Video of the month

This month’s video features an interview with EMDR author and trainer Sue Rogers, Ph.D. speaking in a video from the United State’s Veteran’s Heath Administration: “What is Eye Movement Desensitization And Reprocessing (EMDR)”.

Journal Articles

Kliem, S., Kröger, C., Sarmadi, N. B., & Kosfelder, J. (2012). Wie werden verbesserungen nach typ-II-traumata infolge unterschiedlicher traumabearbeitender interventionen eingeschätzt? Eine re-analyse der umfrage unter psychotraumatologisch erfahrenen psychologischen psychotherapeuten. [How are improvements due to trauma-processing interventions after type-II-trauma rated. A re-analysis of a survey of licensed psychotherapists with psychotraumatological experience.]. Zeitschrift Für Klinische Psychologie Und Psychotherapie: Forschung Und Praxis, 41(1), 30-37. doi:10.1026/1616-3443/a000117

Sören Kliem, Technische Universität Braunschweig.

Abstract

Background: For the treatment of Post-Traumatic Stress Disorder (PTSD) following type-II-trauma, different trauma-processing methods are currently used in clinical practice. Objective: To determine how the improvements in several symptom clusters (intrusion, avoidance, hyperarousal, dissociation, additional complaints) are retrospectively rated by practitioners as a function of using different trauma-processing interventions. Method: In a survey of licensed psychotherapists ( N = 272), those cases were included in which the therapists (1) reported an event that could be assigned to type-II-trauma, and (2) identified specific trauma-processing interventions according to Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT), Eye Movement Desensitization and Reprocessing (EMDR), or Psychodynamic Imaginative Trauma-Therapy (PITT) ( n = 37). Additionally, therapists retrospectively rated the improvements on the symptom clusters at post-treatment. Results: More than 40% of therapists reported using imaginative techniques for dissociation and emotion regulation, as well as processing the perpetrator’s introjects sensu PITT, followed by trauma-processing interventions of either TF-CBT (35.1%) or EMDR (21.6%). Those therapists who reported using interventions of the latter two methods rated the patient’s improvements higher in all symptom clusters than therapists who reported using trauma-processing interventions of PITT. Conclusion: The retrospective ratings of improvements are in line with the recommendations of guidelines for the treatment of PTSD.

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Murphy, D., Archard, P. J., Regel, S., & Joseph, S. (2012). A survey of specialized traumatic stress services in the United Kingdom. Journal of Psychiatric and Mental Health Nursing. doi:10.1111/j.1365-2850.2012.01938.x

David Murphy, School of Education, University of Nottingham, Dearing Building, Jubilee Campus, Wollaton Road, Nottingham NG8 1BB, UK, E-mail: david.murphy@nottingham.ac.uk

Abstract

Specialist care following psychological trauma in the UK has, since 2005, been governed by the National Institute for Health and Clinical Excellence (NICE) Guideline 26, for the treatment of post-traumatic stress disorder. NICE guidance states that the preferred first-line treatment is trauma-focused cognitive behavioural therapy that incorporates techniques of eye movement, desensitization and reprocessing. In light of this guidance, the rationale for this survey was to assess the nature and scope of services available in UK specialist trauma services and range of available therapeutic approaches delivered. Thirteen organizations responded to the survey. Ten were NHS services and three were non-statutory organizations. Professional positions were primarily populated by psychologists. The total number of referrals to UK specialist trauma services surveyed in the 12 months prior to the survey was 2041 with a mean of 157. Trauma-focused cognitive behavioural therapy was the most common therapeutic treatment, but person-centred therapy was found to have increased in availability within specialist trauma services. This arguably reflects the widening availability of person-centred therapy in the improving access to psychological therapies initiative and perhaps suggests some divergence from more uniform cognitive and behavioural approaches within NHS therapy services. Implications for practice are discussed.

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Rougemont-Bücking, A., & Zimmermann, E. N. (2012). EMDR-based treatment of psychotraumatic antecedents in illicit drug abusers: A report of two cases. Schweizer Archiv Für Neurologie Und Psychiatrie, 16(3), 107-115.

Ansgar Rougemont-Bücking, MD, Addiction Unit, Community Psychiatry Service Department of Psychiatry, Centre Hospitalier Universitaire Vaudois and University of Lausanne, 7, rue St-Martin, CH-1003 Lausanne, Switzerland. Email: ansgar.rougemont-buecking@chuv.ch

Full text available at: http://www.sanp.ch/pdf/2012/2012-03/2012-03-017.PDF

Abstract

The co-occurrence of PTSD and of substance use disorder (SD) is known to be very high. However the question of whether and how to treat such patients remains largely unanswered in the EMDR community. We report on two cases of EMDR-based treatment of heavily affected SD patients in whom psychotraumatic antecedents were identified. EMDR sessions focused on trauma-related material and not on the expression of cue-induced drug craving. The treatment appeared to be a difficult and challenging endeavour. However, some beneficial effects on general comfort and on drug consumption could be observed. A long stabilisation phase was mandatory and the standard EMDR protocol needed to be conducted with much flexibility. Interestingly, there was no provocation of a prolonged psychological crisis or of relapse. Experiencing of emotional stress could be limited to the sessions and dissociation could be absorbed with specific well-known techniques without permanently increasing drug craving. These observations are discussed in relation to previously published concepts of using EMDR in the field of trauma and substance abuse.

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Tarquinio, C., Schmitt, A., & Tarquinio, P. (2012). Violences conjugales et psychothérapie eye movement desensitization reprocessing (EMDR): Études de cas. [Conjugal violence and eye movement desensitization reprocessing (EMDR) psychotherapy: Case studies.]. L'Évolution Psychiatrique, 77(1), 97-108. doi:10.1016/j.evopsy.2011.11.002

Cyril Tarquinio, UFR SHA, APEMAC EA 4360, EPSaM, équipe de psychologie de la santé de Metz, université Paul-Verlaine de Metz, Île-du-Saulcy, 57000 Metz, France. CTarquinio@aol.com

Abstract

The objective of this article is to investigate the effects of Eye Movement Desensitization Reprocessing treatment for victims of domestic violence. Five women were offered treatment with between three and nine 60-minute EMDR sessions. Assessments were completed at pre-treatment, post-treatment, and at the 6-month follow-up, with the purpose of demonstrating the ability of EMDR psychotherapy to reduce Posttraumatic Stress Disorder (PTSD), anxiety, and depressive symptoms. Results showed a significant reduction in PTSD scores (intrusion, avoidance symptoms), anxiety, and depression, and were maintained after 6 months. This study opens up original perspectives for the treatment of domestic violence victims. The question of EMDR therapy’s adequacy and pertinence for the treatment of domestic violence will be discussed. In any case, EMDR therapy seems to offer a promising therapeutic, social, and clinical response for this population, which is often difficult to treat.

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Tarquinio, C., Schmitt, A., Tarquinio, P., Rydberg, J. A., & Spitz, E. (2012). Benefits of “eye movement desensitization and reprocessing” psychotherapy in the treatment of female victims of intimate partner rape. Sexologies: European Journal of Sexology and Sexual Health/ Revue Européenne De Sexologie Et De Santé Sexuelle, 12(2), 60-67. doi:10.1016/j.sexol.2011.05.002

Cyril Tarquinio. APEMAC UE 4360 Research Department, Psychological and Epidemiological Approaches to Chronic Diseases, Health Psychology Team, Paul Verlaine de Metz University, Île du Saulcy, BP 80, 794 Metz cedex 1, France. Email: ctarquinio@aol.com

Abstract

This study sought to evaluate the effects of eye movement desensitization and reprocessing ( EMDR) psychotherapy, particularly with regard to the reduction of post-traumatic stress disorder (PTSD), anxiety, and depressive symptoms, based on the treatment of 6 female participants who had been victims of intimate partner rape. All of the participants completed quantitative measures pretreatment and following each session. The measures used were the Hospital Anxiety and Depression Scale and the Impact of Events Scale, as well as the Subjective Units of Disturbance Scale used in EMDR. Participants were also administered qualitative interviews before and after the treatment in order to assess the presence of PTSD symptoms according to the Diagnostic and Statistical Manual of Mental Disorders American Psychiatric Association (APA), 2004. Outcomes were consistent with our expectations and showed a significant and gradual decrease in scores on the various scales during treatment. As the literature has repeatedly shown, individuals who receive EMDR treatment tend to assess themselves as feeling less and less disturbance as the therapy progresses. We also observed a significant decrease of scores on the various scales following the first two sessions. Finally, the psychological treatment based on EMDR therapy led to an important decrease in the number of PTSD symptoms. This reduction was consistent for the American Psychiatric Association (APA), 2004 criteria under consideration (B, C, & D).
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van den Hout, M. A., Bartelski, N., & Engelhard, I. M. (2012). On EMDR: Eye movements during retrieval reduce subjective vividness and objective memory accessibility during future recall. Cognition & Emotion. doi:10.1080/02699931.2012.691087

Marcel A. van den Hout, Clinical and Health Psychology, Utrecht University, PO Box 80140, 3508 TC Utrecht, The Netherlands. Email: m.vandenhout@uu.nl

Abstract

In eye movement desensitization and reprocessing (EMDR), a treatment for post-traumatic stress disorder (PTSD), patients make eye movements (EM) during trauma recall. Earlier experimental studies found that EM during recall reduces memory vividness during future recalls, and this was taken as laboratory support for the underlying mechanism of EMDR. However, reduced vividness was assessed with self-reports that may be affected by demand characteristics. We tested whether recall+EM also reduces memory vividness on a behavioural reaction time (RT) task. Undergraduates (N=32) encoded two pictures, recalled them, and rated their vividness. In the EM group, one of the pictures was recalled again while making EM. In the no-EM group one of the pictures was recalled without EM. Then fragments from both the recalled and non-recalled pictures, and new fragments were presented and participants rated whether these were (or were not) seen before. Both pictures were rated again for vividness. In the EM group, self-rated vividness of the recalled+EM picture decreased, relative to the non-recalled picture. In the no-EM group there was no difference between the recalled versus non-recalled picture. The RT task showed the same pattern. Reduction of memory vividness due to recall+EM is also evident from non-self-report data.

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Welling, H. (2012). Transformative emotional sequence: Towards a common principle of change. Journal of Psychotherapy Integration, 22(2), 109. doi:10.1037/a0027786

Hans Welling, Quinta do Moinho, 7005-839 Canaviais, Portugal. E-mail: hanswelling@yahoo.com

Abstract

Transformative emotional sequence (TES) is proposed as a common principle of therapeutic change underlying a number of therapies: Emotion-focused therapy (EFT), coherence therapy (CT), accelerated experiential-dynamic psychotherapy (AEDP), and eye movement desensitization and reprocessing (EMDR). TES consists of emotional activation of a problematic emotional state followed by the activation of adaptive emotional state(s) within a short window of time. The resulting change is the creation of a permanent connection between previously unintegrated maladaptive emotional memory networks and adaptive emotional networks. Memory reconsolidation provides a plausible explanation for the mechanism underlying the effectiveness of TES. I compare TES to exposure, and argue that it is the intervention of choice for transforming maladaptive emotions, whereas exposure is most appropriate for accessing disowned and avoided experiences.

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Worthington, R. (2012). Dealing with trauma as an intervention for aggression: A review of approaches and the value of reprocessing. Journal of Aggression, Conflict and Peace Research, 4(2), 108-118. doi:10.1108/17596591211208319

Rachel Worthington, Forensic Psychologist at the School of Psychology, University of Central Lancashire, Preston, UK and in the Psychology Department, Alpha Hospitals, Bury, UK.

Abstract

Purpose: The purpose of this paper is to explore the impact of trauma with specific consideration to the neurological impact this has on information processing and potential links with aggression. Design/methodology/approach: This paper provides a summary of the literature in relation to theories of aggression and trauma. The paper considers how the two may interact and overlap and considers a theoretical rationale for why addressing trauma through a treatment such as Eye Movement Desensitization Reprocessing (EMDR) may assist to reduce aggression. Findings: The paper argues that the experience of trauma may contribute to inputs which may take a person closer towards engaging in aggression. This is consistent with information processing models and unified models of aggression such as the General Aggression Model. Factors that were specifically identified included physiological hyper-arousal, hostile attributions of stimulus, and neurological impairments. In addition, the paper also argued that there is evidence that as a result of trauma, a person’s ability to provide cognitive accounts for the function of their behaviour may also be impaired because of the reduced interactivity between the two prefrontal hemispheres. Research limitations/implications: The paper argues that as a result, interventions designed to reduce aggression may benefit from including additional elements which directly assist clients to process emotional information and that a reprocessing treatment such as EMDR could assist to reduce levels of emotional arousal and improve treatment effectiveness. Differences in the way in which EMDR is carried out and the variances in treatment protocols used should be attended to increase the reliability of future research. Originality/value: Current modes of aggression therapy have focused on exposure based and cognitive behavioural therapy (CBT). However, there is evidence that EMDR has benefits over exposure and CBT approaches because of the way in which cognitive verbal accounts of the trauma are not required and because EMDR does not require the individual to have insight into their trauma experience and the link with aggression.