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Моделируем EMDR (17) Francine Shapiro. Interviewed by Bill O’Hanlon
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metanymous wrote in metapractice
http://metapractice.livejournal.com/447894.html
Vol-34-No-3_2
http://erickson-foundation.org/docs/Vol-34-No-3.pdf
https://yadi.sk/i/P4bFzhzLdxo7e

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Francine Shapiro Interviewed by Bill O’Hanlon

Francine Shapiro, PhD, is the originator and developer of EMDR, which has been designated as an effective trauma treatment by a wide range of organizations, including the American Psychiatric Association and the World Health Organization. She is a Senior Research Fellow Emeritus at the Mental Research Institute in Palo Alto, California, Director of the EMDR Institute, and founder of the non-profit EMDR Humanitarian Assistance Programs (HAP), which provides pro bonotraining and treatment to underserved populations worldwide. HAP is now an international NGO in Special Consultative Status with the United Nations Economic and Social Council (ECOSOC), and has received an award for Clinical Excellence from the International Society for Traumatic Stress Studies. Dr. Shapiro is a recipient of the International Sigmund Freud Award for Psychotherapy, presented by the City of Vienna in conjunction with the World Council for Psychotherapy and the American Psychological Association Trauma Psychology Division Award for Outstanding Contributions to Practice in Trauma Psychology. Her books include, Eye Movement Desensitization and Reprocessing: Basic Principles, Protocols and Procedures; Handbook of EMDR and Family Therapy Processes; EMDR as an Integrative Psychotherapy Approach; and Getting Past Your Past.



Edited at 2015-01-15 08:41 am (UTC)

--Bill O’Hanlon: You had a health crisis that led to you becoming a psychologist. Is that right?

--Francine Shapiro: I was about 30 years old. I was finishing up a PhD in English literature and then I got cancer. Norman Cousins’ work was coming out at that time on the effect of stress on the immune system. It made sense. The principles seemed valid but there weren’t techniques widely available to help. I remember thinking: ‘If we’re putting men on the moon, how come we weren’t able to deal with our minds and bodies?’ I had been out to California previously and it seemed cutting-edge approaches were available.

So I left my PhD program and went to California to look for answers. I attended workshops on body work and applied kinesiology, hypnosis, and meditation - a whole slew of things. Then I decided to look at the formal field of psychology and entered a PhD program. I had no intention of becoming a psychologist. I just wanted to see what the principles might be. My goal was to find out what works and get it out to the general public.

One day, I took a walk in the parkand noticed the effect of eye movements on myself. I wasn’t looking at anything, just walking, and I noticed that disturbing thoughts were disappearing. When I brought them back, they didn’t have the same charge. So I started paying close attention because I had been using my own mind and body as a laboratory for the past seven years. I noticed that when a disturbing thought came to mind, my eyes started moving y rapidly in a certain way, and I noticed the thought shifting.

Again, when I brought it back, it didn’t bother me anymore. I wondered if I could do it deliberately. So I brought up something that bothered me, moved my eyes in the same way, and I got the same results.

When I established that I could do it for myself, I wanted to see if it could work with anyone else. I gathered every warm body I could lay my hands on - people at school, folks I knew, and asked, “Do you have anything you want to work on that’s bothering you?” Not surprisingly, everyone did. I showed them how my eyes had moved, asked them to think of the disturbance and move their eyes, but found out most people didn’t have the muscle control to do it.

So I said, “Follow my fingers with your eyes.” I started guiding them, and I found that the eye movements began to take away anxiety, but it would often stop. So I started developing procedures to make the eye movements more effective.

--BOH: Initially you named this EMD, and then as you worked on these protocols you added another element. Why the R?

--FS: Because at first, coming from a behavioral therapy vantage point, I was thinking in terms of decreasing anxiety. I thought I was doing the equivalent of systematic desensitization while using the brain’s own mechanism for it. It seemed like it might be linked with REM sleep, which is when those kinds of rapid saccadic eye movements would often spontaneously go back to a past event, and there we are in psychodynamic territory. I discovered that it was easier and more efficient if I started with the past. If I cleaned that out, generally the present didn’t bother them any longer.

--BOH: Initially you named this EMD, and then as you worked on these protocols you added another element. Why the R?
--FS: Because at first, coming from a behavioral therapy vantage point, I was thinking in terms of decreasing anxiety. I thought I was doing the equivalent of systematic desensitization while using the brain’s own mechanism for it. It seemed like it might be linked with REM sleep, which is when those kinds of rapid saccadic eye movements also occur. I tested the procedure in a randomized study and when it was published in 1989, it was called EMD, Eye Movement Desensitization, focused on getting rid of anxiety.

But as I continued working with the procedures, I noticed that if I let it keep going, new associations were occurring. Emotions were changing dramatically from anxiety to sadness to joy. There were cognitive and emotional changes when I allowed this association process to take place.

--BOH: When you say cognitive, just to clarify: self-talk, beliefs…?
--FS: Yes. People’s beliefs would au-tomatically shift.
--BOH: So those beliefs that used to occur automatically were suddenly new beliefs that were more helpful, less self-condemning, less fearful?
--FS: Yes. If I let the associations move, people were getting insights about themselves, about whatever they were dealing with. And it wasn’t just anxiety that was changing, it was guilt, shame; all the negative feelings moved into healthier emotions. What I was seeing was spontaneous and simultaneous changes in emotion, belief, and somatic responses. I also discovered that if I started with a present issue, it would often spontaneously go back to a past event, and there we are in psychodynamic territory. I discovered that it was easier and more efficient if I started with the past. If I cleaned that out, generally the present didn’t bother them any longer.

--BOH: It generalized out to several things, sometimes things you’d never even talked about?
--FS: Exactly. So I added the Reprocessing around 1990 in order to demonstrate that it was more than just Eye Movement Desensitization. If I had it to do over again, I’d call it Reprocessing Therapy. Unfortunately, it’s too late. But, to be clear, EMDR is now an eight-phase psychotherapy with a wide range of applications.

--BOH: There seems to be two themes: one is practical and experiential, and the other is, “Let’s look at the evidence.” Why did you put so much emphasis on doing scientific research?
--FS: The way to alleviate suffering is to rigorously evaluate what you’re doing. In the first study, results could have been due to characteristics of me as a therapist. The replication studies were extremely important to prove that it worked. I ended up being invited to a variety of VAs and agencies. We would give free trainings if they were going to do research. We continue to do that to this day. Unfortunately, some of the early studies were done badly, so it needed a lot of additional research to convince people that it actually worked. At this point there are about 24 randomized studies on the effect of EMDR therapy with a wide range of trauma victims. The World Health Organization has now stated there are only two validated approaches for the treatment of PTSD in children, adolescents and adults: trauma-focused CBTand EMDR therapy. That’s because of the research base.

--BOH: Is there a place where people can go if they want to check out the research?
--FS: The EMDR HAP website: www.emdrhap.org/content/what-is-emdr/research-findings/
--BOH: Because I’ve known you for years and followed your work, it’s surprising to me that people have dismissed your work and attacked not only the work but sometimes you. Let’s talk about some of those dismissals and how you responded and overcame them.

--FS: The problems started early on because they were doing research that used EMD or EMDR procedures with and without the eye movement. However, they often did it badly. Those earlier studies were evaluated in 2000 by the task force of the International Society for Traumatic Stress Studies, and were deemed inadequate because they used inappropriate populations and not enough treatment, such as multiple traumatized combat veterans, and they only gave them two sessions. Instead of using the 35 clients in each condition that was supposed to be done, they’d use only seven or eight. The researchers weren’t doing it with appropriate fidelity checks. There was a ream of stuff going on, because back then, there was no gold standard to define how you’re supposed to do research.

For instance, when an intern who had never done therapy did a study with multiple traumatized combat veterans, the supervisor told him he wasn’t doing EMDR correctly, but it got published in the Journal of Behavior Therapy with negative results. So I asked a researcher I knew in the VA, “How is it possible that something gets published with a negative fidelity check?” He said, “Oh, well, we never use them.” That taught me that all the previous decades of psychological research really weren’t telling us anything, because no one had checked to make sure that the researcher had done the therapy the way it’s supposed to be done in clinical practice.

--BOH: This leads me to the last question. One afternoon when we were both teaching at a conference, I said, “You’ve traveled around the world, you’ve written these books, and you’ve done all this work… why?” And you said, “I want to help create world peace.” And I said, “World peace, from waving your fingers in somebody’s eyes? How does that happen?” Can you talk about that?
--FS: If you’re trying to bring people together around a conference table when they’ve been exposed to the ethno-political damage from all these wars, they can’t connect because the unprocessed memories from those traumas keep getting triggered. The anger, the “You’re an Other” is there automatically. If we can process that, then they can make connections and reconciliations.

For instance, one of the trainings we did in Northern Ireland included Catholic and Protestant clinicians learning the procedures together. By the end of it, we managed to defuse an IRA death threat because the folks could see the connections being made. When you do EMDR therapy training, people are working on their own experiences, so they understand what’s happened. They can see what’s been driving some of their automatic responses. They develop more compassion for themselves and for others.

Although the results have been quite wonderful, there’s clearly a lot more that needs to be done. There are many more populations in need and a huge amount of negative psychological and physical effects that many clinicians misdiagnose.

Реакция на психотравму бывает разная
http://gutta-honey.livejournal.com/400400.html

Краткий обзор глазодвигательных терапий


Re: Краткий обзор глазодвигательных терапий

Хм, забавный обзор.

Re: Краткий обзор глазодвигательных терапий


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