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Video of the month

This month, I am bringing you an inspirational Ted Talk with social psychologist Amy Cuddy on a simple way to increase personal presence. Body language affects how others see us, but it may also change how we see ourselves. Amy Cuddy shows how "power posing" -- standing in a posture of confidence, even when we don't feel confident -- can affect testosterone and cortisol levels in the brain, and might even have an impact on our chances for success.

Recently released books on EMDR

I am excited to share with you two recently released books on EMDR by Debra Wesselmann, Cathy Schweitzer and Stefanie Armstrong of the Omaha based Attachment and Trauma Center of Nebraska. As an invited reviewer I was able to read these books last year. I consider these books to be essential reading for EMDR trained clinicians treating parents and their children with attachment and trauma issues. They are available for purchase now.

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Journal Articles


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Dilly, R. (2014). Eye movement desensitisation and reprocessing in the treatment of trauma with mild intellectual disabilities: A case study. Advances in Mental Health and Intellectual Disabilities, 8(1), 63-71. doi:10.1108/AMHID-06-2013-0036

Richard Dilly, Advanced Healthcare Practitioner, based at National High Secure Learning Disability Service, Rampton Hospital, Nottinghamshire Healthcare NHS Trust, Nottingham, UK.

Abstract

Purpose: The purpose of this paper is to explore the effectiveness of Eye Movement Desensitisation and Reprocessing (EMDR) therapy in an individual with mild intellectual disabilities currently compulsorily detained in secure care.

Design/methodology/approach: The intervention utilised the EMDR eight-phase protocolised psychotherapeutic approach. Sessions utilised symbol cards to explore the impact of the client's experiences in relation to his thoughts, emotional feelings, physical feelings and behaviour. Drawings were also utilised to assist the client to develop a picture of the traumatic incident. A "safe place visualisation technique" was also utilised at the end of every session to manage any distress. The Posttraumatic Stress Diagnostic Scale (PDS) with some minor adaptations for use with people with intellectual disabilities was utilised as a pre- and post-measure.

Findings: The study identified reductions in symptoms in all three core clinical subgroups of the PDS: re-experiencing, avoidance and arousal, with outcomes being maintained at one-month and six -month follow-up. Reduction in the strength of ratings was most evident in the avoidance domain.

Originality/value: There are limited studies exploring the effectiveness of EMDR with individuals with intellectual disabilities.

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Duros, P., & Crowley, D. (2014). The body comes to therapy too. Clinical Social Work Journal. doi:10.1007/s10615-014-0486-1

Peg Duros, Center for Contextual Change, Skokie, IL, USA. E-mail: pegd@centerforcontextualchange.org

Abstract
Current research reveals that trauma often cannot be resolved solely through interventions that utilize left-brain functions, such as those used in traditional talk therapy. Because trauma is actually something that happens deep in the core of the brain and the body, the most effective treatment approaches integrate traditional therapy modalities with those that focus on calming the nervous system such as yoga, mindfulness, imagery, expressive arts, and eye movement desensitization and reprocessing. This paper will focus on synthesizing current information on traumatic stress, the neurobiology of trauma, and evidence-based, body-integrative interventions provided within the framework of the Collaborative Change Model (CCM) (Barrett in The systemic treatment of incest. Taylor & Francis, Bristol, 1989; Treating complex trauma: a relational blueprint for collaboration and change. Rutledge, New York, 2014). Through the framework of the CCM, this paper will provide clinicians with an understanding of how and when to engage clients in body–mind approaches, how to help clients learn to recognize when they are in fight, flight, or freeze response patterns, and how to develop skills for managing emotional dysregulation. A detailed case study will be provided to illustrate this integrative approach in the treatment of trauma.

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Frommberger, U., Angenendt, J., & Berger, M. (2014). Post-traumatic stress disorder- a diagnostic and therapeutic challenge. Deutsches Ärzteblatt International, 111(5), 59-65. doi:10.3238/arztebl.2014.0059

PD Dr. med. Dipl.-Biol. Ulrich Frommberger, Bertha von Suttnerstr. 1, 77654 Offenburg, Germany. E-mail: ulrich.frommberger@mediclin.de

Full text available at: http://www.aerzteblatt.de/int/archive/article?id=153214

Abstract

BACKGROUND: In Germany, the one-month prevalence of post-traumatic stress disorder (PTSD) is in the range of 1% to 3%. Soldiers, persons injured in accidents, and victims of domestic violence increasingly seek medical help for symptoms of emotional stress. Days lost from work and monetary compensation for emotional disturbances are markedly on the rise. The term "PTSD" is commonly used uncritically and imprecisely, with too little regard for the existing diagnostic criteria. It is at risk of turning into a nonspecific collective term for emotional stress of any kind.

METHOD: We selectively reviewed the literature in the PubMed database and pertinent journals, with additional consideration of the recommendations and guidelines of medical societies from Germany and abroad.

RESULTS: The characteristic types of reactions seen in PTSD are nightmares and an intense, repetitive, intrusive "reliving" of the traumatic event(s). Emotional traumatization manifests itself not only as PTSD but also through major effects on other mental and somatic diseases. An early, trauma-focused behavioral therapeutic intervention involving several sessions, generally on an outpatient basis, can prevent the development of PTSD. The most important components of effective treatment are a focus on the particular trauma experienced and confrontation with the patient's memories of the trauma. The best existing evidence is for cognitive therapy, behavioral therapy according to the exposure paradigm of Foa, and eye movement desensitization and reprocessing therapy. The most recent meta-analysis reveals effect strengths of g = 1.14 for all types of psychotherapy and g = 0.42 for all types of pharmacotherapy taken together (with considerable differences among psychotherapeutic methods and among drugs). The efficacy of psychodynamic therapy, systemic therapy, body-oriented therapy, and hypnotherapy has not been adequately documented in randomized controlled trials.

CONCLUSION: PTSD can be precisely diagnosed and effectively treated when the diagnostic criteria and guideline recommendations are taken into account. Referral for trauma-focused psychotherapy should be considered if the acute symptoms persist for several weeks.

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Nikmorad, A. R., Nejad, A. S., Safdari, S., Goodini, A. A., Azadi, E., Babaei, M. A., . . . Bahrampour, O. (2014). Comparison of the influence of eye movement desensitization therapy and reprocessing (EMDR) and cognitive-behavioral therapy (CBT) method on reducing post-traumatic stress disorder in the war injured. Journal of Social Issues & Humanities, 2(8), 166-171.

Full text online: http://www.journalsih.com/Research%20Articles/Vol%202/Issue%208/Comparison%20of%20the%20influence%20of%20eye%20movement%20desensitization%20therapy%20and%20reprocessing.pdf

Abstract

Introduction: The present research tries to compare the effectiveness of two therapy methods of EMDR and CBT in PTSD. Statistical population included 400 people of 8-year Iran-Iraq war injured who referred to military clinics. 45 people were picked as sample size by means of cluster random sampling. They were put into two groups: experiment group and control group. The present research is an experimental study which involves intervention. Research design is of pretest-posttest type and has a control group. Instruments which were used for data collection include military post-traumatic stress disorder questionnaire (pcl), 8-session CBT package and 8-session EMDR package. Covariance method was used for data analysis.

Materials and methods: statistical population of the present research included all of The Injured of 8-year War imposed on Iran by Iraq. Sample size was 200 people and sampling method was random cluster sampling. 45 people were randomly selected from among 80 respondents who received an acceptable quota from Checklist questionnaire (pcl). They were put into 3 groups: 2 experiment groups and 1 control group. Respondents received 8 sessions of cognitive-behavioral training and 8 sessions of eye movement treatment and reprocessing. Then, the respondents received posttest. Data was analyzed by ANCOVA analysis and using SPSS.

Results: results showed that there is a significant difference between post-traumatic stress disorder mean in eye movement therapy group and cognitive-behavioral therapy group. Results also showed that there is a significant difference between post-traumatic stress disorder mean in the control group and eye movement therapy group. There is also a significant difference between post-traumatic stress disorder in control group and cognitive-behavioral therapy (CBT) group.

Conclusion: Results showed that desensitization therapy methods through eye movement therapy and reprocessing and CBT method influence on reducing post-traumatic stress disorder and eye movement therapy method are more effective than CBT method.

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Ringel, S. (2014). An integrative model in trauma treatment: Utilizing eye movement desensitization and reprocessing and a relational approach with adult survivors of sexual abuse. Psychoanalytic Psychology, 31(1), 134. doi:10.1037/a0030044

Shoshana Ringel, PhD, 1915 Greenberry Road, Baltimore, MD 21209. E-mail: sringel@ssw.umaryland.edu

Abstract

The aim of this article is to offer an integrative approach in the treatment of adult survivors of sexual abuse. The treatment orientation is psychodynamic and intersubjective and will draw on three conceptual models: (a) a developmental model based on current attachment research, (b) current neuroscience findings concerning traumatic memory that emphasize sensory, affective, and implicit knowing in the understanding and treatment of trauma, and (c) eye movement desensitization and reprocessing as an adjunctive technique to help access traumatic memories. The author will summarize each theoretical perspective and will provide a case illustration to demonstrate a treatment approach that incorporates all three modalities.

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Rubin, G. J., & Wessely, S. (2013). The psychological and psychiatric effects of terrorism: Lessons from London. Psychiatr Clin North Am, 36(3), 339-50. doi:10.1016/j.psc.2013.05.008

G. James Rubin, E-mail: gideon.rubin@kcl.ac.uk

Abstract

The 7 July 2005 bombings in London caused heightened levels of distress among some in the general community. This distress was most notable in Muslims and members of ethnic minority groups. These effects were transient for most. An estimated 30% of those who were more affected by the attacks, including victims and witnesses, developed psychiatric disorders as a result. An outreach program was set up to screen those who were exposed to potentially traumatic events and to offer them evidence-based treatment. This article discusses what lessons might be learned from studies of the general community and the screen-and-treat approach.

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Shapiro, F. (2014). The role of eye movement desensitization and reprocessing (EMDR) therapy in medicine: Addressing the psychological and physical symptoms stemming from adverse life experiences. The Permanente Journal, 18(1), 71-7. doi:10.7812/TPP/13-098

Francine Shapiro, PhD, Senior Research Fellow Emeritus at the Mental Research Institute. E-mail: fshapiro@mcn.org

Full text available online: http://www.thepermanentejournal.org/issues/2014/winter/5626-emdr.html

Abstract

Background: A substantial body of research shows that adverse life experiences contribute to both psychological and biomedical pathology. Eye movement desensitization and reprocessing (EMDR) therapy is an empirically validated treatment for trauma, including such negative life experiences as commonly present in medical practice. The positive therapeutic outcomes rapidly achieved without homework or detailed description of the disturbing event offer the medical community an efficient treatment approach with a wide range of applications.

Methods: All randomized studies and significant clinical reports related to EMDR therapy for treating the experiential basis of both psychological and somatic disorders are reviewed. Also reviewed are the recent studies evaluating the eye movement component of the therapy, which has been posited to contribute to the rapid improvement attributable to EMDR treatment.

Results: Twenty-four randomized controlled trials support the positive effects of EMDR therapy in the treatment of emotional trauma and other adverse life experiences relevant to clinical practice. Seven of 10 studies reported EMDR therapy to be more rapid and/or more effective than trauma-focused cognitive behavioral therapy. Twelve randomized studies of the eye movement component noted rapid decreases in negative emotions and/or vividness of disturbing images, with an additional 8 reporting a variety of other memory effects. Numerous other evaluations document that EMDR therapy provides relief from a variety of somatic complaints.

Conclusion: EMDR therapy provides physicians and other clinicians with an efficient approach to address psychological and physiologic symptoms stemming from adverse life experiences. Clinicians should therefore evaluate patients for experiential contributors to clinical manifestations.

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