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Thread: EMDR Therapy

  1. #11
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    Quote Originally Posted by Richard Feynman
    The first principle is that you must not fool yourself, and you are the easiest person to fool.

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    Quote Originally Posted by mingularity View Post
    The Wikipedia sections I linked to contain a plethora of citations to actual published literature. That literature suggests that EMDR only works to the extent that it mimics exposure therapy. There is no evidence that any of the rest of the claims are true.
    So how do you use exposure therapy with sexual trauma? serious question.
    Step into my metaphysical room of mirrors.
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    Quote Originally Posted by fia View Post
    So how do you use exposure therapy with sexual trauma? serious question.
    This looks like one method: http://en.wikipedia.org/wiki/Cogniti...essing_therapy

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    Quote Originally Posted by mingularity View Post
    How about repressed trauma which has been suppressed into the body as chronic pain.

    The problem for me is that my beliefs about my own traumatic event are perfectly profound - forgiving even. That doesn't stop my chronic pain or felt-sense about it.

    Not all traumas are created equal and 12 session is not typically enough for dealing with repressed and repeated trauma events. I do appreciate the info, and the only personal investment I have in EMDR consists of four session which provided some interesting information I don't have access to through other methods. It is a wakeful dream state filled with pronounced metaphorical images and possible memories. So far it helped me realize how much anger I also have in my subconscious which wasn't available to me. It is entirely possible that it won't help me, and that it is as bogus as MBTI I suspect I'll try CPT as well if it seems more helpful. The only thing I know I don't want is to try to retrieve repressed memories as facts.

    Edit: I"m curious why you are so against EMDR? Is it the wiki link alone or are you in the mental health professions? negative experience with it?
    Step into my metaphysical room of mirrors.
    Fear of reality creates myopic morality
    So I guess it means there is trouble until the robins come
    (from Blue Velvet)

    I want to be just like my mother, even if she is bat-shit crazy.

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    Quote Originally Posted by fia View Post
    Edit: I"m curious why you are so against EMDR?
    The reason is that it has very obvious problems with regards to the scientific method. This implies that every professional that developed it and utilizes it has a lack of understanding of the scientific method. That does not create a safe space for trying to heal a mind.

    Quote Originally Posted by fia View Post
    The only thing I know I don't want is to try to retrieve repressed memories as facts.
    Totally agree, don't do that! I recommend practicing self-control as a way to slowly rewire your brain back to the way it used to be before it responded to the trauma.

  6. #16
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    Quote Originally Posted by mingularity View Post
    The reason is that it has very obvious problems with regards to the scientific method. This implies that every professional that developed it and utilizes it has a lack of understanding of the scientific method. That does not create a safe space for trying to heal a mind.
    That's an interesting perspective and I get it to a large extent, but because perception plays such a strong role in the mind, that means one most look at the level of the individual and not just the statistical level for determining cures.

    The meta-analyses in the wiki link you provided are primarily what suggested that EMDR was only as effective as immersion therapy to the degree it imitated it. If these meta-studes did not distinguish between different sorts of trauma, then this could be a problem for delineating what is the most effective treatment for a specific issue.

    Quote Originally Posted by mingularity View Post
    Totally agree, don't do that! I recommend practicing self-control as a way to slowly rewire your brain back to the way it used to be before it responded to the trauma.
    That makes perfect sense for adults who experience trauma, but when it happens to children, then you are dealing with a different process. There may not be a time before the mind responded to trauma, or if there was a time, it was a mind that had different hardware, perceptions, and processes from an adult. I was age two. These developmental traumas would reasonably require a different approach than adult traumas, especially single event, depersonalized traumas.

    What you are saying makes a lot of sense for trauma from a car accident or something similar. I personally overcame debilitating driving anxiety through exposure therapy with some guidance from a counselor, but mostly it was just me making myself do it. It was so clear, linear, direct, that it was possible to draw a line from A-->B and figure out how to fix it and it did fix it to about 90%. From a functional standpoint it was a success. Even though the driving anxiety could have been linked to something earlier on, there were other factors during adolescence and adulthood that could reasonably have exacerbated it, so it was a much different case.

    http://neuro.psychiatryonline.org/ar...ticleID=102021
    Step into my metaphysical room of mirrors.
    Fear of reality creates myopic morality
    So I guess it means there is trouble until the robins come
    (from Blue Velvet)

    I want to be just like my mother, even if she is bat-shit crazy.

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    Quote Originally Posted by fia View Post
    If these meta-studes did not distinguish between different sorts of trauma, then this could be a problem for delineating what is the most effective treatment for a specific issue.
    This is the same criticism that was leveled against the meta-analyses of antidepressant studies, which showed that except in the extreme cases they were basically no better than placebo. The fact is that some of those meds do work for some patients. However, the problem of pairing a set of symptoms with a set of medications is extremely hard. Therapists cannot do it reliably because we don't know of a reliable way to do it. It actually strikes me as unethical for a therapist to prescribe some meds almost at random and wish their patient the best of luck, without making sure they are going to the gym and using other more proven remedies.

    Quote Originally Posted by fia View Post
    That makes perfect sense for adults who experience trauma, but when it happens to children, then you are dealing with a different process. There may not be a time before the mind responded to trauma, or if there was a time, it was a mind that had different hardware, perceptions, and processes from an adult. I was age two. These developmental traumas would reasonably require a different approach than adult traumas, especially single event, depersonalized traumas.
    I would still recommend the self-control approach. It's basically a problem of the following kind: I know my mind is different than other peoples minds. How can I identify that difference and minimize it? Needless to say this is a very hard problem. That said I'm a firm believer that this is the best approach to fixing many kinds of issues with the mind. I feel like most therapists don't even provide a tractable path to recovery, period, whereas this is at least a way to make progress.

    Quote Originally Posted by fia View Post
    What you are saying makes a lot of sense for trauma from a car accident or something similar. I personally overcame debilitating driving anxiety through exposure therapy with some guidance from a counselor, but mostly it was just me making myself do it. It was so clear, linear, direct, that it was possible to draw a line from A-->B and figure out how to fix it and it did fix it to about 90%. From a functional standpoint it was a success. Even though the driving anxiety could have been linked to something earlier on, there were other factors during adolescence and adulthood that could reasonably have exacerbated it, so it was a much different case.
    Wow!

    The problem with this study (which I admittedly only briefly scanned) is that they need another condition - exposure therapy without EMDR.

    Also, stop being so smart. It's making me feel funny.

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    Beware wikipedia! All the info is not correct, and I know for certain that the info on EMDR is not completely reliable. As for the scientific method, EMDR is a psychotherapy which has been empirically validated in over 24 randomized studies of trauma victims. It is considered one of the three treatments of choice for trauma (along with CBT and PE) by organizations such as ISTSS (International Society for Traumatic Stress Studies), American Psychiatric Association, American Psychological Association, Department of Veteran Affairs, Department of Defense, Departments of Health in Northern Ireland, UK, Israel, the Netherlands, France, and other countries and organizations.
    See Foa, E.B., Keane, T.M., Friedman, M.J., & Cohen, J.A. (2009). Effective treatments for PTSD: Practice Guidelines of the International Society for Traumatic Stress Studies New York: Guilford Press. EMDR was listed as an effective and empirically supported treatment for PTSD, and was given an AHCPR “A” rating for adult PTSD.

    And as noted in the American Psychiatric Association Practice Guidelines (2004, p.18), in EMDR “traumatic material need not be verbalized; instead, patients are directed to think about their traumatic experiences without having to discuss them.” Given the reluctance of many combat veterans to divulge the details of their experience, as well as other trauma survivors, this factor is relevant to willingness to initiate treatment, retention and therapeutic gains.

    As for the eye movements, a number of International Practice Guideline committees have reported that the clinical component analyses reviewed by Davidson & Parker (2001) are not well designed (International Society for Traumatic Stress Studies/ISTSS; DoD/DVA). Davidson & Parker note that there is a trend toward significance for eye movements when the studies conducted with clinical populations are examined separately. Unfortunately even these studies are flawed. As noted in the ISTSS guidelines (Chemtob et al., 2000), since these clinical populations received insufficient treatment doses to obtain substantial main effects, they are inappropriate for component analyses. However, as noted in the DoD/DVA guidelines, the eye movements used in EMDR have been separately evaluated by numerous memory researchers. These studies have found a direct effect on emotional arousal, imagery vividness, attentional flexibility, and memory association.

    The World Health Organization now has "Guidelines for the management of conditions that are specifically related to stress. (Geneva, WHO, 2013)
    Trauma-focused CBT and EMDR are the only therapies recommended for children, adolescents and adults with PTSD. Like CBT with a trauma focus, EMDR therapy aims to reduce subjective distress and strengthen adaptive cognitions related to the traumatic event. Unlike CBT with a trauma focus, EMDR does not involve (a) detailed descriptions of the event, (b) direct challenging of beliefs, (c) extended exposure, or (d) homework."

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    Have you tried brainwave entrainment with affirmations? How well does it work compared to EMDR?

  10. #20
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    Quote Originally Posted by drpattijane View Post
    Beware wikipedia! All the info is not correct, and I know for certain that the info on EMDR is not completely reliable. As for the scientific method, EMDR is a psychotherapy which has been empirically validated in over 24 randomized studies of trauma victims. It is considered one of the three treatments of choice for trauma (along with CBT and PE) by organizations such as ISTSS (International Society for Traumatic Stress Studies), American Psychiatric Association, American Psychological Association, Department of Veteran Affairs, Department of Defense, Departments of Health in Northern Ireland, UK, Israel, the Netherlands, France, and other countries and organizations.
    See Foa, E.B., Keane, T.M., Friedman, M.J., & Cohen, J.A. (2009). Effective treatments for PTSD: Practice Guidelines of the International Society for Traumatic Stress Studies New York: Guilford Press. EMDR was listed as an effective and empirically supported treatment for PTSD, and was given an AHCPR “A” rating for adult PTSD.

    And as noted in the American Psychiatric Association Practice Guidelines (2004, p.18), in EMDR “traumatic material need not be verbalized; instead, patients are directed to think about their traumatic experiences without having to discuss them.” Given the reluctance of many combat veterans to divulge the details of their experience, as well as other trauma survivors, this factor is relevant to willingness to initiate treatment, retention and therapeutic gains.

    As for the eye movements, a number of International Practice Guideline committees have reported that the clinical component analyses reviewed by Davidson & Parker (2001) are not well designed (International Society for Traumatic Stress Studies/ISTSS; DoD/DVA). Davidson & Parker note that there is a trend toward significance for eye movements when the studies conducted with clinical populations are examined separately. Unfortunately even these studies are flawed. As noted in the ISTSS guidelines (Chemtob et al., 2000), since these clinical populations received insufficient treatment doses to obtain substantial main effects, they are inappropriate for component analyses. However, as noted in the DoD/DVA guidelines, the eye movements used in EMDR have been separately evaluated by numerous memory researchers. These studies have found a direct effect on emotional arousal, imagery vividness, attentional flexibility, and memory association.

    The World Health Organization now has "Guidelines for the management of conditions that are specifically related to stress. (Geneva, WHO, 2013)
    Trauma-focused CBT and EMDR are the only therapies recommended for children, adolescents and adults with PTSD. Like CBT with a trauma focus, EMDR therapy aims to reduce subjective distress and strengthen adaptive cognitions related to the traumatic event. Unlike CBT with a trauma focus, EMDR does not involve (a) detailed descriptions of the event, (b) direct challenging of beliefs, (c) extended exposure, or (d) homework."
    Thank you for all this information! I'm pretty new to the concept, but I am working with a therapist that I am comfortable with and trust.

    It feels like this is the first time I'm able to get at some of this information in a manner that matches the type of issue that it is. It's helpful to not feel like I have to draw out any repressed memories, but can just describe a lucid dream-state. I get a lot of clear images and metaphors during the process. My positive image that came to me was a little girl and teddy bear which I now use as a screen saver.
    Step into my metaphysical room of mirrors.
    Fear of reality creates myopic morality
    So I guess it means there is trouble until the robins come
    (from Blue Velvet)

    I want to be just like my mother, even if she is bat-shit crazy.

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