Francine Shapiro Library: EMDR Bibliography

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1. Adshead, G. (2000). Psychological therapies for post-traumatic stress disorder. British Journal of Psychiatry, 177(2), 144-148. doi:10.1192/bjp.177.2.144.

Language: English

Format: Journal

Abstract:
Background After exposure to traumatic stressors, a subgroup of survivors (20-30%) will develop post-traumatic stress disorder (PTSD). Aims: Since the incidence and prevalence rates for PTSD in the community are significant, it is important that general practitioners and psychiatrists be familiar with possible therapeutic options. In this review we shall look at the published evidence about the effectiveness of psychological treatments for PTSD. Method: The psychopathological mechanisms involved in PTSD are discussed. Studies of the effectiveness of different psychological therapies are reviewed. Results: The review suggests that persistent fear or shame reactions are key aspects of PTSD. Evidence from systematic reviews suggests that psychotherapeutic treatments are effective in the therapy of reactions based on fear, and may increase the effectiveness of pharmacological therapy. There is less systematic evidence for the efficacy of interventions for symptoms based on shame. Conclusions: Although a proportion of patients with complex or chronic PTSD may require specialist interventions, most patients can be treated effectively by a general psychiatric service which can offer both pharmacological and psychological interventions (BJPsych).

Keywords: Fear  Posttraumatic Stress Disorder  PTSD  Shame  


2. Balcom, D., Call, E., & Pearlman, D. (2000, August). Eye movement desensitization and reprocessing treatment of internalized shame. Traumatology, 6(2), 69-83. doi:10.1177/153476560000600202 .

Language: English

Format: Journal

Abstract:
13 subjects were administered the Internalized Shame Scale (ISS) before and after EMDR therapy to determine whether Eye Movement Desensitization and Reprocessing (EMDR) significantly reduced internalized shame and increased self-esteem as measured by the ISS. While the study did not control for alternative treatment effects, age, diagnosis, SES, or ethnicity of subjects, statistical analysis indicated a significant decrease in internalized shame subscale scores and a significant increase in self-esteem subtest scores following treatment with EMDR. These results support the hypothesis that EMDR is an effective treatment for internalized shame, even when shame is not the identified target of treatment. These preliminary findings suggest that future research is warranted to explore the efficacy of EMDR in the treatment of internalized shame. [Author Abstract]

Keywords: Shame  Self Esteem  Treatment Effectiveness  Adults  European Americans  


3. Blore, D. C., Holmshaw, E. M., Swift, A., Standart, S., & Fish, D. M. (2013). The development and uses of the “blind to therapist“ EMDR protocol. Journal of EMDR Practice and Research, 7(2), 95-105. doi:10.1891/1933-3196.7.2.95.

Language: English

Format: Journal

Abstract:
The blind to therapist (B2T) protocol (Blore & Holmshaw, 2009a, 2009b) was devised to circumvent client unwillingness to describe traumatic memory content during eye movement desensitization and reprocessing (EMDR). It has been used with at least six clinical presentations: • Reassertion of control among “executive decision makers“ • Shame and embarrassment • Minimizing potential for vicarious traumatization • Cultural issues: avoiding distress being witnessed by a fellow countryman • Need for the presence of a translator versus prevention of information “leakage“ • Reducing potential stalling in processing: client with severe stammer This article details the history, development, and current status of the protocol, and provides case vignettes to illustrate each use. Clinical issues encountered when using the protocol and “dovetailing“ the B2T protocol back into the standard protocol are also addressed.

Keywords: Aphasia  Blind to Therapist Protocol  Client-Centered Approach  EMD  Guilt  Shame  


4. Dodgson, P. W. (2007, June). Shame: The adaptive information processing model and introduction of the "protocol interweave" in EMDR with victims of torture, rape and organised violence. Presentation at the annual meeting of the EMDR Europe Association, Paris, France.

Language: English

Format: Conference

Abstract:
Shame is often a key component of post-traumatic stress and one that can inhibit processing because the person concerned feels no compassion for the self that was shamed. Shame may lead to despising or hating that self so that allowing the self to grow, to recovered, feels almost impossible. Shame is experienced cognitively, emotionally, and somatically: in “brain, heart, and body.”
Shame may lead to blocked processing that does not respond to cognitive interweaves or other approaches such as changes in speed, modality and direction of bilateral stimulation, or “TICES’ strategies, changing aspects of images, cognitions or emotional and sensory interventions. Typically, Subjective Units of Distress scale scored stick at 4.
This paper will draw on clinical work with people who have experienced rape, torture and organized violence and explore ways of unlocking the inhibiting factors of shame, enabling the victim of personal violence to have compassion for themselves, and forgiveness. With compassion, a person can allow themself to recover, and processing the memories of the traumatic incident or incidents can move to adaptive resolution.
The paper will present case material using the adaptive information processing model as a helpful way of enabling clinets to normalize their mental, emotional and somatic reactions, to structure what often seems like a chaotic inner world and to address issues including shame.
This paper will propose a protocol for EMDR psychotherapy with people who have been victims of rape, torture, and organized violence and will introduce a “protocol interweave” for working with people for whom shame is a factor that impedes effective processing.
The “protocol interweave” focuses on the ‘self who has been shamed” and adapts the desensitization phase to enable the individual to process material associated with their thoughts, feelings, and sensations with regards to the self of whom they are ashamed and whom they may despise. The paper will also examine recent thinking about shame, compassion and forgiveness and reflect on similarities across psychotherapeutic modalities such as gestalt and cognitive behaviour therapy and the way in which EMDR is an integrative model that accommodates these.
The presentation will include PowerPoint and video clips of clinical consultations.

Keywords: Adaptive Information Processing  AIP  Organised Violence  Protocol Interweave  Rape  Shame  Torture  


5. Holm, O. (2012, October). On the path of shame affect: Its management in traumatized and dissociative patients with the compass of shame and EMDR special interventions and/or IFS ego states. 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:
Five traumatized patients grouped this way: 2 males, 2 females, one boy of 11. The two men had received treatment with CBT, 1 of females Gestalt therapy, the other female with EMDR, and the 11 years old boy with IFS; they had come to a point of stuck in their therapy because of the therapists not being able to manage Shame Affect during trauma confronting; also, when alters appeared during some therapy sessions in one of the adult females. Four of the patients had already worked on some traumatic memories with previous therapists. According to Compass of Shame 2 of the male patients had a rather high urge to enter into Attacking others pole with rage, and one of them, also, into Avoidance pole with drug abuse, compulsive sex and gamble; two females were more urged to enter into Attack self pole and in 1 of the females, her alter and patient described herself as being very upset and paralyzed with Shame. The 11 years old boy was stuck in Withdrawn pole; a highly Shamed Negative Part was so paralyzed that the Integrating Strategy was stopped until the child Ego state was released from Shame. Learning Objectives: EMDR/and not EMDR participants will able to perform interventions characterized by working with Shame or preparing patients to tolerate Shame. Participants will be able to define the scripts inside each pole of the Compass Participants will be able to identify the different poles of Compass of Shame.

Keywords: Compass of Shame  Dissociation  IFS Ego States  Shame Affect  


6. Knipe, J. (2006, June). EMDR toolbox: Video examples of methods of targeting avoidance, procrastination, affect dysregulation, the pain of being "dumped" by a lover, and a shame-based ego state in a client with a identity disorder. Presentation at the annual meeting of the EMDR Europe Association, Istanbul, Turkey.

Language: English

Format: Conference

Abstract:
It is clear from over 17 published studies that the EMDR method is highly effective in assisting clients in resolving PTSD (Maxfield and Hyer, 2002). However, most clients who enter therapy do not have a simple problem of a single disturbing memory, but a complex history. Typically, clients come to therapy with a mixed presentation, of not only emotional disturbance, but also mental structures and actions which function to soothe, contain, avoid or dissociate from emotional disturbance. Thus, the initial presentation of most clients is complex and often ambivalent. In this workshop, examples will illustrate Adaptive Information Processing methods of targeting and resolving psychological defenses, such as avoidance, ambivalence, and idealization. Also, the BHS/CIPOS (Back-of-the-Head Scale/Constant Installation of Present Orientation and Safety) method will be described. This method is a set of procedures that can be used during the EMDR Desensitization Phase to therapeutically reverse dissociative processes while preserving emotional safety. Video segments from therapy sessions will be shown to illustrate each of these methods.

Keywords: Back-of-the-Head Scale  BHS  CIPOS  Contant Installation of Present Orientation and Safety  Psycholgical Defenses  Targeting  


7. Knipe, J. (2009). "Shame is my safe place": Adaptive information processing methods of resolving chronic shame-based depression. In R. Shapiro (Ed.), EMDR Solutions II: For depression, eating disorders, performance, and more, (1st Ed.) (pp. 49-89). New York, NY: W. W. Norton & Co..

Language: English

Format: Book Section

Keywords: Depression  Shame  


8. Knipe, J. (2010, September/October). Shame is my safe place: AIP targeting of shame as a psychological defense. Presentation at the annual meeting of EMDR International Association, Minneapolis, MN.

Language: English

Format: Conference

Abstract:
Within the AIP model, psychological defense can be defined as the part of the trauma-based dysfunctionally stored memory network that blocks access to other parts of the network. For many clients, an essential first step in therapy is to identify and target defense, in order to then access and resolve post-traumatic emotional disturbance. For the AIP therapist, it is useful to categorize defenses as avoidant, idealizing and/or shame-based (i.e. shame as a distortion in identity, left over from a time when it was “better to be a bad kid with good parents than a good kid with bad parents”). This presentation will focus on a method of targeting and processing an identity of shamefulness that is functioning as a defense against full realization of the original trauma.

Keywords: Shame  


9. 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  


10. Leeds, A. M. (1998). Lifting the burden of shame: Using EMDR resource installation to resolve a therapeutic impasse. In P. Manfield (Ed.), Extending EMDR: A casebook of innovative applications, (1st ed.) (pp. 256-281). New York: W. W. Norton.

Language: English

Format: Book Section

Abstract:
With Meredith, what had seemed an insurmountable impasse using a standard PTSD protocol had become amenable to significant resolution when addressed with a non-standard protocol. The key to this approach was to install multiple positive resources without deliberately activating the distressing emotions and associations of a specific, disturbing memory or current stimuli. I have coined the phrase "EMDR resource installation" to describe this protocol. I have since used this approach with other challenging clients who have childhood histories of significant failures of attachment with their primary caregivers. In these cases, their histories and current functioning led me to conclude that their capacity for self-soothing and affect modulation was not yet developed to the point where they could tolerate directly targeting distressing memories using the standard EMDR protocol. [Text, pp. 276-277]

Keywords: Adults  Case Report  Child Abuse  Defense Mechanisms  Diseases  Females  Neglect  Posttraumatic Stress Disorder  Psychotherapeutic Processes  PTSD  Survivors  Treatment Effectiveness  


11. McGoldrick, T., Begum, M., & Brown, K. W. (2008). EMDR and olfactory feference syndrome: A case series. Journal of EMDR Practice and Research, 2(1), 63-68. doi:10.1891/1933-3196.2.1.63.

Language: English

Format: Journal

Abstract:
Olfactory reference syndrome (ORS) is an illness currently considered a delusional disorder under the DSM-IV criteria. Patients believe that they emit a foul odor, causing them great emotional distress and negative social consequences. Its etiology is inadequately understood, and there is generally a poor response to pharmacological and psychotherapeutic interventions. This article describes the treatment of four consecutive cases of ORS whose pathological symptoms had endured for 8-48 years. The administration of EMDR consisted of processing the various life experiences that appeared to cause and/or trigger the pathology. The EMDR sessions resulted in a complete resolution of symptoms in all four cases, which was maintained at follow-up. Given the rapid and sustained results, we offer a hypothesis based on the Adaptive Information Processing (AIP) model to explain the etiopathology and remission. [Author Abstract]

Keywords: Adaptive Information Processing Model  Adults  AIP  Case Report  Delusional Disorder  Females  Olfactory Reference Symptoms  ORS  Shame  Stressors  Survivors  Trauma  Treatment Effectiveness  


12. Mellskog, P. (2004, January 1). Shame and fear can bury a multitude of sins and sorrows - but not forever, according to survivors of traumatic events. The Associated Press State & Local Wire, State and Regional.

Language: English

Format: Other

Abstract:
"I thought it was a bunch of hocus-pocus," said Lisa's therapist, Karen Wray, a Longmont counselor certified to practice EMDR by the Texas-based EMDR International Association.

Keywords: General  Overview  


13. Zangwill, W. M. (1994). EMDR and shame:  A brief report. EMDR Network Newsletter, 4(3), 13.

Language: English

Format: Conference

Abstract:
One of the most difficult issues in an EMDR session is when a patient is not able to "let go" and experience the process. There are a variety of reasons for this happening, one of which involves the shame patients sometimes feel in both reexperiencing the memories and of sharing them with us. Despite assurances that they do not have to share content, some patients have still reported difficulty in letting past material arise to be reprocessed because of fear of embarrassment and humiliation.

Keywords: Shame