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EMDR: Where did it come from? Carolina House Symposium
What is it? Where is it going? Workshop with Gary Peterson, M.D.
EMDR: Where did it come from? Objectives
What is it? Where is it going?
Gary Peterson, M.D. • Explain the origins of EMDR
Chapel Hill, NC • Describe the eight phases of EMDR
Carolina House Symposium • Name the three prongs of the basic
The Washington Duke Inn treatment protocol
Durham, NC
August 23, 2013
Orientation towards EMDR Active Ingredients Project
Efficient Therapies of PTSD (Figley, 1995)
EMDR is one of a wide variety of methods under • Eye Movement Desensitization and
the rubric of “Power Therapies” that target
specific issues and problems, aimed at rapid Reprocessing (EMDR)
resolution. • Thought Field Therapy (TFT)
These methods generally employ attunement to • Visual/Kinesthetic Dissociation (V/KD)
a problem including the emotions and somatic • Traumatic Incident Reduction (TIR)
component, and apply a dual attention task
with a physical sensation that supports
resolution of the client's negative emotional
attachment to the target issue.
Active Ingredients Project
Data Epigenetics
Method Subjects Treatment Follow-up • Environmental influences affect the
time (min.) SUD genetic expression of DNA
EMDR 6 172 2.64
TFT 14 63 3.60 • Epigenetic modifications can be
inherited from one generation to the
V/DK 11 113 3.30 next.
TIR 9 254 5.67
The Washington Duke Inn
Durham, NC August 23, 2013 Pg 1
EMDR: Where did it come from? Carolina House Symposium
What is it? Where is it going? Workshop with Gary Peterson, M.D.
Epigenetic Mechanisms Epigenetic Modification
• DNA methylation and histone
modification can regulate gene
expression without altering the
underlying DNA gene sequence.
Epigenetics and
Environmental Stress Epigenetic effects
• The genome dynamically responds to the • As environmental influences affect the
environment. Stress, diet, behavior, toxins genetic expression of individual traits, many
and other factors activate chemical switches effects can occur.
that regulate gene expression. • In additional to emotional and behavioral
• The lousy childhoods or excellent adventures issues, altered gene expression can affect
of our ancestors might change personality, cardiovascular status and can be associated
bequeathing anxiety or resilience by altering with risk of cancer.
epigenetic expressions of genes in the brain.
Epigenetics and
Epigenetic Inheritance psychotherapy
• DNA sequencing of genes is • “Successful psychotherapy may activate
unchanged. epigenetic mechanisms in brain circuits to
• Some epigenetic tags remain in place reduce psychiatric symptoms by improving
from generation to generation. the efficiency of information processing in
• The new embryo's epigenome is not these circuits, just like effective drug
completely erased and rebuilt from therapy is thought to do.”
scratch.
J Clin Pharm Ther 2012 p253
The Washington Duke Inn
Durham, NC August 23, 2013 Pg 2
EMDR: Where did it come from? Carolina House Symposium
What is it? Where is it going? Workshop with Gary Peterson, M.D.
Intergenerational effects of
smoking Autonomic Nervous System
Stress and the HPA Axis Polyvagal Theory Sequence
Trauma Treatment Overview Trauma Treatment Overview
Phase or Stage Oriented Approach 1. Stabilization Phase
• Safety from self injury, drugs, promiscuity,
1. Safety, stabilization, and symptom destructive relationships
reduction • Stabilization of mood, affect tolerance,
2. Processing traumatic experiences functioning in daily life, relationships
3. Integration or fusion, and rehabilitation • Symptom reduction, learning to self-
soothe, containment of re-experienced
traumas
The Washington Duke Inn
Durham, NC August 23, 2013 Pg 3
EMDR: Where did it come from? Carolina House Symposium
What is it? Where is it going? Workshop with Gary Peterson, M.D.
Trauma Treatment Overview Trauma Treatment Overview
2. Trauma-Processing Phase 3. Integration, Fusion, Rehab Phase
• Re-experiencing, abreacting, desensitizing, • Grapple with loss, grief, mourning,
and detoxifying traumatic events loneliness
• Reframing context of the abuse • Practice new skills
• Tolerating feelings of helplessness, grief • Tolerate not relying on dissociation
confusion, shame, horror, terror, anger and
rage • Deal effectively with everyday problems
The Adaptive Information EMDR Historical Highlights
Processing System
Healing is the usual human response to untoward 1987 Shapiro develops Eye Movement
events Desensitization (EMD)
• Physical - cut heals 1989 Shapiro publishes 2 EMD articles
• Psychological - problems resolve 1991 EMDR renamed EMDR
Learning occurs based upon constant ‘updating’ in 1992 First EMDR Conference
response to changing environment, perceptions, 1995 Shapiro’s EMDR published
and knowledge. 1995 EMDR International Association established
Disturbing events that are not metabolized or nd
“bled off” are stored in a manner that precludes 2001 EMDR, 2 Ed., published
the usual integration that occurs with life events. 2002 Resource Development and Installation
2007 Journal of EMDR Practice and Research begins
EMDR Research Highlights More EMDR Research Highlights
1989 Treatment of somatoform disorder (Brown) 2004 As effective as CBT for sexually abused girls
1998 Treatment of military veterans (Carlson) (Jaberghaderi)
1998 EMDR equivalent to exposure therapy (Van Etten) 2006 Effective treatment after 9/11 (Silver)
1999 Superior to routine Tx for adults with CSA 2007 EMDR Reduces PTSD sx better than SSRI
(Edmond) (van der Kolk)
2002 Positive results with children with PTSD 2008 Effective vs. CBT for child behavior problems
(Chemtob) (Wanders)
2002 Equivalent to CBT for adult PTSD (Several articles) 2012 EMDR and B/SIT significantly reduced test
anxiety (Cook-Vienot)
2004 Group protocol for children (Fernandez) 2012 Traumatized C&A -15 EMDR studies (Cook-Vienot)
The Washington Duke Inn
Durham, NC August 23, 2013 Pg 4
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