EMDR Psychotherapy

The first method of treatment is trauma-focused cognitive-behavioural therapy. In this method, a patient is gradually but carefully exposed to feelings, thoughts, and situations that trigger memories of the trauma. By identifying the thoughts that make the patient remember the traumatic event, thoughts that had been irrational or distorted are replaced with a balanced picture. Another productive method is family therapy since the family of the patient is also affected by PTSD. Family therapy is aimed at helping those close to the patient understand what he/she is going through. This understanding will help in the establishment of appropriate communication and ways of curbing problems resulting from the symptoms (Smith & Segal, 2011).

William Harrar went into private practice in 1991 and continues to maintain a private practice. He provides professional consultations to other therapists and consults at local psychiatric units as well. He also provides psychotherapy to individuals, couples, and families. Dr. Harrar’s emphasis is brief treatments, especially treatments utilizing EMDR. His expertise in EMDR has afforded him as an approved consultant and certified therapist with the Eye Movement Desensitization and Reprocessing International Association (EMDRIA). Dr. Harrar also facilitates at national EMDR Institute trainings.

He discusses the effectiveness of this method and even that it has been proven to completely cure PTSD in some patients, mainly veterans which are my target patient of discussion. This article is credible because it was written by a good psychologist and was published in a credible medical journal.

This paper will examine, compare and contrast Eye Movement Desensitization Reprocessing (EMDR) and Cognitive Processing Therapy (CPT) in the case of Joe, a fictional client with post-traumatic stress disorder from two tours of combat duty as a Marine Corps sniper in the Middle East, without the use of psychotropic medications. EMDR uses side-to-side eye movements in a one-on-one session with a clinician while the client focuses on a distressing memory until he or she reports reduced symptomology or no psychological distress; the clinician then has the client think of positive thoughts while continuing the exercises. EMDR has been the target of debate over its effectiveness, with some scholars suggesting that it is the “rewiring” of the brain that is most beneficial. CPT is often used when other processes of recovery fail. Therapy, administered individually or in a group, initially focuses on misconstrued beliefs of denial and self-blame for the traumatic incident and then addresses beliefs the client has about himself and the world in general. CPT uses talk therapy and worksheets with the goal of the client learning to make sense of what happened and fit it in with the beliefs about themselves and others. Findings suggest that each therapy has its advantages and which is best depends on how responsive the client is to each mode and the therapeutic alliance between the client and therapist.

Treatment of posttraumatic stress disorder is possible. The current treatment of PTSD encompasses several types of psychotherapy combined with a medication regimen. Cognitive therapy is one type of therapy used to combat PTSD. The goal of cognitive therapy is to allow the patient to slowly experience feelings, thoughts, and events associated with the trauma in a controlled setting. This allows the PTSD sufferer, to categorize the traumatic feelings associated with the event and assign a more positive meaning to them. Thus providing a coping mechanism. Another school of thought places the therapeutic focus on gradually exposing the PTSD sufferer to elements of the trauma. The goal is to desensitize the patient to the traumatic event. This allows the patient to resume a normal life. One other form of therapy used in treatment of PTSD is EMDR. EMDR or Eye Movement Desensitization and Reprocessing is a form of exposure therapy that places the emphasis on guided eye movements. The theory is that the movements help retrain how the brain reacts to memories of the traumatic event. Success has

Foa and her colleagues (2011) created prolonged Exposure (PE) for clients trying to overcome with PTSD that is based on the emotional processing therapy (Foa, 2011). PE treatment plan includes collecting of information associated to both the traumatic experience and the trauma survivor's responses to it, the teaching of breathing retraining techniques, education, the re-experiencing of the trauma in imagination, and in vivo exposure (Foa, 2011). When compared with CPT, PE is a 10-session treatment (60-90 minutes) that is centered on both in-vivo and imaginal exposure to the trauma memory and ensuing adaptation. PE reports that repetitive stimulation of the trauma memory allows the clients to integrate new, counteractive information about themself and their world. Additionally, homework assignments in PE allow the client to face safe situations, which were formerly resolute to be threatening based upon inaccurate post-traumatic beliefs (Foa,

The symptoms that are being treated through this individualized treatment plan related to post traumatic stress disorder are: dissociative reactions, irritable and aggressive behavior, concentration problems, and trauma-related external reminders. The first goal is in place to assist Precious in learning to eliminate intrusive memories, a “notable feature of memory in PTSD is the reliving experiences or “flashbacks” to the trauma” (Berwin, 2003, p. 340), and addressing causes of these memories through the intervention of prolonged exposure. In addition, the second goal that is being implemented, preventing and addressing distortions, is being addressed through prolonged exposure. This technique is “a general treatment strategy for reducing anxiety that involves confronting situations, activities, thoughts, and memories that are feared and avoided even though they are not inherently harmful.” (Foa, 1998, p. 65). The flashbacks and distortions that Precious experiences are being addressed through prolonged exposure, due the fact that it

EMDR therapy, EMDR uses an eight-phase approach, referring to the past, present, and future aspects of the traumatic experience, and dysfunctional stress stored memories. The first Phase calls History and Treatment Planning. In this phase the therapist listens the patient's history and develops a treatment plan. In Phase II, the preparation, the therapist teaches the patient how to calm down him/herself with the help of relaxation techniques. The phase III is Assessment in which the therapist asks the patient to visualize the image of the disturbing event, then asks him/her to develop a positive cognition associating with that image. In Phase IV, Desensitization, the patient  focuses on the disturbing memories during short sessions of 15-30 seconds. At the same time, he/she also focuses on the alternative stimulation such as directed eye movements, slapping hands, or voices. This process repeats  many times until the patient's reaction to the target memory becomes less distressed. In Phase V, Installation, the therapist again with the use of bilateral stimulation asks the patient to remember the event about which the positive cognition is developed in the phase III, and makes sure that

This annotated bibliography looked at 6 different journal articles on the effectiveness of Cognitive Behavior Therapy (CBT) in treating Post-Traumatic Stress Disorder (PTSD) versus other methods and variations of CBT. Historically speaking, it is common knowledge in the field of psychology for CBT to have a 50% success rate for patients with PTSD in that it either works or it doesn’t work, which is traceable to the patients commitment to the therapy. These articles review abstract ideas that have been ventured upon by researchers to corroborate the preconceived notions of CBT and PTSD and find a

According to Sharf, (2008) the eye movement desensitization and reprocessing (EMDR) was designed to treat posttraumatic stress disorder. EMDR requires that the clients visualize an upsetting memory and accompanying physical sensations. The clients repeat negative self-statements that they associate with the scene. The procedure is repeated again and again until the client’s anxiety is reduced. EMDR focuses on desensitizing strong emotional reasons in clients and help them to reframe their belief systems to accommodate new emotional states (Sharf, 2008).

EMDR (Eye Movement Desensitization and Reprocessing) incorporates elements of cognitive-behavioral therapy with eye movements or other forms of rhythmic, left-right stimulation, such as hand taps or sounds. These work by “unfreezing” the brain’s information processing system, which is interrupted in times of extreme stress (“Post-Traumatic Stress

Prolonged exposure (PE) is a specific exposure therapy program that derives from Emotional Processing Theory (EPT). The idea of emotional processing is to interpret realistic information and accommodate that information into a fear structure which in turn diminishes the fear (Foa, 2011). Foa (2011) acknowledges that the idea of failing to process trauma is

If veterans do struggle with PTSD after they return from combat the Department of Veterans Affairs, a governmental agency that helps struggling veterans recover, offers two treatments. Studies have been done to see if one of the therapies is more effective than the other. There is not yet evidence that one therapy is better than the other. Cognitive processing therapy, CPT, helps by giving the vet a new way to deal with the maladaptive thoughts that come with PTSD. It also comforts them in gaining a new understanding of the traumatic events that happened to them. One of the other benefits of CPT is that it assists the person in learning how these disturbing events change the way they look at everything in life and helps them cope with that (“PTSD: National”). The second newer option of the two is prolonged exposure therapy, which is repeated exposure to these thoughts, feelings, and situations (“Most PTSD”). This type of therapy is now a central piece in the VA’s war on PTSD. “The problem with prolonged exposure is that it also has made a number of veterans violent, suicidal, and depressed, and it has a dropout rate that some researchers put at more than 50 percent, the highest dropout rate of any PTSD therapy that has been widely studied so far,”(“Trauma Post”). Both of the therapies are proven to reduce the symptoms but both have extremely high drop out rates and low follow through. It

For some patients with excessively traumatic experiences, the following preparation stage will last longer than the 1 to 4 sessions that most patients take. In the preparation phase, the therapist has to build a trustful relationship with the client in order to help establish appropriate expectations for the patient during the treatment. Since EMDR therapy does not require the patient to completely confide in the therapist her experiences, a therapeutic relationship between client and clinician is very important. Otherwise, the following sessions and treatments would be misdiagnosed since the patient’s statements to the therapist may not be completely true. After they establish a connection, the theory, procedures, and expectations of Eye Movement Desensitization and Reprocessing therapy is clarified by the clinician to the patient. Also explained to the patient is the concept of Bilateral Stimulation (BLS), oscillating eye movements, sounds, and sensations. BLS aids the left and

This treatment approach is based on cognitive and learning theories, tackling-misleading beliefs related to the traumatic events of acknowledgments related to the abuse and provides a supportive environment of which individuals are encouraged to talk about their traumatic experience. A numerous amount of research has been carried out to investigate into how effective CBT really can be for PTSD. (Resick et al, 2002) carried out an investigation comparing CBT with strong cognitive restructuring focus and CBT with a strong exposure focus and to a waiting-list control of rape survivors. Prior to this experiment approximately 80% of patients who completed either form of CBT no longer met the criteria for PTSD. Once this investigation was complete a follow up treatment took place of which it was noted 2% of the waiting list group had lost the PTSD diagnoses. Only a year after this investigation Bryant, Moulds, Guthrie, Dang & Nixon, (2003) restructured the experiment comparing exposure alone, exposure plus cognitive restructuring, and supportive counselling in civilians with PTSD resulting from various traumatic events. At this particular follow up 65-80% of participants who either completed either form of CBT were now clear of PTSD diagnosis, compared to less than 40% of those who completed supportive counselling.