Abstract: The current study evaluated the eye movement desensitization and reprocessing integrative group treatment protocol (EMDR-IGTP) delivered within a novel psychosocial program for child refugees. One Libyan and seven Syrian children, aged 6 to 11 years 10 months (five boys), received four 3-hour sessions, with IGTP in the second session. The study investigated whether IGTP would be valuable for child refugees whose trauma symptoms failed to reach Child and Adolescent Mental Health Service thresholds. In addition, the project aimed to identify cultural hurdles that may hinder access to Western psychological approaches. Qualitative data were collected from eight children, two therapists (an eye movement desensitization and reprocessing [EMDR] practitioner and a family care worker), and a focus group of four Arab interpreters. The qualitative design involved children completing rating scales at the beginning and end of each session and the Subjective Units of Disturbance (SUD) scale for traumatic memories before and after EMDR-IGTP. Therapists reflected on outcomes in a postintervention report, and the interpreters discussed cultural challenges in a focus group. IGTP appeared to lead to reduced internal distress and perceived increases in emotional awareness for children. Therapists’ reports affirmed reduced disturbance and highlighted the cultural sensitivity of IGTP. The interpreters’ focus group emphasized the challenges of language, the stigma of mental illness, and the differing levels of communicative control across cultures. Future studies of IGTP, embedded within psychosocial programs for refugee children, need to utilize experimental research designs including culturally sensitive outcome measures.

Abstract: This randomized controlled trial extended the investigation previously conducted by Jarero et al. (2015) which found that the eye movement desensitization and reprocessing Integrative Group Treatment Protocol adapted for ongoing traumatic stress (EMDR-IGTP-OTS) was effective in reducing posttraumatic stress disorder (PTSD) symptoms related to the diagnosis and treatment of different types of cancer in adult women. The current study sought to determine if the results could be replicated and if the treatment would also be effective in reducing symptoms of anxiety and depression. Participants in treatment (N = 35) and no-treatment control (N = 30) groups completed pre, post, and follow-up measurements using the Posttraumatic Stress Disorder Checklist for the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) (PCL-5) and the Hospital Anxiety and Depression Scale (HADS). Data analysis by repeated measures analysis of variance (ANOVA) showed that the EMDR-IGTP-OTS was effective in significantly reducing symptoms of PTSD, anxiety, and depression, with symptoms maintained at 90-day follow-up and with large effect sizes (e.g., d = 1.80). A comparison of the treatment and no-treatment control groups showed significantly greater decreases for the treatment group on symptoms of PTSD, anxiety, and depression. No significant correlation was found when exploring the relationship between scores on the Adverse Life Experiences scale and scores indicating pretreatment severity of PTSD, anxiety, and depression. This study suggests that EMDR-IGTP-OTS may be an efficient and effective way to address cancer-related posttraumatic, depressive, and anxious symptoms.

Abstract: Eye movement desensitization and reprocessing (EMDR) therapy is an established treatment for posttraumatic stress disorder (PTSD), but there is increasing evidence for its use beyond PTSD. EMDR can be effective at treating distressing memories not associated with PTSD, as well as somatic symptoms (like chronic pain), and as such could potentially be used as a treatment for patients with functional neurological disorder (FND). Searches were conducted for published peer-reviewed articles on the use of EMDR for FND. The databases selected and searched were Medline, Embase, Cochrane Library, CINAHL Plus, Web of Science, PsychINFO, PubMed, and Francine Shapiro Library. This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Three relevant articles were found. The studies included are one case series and two case studies. Of the five participants included in the studies, four experienced functional non-epileptic attacks; and one experienced functional movement disorder. Four out of the five patients were successfully treated with EMDR. EMDR is potentially a useful treatment of FND, but further research, including controlled trials, is required. The authors propose that EMDR could be useful in treating patients with FND and comorbid PTSD, as well as patients without comorbid PTSD. We discuss the clinical implications and propose how EMDR could fit into the FND treatment pathway.

Abstract: This case study looks at the application of eye movement desensitization and reprocessing (EMDR) therapy in an 83-year-old White woman with preexisting diagnoses of Parkinson’s disease and Parkinson’s disease dementia. She presented to the community mental health team with depressive symptoms, and during assessment, which included the use of the Trauma Screening Questionnaire, several traumatic life events emerged. Following six sessions of EMDR, subjective reporting on trauma symptoms and resilience improved and this was maintained 9 months later. Depression and anxiety scores (Hospital Anxiety and Depression Scale) remained consistent, though a lack of improvement in these scores was thought to be associated with progression of her physical health symptoms and related poor quality of life. This case highlights the potential use of EMDR in those with dementia and traumatic memories and the success of the standard EMDR protocol, despite difficulties with eye movements due to neurological effects of Parkinson’s disease. Further research in the application of EMDR in later life and in those with neurodegenerative medical conditions is recommended.

Abstract: The purpose of this pre-experimental case study was to explore the efficacy and safety of the Eye Movement Desensitization and Reprocessing (EMDR) Group Traumatic Episode Protocol (G-TEP) in the psychological treatment of cancer survivors and its potential effects on posttraumatic stress, anxiety, and depressive symptoms. Participants ( N = 35) were patients with various types of cancer, in different stages, initial or recurring, with diagnosis or oncology treatment received within the past year. Following an individual psychoeducational intake session, participants received two 90-minute EMDR G-TEP sessions, administered on consecutive days. They were randomly assigned to a treatment group or a delayed treatment group. Assessments were administered at pre, post, and follow-up using the Short PostTraumatic Stress Disorder Interview (SPRINT), State-Trait Anxiety Inventory (STAI), and Beck Depression Inventory (BDI-II). Repeated measures comparisons of PTSD symptoms, anxiety, and depression revealed significant differences between pretest and posttest, with most results maintained at follow-up. Pre-follow-up effect sizes showed medium effects. These promising results suggest the value in providing a lengthier course of treatment. They support the need for research with large sample, randomized clinical trials to examine the viability of providing EMDR G-TEP in the psychological treatment of cancer survivors. No serious adverse effects were reported and we conclude that the EMDR G-TEP may be effective and safe in the psychological treatment of an oncology population.

Abstract: This case series study investigated the effectiveness of an integrative eye movement desensitization and reprocessing (EMDR) and family therapy model, specifically the Integrative Attachment Trauma Protocol for Children (IATP-C), for improving traumatic stress, attachment relationships, and behaviors in children with a history of attachment trauma; specifically, adopted children with a history of maltreatment and foster or orphanage care. Of the 23 child participants, one family dropped out at 6 months, and 22 completed treatment in 6–24 months. Mean treatment length was 12.7 months. Statistical analysis demonstrated significant improvement in scores on children's traumatic stress symptoms, behaviors, and attachment relationships by the end of treatment. Statistical analysis of secondary measures showed significant improvement in mothers' scores related to symptomology and attitudes toward their child. Gains were maintained for the 15 families who complied with completion and returning of follow-up measures. Limitations of the study include the lack of a control group and small sample size. Future directions include controlled efficacy studies with larger sample sizes as well as exploration of application of the model to a similar population of children in other cultures and to children who are not residing in permanent placements.

Abstract: This article seeks to address the underrepresented area of eye movement desensitization and reprocessing (EMDR) treatment for sexually abused children. It presents the child-centered EMDR approach–a new protocol derived from Klaff (2016). This approach is built on Shapiro’s Adaptive Information Processing model and assumes that a successful outcome can be achieved without directly processing memories of the abuse since children have the ability to open channels of association to uncover, process, and resolve emotional trauma relating to the abuse. Instead of focusing on traumatic memories, the treatment targets whatever current concerns the child presents, as it is thought that these concerns may provide a pathway to covert and possibly unconscious issues. This approach is tested with a case study, which explores its use with a 9-year-old girl who presented with emotional triggers originating from sexual abuse by her biological father. She received six sessions addressing memories of being taunted by other children and of her father using drugs, but her memories of the sexual abuse were not directly addressed. Following treatment, her scores on the Child Report of Post-Traumatic Symptoms (CROPS) and Parent Report of Post-Traumatic Symptoms (PROPS) decreased to nonclinical levels, with results maintained 2 months later at follow-up. The promising results suggest the value of future research to further test this approach.

Abstract: Recognition of posttraumatic stress disorder (PTSD) in older adults is often difficult due to its complicated presentation. Once recognized, trauma symptoms can, in accordance with (inter)national guidelines, be successfully treated with eye movement desensitization and reprocessing (EMDR) therapy. However, limited empirical research has been done on the expression and treatment of PTSD in older adults. This article explains trauma and age in the context of psychotherapy. It discusses the interaction between age and pathology and summarizes the cognitive issues related to age, PTSD, and anxiety. It provides practical suggestions for how these can be addressed in treatment. Age-related challenges related to motivation are identified with practical suggestions for addressing them. The case illustrates the necessary additions and subtractions for older adults, with clear explanations and instructions. This article points the way for future research.

Abstract: With the continued advancement in technology, there is a rise in the development and utilization of mobile health applications (mHealth apps) that claim to be using eye movement desensitization and reprocessing (EMDR) theory and techniques to facilitate the therapeutic process. However, there are concerns regarding the quality of these apps and the safety of clients who may be using them, particularly for those who may present with complex posttraumatic conditions and associated comorbidities. Hence, this study evaluates current EMDR apps to determine their purpose, potential benefits, and risks when used by clients and/or clinicians. Twelve apps were found to be eligible for evaluation and are rated on applicability, validity, accuracy, and usefulness. Currently, our review concludes that none of the EMDR apps are recommended for use by a client. Only 6 of the 12 apps would be recommended for use by a trained clinician as a tool to aid with EMDR treatment, provided the clinician were able to offer a safe environment that could adapt to the selected technology. Risks of using EMDR apps include safety concerns with unregulated use, particularly for clients with complex posttraumatic stress disorder (PTSD) and comorbid conditions, such as dysregulated emotions or cognitions, and concerns regarding cyber security and data privacy. Clinical implications for the use of technology and mHealth apps are discussed, and recommendations for the development of an ideal EMDR app for the future are provided.

Abstract: Many studies have shown that the relationship between child and caregivers is critical for healthy development of the child’s brain function, and for intergenerational transmission of attachment. Here, we propose a useful eye movement desensitization and reprocessing (EMDR) target for treatment of maternal emotional dysregulation that can cause maltreatment of the child, with the goal of interrupting intergenerational transmission of attachment trauma. First, we use schematics to demonstrate a hypothetical model of the interaction between a child’s attachment behavior and a mother’s bonding behavior. This schematic shows that the child’s physiologic reaction activates or triggers the mother’s negative affect and somatic sensations in her limbic system and brain stem and that, in turn, evokes the mother’s maltreatment behavior. The negative affect and somatic sensation (maternal emotional dysregulation) are Dysfunctionally Stored Information (DSI) that was produced in the mother’s past experience. We propose that the mother’s negative affect and somatic sensations activated by the child’s behaviors can be useful targets for EMDR therapy based on this hypothetical model. Two Japanese case reports (mothers with 4-year-old daughters) are described to illustrate this application. Further discussion highlights the feature of Japanese cultural relationship and the dissociation, and the meaning and scope of targeting maternal emotional dysregulation with EMDR therapy.

Abstract: Eating disorders (EDs) require a multidisciplinary approach, rather than a hammer-and-nail perspective. Based upon recent research and more than a decade of clinical experience, this article highlights the need to include a trauma-informed and dissociation-sensitive treatment of EDs. The emphasis is on EDs as a dissociative coping strategy, created in many cases to tolerate the intolerable. Ego state therapy, Gestalt principles, and empty chair technique support the adaptive information processing (AIP) of eye movement desensitization and reprocessing (EMDR) in both metabolizing painful experiences that give rise to EDs and in loosening the stranglehold of anxiety and shame. The acronym RUG-C introduces four universal principles in working with ego states: recognition, understanding, gratitude and goal setting, and collaboration. Relational ruptures between ego states/parts of the client (intrapsychic) and between the client and the world (interpersonal) are created in the client’s efforts to deal with painful experiences both large and small. They are repaired in the therapeutic relationship, in the processing of past trauma, and in the rescue of body image from the power of shame. Three case reports, with transcripts, are provided to illustrate conceptualization and its application.

Abstract: This case study investigated the effects of an eye movement desensitization and reprocessing (EMDR)-based divorce recovery group, consisting of four modalities: (a) modified EMDR Integrative Group Treatment Protocol adapted for adolescents and adults living with ongoing traumatic stress (EMDR-IGTP-OTS) to deal with the trauma from the divorce, (b) modified Affect Circuit Reset protocol to reduce intensity of negative affects, (c) psychoeducation on affects and divorce-related issues, and (d) small group discussion. The divorce recovery program is an attempt to provide an affordable, trauma-focused intervention for divorce recovery for low-income populations. This report summarizes the outcomes in a divorce recovery group of six women, all Chinese immigrants. Aside from one person in the midst of divorce, the group consisted of individuals divorced for 7 years or more, for whom the distress had lasted more than the 2 to 3 years typical of divorce recovery. Short Post-Traumatic Stress Disorder (PTSD) Rating Interview (SPRINT) scores collected at the beginning of week 2, at the end of week 7, and at the beginning of week 8 showed PTSD symptoms dropping from severe to mild. The mean SPRINT scores at 6 weeks and 13 weeks after treatment continued to decrease, approaching the no/minimal symptom range. The SPRINT scores showed a 65.6% reduction between week 2 (18.0 [SD = 8.4]) and 13 weeks after treatment (6.2 [SD= 5.5]), with a large effect size of d = 1.40, and a significant decrease of t(4)=4.0, p = .016.

Abstract: This article introduces the integration of a transpersonal psychological approach into the standard eye movement desensitization and reprocessing (EMDR) protocol. The history and philosophy of transpersonal psychology is explained as an expanded context for healing. The applications of a transpersonal context to EMDR therapy are discussed as it applies to taking the client from trauma to healing beyond adaptive functioning leading to exceptional human functioning, as depicted in Native shamanism and Eastern spiritual tradition where consciousness is awakened. The influence of the consciousness of the therapist is explored, as the convergence of science, psychology, and spirituality address the interpersonal nature of a shared energy field. Elements of transpersonal psychotherapy are presented, and transpersonal therapeutic skills are described to enhance the range of tools of the therapist from egoic intervention to an expanded range of perception based in mindful awareness, attunement, and resonance. Comprehensive case examples take us through the standard EMDR protocol where these two approaches integrate and flow as healing unresolved early trauma becomes the doorway for spiritual awakening.

Abstract: This article explores the effectiveness of treating a 17-month-old male diagnosed with posttraumatic stress disorder (PTSD) and a disrupted secure attachment utilizing eye movement desensitization reprocessing (EMDR) and an integrative family therapy approach. The child experienced a life-threatening choking incident requiring hospitalization. Pretreatment, the child was inconsolable by his parents when distressed and could not tolerate anything touching his throat. Posttreatment, the child accepts comfort from his parents and allows his mother to kiss his throat. Results demonstrate a reduction or elimination of PTSD symptoms and a return to a secure attachment. This case study underscores Shapiro’s Adaptive Information Processing (AIP) model (2001). Application and customization of the eight phases of EMDR therapy are highlighted along with the Integrative Attachment Trauma Protocol for Children (IATP-C). Treatment consisted of five sessions. Customization included caregiver psychoeducation; EMDR resource development, focused on strengthening attachment and regulating emotion; and facilitating caregiver co-regulation throughout EMDR. The use of EMDR therapy with customization through the IATP-C protocol shows promise as an effective intervention for treating posttraumatic stress symptoms and repairing attachment in very young children.

Abstract: Just like any other psychotherapy method, eye movement desensitization and reprocessing (EMDR) should conceptualize the intersubjective phenomena that are active during EMDR therapy, especially in the treatment of complex cases. This article describes the concepts of transference and countertransference and how to integrate them in the Adaptive Information Processing (AIP) model. In this article, research on mirror neurons, the concept of action systems, and recent considerations on attachment theory for patients with disorganized attachment are incorporated into the concepts of transference and countertransference. Input from each of these theories is illustrated with a clinical vignette that depicts how the client’s and the therapist’s conscious and unconscious processes are intertwined and how they may affect the efficacy of EMDR therapy. We propose the countertransference-based interweave to release the AIP when countertransference issues block the process. Integrating knowledge on transference and countertransference in EMDR therapy could increase the efficacy of EMDR, especially in complex cases.

Abstract: This qualitative case study explores using eye movement desensitization and reprocessing (EMDR) therapy informed by attachment and neuroscience research about the importance of safety (trust) and relationship (attunement). This was chosen to enable a young child to create vital positive neural networks and process early trauma while remaining within the window of receptivity, despite issues of avoidance and control. A single case study design was used with a 5-year-old child who experienced early traumas. Observable symptoms included separation anxiety, avoidance, compromised motor skills, and compromised speech. Data were obtained from carer, child, and teacher report, notes, observations, case file, ratings of emotions, and behaviors. The data were explored for outcome data points, validity, and protocol adherence. Key findings were that EMDR used with attunement and trust-building strategies appeared to support developmental progress while facilitating pervasive posttraumatic growth. EMDR appears to offer appropriate opportunities for incorporating neuroscience and attachment research in order to facilitate trauma processing. Future research into EMDR storytelling procedures and possible causative relationships between trust-building and attunement with neurodevelopmental markers would be a possible next step.

Abstract: A novel evolutionary-based therapy, treating depression downhill (TDD), was designed as a specific therapy for depression as a syndrome (Krupnik, 2014) and later integrated with eye movement desensitization and reprocessing (EMDR) therapy into a combined TDD-EMDR treatment. The combined therapy integrates modified EMDR procedures into the theoretical context of TDD. These procedures are applied during the second (acceptance) stage of TDD-EMDR’s three-stage proltocol with the focus on acceptance of defeat/failure/loss rather than on distressing memories. Here, we report a case series of 21 military personnel diagnosed with depressive disorders, who received a course of TDD-EMDR. Eighty percent of completers (n = 15) did not meet the criteria of depressive disorder by the treatment’s end. After 12 sessions, they showed a significant reduction on the Beck’s Depression Inventory-II (BDI-II) with a large effect size (d = 2.8) and an increase in accepting disposition (d = 1.8) on the Acceptance and Action Questionnaire. Noncompleters showed similar to completers decrease of BDI-II scores at mid-treatment. We observed no statistically significant decrease of the anxiety symptoms on the Beck’s Anxiety Inventory. These results suggest that TDD-EMDR may be an effective treatment for depressive disorders. They also indicate that it may preferentially target depressive over anxiety symptoms, as was previously observed for TDD. Suggestions are made for future research.

Abstract: Most of the empirical evidence supporting the efficacy of eye movement desensitization and reprocessing (EMDR) has been with individuals suffering from posttraumatic stress disorder (PTSD). This case study reports on the successful treatment of obsessive-compulsive disorder (OCD) in a 13-year-old male using the standard three-pronged approach of EMDR in a private practice setting. The current protocol addressed the initial touchstone event, the current level of distress related to that event, as well as anticipation and planning for future feared events. The participant received 15 sessions of EMDR. At 90-day posttreatment follow-up, there was a substantial decrease in OCD symptoms (from moderate to subclinical) as measured by the Children’s Yale-Brown Obsessive–Compulsive Scale, indicating a large effect size (d = 0.81). The current study provides insight into treating OCD in adolescence and how using the three-pronged approach (past, present, and future) of EMDR can be an effective tool. Study limitations and suggestions for future clinical research are discussed.

Abstract: Cet article présente la technique éclair, une nouvelle technique utilisée pendant la phase de préparation de la thérapie EMDR (désensibilisation et retraitement par les mouvements oculaires) pour faciliter le traitement de souvenirs traumatiques intenses auxquels les patients hésiteraient autrement à accéder. Les premières données, demeurant à confirmer, suggèrent que cette technique pourrait permettre aux patients d’accéder à ces souvenirs d’abord de manière la moins perturbante possible, réduisant leur intensité émotionnelle, afin de pouvoir ensuite les aborder plus pleinement et les traiter à l’aide de la thérapie EMDR. La technique semble aisément tolérée par les patients de tous âges, y compris les enfants ; elle paraît rapide et relativement indolore pour les patients, même ceux qui possèdent des souvenirs cibles particulièrement perturbants ; elle s’enseigne facilement aux cliniciens. Elle se distingue par le fait que les patients qui évitent un souvenir terriblement perturbant peuvent se voir offrir une façon de le traiter sans devoir le ramener clairement à l’esprit. Quatre exemples de cas, dans lesquels quatre cliniciens différents ont utilisé la technique, sont présentés brièvement. Des suggestions sont formulées pour des études à venir. Cet article présente des hypothèses pour expliquer divers mécanismes d’action et évoque les effets en termes de la théorie de reconsolidation mnésique.

Abstract: This special issue aims to highlight the importance of exploring the empirical base for eye movement desensitization and reprocessing (EMDR) therapy with children and adolescents. Such an endeavor is set within a context where the American Psychological Association recommends trauma-focused cognitive behavioral therapy (TF-CBT) as the treatment of choice and the National Institute of Health and Care Excellence (NICE) recommends EMDR for children when TF-CBT fails to be effective. Studies in this special issue suggest otherwise and represent EMDR’s global reach over seven different countries. The studies address a range of conceptual gaps and evaluate differing EMDR protocols for individual and group delivery. Participants from preschool to adolescence experienced single event, cumulative violence, and trajectories of trauma and present with a range of trauma symptoms. Although studies with differing methodologies highlight the efficacy of EMDR with differing populations, recommendations are made for rigorous research designs in order to influence professional guidance organizations.

Abstract: L’expérience du cancer est un facteur de stress particulier au sein de l’infrastructure de l’état de stress post-traumatique (ESPT) car cette maladie débilitante implique des facteurs de stress permanents, et elle est à la fois aiguë et potentiellement chronique. Le cancer peut s’accompagner d’un large éventail d’effets négatifs connexes, tels que la détection d’une tumeur, le diagnostic, la gravité de la maladie et le pronostic, l’agressivité des traitements, la mutilation et le dysfonctionnement physique, les effets secondaires du traitement, les perturbations du fonctionnement physique, social et professionnel et, parfois, la récidive et un diagnostic de maladie terminale. Cet article fournit une description détaillée de l’application clinique du protocole intégratif de traitement de groupe de désensibilisation et de retraitement par les mouvements oculaires (EMDR-IGTP) adapté aux patients adolescents et adultes atteints de cancer et vivant avec un stress traumatique continu. Ce protocole administre les huit phases du traitement EMDR individuel à un groupe de patients en utilisant une composante de l’art-thérapie (c’est-à-dire des dessins) et le « butterfly hug » (BH – le « câlin de papillon », une méthode de stimulation bilatérale autoadministrée utilisée pour traiter le matériel traumatique). Une étude antérieure (Jarero et coll., 2015) avait montré qu’après six séances d’EMDR-IGTP, on observait une diminution significative des symptômes d’ESPT liés au diagnostic et au traitement de différents types de cancer chez des femmes adultes. Les effets se maintenaient lors de la séance de suivi, 90 jours plus tard. Dans le présent article, nous discutons de la manière dont on peut se servir de ce protocole pour fournir efficacement un traitement EMDR intensif à de grands groupes de patients, et nous donnons des instructions détaillées pour son utilisation, afin d’aborder l’une des principales dimensions psychologiques du cancer : les réactions de stress traumatique permanentes que connaissent les patients. Un exemple clinique illustre le processus de traitement.

Abstract: This article provides three case descriptions to demonstrate the use of the “Sleeping Dogs” method to engage children who initially refused to participate in EMDR therapy. The metaphor “sleeping dogs” refers to traumatic memories that children refuse to or cannot discuss; by waking up the “sleeping dogs,” traumatic memories become accessible and treatable. Children in the cases discussed displayed severe symptoms and refused to discuss memories of traumatic experiences. All resided in a residential facility and their symptoms were preventing transition into foster care. Case 1 (age 6) displayed increasingly violent behavior. He witnessed his father kill his mother and was the crown witness in his father’s trial, which isolated him from his family. Case 2 (age 3), was abused by her biological family, and experienced foster placement breakdown. Case 3 (age 6) was abused by her mother, yet idolized her and denied past abuse. This article describes how the Sleeping Dogs method was applied in each case, created stabilization, and led to engagement in EMDR, in which trauma memories were processed. After treatment all children transitioned into foster care. The cases demonstrate the benefits of involving (extended) family members, even when they have abused or neglected the child and may have little or no contact with them, and when reunification is no option. The implications for utilizing the Sleeping Dogs method to engage chronically traumatized children in trauma-focused therapy are discussed.

Abstract: En 2015, plus de 1,5 million de réfugiés sont arrivés en Allemagne, beaucoup d’entre eux gravement traumatisés. La thérapie de désensibilisation et de retraitement par les mouvements oculaires (EMDR) a prouvé son efficacité dans le traitement des symptômes de stress traumatique aigus ou chroniques. Une modification de la thérapie permettant son utilisation en groupe a été développée par E. Shapiro : c’est le protocole EMDR de traitement en groupe d’épisodes traumatiques (G-TEP). Dans cette étude de terrain, nous avons étudié l’efficacité de deux séances d’EMDR G-TEP pour traiter des réfugiés victimes de traumas. Après une séance de psychoéducation, 18 réfugiés provenant de Syrie et d’Irak, arabophones, arrivés en Allemagne au cours des cinq mois précédents, ont été affectés au traitement et/ou à une liste d’attente. On utilisa en pré- et post-traitement l’échelle révisée d’impact des événements (IES-R) et l’inventaire de dépression de Beck (BDI) et les analyses furent conduites à l’aide du test U de Mann-Whitney et des tests planifiés Kolmogorov-Smirnov. Les résultats montrèrent des différences importantes entre le groupe de traitement et le groupe en liste d’attente, avec une baisse significative des notes IES-R (p > .05). Bien que les différences des notes BDI n’aient pas atteint le niveau de signification statistique (p = .06), une baisse importante des notes BDI fut observée dans le groupe de traitement. Ces résultats fournissent une preuve préliminaire indiquant que l’EMDR G-TEP pourrait permettre de traiter efficacement des personnes réfugiées souffrant de traumatismes.

Abstract: L’exposition à une maladie mortelle comme le cancer peut constituer une expérience traumatique qui dans certains cas peut conduire au développement d’un état de stress post-traumatique (ESPT). Au cours des dernières années, plusieurs études ont investigué ce syndrome chez des patients atteints de cancer, mais peu se sont centrées sur la neurobiologie sous-jacente. Le but de ce texte est de passer en revue la littérature actuelle sur la neurobiologie de l’ESPT dans les maladies oncologiques, en se centrant sur une comparaison des résultats d’études neurobiologiques de l’ESPT chez des patients non atteints de cancer ainsi que sur les traitements ayant montré des résultats efficaces pour ce trouble. Les structures cérébrales jouant un rôle dans l’apparition de l’ESPT en psycho-oncologie, en particulier des symptômes intrusifs, semblent être les mêmes que celles impliquées dans l’ESPT non-oncologique. Ces résultats peuvent avoir des implications importantes sur un plan clinique également, en suggérant que les psychothérapies démontrées comme efficaces dans le traitement de l’ESPT dans différentes populations peuvent aussi être proposées aux patients présentant des symptômes post-traumatiques dus au cancer. D’autres études sont nécessaires pour approfondir nos connaissances sur la neurobiologie de l’ESPT lié au cancer et son traitement, afin de transposer les résultats dans la pratique clinique.

Abstract: De nombreuses études ont identifié des liens entre la psychopathologie et des antécédents d’événement de vie traumatiques et de relations d’attachement dysfonctionnelles. Compte tenu des origines traumatiques possibles de cette pathologie, il pourrait être utile d’apporter une intervention centrée sur le trauma comme la thérapie EMDR (désensibilisation et retraitement par les mouvements oculaires). Cet article s’appuie sur un cas clinique pour décrire les résultats positifs de la thérapie EMDR dans le rétablissement d’une anorexie mentale résistante chez une patiente de 17 ans en hospitalisation. Elle avait déjà été hospitalisée à quatre reprises au cours des quatre dernières années et avait suivi des thérapies psychodynamique et cognitive comportementale. Au début de la prise en charge, la patiente pesait 28 kg et son indice de masse corporelle était 14. Elle s’est vu attribuer un style d’attachement désengagé/évitant sur l’entretien de l’attachement adulte (Adult Attachment Interview). La thérapie EMDR lui a été proposée à l’hôpital sur une durée de six mois sous la forme de séances de 50 minutes, deux fois par semaine, correspondant aux procédures standard qui se centraient principalement sur ses traumas relationnels ; elle était combinée à des séances de psychoéducation et intégrée à la thérapie des états du moi. À la fin de la prise en charge, la patiente pesait 55 kg et son indice de masse corporelle était 21,5. Elle ne remplissait plus les critères diagnostiques de l’anorexie mentale et son style d’attachement s’était modifié en faveur d’un état d’esprit libre-autonome acquis. Elle décrivait une confiance en soi accrue et une plus grande capacité à gérer différentes situations sociales. Les résultats étaient maintenus lors du suivi après 12 et 24 mois. Les implications de cette étude de cas pour la prise en charge sont examinées.