Video of the month

This month’s brief video from Shamengo features an interview with Francine Shapiro in a video highlighting EMDR Humanitarian Assistance Program work in Haiti and a visit to the offices of Gerald Puk, Ph.D.

Journal Articles

de Jongh, A. (2012). Treatment of a woman with emetophobia: A trauma focused approach. Mental Illness, 4(1), e3.

Ad de Jongh, Department of Behavioral Sciences, Academic Centre for Dentistry Amsterdam, Louwesweg 1, 1066 EA Amsterdam, The Netherlands. E-mail: a.de.jongh@acta.nl

Full text available at: http://www.pagepress.org/journals/index.php/mi/article/view/mi.2012.e3

Abstract

A disproportionate fear of vomiting, or emetophobia, is a chronic and disabling condition which is characterized by a tendency to avoid a wide array of situations or activities that might increase the risk of vomiting. Unlike many other subtypes of specific phobia, emetophobia is fairly difficult to treat. In fact, there are only a few published cases in the literature. This paper presents a case of a 46-year old woman with emetophobia in which a trauma-focused treatment approach was applied; that is, an approach particularly aimed at processing disturbing memories of a series of events which were considered to be causal in the etiology of her condition. Four therapy sessions of Eye Movement Desensitization and Reprocessing (EMDR) produced a lasting decrease in symptomatology. A 3-year follow up showed no indication of relapse.

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Flu, B. R. L. (2012). Tap, tap tap the usefulllness of EMDR on kids on the autism spectrum. European Psychiatry, 27, 1. doi:10.1016/S0924-9338(12)74434-6

R.L. Brand Flu, The Town House, Child and Adolescence Psychiatry, Derby, UK

Abstract

EMDR, Eye movement Reprocessing and Desensitisation is an amalgamated psychotherapy and brain activation intervention. This hyper-focussed therapy has shown its value beyond the treatment of trauma i.e. in a large number of mental health issues and developmental disorders.
In autism this method requires some adaptations as described below.

Aim
To give an introductory of EMDR in autism children.

Objective
To establish the usefulness of this treatment.

Methods
The general method is after establishing a baseline of disturbance to work through the touchstone event or focus of the trauma/feared situation from image, feelings, self-judgment and bodily feelings. The preparation also consists of exploring the ability to work with imagery and understanding of feelings. Imagery is tailored to their special interest and at time bodily sensations and feelings are worked on together when no differentiation of these experiences exist 18 cases of the age of 9– 16 underwent the method. 11 had generalised but extreme anxiety issues, 5 had experienced bullying, 4 had aggression regulation problems, 1 had obsessive compulsive disorder, 1 had a spider phobia, one had a developing eating disorder. The level of disturbance went down in all cases. One relapsed. Three needed visual augmentation for the visualisation. Three could not bear physical contact and therefore required self-tapping. 12 cases needed only one session for the focussed treatment. 9 displayed continual improvement over the next 4 weeks and 5 were treated further under conventional therapy.

Conclusion
EMDR is a valuable therapy in autism children but requires specific modification.

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Hunt, N. (2012). Methodological limitations of the RCT in determining the efficacy of psychological therapy for trauma. Journal of Traumatic Stress Disorders & Treatment, 1(1). doi:10.4172/jtsdt.1000e101

Nigel Hunt, University of Nottingham, UK, E-mail: nigel.hunt@nottingham.ac.uk

Full text available at: http://www.scitechnol.com/JTSDT/JTSDT-1-e101.pdf

Abstract

Which therapy to use with traumatized individuals is always a difficult choice, particularly as the evidence regarding the therapies available is often contradictory.
Currently, the National Institute for Health and Clinical Excellence (NICE) Guidelines in the UK recommend, on the basis of a number of trials and reviews, that practitioners in the National Health Service (NHS) only use trauma-focused cognitive behavior therapy (TFCBT) and eye movement desensitization and reprocessing (EMDR) [1]. There is little attempt to consider the methodological limitations of the research which identifies these two therapies as the most effective. While it is true that TF-CBT and EMDR work well for many people, they are not effective for everyone. While the NICE guidelines do recognize drug treatments for individuals who express a preference not to engage in trauma-focused therapy there is no recognition of other forms of therapy.

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Marich, J. (2012). What makes a good EMDR therapist? Exploratory findings from client-centered inquiry. Journal of Humanistic Psychology. doi:10.1177/0022167811431960

Jamie Marich, e-mail: jamie@jamiemarich.com

Abstract

There are several qualities of good EMDR (eye movement desensitization and reprocessing) therapists that must be examined to understand what clients most value in this specialized treatment. These qualities, as defined by former clients, include therapist personality, an ability to empower clients, flexibility, intuition, a sense of ease and comfort in working with trauma, and a commitment to the small measures of caring that clients identify as helping them feel safer. This article highlights the importance of honoring client safety in EMDR treatment by further exploring a theme from a phenomenological parent study on the use of EMDR with women in addiction continuing care. The parent study offered qualitative evidence showing that there is a place for EMDR as part of a comprehensive women’s addiction recovery program when applied properly. In this article, participants’ descriptions of their EMDR therapists and how these therapists were able to establish safety are described in greater detail than the parent study article allowed. Implications for emphasis on client-centered factors in the training and formation of EMDR therapists are discussed using the data extrapolated from the clients’ experiences, and further directions for researching the client-centered perspective in EMDR are presented.

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Pagani, M., Di Lorenzo, G., Verardo, A. R., Nicolais, G., Lauretti, G., Russo, R., . . . Fernandez, I. (2012). Pre- intra- and post-treatment EEG imaging of EMDR - neurobiological bases of treatment efficacy. European Psychiatry, 27, Supplement 1(0), 1 -. doi:10.1016/S0924-9338(12)75329-4

Marco Pagani, Istituto di Scienze e Tecnologie della Cognizione, CNR, Roma, E-mail: marcopagani2@yahoo.it

Abstract

Aim
Eye Movement Desensitization and Reprocessing (EMDR) is a recognized first-line treatment for psychological trauma. However its neurobiological bases have not been disclosed yet.

Methods
Electroencephalography was used for the first time to fully monitor neuronal activation during whole EMDR sessions including the autobiographical script. Nine clients with major psychological trauma were investigated during the first EMDR session and during the last one performed after processing the index trauma. Comparisons between the EEG of the first and last EMDR session and between the EEG of the clients at the first session and those of 9 controls undergoing the same EMDR procedure were performed.

Results
During both script listening and bilateral stimulation EEG showed significantly higher activity in the prefrontal limbic cortex (Brodmann Areas, BA 9–10) at the first as compared to the last EMDR session. The opposite comparison showed a shift of the prevalent activity towards temporal, parietal and occipital cortical regions (BAs 20, 21, 22, 37, 17, 18, 19) with leftward lateralisation. The comparison between the 9 clients and the 9 controls confirmed the maximal activation in the limbic cortex in the clients before processing the trauma.

Conclusions
The implemented methodology made possible to image for the first time the specific activations associated with the therapeutic actions contemplated by EMDR. The findings suggest cognitive processing of traumatic events following successful EMDR therapy supporting the evidence of distinct neurobiological patterns of brain activations during bilateral ocular stimulation associated with a significant relieve from negative emotional experiences.

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Poon, M. W. L. (2012). EMDR in competition with fate: A case study in a chinese woman with multiple traumas. Case Reports in Psychiatry, 2012. doi:10.1155/2012/827187

Maggie Wai-Ling Poon, Clinical Psychological Unit 3, Social Welfare Department, 14/F. Cornwall House, Taikoo Place, 979 King's Road, Quarry Bay, Hong Kong.

Abstract

This paper described the application of eye movement desensitization reprocessing (EMDR) for addressing the posttraumatic stress disorder (PTSD) symptoms in a Chinese woman who had experienced multiple traumas in her childhood. EMDR is an integrative therapeutic intervention that uses a standardized eight-phase approach to treatment. It is also a proven, effective, and efficient treatment for trauma. In this client with multiple traumas, the etiological event that lay the foundation of her dysfunctional responses was reprocessed first. The successful resolution of this event allowed the positive treatment effects to transfer to other traumatic events of a similar theme. This case also illustrates the importance of identifying a culturally appropriate positive cognition (PC) in contributing to the success of the treatment.

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Tarquinio, C., Brennstuhl, M. J., Reichenbach, S., Rydberg, J. A., & Tarquinio, P. (2012). Early treatment of rape victims: Presentation of an emergency EMDR protocol. Sexologies. doi:10.1016/j.sexol.2011.11.012

Cyril Tarquinio, APEMAC UE 4360 Research Department, Psychological and Epidemiological Approaches to Chronic Diseases, Health Psychology Team, Paul-Verlaine-de-Metz University, UFR SHA, Île-du-Saucy, BP 30309, 57006 Metz, France. E-mail: CTarquinio@aol.com

Abstract

This research aims to test the effectiveness of a new form of early treatment for the consequences of rape. Using several emergency EMDR protocols such as Shapiro's (2009) R-TEP (Recent Traumatic Episode Protocol) and Kutz, Risnik and Dekel's (2008) Modified Abridged EMDR Protocol, as well as the practice of psychological debriefing, we treated in one session 17 female rape victims within 24 to 78 hours after their aggression. Follow-up was done after 4 weeks and 6 months during which we measured the effects of this psychological support on posttraumatic symptomatology and psychological distress, as well as on certain indicators of the sexuality of these victims compared to their prior sexuality. The results show, after one session, an interesting reduction in the different measures which remains stable 4 weeks and 6 months after the treatment, as does the way in which the victims appear to take an interest in their sexuality. If this type of emergency intervention is not a complete substitution for in-depth psychotherapy, its contribution and pertinence in the context of immediate treatment offers interesting perspectives for treating victims of sexual aggression.