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  #1  
Unread January 30th, 2005, 08:54 AM
Brendan Ballinger Brendan Ballinger is offline
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Question EMDR in depression and anxiety

I am new to the forum and to EMDR. I have just completed Level 1 last month. I am particularly interested in the use of EMDR in depression and anxiety, as these are by far the biggest group of problems that my clients suffer from. I am a Community Mental Health Nurse working in a Community Mental Health Team, the clients that are referred to us all suffer from "severe and/or enduring mental illness". This tends to mean that their illnesses are refractory or cause them not to be able to function well with everyday activities of daily living.
At the moment I am not working on any of these problems with EMDR, but would appreciate an overview of how this might be done. I am particularly unsure of how to tackle anxiety, where a previous traumatic event cannot be identified.
Regards,
Brendan
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Brendan Ballinger Community Mental Health Nurse
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  #2  
Unread January 31st, 2005, 11:22 PM
Sandra Paulsen Sandra Paulsen is offline
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Join Date: Jul 2004
Location: Bainbridge Island WA
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Default Re: EMDR in depression and anxiety

There are no studies on the use of EMDR with depression, however, there are clinical anecdotal reports of its use with chronic depression, especially by Landry Wildwind and April Steele, both of whom have strategies for remediating early attachment injuries, which correlates with some cases of depression. Wildwind's approach involves remediating a maternal introject or other resource to provide nurturing to a wounded inner child. Steele does the same, but instead of an introject she works from the adult self. I prefer Wildwind's but Steele has tapes on her method that are instructive.

As to anxiety, it depends which anxiety condition you are discussing.

There are many controlled studies saying that EMDR is a viable means to treat PTSD.

There is anecdotal case report evidence but no particularly good experimental support for the use of EMDR with phobias. The EMDR phobia protocol, taught at Part II workshop, is complex, involving processing the 1) first, 2) worst, and 3) most recent occurrence of a phobic event. The protocol for a complex or procedural phobia, such as most social phobias, is more complex, as it involves processing all the elements of the procedure, from beginning to end (namely, for example, from the time one packs the suitcase, through going to the airport, flying, landing, disembarking, so forth).

There isn't much of anything I have seen on EMDR with generalized anxiety. My experience clinically is that generalized anxiety goes down, however, when we "tent the whole house" by doing EMDR on disturbing early memories with key family memories, until childhood feels neutral and resolved, and future templates (taught in Part II) "come out clean," meaning, they can imagine themselves in future scenarious without disturbing distractions, across many life domains.

Finally, I urge you in the strongest terms to get in the consistent habit of screening each and every person using the DES before doing EMDR on anyone, moreover, do it at the time of intake. This is because, in your population, there are likely a number of highly dissociative individuals, whose presenting complaints are of depression and anxiety, but whose underlying problems include a dissociative self structure.

It is potentially harmful to do EMDR on such an individual without knowing how to treat them for their dissociation. Such training can be achieved through ISSD at www.issd.org, which now offers online courses. EMDR can be lifechanging for such individuals, after (and NOT BEFORE) containment, stabilization, affect regulation and other steps are achieved.

Best of luck, and thank you for your service to your community.

Sandra Paulsen PhD
Bainbridge Island WA
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