EMDR treatment for anorexia nervosa triggered by early traumatic experiences

Description

Uvod:
U prikazu slučaja opisana je primjena terapije desensitizacije i reprocesiranja uz pomoć pokreta očiju - EMDR-a (eng. Eye Movement Desensitization and Reproccesing – EMDR), u tretmanu rane traume kod adolescentice kojoj je dijagnosticirana Anoreksija nervoza. Nakon što je djevojčica počela rapidno gubiti na kilaži potražena je stručna pomoć.

Cilj:
Ovim prikazom se nastojao pokazati slučaj specifične prirode tretmana rane traume kao okidača Anoreksije Nervoze kod adolescentice, a čiji je cilj bio prihvatanje promjena na tijelu uz vraćanje kilaže koja je optimalna za neometano funkcioniranje u svakodnevnom životu.

Prikaz slučaja:
Klijentica je u dobi od 17 godina, pohađa 3. razred gimnazije, živi s majkom i sestrom. Tretman se sastojao od nekoliko dijelova. Prvi se odnosio na psihološki \ suport i psihoedukaciju. Drugi je uključivao tehnike iz kognitivno - bihevioralne terapije kao što su kognitivna restrukturacija, tehnike abdominalnog disanja, vizualizacije, relaksacije, uvježbavanje pozitivnog samogovora, asertivnog komuniciranja, savladavanja ljutnje, i tehnike usredotočene svjesnosti. U trećem je dijelu primijenjena EMDR terapija usmjer - ena na prorađivanje traumatskog iskustva koje je identificirano kao jedan od značajnih okidača poremećaja hranjenja kod djevojčice. Ekstremno je promijenilo njezinu percep - ciju majke kao predmeta njezinog obožavanja u majku “čudovište” od kojeg se imala potrebu zaštititi, a time značajno utjecalo i na stvaranje iskrivljene percepcije slike svoga tijela i to po principu “jedino u tijelu djeteta sam sigurna”. Primijenjen je standardni EMDR protokol koji se sastoji od osam faza. S obzirom da EMDR pristup omogućava aktivaciju adaptivnih neurofizioloških mehanizama koji obezbjeđuju funkcionalniju obradu infor - macija preko procesa rekonsolidacije memorije vezane za stresogena iskustva (disfunk -cionalno pohranjena memorija), u tretmanu se osim reduciranja anksioznosti I simptom- \atskog poboljšanja opravdano očekivalo postizanje značajnih uvida, te izmjene uvjerenja i ponašanja vezanih za proživljenu traumu. U samo dvije seanse došlo je do značajnog prepoznavanja i mijenjanja emocija vezanih za traumu, kao i racionalno-emocionalne integracije traumatskog iskustva. Tretman nije završen. Jedan od razloga za to je da je djevojčica osjećala poboljšanje u funkcioniranju i nije se odazivala na dogovorene susrete što je podržala i njena majka.

Zaključci:
Na temelju aktualnog prikaza slučaja zaključuje se da EMDR može aktivno do - prinijeti ublažavanju psihopatološke simptomatike poremećaja hranjenja koji u podlozi ima rano traumatsko iskustvo. Za pouzdane i generalne zaključke o stvarnoj ulozi EMDR-a u tretmanu ovog poremećaja neophodno je ispitivati efikasnost njegove primjene u kon- troliranim studijama.

Background:
The case study presents the use of EMDR therapy in the treatment of early traumatic experiences in an adolescent girl with a diagnosis of Anorexia Nervosa. Help was initially sought after the patient began rapidly losing weight.

Aims:
The aim of the study is to show the use of EMDR as a specific treatment for trauma, perceived as a trigger for Anorexia Nervosa. The treatment aim was to accept the body changes and return to a weight which enabled optimal functioning in everyday life.

Case report:
The patient was a 17 year old female, attending the third grade of high school and living with her mother and sister. The treatment was conducted in several phases. Phase one involved psychological support and psychoeducation. Phase two consisted of teaching techniques, such as diaphragmic breathing, visualization, relaxation, practicing of positive self-talk, assertive communication skills, anger management and the development of self-awareness. In phase three, EMDR therapy was used in order to process a traumatic experience identified as a major trigger for her eating disorder. There was a change in the patient’s perception of her mother from someone that she adored into “a monster”. This led to a distorted perception of her body based on the assumption “I am only safe in a child’s body”. EMDR therapy activates adaptive neurophysiological pathways, which in turn facilitate functional information processing and the reconsolidation of the dysfunctionally stored memories. This leads to a reduction in anxiety and an improvement in symptomatology. In addition, the treatment facilitates the development of more adaptive insights and the change of beliefs and behaviours previously connected with the experienced traumas. The standard EMDR protocol consisting of eight phases was used. In just two sessions the patient developed a considerable awareness of, and change in, her emotional reactions connected to the trauma, as well as the cognitive and emotional integration of the traumatic experiences. The treatment was not completed. The patient reported feeling an improvement in functioning and did not attend offered appointments, a decision supported by her mother.

Conclusions:
Based on this case study it is concluded that EMDR can actively contribute to the alleviation of pathological symptoms of an eating disorder that includes an early traumatic experience. For reliable and general conclusions about the role of EMDR in the treatment of eating disorder, it is necessary to examine the effectiveness of its use in controlled studies.

Format

Journal

Language

Croatian

Author(s)

Vildana Aziraj Smajić
Cornelia de la Fosse

Original Work Citation

Smajić, V. A., de la Vosse, C. (2019). EMDR treatment for anorexia nervosa triggered by early traumatic experiences.  Psychotherapy in Achieving Health and Well-Being for Children and Young People, 2, 65-76. Croatian

Collection

Citation

“EMDR treatment for anorexia nervosa triggered by early traumatic experiences,” Francine Shapiro Library, accessed October 20, 2020, https://emdria.omeka.net/items/show/25999.

Output Formats