Existe un interés creciente en usar la terapia de desensibilización y reprocesamiento mediante movimientos oculares (EMDR) más allá del trastorno por estrés postraumático; para el cual dicha aplicación está bien consolidada. Con el fuerte consenso académico de que las experiencias vitales adversas y traumáticas contribuyen al desarrollo del trastorno límite de la personalidad (TLP), parecería que EMDR podría aportar mucho al tratamiento de las personas con TLP. Sin embargo, dadas las características específicas de estos pacientes, la aplicación de la terapia EMDR a su tratamiento puede ser todo un reto y son necesarias pequeñas adaptaciones de los procedimientos estándar de EMDR para el TEPT. Este artículo proporciona una orientación a los principios y estrategias para preparar de manera segura y eficaz a los pacientes con TLP para la terapia EMDR, y para acceder a los orígenes traumáticos del TLP y reprocesarlos. Se ofrecen ejemplos clínicos a lo largo del artículo.
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- Go to article: Evidence of the Efficacy of EMDR With Children and Adolescents in Individual Psychotherapy: A Review of the Research Published in Peer-Reviewed Journals
Evidence of the Efficacy of EMDR With Children and Adolescents in Individual Psychotherapy: A Review of the Research Published in Peer-Reviewed Journals
Research on psychotherapy with children is generally underrepresented in the empirical literature. Currently, there are four randomized clinical trials (RCT) evaluating EMDR in individual psychotherapy with traumatized children—two for children diagnosed with PTSD and two for children presenting with symptoms of posttraumatic stress. Since the first case studies of EMDR with children were published in 1993, 19 studies were identified that met the inclusion criteria for this review. The gold standards identified by Foa and Meadows (1997) to assess the methodology of studies designed to treat trauma were applied to the research on EMDR with children. This analysis discusses the challenges to conducting research on psychotherapy with children including the debate regarding the assessment and diagnosis of PTSD in children. Recommendations for future studies designed with methodological rigor are suggested to investigate the efficacy of EMDR with children who have experienced trauma and other mental health symptoms and diagnoses.
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.
Three case studies illustrate pre– and post–eye movement desensitization and reprocessing (EMDR) adult attachment status as measured by the Adult Attachment Interview (AAI). Two adult males and one adult female presented for outpatient therapy; all of them were categorized with an insecure or disorganized attachment status at pretreatment. All presented with symptoms of depression and anxiety and complaints regarding problems in their current marital and family relationships. The three patients received 10 to 15 EMDR sessions over the course of approximately 1 year, interspersed with talk therapy sessions for the purpose of debriefing and psychoeducation. The EMDR approach utilized all eight phases of treatment within the three-pronged approach. Following EMDR therapy, all three patients made positive changes in attachment status as measured by the AAI, and all three reported positive changes in emotions and relationships. This article provides an overview of the literature related to adult attachment categories and summarizes the effect of adult attachment status on emotional and social functioning. The rationale and scoring procedures for the AAI are explained.
- Go to article: Building Resilience and Dismantling Fear: EMDR Group Protocol With Children in an Area of Ongoing Trauma
Building Resilience and Dismantling Fear: EMDR Group Protocol With Children in an Area of Ongoing Trauma
A number of studies indicate that EMDR (eye movement desensitization and reprocessing) may be efficacious in treatment of children and young people with symptoms of posttraumatic stress. However, reports are limited in the use of the EMDR psychotherapy approach in situations of ongoing violence and trauma. This case study describes work with seven children in an area of ongoing violence who were subject to repeat traumas during the course of an EMDR psychotherapy intervention, using a group protocol. Results indicate that the EMDR approach can be effective in a group setting, and in an acute situation, both in reducing symptoms of posttraumatic and peritraumatic stress and in “inoculation” or building resilience in a setting of ongoing conflict and trauma. Given the need for such applications, further research is recommended regarding EMDR’s ability to increase personal resources in such settings.
- Go to article: L'EMDR dans la psychose : lignes directrices pour la conceptualisation et le traitement
Un grand nombre de patients présentant une psychose ont vécu des traumatismes infantiles et souffrent d'un état de stress post-traumatique comorbide. La recherche indique que l'exposition à des événements perturbants en début de vie joue un rôle considérable dans l'émergence et la persistance de symptômes psychotiques – directement ou indirectement. L'approche des deux méthodes pour la conceptualisation EMDR et les données récentes sur le retraitement d'imagerie psychotique répondent bien aux modèles cognitifs existants de la psychose. Cet article présente une série de lignes directrices préliminaires pour la conceptualisation du traitement EMDR dans la psychose, fondées à la fois sur la théorie et sur l'expérience clinique, et illustrées par des exemples de cas. Plusieurs obstacles et stratégies thérapeutiques associées concernant l'utilisation de l'EMDR dans la psychose sont décrits. L'EMDR dans la psychose peut très bien se combiner avec d'autres interventions standard telles que les psychotropes et la thérapie cognitive comportementale.
The U.K. armed forces are currently involved in a number of military operations throughout the world. Offering structured psychological interventions such as eye movement desensitization and reprocessing (EMDR) in theater has a number of potential advantages. This single-case study describes how the EMDR recent event protocol (Shapiro, 1995) was used in theater with a 27-year-old active-duty U.K. soldier who was experiencing an acute stress reaction after treating a land mine casualty. The intervention took place 2 weeks posttrauma with four sessions conducted on consecutive days, resulting in a positive outcome, with the soldier able to return immediately to frontline duties. Treatment response was assessed with administration of four standardized measures at pretreatment, posttreatment, and 18-month follow-up. Treatment effects remained at 18-month follow-up. The challenges of conducting EMDR in operational theaters and clinical implications are explored.
- Go to article: EMDR With Children and Adolescents After Single-Incident Trauma An Intervention Study
This study used a naturalistic design to investigate the effectiveness of eye movement desensitization and reprocessing (EMDR) with children and adolescents who were exposed to single-incident trauma. Participants were 36 children and adolescents ranging in age from 1 year 9 months to 18 years 1 month who were referred consecutively to the author’s private practice. Assessments were conducted at intake, post-waitlist/pretreatment, and at follow up. EMDR treatment resulted in significant improvement (Cohen’s d = 1.87). Follow-ups after 6 months revealed stable, further slight improvement. It was shown that children younger than 4 years of age can be treated using EMDR and that the group of preschool children had the same benefit from the treatment as the school-age children.
Disasters, both natural and “man-made,” affect a large portion of the Earth’s population and can be expected to increase in intensity over the coming decades. The impact of disasters on mental health of affected populations is substantial and likely to be insufficiently addressed in the overall context of disaster response. While successful mental health intervention has been demonstrated in a variety of cases, including through the use of EMDR treatment, this problem needs more attention. Effective mental health response will be greatly supported by increased research on questions related to the incidence, form, and prognosis of disaster-generated traumatic stress, as these are affected by type of disaster, culture of affected population, sociological conditions, and neuropsychological factors, and the interactions among these. A brief summary of desirable research is presented that could help responders meet these challenges.
- Go to article: EMDR After a Critical Incident: Treatment of a Tsunami Survivor With Acute Posttraumatic Stress Disorder
EMDR After a Critical Incident: Treatment of a Tsunami Survivor With Acute Posttraumatic Stress Disorder
Research indicates that EMDR is effective for the treatment of posttraumatic stress disorder (PTSD), with numerous studies showing a high percentage of symptom remission after 3 sessions. The case of a tsunami survivor with acute PTSD is presented. Treatment for overt trauma symptoms was completed within 3 sessions, including all 8 phases and the 3-pronged protocol (i.e., past, present, future targets). One EMDR session was sufficient to process the trauma and alleviate the related symptoms, while another session was necessary for re-evaluation and processing present triggers and future templates. Resource installation was particularly helpful to prepare him for those future situations that had been generating anxiety as a result of his traumatization.