Post Traumatic Stress

Disorder

And EMDR as Alternative

Therapeutic Technique

TRAUMA
Psychological trauma a type of damage
to the psyche that occurs as a result of a
traumatic event. Traumatization occurs
when both internal and external resources
are incapable to cope with the external
event.
the loss of faith that there is order and
continuity in life (Adams, 1994)

Emotional Trauma
It was unexpected
The person was unprepared
There was nothing the person could do to
prevent it from happening
TRAUMA EVENT
TRAUMA = PERCEPTION OF EVENT

Modern Theories on Trauma 1

Horowitz (1970) Stress Response Theory
(one of the original cognitive models of
PTSD)
2 processes:
1. The initial emotional reaction to trauma
2. Efforts to assimilate the new
information from the trauma into the
victims base of knowledge (information
overload defense mechanisms)

Modern Theories on Trauma 2

Information Processing (IP) theories:
Incomplete processing of traumatic
memories lead to the development of
PTSD or other disorders.
Cognitive Appraisal Theory, Emotional
Process Theory, Fear Networks, Dual
Representation Theory and
Neuropsychology, Cognitive Action Theory,
Multidimensional model of Guilt, etc.

Types of Trauma
One-time trauma: natural disasters,
rape, assault, robbery, accidents (car,
plane, etc.)
Prolonged trauma: physical or sexual
abuse as a child or spouse, war, life in a
prison camp, life as a refugee, hostage
situations, life in a concentration camp,
life in some religious cults PTSD

What is PTSD?
DSM IV an anxiety disorder
DSM V included in a new chapter on
Trauma- and Stress-or Related Disorders
a complex disorder in wich the affected
persons memory, emotional responses,
intellectual processes, and nervous system
have all been disrupted by one ore more
traumatic experiences.

Reaction to Trauma

Normal
Shock denial
Anger
Bargaining
Depression
Acceptance

PTSD
Shock
Overwhelmed
Freezing state (no
longer process the
event, not moving,
not aware)

New Types of PTSD

Complex post-traumatic stress
disorder (C-PTSD) introduced by Judith
Herman in Trauma and Recovery a
psychological injury that results from
protracted exposure to prolonged social
and/ or interpersonal trauma with lack or
loss of control, disempowerment, and in
the context of either captivity or
entrapment, i.e. the lack of viable escape
route by the victim

New Types of PTSD contd

Continuous Post Traumatic Stress
Disorder (CTSD) introduced by Gill
Straker in 1987.
Used by South African clinicians - exposure
to frequent, high levels of violence usually
associated with civil conflict and political
repression.
Applicable to gang violence victims and
exposure to life threats such as police, fire
or emergency services.

Symptoms of PTSD
1. Re-experiencing the traumatic event
2. Avoiding reminders of the trauma
3. Increased anxiety and emotional arousal

Symptoms - Re-experiencing
the traumatic event
Intrusive, upsetting memories of the event
Flashbacks (acting or feeling like the event
is happening again)
Nightmares (either of the event or of other
frightening things)
Feelings of intense distress when reminded
of the trauma
Intense physical reactions to reminders of
the event (e.g. pounding heart, rapid
breathing, nausea, muscle tension, sweating)

Symptoms - Avoiding
reminders of the trauma

Staying away from places, events, or objects that

are reminders of the experience
Inability to remember important aspects of the
trauma
Loss of interest in activities and life in general
Feeling detached from others and emotionally
numb
Sense of a limited future (you dont expect to live
a normal life span, get married, have a career)
Feeling strong guilt, depression, or worry
Losing interest in activities that were enjoyable in
the past

Symptoms - Increased anxiety

and emotional arousal

Difficulty falling or staying asleep

Irritability or outbursts of anger
Difficulty concentrating
Hypervigilance (on constant red alert)
Feeling jumpy and easily startled
Feeling tense or on edge

Other Symptoms

Anger and irritability

Guilt, shame, or self-blame
Substance abuse
Feelings of mistrust and betrayal
Depression and hopelessness
Suicidal thoughts and feelings
Feeling alienated and alone
Physical aches and pains

Understanding PTSD_ Teresa's story.avi

Understanding PTSD_ Frank's story.avi

TRAUMA MAP
Protective factor
- Sense of coherence
- Social support
- Coping processes

Factors
concerning
event
- Severity of the
trauma
- Unexpectedness
- Level of control

Posttraumatic
psychological
processes
Intrusion
Hyperarousal
Avoidance/ Freezing

Risk factors
- Age of the time of traumatizing
- Previous stressful experiences
- Socio-economic status

Effects
- Symptoms of
PTSD
- Restabilising
- Personal
maturing

Treatment for post-traumatic

stress disorder
Psychotherapy (talk therapy)
medications, or both.

Psychotherapy
1. Trauma-focused cognitive-behavioral
therapy
1.1 Exposure therapy
1.2 Cognitive restructuring
1.3 Stress inoculation training

2. Family therapy
3. EMDR

Eye Movement Desensitization

and Restructuring - EMDR
Dissociation as a defensive tool
Adult trauma tendency to capsulize a
traumatic occurrence together, so that if
the memory is triggered then the entire
memory is reexperienced.
Childhood trauma children divide
dissociated memories so that only one
aspect of an event can be triggered at one
time hard to understand.

EMDR
In PTSD experiences are dissociated
because the person is unable to integrate
them. Therefore, the information is
stocked distortedly.
EMDR intervenes directly in the Central
Nervous System (Hypocampus)
What is Eye Movement Desensitization And
Reprocessing (EMDR) [for posttraumatic st
ress disorder]_.

EMDR Therapy Phases

1.
2.
3.
4.
5.
6.
7.
8.
9.

Anamnesis and treatment plan

Preparation
Assessment
Desensibilization
Anchoring
Checking body sensations
Closing
Reassessment
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THANK YOU!