI should be offered cautiously, if at al, but alternate stabilization methods should be considered; and for which patients (4) RDI should not be offered but where standard EMDR processing should be offered without delay. An overview of RDI procedural steps will be presented (5) to clarify its clinical application. Strategies will be offered to address technical, clinical and countertransference issues that may b associated with misuse or excessive use of RDI. A series of ten clinical vignettes will be presented to illustrate appropriate clinical use, clinical cautions and misuse of RDI.
Keywords: Complex Posttraumatic Stress Disorder Complex PTSD C-PTSD RDI Resource Development and Installation
Accuracy Verified: Yes
7. Leeds, A. (2010, July). Criteria for assuring appropriate clinical use and avoiding misuse of resource development and installation when treating complex posttraumatic stress syndromes. Presentation at the 1st EMDR Asia Conference, Bali, Indonesia.
Language: English
Format: Conference
Abstract:
The consensus model of treatment for patients with complex posttraumatic syndromes emphasizes assuring adequate
stabilization before and during uncovering and resolving of traumatic memories. Resource Development and Installation
(RDI) has been reported to be a potentially effective intervention for enhancing patient stabilization. There are now several
published descriptions and case reports of RDI including a summary in the standard reference text on EMDR. The growing
use of RDI by EMDR trained clinicians has been followed by reports indicating that a significant number of patients with
posttraumatic stress syndromes who meet standard EMDR readiness criteria for ego strength and stability have been offered
RDI without being offered standard EMDR reprocessing. This presentation will review specific criteria for identifying: for
which patients (1) and clinical situations (3) the use of RDI is indicated; for which patients and clinical situations (4) RDI should
be offered cautiously, if at all, but alternate stabilization methods should be considered; and for which patients (2) RDI should
not be offered but where standard EMDR reprocessing should be offered without delay. An overview of RDI procedural steps
will be presented (5) to clarify its use. Strategies will be offered to address technical, clinical and countertransference issues
that may be associated with misuse of RDI. Clinical vignettes will be presented to illustrate appropriate clinical use, clinical
cautions and misuse of RDI.
Keywords: Posttraumatic Stress Disorder PTSD RDI Resource Development & Installation
Accuracy Verified: Yes
8. Scaer, R. (2006, September). Dissociation theory and the healing of trauma. Plenary at the annual meeting of the EMDR International Association, Philadelphia, PA.
Language: English
Format: Conference
Abstract:
The early studies of trauma in late 19th century Paris
centered on the clinical phenomenon of conversion
hysteria, a dissociative disorder. Janet and Freud
wrote extensively on this topic, and actually
described many of the posttraumatic syndromes that
we are revisiting today. I will make the case that the
late syndromes of Posttraumatic Stress Disorder,
especially dissociation, are clearly the defining
symptomatic and physiological manifestations of
trauma. These syndromes all have prominent
somatic features, all of which represent posttraumatic
sornatosensory implicit memory. This unconscious,
body-based feature of the posttraumatic syndrome
presents a compelling case for the universal
application of somatically-based therapies such as
EMDR in the healing of trauma.
Keywords: Dissociation Plenary
Accuracy Verified: Yes
9. Tym, R., Dyck, M., & McGrath, G. (2000, July-August). Does a visual perceptual disturbance characterize trauma-related anxiety syndromes?. Journal of Anxiety Disorders, 14(4), 377-394. doi:10.1016/S0887-6185(00)00029-3.
Language: English
Format: Journal
Abstract:
The i-test was developed to assess the visual-perceptual disturbances (VPDs) frequently reported by anxious patients. Persons with the disturbance report a specific abnormal illusion of movement when they maintain a fixed gaze at the i-test stimulus. Base rates for positive responses to the i-test and for reports of a "recurrent specific memory" (RSM) of a fear experience were obtained in psychiatric outpatient (n = 301) and community (n = 128) samples. In each case, approximately one fifth of participants had a positive response to the i-test and one fifth of participants reported an RSM of fear. A positive response to the i-test is observed in women more frequently than in men. Among psychiatric patients, approximately 90% of patients who report one symptom also report the other symptom; among community members, the concordance rate is approximately 33%. When psychiatric patients with both an abnormal illusion of movement response and an RSM of trauma are treated with eye movement desensitization, both symptoms are removed in 70% of cases; when these patients undergo some other form of treatment, both symptoms are removed in 30% of cases. These results indicate that the i-test is an effective way of identifying VPDs associated with psychopathologic conditions; the association between the abnormal illusion of movement and reports of recurrent specific memories of fear experiences suggests that the VPD may be a marker of traumatic stress syndromes. [Author Abstract]
Keywords: Adolescents Adults Assessment Children Depressive Disorders Females Males Injuries Memory Retrieval Techniques Posttraumatic Stress Disorder PTSD Somatic Symptoms Survivors Treatment Effectiveness Visual Hallucinations Witnesses
Accuracy Verified: Yes
10. Kutz, I., Dekel, R., Schreiber, S., Resnick, V., Dolberg, O. T., Barkai, G., Leor, A., Rapoport, E., & Bloch, M. (2008, November). The effect of a single session of EMDR on intrusive distress in acute stress syndromes. Symposium/panel conducted at the 24th annual meeting of the International Society for Traumatic Stress Studies, Chicago, IL.
Language: English
Format: Conference
Abstract:
Early diagnosis and intervention in mass
casualty events: Since September 2000, Israeli and Palestinian societies suffered
great losses. on the Israeli side, civilians of all ages, and ethnic
groups, have been exposed to various types of terrorist attacks.
This symposium examines issues of diagnosis and interventions
The effect of a single session of EMDR on intrusive distress in acute stress syndromes: Purpose: To examine the efficacy of a single session of a modified
abridged EMDR protocol in reducing Acute Stress Syndromes
(ASS) following accidents and terrorist bombing attacks.
Methods: Treatment was provided, in a general hospital inpatient
and out-patient setting to 86 patients with ASS.
Friday: 11:00 a.m. – 12:15 p.m.
Presenters are underlined and discussants are italicized.
If serving in both roles, they are both underlined and italicized. Findings: Fifty percent reported immediate fading of their intrusive
symptoms and general alleviation of their distress, 27% described
partial alleviation of their symptoms, while 23% reported no
improvement. Four week and six month follow-up, in the terror
victims group only, showed that the immediate responders
remained symptom free, while half of the non-responders, who
also received subsequent additional interventions modalities, were
still symptomatic.
Conclusions: The difference in response may be attributed, in part,
to the fact that immediate responders tended to have an
uncomplicated ASS with fewer risk factors for PTSD, while the
non-responders had higher exposure to former traumas and
endorsed more risk factors for PTSD. These results support other
anecdotal reports on the rapid effects of brief EMDR intervention in
uncomplicated cases and offer a psycho-physiological hypothesis
for immediate response. While additional controlled studies are
essential, this immediate symptomatic relief may be a potential
addition for focused interventions in acute trauma victims.
Keywords: Acute Stress Disorder ASD Bombings Israel Palenstine Panel Symposium Terrorists
Accuracy Verified: Yes
11. Kutz, I., Resnik, V., & Dekel, R. (2008). The effect of single-session modified EMDR on acute stress syndromes. Journal of EMDR Practice and Research, 2(3), 190-200. doi:10.1891/1933-3196.2.3.190.
Language: English
Format: Journal
Abstract:
A single session of a modified, abridged EMDR protocol was provided in a general hospital inpatient and outpatient setting to 86 patients with acute stress (AS) syndrome suffering from intrusion distress following accidents and terrorist bombing attacks. Fifty percent reported immediate fading of intrusive symptoms and general alleviation of distress, 27% described partial alleviation of their symptoms and distress, while 23% reported no improvement. Partial and nonresponders were provided with or referred for more comprehensive treatment. At 4-week and 6-month follow-up, the immediate responders in the terror victims group remained symptom free. The immediate responders tended to have uncomplicated AS symptoms with fewer risk factors for posttraumatic stress disorder (PTSD), while the nonresponders had higher exposure to former traumas and endorsed more risk factors for PTSD. These results support other anecdotal reports on the rapid effects of brief EMDR intervention on intrusive symptoms in early uncomplicated posttraumatic cases. Although more controlled studies are essential, this immediate method for symptomatic relief may be a potential addition for focused interventions in acute trauma victims.
Keywords: Acute Stress Disorder ASD Intrusions Mass Casualty Event MCE Posttraumatic Stress Disorder PTSD
Accuracy Verified: Yes
12. Shapiro, E. (2012). EMDR and early psychological intervention following trauma. Revue Européenne De Psychologie Appliquée/European Review of Applied Psychology, 62(4), 241-251. doi:10.1016/j.erap.2012.09.003.
Language: English
Format: Journal
Abstract:
Introduction:
This article evaluates developments in the field of early psychological intervention (EPI) after trauma in general and the place of early eye movement desensitization and reprocessing (EMDR) intervention (EEI) in particular. The issues and dilemmas involved with EPI and EEI will be outlined; related research presented and the current status evaluated.
Literature and clinical findings:
Reviewing the literature and drawing on findings from initial research and case studies, the rationale and contribution that EMDR therapy has to offer is discussed relative to current evidence and theory regarding post-traumatic stress syndromes and trauma memories. The relative advantages of EEI will be elaborated.
Discussion and conclusion:
It is proposed that EEI, while trauma memories have not yet been integrated, may be used not only to treat acute distress but may also provide a window of opportunity in which a brief intervention, possibly on successive days, could prevent complications and strengthen resilience. Through the rapid reduction of intrusive symptoms and de-arousal response as well as by identifying potential obstructions to adaptive information processing (AIP), EMDR therapy may reduce the sensitisation and accumulation of trauma memories.
Keywords: Early Psychological Intervention EPI Trauma
Accuracy Verified: Yes
13. Lanius, U. F. (2008, June). EMDR and information processing: Towards a neurobiological model. Keynote presented at the annual meeting of the EMDR Europe Association, London, England.
Language: English
Format: Conference
Abstract:
Recent neuroscience research is discussed with a view towards increasing our
understanding of underlying neurobiological processes with respect to
traumatic stress syndromes and EMDR treatment. Moreover, the relevant
neuroscience research and theory with regard to learning, memory and
information processing is reviewed, with a view towards integrating Shapiro's
Adaptive Information Processing Model and EMDR clinical practice with
current theory and research in the field of neuroscience.
Keywords: Keynote Neurobiology
Accuracy Verified: Yes
14. Lanius, U. (2009, May). EMDR and information processing: Towards a neurobiological model. Presentation at the EMDR Canada Conference, Vancouver, British Columbia Canada.
Language: English
Format: Conference
Abstract:
Recent neuroscience research is discussed with a view towards increasing our understanding of underlying
neurobiological processes with respect to traumatic stress syndromes and EMDR treatment. Moreover, the relevant
neuroscience research and theory with regard to learning, memory and information processing is reviewed, with a
view towards integrating Shapiro's Adaptive Information Processing Model and EMDR clinical practice with current
theory and research in the field of neuroscience.
Keywords: Neurobiology
Accuracy Verified: Yes
15. van Rood, Y., & de Roos, C. (2012, June). EMDR and medically unexplained physical symptoms (MUPS): Case conceptualisation and treatment [EMDR y los síntomas somáticos inexplicables por la medicina (MUPS): Conceptualización del caso y tratamiento]. Presentation at the annual meeting of the EMDR Europe Association, Madrid, Spain.
Language: English
Format: Conference
Abstract:
Medically unexplained physical symptoms (MUPS) are symptoms for which adequate examination did not reveal sufficiently
explanatory structural or other specified pathology. This includes patients with somatoform disorders such as conversion disorder,
hypochondriasis, and pain disorder. But also patients with functional syndromes such as fibromyalgia, chronic fatigue syndrome, and irritable
bowel syndrome and patients with specific physical symptoms such as pain, nausea, itch for which no medical cause has been detected.
Empirical evidence suggests that traumatic experiences can play a role in the aetiology of MUPS and somatoform disorders (Roelofs &
Spinhoven, 2007). Furthermore, unprocessed traumatic memories can play a role in the maintenance of MUPS (de Roos & van Rood, in
press). Indeed,the results of a systematic review suggest that EMDR might be an effective treatment for MUPS and somatoform disorders, particularly when
the somatic complaints are trauma related (van Rood & de Roos, 2009). Clinicians need to establish if the specific complaint of their patient
is trauma related, whether the unprocessed trauma memory maintains the somatic symptom, and if so in what way.
In this presentation the different ways are discussed in which trauma memories can be related to MUPS and how this may maintain the
complaint; i.e. hinder recovery. The presentation will be illustrated with video fragments of the EMDR process in several patients with diverse
somatic complaints.
Los síntomas somáticos médicamente inexplicables (MUPS), son síntomas para los cuales un adecuado examen no muestra
una explicación estructural suficiente ni otra patología específica. Esto incluye pacientes con trastornos somatomorfos como el trastorno de
conversión, hipocondría y trastorno por dolor. Pero también los pacientes con síndromes funcionales como la fibromialgia, síndrome de fatiga
crónica, síndrome del colon irritable y pacientes con síntomas físicos específicos como dolor, náuseas, picores sin causa médica, fueron
detectados. La evidencia empírica sugiere que las experiencias traumáticas pueden jugar un papel en la etiología del MUPS y los trastornos
somatomorfos (Roelofs & Spinhoven, 2007). Es más, los recuerdos traumáticos sin procesar pueden jugar un papel en el mantenimiento del
MUPS (de Roos & van Rood, in press). De hecho, los resultados de revisiones sistemáticas sugieren que el EMDR puede ser un tratamiento
efectivo para MUPS y los trastornos somatomorfos, de manera específica cuando las quejas somáticas de los pacientes están relacionadas
con un trauma. Los clínicos necesitan establecer si existen quejas específicas de sus pacientes relacionadas con el trauma o no. Si el trauma
sin procesar mantiene los síntomas somáticos o no.
En esta presentación diferentes caminos serán discutidos, en donde el trauma puede estar relacionado con el MUPS y cómo éste puede
mantener la queja. La presentación será acompańada de fragmentos de vídeo para el procesamiento de EMDR en numerosos pacientes con
diversas quejas somáticas.
Keywords: Medically Unexplained Physical Symptoms MUPS
Accuracy Verified: Yes
16. Strauss, J.-W. (2006). EMDR in der behandlung chronischer schmerzyndrome [EMDR in the treatment of chronic pain syndromes]. In F. Lamprecht (Hrsg.), Praxisbuch EMDR: Modifizierungen für spezielle anwendungsgebiete (pp. 28-67). Stuttgart: Klett-Cotta.
Language: German
Format: Book Section
Keywords: Chronic Pain
Accuracy Verified: Yes
17. Lanius, U. F. (2005). EMDR processing with dissociative clients: Adjunctive use of opioid antagonists. In R. Shapiro (Ed.), EMDR solutions: Pathways to healing (pp. 121-146). New York: W W Norton & Co.
Language: English
Format: Book Section
Abstract:
Dissociative symptoms are common in traumatic stress syndromes (e.g., complex PTSD, disorder of extreme stress not otherwise specified [DESNOS], borderline personality disorder, and dissociative disorders). They commonly interfere with psychotherapy including EMDR treatment. It appears that the adaptive information processing system gets overwhelmed and shuts down, thereby barring the integration and resolution of traumatic experience and thus precluding positive treatment outcomes. A series of case studies by Ferrie and Lanius found that the administration of an opioid antagonist prior to EMDR treatment significantly reduced dissociative symptoms, somatization, and numbing, as well as aiding trauma processing. The present chapter describes the relevant scientific research, as well as a theoretical rationale and a protocol, for the use of opioid antagonists in trauma processing with EMDR. [Text, p. 121]
Keywords: Analgesic Drugs Dissociative Symptoms Posttraumatic Stress Disorder PTSD Stressors Survivors
Accuracy Verified: Yes
18. Korn, D. L. (2008, May). EMDR treatment with survivors of chronic abuse and neglect: Repairing developmental deficits and shattered selves - [Utilisation d’EMDR dans le traitement des survivants d’abus ou négligence chroniques: Réparer les déficits développementaux et les sois éclatés]. Presentation at an annual meeting of EMDR Canada, Montréal, Quebec Canada.
Language: English
Format: Conference
Abstract:
Cet atelier d’une journée met l’accent sur l’intégration de l’EMDR ŕ l’intérieur d’un plan thérapeutique. Nous aborderons l’utilisation d’EMDR pour traiter le Stress post-traumatique complexe, de męme que d’autres syndromes cliniques d’origine traumatique, tels que le Trouble de personnalité limite et les Troubles
dissociatifs. Des modifications et/ou additions au protocole EMDR seront proposées afin de tenir compte des capacités limitées ŕ tolérer les affects, des défenses rigides, de la sur-utilisation des stratégies d’évitement, des conflits entre les états du moi, des tendances ŕ la dissociation ou des dérégulations émotionnelles
importantes.
Nous aborderons l’évaluation des aspects développementaux et des besoins d’attachement du client, l’établissement d’une bonne compréhension de la situation clinique et le développement d’un plan de traitement intégré avec des objectifs atteignables et réalisables. On portera plus particuličrement notre attention sur l’intégration de l’EMDR comme moyen de renforcer l’Ego et le développement des ressources au
cours des différentes étapes du traitement.
This full-day workshop will focus on integrating EMDR into an overall recovery plan. The use of EMDR in treating complex PTSD as well as other trauma-related syndromes such as borderline personality disorder and dissociative disorders will be addressed. In recognition of clients’ limited affect tolerance, rigid defenses,
overdeveloped avoidance patterns, ego state conflicts, dissociative tendencies, and extreme emotional dysregulation, strategies for modifying and supplementing standard EMDR protocols will be explored.
Assessing the developmental and attachment needs of the client, establishing a useful case conceptualization, and developing an integrated treatment plan with achievable goals will be discussed. Considerable attention will be devoted to integrating EMDR ego strengthening and resource development protocols into all phases of treatment.
Keywords: Complex PTSD Dissociative Disorders
Accuracy Verified: Yes
19. Jones, J. (1995, June). EMDR: A candid view from the psychiatrist's couch. Presentation at the EMDR Network Conference, Santa Monica, CA .
Language: English
Format: Conference
Abstract:
I will attempt to present an overview of the major psychiatric disorders, some medical and neurologic syndromes and general concepts on how I approach diagnosis, prognosis and treatment. Our time will include all this and put special focus on psychpharmacology. The nature and scope of this material will be mostly introductory but i will certainly be open to exploring my topic at greater depth depending the needs of the group present. The audience should be any among you who would likea way to begin organizing you approach to pharmacology and the impact that is having on your practice and the use of EMDR. Licensed clinical social workers, marriage and family counselors and psychologists should especially benefit form the discussion. You can expect to hear about major depression and its variants, bipolar disorder, panic disorder and the general anxiety disorders- some coverage of eating disorders, PTSD and adult attention deficit disorder but in less detail. I shall only touch upon schzophrenia and the psychotic disorders unless you show a special interest. The same is true for medical and neurologic diagnosis which have psychotic sequelas. I shall then to proceed to describe the differences and similarities among the antidepressants following that with a less detailed presentation of anit-anxiety agents, anti-psychotics, lithium and its siblings and a few of the "tried-and-true" substances of abuse like alcohol, stimulants, hallucinogens and narcotics. Please forgive me if I draw the line at designer drugs. This is a vast amount of information. I shall empasize general organizing concepts which will help the clinician who would like to understand some of his/her clients better, know better when to make a referral to a psychiatrist, now some of the potentials and limitations of EMDR when your clients are taking medications and/or have a major psychiatric disorder. Do not come to if you wish to set sail on a sea of psychiatric and medical details - 90 minutes just will not suffice! I will depend on you to speak up at any time with your concerns and queries (not to mention contradictions) so we can tailor the moment to the real interests of those present. I will attempt to reserve a substantial amount of time for question, answers, and observations but, if we are lucky, this will be happening throughout the ninety minutes. If we have time left I will explore the subject of "you and your psychiatrist" with both panache and hubris. We have a reputation for not being the most ingratiating of colleagues. I have a number of suggestions from a psychiatrist perspective which could make it easier to manage (sic) your psychiatrist. I hope we will be able to conclude with some high spirits and as they say here in California, a time for sharing and mutual understanding.
Accuracy Verified: Yes
20. Mueser, K. T., & Herbert, J. T (1993, September). EMDR: Caveat emptor!. the Behavior Therapist, 16(8), 218-219.
Language: English
Format: Newsletter
Abstract:
The past year has witnessed a
flurry of letters to the Behavior Therapist
about Eye Movement Desensitization
and Reprocessing (EMDR) treatment.
Most of these letters address the controversy
over the methods used to
train clinicians in EMDR, such as the
requirement that participants in workshops
sign statements agreeing not to
share any of the training materials
with other clinicians. The recent surge
in interest in EMDR is reflected by the
explosive growch in training opportunities
and applications to diverse clinical
populations and syndromes (e.g.,
the children of alcoholics). Given such
widespread interest, it is troubling that
the most fundamental question about
EMDR-its efficacy-has received so
little attention.
Keywords: Letter
Accuracy Verified: Yes
21. Feener, R. S. (2004). Eye movement desensitization and reprocessing: A new method in the treatment of performance anxiety for singers. Florida State University, Tallahassee, FL. AAT 3156073.
Language: English
Format: Dissertation/Thesis
Abstract:
The purpose of this thesis is to provide information and exposure for EMDR therapy as it relates to performance anxiety in singers and other musicians. Since EMDR therapy is a relatively new approach to relieving issues of anxiety, this thesis provides a description of its discovery, background, development, and proper procedures and protocols. In 1987 Francine Shapiro discovered and began to develop a new method in the treatment of trauma using guided eye movements. These guided eye movements were theorized to create bilateral brain stimulation, which through the simultaneous component of recalling ones trauma both physically and emotionally, an individual’s trauma can be processed toward a state of mental health. This is similar to what is theorized to happen during REM sleep. Francine Shapiro states that every human being possesses an innate information processing system that guides each individual toward a balanced state of mental health, similar to the way our bodies heal physically. Once an individual experiences a trauma, the events become locked into the nervous system into its own separate neuro-network, unable to be accessed by the individual for positive processing. Our ability to process the traumatic experience is hindered and the trauma relives itself through nightmares, flashbacks, disturbing or intrusive thoughts, anxiety, or any number of life hindering events.
The theory of EMDR is that through guided eye movements, or other sources of bilateral brain stimulation such as hand taps, alternating lights or sounds, or hand buzzers, the traumatic information held in its separate neuro-network is able to bridge itself to more positive information stored in the individual’s memory. EMDR not only helps to desensitize our traumatic memories but also helps to reprocess our thoughts and feelings regarding the trauma with positive statements and beliefs such as “I am in control” and “I deserve this”. One of the most impressive aspects of the therapy is the rate in which patients improve. The success rate of EMDR is between 84 and 90 percent effective in one to three sessions or less, depending on the severity of the trauma.
EMDR began treating patients suffering primarily from PTSD (Post-Traumatic Stress Syndrome) but has expanded over the years to include a wide range of pathologies, traumas, and anxiety disorders. Francine Shapiro is continuously striving to enhance the protocols and procedures of EMDR in order to better understand and improve its effectiveness. I discovered EMDR only a ew years ago and realized that it was being used by therapists across the country in the treatment of performance anxiety, but very little had been written on this topic. Therefore, my goal is to expose both singers and instrumentalists to this new method as a new option in the treatment of performance anxiety.
Keywords: Bilateral Brain Stimulation Brain Stimulation Cognitive Processes Emotional Trauma Eye Movements Information Processing System Mental Health Musicians Performance Anxiety Posttraumatic Stress Disorder PTSD Singers Stress Syndromes Trauma
Accuracy Verified: Yes
22. Leeds, A. (2006, September). Installation when treating complex posttraumatic stress syndromes. In Criteria for assuring appropriate clinical use and avoiding misuse of Resource Development & Installation when treating complex posttraumatic stress syndromes (A. Leeds. Presentation at the annual meeting of the EMDR International Association, Philadelphia, PA.
Language: English
Format: Conference
Abstract:
The consensus model of treatment for patients with complex posttraumatic syndromes emphasizes assuring adequate stabilization before and during uncovering and resolving of traumatic memories. Resource Development and Installation (RDI) has been reported to be a potentially effective intervention for enhancing patient & stabilization. There are now several published descriptions and case reports of RDI including a summary in the standard reference text on EMDR. The growing use of RDI by EMDR trained clinicians has been followed by reports indicating that a significant number of patients with posttraumatic stress syndromes who meet standard EMDR readiness criteria for ego strength and stability have been offered RDI without being offered standard EMDR reprocessing. This presentation will review specific criteria for identifying: for which patients and clinical situations the use of RDI is indicated; for which patients and clinical situations RDI should be offered cautiously, if at all, but alternate stabilization methods should be considered; and for which patients RDI should not be offered but where standard EMDR reprocessing should be offered without delay. An overview of RDI procedural steps will be presented to clarify its use. Strategies will be offered to address technical, clinical and countertransference issues that may be associated with misuse of RDI. Clinical vignettes will be presented to illustrate appropriate clinical use, clinical cautions and misuse of RDI.
Keywords: Complex Posttraumatic Stress Disorder Complex PTSD Consensus Model C-PTSD RDI Resource Development and Installation Treatment Criteria
Accuracy Verified: Yes
23. Munnukka-Dahlqvist, M. (2004, June). Integrating EMDR in psychotherapy treating complex trauma in a client with previous long-term psychotherapies. In complex traumatisation and EMDR (K. Linder, Chair). Symposium conducted at the EMDR Europe Association annual meeting, Stockholm, Sweden .
Language: English
Format: Conference
Abstract: Keywords: Complex Trauma Symposium Accuracy Verified: Yes 24. Gilson, S., & Foisson, P. (2005). L'EMDR science ou croyance? Une revue critique de la littérature [EMDR science or faith? A critical review of the literature EMDR science or belief?]. Acta Psychiatrica Belgica, 105(1), 47-58. Language: French Format: Journal Abstract: Keywords: Review Posttraumatic Stress Disorder PSTD Accuracy Verified: Yes 25. Masters, R. (2009). Letters to the editor. Journal of EMDR Practice and Research, 3(1), 57. doi:10.1891/1933-3196.3.1.57. Language: English Format: Journal Abstract: Keywords: Letter Accuracy Verified: Yes 26. Puliatti, M. (2009). L’EMDR nel trattamento delle sindromi uro-ginecologiche [EMDR in the treatment of uro-gynecological syndromes]
. Medicina Psicosomatica, 54(4), 131-142
. Language: Italian Format: Journal Abstract: Keywords: Uro-Gynecological Syndromes Accuracy Verified: Yes 27. Pulilatti, M. (2009). L’EMDR nel trattamento delle sindromi uro-ginecologiche [EMDR in the treatment of uro-gynecological syndromes]. Medicin Psicosomatica, 54(4), 131-142. Language: Italian Format: Journal Keywords: Uro-Gynecological Syndromes Accuracy Verified: Yes 28. Kutz, I., & Bleich, A. (2005). Mental health interventions in a general hospital following terrorist attacks: The Israeli experience. Journal of Aggression, Maltreatment and Trauma, 10(1/2), 425-437. doi:10.1300/J146v10n01_10. Language: English Format: Journal Abstract: Keywords: Acute Stress Disorder ASD Crisis Emergency Rooms Group Psychotherapy Israelis Posttraumatic Stress Disorder PTSD Survivors Terrorism Accuracy Verified: Yes 29. Ralaus, D. (2006). Metodika psychoterapie - Spracovavanie traumatickych zazitkov pomocou ocnych pohybov - EMDR: Eye movement desensitization and reprocessing [Methodology for psychotherapy - Processing of traumatic experiences with eye movements - EMDR Eye movement desensitization and reprocessing]. Psychiatria, 13(3-4), 167-176. Language: Slovak Format: Journal Abstract: Keywords: Practice Psychotraumatology Psychotherapt Theory Trauma Accuracy Verified: Yes 30. 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: Keywords: Anterior Cingulate Cortex Bilateral Activation Dissociation Emotional Trauma Gyrus Cinguli Hypnosis Hypnotic Dissociation Mindfulness Posttraumatic Syndromes Reciprocal Interaction Accuracy Verified: Yes 31. Lanius, U. (2008, September). The neurobiology of dissociation: Current findings and treatment approaches. Presentation at the annual meeting of the EMDR International Association, Phoenix, AZ. Language: English Format: Conference Abstract: Keywords: Dissociation Neurobiology Accuracy Verified: Yes 32. Uram, S. (2012, October). The neurobiology of trauma made simple. Presentation at the annual meeting of the EMDR International Association, Arlington, VA. Language: English Format: Conference Abstract: Keywords: Neurobiology Trauma Accuracy Verified: Yes 33. Bodill, B. (2009, September). Patterns of reduction of distress in clinical conditions using eye movement desensitisation and reprocessing (EMDR). University of University of Kwa Zulu Natal. Language: English Format: Dissertation/Thesis Abstract: Keywords: Reduction of Distress Accuracy Verified: Yes 34. Plummer, C. D. (2007). Performance enhancement for brass musicians using eye movement desensitization and reprocessing. University of Cincinnati, Cincinnati, OH. AAT 3262543. Language: English Format: Dissertation/Thesis Abstract: Keywords: Auditory Stimulation Brass Musicians Empirical Study Hemispheres Musicians Posttraumatic Stress Disorder PTSD Quantitative Study Syndromes Accuracy Verified: Yes 35. Greway, G. (2003). Personality change in trauma victims by the use of eye movement desensitization and reprocessing, resource development and installation, and emotional freedom techniques. Union Institute and Unversity, Cincinnati, OH. AAT 3088540. Language: English Format: Dissertation/Thesis Abstract: Keywords: Emotional Freedom Techniques Emotional Trauma Emotions Freedom Empirical Study Personality Change Resource Development Resource Installation Trauma Victims Accuracy Verified: Yes 36. Pearson, H. J. (2009). Present and accounted for: Sensory stimulation and parietal neuroplasticity. Journal of EMDR Practice and Research, 3(1), 39-49. doi:10.1891/1933-3196.3.1.39. Language: English Format: Journal Abstract: Keywords: Neglect Parietal Lobe Plasticity Accuracy Verified: Yes 37. Ferrie, R. K. (2004, September). Problems with SSRIs in the treatment of traumatic syndromes. Presentation at the annual meeting of the EMDR International Association, Montréal, Quebec Canada. Language: English Format: Conference Abstract: Keywords: SSRIs Accuracy Verified: Yes 38. Monticelli, M. L. (2008, Novembre). Psicoterapia cognitivo costruttivista e EMDR integrati: verso un’evoluzione mente-corpo consapevole e collettiva [Cognitive constructivist EMDR integrated into development mind-body awareness and collective]. Poster presentato al Applicazioni Cliniche dell'EMDR Congresso Nazionale, Milano, Italia. Language: Italian Format: Conference Abstract: Keywords: Mind-Body Awareness Poster Accuracy Verified: Yes 39. Figley, C., Dietrich, A., Maxfield, L., & Gentry, J. E. (1999, November). Review of neoteric trauma treatments and suggested practice guidelines. In C. Figley (Chair) Discussion, Clinical Theory. International Society for Traumatic Stress Studies, Miami, FL. Language: English Format: Conference Abstract: Keywords: Neoteric Trauma Treatments Practice Guidelines Accuracy Verified: Yes 40. Lanius, U. (2012, October). Science & practice: Attachment, dissociation and EMDR. Presentation at the 29th annual meeting of the International Society for the Study of Trauma and Dissociation, Long Beach, CA. Language: English Format: Conference Abstract: Keywords: Attachment Dissociation Accuracy Verified: Yes 41. Barre, K., & Biesold, K.-H. (2002). Therapie psychischer traumatisierungen bei soldaten der Bundeswehr [Treatment of psychological trauma suffered by soldiers of the Bundeswehr]. In Eberhard Okon & Rolf Meermann (Hsrg). Prävention und Behandlung posttraumatischer Störungsbilder im Rahmen militärischer
und polizeilicher Aufgabenerfüllung, (S. 41-46). Language: German Format: Book Section Abstract: Keywords: Bundeswehr Soldiers Accuracy Verified: Yes 42. Kutz, I. (2009). To the editor. Journal of EMDR Practice and Research, 3(1), 57-58. doi:10.1891/1933-3196.3.1.57. Language: English Format: Journal Abstract: Keywords: Accidents Acute Stress Syndromes Bombing Attacks Intrusion Distress Letter Terrorist Accuracy Verified: Yes 43. Mevissen, L. (2011, June). Treatment of people with developmental disabilities. How far can we go?. Presentation at the annual meeting of the EMDR Europe Association, Vienna, Austria. Language: English Format: Conference Abstract: Keywords: Developmental Disabilities Treatment Accuracy Verified: Yes 44. Ferrie, R. (2012, April). The use of dreams in ego state and EMDR therapies for trauma and dissociation. Presentation at the annual meeting of the EMDR Canada, Montreal, Canada. Language: English Format: Conference Abstract: Keywords: Dissociation Dreams Ego State Therapy Trauma Accuracy Verified: Yes 45. Kutz, I. (2007, June). The use of single session EMDR protocol in acute stress syndromes (ASS). Presentation at the annual meeting of the EMDR Europe Association, Paris, France. Language: English Format: Conference Abstract: Keywords: Acute Stress Syndrome Early Intervention Accuracy Verified: Yes 46. Tinker, R. H. (1995, June). Using EMDR to treat children. Presentation at the EMDR Network Conference, Santa Monica, CA. Language: English Format: Conference Abstract: Keywords: Children Accuracy Verified: Yes 47. Tinker, R. (1996, June). Using EMDR with children. Presentation at the annual meeting of the EMDR International Association, Denver, CO. Language: English Format: Conference Abstract: Keywords: Children Accuracy Verified: Yes 48. Russell, M. C. (2008). War-related medically unexplained symptoms, prevalence, and treatment: Utilizing EMDR within the armed services. Journal of EMDR Practice and Research, 2(3), 212-225. doi:10.1891/1933-3196.2.3.212. Language: English Format: Journal Abstract: Keywords: Adults Americans Iraq War Marine Personnel Medically Unexplained Symptoms Military Psychiatry Operation Iraqi Freedom Combat Posttraumatic Stress Disorder Psychotherapeutic Processes PTSD Somatic Symptoms Veterans War Syndromes Accuracy Verified: Yes
The goal of this paper is to examine one therapy process in order to explore what resources EMDR treatment can provide to complex traumatized clients with previous long-term therapies. How important is the role of mind/body connection? How could it be best observed and taken into consideration when deciding on therapeutic choices during difference phases in psychotherapy? This case raises also the following questions: When it is best to use EMDR? How do the therapist and client know when the client is ready for EMDR? How can clients learn to feel, become aware of their own bodies, observe their body sensations and label these observations? What is the importance of these skills before using EMDR? How do EMDR protocols work in this context?
Case: This client had been severely traumatized in childhood and also in adult life. She came to EMDR treatment with own question: “Have I ever been able to feel anything?” She had been in different psychotherapies, but her body was not ready for EMDR and she could not regulate emotions. She had good ego strength. This presentation shows how the therapy process progressed and it includes a therorectical discussion.
It is possible to integrate different kinds of therapies. Previous “traditional talking therapies” can give to the client the necessary ego strength, boundaries and make it easier to build a therapeutic relationship. Since trauma-related syndromes split the mind and body, it is necessary to address what occurs in the body, just as it is equally necessary to use words to make sense of and describe an experience. E
L'« Eye Movement Desensitization and Reprocessing » (EMDR) est une intervention thérapeutique controversée utilisée essentiellement dans le traitement des syndromes de stress post traumatiques (PTSD). Cet article a pour objectif de passer en revue la littérature scientifique afin d'évaluer l'état des connaissances actuelles quant ŕ l'efficacité et la spécificité de la technique et de pouvoir éventuellement envisager d'autres champs de recherche. Le nombre et la qualité scientifique des études sont encore insuffisants. Leurs conclusions contradictoires ne permettent pas de valider l'EMDR comme une technique efficace et spécifique dans le traitement du PTSD ou d'autres pathologies. Néanmoins, certains résultats positifs, la rapidité d'action et le faible coűt de la technique justifient de plus amples recherches.
The "Eye Movement and Desensitizer Reprocessing (EMDR) is a controversial therapeutic intervention used primarily in the treatment of post traumatic stress syndrome (PTSD). This article aims to review the scientific literature to assess the state of current knowledge regarding the effectiveness and specificity of the technique and to possibly explore other fields of research. The number and quality of scientific studies are still insufficient. Their contradictory findings do not validate EMDR as an effective technical and specific in the treatment of PTSD or other disorders. Nevertheless, some positive results, speed of action and the low cost of technology warrant further investigation.
“The Effect of Single-Session Modified
EMDR on Acute Stress Syndromes,” Kutz, Resnik, and
Dekel (2008). As my long-suffering research professor drummed
into me years ago, the most serious error that can
be made in experimental research is to confuse a
correlation with a cause: in the case of this study, the
fact that recovery followed the use of EMDR does not
mean that EMDR caused the recovery. The cause of
recovery may have been the natural healing properties
of the brain or myriad other factors. (Excerpt)
La rilevazione di disturbi uro-ginecologici č in costante crescita, č ciň probabilmente a causa della maggiore attenzione che i clinici dimostrano nei confronti di disturbi variegatati, a volte quasi impalpabili, ma che possono anche dimostrarsi invalidanti. Oltre al vaginismo e alla dispareunia, ben noti nella letteratura scientifi ca da decenni, crescente interesse stanno dimostrando disturbi come la cistite interstiziale, il dolore pelvico e la vulvodinia. Complessivamente considerati, la componente psicosomatica di tali disturbi viene abbondantemente confermata dalla letteratura. A prescindere dagli approcci piů chiaramente monolaterali e riduttivi, si nota nella letteratura un interesse consolidato per una terapia che sia per definizione integrata: ginecologica/riabilitativa, psicoeducazionale, sessuologica e psicoterapeutica. L’EMDR si propone in questo ambito clinico come uno strumento di straordinaria versatilitŕ, potendo infatti intervenire sia a livello delle cause remote (eventi stressanti/traumatici, educazione sessuale distorta, etc.), che delle contingenze attuali che mantengono o peggiorano la sintomatologia, offrendo inoltre la possibilitŕ di intervenire direttamente sia sul dolore inteso come sintomo, che sugli scenari futuri connotati negativamente dalla paziente, che frequentemente sono connessi alla percezione del dolore stesso. Infine, si rivela di particolare utilitŕ nel caso in cui il dolore sia correlato a difficoltŕ relazionali caratterizzate da scarsa assertivitŕ. In questo lavoro verranno approfondite le seguenti tematiche: • diagnosi differenziale tra i differenti tipi di dolore uro-ginecologico. • Valutazione dell’eziologia multifattoriale: cause biologiche, psicosessuali, relazionali e presenza di eventi traumatici. • Ruolo dell’abuso sessuale. • Meccanismi psicofi siologici nell’insorgenza dei disturbi: il ruolo della tensione muscolare. • Caratteristiche psicologiche della donna che presenta dolore uro-ginecologico. • Strumenti di screening psicodiagnostico. • Cenni sulle principali strategie di valutazione e di intervento uro-ginecologiche e farmacologiche • Pianifi cazione e fasi del trattamento con l’EMDR, e loro integrazione con differenti approcci psicoterapeutici: aree di indagine, aspetti psicoeducazionali, tecniche sessuologiche specifi che, target caratteristici, l’utilizzo dell’EMDR nelle differenti fasi del trattamento.
The detection of uro-gynecological disorders is growing, this is probably due to the increased attention that clinicians demonstrate against variegatati disorders, sometimes almost impalpable, but may also prove to be disabling. In addition to vaginismus and dyspareunia, well known in the scientific literature about for decades, are showing increasing interest in disorders such as interstitial cystitis, pelvic pain and vulvodynia. Overall, the psychosomatic component of these disorders is abundantly confirmed by the literature. Apart from the unilateral and reductionist approaches more clearly, there is a vested interest in the literature for a treatment that is by definition integrated: gynecological / rehabilitation, psycho-educational, sexology and psychotherapy. EMDR is proposed in this clinical setting as an instrument of extraordinary versatility, allowing it to intervene at the level of remote causes (stressful events / trauma, distorted sex education, etc..) That the current quotas that maintain or worsen the symptoms, while also offering the opportunity to speak directly about pain is understood as a symptom, which negatively on future scenarios of patient characteristics, which are frequently related to the perception of pain itself. Finally, it proves particularly useful in cases where the pain is related to relationship difficulties with low assertiveness. In this paper we will examine the following issues: • differential diagnosis between different types of pain, uro-gynecology. • Evaluation multifactorial etiology: biological, psychosexual, relationship and presence of traumatic events. • Role of sexual abuse. • psychophysical mechanisms in the onset of physiological disorders: the role of muscle tension. • Psychological characteristics of women with uro-gynecological pain. • Tools psychodiagnostic screening. • Work on the main strategies of assessment and intervention and uro-gynecological drug • Plans and application phases of treatment with EMDR, and their integration with different psychotherapeutic approaches: survey areas, psychoeducational aspects, specific sexological techniques that target characteristic the use of EMDR in various stages of treatment.
Over three years of repeated terrorist attacks in Israel have shown that the victims suffering from acute stress syndromes constitute the bulk of the casualties. The large number of psychological victims presents an immediate problem of hospital surge capacity. The need for alleviating acute suffering and preventing chronic, disabling posttraumatic syndromes requires organizational and clinical skills. The article reviews deployment and intervention protocols for the treatment of victims and affected staff members in a general hospital setting. [Author Abstract]
Psychodynamic metódy a kognitívno-behaviorálna terapia boli najčastejšie metódy na liečbu posttraumatickej stresovej poruchy a napätie vyvolané syndrómy. EMDR - Eye Movement desenzibilizácie a prepracovanie nový psychoterapeutický prístup, ktorý integruje prvky Cognis a psychopdynamictive behaviorálna terapia spolu s bilaterálnou stimuláciu, hlavne pohyby očí. Táto metóda bola vytvorená Dr Francine Shapiro. Teraz je jedným z najúčinnejších a najlepšie tolerovaná terapeutických prístupov a jeho účinnosť je vykonávať na spoľahlivé vedecké štúdie, aj keď presný mechanizmus účinku nie je doteraz úplne jasné. V súčasnej dobe výskumu a praxe v psychotraumatology EMDR a je jedným z najviac dynamicky sa rozvíjajúca oblasť psychoterapie v USA a západnej Európe.
Psychodynamic methods and cognitive behavioral therapy were the most common methods for treatment posttraumatic stress disorder and stress induced syndromes. EMDR - Eye Movement Desensitization and Reprocessing is a new psychotherapeutic approach, Which integrates elements of Cognis and psychopdynamictive behavioral therapy together with bilateral stimulation, mainly eye movements. The method was created by Dr. Francine Shapiro. Now it is one of the most effective and best tolerated therapeutic approaches and its efficiency is Execute by reliable research studies, although the exact mechanisms of action are still not
absolutely clear. At the present Research and Practice in psychotraumatology and EMDR is one of the most dynamic developing area in psychotherapy in the USA and West Europe.
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
Current research in neuroscience and the neurobiology of dissociation is discussed and its connection to a wide variety of traumatic stress syndromes and attachment related disorders. Dissociation is a normal and adaptive response to overwhelming experience. At the same time, dissociative symptoms interfere with mindfulness and the continuity of self. Moreover, information processing becomes compromised or shut down, thus barring the integration and resolution of the traumatic experience. Thus, dissociation interferes with effective psychotherapeutic intervention. Therefore, addressing dissociative symptoms is essential for positive treatment outcomes. A neurobiological model is described that guides therapeutic interventions and integrates diverse approaches that include not only EMDR, but also mindfulness, body therapy approaches, ego-state interventions, sensory integration, as well as neurobiologically based interventions. Participants will become familiar with interventions that reduce dissociative symptoms, as well as when and how to use them to maximize treatment effects.
This workshop explains the neurobiology of trauma in a simple, yet highly usable manner. Upon completion of this workshop, attendees should be able to readily apply this information for better formulating their clients’ issues and treatment planning. The topics include: 1) How does a normal nervous system operate? 2) What is Trauma? 3) What is the “bottom line” of chronic trauma syndromes (e.g., PTSD)? 4) How does childhood development factor into adult trauma symptoms? 5) Treatment.
This study investigated the patterns of reduction of distress in clinical personality
patterns, severe personality patterns, depressive constructs, other clinical syndromes, severe
clinical syndromes and dissociation following EMDR treatment. Thirty-two people, ranging
from 23 to 65 years old, underwent the full EMDR protocol treatment for up to three traumas.
The findings regarding clinical personality patterns revealed that EMDR is most
effective in reducing the symptoms of dependent personality pattern because 76% of
participants with clinically significant dependent personality pattern before EMDR treatment
no longer had a clinically significant score (>75) on the MCMI-III at the end of EMDR
treatment; compared to 75% with masochistic personality pattern, 77% with negativistic
personality pattern, 69% with avoidant personality pattern, 40% with depressive personality
pattern and 29% with schizoid personality pattern. These gains were maintained on the
MCMI-III at follow-up by 76% with dependent personality pattern, 64% with masochistic
personality pattern, 46% with negativistic personality pattern, 38% with avoidant personality
pattern, 30% with depressive personality pattern and 29% with schizoid personality pattern.
The analysis of the severe personality patterns at the end of EMDR treatment revealed
that the scores on the MCMI-III reduced from within one standard deviation above the mean
(60-74) to below the mean (<60) for 84% of participants with borderline personality pattern,
compared to 68% with paranoid personality pattern and 52% with schizotypal personality
pattern. These gains were maintained on the MCMI-III at follow-up by 84% with borderline
personality pattern, 68% with paranoid personality pattern and 48% with schizotypal
personality pattern.
The analysis of the depressive constructs revealed that EMDR is most effective in
reducing symptoms of major depression as 86% of participants with clinically significant
major depression before EMDR treatment no longer had a clinically significant score (>75) on the MCMI-III at the end of EMDR treatment; compared to 73% with dysthymia and 40%
with depressive personality pattern. These gains were maintained on the MCMI-III at followup
by 86% with major depression, 58% with dysthymia, and 33% with depressive personality
pattern.
The findings regarding the other clinical syndromes revealed that 91% of participants
with clinically significant post traumatic stress before EMDR treatment, no longer had a
clinically significant score (>75) on the MCMI-III at the end of EMDR treatment, compared
to 75% of participants with anxiety. These gains were maintained on the MCMI-III at followup
by 91% of participants with post traumatic stress and 69% of participants with anxiety.
The analysis of the severe clinical syndromes at the end of EMDR treatment revealed
that the scores on the MCMI-III reduced from within one standard deviation above the mean
(60-74) to below the mean (<60) for 78% of participants with delusional disorder, compared
to 67% with thought disorder, 32% with bipolar (manic), 28% with alcohol dependence and
28% with drug dependence. These gains were maintained on the MCMI-III at follow-up by
67% of participants with delusional disorder, compared to 63% with thought disorder, 53%
with bipolar (manic), 48% with alcohol dependence and 57% with drug dependence.
The analysis of the effects of EMDR on dissociation revealed that there was a
significant decrease in symptoms of dissociation on the DES at the end of EMDR treatment
and these gains were maintained at the follow-up measurement at the end of the study.
Whilst the findings of the present study cannot be generalised due to the small sample
size, the findings do suggest that EMDR is successful in the treatment of a number of clinical
conditions in addition to post traumatic stress; with further research being strongly indicated
in order to further explicate the efficacy of EMDR across different psychiatric conditions.
Eye Movement Desensitization and Reprocessing (EMDR) is an innovative therapy that is currently used to treat anxiety disorders. Discovered by Francine Shapiro in 1987, the treatment was originally utilized on individuals suffering from Post Traumatic Syndrome Disorder; however, the original treatment protocol has evolved to include other forms of trauma such as performance anxiety. The main hypothesis of EMDR states that traumatic memories cause the nervous system to become dysfunctional and unbalanced. As a result, stimuli such as sound and images from these events are looped continuously within the nervous system until the body can functionally process the events toward an adaptive solution. Until a solution is established, the original thoughts and feelings encountered during previous disturbing events resurface each time a resembling experience occurs. EMDR serves as a performance enhancement for brass musicians by desensitizing and reprocessing maladaptive memories through bilateral stimulation of both hemispheres of the brain. (PsycINFO Database Record (c) 2008 APA, all rights reserved)
Dissertation Abstracts International Section A: Humanities and Social Sciences. 68(4-A), 2007, pp. 1221.
Personality change in victims of trauma has been demonstrated by key researchers in the field of trauma. This research explored this area further by studying if problem personality patterns can improve to healthier levels by processing trauma symptoms with new rapid trauma techniques. This research provides new information in trauma and personality, as well as offers links to possible new treatment methods. The hypothesis tested in this research was that significant change in problem personality patterns would occur in trauma subjects whose symptoms were processed through a multi-impact therapy that included Eye Movement Desensitization and Reprocessing (EMDR), building ego structure through Resource Installation and Development and reducing physiological stress through the use of Emotional Freedom Techniques, as compared to subjects in the control group who received talking therapy. A sample of ten female participants was selected that had traumatic backgrounds and posttraumatic symptoms. All subjects received the Millon Clinical Multiaxial Inventory III (MCMI III) as a pre and a post test, and the Personality Assessment Screener (PAS) throughout 14 weeks of treatment. The PAS provided a means to measure subjects through descriptive statistics and the MCMI III measured the three highest clinical personality scales and the changes that occurred after the treatment. Within the two groups, the results of the PAS showed that talking therapy may be extremely helpful for personality improvement for some individuals processing trauma issues, but not all. The MCMI III results showed that the multi-impact group appeared to be somewhat more stable, meaning that the multi-impact treatment appeared to aid improvement on all three personality scales. The talking treatment group showed improvement on the most problematic personality scale, minimal increase on the second highest personality scale, and the third highest personality scale became significantly worse as compared to the multi-impact treatment group. This confirmed the hypothesis that there would be significant change in clinical personality scores. This implies that the multi-impact treatment helped individuals in a more efficient manner, in that improvement on personality syndromes or disorders was global. (PsycINFO Database Record (c) 2008 APA, all rights reserved)
Dissertation Abstracts International: Section B: The Sciences and Engineering. 64(4-B), 2003, pp. 1902.
There are commonalities between neurologic syndromes arising from lesions of the parietal cortex and psychiatric syndromes secondary to psychological trauma. Additionally some posttraumatic syndromes may reflect functional disruption of parietal areas. Directional or bilateral alternating peripheral sensory stimulation appear to assist in the amelioration of a wide range of clinical conditions, including the neglect syndrome and Posttraumatic Stress Disorder. It is posited that the stimulation may exert its effect through activation of parietal higher-order functions. The activation may result in an integration of sensory information and an updating of the current representation of person and space, which incorporates an awareness of current body reality, sense of self, and world view. It is hypothesized that the EMDR procedure is ideally constructed to facilitate parietal activation through multimodal sensory stimulation, attention and episodic memory retrieval and focus on internal and external body, space, and self. Further investigations and an integration of data between disciplines are suggested, in order to expand our range of effective treatments.
This workshop will focus on the biological and clinical evidence supporting
the notion that depression, dissociation, somatization, and PTSD may be
symptomatic responses to traumatic events which affect the brain. The safety of SSRls and their application for the treatment of PTSD will be
discussed as will the complications arising from their short and long lerm
use. Single system designated case studies, will be used to demonstrate how
treatment with EMDR allows one to arrive at successful outcomes in
trauma spectrum disorders, with or without psychopharmacology.
I limiti mentali autoimposti acquisiti da copioni familiari reiterati in etŕ evolutiva e da modelli operativi interiori acquisiti dalle autoritŕ societarie attraverso mezzi di comunicazione di massa e regole educativo-lavorative, inducono percentuali sempre piů rilevanti della popolazione europea alla vulnerabilitŕ psicopatologica. L’esordio delle sintomatologie psichiche e somatiche di varia entitŕ, avviene giŕ in fasi precoci, nella primissima infanzia e spesso giŕ nelle fasi prenatali, e il limite di etŕ tende percentualmente a essere sempre piů sensibile fin dal primo mese di vita. In etŕ scolare si manifestano situazioni comportamentali quali il cosiddetto “bullismo” e fenomeni con campionature rilevanti di sindromi ipercinetiche con deficit attentivo e disturbi del-l’apprendimento. In adolescenza il contesto si complica e gli attacchi di panico, le sindromi depressive e i disturbi alimentari psicogeni dilagano, fino all’esordio di disturbi post-traumatici da stress che si incrementano in seguito alle difficili scelte di orientamento universitario o lavorativo. La vulnerabilitŕ dell’etŕ adulta si manifesta con disturbi somatoformi di diversa natura, disturbi psicocardiologici, sindromi ansioso-depressive, attacchi di panico, disturbi di coppia e relazionali, per citare i piů frequenti e limitandomi solo ad accennare l’esistenza della molteplicitŕ di disturbi iatrogeni. In tali soggetti, la consapevolezza di essere indotti in stati di shock che incrementano molteplici disturbi somatoformi e psicopatologici č praticamente assente. Essi, come pazienti, si rivolgono agli specialisti in ambito sanitario con la convinzione, spesso indotta da propagande dei mass-media, che tutto sia solo genetico, e vada "curato" con farmaci per lunghi periodi se non per tutta la vita. Anche da parte degli operatori sanitari vi sono ampie aree di inadeguatezza metodologica: ad esempio, la gravidanza viene gestita come fosse una malattia, riducendo la donna partoriente a una paziente alla quale troppo facilmente si “consiglia” il parto cesareo (statisticamente tra i piů frequenti in Italia!) come metodo “veloce e sicuro” di parto, togliendo la competenza materna dell’imprinting alla nascita del bambino con le conseguenze psicologiche che ne derivano per la relazione madre-bambino e per la crescita serena di quest’ultimo, e, sempre a titolo esemplificativo, ignorano quasi del tutto gli aspetti di psicocardiologia, e il loro intervento si riduce a esami medici invasivi e a somministrazione di farmaci. Eppure, la psicoterapia cognitiva costruttivista, e specificamente modelli teorici e tecniche strategiche specialistiche note come EMDR (Eye Movement Desensitization and Reprocessing), l’utilizzo di biofeedback, l’innovativo training emotivo-cognitivo-comportamentale da me ideato nelle due versioni per la psicoterapia e per i gruppi in formazione che incrementa il riconoscimento emotivo e l’implementazione di immagini mentali idonee a modificare cognizioni e comportamenti irrazionali, quando eticamente e competentemente applicati, fanno molto per questi pazienti, sia in quanto si incrementa sensibilmente il livello della loro consapevolezza e della loro capacitŕ di farsi protagonisti nel-l'evoluzione positiva della loro “guarigione”, sia in quanto si puň intervenire in modo mirato con sperimentati protocolli per la risoluzione dello stato di trauma psichico in tempi ragionevolmente rapidi e con risultati attendibili e verificabili. Passando dalla dimensione individuale a quella collettiva, ossia alla psicopatologia collettiva cagionata dall’esposizione (anche solo mediatica) ad eventi catastrofici o angoscianti (magari associati a senso di impotenza, insicurezza, precarietŕ) o a diversi tipi di stress e vulnerabilitŕ, possiamo aggiungere che, analogamente, mediante un lavoro su sistemi di neuroni specchio e sull'attivazione di nuove connessioni di reti neurali con un modello operativo non invasivo, si potrebbe migliorare la condizione di intere popolazioni rispetto a disturbi che, oggettivamente, sono in continua diffusione.
Sarebbe opportuno iniziare una sensibilizzazione collettiva partendo dalla formazione per livelli differenziati degli operatori educativi e sanitari, per poi estenderla alla popolazione suddividendola
per fasce di etŕ e per territori di appartenenza; purtroppo la consapevolezza non č tra le aspettative primarie di committenti rivolti solo al profitto economico.
In un contesto storico-culturale dove l’etica, le relazioni umane, la cooperazione sembrano utopiche fiabe, questa č la sfida di essere una perturbatrice emotivamente orientata ad amplificare la consapevolezza attraverso un nuovo modello psicoterapeutico e formativo integrato, al quale sto lavorando da alcuni anni con risultati incoraggianti e che sarŕ mia premura esporre dettagliatamente durante il Congresso EMDR 2008.
The self-imposed mental limitations acquired from family scripts repeated age and developmental models inner acquired by the company operating through means of mass communication and
educational and working rules, induce percentage increasing as the population of Europe vulnerability to psychopathology. The onset of symptoms of various psychological and somatic
entity, is already in the early stages, in early childhood and often known during prenatal and age limit percentage tends to be more sensitive since the first month of life. Age
school behavioral situations occur where the so-called "bullying" and phenomena samples relevant syndromes of attention-deficit and hyperactive disorder - learning. In adolescence the context is complicated and panic attacks, the syndromes psychogenic depression and eating disorders are rampant, until onset of post-traumatic disorders stress which increases as a result of difficult choices of university or business orientation. The vulnerability of adulthood is manifested by different types of somatoform disorders, disorders psycho, anxious-depressive syndrome, panic attacks, disorders of torque and relational to cite the most frequent is limited only to mention the existence of multiplicity of disorders iatrogenic. In these subjects, conscious of being led into a state of shock that increase multiple somatoform disorders and psychopathology is virtually absent. They, like patients, addressed to specialists in the health field with the belief, often driven by propaganda media, that everything is just genetic, and must be "cured" with drugs for long periods if not for life. Including by health workers there are large areas of inadequacy
methodological: for example, pregnancy is managed as if it were a disease, reducing the woman in labor to a patient which too easily "advise" Caesarean (statistically the most frequent in Italy!) as a method of "fast and safe childbirth, removing the competence of imprinting the birth mother of the child with the psychological consequences that entailed for the mother-child and to the peaceful growth of the latter, and, also example, know little about the aspects of psycho, and their intervention reduces to invasive medical examinations and medication. Yet, cognitive psychotherapy
constructivist theoretical models and specific strategic and technical specialists known as EMDR (eye movement desensitization and reprocessing), the use of biofeedback, the innovative
emotional-cognitive-behavioral training which I designed in two versions for psychotherapy and groups in training that increases the emotional recognition and implementation of
mental images likely to change, knowledge and irrational behavior, when ethically and competently applied, do a lot for these patients, both because it increases
significantly the level of their awareness and their ability to get players in - the positive development of their "healing", both as it can intervene in a targeted manner with
tested protocols for the resolution of the state of psychic trauma in the reasonably rapid and reliable and verifiable results. Moving from individual dimension to that
collective, that is caused by exposure to psychopathology group (even the media) to distressing or catastrophic event (perhaps associated with the sense of powerlessness, insecurity, instability) or
different types of stress and vulnerability, we can add that, similarly, through a work on systems of mirror neurons and activation of new connections of neural networks with a model
operating non-invasive, it could improve the condition of entire populations than disorders that, objectively, are in constant circulation. It would be appropriate to start a collective awareness levels, starting from training differential operators' education and health, then extend it to the population divides
by age and territories belonging unfortunately the awareness is not between the expectations primary principals addressed only in profit or loss. In a historical-cultural context where ethics, human relations, cooperation seem utopian fairy tales, this is the challenge of being an emotionally disturbing oriented to amplify the awareness through a new model of psychotherapy and integrated training, which I working for several years with encouraging results and that will spell out my readiness EMDR 2008 during the Congress.
Eye Movement Desensitization and Reprocessing (EMDR),
Thought Field Therapy (TFT), Time-Limited Trauma Therapy (TLTT),
Traumatic Incident Reduction (TIR), and Visual/Kinesthetic
Dissociation (V/KD) are relatively new approaches in the treatment
of trauma-related disorders. These approaches have come
under intense scientific and professional scrutiny and criticism,
with proponents and critics offering diverse and intriguing arguments
in support of their respective points of view. This discussion
will focus on the current empirical and anecdotal evidence on
the efficacy of these five approaches, as well as various criticisms
that have been proferred in response to the empirical and clinical
literature on treatment efficacy and theory. EMDR will be highlighted,
given the growing empirical database on EMDR outcome
studies and the contention surrounding the treatment and its’ theory.
The evidence for and/or against the other four approaches will
also be presented, upon which we will raise for discussion issues
relating to methodological rigour, scientific reporting of clinical
data, and the interpretation of efficacy studies in general. The discussion
will occur within the context of philosophical discourse on
the ideal of integration of science and practice, and the feasibility
of attaining this ideal within the current scientific Zeitgeist.
INTERVENTION RESEARCH, CLINICAL CASE STUDY
Sandringham
Skills-Based Treatment
of Dissociation: A Case Study 238
Chair: ELHAI, Jon D., Nova Southeastern University
Discussant: GOLD, Stephen
A clinical case study of skills-based treatment of a 48-year-old,
female survivor of child sexual abuse (CSA) reporting severe dissociative
symptomatology is presented. Chief complaints were daily
amnestic episodes, depersonalization, panic attacks, agoraphobia,
and consequent long-term unemployment. In contrast to most
approaches to therapy for dissociative syndromes, it is argued that
treatment does not need to be primarily trauma-focused. Instead
treatment focused on targeting dissociation and anxiety by teaching
skills to be implemented by the client outside of session.
Functional behavioral analysis of particular recent incidents of dissociation
were conducted over several sessions. Imagery-based
relaxation and progressive muscle relaxation were used and monitored
to help the client learn additional methods of reducing distress.
Grounding techniques were implemented to counter the dissociative
tendency to lose experiential awareness of the here and
now. Cognitive interventions were utilized to challenge the erroneous
notions reported about dissociative experiences, such as the
panic she experienced when her dissociation had been revealed to
others. Last, in vivo systematic desensitization was used with a fear
hierarchy, ranging from the least to most fearful stimuli that precipitate
dissociation, where graduated exposure was followed by relaxation.
At termination the client reported elimination of panic
attacks, resumption of driving, and marked reduction in frequency
and duration of amnestic periods, with substantial additional gains
and progress in finding full-time employment reported at 8 month
follow-up. Treatment outcome is assessed based on psychological
test data obtained at intake, discharge, and 8 month follow-up, as
well as client anecdotal report.
EMDR is a powerful integrative psychotherapeutic intervention. However, in the case of disrupted attachment and significant dissociative symptoms EMDR can be destabilizing if used early on in treatment. That is, fragmentation of self and dissociative symptoms commonly interfere with information processing, thus barring the integration and resolution of the traumatic experience through EMDR. Dissociation interferes with clients sense of their own body, their ability to experience emotion, their capacity for emotional regulation and their sense of self. Addressing dissociative symptoms prior to proceeding with EMDR treatment is essential for positive treatment outcomes.
A neurobiological model is described that guides therapeutic interventions and integrates diverse approaches that include not only EMDR and relevant target selection, but also mindfulness, body therapy approaches, ego-state interventions, sensory integration, as well as neurobiologically based interventions. Such interventions can be used both in the preparation phase but can also form useful interweaves during EMDR information processing.
Using a neurobiologically informed approach, the case is made for the use of somatic and ego-state interventions when dissociation is a significant part of the clinical presentation. Specific focus is on different ego-state and body therapy interventions to increase awareness of the self and ones body. Body therapy and somatic interventions are distinguished from other psychotherapeutic interventions in that they are expressed in markedly slowed-down time, in order to give clients ample time to experience the felt sense of their bodies. Similarly ego-state work can be utilized to titrate information processing, as well as provide clients with internal resources that aid in enhanced information processing.
Attendees will gain knowledge about possible underlying neurobiological processes with regard to attachment, dissociation and adaptive information processing and how this relates to EMDR treatment. The workshop will teach specific interventions intended to stabilize clients, create safety, help the client stay connected or get reconnected and therefore minimize dissociative symptoms and their effect. Participants will learn how to effectively integrate different somatic and ego-state interventions in the treatment of attachment and trauma related syndromes and dissociative disorders, as well as how to enhance information processing during the EMDR treatment. The workshop also will discuss innovative use of opioid antagonists in the treatment of dissociative symptoms with a particular focus on EMDR.
Learning Objectives:
Attendees will gain knowledge about possible underlying neurobiological processes with regard to attachment, dissociation and adaptive information processing and how this relates to EMDR treatment.
Participants will learn how to effectively integrate different somatic and ego-state interventions in the treatment of attachment and trauma related syndromes and dissociative disorders, as well as how to enhance information processing during the EMDR treatment.
The workshop will teach specific interventions intended to stabilize clients, create safety, help the client stay connected or get reconnected and therefore minimize dissociative symptoms and their effect.
Traumatherapie ist eine spezifische Form der Psychotherapie. Sie orientiert sich schulübergreifend am Drei-Phasen-Modell von P. Janet. Im Bundeswehrkrankenhaus Hamburg werden seit 1994 Soldaten mit einsatzbedingten und einsatzunabhängigen psychotraumatischen Syndromen behandelt. Dabei wird im Rahmen eines integrativen Therapieansatzes insbesondere Eye-Movement-Desensitization-and-Reprocessing (EMDR) als therapeutische Methode eingesetzt. Der therapeutische Ansatz wird erläutert. Auf die spezifischen Bedingungen
im soldatischen Umfeld und anderen Gefahrenberufen wird eingegangen.
Trauma therapy is a specific form of psychotherapy. It is oriented across schools at the three-phase model of P. Janet. In Armed Forces Hospital Hamburg since 1994, soldiers with service-related and use-independent psycho-traumatic syndromes treated. It is in the context of an integrative therapy approach, in particular eye movement desensitization-reprocessing-and-(EMDR) is used as a therapeutic method. The therapeutic approach is discussed. On the specific conditions
in the military environment and other hazardous occupations will be discussed.
Reply by the current author to the comments made by Rosemary Masters (see record 2009-02768-007) on the original article by I. Kutz, V. Resnik and R. Dekel (see record 2008-13102-003). I sincerely thank Ms. Masters for her important comments. Indeed, to the list of confounding variables enumerated by Ms. Masters, one may add others like suggestibility. She may have missed the main point of the article—the immediacy of the response. By equating the epidemiological figures of natural recovery from trauma exposure to the numbers described in our study, Ms. Masters is comparing a process that progresses over several months to a process that occurred within a single session that lasted approximately 45 minutes. More strikingly, these dramatic changes in traumatic memories and intrusion distress are tightly correlated with the EMDR set, which lasted a minute or less and appeared within a minute or two after the set. However, since we did not systematically follow up on many of those patients we described, we should emphasize and restate that 50% of our population had complete immediate relief following a single session of EMDR. (PsycINFO Database Record (c) 2009 APA, all rights reserved)
There is evidence to suggest that people with developmental disabilities are at greater risk to suffer from the disruptive effects of traumatic events. However, parents, teachers, caregivers and even clinicians who offer specialized outpatient treatments often lack awareness of this. In general, emotional and behavioural problems are attributed to other diagnosed disorders such as genetic syndromes, cognitive impairments, ADHD or autism. Taking history with regard to behavioural changes following overwhelming events appears not to be a common practice at all. Moreover, the expression of trauma symptoms as well as the interpretation of distressing experiences often differs in comparison with the general population. Furthermore, because of their limited communication skills, common treatment methods are not appropriate. As a result, this patient category seldom receives treatment for exposure to disturbing events, including apparent symptoms of PTSD.
Preliminary research findings illustrate that EMDR, because of its strongly non-verbal character, seems to be an applicable, effective and efficient treatment method for this patient category. But how far can we go? During this workshop these findings will be presented, illustrated by many video clips of treatments of patients carried out in a centre for child and adolescent psychiatry and an outpatient treatment of adults with mental health problems. Special attention is given to creative adaptations of the EMDR protocol and the cooperation with parents, who are often traumatized themselves and have to be treated as well, either to make them able to function as a co-therapist or to strengthen their skills in educating a child with special needs.
Learning objectives:
After this workshop attendees will be aware of the specific expression of PTSD symptoms in people with various serious developmental disabilities and the various possibilities of EMDR treatment in this population.
Today, the dreaming mind is understood to improve learning, organize novel solutions to problems from waking consciousness and, thus, creatively support survival. This function, of finding new creative solutions, is also observed in the desensitization phase four of the EMDR protocol and is a key component in Ego State Therapy (EST). Dreams appear to select targets from the client’s history, that are causing problems in current time. In addition, dreams may respond to interventions made during a therapeutic session, as if the dreaming mind were in a dialogue with the client and the therapist. This type of dream leads to a more creative dialogue in subsequent therapy. Repetitive nightmares are the dreaming signature of PTSD, and these too respond well to EMDR and rehearsed changes in imagery, including that of ego states and can result in improved sleep quality. Dreams can offer a resource figure in blocked therapy; demonstrate the validity of ego states and of ego state relationships. This presentation focuses on the use of dreams, in combination with EMDR, as well as EST, for clients suffering from post traumatic syndromes. A review of the literature will be given but primarily case studies and video material from actual sessions will shared.
Learning objectives:
1. Understand the neuroscience that underlies the present state ofknowledge of the dreaming mind/brain
2. Develop skill in using the language of the dreaming mind to improve interweaves and interventions in the course of therapy
3. Develop skills in carrying nightmares forward using EMDR and thus improving sleep quality
4. Formulate a script that explains to clients why dreams and the imagination are useful in therapy.
5. Participate in a practicum on the use of dreams.
The workshop provides novel concepts regarding the nature of Acute Stress Syndromes following research in Israel. The use of a single session, modified protocol for EMDR in ASS is described, following terror attacks, motor vehicle accidents, and the war with Lebanon. The following themes will be covered in the workshop.
Part one: Novel approaches to Acute Stress Syndromes – Redefining the time axis of SS; the diagnosis of Immediate; Acute Stress Reaction (ASR) and Prediction of Risk Vulnerability: A novel assessment tool; a review of Acute Post Traumatic Stress Syndromes and how they differ from chronic PTSD; the characteristics of intrusive phenomena in ASS; and a phase oriented intervention model for ASS.
Part Two: EMDR in ASS – A brief review regarding the nature of EMDR and PTSD; the modified brief EMDR Protocol; the use of a single session EMDR in ASS – in a GH practice, during terror attacks and following war situations; clinical demonstrations of a single session EMDR in ASS patients (video movies); indications, advantages and precautions using the single session EMDR intervention; and possible psycho-physiological mechanisms.
Last year over 3 million children were exposed to physical and sexual abuse, and/or community and domestic violence (based on
conservative estimates. Of these, approximately 1 million will require mental health, medical and educational services related to
PTSD symptoms. The present workshop will make extensive use of videotaped sessions to illustrate the effectiveness of EMDR
with traumatized children and children who exhibit symptomatology related to the major psychiatric syndromes exhibited in
childhood.
General considerations in using EMDR with children will be covered. Issues related to client safety during EMDR will be
illustrated with a tape of a 10-year-old boy who was traumatized by physical abuse and his inability to protect his younger brothers.
Standard protocols for use with children will be demonstrated by videotape, ranging from protocols appropriate for eight-year-olds
and older; to those appropriate for most five- to eight-year-olds; and finally to those appropriate for children less than five. For
example, nightmares are often a target of choice for young children, and this will be illustrated with a video of a four-year-old boy
resolving a nightmare image.
Diagnostic issues in using EMDR with children will also be covered. A majority of children referred for psychotherapy are referred
for abuse (physical and sexual) and Attention Deficit/Hyperactivity Disorder (ADHD). An overview of ADHD will be provided,
with a discussion of how these-symptoms often overlap with PTSD symptomatology, causing diagnostic difficulties. Videotapes
and overheads will be used in case presentations. The effects of divorce on children will be adumbrated, along with developmental
considerations. Again, videos will be used to amplify the discussion. The effects of physical and sexual abuse on children, and how
EMDR can be helpful with these children will be another major topic for consideration. Videos illustrating this process will be
presented. PTSD in children will be examined, along with developmental considerations, and illustrated by videotape. If possible,
footage from children traumatized by the bombing in Oklahoma City, will be included. Other videos could include using EMDR
with a four-year-old child who was in an automobile accident, whose behavior continued to be impaired six months later, and a
youth who accidentally shot and killed his younger cousin. Childhood disorders following bereavement will also be discussed and
illustrated via videotape. References will be provided.
Last year over 3 million children were exposed to physical and sexual abuse, andor community and domestic violence (based on
conservative estimates. Of these, approximately 1 million will require mental health, medical and educational services related to
PTSD symptoms. The present workshop will make extensive use of videotaped sessions to illustrate the effectiveness of EMDR
with traumatized children and children who exhibit symptomatology related to the major psychiatric syndromes exhibited in
childhood.
General considerations in using EMDR with children will be covered. Issues related to client safety during EMDR will be
illustrated with a tape of a 10-year-old boy who was traumatized by physical abuse and his inability to protect his younger brothers.
Standard protocols for use with children will be demonstrated by videotape, ranging from protocols appropriate for eight-year-olds
and older; to those appropriate for most five- to eight-year-olds; and finally to those appropriate for children less than five. For
example, nightmares are often a target of choice for young children, and this will be illustrated with a video of a four-year-old boy
resolving a nightmare image.
Diagnostic issues in using EMDR with children will also be covered. A majority of children referred for psychotherapy are referred
for abuse (physical and sexual) and Attention Deficit/Hyperactivity Disorder (ADHD). An overview of ADHD will be provided,
with a discussion of how these-symptoms often overlap with PTSD symptomatology, causing diagnostic difficulties. Videotapes
and overheads will be used in case presentations. The effects of divorce on children will be adumbrated, along with developmental
considerations. Again, videos will be used to amplify the discussion. The effects of physical and sexual abuse on children, and how
EMDR can be helpful with these children will be another major topic for consideration. Videos illustrating this process will be
presented. PTSD in children will be examined, along with developmental considerations, and illustrated by videotape. If possible,
footage from children traumatized by the bombing in Oklahoma City, will be included. Other videos could include using EMDR
with a four-year-old child who was in an automobile accident, whose behavior continued to be impaired six months later, and a
youth who accidentally shot and killed his younger cousin. Childhood disorders following bereavement will also be discussed and
illustrated via videotape. References will be provided.
The mental health impact of war is often underestimated by military, government, and media officials who focus primarily on well-known conditions like depression and posttraumatic stress disorder (PTSD) while ignoring the complex toll of modern warfare. These effects are clearly evident in "war syndromes," many of which can be collectively understood as medically unexplained symptoms (MUS). The current study provides a brief historical review of combat-related MUS as well as an analysis of present evidence of a possible "Iraqi War Syndrome." An overview of past and current treatments for combat MUS is followed by a single case study treating an Iraqi war combat veteran with combat-related MUS with eye movement desensitization and reprocessing (EMDR). Therapy resulted in significant improvement of the patient's 1-year psychophysical condition and comorbid PTSD. We provide a detailed account of those treatment sessions as well as a discussion of EMDR's potential to simultaneously treat a range of combat-related psychophysical conditions without requiring extensive homework or self-disclosure that some military patients may resist. The results are promising, but they require further research. [Author Abstract]


