PTSD Facts 1 in 10 Americans will experience a traumatic event that will cause psychological & biological changes known as PTSD. In the U.S., 60% of men and 50% of women experience a traumatic event during their lifetime. Of these, 8% of men and 20% of women will develop PTSD. PTSD affects women at higher rates than men. This can be attributed to the higher incidence of rape towards women (9% vs. less than 1%). 88% of men & 79% of women who are diagnosed with PTSD also have another psychiatric disorder. About half suffer from major depression, 16% with anxiety disorders, & 28% with social phobia.
PTSD FACTS….. Individuals with PTSD have higher rates of substance abuse. In men, alcohol abuse is 52% & drug abuse is 35%. With women, alcohol abuse is 28% and drug abuse is 27%. More than half of the Vietnam War veterans (1.7 million) experienced PTSD. African Americans are more likely to develop PTSD than their Caucasian counterparts. Individuals diagnosed with heart attacks and cancer have been diagnosed with PTSD. Refugees who have fled their native countries may develop PTSD and go without treatment for years.
PTSD FACTS…. New mothers who experience difficult delivery during childbirth may develop PTSD, as well as an individual who regains partial consciousness during surgery. Percentage of soldiers reporting mental health problems during screenings: Active duty: Upon return from Iraq: 11.8% three to six months later: 16.7% Reserves: Upon return from Iraq: 12.7% three to six months later: 24.5%
PTSD SYMPTOMS….. re-experiencing Flashbacks-physical symptoms, racing heart…sweating BAD DREAMS Frightening thoughts!!!!
Avoidance…. Feeling Stay away from emotionally reminders numb Feeling Loss of interest guilt, depression in activities or worry Having trouble remembering the “EVENT”
Hyperarousal…. Being easily startled! Feeling tense or on edge Difficulty sleeping or having angry outbursts!
DSM…. 309.81 saysThe person has been exposed to a traumatic eventThe traumatic event is personally experienced in oneor more waysPersistent avoidance of stimuli or traumatic event andnumbing of general responsivenessPersistent symptoms of increased arousalDuration of the disturbance is more than 1 monthDisturbance causes clinically significant or impairment
Eye Movement Desensitization and Reprocessing God whispers to us in our pleasures, speaks in our conscience, but shouts in our pains: it is His megaphone to rouse a deaf world. -C.S Lewis
brief history…Francine Shapiro Ph.D….clinicalpsychologist from California withaccolades, membership and world classrecognition in Trauma Psychology andPsychotherapy Adaptive Information Processing
brief history…. Walk in the park reveals that spontaneous eye movements were associated with negative emotions & cognitive changes AND … “bilateral eye movements relieve negative emotions associated with distressing memories” Implementation of a controlled case study with 22 random assignments; ½ - EMD , ½ - imagery & description. EMD decreased subjective distress and significantly increased ratings of positive belief Participants in EMD resulted in greater change than those in imagery conditioning
Nice Cat! OH CAT BIT ME! Fast ride away uglyNO! GATE IS OMG! BLOOD from doctor! OPEN! …and LOTS of VACATION! pain!Bright lights…oxygen…surgery…. You want me to sign WHAT? Theory of Adaptive Information Processing Model says.. Physiologically based processing… memories are stored network links. Learning occurs when links to previously stored memory are combined with new associations.
Process of trauma… Trauma event happens Incomplete thoughts Or dissociation Prevention of appropriate memory storage Dysfunctional Memory Storage…bad connections! Triggered memories thenenable people to relive either emotions or physical sensations! “This prevents the forging of connections to adaptive information in other memory networks !!”-Shapiro
Small “t”rauma is what produces the personality disorders which become the basis for dysfunctional reactions !!!!
Theory of personality EVERYONE HAS THE ABILITY TO RECOVER! – ShapiroMany have “unrelenting standards” meaning…. People are hard on themselves! Interaction of persons’ temperament + hurtful experiences = TRAUMA
Theory of trauma"When trauma occurs, the information processing system becomes imbalanced. Perceptions that were there at the time of the event become locked metaphorically in their own neural network. Theyre unable toconnect with anything more adaptive.”
Mechanisms of psychotherapyORIENTING RESPONSE is a natural response ofinterest & attention that is elicited when attention isdrawn to a new stimulus.Cognitive/Information ProcessingBehavioralNeurobiologicalThis happens through dual stimulation andimplemented in one of three ways: bilateral eyemovements, audio-tones, or hand pats.
…process of psychotherapy- 8phases1. Take the client 5. Perform installation history –of newly desired2. Prepare or educate cognitions the client about the 6. Direct client to body process scan-in terms of3. Perform assessment physical a. Identifying rating sensations scales 7. Install closure- b. Therapeutic request for targets journaling progress4. perform & self control Desensitization sets techniques
Application issues…. Can be used to treatPTSD, depression, addiction, grief, andSOME psychotic symptoms…even stressedgolfersIs multifaceted – because of differentmethods of dual stimulation available intreatment, EMDR can be used to treathearing & visually impaired and children toseniors in every culture where EMDRtherapists are trained
A review of current research According to a 2009 intervention where EMDR was used with child flood victims in Argentina, Bluthgen and Knofler report in International Journal of Stress Mgmt that “A comprehensive group intervention with 124 children, who experienced disaster related trauma during a massive flood utilizing a one session group protocol. Significant differences were obtained and maintained at 3-month follow up.” In a 2002 position paper for the Israeli National Council for Mental Health, Bleich, Kotler, Kutz and Shalev reported that EMDR is “one of three treatment methods that are used to treat terror victims”. In a 2007 with “person-under-train accident or
Empirical evidence Study submitted in 2006In the 1999 Turkish Earthquake survivors study, using the PSS-SR criteria, 38 (92.7%) of the 41participants who were tested at pre-treatment no longer exhibited PTSD at post-treatment.At follow-up, 18 (85.7%) of the 21 participants no longer met criteria for PTSD
EMDR in the 1999 Turkey earthquakesurvivorsFigure 1. Comparison of early and late treatment pre and posttestPTSD Symptom Scale Self-Report (PSS-SR) scores (N 41).(Konuk, Knipe, Eke, Yusek, Yurtsever and Ostep,2006)
Comparison of pre and post follow-up Posttraumatic StressDisorder Symptom Scale (PSS-SR) scores (N 21) for early and late-treated groups combined (Konuk, Knipe, Eke, Yusek, Yurtsever and Ostep,2006)
Another example: treatment of PTSD ….Means and Standard Deviations for PTSD and BDI Scores before and after Six SessionsTable 1*__________________________________________________________________ Treatment Pre Post____________ PTSD Scores PE 34.56 means 15.78** (8.06) SD (9.16) EMDR 26.58 9.10** (11.56) (11.22) BDI Scores PE 27.00 10.67** (10.84) (3.13) EMDR 17.20 5.50** (8.60) (4.35) Note. n 5 19 (PE n 5 9, EMDR n 5 10). **p , .01. *Sessions included one for evaluation, two for preparation, and three active treatment sessions with PE or EMDR with 22 individuals
Criticisms from literatureWhat people have said about EMDR ….the TRUTH EMDR IS Hypnosis No. Hypnosis induces relaxation. EMDR connects with an anxious mental state EMDR is simple eye It is a complex movement therapy approach to psychotherapy used EMDR cures PTSD in along with one session psychodynamic, cogniti ve & family therapies EMDR… desensitizes the anxiety..not to
Conclusions to EMDR treatment methodsAdaptive information processing says that memory is physiological and stored in network links. EMD was devised in order to enable individuals toappropriate negative thoughts to a positive adaptable setof storage rules EMDR is an effective treatment method for treatingtrauma, addictions, depression, & some psychoticissues across cultures Treatment can more often be completed in less time Treatment outcomes are much higher than othermethods used to treat disorders….in follow-upstudies