Critically evaluate eye movement desensitization and reprocessing (EMDR) as a treatment method for post-traumatic stress disorder (PTSD)
Post-Traumatic Stress Disorder is a severe mental disease. It is classified as an anxiety disorder, although it often presents a cluster of heterogeneous symptoms (Wilson, Friedman & Lindy, 2001). The core of PTSD is a traumatic event (exposition to threat of death, real or imaginary, to severe physic injury or sexual violence; APA, 2013). The trauma triggers a series of psychological, psychobiological and behavioural changes in the victim, that are clustered in three groups (Wilson, Friedman & Lindy, 2001): a) Traumatic memory and stress re-experiencing phenomena; b) Avoidance, numbing, depression and coping adaptation; c) Psychobiological alteration in behaviour (such as hypervigilance, irritability and self-destroying behaviours) According to Wilson, Friedman & Lindy (2001), identity is also impaired, resulting in (d) impact on attachment and intimacy and (e) in an impairment on the self-image, identity itself and life-course development. The prevalence in adult population in USA is 3,5%; in Europe, Africa and Asia is about 0,5-1,0%. The prevalence is higher in risky categories such as military in combat mission, firemen, ambulance doctors and policemen (APA, 2013). In UK, 17% of the military population deployed in combat role in Iraq and Afghanistan developed PTSD (Stevelink et al. 2018). Eye Movement Desensitization and Reprocessing (EMDR) is a treatment developed specifically to treat trauma (Shapiro, 1989). The effectiveness of EMDR as a therapy for PTSD is proven over time by a wide range of studies and reviews (Sharpless & Barber, 2011; van den Hout & Engelhard, 2012; Gilderthorp, 2014; Diehle et al. 2015; for a review see Cusack et al. 2016). In EMDR therapy, the patient has to recall the traumatic memory whilst he is doing a simple task. The task is, for instance, to look to a dot on a screen that moves from left to right, or vertically. The stimulation, that can be delivered in a wide range of ways, is called bilateral stimulations (BLS). The therapy is delivered in two sits a week for 6-12 sits in total. The emotional arousal associated with the traumatic memory will decrease as well as the maladaptive behaviours associated to it. BLS will stimulate the production of new memories and the reprocessing of the trauma (Shapiro, 2007; van den Hout & Engelhard, 2012). According to APA guidelines ("Eye Movement Desensitization and Reprocessing (EMDR) Therapy", 2019), EMDR is a treatment of choice for PTSD. The treatment consists in eight steps: 1) History Taking and Treatment-Planning; 2) Preparation: the therapist explains the procedure and lead the patient through the exercise Safe/Calm Place; 3) Assessment: assessment is made by VOC and SUD tests, to assess cognition and emotion changes; 4) Desensitization: this is the proper EMDR, in which the BLS are delivered. During the sessions the patient is encouraged to speak every thought emerged. This phase continues until the patient reports that the memory is no more distressing; 5) Installation: during this phase the positive memories are strengthen; 6) Body Scan: the body scan aims to find any last piece of somatic disease left by PTSD; if the patient reports any problems they are processed by BLS; 7) Closure: this part of the session aims to process any part of the memory left untouched by BLS. In this part specific techniques are used; 8) Re-evaluation: during this phase the therapist evaluates the patient’s psychological state, if the treatment’s effect is maintaining, what memories emerged in the last session and the target for the current session ("Eye Movement Desensitization and Reprocessing (EMDR) Therapy", 2019).
Original Work Citation
Giovanni, M. ( ). Critically evaluate eye movement desensitization and reprocessing (EMDR) as a treatment method for post-traumatic stress disorder (PTSD). (University of Kent)
“Critically evaluate eye movement desensitization and reprocessing (EMDR) as a treatment method for post-traumatic stress disorder (PTSD),” Francine Shapiro Library, accessed May 28, 2020, https://emdria.omeka.net/items/show/25933.