John O'Donohue (1 January 1956 – 4 January 2008) was an Irish poet, author, priest, and Hegelian philosopher. He was a native Irish speaker,[1] and as an author is best known for popularisingCeltic spirituality.[2][3]
Eldest of four siblings, he was raised in west Ireland in the area of Connemara and County Clare, where his father Patrick O'Donohue was a stonemason, while his mother Josie O'Donohue was a housewife.[4]
O'Donohue's first published work of prose, Anam cara (1997), catapulted him into a more public life as an author, speaker and teacher, particularly in the United States. O'Donohue left the priesthood in 2000. O'Donohue also devoted his energies to environmental activism, and is credited with helping spearhead the Burren Action Group, which opposed government development plans and ultimately preserved the area of Mullaghmore and the Burren, a karst landscape in County Clare.[7]
Later in life, O’Donohue became a prominent speaker on creativity in the workplace. He consulted executives in the corporate sector “on integrating a sense of soul and of beauty into their leadership and their imagination about the people with whom they work.”[8]
Just two days after his 52nd birthday and two months after the publication of his final complete work, Benedictus: A Book of Blessings, O'Donohue died suddenly in his sleep on 4 January 2008 while on holiday near Avignon, France. The exact cause of death has not been released by his family, leaving writers of non-fiction to speculation regarding the cause. Articles and posts have listed an aneurysm, heart problem, and aspiration as possible causes.[9][failed verification] He was survived by his partner Kristine Fleck, his mother Josephine (Josie) O'Donohue, his brothers, Patrick (Pat) and Peter (PJ) O'Donohue, and his sister, Mary O'Donohue.[5][10]
Posthumous publications include a reprinting of The Four Elements, a book of essays, in 2010[11] and Echoes of Memory (2011), an early work of poetry originally collected in 1994.[12] In March 2015, a series of radio conversations he had recorded with close friend and former RTÉ broadcaster John Quinn was collated and published as Walking on the Pastures of Wonder.[13]
O'Donohue's last will was held to be invalid by the High Court in December 2011, Justice Gilligan holding that "As a piece of English, the Will is unclear on its face" and that the will was void for uncertainty.[5] The will did not leave anything to his partner Kristine Fleck. In the absence of a valid will his estate devolved on his mother, Josie O'Donohue.[5]
"When you cease to fear your solitude, a new creativity awakens in you. Your forgotten or neglected wealth begins to reveal itself. You come home to yourself and learn to rest within. Thoughts are our inner senses. Infused with silence and solitude, they bring out the mystery of inner landscape."
- Anam Cara, p. 17
"Part of understanding the notion of Justice is to recognize the disproportions among which we live...it takes an awful lot of living with the powerless to really understand what it is like to be powerless, to have your voice, thoughts, ideas and concerns count for very little. We, who have been given much, whose voices can be heard, have a great duty and responsibility to make our voices heard with absolute integrity for those who are powerless."
“Music is what language would love to be if it could.” [14]
^O'Donohue, John; Krista Tippett (28 February 2008). "The Inner Landscape of Beauty". Speaking of Faith. National Public Radio. Retrieved 3 September 2015.
Eye movement desensitization and reprocessing (EMDR) is a form of psychotherapy in which the person being treated is asked to recall distressing images; the therapist then directs the patient in one type of bilateral stimulation, such as side-to-side eye rapid movement or hand tapping.[1] EMDR was developed by Francine Shapiro starting in 1988. According to the 2013 World Health Organization (WHO) practice guideline: "This therapy [EMDR] is based on the idea that negative thoughts, feelings and behaviours are the result of unprocessed memories. The treatment involves standardized procedures that include focusing simultaneously on (a) spontaneous associations of traumatic images, thoughts, emotions and bodily sensations and (b) bilateral stimulation that is most commonly in the form of repeated eye movements."[2]
EMDR is included in several evidence-based guidelines for the treatment of post-traumatic stress disorder (PTSD), with varying levels of recommendation and evidence (very low to moderate per WHO stress guidelines).[3][2][4] As of 2020, the American Psychological Association lists EMDR as an evidence-based treatment for PTSD[5] but stresses that "the available evidence can be interpreted in several ways" and notes there is debate about the precise mechanism by which EMDR appears to relieve PTSD symptoms with some evidence EMDR may simply be a variety of exposure therapy.[6] Even though EMDR is effective, critics call it a pseudoscience because only the desensitization component has scientific support.
Exposure therapy began in the 1950s, when South African psychologists and psychiatrists used it to reduce pathological fears.[7] They then brought their methods to England in the Maudsley Hospital training program.[7] Since the 1950s several sorts of exposure therapy have been developed, including systematic desensitization, flooding, implosive therapy, prolonged exposure therapy, in vivo exposure therapy, and imaginal exposure therapy.[7]
EMDR therapy was first developed by American psychologist Francine Shapiro after noticing, in 1987,[8] that eye movements appeared to decrease the negative emotion associated with her own distressing memories.[9][10][11] She then conducted a scientific study with trauma victims in 1988 and the research was published in the Journal of Traumatic Stress in 1989.[12] Her hypothesis was that when a traumatic or distressing experience occurs, it may overwhelm normal coping mechanisms, with the memory and associated stimuli being inadequately processed and stored in an isolated memory network.[13]
Shapiro noted that, when she was experiencing a disturbing thought, her eyes were involuntarily moving rapidly. She further noted that her anxiety was reduced when she brought her eye movements under voluntary control while thinking a traumatic thought.[14] Shapiro developed EMDR therapy for post-traumatic stress disorder (PTSD). She speculated that traumatic events "upset the excitatory/inhibitory balance in the brain, causing a pathological change in the neural elements".[14]
EMDR consists of eight essential phases. The first phase includes history taking and treatment planning. The second phase includes preparation. The third phase is an assessment phase followed by the fourth phase of desensitisation. Phases 5 & 6 involve installing positive cognitions and body scan. The last phase is the reevaluation phase [2]EMDR is typically undertaken in a series of sessions with a trained therapist.[15]The number of sessions can vary depending on the progress made. A typical EMDR therapy session lasts from 60-90 minutes.[16]
The person being treated is asked to recall an image, phrase and emotions which represents a level of distress related to a trigger while generating one of several types of bilateral sensory input, such as side-to-side eye movements or hand tapping.[1][3] The 2013 World Health Organization practice guideline says that "Like cognitive behavioral therapy (CBT) with a trauma focus, EMDR aims to reduce subjective distress and strengthen adaptive beliefs 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."[2]
While multiple meta-analyses have found EMDR to be as effective as trauma focused cognitive behavioral therapy for the treatment of PTSD, these findings have been regarded as tentative given the low numbers in the studies, high risk rates of researcher bias, and high dropout rates.[17][18][19]
A 2020 systematic review and meta-analysis was the "first systematic review of randomized trials examining the effects of EMDR for any mental health problem." The authors raised concerns about bias in previous studies, concluding:
Despite these limitations, the results of this meta-analysis aid us in concluding that EMDR may be effective in the treatment of PTSD in the short term and possibly have comparable effects as other treatments.However, the quality of studies is too low to draw definite conclusions. Further, it is evident that the long-term effects of EMDR are unclear and that there is certainly not enough evidence to advise its use in patients with mental health problems other than PTSD.[19]
A 2013 systematic review examined 15 clinical trials of EMDR with and without the eye movements, finding that the effect size was larger when eye movements were used.[20][17] Again, interpretation of this meta-analysis was tentative. Lee and Cuijpers (2013) stated that "the quality of included studies was not optimal. This may have distorted the outcomes of the studies and our meta-analysis. Apart from ensuring adequate checks on treatment quality, there were other serious methodological problems with the studies in the therapy context."[17] A meta-analysis in 2020, could not confirm the results of this 2013 study, due to "differences in inclusion criteria."[19]
A Cochrane systematic review comparing EMDR with other psychotherapies in the treatment of Chronic PTSD, found EMDR to be just as effective as Trauma-Focused Cognitive Behavior Therapy (TF-CBT) and more effective than the other non-TF-CBT psychotherapies.[18][21] Caution was urged interpreting the results due to low numbers in included studies, risk of researcher bias, high drop out rates, and overall "very low" quality of evidence for the comparisons with other psychotherapies.[18]
A 2010 meta-analysis concluded that all "bona fide" treatments were equally effective, but there was some debate regarding the study's selection of which treatments were "bona fide".[22]
A 2009 review of rape treatment outcomes concluded that EMDR had some efficacy.[23] Another 2009 review concluded EMDR to be of similar efficacy to other exposure therapies and more effective than SSRIs, problem-centered therapy, or "treatment as usual".[24]
Two meta-analyses in 2006 found EMDR to be at least equivalent in effect size to specific exposure therapies.[17][25]
A 2005 and a 2006 meta-analysis each suggested that traditional exposure therapy and EMDR have equivalent effects immediately after treatment and at follow-up.[26][25]
A 2002 meta-analysis concluded that EMDR is not as effective, or as long lasting, as traditional exposure therapy.[27]
EMDR is included in a 2009 practice guideline for helping children who have experienced trauma.[40] EMDR is often cited as a component in the treatment of complex post-traumatic stress disorder.[41][42]
A 2017 meta-analysis of randomized controlled trials in children and adolescents with PTSD found that EMDR was at least as efficacious as cognitive behavior therapy (CBT), and superior to waitlist or placebo.[43]
Studies have indicated EMDR effectiveness in depression.[45][46] A 2019 review found that "Although the selected studies are few and with different methodological critical issues, the findings reported by the different authors suggest in a preliminary way that EMDR can be a useful treatment for depression."[47]
EMDR may have application for psychosis when co-morbid with trauma,[44] Other studies have investigated EMDR therapy’s efficacy with borderline personality disorder,[53] and somatic disorders such as phantom limb pain.[54][55] EMDR has also been found to improve stress management symptoms.[56] EMDR has been found to reduce suicide ideation,[57] and help low self-esteem.[58] Other studies focus on effectiveness in substance craving[59] and pain management.[60] EMDR may help people with autism who suffer from exposure to distressing events.[61]
A 2021 major review that included RCT's, group studies and case studies that specifically did not focus on the use of EMDR in the treatment of trauma or PTSD, found that EMDR may be beneficial in at least fourteen conditions that included: addictions, somatoform disorders, sexual dysfunction, eating disorders, disorders of adult personality, mood disorders, reaction to severe stress, anxiety disorders, performance anxiety, Obsessive-Compulsive Disorder (OCD), pain, neurodegenerative disorders, mental disorders of childhood and adolescence, and sleep. The authors concluded that "Results shed light on several aspects that support the interest of its practice in mental health care. Despite the clear need for more rigorous research, our review also demonstrated that EMDR has translational interests. The fact that this therapy could be helpful in non-pathological situations (e.g., performance) broadens the scope of its benefits and invites for interdisciplinary research. Also, because of its potential advantages, we believe that EMDR could be considered in major crisis situations, such as to alleviate the imminent and disproportionate mental health sequelae of a world pandemic(...)" .[62]
A 2020 systematic review and meta-analysis was the "first systematic review of randomized trials examining the effects of EMDR for any mental health problem." The authors concluded: "it is evident that the long-term effects of EMDR are unclear, and... there is certainly not enough evidence to advise its use in patients with mental health problems other than PTSD."[19]
A 2013 overall literature review covered research up to that time.[63][specify]
Incomplete processing of experiences in trauma[edit]
Many proposals of EMDR efficacy share an assumption that, as Shapiro posited, when a traumatic or very negative event occurs, information processing of the experience in memory may be incomplete. The trauma causes a disruption of normal adaptive information processing, which results in unprocessed information being dysfunctionally held in memory networks.[64] According to the 2013 World Health Organization practice guideline: "This therapy [EMDR] is based on the idea that negative thoughts, feelings and behaviours are the result of unprocessed memories."[2]
EMDR allowing correct processing of memories[edit]
EMDR is posited to help in the correct processing of the components of the contributing distressing memories.[65][66] EMDR may allow the client to access and reprocess negative memories (leading to decreased psychological arousal associated with the memory).[67] This is sometimes known as the Adaptive Information Processing (AIP) model.[68][69][unreliable medical source]
Proposed mechanisms by which EMDR achieves efficacy[edit]
The mechanism by which EMDR achieves efficacy is unknown, with no definitive finding. Several possible mechanisms have been posited;
EMDR impacts working memory.[70] By having the patient perform a bilateral stimulation task while retrieving memories of trauma, the amount of information they can retrieve about the trauma is limited, and thus the resulting negative emotions are less intense.[71] This is seen by some as causing a distancing effect which enables the client to 'stand back' from the trauma. The client is enabled to re-evaluate the trauma and their understanding of it, and thus process it correctly, because they can re-experience it whilst not feeling overwhelmed by it.[44]
EMDR enables ‘dual attention’ (recalling the trauma whilst keeping ‘one foot in the present’ assisted by bilateral stimulation). This allows the brain to access the dysfunctionally stored experience and stimulate the innate processing system, allowing it to transform the information to an adaptive resolution.[44]
Connectivity among several brain regions has been found to be changed by bilateral eye movement and by EMDR. In one 15 person study, EMDR was found to lead to reduced connectivity between some brain areas.[72] These changes may cause EMDRs efficacy.[73][74]
EMDR efficacy has been linked to the Zeigarnik effect (i.e. better memory for interrupted rather than completed tasks).[75]
Horizontal eye movement triggers an evolutionary 'orienting response' in the brain, used in scanning the environment for threats and opportunities.[76]
EMDR gives an effect similar to the effects of sleep,[77] and posit that traumatic experiences are processed during sleep.
Trauma can be overcome or mastered, and EMDR facilitates a form of mindfulness or other form of mastery over the trauma.[44]
It may be that several mechanisms are at work in EMDR.[44]
Bilateral stimulation, including eye movement[edit]
Bilateral stimulation is a generalization of the left and right repetitive eye movement technique first used by Shapiro. Alternative stimuli include auditory stimuli that alternate between left and right speakers or headphones, and physical stimuli such as tapping of the therapist's hands.[78] Research has attempted to correlate other types of rhythmic side-to-side stimuli, such as sound and touch, with mood, memory and cerebral hemispheric interaction.
Research results and opinions have been mixed on the effectiveness and importance of the technique;
2020 research showed that bilateral alternating stimulation caused a significant increase in connectivity between several areas of the brain, including the two superior temporal gyri, the precuneus, the middle frontal gyrus and a set of structures involved in multisensory integration, executive control, emotional processing, salience and memory.[79]
A 2020 review questioned the consistency and generalizability of the technique.[80]
A 2013 meta-study found the effect size of eye movement was large and significant, with the strongest effect size difference being for vividness measures.[17][44]
A 2012 review found that the evidence provided support for the contention that eye movements are essential to this therapy and that a theoretical rationale exists for their use.[76]
A 2002 review reported that the eye movement is irrelevant, and that the effectiveness of EMDR was solely due to its having properties similar to CBT, such as desensitization and exposure.[81]
A 2001 meta-analysis suggested that EMDR with the eye movements was no more efficacious than EMDR without the eye movements (Davidson & Parker, 2001).[20][82][83]
A 2000 review found that the eye movements did not play a central role, and that the mechanisms of eye movements were speculative.[84]
A small 1996 study found that the eye movements employed in EMDR did not add to its effectiveness.[85]
Francine Shapiro noticed that eye movements appeared to decrease the negative emotion associated with her own distressing memories.[86][87][88] Bilateral stimulation seems to cause dissipation of emotions.[89][90]
Concerns have included questions about its effectiveness and the importance of the eye movement component of EMDR. In 2012, Hal Arkowitz, and Scott Lilienfeld summed up the state of the research at the time, saying that while EMDR is better than no treatment and probably better than merely talking to a supportive listener,
Yet not a shred of good evidence exists that EMDR is superior to exposure-based treatments that behavior and cognitive-behavior therapists have been administering routinely for decades. Paraphrasing British writer and critic Samuel Johnson, Harvard University psychologist Richard McNally nicely summed up the case for EMDR: "What is effective in EMDR is not new, and what is new is not effective."[93]
Client perceptions of effectiveness are also mixed.[94]
Skeptics of the therapy argued that EMDR is a pseudoscience, because the underlying theory is unfalsifiable. Also, the results of the therapy are non-specific, especially if the eye movement component is irrelevant to the results. What remains is a broadly therapeutic interaction and deceptive marketing.[84][27] According to Yale neurologist and skeptic Steven Novella:
[T]he false specificity of these treatments is a massive clinical distraction. Time and effort are wasted clinically in studying, perfecting, and using these methods, rather than focusing on the components of the interaction that actually work.[95]
Shapiro has been criticized for repeatedly increasing the length and expense of training and certification, allegedly in response to the results of controlled trials that cast doubt on EMDR's efficacy.[96][84] This included requiring the completion of an EMDR training program in order to be qualified to administer EMDR properly, after researchers using the initial written instructions found no difference between no-eye-movement control groups and EMDR-as-written experimental groups. Further changes in training requirements and/or the definition of EMDR included requiring level II training when researchers with level I training still found no difference between eye-movement experimental groups and no-eye-movement controls and deeming "alternate forms of bilateral stimulation" (such as finger-tapping) as variants of EMDR by the time a study found no difference between EMDR and a finger-tapping control group.[96] Such changes in definition and training for EMDR have been described as "ad hoc moves [made] when confronted by embarrassing data".[97]
^ Jump up to:abShapiro, Francine; Laliotis, Deany (2015). "EMDR Therapy for Trauma-Related Disorders". Evidence Based Treatments for Trauma-Related Psychological Disorders: A Practical Guide for Clinicians. Springer International Publishing. pp. 205–228. doi:10.1007/978-3-319-07109-1_11. ISBN978-3-319-07109-1.
^Shapiro, F. (1989). Efficacy of the eye movement desensitization procedure in the treatment of traumatic memories. Journal of Traumatic Stress, 2, 199-223.
^Shapiro, F. & Forrest, M. (1997). EMDR The Breakthrough Therapy for Overcoming Anxiety, Stress and Trauma. New York: Basic Books
^Shapiro, Francine; Laliotis, Deany (12 October 2010). "EMDR and the adaptive information processing model: Integrative treatment and case conceptualization". Clinical Social Work Journal. 39 (2): 191–200. doi:10.1007/s10615-010-0300-7. S2CID144611109.
^ Jump up to:abShapiro, F (1989). "Efficacy of the eye movement desensitization procedure in the treatment of traumatic memories". Journal of Traumatic Stress. 2 (2): 199–223. doi:10.1002/jts.2490020207.
^UK Nice guidelines: 1.6.20 EMDR for adults should: be based on a validated manual typically be provided over 8 to 12 sessions, but more if clinically indicated, for example if they have experienced multiple traumas be delivered by trained practitioners with ongoing supervision be delivered in a phased manner and include psychoeducation about reactions to trauma; managing distressing memories and situations; identifying and treating target memories (often visual images); and promoting alternative positive beliefs about the self use repeated in-session bilateral stimulation (normally with eye movements[1]) for specific target memories until the memories are no longer distressing include the teaching of self-calming techniques and techniques for managing flashbacks, for use within and between sessions. [2018]
^Watts BV, Schnurr PP, Mayo L, Young-Xu Y, Weeks WB, Friedman MJ (2013). "Meta-analysis of the efficacy of treatments for posttraumatic stress disorder". Journal of Clinical Psychiatry. 74 (6): e541–550. doi:10.4088/JCP.12r08225. PMID23842024. S2CID23087402.
^Cloitre M (January 2009). "Effective psychotherapies for posttraumatic stress disorder: a review and critique". CNS Spectrums. 14 (1 Suppl 1): 32–43. PMID19169192.
^ Jump up to:abSeidler, Guenter H.; Wagner, Frank E. (2 June 2006). "Comparing the efficacy of EMDR and trauma-focused cognitive-behavioral therapy in the treatment of PTSD: a meta-analytic study". Psychological Medicine. 36 (11): 1515–1522. doi:10.1017/S0033291706007963. PMID16740177. S2CID39751799.
^Bradley, R.; Greene, J.; Russ, E.; Dutra, L.; Westen, D. (2005). "A multidimensional meta-analysis of psychotherapy for PTSD". The American Journal of Psychiatry. 162 (2): 214–227. doi:10.1176/appi.ajp.162.2.214. PMID15677582. S2CID25882739.
^Schwarz, Jill E.; Baber, Dana; Barter, Ariel; Dorfman, Katherine (2020-01-02). "A Mixed Methods Evaluation of EMDR for Treating Female Survivors of Sexual and Domestic Violence". Counseling Outcome Research and Evaluation. 11 (1): 4–18. doi:10.1080/21501378.2018.1561146. S2CID195574249.
^Foa EB; Keane TM; Friedman MJ (2009). "Effective treatments for PTSD: Practice guidelines from the International Society for Traumatic Stress Studies". New York: Guilford Press.
^National Institute for Health and Care Excellence (2016). Post-traumatic stress disorder overview: Interventions for symptoms present for more than 3 months after a trauma [1]
^Dutch National Steering Committee Guidelines Mental Health and Care (2003). "Guidelines for the diagnosis treatment and management of adult clients with an anxiety disorder". Utrecht, Netherlands: The Dutch Institute for Healthcare Improvement (CBO). [page needed]
^Ursano, RJ; Bell, C; Eth, S; Friedman, M; Norwood, A; Pfefferbaum, B; Pynoos, JD; Zatzick, DF; Benedek, DM; McIntyre, JS; Charles, SC; Altshuler, K; Cook, I; Cross, CD; Mellman, L; Moench, LA; Norquist, G; Twemlow, SW; Woods, S; Yager, J (November 2004). "Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder". The American Journal of Psychiatry. 161 (11 Suppl): 3–31. PMID15617511.
^Department of Veterans Affairs & Department of Defense (2010). VA/DoD Clinical Practice Guideline for the Management of Post-Traumatic Stress. Washington, DC: Veterans Health Administration, Department of Veterans Affairs and Health Affairs, Department of Defense
^SAMHSA’s National Registry of Evidence-based Programs and Practices (2011)
^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.[page needed]
^Foa B; Keane TM; Friedman MJ Cohen JA (eds.) (2009). Effective treatments for PTSD: practice guidelines from the International Society for Traumatic Stress Studies (2nd ed.). New York: Guilford Press. ISBN978-1-60623-001-5.[page needed]
^Adler-Tapia R; Settle C (2008). EMDR and The Art of Psychotherapy With Children. New York: Springer Publishing Co. ISBN978-0-8261-1117-3.[page needed]
^Scott CV; Briere J (2006). Principles of Trauma Therapy: A Guide to Symptoms, Evaluation, and Treatment. Thousand Oaks, California: Sage Publications. p. 312. ISBN978-0-7619-2921-5.
^Hogan, William Andrew (2001). The comparative effects of eye movement desensitization and reprocessing (EMDR) and cognitive behavioral therapy (CBT) in the treatment of depression (Thesis). OCLC50743943.[page needed]
^Gauhar, Yasmeen Wajid Mauna (1 January 2016). "The Efficacy of EMDR in the Treatment of Depression". Journal of EMDR Practice and Research. 10 (2): 59–69. doi:10.1891/1933-3196.10.2.59. S2CID148294753.
^Malandrone, Francesca; Carletto, Sara; Hase, Michael; Hofmann, Arne; Ostacoli, Luca (1 November 2019). "A Brief Narrative Summary of Randomized Controlled Trials Investigating EMDR Treatment of Patients With Depression". Journal of EMDR Practice and Research. 13 (4): 302–306. doi:10.1891/1933-3196.13.4.302. S2CID212874892.
^Gauvreau, Philippe; Bouchard, Stéphane (March 2008). "Preliminary Evidence for the Efficacy of EMDR in Treating Generalized Anxiety Disorder". Journal of EMDR Practice and Research. 2 (1): 26–40. doi:10.1891/1933-3196.2.1.26. S2CID145460514.
^Faretta, Elisa; Farra, Mariella Dal (1 November 2019). "Efficacy of EMDR Therapy for Anxiety Disorders". Journal of EMDR Practice and Research. 13 (4): 325–332. doi:10.1891/1933-3196.13.4.325. S2CID213886603.
^Markus, Wiebren; de Weert – van Oene, Gerdien H.; Woud, Marcella L.; Becker, Eni S.; DeJong, Cornelis A. J. (1 September 2016). "Are addiction-related memories malleable by working memory competition? Transient effects on memory vividness and nicotine craving in a randomized lab experiment". Journal of Behavior Therapy and Experimental Psychiatry. 52: 83–91. doi:10.1016/j.jbtep.2016.03.007. PMID27038191.
^Recommended Guidelines: A General Guide to EMDR’s Use in the Dissociative Disorders (authored by the EMDR Dissociative Disorders Task Force and published in Shapiro, 1995, 2001)
^p159, Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision, International Society for the Study of Trauma and Dissociation Available online: 03 Mar 2011
^Brown, Susan; Shapiro, Francine (October 2006). "EMDR in the Treatment of Borderline Personality Disorder". Clinical Case Studies. 5 (5): 403–420. doi:10.1177/1534650104271773. S2CID143299210.
^Wilson, Sandra A.; Tinker, Robert H.; Becker, Lee A.; Logan, Carol R. (2001). International Journal of Stress Management. 8(3): 179–200. doi:10.1023/A:1011366408693. S2CID142177247. Missing or empty |title= (help)
^Markus, Wiebren; de Weert – van Oene, Gerdien H.; Woud, Marcella L.; Becker, Eni S.; DeJong, Cornelis A. J. (1 September 2016). "Are addiction-related memories malleable by working memory competition? Transient effects on memory vividness and nicotine craving in a randomized lab experiment". Journal of Behavior Therapy and Experimental Psychiatry. 52: 83–91. doi:10.1016/j.jbtep.2016.03.007. PMID27038191.
^Tesarz, Jonas; Wicking, Manon; Bernardy, Kathrin; Seidler, Günter H. (1 November 2019). "EMDR Therapy's Efficacy in the Treatment of Pain". Journal of EMDR Practice and Research. 13 (4): 337–344. doi:10.1891/1933-3196.13.4.337. S2CID213240106.
^Lobregt-van Buuren, Ella; Sizoo, Bram; Mevissen, Liesbeth; de Jongh, Ad (25 July 2018). "Eye Movement Desensitization and Reprocessing (EMDR) Therapy as a Feasible and Potential Effective Treatment for Adults with Autism Spectrum Disorder (ASD) and a History of Adverse Events". Journal of Autism and Developmental Disorders. 49 (1): 151–164. doi:10.1007/s10803-018-3687-6. PMID30047096. S2CID51718529.
^Solomon, Roger M.; Shapiro, Francine (November 2008). "EMDR and the Adaptive Information Processing ModelPotential Mechanisms of Change". Journal of EMDR Practice and Research. 2 (4): 315–325. doi:10.1891/1933-3196.2.4.315. S2CID7109228.
^Shapiro, Francine (October 2007). "EMDR, Adaptive Information Processing, and Case Conceptualization". Journal of EMDR Practice and Research. 1 (2): 68–87. doi:10.1891/1933-3196.1.2.68. S2CID145457423.
^van den Hout, Marcel A.; Engelhard, Iris M.; Beetsma, Daniel; Slofstra, Christien; Hornsveld, Hellen; Houtveen, Jan; Leer, Arne (1 December 2011). "EMDR and mindfulness. Eye movements and attentional breathing tax working memory and reduce vividness and emotionality of aversive ideation". Journal of Behavior Therapy and Experimental Psychiatry. 42 (4): 423–431. doi:10.1016/j.jbtep.2011.03.004. PMID21570931.
^Chen, Ling; Zhang, Guiqing; Hu, Min; Liang, Xia (June 2015). "Eye Movement Desensitization and Reprocessing Versus Cognitive-Behavioral Therapy for Adult Posttraumatic Stress Disorder". The Journal of Nervous and Mental Disease. 203 (6): 443–451. doi:10.1097/NMD.0000000000000306. PMID25974059. S2CID34850645.
^ Jump up to:abJeffries, Fiona W.; Davis, Paul (29 October 2012). "What is the Role of Eye Movements in Eye Movement Desensitization and Reprocessing (EMDR) for Post-Traumatic Stress Disorder (PTSD)? A Review". Behavioural and Cognitive Psychotherapy. 41 (3): 290–300. doi:10.1017/S1352465812000793. PMID23102050. S2CID33309479.
^Rodenburg, Roos; Benjamin, Anja; de Roos, Carlijn; Meijer, Ann Marie; Stams, Geert Jan (November 2009). "Efficacy of EMDR in children: A meta-analysis". Clinical Psychology Review. 29 (7): 599–606. doi:10.1016/j.cpr.2009.06.008. PMID19616353.
^Rousseau, Pierre-François; Boukezzi, Sarah; Garcia, René; Chaminade, Thierry; Khalfa, Stéphanie (August 2020). "Cracking the EMDR code: Recruitment of sensory, memory and emotional networks during bilateral alternating auditory stimulation". Australian & New Zealand Journal of Psychiatry. 54 (8): 818–831. doi:10.1177/0004867420913623. PMID32271126. S2CID215598663.
^Roberts, Brady R. T.; Fernandes, Myra A.; MacLeod, Colin M.; Manelis, Anna (27 January 2020). "Re-evaluating whether bilateral eye movements influence memory retrieval". PLOS ONE. 15 (1): e0227790. Bibcode:2020PLoSO..1527790R. doi:10.1371/journal.pone.0227790. PMC6984731. PMID31986171. No evidence of a SIRE effect was found: Bayesian statistical analyses demonstrated significant evidence for a null effect. Taken together, these experiments suggest that the SIRE effect is inconsistent. The current experiments call into question the generalizability of the SIRE effect and suggest that its presence is very sensitive to experimental design. Future work should further assess the robustness of the effect before exploring related theories or underlying mechanisms.
^Davidson, Paul R.; Parker, Kevin C. H. (2001). "Eye movement desensitization and reprocessing (EMDR): A meta-analysis". Journal of Consulting and Clinical Psychology. 69 (2): 305–316. doi:10.1037//0022-006x.69.2.305. PMID11393607. S2CID8526886.
^ Jump up to:abcHerbert JD, Lilienfeld SO, Lohr JM, Montgomery RW, O'Donohue WT, Rosen GM, Tolin DF (November 2000). "Science and pseudoscience in the development of eye movement desensitization and reprocessing: implications for clinical psychology". Clinical Psychology Review. 20 (8): 945–71. doi:10.1016/s0272-7358(99)00017-3. PMID11098395.
^Pitman, Roger K; Orr, Scott P; Altman, Bruce; Longpre, Ronald E; Poiré, Roger E; Macklin, Michael L (November 1996). "Emotional processing during eye movement desensitization and reprocessing therapy of vietnam veterans with chronic posttraumatic stress disorder". Comprehensive Psychiatry. 37 (6): 419–429. doi:10.1016/s0010-440x(96)90025-5. PMID8932966.
^Shapiro, F. (1989). Efficacy of the eye movement desensitization procedure in the treatment of traumatic memories. Journal of Traumatic Stress, 2, 199-223.
^Shapiro, F. & Forrest, M. (1997). EMDR The Breakthrough Therapy for Overcoming Anxiety, Stress and Trauma. New York: Basic Books
^Armstrong, Michael S; Vaughan, Kevin (March 1996). "An orienting response model of eye movement desensitization". Journal of Behavior Therapy and Experimental Psychiatry. 27 (1): 21–32. doi:10.1016/0005-7916(95)00056-9. PMID8814518.
^Sikes, Charlotte; Sikes, Victoria (2003). "EMDR: Why the controversy?". Traumatology. 9 (3): 169–182. doi:10.1177/153476560300900304.
^Arkowitz, Hal; Lilienfeld, Scott (August 1, 2012). "EMDR: Taking a Closer Look Can moving your eyes back and forth help to ease anxiety?". Scientific American. Archived from the original on March 6, 2014. Retrieved 12 August 2020. So, now to the bottom line: EMDR ameliorates symptoms of traumatic anxiety better than doing nothing and probably better than talking to a supportive listener. Yet not a shred of good evidence exists that EMDR is superior to exposure-based treatments that behavior and cognitive-behavior therapists have been administering routinely for decades. Paraphrasing British writer and critic Samuel Johnson, Harvard University psychologist Richard McNally nicely summed up the case for EMDR: 'What is effective in EMDR is not new, and what is new is not effective.'
^Shipley, Gemma; Wilde, Sarah; Hudson, Mark (April 2021). "What do clients say about their experiences of Eye Movement Desensitisation and Reprocessing therapy? A systematic review of the literature". European Journal of Trauma & Dissociation: 100226. doi:10.1016/j.ejtd.2021.100226. S2CID235544895.
EMDR (, Eye Movement Desensitization and Reprocessing)은 안구 운동에 의한 탈 감작과 재생 법 의 약어로 [1] , 프랑 장면 샤피로 ( 영어 버전 ) 에 의해 개발 된 심리 . 비교적 새로운 치료 기법이며, 특히 외상 후 스트레스 장애 (PTSD)에 대한 유효성 알려져있다 [2] . 또한 발안 원래는 EMD (Eye Movement Desensitization)라고하며, 1990 년 에 EMDR로 명명되었다.
개발 초기 1989 년에도 EMD (Eye Movement Desensitization)의 무작위 비교 시험 에 의한 효과를보고 [4] 이 이루어 EMDR되어 [3] 그 후에도 여러 가지 EMDR의 효과에 대한 연구가 반복 이루어왔다. 국제 트라우마 틱 스트레스 학회는 2000 년 에 EMDR 사용 외상 치료로 인정했다.
2000 년대에는 영국, 호주 등의 PTSD의 진료 지침에서 EMDR은 외상 에 초점 된 인지 행동 치료 (CBT)와 함께 근거가있는 치료법으로 권장되었다[5] . 2011 년 영국 국립 의료 기술 평가기구 (NICE)의 임상 가이드 라인 에서는 PSTD 치료에 CBT 및 EMDR을 권장하고있다 [2] .
2018 년, PTSD 환자에 대한 CBT와 EMDR의 효과를 비교 한 무작위 비교 시험 (RCT)의 메타 분석 논문 발표되고있다. 그 결과에 따르면 11 건의 RCT (n = 547)의 메타 분석에서 PTSD의 개선에서 EMDR은 CBT보다 우수했다 [SDM (95 % CI) = -0.43 (-0.73 --- 0.12) , p = 0.006]. 한편, 3 개월의 후속으로 4 개의 RCT (n = 186)의 메타 분석에서는 양자에 통계적으로 유의 한 차이는 보이지 않았다 [SDM (95 % CI) = -0.21 (-0.50- 0.08), p = 0.15]. EMDR은 불안 증상의 완화에서 CBT보다 우수했다 [SDM (95 % CI) = -0.71 (-1.21 --- 0.21), p = 0.005]. 불행히도 우울증 증상의 완화에서 CBT와 EMDR의 차이는 없었다 [SDM (95 % CI) = -0.21 (-0.44-0.02), p = 0.08]. [6] .
좌우로 흔들릴 치료사의 손가락을 눈으로 쫓으면서 과거의 충격적인 경험을 회상하는 절차를 이용한다. 정규의 방법은 평가 및 일지 기록 등 8 단계로 구성되어 있으며, 안구 운동 개입이 이루어지는 그 중 제 4-6 단계이다. 또한, 상기 된 기억뿐만 아니라 신체 감각이나 자기 부정적인지 등도 안구 운동에 의한 탈 감작의 대상이된다.
최근에는 손가락을 좌우 방향으로 흔들어 추종시키는 데 반드시 고집하지 않고, 의뢰인의 특성 ( 시각 장애인 , ADHD 아동 등)에 맞게 연구도 제안되고있다. 아이의 트라우마에 대한 심리 치료 인 나비 포옹도 EMDR의 변법이다.
치료 효과가生起하는 메커니즘에 대해서는 여러 설이 있고, 또한 해명의 개발이다.외상 경험에 대한 뇌의 처리 과정이 촉진되는라고도, REM 수면 이나 정위 반사 등 생리적 과정과의 관련도 논의되고있다. 마인드 풀 네스 이나 리 프레이밍 등 인지 행동 치료 적인 기법, 행동 치료 의 노출, 정신 분석 의 자유 연상 등 유사한 요소도 관련되어 있다고 여겨져왔다 [7] .
2018 년의 조사에서는 그 메커니즘을 탐구 한 연구가 32이고, 그 중에서도 27 연구가 워킹 메모리 를 검토하고있다 [3] .
샤피로는 안구 운동을 통제하기위한 괴로운 기억에 대한 불안을 감소시키는 것을 공원을 걷고있을 때 우연히 발견했다 [3] .
^ Shapiro, Francine (1989). "Efficacy of the eye movement desensitization procedure in the treatment of traumatic memories " Journal of Traumatic Stress 2 (2) : 199-223. doi : 10.1002 / jts.2490020207 .
^ 아스카 우물 소망 " 증거 기반 PTSD 치료( PDF )」 「정신 신經學雜誌」제 110 권 제 3 호, 2008 년 3 월 25 일, 244-249 쪽.
Watch master EMDR clinician and trainer Dr. Jamie Marich work with a single incident trauma case using Phases 1-8 of the standard EMDR therapy protocol. Excellent example of working with abreaction and a future template contained in this demonstration.
