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1. Stofsel, M., & Mooren, T. (2012, March). Behandeling van complex trauma: EMDR en meer hoe geef je zo’n behandeling vorm, welke valkuilen kunnen er zijn, welke plek heeft EMDR en hoe bewaak je de rode lijn bij deze vaak langdurige behandelingen? [Treatment of complex trauma: EMDR and more how do you form such a treatment, what pitfalls may exist, which place has EMDR and how do you monitor the red line in these often long-term treatments?]. Presentatie op de 6e congres van de Vereniging EMDR Nederland, Arnhem, Nederland.

Language: Dutch

Format: Conference

Abstract:
Behandeling van ‘Complex trauma’ is lastig, omdat er vaak op veel verschillende levensgebieden problemen zijn. Daarbij is er sprake van een opeenstapeling van traumatische ervaringen. Dit kan leiden tot een soort schrik of terughoudendheid bij behandelaren, om complex trauma adequaat aan te pakken. In deze workshop willen wij duidelijk maken dat complex trauma goed te behandelen is, mits men de ruimte heeft om een langere behandeling aan te gaan, een therapeutische relatie (met tegenoverdrachtelijke valkuilen) aan kan gaan met cliënten met een geschokt wantrouwen in hun medemens en men niet te snel terugschrikt en mits men goed overzicht houdt over het verloop van de behandeling. Wij presenteren een model dat richting geeft aan de behandeling van complex trauma. We gaan uit van het drie-fasen model (Herman, 1992) met stabilisatie, verwerking en integratie en vullen dit aan met handvatten voor praktisch gebruik. Dit model gebruiken we om op systematische wijze de verandermogelijkheden te kunnen bepalen bij complexe traumaproblematiek. We zullen uit elke fase een of meerdere technieken demonstreren en op een rijtje zetten hoe EMDR toegepast wordt bij de behandeling van j complexe traumaproblematiek.

Treatment of 'Complex trauma is difficult, because there are often many different areas of life problems. In addition, there is an accumulation of traumatic experiences. This can lead to a kind of fear or reluctance of clinicians to adequately handle complex trauma. In this workshop we want to make clear that complex trauma can be treated well, provided they have the space for a longer treatment to enter a therapeutic relationship (with counter-transference traps) to can deal with clients with a shaken confidence in their fellow man and one not afraid to quickly and if one does good overview over the course of treatment. We present a model that gives direction to the treatment of complex trauma. We assume the three-phase model (Herman, 1992) with stabilization, processing and integration and supplement this with handles for practical use. The model we use to systematically change the options to determine in complex trauma problems. We will phase out any one or more techniques and demonstrate how this straight EMDR is used in the treatment of complex trauma problems j.

Keywords: Complex Trauma  

Accuracy Verified: Yes


2. Korn, D., Weir, J., & Rozelle, D. (2005, June). Beyond the data:  Clinical lesions learned from a four-year treatment outcome study comparing EMDR to prozac. Plenary presented at the annual meeting of the EMDR Europe Association, Brussels, Belgium.

Language: English

Format: Conference

Abstract:
"Bridging the gap between research and clinical practice" is a challenging and elusive goal. Outcome data, while critical for the legitimacy and advancement of clinical work, often fail to translate into practical skill sets. It is only when clinicians look beyond the data that they learn some of the most valuable lessons of research.
In this session, we will present the results of a four-year, randomized controlled study comparing EMDR to Prozac in the treatment of PTSD. We will also explore the clinical and practical lessons learned throughout the study. We will address assessment and history taking, treatment planning, readiness for processing, target selection. transference and countertransference, and adult versus childhood onset trauma. We hope to give EMDR practitioners an in-depth analysis of the real-life processes, dilemmas, and learning that took place during our protocol based treatment outcome study. Video segments will be used to illustrate clinical concepts and key points. And perhaps, most importantly, these same segments will be used to demonstrate how we struggled to recognize and learn from our own mistakes.

Keywords: Plenary  Prozac  

Accuracy Verified: Yes


3. Leeds, A., & Mosquera, D. (2012, October). Borderline personality disorder and EMDR. Presentation at the annual meeting of the EMDR International Association, Arlington, VA.

Language: English

Format: Conference

Abstract:
BPD patients present difficulties with self-regulation and relating to others. The management of these difficulties is central to the treatment of BPD. Working with cases of BPD and complex trauma is intrinsically relational, often involving the need to manage moments of intense affect and affect phobias in the transference and countertransference. Understanding and having strategies for addressing these issues is essential. This workshop integrates theoretical exposition with the presentation of videos cases. The general structure of EMDR therapy in treating BPD and interventions for the preparation phase and considerations for trauma-focused EMDR work will be demonstrated and explained.

Keywords: Borderline Personality Disorder  

Accuracy Verified: Yes


4. Goldman, J., & Coane, J. (2010, October). A case of strategic collaboration: Two therapists and one DDNOS patient in end phase treatment. Presenttion at the 27th Annual Meeting of the International Society for the Study of Trauma and Dissociation, Atlanta, GA.

Language: English

Format: Conference

Abstract:
A colleague, experienced in DID treatment, was invited to collaborate by the primary therapist in the end phase of treatment to facilitate patient movement through the introduction of EMDR. The nature of the collaborative relationship, its influence on transference and countertransference, the contribution of the different genders of the two therapists, as well as issues of launching the patient more fully into adult life as influenced by the collaboration will be explored. The rationale for introducing EMDR as well as its specific contribution will be explicated. The argument for therapeutic collaboration, as related to the patients history and treatment process, will also be addressed.
Participants will be able to : ♦♦ List the indications for initiating adjunctive treatment. ♦♦ assess the effects of collaboration. ♦♦ appraise the treatment trajectory to decide when to bring in another modality.

Keywords: DDNOS  

Accuracy Verified: Yes


5. Groenendijk, M. (2012, June). A demonstration of EMDR in the second phase of trauma-treatment of DID [Una demostración de EMDR en segunda fase del tratamiento de Trastorno de identidad disociativo]. Presentation at the annual meeting of the EMDR Europe Association, Madrid, Spain.

Language: English

Format: Conference

Abstract:
This workshop is about the application of EMDR in the treatment of secondary and tertiary structural dissociation with survivors of early chronic traumatization. The succeeding of the EMDR sessions in the treatment of DID, depends mainly on the appropriate indication and a thorough preparation. How to do this in clinical practice, will be pointed out in this presentation. What follows is an explanation of the process (and the essential elements in it) of the integration of traumatic memories and this process will be demonstrated by a dvd of Maria, an woman with DID. We can select and analyze particular scenes, depending on the requests from the audience. For example scenes about confirming positions of ANP's and EP's at the beginning of the session, attacking the NC by the self-­‐destructive part, guiding reliving experiences, presentification, coping with anger, differentiating between the past and the present, personification, preventing the flight-­‐reaction, coping with transference and facilitate internal cooperation. After reporting on the outcome of this therapy, the conclusion will be that EMDR can be effective for dissociative patients if several specific criteria are met. These criteria are about conceptualization according to the model of structural dissociation, about indication, timing and preparation of the sessions, about adaptations in the EMDR-­‐protocol and about integration of EMDR in the broader phase-­‐oriented treatment of DID.

Este taller trata la aplicación de EMDR en el tratamiento de disociaciones estructurales secundarias y terciarias con supervivientes de la traumatización crónica temprana. El éxito de la sesiones de EMDR en el tratamiento de Trastornos de identidad disociativo, depende principalmente de unas instrucciones apropiadas y una dura preparación. Como hacer esto en la práctica clínica será el tema de esta presentación. Continuaremos con una explicación del proceso (y los elementos esenciales dentro de este) de la integración de los recuerdos traumáticos y este proceso será demostrado en el DVD de María, una mujer con trastorno de identidad disociativos. Podemos señalar y analizar escenas particulares, dependiendo de las peticiones que hagan los participantes a la presentación. Por ejemplo, escenas acerca de la confirmación de posiciones de ANP y EP al principio de la sesión, atacando al NC por la parte autodestructiva del yo, guiando y reviviendo experiencias, atención al presente, gestionar la ira, diferenciar entre pasado y presente, personificación, prevenir la evitación, afrontar la transferencia y facilitar la cooperación interna Después de informar acerca de los resultados de la terapia, la conclusión es que el EMDR puede ser efectivo para pacientes disociados si cumplen muchos requisitos previos. Este criterio es sobre la conceptualización de acuerdo con el modelo estructural de disociación, sobre la indicación, temporalización y preparación de las sesiones, sobre las adaptaciones del protocolo del EMDR y la integración del mismo en un tratamiento más amplio en fases del tratamiento del Trastorno de Identidad Disociativo.

Keywords: DID  Dissociative Identity Disorder  

Accuracy Verified: Yes


6. Titze, M. (1997). EMDR - Unterstützte thematisierung bei psychodynamisch fundierten fokaltherapien [EMDR - Supported theming in-depth psychodynamic focal therapy]. In C. T. Eschenröder: EMDR. Eine neue Methode zur Verarbeitung traumatischer Erinnerungen (pp. 179-188). Tübingen: DGVT-Verlag.

Language: German

Format: Book Section

Abstract:
Lange Zeit galt eine im Sinne der psychoanalytischen Standardmethode durchgeführte Langzeittherapie als qualitativ besonders hochstehend. Dabei ließ sich argumentieren, dass die entscheidenden Eckpfeiler des analytischen Prozesses (Erinnern, Wiederholen, Durcharbeiten) einer zeitaufwendigen Methodik (freie Assoziation, "gleichschwebende Aufmerksamkeit" und regressionsfördernde Zurückhaltung / Schweigen des Analytikers, Übertragungs- und Widerstandsdeutungen usw.) bedürfen (vgl. Thomä & Kächele, 1989). Eine unbestreitbare methodische Schwäche dieser Vorgehensweise resultiert allerdings aus dem Verzicht auf eine aktive Strukturierung durch den Analytiker. Dies kann dazu führen, dass sich manche Klienten in der realen therapeutischen Beziehung allein gelassen bzw. nicht ernst genommen fühlen. Eine nicht selten mehrjährige Behandlungsdauer kann zudem eine Unzufriedenheit hervorrufen, die dann zu realen Widerstandstendenzen auf Seiten des Klienten führen wird, wenn ein spürbarer Behandlungserfolg ausblieb (vgl. dazu Eschenröder, 1986, Kap. 11). Doch es sind nicht allein solche Einwände, die zu einer Relativierung der Bedeutung von analytischen Langzeittherapien geführt haben. Es waren auch reale ökonomische Gegebenheiten, die diese Bedeutung in den letzten Jahren zunehmend in Frage gestellt haben. Nachdem nämlich, zunächst in den Vereinigten Staaten, die Versicherungen dazu übergegangen sind, nur eine stark begrenzte Anzahl psychothe-rapeutischer Leistungen zu erstatten, kam es auch im Bereich der Tiefenpsychologie zu einer verstärkten Hinwendung gegenüber kurzzeittherapeutischen Verfahren (vgl. Goleman, 1981).

Long considered a standard in the sense of the psychoanalytic method carried out as long-term therapy of particularly high standing. It could be argued that the crucial cornerstone of the analytical process (remembering, repeating, working through) a time-consuming method require (free association, evenly suspended attention "and regression-promoting restraint / silence of the analyst, transference and resistance interpretations, etc.) (see Thoma & Kächele, 1989). One undoubted methodological weakness of this approach, however, results from the absence of an active structure by the analyst. This can cause that some clients feel in the real therapeutic relationship alone and not taken seriously. An often multi-year duration of treatment may also cause discontent that will lead to real resistance tendencies on the part of the client when a substantial treatment effect failed to (cf. Eschenröder, 1986, Chapter 11). But it is not only an objection that led to a relativization of the importance of long-term analytic therapies. There were also real economic conditions that have made this meaning in recent years increasingly in question. After that is to report first in the United States, the insurance companies have started, only a very limited number of psychotherapy therapeutic services were also provided in the field of depth psychology (1981 cf. Goleman,) to an increased turn over short-therapeutic procedures.

Keywords: Focal Therapy  

Accuracy Verified: Yes


7. Woller, W. (2003). EMDR in der psychotherapie von persönlichkeitsstörungen [EMDR in the treatment of personality disorders]. Zeitschrift für Psychotraumatologie und Psychologische Medizin (ZPPM), 1(3), 17-24.

Language: German

Format: Journal

Abstract:
Behandlung psychotraumatischer belastungsstörungen mit EMDR
Die Arbeit stellt dar, (1) welche Modifikationen oder Einschränkungen sich für die Behandlung Posttraumatischer Belastungsstörungen mit EMDR durch die Präsenz komorbider Persönlichkeitsstörungen ergeben und (2) welche Möglichkeiten EMDR darüber hinaus für die Behandlung von Persönlichkeitsstörungen ohne die Symptomatik einer PTBS bieten kann. Beim Vorliegen einer Persönlichkeitsstörung muss EMDR in einen Gesamtbehandlungsplan integriert werden, der neben umfassender Stabilisierung, Symptomkontrolle und Ressourcenaktivierung die Modifikation verzerrter interpersoneller Wahrnehmungsmuster und maladaptiver Interaktionsmuster umfasst. Probleme der therapeutischen Arbeitsbeziehung können die Stabilisierungsphase schwierig und zeitaufwändig gestalten. Die EMDR-Technik muss entsprechend dem Typ der Persönlichkeitsstörung, der Abwehrstruktur und der symptomatischen Komorbidität modifiziert werden. Zusätzlich zur Behandlung von Traumatisierungen kann EMDR zur Bewältigung aktueller und künftiger Stressoren und zur Ressourcenstärkung eingesetzt werden.

EMDR has been shown to be an effective treatment method in posttraumatic stress disorder (PTSD). There is a marked comorbidity between PTSD and personality disorders, some of which have been found to be long-term sequelae of cumulative childhood physical and sexual traumatization. Personality disorders are also included in the concepts of "complex PTSD" and "DESNOS". The paper discusses (1) modifications and limitations of EMDR technique required for treatment of posttraumatic stress disorder with comorbid personality disorders, and (2) further applications of EMDR in the treatment of personality disorders without PTSD. If comorbid personality disorder is present, EMDR has to be integrated into a complex treatment plan which includes stabilization, symptom control, resource installation, identification of distorted interpersonal perceptions, and modification of maladaptive interpersonal interactions. Because of the central role of generalized negative beliefs in maintaining cyclical maladaptive patterns, EMDR is regarded a valuable tool to modify negative beliefs along with processing traumatic memories and body sensations. Problems of therapeutic alliance due to transference phenomena and acting-out can make stabilization difficult and time-consuming. EMDR technique should be subjected to important modifications depending on personality disorder subtype, defence structure and symptomatic comorbidity. Structural dissociations of the personality (e.g. as in dissociative identity disorder) call for a consideration of all ego-states of the personality system before planning EMDR treatment. In addition to unresolved trauma, current and future interpersonal stressors can be chosen as EMDR targets.

Keywords: Personality Disorders  

Accuracy Verified: Yes


8. Parnell. L. A. (1999, June). EMDR in the treatment of adults abused as children. Presentation at the annual meeting of the EMDR International Association, Las Vegas, NV.

Language: English

Format: Conference

Abstract:
Participants will: 1) be able to describe the three phases of treatment; 2) be able to use at least three ego strengthening methods using EMDR, including identification, development, and installation of inner and outer resources important for preparing clients for EMDR processing, such as: safe place, positive internal resource images, such as the inner advisor child-self – adult-self assessment and development, nurturer and protector figures, spiritual resources, positive memories, images from nature, and others; 3) learn tips for successful target development; 4) learn how to develop and use special targets for EMDR processing such as: visual memories, including flashbacks; dreams; artwork; emotions, physical sensations, and body memories; TV shows and movies; and negative cognitions; 5) learn helpful modifications to the standard EMDR procedural steps; 6) learn at least two interventions to help clients who experience problems during EMDR processing with, such as dissociation, numbness, sleepiness, lack of channel activation and integration, and memory chaining; 7) learn at least two suggestions for working with client transference; 8) learn at least five techniques for working with blocked processing and abreactions; 9) learn how to use a selection of imaginal and cognitive interweaves; and 10) learn at least three techniques for closing incomplete sessions.

Keywords: Abreaction  Abuse  Adults  Blocked Processing  Closing Incomplete Session  Cogntive Interweave  Ego Strengthening  Imaginal Interweave  Target Development  Transference    

Accuracy Verified: Yes


9. Zangwill, W., & Britt, V. (2006, September). The EMDR therapist as case consultant. Presentataion at the annual meeting of the EMDR International Association, Philadelphia, PA.

Language: English

Format: Conference

Abstract:
As EMDR's reputation for powerful and effective treatment grows, EMDR clinicians are increasingly being asked to provide services as consulting or adjunct therapists. These consultations can be intensely productive and stimulating if done properly; they can also be counterproductive if not. This workshop will provide the consulting therapist with specific techniques for ethical and effective treatment of the patient and guidelines for working with the primary therapist. It will include: 1) setting realistic goals with both the patient and the primary therapist; 2) exploring the eight phases of EMDR treatment from a consulting perspective; 3) understanding the ethical issues concerned with this type of treatment; 4) dealing with treatment implications such as splitting and transference; 5) how to avoid common pitfalls such as judging the primary clinician's performance; and 6) the satisfaction of developing an ongolng productive, collegial relationships. The workshop will provide a step-by-step framework for consultation work, clear case examples and didactic information woven into a lively interactive format.

Keywords: Case Consultation  

Accuracy Verified: Yes


10. Wolff, R. P. (2004). Evaluation of effectiveness of individual therapy sessions over 60 minutes. California Institute of Integral Studies, San Francisco, CA. AAT 3158599.

Language: English

Format: Dissertation/Thesis

Abstract:
Research has produced few studies that support the 50-minute therapy session as the most effective session length for achieving optimal therapeutic results. This descriptive study attempted to determine differences in therapists' perceptions of how session length might impact therapeutic process, therapeutic outcome, treatment of specific psychological disorders, and if session length preference was based on theoretical orientation or procedures/techniques. A total of 65 practicing therapists drawn from the International Society for the Study of Dissociation, EMDR International Association, Trauma Incident Reduction Practitioners, San Francisco Society of Lacanian Study, and California Psychological Network completed questionnaires regarding their perceptions about psychotherapy for individuals employing longer session lengths versus the standard 50-minute session.Overall frequencies of questionnaire responses and between groups comparisons were analyzed using Chi-Square. The sample endorsed the use of longer sessions at statistically significant frequencies on the following questionnaire items: three therapeutic outcome items: Increases client's satisfaction, Shortens overall duration of therapy, and Facilitates corrective emotional experience; and nine therapeutic process items: Access to client's emotional material, Integration of experience before leaving session, Deepens development of transference, Working through defenses, Access to traumatic experiences, Integrate traumatic experience within session, Working through traumatic experience, and Improving likelihood of breakthrough experiences. The sample also agreed on the use of longer sessions as potentially contributing to positive outcome for treatment of the following disorders: Substance Abuse, Panic Disorder, Agoraphobia, Specific Phobia, Social Phobia, PTSD, GAD, and Eating Disorders. The findings of this study suggest that longer session lengths may have a positive impact on therapeutic process, therapeutic outcome, and certain disorders. Specific implications for the field of psychology and suggestions for research are discussed. [Author Abstract]

Dissertation Abstracts International: Section B: The Sciences and Engineering. 65(12-B), 2005, pp. 6680.

Keywords: Empirical Study  Health Personnel Attitudes  Individual Psychotherapy  Posttraumatic Stress Disorder  Psychotherapeutic Processes  PTSD  Quantitative Study  Treatment Duration  Treatment Effectiveness  

Accuracy Verified: Yes


11. Rose, L. (2012). Eye movement desensitization and reprocessing: An exploration from science to soul. Pacifica Graduate Institute, Carpinteria, CA. 1507791.

Language: English

Format: Dissertation/Thesis

Abstract:
Eye Movement Desensitization and Reprocessing (EMDR) is a treatment for trauma that has been approached primarily from cognitive-behavioral and neurobiological perspectives. This thesis explores the notion that much of EMDR's effect in the way of transformation and healing trauma is due to its ability to provoke imagination. The possibility of EMDR's connection with the imaginal faculty of the psyche is investigated with an emphasis on the qualities of EMDR that are grounded in depth psychology principles. Trauma and the importance of imagination in the healing process are discussed from the approach of the analytical and archetypal schools of psychology in addition to current bioscience perspectives. The research methodology used is alchemical hermeneutics, which facilitates the mining of unconscious material through transference dialogues. The thesis demonstrates that EMDR, when practiced within the context of depth psychology, is one avenue for activating significant, transformative imagery and accessing the unconscious to facilitate healing.

Keywords: Archetype  Biological Sciences  Dream  

Accuracy Verified: Yes


12. Maltz, W. (1995, June). Healing the sexual problems caused by sexual abuse. Presentation at the EMDR Network Conference, Santa Monica, CA.

Language: English

Format: Conference

Abstract:
Sexual abuse is abuse to a person's sexuality. It can seriously harm the development of healthy sexual attitudes, self-concept, and behavior. In particular, survivors are often troubled by a variety of sexual problems, such as, fear and avoidance of sex, approaching sex as an obligation, automatic negative reactions to touch, difficulty becoming aroused or feeling sensation, emotional detachment during sex, disturbing sexual thoughts and fantasies, compulsive sexual behaviors, difficulty with intimate partners, and sexual functioning concerns. EMDR is a technique which can effect significant changes in cognition, sensation, and emotional experience. It can be a powerful tool to help survivors reprocess traumatic material blocking healthy sexual experience. But because sex is often an extremely loaded issue for survivors, and EMDR is seen as technique in which the therapist "does something" to the client, precautions must be taken to avoid negative, retraumatizing reactions and increase positive results. Due to the high potential for negative transference in sex therapy with survivors, the therapist must present the EMDR technique in a style which values client safety and empowerment. This can involve associating the techque with safe images and prior positive experiences, developing relaxation and containment skills, and modifying the physical aspects associated with the technique. There are a variety of sexual concerns which respond well to EMDR intervention. EMDR can be used to help replace old negative messages about sex with new messages which view sex as based on consent, equality, respect and safety. Sexual self-concept can be improved as survivors undo irrational belief systems which blame their sexuality and/or sexual parts for having caused the abuse. EMDR can help introduce new experiences of self-forgiveness and self-acceptance. EMDR can also help desensitize particular objects, sexual settings, types of touch, and associations to the intimate partner which trigger negative reactions. Therapists who focus on sexual healing need to be familiar with a variety of sexual healing techniques. These include the sexual response cycle exercise, relearning touch exercises, techniques for healing unwanted sexual fantasies, and techniques for improving sexual functioning. Therapists can use EMDR to help survivors work through blocks and impasses encountered with the techniques.

Keywords: Sexual Abuse  Sexual Issues  

Accuracy Verified: Yes


13. Leeds, A. M. (1997, July). In the eye of the beholder:  Reflections on shame, dissociation, and transference in complex post-traumatic stress and attachment disorders. Presentation at the annual meeting of the EMDR International Association, San Francisco, CA.

Language: English

Format: Conference

Abstract:
This paper covered material on how affect theory, attachment theory and EMDR theory can help with case formulation and treatment planning. This paper provided the first in depth presentation on Resource Development and Resource Installation which previously had been presented only at EMDR Institute trainings at speciality presentations. [Author abstract]

Keywords: Neurobiological Correlates  RDI  Resource Development and Installation  Shame  

Accuracy Verified: Yes


14. Marcus, S. (2005, September). Integrated EMDR headache treatment. Presentation at the annual meeting of the EMDR International Association, Seattle, WA.

Language: English

Format: Conference

Abstract:
Ninety percent of the American public gets occasional headaches. An estimated fifty million Americans have severe re-occurring headaches. Up until now, the primary treatment for headaches has been pharmaceuticals. This workshop seeks to familiarize you with a non-medication natural alternative for the treatment of headaches that utilizes EMDR. This workshop will employ lecture, demonstration and actual practice of the Integrated EMDR approach. The purpose of this teaching strategy is to prepare you for clinical practice. Objectives include understanding headache etiology, headache trigger identification, threshold theory, training in the integrated EMDR prorocol used in Dr. Marcus' headache research, discussion of protocol utilization in clinical practice, informed consent, transference issues, and discussion of the role of provider when deploying this approach. This workshop is for advanced EMDR practitioners but previous experience in headache treatment is not required.

Keywords: Headache  

Accuracy Verified: Yes


15. Heber, R., Linnihan. C., Butler, P., Leighton, J., & Knipe, J. (2003, September). Integrating EMDR and psychoanalytic psychotherapies. Symposium conducted at the annual meeting of the EMDR International Association, Denver, CO.

Language: English

Format: Conference

Abstract:
The symposium will explore integration of EMDR into analytic framework and promote a dialogue among clinicians of various orientations. The chair will provide overview and panelists will present three cases representing somewhat different orientations. Issues addressed will include reason for doing EMDR, timing, ways of introducing and incorporating EMDR, relational considerations, and challenges of identifying and dealing with such phenomena as transference, countertransference, enactment or resistance. Discussant will provide additional perspective by reframing some analytic constructs in term of the EMDR trauma-based, information processing model. Second part will consist of audience participation and discussion. Case materials are invited. Clinicians from all perspectives (analytic, cognitive, etc.) are encouraged to participate.

Keywords: Psychoanalytic Psychotherapies  Symposium  

Accuracy Verified: Yes


16. Grand, D. (1995, June). Integrating EMDR into the psychodynamic treatment process. Presentation at the EMDR Network Conference, Santa Monica, CA.

Language: English

Format: Conference

Abstract:
The discovery of EMDR (Eye Movement Desensitization and Reprocessing) has led to a structured treatment model conceptualized in cognitive constructs (the three pronged approach). Based on the diagnostic and treatment situation, this may or may not, be easily integrated into a psychodynamic (insight oriented) treatment approach. However, I have empirically found a dramatic, acceleration and deepening of the psychodynamic treatment process with patients when flexibly utilizing EMDR in session. This presentation will explore the different applications of EMDR incorporating Freudian, ego psychological, separation/individuation and self psychological theories with practice wisdom derived from extensive case material. Attention will be given to the associative process, screen memories, dream work, resistance, transference, countertransference and character analysis. The structural (id, ego and superego) and topographical (unconscious, preconscious and conscious) models of the mind as well as the listening process will be examined as they inform the use of EMDR. Particular focus will be devoted to how the cognitive interweave can be expanded conceptually to incorporate the techniques of interpretation and mirroring. The anxieties, resistances and allegiance issues evoked in the psychodynamically trained therapist, as they attempt to integrate EMDR into their practices will also be addressed.

Keywords: Psychodynamic  

Accuracy Verified: Yes


17. Heber, R., & Shapiro, S. (2002, June). Integrating EMDR with psychoanalytic constructs in dealing with open-ended trauma. Presentation at the annual meeting of the EMDR International Association, San Diego, CA.

Language: English

Format: Conference

Abstract:
Recent acts of terrorism dictate re-examination of therapeutic srrategies when dealing wlth traumatic events without true closure and involving environmental stressors common to therapist and client. Thc participant will learn to 1) identify issues that arise open-ended and and shared events; 2) identify and address transference, counter-transference and subjective counter-transference; 3) the therapist's own triggers, responses, and needs for personal support; 4) utilize the client's narrative to identify past and current issues and client coping methods. Case illustrations will be included.

Keywords: Open-Ended Trauma  Psychoanalytic Constructs  

Accuracy Verified: Yes


18. Dworkin, M. (2003, June). Integrative approaches to EMDR:  Empathy, the intersubjective, and the cognitive interweave. Journal of Psychotherapy Integration, 13(2), 171-187. doi:10.1037/1053-0479.13.2.171.

Language: English

Format: Journal

Abstract:
EMDR represents an integrative model of psychotherapy at the theoretical level. During its 16-year history, it has created quite a controversy in academic psychology. Missing from these debates have been additional therapeutic elements that are necessary to propel productive thinking into ways of making greater use of the model. These elements—empathy, the intersubjective, and usage of the cognitive interweave in conjunction with transference and countertransference issues—are explored. This addition constitutes an assimilative approach to an ever-evolving model of resolving posttraumatic stress disorder.

Keywords: Empathy  Intersubjective  Cognitive Interweave  Cognitive Processes  Countertransference Integrative Model  Integrative Psychotherapy  Interpersonal Interaction  Models  Posttraumatic Stress Disorder  Psychotherapy  PTSD  Transference  Psychotherapeutic Transference  Subjectivity  

Accuracy Verified: Yes


19. Snyker, E. (1998). The invisible volcano: Overcoming denial of rage. In P. Manfield (Ed.), Extending EMDR: A casebook of innovative applications, (1st ed.) (pp. 91-112). New York: W. W. Norton. xii, 292 pp.

Language: English

Format: Book Section

Abstract:
The case in this chapter integrates EMDR and interpretive short-term dynamic therapy as contrasted with cognitive, interpersonal, or existential short-term therapies. I became interested in Davanloo's technique of intensive short-term dynamic psychotherapy (ISTDP) after attending a workshop in 1981. Short-term dynamic therapy, which is rooted in psychoanalytic theory, emphasizes brevity, focus, therapist activity, and patient selection. The goal is to effect change in the personality or character structure of the person, not simply alleviate symptoms. The treatment is dynamic in that it emphasizes a single focal issue that serves as a link to core conflicts arising from early life experiences. The transference relationship is used to examine and reexperience important past relationships that account for current difficulties. In addition to dealing with issues of transference and complexity of the case (single versus multi-foci), handling resistance (conscious and unconscious) aimed at avoiding painful affects must be addressed. [Text, p. 91]

Keywords: Adults  Americans  Anger  Anxiety Disorders  Brief Psychotherapy  Case Report  Child Abuse  Defense Mechanisms  Depressive Disorders  Females  Life Experiences  Psychotherapeutic Processes  Survivors  Treatment Effectiveness  

Accuracy Verified: Yes


20. Woller, W. (2004, June). Is there a place for EMDR in the treatment of personality disorders?. In complex traumatisation and EMDR (K. Linder, Chair). Symposium conducted at the EMDR Europe Association annual meeting, Stockholm, Sweden .

Language: English

Format: Conference

Abstract:
There is substantial evidence that EMDR is an effective treatment method un posttraumatic stress disorder (PTSD). However, comorbid disorders have to be taken into account when treating PTSD with EMDR. Personality disorders are a frequent comorbid disorder of PTSD, and a high prevalence of childhood traumatization has been found in personality disorders as well. Given this background, the paper to be presented discussed (1) modifications and limitations of EMDR technique required for treatment of posttraumatic stress disorder with comorbid personality disorders, and (2) further applications of EMDR in the treatment of personality disorders without PTSD. If comorbid personality disorder is present, EMDR has to be integrated into a complex treatment plan which includes stabilization, symptom control, resource installation, identification of distorted interpersonal perceptions, and modification of maladaptive interpersonal interactions. Because of the central role of generalized negative beliefs in maintaining cyclical maladaptive patterns, EMDR is regarded a valuable tool to modify negative beliefs along with processing traumatic memories and body sensations, Problems of therapeutic alliance due to transference phenomena and acting out can make stabilization difficult and time-consuming. EMDR technique should be subjected to important modifications depending on personality disorder subtype, defence structure and symptomatic comorbidity. Structural dissociations of the personality (e. g., as in dissociative identity disorder) call for a consideration of all ego-sates of the personality system before planning EMDR treatment. In addition to unresolved trauma, current and future interpersonal stressors can be chosen as EMDR targets.

Keywords: Personality Disorders  Symposium  Trauma  

Accuracy Verified: Yes


21. Mosquera, D. (2012, March). Met behulp van EMDR bij de behandeling van borderline-stoornis bersonality [Using EMDR in the management of borderline personality disorder]. Preconference presentatie op de 6e congres van de Vereniging EMDR Nederland, Arnhem, Nederland .

Language: Dutch

Format: Conference

Abstract:
Onveilige en ongeorganiseerd bijlagen en het begin van relationele verwaarlozing en trauma diepgaand effect op het ontwikkelingstraject van de toekomstige volwassen en verhogen het risico op het ontwikkelen Borderline persoonlijkheidsstoornis (BPD). Mensen met een borderline-stoornis en een geschiedenis complex trauma hebben veel problemen met zelfregulering en met betrekking tot anderen. Het beheer van deze zelfregulering en relationele problemen zijn centrale aspecten in de behandeling van BPS. De stabilisatiefase is opgemerkt als essentieel oor trauma werk. Bij de behandeling van de borderline-stoornis en complexe trauma betekent dit vele bijzonderheden die we moeten in gedachten houden, waaronder: de rol van gehechtheid-gerelateerde gemoedstoestanden en fobieën voor de bevestiging, beïnvloeden en traumatische herinneringen. Werken met gevallen van BPS en complex trauma is intrinsiek relationeel en vaak gepaard gaat met de noodzaak om momenten van intense beïnvloeden en invloed hebben op fobieën beheren in de overdracht en tegenoverdracht. Inzicht in deze aspecten en met strategieën voor het aanpakken van hen is van essentieel belang zowel voor als tijdens EMDR opwerking van traumatische herinneringen om ervoor te zorgen dat de verwerking van traumatische herinneringen veilig en effectief kan worden gedaan met deze patiënten. Deze workshop integreert theoretische uiteenzetting met de presentatie van video's gevallen. De algemene structuur van EMDR therapie bij de behandeling van BPD, interventies in de voorbereidings-en overwegingen voor trauma-gerichte EMDR werk zal worden gedemonstreerd en uitgelegd.

Insecure and disorganized attachments and early relational neglect and trauma profoundly affect the developmental trajectory of the future adult and increase the risk of developing Borderline Personality Disorder (BPD). People with BPD and a history complex trauma have many difficulties with self-regulation and relating to others. The management of these self-regulation and relational difficulties are central aspects in the treatment of BPD. The stabilization phase has been remarked as essential prior to trauma work. In treating BPD and complex trauma this implies many particularities that we should keep in mind including: the role of attachment-related states of mind and phobias for attachment, affect and traumatic memories. Working with cases of BPD and complex trauma is intrinsically relational and often involves the need to manage moments of intense affect and affect phobias in the transference and countertransference. Understanding these aspects and having strategies for addressing them is essential both before and during EMDR reprocessing of traumatic memories to ensure that reprocessing of traumatic memories can be done safely and effectively with these patients. This workshop integrates theoretical exposition with the presentation of videos cases. The general structure of EMDR therapy in treating BPD, interventions for the preparation phase and considerations for trauma-focused EMDR work will be demonstrated and explained.

Keywords: Borderline Personality Disorder  

Accuracy Verified: Yes


22. Manfield, P. (1995, June). Narcissistic disorders:  Using EMDR with these difficult clients. Presentation at the EMDR Network Conference Santa Monica, CA.

Language: English

Format: Conference

Abstract:
Definition of client population: Disorder of the self. The narcissistic character is often identified by his or her grandiose facade concealing an underlying sense of emptiness and worthlessness. To experience the underlying emptiness is so painful for them that these people cut off their inner experience and rely instead on external admiration and praise to support their grandiose or superior view of themselves; their condition is often referred to as a "disorder of the self." Because of their dependence on others for their sense of themselves, they are exquisitely sensitive to criticism or disapproval, often warding off deflation by becoming increasingly grandiose, superior, disdainful or demeaning. Many conceal their grandiosity, maintaining a secret sense of superiority which may be based upon their perfectionism or their quiet devaluing of others. View of others: there is a range of severity of the narcissistic character from personality disorders to a narcissistic character style. People with personality disorders, are unable to form a trusting bond with another person; they view people primarily as interchangeable, performing a function which could equally be performed by many others. Less impaired narcissistic characters, however, are able to form varying degrees of attachments to other people, although their ability to trust and care about other people is limited. Most commonly they relate to people they can idealize or be admired by. People tend to be seen in extremes as either superior and powerful or inferior and worthless; supportive and admiring or critical and attacking. Difficulties in using EMDR: Clinically these clients represent a difficult and often frustrating population to treat; they are brittle and easily injured if they to not feel perfectly understood by their therapists, and they will distance at the slightest hint that they are being judged or used. They resist focusing inward and defining their problems as arising within themselves, and find it difficult to sustain any genuine affect, other than perhaps rage. If they feel understood and accepted, however, they will eventually talk about their sense of emptiness and worthlessness and their confusion about who they are and what is truly meaningful and valuable to them. Beck, Young and others have described factors that make it difficult to treat any personality disorder using a cognitive behavioral approach. There have in fact been very few reported "successes" in the literature. Most of the difficulties are related to the self and object splitting characteristic of these clients. These clients have limited access to feelings, limited access to spontaneous thoughts, body sensations, memories, etc., and vague unfocussed presenting problems making targeting difficult. They usually have difficulty with emotional and often intellectual continuity from session to session; they will rarely keep a log or follow through with homework; transference issues often come into central focus and must be addressed before other targets; and their selfdefeating beliefs and behavior patterns are extremely deeply held, pervasive and resistant to change. In addition to varying degrees of these difficulties, narcissistic clients present all of the problems in EMDR that they do in more traditional therapies; including their tendencies to act out, deny, and avoid. These and other defenses interfere with completion of segments of therapeutic work and make it difficult for the clinician to keep work focused within one neural network. Self and object splitting leads to continuity problems within or between sessions and a difficulty maintaining clarity about the reason for being in treatment. The client may feel suicidal one week and declare himself or herself to be fully recovered the next. Perhaps the most confirming aspect of the treatment of these clients, however, is their emotionally impoverished pasts; they have very limited experience of nurturing, loving and caring to draw !?om in order to interweave new meanings and perspectives into traumatic or painful past experiences. Length of treatment: I have found that I have been able to achieve good results with higher level narcissistic clients with whom I have had an established relationship at the time I introduced EMDR into the treatment. My results with clients who have come to therapy asking specifically for EMDR and with whom I have begun using EMDR soon after the beginning of treatment have been generally poorer, varying with the severity of the client's disorder, the less severe doing best. The client needs to be able to establish a meaningful trusting relationship with the therapist; the more severe the client's difficulties with attachment, the more time this process requires. Narcissistic clients do not tend to see their difficulty with vulnerability, trust and intimacy as a problem within themselves. If they are able to recognize personal problems, they are usually in the area of self esteem and obstacles to achievement. When they are able to resolve some of these latter problems fairly rapidly through treatment they tend to terminate, no longer seeing a sufficient purpose for treatment. In a sense, they can become better narcissists; their grandiose view of themselves is enhanced and they are reinforced in their use of self-sufficiency as a defense against interpersonal vulnerability. I view the relative efficiency of EMDR as a problem for deeper treatment of narcissistic clients because there is less time for the therapeutic relationship to develop and consequently a limited opportunity to impact the client's object splitting. I believe that this is why I have found EMDR with narcissistic clients to be most effective when it is introduced after a therapeutic relationship has had time to develop. Negative cognitions: The early maladaptive schemas of narcissistic clients are pervasive in their lives and point to a plethora of negative cognitions. Typical early schemas are: I must control myself (or my feelings, my behavior, my body) at all times; no one cares; my needs will never be met; I can't trust anyone; I am deeply flawed and unlovable; I am dikeable, unattractive to others; I will always fail; my flaws are totally unacceptable to others; I must be perfect or I am worthless; I deserve to be treated more specially than others; I must please others to avoid attack; I'm alone; nobody understands me; I am OK if I am better than others; I am OK only if others admire me. It is often helpful to narrow these cognitions down to make them manageable with EMDR Treatment: In addition to the recommended protocol of establishing a safe space to which the client can retreat if necessary, before doing an EMDR session with one of these clients, the therapist should identify as many of the client's emotional resources possible, in particular expriences if any of having felt loved and accepted ad examples of loving people or relationships the client has observed Among other things, these facilitate more effective copitive interweaves. The initial task in doing an EMDR session with this client population is to establish an appropriate and richly defined target. Since it is more difficult for these clients to access meanm&l memories in an emotionally alive way, the therapist must be more active in helping the client stimulate the associated neural netork as I l l y as possible. In addition to the client's reaction to the plight of children he may be related to or observe (Level I1 training), a rich source of emotional responsiveness and resources is the client's own response to situations he has witnessed in news media, TV, movies or theater. A major challenge in addressing a narcissistic character type using EMDR is tracking the course of the session with these clients and identifying when they drip out of the targeted neural network. This process can be subtle because it requires an ability to differentiate true avoidance hm spontaneous associations which may appear at hat to be irrelevant; it requires a familiarity with and sensitivity to the protective or defensive mechanisms they use to insulate themselves fiom painful memories and affect. As the patterns ofmovement in and out of the targeted network are identified it is important to use interventions that are experienced by the client as supportive but nevertheless make hun or her aware of having wandered. Although the narcissistic client may initiate treatment with the stated goal of improving his performance in specified areas, he will agree upon reflection that the real problem is that he feels an overriding need to perform in order to feel worthwhile. Since he has never known any other way of dealing with his self-worth, he will be skeptical about whether it is possible to feel a sense of worth that is not based upon performance, and it is easy for the therapist to lose perspective and join him in that beliet especially while doing EMDR with its potential for reprocessing with extraordinary precision specific obstacles to performance. The therapist must, however, retain her healthy perspective if the client is to learn to accept himself. For more clinical information about treating disorders of the self: 1.)Beck, Aaron T., et al, Cognitive Therapy Of Personality Disorder Guilford Press, New York, N. Y., 1990 2.)Manfield, Philip, Split Self/Split Object: Understanding And Treating Borderline, Narcissistic And Schizoid Disorders, Jason Aronson Publishers, Northvale, N.J., 1992. 3.)Young, Jeffrey, E, Cognitive Therapy For Personality Disorders: A Schema-Focused Approach, Professional Resource Exchange, Inc., Sarasota, Florida, 1990.

Keywords: Narcissistic Personality Disorder  

Accuracy Verified: Yes


23. Schore, A. (2009, August). Part I: Right brain affect regulation: An essential mechanism of development, trauma, dissociation and psychotherapy. Plenary at the annual meeting of the EMDR International Association, Atlanta, GA.

Language: English

Format: Conference

Abstract:
Dr. Schore will discuss current models of the neurobiology of attachment, detailing the enduring positive and negative impact of interactively regulated and dysregulated bodily-based affective transactions on the organization of the infant’s developing right brain, which for the rest of the life span is dominant for the nonconscious processing of emotions, stress regulation, and intersubjectivity. Dr. Schore will then describe the negative impact of relational trauma on the developmental trajectory of the right brain and the origins of pathological dissociation. Applying the developmental model to the change process of psychotherapy, he will then describe the critical role of the right brain in implicit facial, gestural, and prosodic communications within the therapeutic alliance, in dysregulated states of affective hyper- and hypoarousal, and in empathy, transference-countertransference, and affect regulation. This work suggests that interactive regulation within the therapeutic alliance is a central mechanism in the treatment of patients with a history of early relational trauma.

Keywords: Dissociation  Mechanism  Plenary  Right Brain Affect Regulation  Trauma  

Accuracy Verified: Yes


24. Perkins, B. (2001, June). Psychoanalysis and EMDR: A theoretical and clinical bridge. Presentation at the annual meeting of the EMDR International Association, Austin, TX.

Language: English

Format: Conference

Abstract:
Participants will learn to identify: 1) the role of transference in psychotherapy in general and EMDR in particular; 2) the developmental levels of Lawrence Hedge's psychoanalytic model; 3) the influence of developmental states on later traumatic events; and 4) how the therapeutic relationship can come to constitute the essential non-traumatic relational pole of the EMDR process iself.

Keywords: Larence Hedge's Psychoanalytic Model  Psychoanalysis  Transference  

Accuracy Verified: Yes


25. Hans Snijders, H., Oprel, D., & Romer, C. (2006, Januari). Psychotherapie leeft! De bruisende ontwikkelingen in de psychotherapie zelf [Psychotherapy is alive! The exciting developments in psychotherapy itself]. Tijdschrift voor Psychotherapie, 32, 144–147. doi:10.1007/BF03062215.

Language: Dutch

Format: Journal

Abstract:
Dit drukbezochte congres begon met drie workshops waarin ‘nieuwe’ behandelvormen werden gepresenteerd: Transference focused psychotherapy (TFP), de Kortdurende psychoanalytische steungevende psychotherapie (KPSP) en de Eye movement desensitisation and reprocessing (EMDR) bij kinderen. Van de laatste ontbreekt helaas een impressie in dit verslag. In de wandelgangen bleek dat deze workshop hooglijk gewaardeerd werd.

This busy conference began with three workshops in which 'new' forms of treatment were presented: Transference focused psychotherapy (TFP), the Short-term psychoanalytic supportive psychotherapy (SPSP) and Eye Movement Desensitisation and Reprocessing (EMDR) in children. Of the latter sadly lacking an impression in this report. In the corridors showed that this workshop was highly appreciated.

Keywords: Children  Practice  Theory  

Accuracy Verified: Yes


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

Language: English

Format: Conference

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

Keywords: Relationship Issues  Trauma  

Accuracy Verified: Yes


27. Dworkin, M., & Bender, S. (2000, September). The role of transference and countertransference in EMDR. Presentation at the annual meeting of the EMDR International Association, Toronto, Ontario Canada.

Language: English

Format: Conference

Abstract:
Participants will be able to: 1) identify countertransference issues in an EMDR session; 2) apply knowledge of transference and countertransference during any phase of EMDR therapy protocol; and 3) employ proactive stratgegies such as cognitives interweaves utilizing transference and countertransference principles.

Keywords: Cognitive Interweave  Countertransference  Transference  

Accuracy Verified: Yes


28. Schubbe, O. (2011, June). Self care during the EMDR session: The application of the standard protocol for working with counter-transference. Presention presented at the annual meeting of the EMDR Europe Association, Vienna, Austria.

Language: English

Format: Conference

Abstract:
Secondary traumatization and appropriate self care are relevant current topics for psychotherapists, especially when working with complex trauma. During the application of the standard protocol, EMDR therapists are often confronted with reports of severe traumatic incidents, strong emotions, and different forms of transference. In reaction, they experience post-traumatic counter-transference, and sometimes even secondary trauma. The EMDR standard protocol provides the opportunity for dual application - parallel for client and therapist. Through processing of the initial counter-transference, the therapist experiences a unique EMDR process. This process resolves any disturbance that might occur through counter-transference issues. Learning objectives: The therapist can better support the EMDR process of the client, e.g. through more creative ideas for cognitive interweaves. The indication and contra-indications for this procedure will be discussed.

Keywords: Countertransference  Self-Care  

Accuracy Verified: Yes


29. Dworkin, M. (2010, March). Solving transference and counter-transference with dissociative disorders in EMDR. Presentation at the 8th EMDR Association UK & Ireland Annual Conference & AGM, Dublin, Ireland.

Language: English

Format: Conference

Abstract:
Chair, Michael Paterson
This workshop will focus on the types of transference and counter-transference that arise in EMDR with dissociative clients and teach solutions. Procedural modifications have been the focus in dealing with pathological dissociation in EMDR treatment. Separately, transference and counter-transference with dissociative patients have been written about extensively by experts in the dissociation field. Research findings about the effects of mirror neurons and embedded simulation on the inter-subjective field of patient and therapist have also been published. Strategies for dealing with these transference and counter-transference in EMDR treatment have received little attention even though this population has intense transference, and can activate intense counter-transference. These issues may begin during an evaluation of the presenting problems. Strategies for identifying and using transference to enhance dual awareness during history taking will be demonstrated. An elongated preparation phase to develop enough trust and stabilization before exploring traumatic memories can limit induced transference. Different parts of a dissociative patient may have different kinds of transferences. These transferences may cause the patient to withdraw, cling or attack; affecting the therapist’s abilities to stay attuned and focused on the work in different phases of EMDR. Strategies of attunement to the activated part of the client will be demonstrated in order to repair or prevent ruptures of attunement. Interactions are bi-directional, and different (transferential) parts may activate dissociative parts of the therapist. Strategies to somatically identify and use these counter-transferential activations in the therapist will be taught through body based awarenesses. R/D/I strategies can be used to limit countertransference to remain grounded and attuned. Transference and counter-transference during the assessment phase will be identified and solutions presented. During the Desensitization phase under-accessing or over-accessing target memories; abreaction vs. vehement emotions will be discussed as unacknowledged dissociative moments with indications for inducing transference, counter-transference, or both. Decisions need be made collaboratively whether to process or contain these events. Understanding and dealing with dilemmas of dissociative enactments are crucial to keeping the healing process going. These inter-subjective issues may be most intense during the first four phases, but some problems may continue into Installation and the Body Scan. Problems and solutions during Incomplete Closure and the Re-evaluation phases will be given. Activated parts in the patient may cling or be angry with the therapist at the end of an EMDR session. Failure or defectiveness parts of the therapist may become activated as well. Solutions to these issues that occur during different phases will be taught so that participants will leave the workshop with additional strategies to use with their dissociative patients. Attunement to dissociative parts, identifying transference and counter-transference binds; The Clinician Self Awareness Questionnaire ; Compartmentalization; use of self soothing skills; using Relational, Empathic, and Transferential Interweaves; identifying moments of projective identification and enactments, and then to use them to deepen EMDR will be taught, as well as innovative inter-subjective strategies . Case examples and awareness exercises will used throughout the workshop to facilitate intellectual and experiential learning.

Keywords: Counter-transference  Dissociative Disorders  Transference  

Accuracy Verified: Yes


30. Dworkin, M. (2009, August). Solving transference and countertransference with dissociative disorders in EMDR. Presentation at the annual meeting of the EMDR International Association, Atlanta, GA.

Language: English

Format: Conference

Abstract:
This workshop will focus on transference and countertransference problems and solutions in EMDR with dissociative clients. There will be a short literature review on procedural modifications in dealing with dissociation in EMDR, and transference and countertransference with dissociative patients. Research findings on mirror neurons and embodied simulation will be taught to enhance the participant’s understanding of the neurobiological substrates for attunement and resonance, and for solving transference and countertransference with dissociatives in EMDR when ruptures to relatedness occurs. Identifying and using transference reactions to enhance dual awareness will be demonstrated in history taking. Enhancements in preparation phase will be shown through case example to limit induced transference. Transference and countertransference during the assessment phase will be identified and solutions offered. In the Desensitization phase EMDR processing may induce transference, countertransference, or both (even with procedural modifications). Intersubjective challenges seem to be more intense during phases 1 -4 and 7-8. Activated parts in the patient may cling or be angry with the therapist at the end of an EMDR session, or during Re-evaluation. Failure or defectiveness parts of the therapist may become activated then as well. Different parts of a dissociative patient may appear with different kinds of transferences during different EMDR phases. These transferences challenge therapist’s abilities to stay attuned. Strategies of attunement to the activated part of the patient will be demonstrated in order to repair or prevent ruptures to the alliance and to understand the nature of the dissociated communication. Bi-directional interactions may activate parts of the patient and therapist without conscious awareness. Strategies to somatically identify and use these countertransferential activations will be taught through experiential exercises so that the therapist may have a more in depth understanding of the dissociative patient’s communications. R/D/I strategies will be reviewed and applied to the therapist to limit countertransference activations. Dealing with dissociative enactments are crucial to identify ruptures to the therapeutic alliance, restore attunement and resonance, uncover dissociative messages that can be used during EMDR processing.. Solutions to the problems that occur during different EMDR phases will be taught using lecture, discussion, case examples, written and experiential exercises so that participants will leave the workshop with additional strategies. Solutions include how to maintain attunement to dissociative parts during transferential activations while enhancing dual awareness; how to identify transference and countertransference problems during phases 1-4 and 7-8 and use them as additional sources of dissociated communications that can be used in EMDR processing ; how to use the Clinician Self Awareness Questionnaire to identify and process countertransference problems ; how to use compartmentalization strategies using R/D/I to limit countertransference activations; how to develop self soothing skills for the therapist’s dissociated parts; how and when to use Relational, Empathic, and Transferential Interweaves during Desensitization; and how to identify moments of enactments, and using EMDR strategies to deepen the EMDR experience .

Keywords: Countertransference  Transference  

Accuracy Verified: Yes


31. Dworkin, M. (2009, June). Solving transference and countertransference with dissociative disorders in EMDR. Presentation at the annual meeting of the EMDR Europe Association, Amsterdam, the Netherlands.

Language: English

Format: Conference

Keywords: Countertransference  Transference  

Accuracy Verified: Yes


32. Woller, W. (2010, July). Therapeutic relationship in the treatment of traumatized clients with personality disorders. Preconference presentation at the 1st EMDR Asia Conference, Bali, Indonesia.

Language: English

Format: Conference

Abstract:
Therapeutic relationship is often a major challenge in the treatment of traumatized clients with comorbid personality disorders. Maladaptive interpersonal styles and negative transferences resulting from attachment trauma can make a trauma-oriented therapy very difficult. However, an understanding of personality disorders as a consequence of attachment trauma creates new therapeutic possibilities for patients who are considered difficult to treat though urgently in need of therapy. Given this background, the workshop aims at enhancing the participants’ capacity to manage problems of therapeutic relationship in traumatized clients with personality disorder. In the first part of the workshop, an overview on possible neurobiological causes of specific patterns of experiencing and behavior in personality disorders will be given. Deficits in emotion regulation, mentalization function, and personality integration, all of which have been identified as underlying dysfunctional and self-destructive behavioral patterns, can be understood as consequences of attachment trauma. In the second part of the workshop, a phase-oriented treatment conception will be presented which combines elements from resource-oriented trauma therapies with aspects of a psychodynamic understanding of attachment relationships. In the framework of this concept, the notions of transference and countertransference will be introduced to explain difficulties typically arising in the relationship with traumatized clients with severe personality disorders. On the basis of case material, strategies will be presented to deal with recurrent problems of therapeutic relationship.

Keywords: Interpersonal Relationship  Personality Disorders  

Accuracy Verified: Yes


33. Haskin, P. S. (2005). Trauma and the relational matrix: The therapeutic relationship in eye movement desensitization reprocessing (EMDR): A project based upon an independent investigation. Smith College School for Social Work, Northampton, MA.

Language: English

Format: Dissertation/Thesis

Keywords: Countertransference  Intersubjectivity  Transference  

Accuracy Verified: Yes


34. Manfield, D. C. (1998). Treating a highly defended client: reworking traditional approaches. In P. Manfield (Ed.), Extending EMDR: A casebook of innovative applications, (1st ed.) (pp. 217-231). New York: Norton.

Language: English

Format: Book Section

Abstract:
Several key points emerge for consideration when treating the highly defended client with EMDR, in particular clients whose primary defenses are distancing ones. The first is to carefully gauge the client's level of functioning, the depth of therapeutic alliance, and the client's perceived sense of safety. These factors determine the appropriateness of EMDR, and presuming that, the style and directiveness of the clinician.Secondly, the use of EMDR with highly defended clients may require a directiveness that exceeds the basic protocol designed by Shapiro. Once the therapeutic alliance has been established, the clinician must balance, while being sensitive to, the client's need for control over the therapeutic process, hopefully avoiding unproductive periods of defensive distancing. This balance and sensitivity, inherent in all effective treatments and psychotherapies, is particularly important when the modality is as potent and emotionally evocative as EMDR can be. The case of William illustrates the risks in a directive approach, such as initiating EMDR too early, promoting a withdrawing or angry transference, or choosing the wrong cognitions. Knowing your client well and securing an effective working alliance is crucial to success. [Text, pp. 230-231]

Keywords: Adults  Americans  Anxiety Disorders  Case Report  Defense Mechanisms  Life Experiences  Male  Psychotherapeutic Processes  Self Concept  Survivors  Treatment Effectiveness  

Accuracy Verified: Yes


35. Marcus, S. (2007, June). Treating headaches with EMDR. Presentation at the annual meeting of the EMDR Europe Association, Paris, France.

Language: English

Format: Conference

Abstract:
Headaches are the most common pain-related complaint and the seventh leading ailment seen in medical practice. Yearly, over 35% of the population is affected by tension-type headaches. Migraine headaches are a common condition with one-year prevalence rates around 15%. Prevalence rates generally peak in the third and fourth decades but for many migraines become a chronic condition requiring a lifetime of treatment.
Migraine sufferers are frequently disabled during their acute attacks. A 2001 study found that 90% of migraineurs reported functional impairment. 53% required bed rest and nearly 30% missed 1 day of work or school within a 3-month period. Migraine in the USA results in 112 million bedridden days per year. The cost of the migraine to the total American work force is estimated at $13 billion per year in missed work days and lost productivity. Direct medical costs (i.e., MD office visits, prescription medication claims, and hospitalizations) for migraine care average $1 billion annually. Clouse & Osterhaus (1994) found that migraineurs generate twice the medical claims and two times the pharmacy claims in HMO’s when compared to patients without migraines.
Considering the sheet number of individuals afflicted with migraine and tension headaches, the societal impact with increased medical costs, lost work days, and reduced productivity represent a major public health concern.
The pharmacologic therapies have long been the most common and widely used method of treating headaches. Unfortunately, pharmacologic treatments are ineffective or inadequate for a sizeable number of patients. One third of patients participating in clinical trials with oral triptans fail to respond. Moreover, fewer than half become pain-free, which is the primary efficacy measure recommended by the International Headache Society. Reasons for considering an EMDR treatment for migraine and tension headaches are patient preferences for non-pharmacologic interventions, pregnancy, planned pregnancy or nursing, deficient stress coping skills, medication rebound, patient overuse of medications, medical contraindications, and poor medication tolerance.
In view of the state of the art of current headache treatment an EMDR approach that can eliminate severe headache pain in less time than an oral medication (20 to 30 min) and within 5 to 10 sessions may reduce frequency, duration and intensity of future headaches could result in a decrease in medication utilization, physician visits and overall medical costs, with an improvement in patient satisfaction. This would be a welcome addition to current headache treatments.
This workshop will employ lecture, demonstration and actual practice of an integrated EMDR approach. The purpose of this teaching strategy is to prepare you for clinical practice. Objectives include understanding headache etiology, headache trigger identification, threshold theory, training in the EMDR protocol used in Dr. Marcus’s migraine research, discussion of protocol utilization in clinical practice, informed consent, transference issues, and discussion of the role of provider when deploying this approach. This workshop is for advanced EMDR practitioners but previous experience in headache treatment is not required.

Keywords: Headaches  Health Problems  Illness  Pain  

Accuracy Verified: Yes


36. Lawson, C. A. (2004). Treating the borderline mother:  Integrating EMDR with a family systems perspective. In M. M. McFarlane (Ed.), Family treatment of personality disorders: Advances in clinical practice (pp. 305-334).  New York:  Haworth Clinical Practice Press.

Language: English

Format: Book Section

Abstract:
Describes the features borderline personality disorders (BPD) in mothers and the impact it can have the family, then describes the treatment model, which combines Bowen's family systems theory with eye movement desensitization reprocessing (EMDR). Following illustrative case material, the author discusses the treatment model's strengths and limitations, benefits for the family, indications and contraindications, management of transference issues, management of crises and acting-out behavior, integration with psychiatric services and the role of medication, and cultural and gender issues. (PsycINFO Database Record (c) 2008 APA, all rights reserved)

Keywords: Borderline Personality Disorder  Bowen's Family Systems Theory  Family Therapy  Mothers  Treatment Model  

Accuracy Verified: Yes


37. Parnell, L. (1995, June). The use of imaginal and cognitive interweaves with sexual abuse survivors. Presentation at the EMDR Network Conference, Santa Monica, CA.

Language: English

Format: Conference

Abstract:
This hour and a half presentation addresses the use of cognitive and imaginal interweaves in the treatment of adult survivors of sexual abuse. The overall course of treatment with EMDR is briefly outlined including a variety of interweave interventions for use in the beginning, middle and end of EMDR sessions. In working with sexual abuse survivors with EMDR it is important to understand the issues commonly encountered in their treatment. These include issues of safety, trust, responsibility, choice/control, interpersonal relationships, body awareness and image, sexuality and self esteem. A sexual abuse assessment can be taken which includes information on the perpetrator(s), severity and frequency of abuse, type of abuse, age of onset of abuse, duration of abuse, disclosure and family response. Sexual abuse survivors present themselves in treatment in different ways. Some clients come to treatment remembering abuse and want to clear it with EMDR. Other clients come to treatment with no clear memories of incidents but have a "feeling" something happened to them and have symptoms of abuse. There are clients who have no clear memories but something has triggered flashbacks and nightmares of sexual abuse. Finally, there are clients who have no memory of abuse and come to therapy for another reason but uncover what they believe to be sexual abuse memories with EMDR. There are three phases of treatment in sexual abuse cases. In the beginning phase, a history is taken and there is the establishment of a trusting relationship. The client is prepared for EMDR. In the middle phase, there is the reprocessing and working through of traumatic memories and transference work. In the end phase of treatment there is integration of the information which has been uncovered and preparation for life outside of therapy. Interweaves can be utilized in the beginning, middle and end of EMDR sessions. In the beginning of individual EMDR sessions there is a check-in with clients to see how they have been doing during the week. What has come up for them in their dreams or daily life since the last session? Next there is the selection and development of targets for EMDR (body sensation, memory, flashback, symptom, dream, feeling, vague sense, negative cognition or drawing). A safe place is then established where the client can go at the beginning, middle or end of the session as needed. Along with the safe place an inner advisor or other inner resources can be contacted and developed for use in sessions. A connection with the client's inner child is important which can be done through the use of guided imagery, photographs and/or artwork. Instructions on how EMDR will be used are given with attention paid to issues of safety and control (they are in control, they can stop at any time, they can return to the safe place, they know the signal for stop). Negative and positive cognitions are established along with the EMDR protocol. In the middle of individual EMDR sessions there are commonly problems with looping or being "stuck." This seems to occur frequently with sexual abuse survivors because of the intensity of the trauma and because the child self is often frozen in time lacking access to the adult self's information. Ways to work with this include looking for the blocking beliefs (i.e., The perpetrator can hurt me), look for blocking images, and talking to the child part (what does he/she need?). Imaginal and cognitive interweaves can be used in a variety of different ways in the middle of EMDR sessions. Some of these include: imagining the adult self helping the child self in the traumatic scene, bringing in inner and outer resources for help (i.e., a powdl imaginary being, a strong loving fiend, the therapist, etc.), and reality check interweave where is the perpetrator now?, can helshe hurt you now?) It is also important to educate the child part that his or her feelings are normal, sexual feelings are normal etc. It can be helpful to ask the adult self to talk to the child self explaining things to the child. Another useful interweave is to have the adult self hold the perpetrator and allow the child to beat him or her up or have the adult self beat up the perpetrator allowing anger to be expressed safely. Asking clients if they would like to return to the safe place for a break can also be helpful if they are feeling too overwhelmed. There are a number of ways to end or close incomplete EMDR sessions. Often it will not be possible to completely clear a traumatic memory in a session or the memory worked on is completed but connected to a whole network of other traumatic events. For these cases there are a number of interweaves that can be used. Clients can be requested to have the adult self comfort the child self in the . safe place. The client can imagine putting the scary unfinished disturbance that has been uncovered in a file folder, box, safe, leave it in the therapist's office, etc. The client can return to the safe place where the child and adult selves can play together. The adult can comfort the child or do whatever is needed to create safety and containment. Clients can imagine their child self being held by protector figures repeating cognitions related to safety, responsibility and choice. They can also be asked what they learned from the session, installing their response with eye movements. It is helpful to give homework to clients such as journaling, artwork, walks in nature, meditation, stress reduction, group work, exercise, nutritious diet, and restriction of drugs and alcohol. Loving Kindness or Metta Meditation is another very helpful tool for teaching self soothihg to adult survivors of sexual abuse.

Keywords: Cognitive Interweave  Imaginal Interweave  Sexual Abuse  Survivors  

Accuracy Verified: Yes


38. Tobin, S. (2002, June). Use of therapeutic alliance for resource installation. Presentation at the annual meeting of the EMDR International Association, San Diego, CA.

Language: English

Format: Conference

Abstract:
Dr. Tobin will show why it is important to address the often overlooked therapeutic relationship; how to notice transference and countertransference issues, how to foster the therapeutic alliance; and how to utilize EMDR to install the alliance, once it has been established, as a resource to foster increased self-support, grounding, enhanced self-esteem and self-soothing capacities. Relevant psychodynamic theory on transference and countertransference, the applicability of this approach to various diagnostic groups will be discussed, contraindications will be cited and clinical examples will be presented.

Keywords: RDI  Resource Installation  Therapeutic Alliance  

Accuracy Verified: Yes


39. Manfield, P., Knipe, J., & Snyker, E. (1998, July). Using EMDR with narcissistic personalities. Presentation at the annual meeting of the EMDR International Association, Baltimore, MD.

Language: English

Format: Conference

Abstract:
Participants will: 1) be able to identify narcissistic defenses of splitting, projective identification, avoidance, denial, primitive idealization, devaluation, grandiosity; 2) learn methods of addressing these defenses; and 2) learn how to use EMDR to process transference issues that typically arise.

Keywords: Narcissistic Defenses  Transference  

Accuracy Verified: Yes


40. Dworkin, M. (2008, June). Using the therapeutic relationship in EMDR with patients with complex PTSD. Presentation at the annual meeting of the EMDR Europe Association, London, England UK.

Language: English

Format: Conference

Abstract:
Now that the therapeutic relationship is firmly part of EMDR, it is time to show its uses with difficult populations. Skilful emphasis on empathic attunement beginning in the history taking phase with emphasis on using the Procedural Steps Outline diagnostically, and Light stream as an affect management tool, starting in the first session will be shown to be of use specifically with this population. This population needs special attention regarding alterations in affect regulation, self perception, consciousness and attention, somatisation, trust, and identity. In the preparation phase participants will learn various relational strategies to accomplish these tasks. They will also learn to use the relationship as an additional resource for containment with appropriate boundaries. Relational concepts such as “Implicit Relational Knowing”, “Moments of Meeting”, and “Dyadic Expansion of Consciousness” will be taught to expand methods of stabilization for preparation, and for active trauma work. Modifications of active trauma work using active resourcing; titrating or dosing; treating transference and counter transference phenomenon will all be demonstrated to enhance EMDR work with complex PTSD and Dissociation. Dworkin's Trauma Case Conceptualization Questionnaire and his Clinician Self Awareness Questionnaire will be taught and used to

Keywords: Complex Posttraumatic Stress Disorder  Complex PTSD  C-PTSD  Therapeutic Relationship  

Accuracy Verified: Yes