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Моделируем EMDR (17) Francine Shapiro. Interviewed by Bill O’Hanlon
brain
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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--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: So you made a commitment to make sure the people who do this research are well trained and that the research is solid.
--FS: Yes. Controversy about the eye movement being bogus is based on those early negative studies, but since then…
--BOH: More studies have comein, and they’re legitimate, valid, well-designed studies with people who knew how to do the procedure.
--FS: And a new meta-analysis just came out that evaluated the various studies and demonstrated definitively that the eye movements do add to it. One of the research supported hypotheses revealed that it indeed seems to link into the same processes that occur during rapid eye movement sleep. Another 12 studies have been done supporting another hypothesis - that it taxes working memory. I believe both of them are true. They just come in at different times during the therapy.

--BOH: So the procedure’s been validated, there are more studies going on, and hypotheses are still being investigated. Let’s address dismissals of the work. “It’s just hypnosis.” What do you say to that?
--FS: Well, it’s simply not. It’s a different brain state. There was a study that compared brain states between EMDR therapy and hypnosis.

--BOH: So, it’s just placebo?
--FS: The two dozen randomized studies show it’s not.

--BOH: This isn’t a dismissal, but sometimes it was lumped in with another rapid trauma treatment that came out around that same time known as “tapping.”
--FS: The effects are quite different, and there also isn’t research in support of that.

--BOH: They’re just starting to do some research, but they didn’t emphasize it, which was one of the contrasts I wanted to make. Early on you said, “Let’s do research,” and they said, “No, it works in clinical use. That’s all we need to do.”
--FS: What you see that’s also different with EMDR therapy is that you get pronounced cognitive changes and insights going on as you do it. The disturbing event becomes a source of resilience. With EMDR therapy, if you have a single trauma victim with PTSD, the research indicates that 84percent to 100 percent of single trauma victims no longer have PTSD after the equivalent of three 90-minute sessions. And it lasts in follow-ups, so you don’t have to keep redoing it.

--BOH: So it’s taken from NLP?
--FS: Well, you know NLP…

--BOH: I do, so I guess I can speak to it. I did learn a procedure in NLP of having people watch their eye movements while they were describing the problem, and then have them do different eye movements. But when I learned EMDR, it was a whole different procedure, which seemed to work a lot faster and a lot more consistently. All right, once you figured out this worked and the research started to come in, you then created an orientation toward charitable service in the wake of natural disasters and other mass traumas. Why?
--FS: Remember, I came into it from the position of having cancer, so my emphasis has always been on what’s going to work for the general public. Even though I had a behavioral orientation, because that’s what was being taught in graduate school, my emphasis wasn’t on academia, it was on: How do we help? What do we do?

Westarted the non-profit EMDR Humanitarian Assistance Program at the time of the Oklahoma City bombing because we got a call from an FBI agent who had received EMDR therapy. He said, “Could you please do something? The mental health professionals here are dropping like flies.” At that time, there weren’t any empirically validated PTSD treatments. It was considered intractable.

So, most of the therapists who were there hadn’t learned appropriate procedures. They were hearing all of the disturbing stories and developing vicarious traumatizations. We flew out a group of volunteer clinicians, did a needs assessment, made the appropriate connections, and began doing free treatment for the first responders and the victims. Then we started doing free trainings for the clinicians in Oklahoma.

The evaluations of that program indicated an 85 percent success rate after three sessions, which duplicateda study that had come out in the Journal of Consulting and Clinical Psychology that year, so we knew that we were doing what we needed to do. At that point, we set up the EMDR HAP…

--BOH: Which has gone on to respond to many other world crises.
--FS: The Balkans, after 9/11, after Katrina and Sandy, after the tsunamis in Asia, etc. Something beautiful about it is that these clinicians are donating their time. We’ve sometimes funded projects through the equivalent of bake sales. But we feel it’s extremely important to do what we can. We’ve also developed trauma response networks throughout the U.S. that have responded after events like the Newtown shootings, Boston Marathon bombing, and Arizona fires.

Also, all the international humanitarian assistance programs from the U.S. and the EMDR Europe Association resulted in trained clinicians in different countries. They set up their own EMDR associations, and then, for instance, the relevant national associations joined together to create the EMDR Asia Association about four years ago.

In Latin America, we got a request for help after a hurricane in Mexico. HAP clinicians from the U.S. went to investigate and there were schoolyards of traumatized children, so we trained the local clinicians. They developed a group protocol for EMDR treatment and published the results. Then, when there was a natural disaster in another part of Latin America, the Mexican clinicians went to assist them, and that’s how it’s continued to spread. Now there’s an EMDR Ibero-America Association.

We’ve trained people on both sides of ethno-political divides. In some places, historical trauma gets transmitted from generation to generation, and we can help stop the cycle of suffering and violence.

Israeli clinicians trained Palestinian clinicians, and now they do conference presentations together because the pain is the same on both sides.

What we’re hoping is, with enough clinicians treating the trauma in the different populations, we can bring people together so that these common denominators will become larger than the past historical traumas.

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