This article describes a comprehensive treatment of a case of panic disorder with agoraphobia. A thorough history taking revealed that experiential contributors had a pivotal role in the development of the condition. Therefore, eye movement desensitization and reprocessing (EMDR) was used to address early traumatic events as well as the present stimuli that caused disturbance and had maintained symptomatology for the past 12 years. Although the client's symptoms were resolved after 15 sessions, EMDR was also effective in addressing future behaviors and resolving anticipatory anxiety. During EMDR processing, the client demonstrated emotional and cognitive changes consistent with trauma resolution, insight, and personal growth. The client gradually enacted functional new behaviors spontaneously as treatment unfolded. The therapeutic process and the targets are described in detail.
Research in clinical psycho-oncology is becoming an area of key importance in investigating the effects of the interventions of support and/or psychotherapy with patients. This study was conducted with the aim of evaluating the effectiveness of the eye movement desensitization and reprocessing (EMDR) approach compared to a non–trauma-focused cognitive behavioral therapy (CBT) intervention. There were 11 male and 46 female participants, with mixed cancer diagnoses. Thirty-one subjects received EMDR therapy, and 26 received CBT for 12 sessions of 60 minutes each. The Symptom Checklist-90-R (SCL-90-R), COPE inventory, and Davidson Trauma Scale (DTS) were administered at three different times (T0, before intervention; T1, after the sixth session; and T2, after the 12th session); the Karnofsky Performance Status was administered at T0 only. In the EMDR group, a significant improvement was reported for the following 11 of the 17 dependent variables: COPE subscales, Avoidance Strategies and Positive Attitude; all three DTS subscales, Intrusion, Avoidance, and Hyperarousal; and 6 SCL-90-R subscales. In the CBT group, a significant improvement was reported for the following 4 of the 17 dependent variables: COPE subscales Positive Attitude and Transcendent Orientation; two DTS subscales, Intrusion, and Avoidance, with no improvement on any of the SCL-90-R subscales. This innovative study shows the value of trauma-focused treatment for patients with cancer and allows important preliminary suggestions on the usefulness of applying EMDR therapy in an oncological setting, although further research in this context is still needed.
A pilot comparison was made between two treatments for panic disorder, eye movement desensitization and reprocessing (EMDR) and cognitive behavioral therapy (CBT). Treatment was provided in the private practice settings of 7 credentialed therapists, whose treatment fidelity was monitored throughout the study. Five outcome measures were administered at pretreatment, posttreatment, and 1-year follow-up. There was significant improvement for participants in both groups (N = 19) after 12 sessions of treatment. No significant differences in outcome were seen between the 2 therapies, except for lower frequency of panic attacks reported by those in the EMDR group. The current study reanalyzed the data previously reported in Faretta (2012). Further research in this area is suggested.
In the context of psycho-oncology today, there is a specific need to develop better tools for psychological assessment, as well as clinical intervention, that address cancer-related stressors. Particularly, focus should be on the events that preceded and underpinned the onset of the organic disease to treat these throughout the entire course of the illness and to help the patient face cancer and its correlates. It is hypothesized that eye movement desensitization and reprocessing (EMDR) therapy promotes the elicitation of the innate self-healing capacity; its effect is believed to be mainly linked to the interaction between the natural healing process of the immune system and adaptive information reprocessing. Because of the specific characteristics of the “cancer event,” seen as a “traumatic event,” it is fundamental to develop and adopt specialized protocols focused on the illness. This article outlines a comprehensive model that helps to identify crucial target memories for EMDR psychotherapy with patients with cancer. Examining each stage of the cancer treatment may help in understanding the relationship between the body and EMDR and how the imbalance may be corrected. The EMDR protocol for patients with cancer is explained step by step, in detail, and illustrated with clinical vignettes and through a case history.
Six randomized controlled trials (RCTs) investigated the efficacy of eye movement desensitization and reprocessing (EMDR) therapy for adults with anxiety disorders over a span of 20 years (1997–2017). Three RCTs focused on panic disorder, with or without agoraphobia (PDA); two studies targeted specific phobias, whereas the dependent variable of another RCT was “self-esteem,” considered as a mediator factor for anxiety disorders. In four RCTs, EMDR therapy demonstrated a positive effect on panic and phobic symptoms, whereas one RCT on PDA was partly negative and one study failed in improving self-esteem in patients with anxiety disorders. Considered as a whole, these preliminary data suggest EMDR therapy may be effective not only for PD but also for specific phobias. Further controlled studies are needed to corroborate these findings and also to systematically evaluate the efficacy of EMDR therapy for generalized anxiety disorder, social anxiety, and agoraphobia. Because cognitive behavioral therapy (CBT) is presently considered a first-line treatment for anxiety disorders, controlled comparisons between EMDR therapy and CBT would be especially useful in future investigations of EMDR treatment of anxiety disorders.
Of the many life-threatening illnesses, cancer can be one of the most traumatic and distressful. It impacts the individual’s sense of identity and interferes with essential features intrinsic to the person’s uniqueness and self-awareness. It attacks patients’ physical integrity, bringing death into the foreground and can directly threaten their sense of belonging to micro and macro social systems. This article stresses the importance of understanding that psychological pain and physical suffering are closely interconnected and, within the context of psycho-oncology, proposes a clinical perspective based on the eye movement desensitization and reprocessing (EMDR) approach, in which the cancer event is nested in the history of life of the patient. EMDR is a therapeutic approach guided by the adaptive information processing (AIP) model. The AIP model postulates that psychopathology results when unprocessed experiences are stored in their own neural network, incapable of connecting with other more adaptive networks. In this perspective, the core of the clinical suffering is hypothesized as embedded in these dysfunctionally suspended memories. In line with recent scientific literature presented in this article, it appears that previous and cancer-related traumas maintain a vicious cycle between psychological and physical health, and the aim of EMDR therapy is to break this cycle. Recent scientific research has hypothesized that EMDR therapy is effective at both the psychological and physical levels. However, because of the consistent heterogeneity of the research design, the findings reported in this article highlight the need for further controlled research for more comprehensive examination.
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