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Emdr final

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psychotherapy, PTSD

psychotherapy, PTSD

Published in: Health & Medicine

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  • 1.  
  • 2. Eye movement desensitization and reprocessing  ( EMDR ) is a form of  psychotherapy  that was developed to resolve  symptoms  resulting from disturbing and unresolved life experiences
  • 3. It uses a structured approach to address past, present, and future aspects of disturbing  memories . The approach was developed by Francine Shapiro  to resolve the development of  trauma -related disorders as resulting from exposure to a traumatic or distressing event, such as  rape  or military  combat . 
  • 4. Posttraumatic stress disorder (PTSD) 
  • 5. The three groups of symptoms that are required to assign the diagnosis of PTSD are recurrent re-experiencing of the trauma (for example, troublesome memories, flashbacks that are usually caused by reminders of the traumatic events, recurring  nightmares  about the trauma and/or dissociative reliving of the trauma), avoidance to the point of having a phobia  of places, people, and experiences that remind the sufferer of the trauma and a general numbing of emotional responsiveness, and chronic physical signs of hyperarousal , including  sleep  problems, trouble concentrating, irritability, anger, poor concentration, blackouts or difficulty remembering things, increased tendency and reaction to being startled, and hypervigilance to threat.
  • 6. Although EMDR is established as an  evidence-based treatment  for PTSD two main perspectives on EMDR therapy. First, Shapiro proposed that although a number of different processes underlie EMDR, the eye movements add to the therapy's effectiveness by evoking  neurological and  physiological  changes that may aid in the processing of the trauma memories being treated. The other perspective is that the eye movements are an epiphenomenon , unnecessary, and that EMDR is simply a form of  desensitization
  • 7. Posttraumatic stress disorder (PTSD) is an emotional illness that usually develops as a result of a terribly frightening, life-threatening, or otherwise highly unsafe experience. PTSD sufferers re-experience the traumatic event or events in some way, tend to avoid places, people, or other things that remind them of the event (avoidance), and are exquisitely sensitive to normal life experiences (hyperarousal
  • 8. According to  Francine Shapiro 's theory when a traumatic or distressing experience occurs, it may overwhelm usual ways of coping and the memory of the event is inadequately processed; the memory is dysfunctionally stored in an isolated  memory network .
  • 9. When this memory network is activated, the individual may re-experience aspects of the original event, often resulting in inappropriate overreactions. This explains why people who have experienced or witnessed a traumatic incident may have recurring sensory  flashbacks , thoughts, beliefs, or dreams. An unprocessed memory of a traumatic event can retain high levels of sensory and emotional intensity, even though many years may have passed.
  • 10.  
  • 11. anhedonia
  • 12.  
  • 13. The therapy process and procedures are according to Shapiro 
  • 14.
    • Phase I
      • In the first sessions, the patient's history and an overall treatment plan are discussed. During this process the therapist identifies and clarifies potential targets for EMDR. Target refers to a disturbing issue, event, feeling, or memory for use as an initial focus for EMDR.  Maladaptive  beliefs are also identified.
  • 15.
    • Phase II
      • Before beginning EMDR for the first time, it is recommended that the client identify a safe place, an image or memory that elicits comfortable feelings and a positive sense of self. This safe place can be used later to bring closure to an incomplete session or to help a client tolerate a particularly upsetting session.
  • 16.
    • Phase III
      • In developing a target for EMDR, prior to beginning the eye movement, a snapshot image is identified that represents the target and the disturbance associated with it. Using that image is a way to help the client focus on the target, a negative cognition (NC) is identified – a negative statement about the self that feels especially true when the client focuses on the target image. A positive cognition (PC) is also identified – a positive self-statement that is preferable to the negative cognition.
  • 17.
    • Phase V
      • The "Installation Phase": the therapist asks the client about the positive cognition, if it's still valid. After Phase IV, the view of the client on the event/ the initial snapshot image may have changed dramatically. Another PC may be needed. Then the client is asked to "hold together" the snapshot and the (new) PC. Also the therapist asks, "How valid does the PC feel, on a scale from 1 to 7?" New sets of eye movement are issued.
  • 18.
    • Phase VI
      • The body scan: the therapist asks if anywhere in the client's body any pain, stress or discomfort is felt. If so, the client is asked to concentrate on the sore knee or whatever may arise and new sets are issued.
  • 19.
    • Phase VI
      • The body scan: the therapist asks if anywhere in the client's body any pain, stress or discomfort is felt. If so, the client is asked to concentrate on the sore knee or whatever may arise and new sets are issued.
  • 20.
    • Phase VII
      • Debriefing: the therapist gives appropriate info and support.
  • 21.
    • Phase VIII
      • Re-evaluation: At the beginning of the next session, the client reviews the week, discussing any new sensations or experiences. The level of disturbance arising from the experiences targeted in the previous session is assessed. An objective of this phase is to ensure the processing of all relevant historical events.
    • EMDR also uses a three-pronged approach, to address past, present and future aspects of the targeted memory.
  • 22. The three groups of symptoms that are required to assign the diagnosis of PTSD are recurrent re-experiencing of the trauma (for example, troublesome memories, flashbacks that are usually caused by reminders of the traumatic events, recurring  nightmares  about the trauma and/or dissociative reliving of the trauma), avoidance to the point of having a phobia  of places, people, and experiences that remind the sufferer of the trauma and a general numbing of emotional responsiveness, and chronic physical signs of hyperarousal , including  sleep  problems, trouble concentrating, irritability, anger, poor concentration, blackouts or difficulty remembering things, increased tendency and reaction to being startled, and hypervigilance to threat.
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