Complex trauma is prevalent in the general therapy population and is rooted in early neglect, and traumas of long duration, resulting in posttraumatic stress disorder (PTSD), dissociative disorders, attachment problems, and personality disorders. This chapter provides information that will help Eye Movement Desensitization and Reprocessing (EMDR) therapists enhance their ability to provide effective EMDR treatment for clients diagnosed with complex trauma who are also dealing with current health problems. It highlights the use of the adverse childhood experiences (ACE) questionnaire, which provides much needed information on childhood abuse, neglect, attachment disorders, PTSD, and dissociation. This questionnaire, when combined with a broad developmental and health history, will be very helpful in case conceptualization and development of targets for work in phases 4 to 7. Additionally, the chapter describes the links between the ACE issues and later health risks and problems that make these clients difficult to treat.
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- Go to chapter: The Impact of Complex PTSD and Attachment Issues on Personal Health: An EMDR Therapy Approach
The Eye Movement Desensitization and Reprocessing (EMDR) therapy model of self-care for clients was developed by González and Mosquera. Typically, self-care has reduced to physical self-care, namely, food, sleep, and exercise. It is important to take into consideration the person’s mental and emotional needs, including the following: realistic view of self, protecting self from any harmful figures, maintaining appropriate boundaries while interacting with others, recognition and validation of own emotions, finding time to dedicate to self, asking for and being capable of accepting help, treating self well, enhancing rather than destroying well-being. The chapter explains the ways to help clients relate to themselves in a more compassionate way by learning a completely new way of looking at themselves with acceptance, comprehension, and care. This type of works helps repair attachment wounds and introduces new adaptive information that client’s lack, which is a great preparation for future processing of traumatic events.
Although treatment fidelity measures for eye movement desensitization and reprocessing (EMDR) have been cited in past research, none have been subject to any empirical investigation of reliability. This three-phase study aimed to quantify the interrater reliability of a measure of EMDR treatment fidelity. First, two raters refined the reprocessing section of the EMDR Fidelity Checklist (Leeds, 2016) by developing a descriptive item-by-item scoring system to improve interpretation and reliability. The resultant checklist was piloted on recordings of five EMDR session recordings from the Laugharne et al. (2016) study. The checklist was then revised. Next, the raters used the checklist to assess 15 other recorded EMDR sessions from the same study. The intraclass correlations (ICCs) were in the excellent range for all subscales and total session scores (i.e., >0.75), with an exception of the Desensitization subscale, ICC = 0.69 (0.08, 0.90). Finally, individual items in that subscale were evaluated, finding that five items did not contribute to the ICC. When these were removed/revised, the ICC for this subscale moved into the excellent range, ICC = 0.81(0.43, 0.94). The findings of this study indicate that this checklist may be a reliable measure of treatment fidelity for single reprocessing EMDR sessions with the possible exception of the Body Scan phase. Future research using the checklist with raters who were not involved in checklist development is needed to confirm the generalizability of these findings.
- Go to article: Flash Technique Group Protocol for Highly Dissociative Clients in a Homeless Shelter: A Clinical Report
Flash Technique Group Protocol for Highly Dissociative Clients in a Homeless Shelter: A Clinical Report
The Flash Technique is a new protocol for use in the preparation phase of eye movement desensitization and reprocessing (EMDR) to quickly reduce the emotional intensity of traumatic memories, prior to full processing with EMDR. This report presents results from a Flash Technique group for five highly dissociative, currently sober addicts in a men's shelter. This group was an attempt to provide an affordable, trauma-focused intervention for the homeless. As part of the intake, each client met individually with the therapist for 30 minutes, to learn to use the flash technique to process a traumatic memory. Three inventories were used to measure treatment outcome: the Short PTSD Rating Interview (SPRINT), the Dissociative Experience Survey (DES-II), and the Beck Depression Inventory-II (BDI-II). Clients filled out the surveys 3 weeks before the start of the group and had their individual sessions 2 weeks before the start of the group. The DES and BDI-II were repeated at the beginning of the eighth session of the group. Clients' surveys showed a decline in scores after seven sessions of therapy: the DES scores dropped from 39.07 (standard deviation [SD] = 23.01) to 20.48 (SD = 10.02) with d = 0.81 and the BDI-II scores dropped from 32.4 (SD = 11.01) to 13.2 (SD = 8.4) with d = 1.74. Pre- and 2-week posttreatment SPRINT surveys showed scores dropping from 28 [SD = 2.05] pretreatment to 15.75 [SD = 5.19] 2 weeks posttreatment, with d = 6.07.
The chapters of the book examine neuroplasticity as it manifests in maturation, development, information processing, and the disorders associated with each. Growth, development, and integration of neural networks, as manifestations of neuroplasticity, are the mechanisms underlying consciousness, parenting, interpersonal relationships, and the healing process of psychotherapy. Today, neuroplasticity is increasingly understood to be an underlying mechanism of neurofunction at any age. The adult brain appears to possess a tendency toward neural stabilization, while at the same time maintaining a potential for plastic reorganization. More and more, we see evidence that the brain is capable of reorganization in response to changes in stimulation. Some examples of these changes are dramatic and result, in great part, from the application of sensory stimulation. The robust effect of eye movement desensitization and reprocessing in type I posttraumatic stress disorder is one such example.
The inner subjective world of the mind was historically relegated to the margins of social science, confined instead within the traditional domains of psychology and psychoanalysis. In the seven years since the first edition of this book was written, many developments in the fields of neuroscience and psychotherapy that were just beginning to appear on the horizon have received a massive increase in interest and study. Eye Movement Desensitization and Reprocessing (
EMDR) is so profoundly guided by the adaptive information processing ( AIP) model, it is crucial to examine how it measures up to researched neurobiological models of consciousness and information processing. The book is written with language that is not only technical but also suitable as an introduction to the neural underpinnings of consciousness and EMDR. It examines pertinent neuroscience research related to the understanding of consciousness, information processing, and traumatic disorders of consciousness. The book first presents with basic research in the neurosciences relevant to online/wakeful information processing, which includes sensation, perception, somatosensory integration, cognition, memory, emotion, language, and motricity. The second section examines the neuroscience research relevant to disorders of consciousness, which include anesthesia, coma, and other neurological disorders. Major focus is given to the disorders of type I posttraumatic stress disorder ( PTSD), complex PTSD/dissociative disorders, and personality disorders. The third section presents the reader with an examination of neuroscience research relevant to chronic trauma and autoimmune function. A number of medical illnesses, collectively known as “medically unexplained symptoms”, are examined. These include fibromyalgia, chronic fatigue syndrome, reflex sympathetic dystrophy, systemic lupus erythematosus, type 1 diabetes, Hashimoto’s thyroiditis, Graves’ disease, multiple sclerosis, Sjögren’s syndrome, and rheumatoid arthritis. The final section examines the foregoing material with respect to the AIPmodel. It explores treatment implications vis-à-vis the various types of PTSDand the presentations of medically unexplained symptoms.
Investigating the human mind as an abstract concept is very difficult. Exploring its biological foundations—especially consciousness—is an even more daunting task. If developing a map of the mind is the final frontier of the life sciences, the cartography of consciousness will be its last and most important accomplishment. The study of the conscious mind alone could not lead to a complete understanding of the brain. Consciousness and Eye Movement Desensitization and Reprocessing (
EMDR) have long been intimately related, albeit under a different name. Whereas the field of neurobiology has utilized the term consciousness to denote the processes of sensation, perception, learning, cognition, emotion, somatosensory integration, and memory, the discipline of psychology has chosen to use the term information processing. EMDRhas evolved into a comprehensive therapeutic approach guided by the adaptive information processing model. This introductory chapter discusses consciousness and EMDRand provides a brief description about the book.
- Go to article: A Brief Narrative Summary of Randomized Controlled Trials Investigating EMDR Treatment of Patients With Depression
A Brief Narrative Summary of Randomized Controlled Trials Investigating EMDR Treatment of Patients With Depression
Depression, one of the most common mental disorders, is characterized by enormous social costs and limited rates of treatment success, even though psychotherapeutic and pharmacological treatments currently contribute to an increase in the remission rate. In light of recent studies that have shown that traumas and adverse life experiences may represent risk factors for the onset of depression, the therapeutic approach of eye movement desensitization and reprocessing (EMDR) therapy has been seen as potentially effective in the treatment of depression. The purpose of the present brief narrative review is to summarize the current literature on the efficacy of EMDR in patients with depression, in particular by referring to randomized controlled clinical trials (RCTs) that examined depression as a primary outcome. The data examined are updated to March 2019 and count seven RCT studies covering the years from 2001 to 2019. They are heterogeneous by type of intervention and demographic characteristics of the sample. Although the selected studies are few and with different methodological critical issues, the findings reported by the different authors suggest in a preliminary way that EMDR can be a useful treatment for depression.
The standard Three-Pronged Protocol for Eye Movement Desensitization and Reprocessing (
EMDR) therapy guides the overall treatment of the client. It consists of a “three-pronged” (past, present, and future) approach in which initially past events, then present issues, and finally anticipated future situations are targeted in therapy. The Flashforward Procedure has appeared to be an effective application of EMDR therapy to deal with the second of the three-pronged approach. It is a procedure to address clients’ irrational fears and anticipatory anxiety responses that persist after the core memories of past events have been fully processed. The fear of future catastrophe is a key component in several psychological conditions--obsessive-compulsive disorder (OCD) and specific phobias. When clients have been carefully prepared and therapists know their clients well, the Flashforward Procedure can become another valuable tool in the EMDR therapist’s toolkit.
- Go to chapter: EMDR Therapy Protocol for the Prevention of Birth Trauma and Postpartum Depression in the Pregnant Woman
EMDR Therapy Protocol for the Prevention of Birth Trauma and Postpartum Depression in the Pregnant Woman
Recent studies on preventing postpartum depression (PPD) and on childbirth-related post traumatic stress disorder (PTSD) have identified the risk factors, including anxiety and depression related, trauma related, family and/or relationship related, and financial and/or work related risks. Primary PPD prevention can take place in a group setting or in an individual setting. The Eye Movement Desensitization and Reprocessing (
EMDR) Therapy Protocol for the prevention of birth trauma and PPD in the pregnant woman was designed improve the woman’s performance and reduce risks of childbirth trauma, and strengthen the woman’s resiliency while reducing the negative effects of stress suffered in childbirth. By means of bilateral stimulation (BLS), expectant mothers can both reprocess any maladaptive encoding information that would interfere with future childbirth performances, and anchor positive information associated with images and scenes, which represent personal resources to be used in coping with the critical moments of childbirth.