In 2013, Dr. Vincent John Felitti presented Dr. Robert F. Anda and his groundbreaking work on “The Adverse Childhood Experiences Study” (ACE Study) at the EMDR International Association’s annual conference in Austin, Texas. The ACE Study is a research study conducted by Kaiser Permanente Health Maintenance Organization and the Centers for Disease Control and Prevention with the purpose of finding out the effects of stressful and traumatic experiences during childhood on adult health (acestudy.org website, 2015). Between 1995 and 1997, more than 17,000 volunteers were recruited into a long-term study to follow up on their health outcomes from a Kaiser HMO. In this cohort, 50% were female, 74.8% were Caucasian, 75.2% had attended college, all had jobs and health care, and the average age was 57 years. What they learned revolutionized our basic understanding of the etiology of mental and physical illness. From the reports of the participants in the survey, they discovered that 63% had at least one childhood trauma, whereas 20% had experienced at least three or more categories of trauma, which were labeled adverse childhood experiences (ACE). ACE included experiences of abuse as in emotional (11%), physical (28%), and sexual (21%); neglect comprising emotional (15%), and physical (10%); growing up in households where a member was mentally ill (19%), in jail or prison (5%); used alcohol and/or drugs (27%), lost a parent due to separation or divorce (23%); or witnessed their mother-treated violently (13%). Felitti and Anda’s important discovery was the more categories of trauma experienced in childhood, the greater the likelihood of experiencing high-risk factors in adulthood for alcoholism and alcohol abuse, chronic obstructive pulmonary disease (COPD), depression, fetal death, hallucinations, illicit drug use, ischemic heart disease (IHD), liver disease, risk of intimate partner violence, multiple sexual partners, obesity, poor health-related quality of life, posttraumatic stress disorder (PTSD), sexually transmitted diseases (STDs), smoking, suicide attempts, and/or unintended pregnancies. These are important findings that inform our work as EMDR practitioners.

Felitti and Anda (2009, pp. 77–87), in their chapter “The Relationship of Adverse Childhood Experiences to Adult Medical Disease, Psychiatric Disorders, and Sexual Behavior: Implications for Healthcare,” concluded the following concerning adverse childhood experiences:

Dr. Francine Shapiro’s Adaptive Information Processing (AIP) model is in keeping with the important findings of Felitti and Anda’s ACE Study (Shapiro, 2001, 2002, 2006, 2007). This model is used to guide our clinical practice and show EMDR Therapy’s clinical effects. The idea is that the direct reprocessing of the stored memories of the first and other events connected with the problem—as well as any other experiential contributors—has a positive effect on clients’ presenting problems. The results of case studies and open trials with various diagnostic categories support this prediction. In fact, many experts have taken the basic Standard EMDR Therapy Protocols reported by Dr. Shapiro in Eye Movement Desensitization and Reprocessing (EMDR): Basic Principles, Protocols and Procedures (1995, 2001) and adapted them to meet the particular needs of their clients while maintaining the integrity of EMDR Therapy.

The work on EMDR Therapy and clinical applications, as seen in the chapters in this book, are based on the AIP model. A number of EMDR Therapy clinical applications are mainly case studies or open trials that show promise; however, they are in need of further investigation. The following is a small sample of the types of conditions for which clinicians are using these clinical applications: addictions; anxiety; body dysmorphia; depression; dissociative disorders; excessive grief; family, marital, and sexual dysfunction; intellectual disabilities; pain; phobias; panic; and so on. For more information, visit the EMDR International Association website (www.emdria.org) or the EMDR Institute website (www.emdr.com).

The following are the randomized clinical trials reporting on the effectiveness of EMDR in conditions other than PTSD: adjustment disorder (Cvetek, 2008); bipolar disorder (Novo et al., 2014); fears and phobias (Doering, Ohlmeier, de Jongh, Hofmann, & Bisping, 2013; Muris & Merckelbach, 1997; Muris, Merckelbach, Holdrinet, & Sijsenaar, 1998; Muris, Merckelbach, van Haaften, & Mayer, 1997; Triscari, Faraci, D’Angelo, Urso, & Catalisano, 2011); general symptoms of anxiety and distress (Abbasnejad, Mahani, & Zamyad, 2007; Arabia, Manca, & Solomon, 2011); obsessive-compulsive disorder (Nazari, Momeni, Jariani, & Tarrahi, 2011); and panic disorder (Feske & Goldstein, 1997; Goldstein, de Beurs, Chambless, & Wilson, 2001).

This is the fourth in a series of books dedicated to the better understanding of EMDR Therapy and how the Standard EMDR Therapy principles, protocols, and procedures form the basis for the work that we do as EMDR Therapy clinicians. To understand any subject matter deeply, the rule of thumb is to know the basics so that if a departure from the structure is needed, it is done in an informed manner. The purpose of Eye Movement Desensitization and Reprocessing (EMDR) Scripted Protocols: Basics and Special Situations (Luber, 2009a) was to support the structure in Dr. Shapiro’s earlier texts (1995, 2001) by showing each step in detail. Eye Movement Desensitization and Reprocessing (EMDR) Scripted Protocols: Special Populations (Luber, 2009b) built on that structure and showcased how many experts adapt the EMDR Therapy principles, protocols, and procedures for use with their specific populations, such as children; couples; and patients with dissociative disorders, complex PTSD, addictive behaviors, pain, and specific fears. The next book would have been: Eye Movement Desensitization and Reprocessing (EMDR) Scripted Protocols and Summary Sheets: Anxiety, Depression, and Medical-Related Issues to continue to show how expert clinicians are working with EMDR Therapy for anxiety disorders, depression, and medical-related issues. However, in 2011, man-made and natural disasters were coming to the fore and impacting our colleagues experiencing the To¯hoku earthquake and tsunami in Japan; floods in China, the Philippines, Thailand, Pakistan, Cambodia, India, and Brazil; earthquakes in Turkey and New Zealand; droughts and consecutive famines affecting Ethiopia, Kenya, and Somalia; storms in the United States, and so on. In consultation with Springer and EMDR colleagues in the EMDR Humanitarian Assistance Programs worldwide, the decision was made to move up the publication of Implementing EMDR Early Mental Health Interventions for Man-Made and Natural Disasters, in book, CD, and e-book formats. It was published in 2014 as an up-to-date collection of the current EMDR Therapy–related responses and protocols for recent trauma events.

In 2012, Eye Movement Desensitization and Reprocessing (EMDR) Scripted Protocols and Summary Sheets: Anxiety, Depression and Medical-Related Issues was slated to appear and was originally conceptualized with Diagnostic and Statistical Manual of Mental Disorder, Fourth Edition (DSM-IV-R; American Psychiatric Association, 1994) in mind; however, by the time publication grew near, DSM-5 (5th ed.; American Psychiatric Association, 2013) had become the standard. This entailed some reorganization of the structure of the book. However, so much material was involved that it was decided to create three books instead of one. This is the first of a trio of books based on this material: Eye Movement Desensitization and Reprocessing (EMDR) Therapy Scripted Protocols and Summary Sheets: Treating Anxiety, Obsessive-Compulsive, and Mood-Related Conditions, with the choice of book, CD, and/or e-book formats. Trauma- and stressor-related issues were separated from this current book and will appear as Eye Movement Desensitization and Reprocessing (EMDR) Therapy Scripted Protocols and Summary Sheets: Treating Trauma- and Stressor-Related Conditions (Luber, in press) in late 2015 or early 2016. Medical-related issues, as well, were separated from this current book and will appear as Eye Movement Desensitization and Reprocessing (EMDR) Therapy Scripted Protocols and Summary Sheets: Treating Medical-Related Issues (Luber, in press) in 2016.

The following description from Eye Movement Desensitization and Reprocessing (EMDR) Scripted Protocols: Basics and Special Situations gives a clear understanding of the evolution and importance of this format:

In 2012, the CD-ROM versions of the original 2009 books were published in a different format (Luber, 2012a, 2012b). Included in the CD-ROM were just the protocols and summary sheets (the notes were not included, but are available in the 2009 texts in book form). As explained in the preface of Eye Movement Desensitization and Reprocessing (EMDR) Scripted Protocols With Summary Sheets (CD ROM Version): Basics and Special Situations (Luber, 2012a):

This text is divided into three parts with 10 chapters that cover working with anxiety disorders, including specific phobia, panic disorder, and the use of a specific procedure in the treatment of anxiety disorder; obsessive-compulsive and related disorders, including obsessive-compulsive disorder, body dysmorphic disorder, olfactory reference syndrome, and hoarding behaviors; and mood disorders, including bipolar disorder, major depression, and postpartum depression. To address the specific needs of their populations, authors were asked to include the types of questions relevant for history taking, helpful resources and explanations needed in the preparation phase, particular negative and positive cognitions that were frequent in the assessment phase and for cognitive interweaves, other concerns during phases 4 (desensitization) through 8 (reevaluation), a section on case conceptualization and treatment planning, and any pertinent research on their work.

In Part I, “EMDR Therapy and Anxiety Disorders,” the first chapter for “Specific Phobia” is by Ad de Jongh, on “EMDR Therapy for Specific Fears and Phobias: The Phobia Protocol.” This is an updated version that originally appeared in Eye Movement Desensitization and Reprocessing (EMDR) Scripted Protocols: Special Populations (de Jongh, 2009) and includes an important addition on the “Flashforward Procedure.” Under “Panic Disorder and Agoraphobia,” Ferdinand Horst and Ad de Jongh’s chapter, “EMDR Therapy Protocol for Panic Disorders With or Without Agoraphobia,” points to the connection of panic attacks with the patient’s perception of it as a life-threatening experience as the inspiration to work within the EMDR Therapy framework. In the section on “Use of Specialized Procedures in the Treatment of Anxiety Disorders,” Robin Logie and Ad de Jongh’s chapter, “The Flashforward Procedure,” introduces us to a very helpful way of addressing worst-case scenarios that have been resistant to resolution. This new procedure is included in a number of chapters in this book, because of its helpfulness in reframing and reprocessing difficult situations.

Part II, “EMDR Therapy and Obsessive-Compulsive and Related Disorders,” used to be included in Anxiety Disorders in DSM-IV (American Psychiatric Association, 1994) and now has its own section in DSM-5 (American Psychiatric Association, 2013). Karsten Böhm—who is on the German National Guideline Commission for the treatment of OCD—introduces us to the use of EMDR Therapy and OCD in his chapter, “Obsessive-Compulsive Disorder and EMDR Therapy.” Therese McGoldrick has been an early proponent of the use of EMDR Therapy with body dysmorphic disorder. With her colleagues Millia Begum and Keith Brown, she introduces us to a “Body Dysmorphic Disorder and Olfactory Reference Syndrome EMDR Therapy Protocol.” Priscilla Marquis and Christie Sprowls bring their wealth of knowledge of EMDR and the treatment of OCD spectrum disorders to their chapter, “EMDR Therapy and Hoarding: The Hoarding Protocol.”

In Part III, “EMDR Therapy and Mood Disorders,” the first section on “bipolar disorder contains the chapter “The EMDR Therapy Protocol for Bipolar Disorder.” It is by the Barcelona EMDR Research Group under the tutelage of Benedikt L. Amann, and including Roser Batalla, Vicky Blanch, Dolors Capellades, Maria José Carvajal, Isabel Fernández, Francisca García, Walter Lupo, Marian Ponte, Maria José Sánchez, Jesús Sanfiz, Antonia Santed, and Marilyn Luber. It is based on the results of a controlled, randomized, single-blind pilot study with 20 bipolar I and II patients with subsyndromal symptoms, and a history of various traumatic events (Novo et al., 2014). The section “Major Depression” includes the chapter “DeprEnd^©—EMDR Therapy Protocol for the Treatment for Depressive Disorders,” by Arne Hofmann, Michael Hase, Peter Liebermann, Luca Ostacoli, Maria Lehnung, Franz Ebner, Christine Rost, Marilyn Luber, and Visal Tumani. DeprEnd^© is the result of a European network of depression researchers who created the EDEN Study—a multicenter randomized study in Germany, Italy, Spain, and Turkey—and offers an elegant and helpful way to address major depression. The last two chapters, in the section “Postpartum Depression,” by Anna Maria de Divitiis and Marilyn Luber, include “EMDR Therapy Protocol for the Prevention of Birth Trauma and Postpartum Depression for the Pregnant Woman,” and “EMDR Therapy Group Protocol for the Prevention of Birth Trauma and Postpartum Depression for Pregnant Women.” These chapters are helpful in primary prevention in an individual or group setting to reduce or avoid exposure to risk factors and to enhance clients’ defenses to prevent or minimize the effects of exposure to risk factors by encouraging their optimal participation in the process of childbirth and strengthening their resilience to reduce the negative effects of stressors experienced during childbirth.

Appendix A includes the scripts for the 3-Pronged Protocol that include past memories, present triggers, and future templates. This section helps clinicians remember the important component parts of the Standard EMDR Therapy Protocol to ensure fidelity to the model. Furthermore, it allows practitioners to copy the protocols and put them in clients’ charts. Appendix B includes an updated version of this author’s “EMDR Summary Sheet” (Luber, 2009a) and the EMDR Therapy Session Form to assist in easy retrieval of important client information and the most important components of EMDR Therapy sessions. A summary sheet that serves as a checklist showing the important steps needed in these protocols accompanies each of these chapters, with a CD-version format also available to provide mobile access.

Eye Movement Desensitization and Reprocessing (EMDR) Therapy Scripted Protocols and Summary Sheets: Treating Anxiety, Obsessive-Compulsive, and Mood-Related Conditions, in the manner of its predecessors, offers EMDR Therapy practitioners and researchers a window into the treatment rooms of experts in the fields of anxiety, obsessive-compulsive, and spectrum disorders, and mood-related conditions. It is designed to apply what we are learning through research and to support the increasing knowledge and capabilities of clinicians in the method of EMDR Therapy.