Cet article présente la technique éclair, une nouvelle technique utilisée pendant la phase de préparation de la thérapie EMDR (désensibilisation et retraitement par les mouvements oculaires) pour faciliter le traitement de souvenirs traumatiques intenses auxquels les patients hésiteraient autrement à accéder. Les premières données, demeurant à confirmer, suggèrent que cette technique pourrait permettre aux patients d’accéder à ces souvenirs d’abord de manière la moins perturbante possible, réduisant leur intensité émotionnelle, afin de pouvoir ensuite les aborder plus pleinement et les traiter à l’aide de la thérapie EMDR. La technique semble aisément tolérée par les patients de tous âges, y compris les enfants ; elle paraît rapide et relativement indolore pour les patients, même ceux qui possèdent des souvenirs cibles particulièrement perturbants ; elle s’enseigne facilement aux cliniciens. Elle se distingue par le fait que les patients qui évitent un souvenir terriblement perturbant peuvent se voir offrir une façon de le traiter sans devoir le ramener clairement à l’esprit. Quatre exemples de cas, dans lesquels quatre cliniciens différents ont utilisé la technique, sont présentés brièvement. Des suggestions sont formulées pour des études à venir. Cet article présente des hypothèses pour expliquer divers mécanismes d’action et évoque les effets en termes de la théorie de reconsolidation mnésique.
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- Go to article: Changing the Adult State of Mind With Respect to Attachment: An Exploratory Study of the Role of EMDR Psychotherapy
Changing the Adult State of Mind With Respect to Attachment: An Exploratory Study of the Role of EMDR Psychotherapy
We aimed to assess changes in the attachment internal working model and reflective function (RF) as mechanisms of change in eye movement desensitization and reprocessing (EMDR) treatment for patients with traumatic memories. Twenty adult female patients with parenting and relational problems participated in the study. Attachment organization was assessed with the Adult Attachment Interview (AAI) and the RF coding scale pre- and posttreatment. We found that EMDR therapy increased patients' narrative coherence and RF. We noted a significant decrease in the number of participants classified as unresolved following the course of EMDR treatment in which loss and/or trauma were resolved. This article summarizes the changes after EMDR therapy regarding attachment status and its efficacy to reprocess early traumatic memories in a more adaptive way. Finally, our results also support the usefulness of the AAI as a tool for understanding the changing processes during a therapeutic treatment.
It has only been in this last decade that trauma-focused treatments (TFT) have been studied in patients with psychotic disorders. Before, the paradigm stated that TFT was contraindicated in these patients because clinicians and researchers assumed the risk of exacerbation of symptoms was too high. The purpose of this article is to examine the effectiveness of eye movement desensitization and reprocessing (EMDR) therapy in the treatment of psychosis. To this end, we will present a brief narrative review of the current state of research in this particular field. The results suggest that, contrary to the “no-TFT-in-psychosis” paradigm, TFTs such as EMDR therapy can successfully be used to reduce trauma-related symptoms in patients with psychosis. Moreover, there are now provisional indications that psychotic symptoms such as delusions and hallucinations can be targeted directly and indirectly using EMDR therapy.
- Go to article: The Traumatic Flashback as One Basis of Misunderstanding Between Patients and Law Enforcement Officers
The Traumatic Flashback as One Basis of Misunderstanding Between Patients and Law Enforcement Officers
A patient in psychoanalytic psychotherapy reported to the analyst that the patient recently had been forced by satanic cult members to commit a murder. After discussion, the patient and the analyst agreed to inform the police. The police could not find evidence for the occurrence of the crime. Continued psychoanalytic work revealed that it was not a contemporary murder but a flashback of a childhood horror. Because flashbacks of past traumatic experiences are not an uncommon phenomenon, they would account for some of the gruesome events reported by patients but which law enforcement officers cannot validate as having recently occurred.
Numerous studies have identified links between psychopathology and a history of traumatic life events and dysfunctional attachment relationships. Hence, given the possible traumatic origins of this pathology, it may be useful to provide a trauma-focused intervention such as the eye movement desensitization and reprocessing (EMDR) therapy. This article illustrates a clinical case by describing the positive results of the EMDR therapy in the recovery of unremitting anorexia nervosa in a 17-year-old inpatient. She had previously been hospitalized on 4 occasions in the previous 4 years and received both psychodynamic and cognitive-behavioral therapy. At pretreatment, the client weighed (28 kg, 62 lb) and had a body mass index of 14. She was designated with a dismissing attachment style on the Adult Attachment Interview. EMDR therapy was provided for 6 months in hospital, in twice weekly 50-minute sessions and consisted of standard procedures primarily focusing on her relational traumas, interspersed with psychoeducational talk therapy sessions, and integrated with ego state therapy. At the end of treatment, the client weighed (55 kg, 121 lb) and had a body mass index of 21.5. She no longer met diagnostic criteria for anorexia nervosa, and her attachment style had changed to an earned free-autonomous state of mind. She reported an increase in self-confidence and in her ability to manage various social challenges. Results were maintained at 12 and 24 months follow-up. The treatment implications of this case study are discussed.
This article introduces a Wellness First Approach to addressing adverse community experiences and encouraging community healing and resilience. Structural violence and traumatic conditions can contribute to poor mental health outcomes for communities.However, communities have the capacity to amplify protective factors to mitigate the negative effects of adverse community experiences, toxic stress, and trauma. The authors offer that a better understanding of these experiences can transform the ways mental health is approached. Rather than predominantly focus on prevention and treatment practices on an individual level, there is a need to engage in prevention and healing through an ecological approach that includes whole communities. Recommendations of frameworks for mental health and well-being promotion that are aligned with a Wellness First Approach are provided.
- Go to article: EMDR as a Transpersonal Therapy: A Trauma-Focused Approach to Awakening Consciousness
This article introduces the integration of a transpersonal psychological approach into the standard eye movement desensitization and reprocessing (EMDR) protocol. The history and philosophy of transpersonal psychology is explained as an expanded context for healing. The applications of a transpersonal context to EMDR therapy are discussed as it applies to taking the client from trauma to healing beyond adaptive functioning leading to exceptional human functioning, as depicted in Native shamanism and Eastern spiritual tradition where consciousness is awakened. The influence of the consciousness of the therapist is explored, as the convergence of science, psychology, and spirituality address the interpersonal nature of a shared energy field. Elements of transpersonal psychotherapy are presented, and transpersonal therapeutic skills are described to enhance the range of tools of the therapist from egoic intervention to an expanded range of perception based in mindful awareness, attunement, and resonance. Comprehensive case examples take us through the standard EMDR protocol where these two approaches integrate and flow as healing unresolved early trauma becomes the doorway for spiritual awakening.
- Go to article: Preliminary Evidence for the Treatment of Performance Blocks in Sport: The Efficacy of EMDR With Graded Exposure
Preliminary Evidence for the Treatment of Performance Blocks in Sport: The Efficacy of EMDR With Graded Exposure
Sport psychologists are increasingly confronted with performance problems in sport where athletes suddenly lose the ability to execute automatic movements (Rotheram, Maynard, Thomas, Bawden, & Francis, 2012). Described as performance blocks (Bennett, Hays, Lindsay, Olusoga, & Maynard, 2015), these problems manifest as locked, stuck, and frozen movements and are underpinned by an aggressive anxiety component. This research used both qualitative and quantitative methods in a single case study design to investigate the effectiveness of eye movement desensitization and reprocessing (EMDR) therapy with graded exposure as a treatment method. The participant was a 58-year-old professional male golfer who had been suffering a performance block for 11 years. Specifically, the participant was experiencing involuntary spasms, shaking, muscle tension, and jerking in the lower left forearm while executing a putting stroke. Physical symptoms were coupled with extreme anxiety, panic, and frustration. The study tested the hypothesis that reprocessing related significant life events and attending to dysfunctional emotional symptoms would eliminate the performance block and related symptoms and that the individual would regain his ability to execute the affected skill. Pre-, mid-, and postintervention performance success, using the Impact of Event scale, subjective units of distress (SUD; Wolpe, 1973), and kinematic testing revealed improvements in all associated symptoms in training and competition. These findings suggest that previous life experiences might be associated with the onset of performance blocks and that EMDR with graded exposure might offer an effective treatment method.
The theory of attachment underlines how traumatic experiences from the parent’s past—when stored in a dysfunctional way—can be reactivated in the parent caregiving system, emerging from an internal working model (IWM) of attachment that holds the memory traces of such traumatic events. This article presents a clinical case report of a mother who was referred to treatment because she presented strong depressive symptoms. Forty sessions were provided, consisting of eye movement desensitization and reprocessing (EMDR) to address maternal trauma issues and cognitive behavioral therapy (CBT) for parenting skill development, debriefing, cognitive restructuring, and psychoeducation. The positive treatment results included distinct evidence of changes in the mother’s relationship with her child, and her mental representation of her caregiving system as measured with the Parent Development Interview (Slade et al., 1993).
Since 2007, mental health workers in sub-Saharan Africa have been trained in eye movement desensitization and reprocessing (EMDR) therapy. This qualitative study used an Afrocentric design with thematic analysis to investigate adaptations to the EMDR standard protocol that make it culturally relevant for African clients. Participants were 25 EMDR therapists (three male, age range 32–60 years, x̄ = 44) from five African countries, who practiced EMDR for 1–11 years (x̄ = 7). All answered a survey questionnaire, eight participated in a focus group discussion, and two provided a supervision notes analysis. Participants found EMDR a useful and beneficial therapy and preferred it over other therapies because of its nonnarrative nature and quick results. We identified four areas in which African therapists consistently made adaptations to the standard protocol: wording of the protocol text, cultural expression of thoughts and emotions, stimulation choice, and simplification of quantitative scales. Based on the study results, we make numerous recommendations for cultural adaptions to the EMDR protocol. These include language changes to take into account the clients' “we oriented” communication; cultural interpretations of positive and negative thoughts and events; adding cultural activities such as dance, music, and religious practices as resourcing exercises; using hand gestures or the pictorial faces scale instead of ordinal scales; and using tapping for bilateral stimulation instead of eye movements, which were sometimes seen as “witchcraft.” The relevance of the findings for EMDR practice and training are discussed. We recommend that African researchers further study the acceptability, use, and effectiveness of EMDR in their countries.