This chapter serves as a one-stop resource where therapists can access a wide range of word-for-word scripted protocols for Eye Movement Desensitization and Reprocessing (EMDR) practice, including the past, present, and future templates. These scripts are conveniently outlined in an easy-to-use, manual style template for therapists, allowing them to have a reliable, consistent form and procedure when using EMDR with clients. For some clients finding a Safe/Calm Place is very difficult, either because of their life experiences or their difficulty in using their imagination. In cases such as these, construction of a container to hold traumatic material, both during desensitization and between sessions, may be an alternative strategy to help the client develop a sense of safety. Constructing a container follows the same basic setup protocol as establishing the Safe/Calm Place.
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- Go to article: Review of EMDR Interventions for Individuals With Substance Use Disorder With/Without Comorbid Posttraumatic Stress Disorder
Review of EMDR Interventions for Individuals With Substance Use Disorder With/Without Comorbid Posttraumatic Stress Disorder
A large proportion (11%–60%) of people with posttraumatic stress disorder (PTSD) also suffer from substance use disorder (SUD). As the high cooccurrence of PTSD and SUD leads to a worsening of psychopathological severity, development and evaluation of integrated treatments become highly valuable for individuals presenting with both diagnoses. Eye movement desensitization and reprocessing (EMDR) therapy may fit these needs. This article summarized all studies that investigated EMDR treatment for SUD, to clarify whether EMDR might be a useful approach. A comprehensive Title/Abstract/Keyword search was conducted on PsycInfo, PsychArticle, PubMed, and Scopus databases. A total of 135 articles were retrieved, and 8 articles met inclusion/exclusion criteria. One RCT and one case study evaluated trauma-focused EMDR; one clinical RCT, one non-clinical RCT, one cross-over study, and one case study evaluated addiction-focused EMDR; and one quasi-experimental and one multiphase case study evaluated the combination of addiction-focused and trauma-focused EMDR. Results show that EMDR treatment consistently reduces posttraumatic symptoms, but that its effects on SUD symptoms are less evident. Although EMDR should be considered as a promising tool for this population due to its possible potential to improve SUD outcomes, further research is needed to see whether EMDR therapy, either trauma-focused or addiction-focused, is effective for SUD. We conclude with suggestions for future research and clinical practice in this area.
- Go to article: EMDR Therapy as Portal to a Child’s Processing of a Medical Condition: A Case Study and Session Deconstruction
EMDR Therapy as Portal to a Child’s Processing of a Medical Condition: A Case Study and Session Deconstruction
This case study demonstrates the effective use of EMDR in helping a child manage fears triggered by a life-threatening chronic medical condition—congenital heart failure. It is well documented that childhood chronic illness creates ongoing stress and psychological problems for children and their families. Evidence suggests that interventions to enhance coping skills improve psychological functioning. EMDR has the potential to contribute to this end. Deconstructive analysis of a single EMDR session illustrates the working of Shapiro’s adaptive information processing (AIP) model. It demonstrates that the child can spontaneously open up channels of association to uncover, process, and resolve fears relating to the medical condition, as well as other concerns. A case is made for targeting whatever current, overt problem or symptom the child presents, because this inevitably serves as a portal to more covert, even unconscious core issues. Past, current, and future fears and traumatic experiences emerge and are processed to resolution. Also highlighted is the importance of integrating the individual EMDR treatment component into a family systems treatment approach for optimum outcome, because the illness impacts the whole family, ergo, the child. Recommendations for EMDR treatment planning and implementation with chronic illness are offered.
- Go to article: Integration of Religion and Spirituality Into Trauma Psychotherapy: An Example in Sufism?
Bilateral stimulation (BLS) is of significant importance to eye movement desensitization and reprocessing (EMDR) therapy. Eye movements seem to be the most effective form of BLS in EMDR. A brief summary of the cultural applicability of EMDR is provided, and research which showed the value of incorporating religion and/or spirituality into psychotherapy is highlighted. Islamic Sufism, in common with other traditional religions, has long been known to have a psychotherapeutic perspective and has been used over time to help people to overcome trauma and stress. This article argues that the ritual movements associated with the Sufi Dhikr may involve a form of BLS and that this might underline some of the therapeutic effectiveness of Dhikr and Sufism. The authors recommend investigating if the Sufi Dhikr element could be incorporated into a modified EMDR protocol. We anticipate that this would give EMDR an even wider and more popular acceptance in the Middle East and the Muslim world.
- Go to article: Adaptive Information Processing, Targeting, the Standard Protocol, and Strategies for Successful Outcomes in EMDR Reprocessing
Adaptive Information Processing, Targeting, the Standard Protocol, and Strategies for Successful Outcomes in EMDR Reprocessing
This article provides excerpts from each chapter of An EMDR Primer: From Practicum to Practice (Hensley, 2009) to assist novice eye movement desensitization and reprocessing (EMDR) clinicians who are learning how to use this approach and to serve as a refresher for therapists who have not used EMDR consistently in their practices. Actual cases are presented that demonstrate various strategies that the therapist can use to help clients reach adaptive resolution of trauma. Tables and figures highlight important features to explain the obvious and subtle nuances of EMDR. Focal points are the following: (a) the adaptive information processing model; (b) the types of targets accessed during the EMDR process; (c) the 8 phases of EMDR; (d) the components of the standard EMDR protocol used during the assessment phase; (e) past, present, and future in terms of appropriate targeting and successful outcomes; and (f) strategies and techniques for dealing with challenging clients, high levels of abreaction, and blocked processing.
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.
This practice-based article discusses the use of eye movement desensitization and reprocessing (EMDR) in counseling “Paul” and “Eddie” (aliases), a couple for 4 years who presented with what they identified as “communication problems.” Through the use of psychosocial assessments of the men’s personal histories, it was determined that Paul’s experience of feeling controlled and Eddie’s struggles to believe that he mattered in the relationship were linked to traumatic memories in each man’s childhood that related to his sexual identity development. EMDR was used to target the men’s traumatic memories, alternating between Paul and Eddie. Following each EMDR treatment series, the work was integrated by talking through how the reprocessed material integrated into the overall couple experience, leading to both men’s increased satisfaction in the relationship.
- Go to article: Electroencephalography Coherence, Memory Vividness, and Emotional Valence Effects of Bilateral Eye Movements During Unpleasant Memory Recall and Subsequent Free Association: Implications for Eye Movement Desensitization and Reprocessing
Electroencephalography Coherence, Memory Vividness, and Emotional Valence Effects of Bilateral Eye Movements During Unpleasant Memory Recall and Subsequent Free Association: Implications for Eye Movement Desensitization and Reprocessing
This study examined the effects of bilateral stimulation during unpleasant memory recall followed by free association, similar to Phase 4 of EMDR therapy. Forty-six female nonpatients were randomly assigned to one of three conditions: bilateral eye movements (BEMs), eye fixation with background movements (BDM), or eye fixation (Dot) control, each while recalling a moderately unpleasant memory and each followed by free association to the memory. Electroencephalography recordings were conducted on these participants during the 1-minute free association of the original memory after each of five administrations of the conditions. Results revealed only trend increases in Beta interhemispheric coherence following BEMs. However, statistically significant increases in Right Frontal Theta and Beta intrahemispheric coherences were found following BEMs, with similar trend increases for Left Frontal Theta and Beta and for Right Frontal Gamma. Cortical electrode maps are presented for these Beta coherence effects. Ratings of imagery vividness and emotional valence were collected after each set of eye movements plus free associations and showed a significant decrease across all conditions. Results are discussed within the context of a proposed integrated 2-stage cortical coherence model. Suggestions are made for future research, including investigation of possible implications for treatment of traumatic brain injury.
In this article, the concept of humanitarian aid, the basic needs in crisis situations, the definition of eye movement desensitization and reprocessing (EMDR), and EMDR as a humanitarian intervention are explained. General needs and needs in Middle East are discussed. Some of the published studies about the EMDR therapy as a humanitarian intervention are summarized. Training and humanitarian programs in Turkey are documented. Two of our important humanitarian projects with EMDR including Marmara earthquake training and Intervention and Kilis Syrian refugees projects are described in detail. The aim of this article is to underline the importance of basic elements of natural and man-made disasters in terms of organization, financing, training, and intervention.
- Go to article: Effects of the EMDR Protocol for Recent Traumatic Events on Acute Stress Disorder: A Case Series
The purpose of this study was to evaluate the effectiveness of the eye movement desensitization and reprocessing (EMDR) protocol for recent traumatic events in the treatment of acute stress disorder. Within weeks of being exposed to an isolated traumatic event, 7 adults diagnosed with acute stress disorder were provided with multiple sessions of the EMDR protocol for recent traumatic events, an extended version of the EMDR therapy standard protocol. In each case, an individual’s subjective distress caused by the traumatic events was measured using the Impact of Events Scale-Revised and the goal of alleviating symptoms was accomplished. The positive results suggest the EMDR protocol for recent traumatic events may be an effective means of providing early treatment to victims of trauma, potentially preventing the development of the more severe symptoms of posttraumatic stress disorder.