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Transcript
Dr David Blore PhD
EMDR Europe Consultant
Chair: EMDR and Positive Psychology Special Interest Group
Specialist visiting lecturer in EMDR: Teesside University UK
1
"Our English language is deficient in some respects. We have the word
'trauma' to denote an unfortunate blow that injures the personality, but as yet
we have no word that describes an experience that is fortunate, that
strengthens the personality. The closest we come to this is to say it is a
blessing, but counting our blessings does not really meet our need for a word
directly opposite in meaning to 'trauma'."
Margaret Mead 1901-78 Cultural anthropologist
“…something positively new that signifies a kind of surplus
compared to precrisis level…”
Zöellner & Maercker (2006p.334)
“…Post Traumatic Growth…”
Tedeschi & Calhoun (1995)
2
“…EMDR includes as standard Phase 5. Given that RCTs
and meta analyses, by virtue of their focus on reducing
negative symptoms in order to achieve an evidence base,
do not take into account the positive growth that Phase 5
can frequently achieve in addition (to the insights achieved
in Phase 4)… therefore EMDR is not fully appreciated.”
“David B: you don't know what you're talking about.”
3
1.
2.
3.
4.
Has EMDR’s full potential been established?
What is feasible with EMDR… over and above the total
reduction of negative ‘symptoms’?
Is Post Traumatic Growth the ‘territory’ of mental health
practitioners who do not work in performance
enhancement and related fields?
How hard has Phase 5 been made to work and been
reflected in psychometric outcomes?
4
5.
As regards EMDR, what is the role of healthcare?
6.
As regards EMDR, are healthcare monies spent on
‘positive healthcare’ inefficient and if so, why?
7.
8.
Is ‘throughput’ the only way to keep waiting lists down?
Would a longer-term view of healthcare decided upon by
clinical imperatives help? The current ‘indirect factors’
(non-clinical) suggest that not only will this not happen but
matters are happening increasingly so in the opposite
direction!
5
In the UK we don’t even spend half the minimum amount
cited by NICE as being required to treat mental health
suffering and that “70% of patients who had ‘high intensity’
therapy did not receive the minimum number of treatment
sessions that NICE recommends.”
(Griffiths & Steen 2013a p.153 see also Griffiths, Foster, Steen &
Pietroni 2013; Griffiths Steen 2013b; Royal College of Psychiatrists
2011; Office for National Statistics 2013; NHS Information Centre for
Health and Social care 2013; Griffiths 2010)
6
16th anniversary of Martin Seligman’s
Presidential address to the American
Psychological Association to make his
mission to establish Positive Psychology
25th anniversary of Francine Shapiro’s
first published papers on EMDR
60th anniversary of Abraham Maslow’s
famous criticism
7
“The science of psychology has been far more successful
on the negative than on the positive side. It has revealed to
us much about man’s shortcomings, his illness, his sins,
but little about his potentialities, his virtues, his achievable
aspirations, or his full psychological height. It is as if
psychology has voluntarily restricted itself to only half its
rightful jurisdiction, and that, the darker, meaner half.”
(Maslow 1954 p.354)
8
“It would be a misunderstanding to think that trauma is
good – we most certainly are not saying that. What we are
saying is that despite (trauma), people often report positive
transformation… posttraumatic growth is common but
certainly not universal… we should never have the
expectation that every trauma survivor will experience
growth or that it is a necessary outcome for full trauma
recovery.”
Tedeschi & Calhoun 2004 p.408
9
Promoting PTG in EMDR
Rule 1:
Take a positive and longer-term view of mental health… which includes
looking for ‘potential’…and being wary of stereotypes
"Clinicians might benefit from reflecting on the young new client who walks into the
clinic. How do we know we are not addressing a future General Secretary of the
United Nations?“
(from ‘In Search of the Antonym to Trauma’ Blore 2012 p315.)
10
Promoting PTG in EMDR
Rule 2:
Look for existing resources… and their utilisation… not just between
sessions but during history taking (i.e. what networks already exist?)
“Despite everything, during the traumatic event she was able to plan for herself and those with
her who were distressed. She had at least some positive views of the future although she had
no idea how to realise them. She looked for resources to cope, gained wisdom not marred by
revenge of vengeance and thought first of others.
She helped wherever she could and she still did not ‘give up’….”
11
Promoting PTG in EMDR
Rule 3:
Make Phase 5 ‘work harder’…
don’t just accept 2 scores of 7 on VoC… try tiering PCs
“…once the cognition reaches at least 7 on the VoC scale…
and does not increase in strength with additional sets…” (Shapiro 2001 p.162)
12
Tier Four: I am wiser and can help others
– 2nd reassessment at the end of Phase Five
Tier Three: I am wiser and successful
– 1st reassessment at the end of Phase Five
Tier Two: I am a success
– PC reassessed at start of Phase Five
Tier One: I can learn to succeed
– PC established at Phase Three
13
Promoting PTG in EMDR
Rule 4:
Expect positive change in clients following EMDR…
AIP predicts it anyway!
“Out of suffering have emerged the strongest souls;
the most massive characters are seared with scars”
Khalil Gibran
(Lebanese artist, poet, and writer)
14
Current life direction >>>>
Projected life direction >>>>
Aspirations
Secondary
traumas
‘Rock bottom’
New’
directions
‘Hankering cycle’
Promoting PTG in EMDR Rule 5:
Install a ‘road map’ to PTG
Significant life event (SLE)
‘Existential escape route’
3 types of Wisdom
15
“The more we know about posttraumatic growth
(PTG), the more we know that we do not know very
much.”
Calhoun & Tedeschi 1998 p.215
The only meta analysis on the subject stresses: “…the
findings do not necessarily correspond to any given
individual’s experience of adversarial growth (Linley &
Joseph’s own term for PTG)”
Linley & Joseph 2004 p.19
16
“After my road crash, I spent 70 sessions going to and from
counselling. I learnt a lot about my younger days but it only
made my travel anxiety worse for I had to travel 8 miles there
and back each time.
Then I went for about half a dozen sessions of EMDR and I
realised that I’d been having ‘treatment’ of a sort before and after
counselling. I also realised I could train to be a therapist to help
others with a travel anxiety get to EMDR sessions - and give
them the chance to make something of their lives.
By the way, did you know that nowadays my biggest customer is
the insurance company that I originally claimed compensation
from?”
17
Acknowledgements and sincere thanks:
‘The social media responder’, Martin Seligman, Francine Shapiro, Abraham Maslow, Khalil Gibran,
‘Christine’, and my fellow speakers today: Ann-Marie McKelvey, Claudia Herbert, Candida Condor
Dr David Blore:
[email protected]
+44(0)7976 933096
18