THROUGH THE EYE OF THE TRAUMA STORM: EMDR in the treatment of injury

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WHAT IS EMDR?. Eye Movement Desensitization

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THROUGH THE EYE OF THE TRAUMA STORM: EMDR in the treatment of injury Alexandra (Sandi) Richman

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WHAT IS EMDR? Eye Movement Desensitization & Reprocessing Innovative clinical treatment for injury Also compelling in treating tension related issue EMDR is an unpredictable strategy for psychotherapy joining a scope of restorative methodologies in blend with option double consideration incitement EMDR actuates the data handling arrangement of the mind

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WHAT IS EMDR? Amid EMDR treatment the customer goes to candidly aggravating material in a nutshell successive dosages while at the same time concentrating on an outer boost Traumatic recollections stay "stuck" in the non-verbal, non-cognizant subcortical areas and are not available to the frontal projections

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WHAT IS EMDR? At the point when the customer reviews a traumatic memory or sensation, the advisor urges them to notice what is coming up while following the specialist's fingers Information is adaptively prepared with new affiliations being made between the aggravating memory and more versatile recollections or data Leads to more total data handling, mitigation of enthusiastic and physiological pain and improvement of subjective experiences

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HOW WAS EMDR DEVELOPED? Found and Developed by Francine Shapiro 1987 She saw that : Disturbing Anxious Thoughts Changed with unconstrained eye developments to: LESS DISTURBING THOUGHTS LEADING TO ADAPTIVE RESOLUTION (ie. The negative charge was significantly diminished)

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1987 EMD : EYE MOVEMENT DESENSITIZATION 1990 EMDR : EYE MOVEMENT DESENSITIZATION & REPROCESSING ( handled traumatic recollections into something more versatile and practical)

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EIGHT PHASES OF TREATMENT PHASE 1 : CLIENT HISTORY PHASE 2 : PREPARATION PHASE 3 : ASSESSMENT Image Negative Cognition Positive Cognition Validity of Cognition (VOC) Emotions Subjective Units of Disturbance (SUDs) Body Sensation

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ASSESSMENT Worst Part: " Him bolting the entryway, hearing the bolt turn' NC : " I'm Completely vulnerable " PC : 'It's previously, I'm sheltered now' or 'I can deal with myself' or 'I can settle on better decisions " VOC: 2 Emotions: " fear, frightfulness' SUD: 9 Body Sensation: " in the throat'

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EIGHT PHASES OF TREATMENT cont… PHASE 4 : DESENSITIZATION - Worst minute : picture, sound or smell - Negative comprehension - Where felt in body PHASE 5 : INSTALLATION PHASE 6 : BODY SCAN PHASE 7 : CLOSURE PHASE 8 : RE-EVALUATION EMDR is a PAST, PRESENT AND FUTURE model

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WHAT HAPPENS DURING EMDR? TRAUMATIC MEMORY EMDR MEMORY Associated with irritating Image, Cognitions, Affect, Physical Sensations (divided, not coordinated) Less aggravating Image, a Positive Cognition, Appropriate Affect without exasperating Physical Sensations STATE-SPECIFIC FORM IN IMPLICIT MEMORY (Right Hemisphere) FUNCTIONAL FORM IN EXPLICIT MEMORY (Left Hemisphere) RE-EXPERIENCING Timeless REMEMBERING Sense of time

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ADAPTIVE INFORMATION PROCESSING Pathology comes about when natural encounters are put away in one neural system, not able to interface up actually with more versatile data in another neural system/s Implicit recollections from past occasions are not handled These natural recollections are at the base of an assortment of psycho-social issues in the present The past is the Present circumstance produces trouble as it is a trigger for past, natural occurrence/s

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ADAPTIVE INFORMATION PROCESSING Stored certain recollections in natural neuro-systems are in charge of current broken practices, emotions, contemplations EMDR preparing includes working with natural recollections of prior encounters EMDR isolates memory organizes that don't go together EMDR urges making versatile associations with capacity all the more suitably in the present

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HOW DOES EMDR WORK? Not by any stretch of the imagination clear! EMDR prompts changes in territorial mind actuation like REM rest EMDR increments prefrontal flap initiation prompting to more fitting reactions to triggers The Eye Movements or other double consideration boosts evoke an Orienting Response which upsets the traumatic memory organize, hindering past connections to negative feelings and permits coordination of new data

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HOW DOES EMDR WORK? EMDR has developed into a union of customary introductions: Aspects of CBT Brief/Interrupted presentation Free Association : Directed and Non-coordinated Focus on physical sensations Dual consideration incitement

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Processing torment recollections

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CLIENT 20 year old lady from Sierra Leone 12 yrs. Snatched by "radicals" and methodicallly assaulted; saw murdering of sister 14 yrs. Seen mother's rough murder and snatched with 2 siblings; made to convey arms and prepared to execute Systematically and persistently assaulted and marked Extreme physical re-encountering of assault/marking Overriding feeling of self as harmed & nauseating

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CLIENT Re-encountered the physical agony Boundary transgressing body encounters tossed her back to dumbfounded state Rejected her body Dissociated to shield herself from the disgrace Somatoform torment states

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PREPARATION Able to make a 'sheltered place' in her creative energy, i.e. being inside a congregation she knew with odors, hues, warmth, sound of cleric's voice. BLS used to introduce wonderful, loose body sensations while being in this place. Introduced with BLS inner assets – time when she had accomplished acclaim from instructor for fruitful test outcomes; time when she had been benevolent to a companion

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Treatment Focus on body sensations Saccadic eye developments while simply seeing the awkward body sensations without passing judgment on them or permitting considerations or sentiments associated with them to interrupt More ready to be in her body

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Treatment Processing of injury – assault, marking, murder of mother Profound addressing of her reality : 'I am nothing' With handling discovered more versatile structure inside which to store what had happened to her

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CASE MATERIAL ADRIAN 39 year old man Involved in a RTA (spouse and 5 year old child in auto) Son has serious slice on right cheek Wife additionally harmed with back torment History : Mother had 2 breakdowns Parents separated when 6 years of age First EMDR Session Image of child seeping from wound and saying 'Gee golly, Oh no, I'm sad Daddy' NC: 'I am feeble's Feelings: furious and dismal Body pressure in trunk

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CASE MATERIAL (cont) Second EMDR Session Image : Scar all over Negative Cog : 'My situation is practically hopeless I'm vulnerable's Positive Cog : " I can take great care of my family' VOC : 2 Emotions : Frustration & Anger SUDS : 10 (Highest Level of Disturbance) Physical Sensation : Felt in trunk

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CASE MATERIAL (cont) Third EMDR Session Same concentration as last session Disturbance settled PC :'I can take great care of my family'

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RESEARCH EVIDENCE FOR EMDR More RCTs on PTSD and EMDR than all different methodologies Generally observed to be as compelling as introduction and CBT approaches But more effective Fewer drop-outs EMDR demonstrates more positive changes on interruption measures NICE, 2005 : EMDR & Trauma-centered CBT medications of decision for tx of PTSD

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CONCLUSION Supervised preparing fundamental Basic, Intermediate and Advanced EMDR trainings EMDR sounds misleadingly basic however is a complex and colossally capable treatment

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RESILIENCE "I still sob here and there and I feel torment yet I can recount the narrative of my life. I had not words for my distresses but rather I could impart a few minutes to you and you heard and you saw my agony. Perhaps I could recount my story some time recently, yet I was not able feel anything. I needed to discover how I feel. That was agonizing yet some way or another my weight was less demanding to convey and more far off rather than ideal inside me. My body is more mine now and I comprehend what I feel. There are minutes when now and then I even attempt to consider the future … "