Prof. Bridget Hogg
Institut de Recerca Hospital del Mar, Barcelona
Ponència | EMDR: Una perspectiva crítica en el tractament del trauma |
Data | Divendres, 26 d'abril, 2024 |
Hora | 17:15 - 18:00 |
Taula rodona 3 | Intervencions terapèutiques |
BIOGRAFIA
Bridget Hogg is a psychologist and post-doctoral researcher, specialised in psychological trauma and mental disorder. Originally from the UK, where she studied psychology at the University of Liverpool, she has a PhD in Psychiatry and a Masters in General Health Psychology from the Universitat Autònoma de Barcelona. She has been working with the Hospital del Mar Research Institute since 2018 as a researcher along two main lines of investigation; firstly, with psychological trauma in mental disorder and its treatment with Eye Movement Desensitization and Reprocessing (EMDR) therapy across a range of disorders. Secondly, in three European projects related to improving mental health in the workplace and in the community. She is qualified as an EMDR therapist.
RESUM
Eye Movement Desensitisation and Reprocessing (EMDR) therapy is a third generation therapy for psychological trauma, which combines cognitive behavioural and psychodynamic elements. It was first developed by Francine Shapiro in 1987, with a standardised 8-phase protocol published in 2001. This protocol combines imagined exposure with the simultaneous use of bilateral stimulation, most commonly in the form of side to side eye movements, to desensitise and reprocess the memory and the emotional and somatic symptoms associated with it.
EMDR therapy is based on the Adaptive Information Processing (AIP) model, which posits that maladaptively stored memories cause PTSD symptoms, and these symptoms can be reduced through reprocessing the memory and storing it adequately. There are hypotheses for a range of suggested mechanisms of action by which EMDR therapy and its distinctive use of bilateral stimulation reduce trauma symptoms.
EMDR is widely recommended in international treatment guidelines, alongside trauma-focused cognitive behavioural therapy (TF-CBT) and prolonged exposure therapy, in the treatment of post-traumatic stress disorder (PTSD). Evidence from a range of reviews and meta-analyses has shown it to be effective in treating PTSD in both adult and child/adolescent populations, and can also help reduce comorbid symptoms of depression and anxiety. The standard EMDR protocol can also be modified to work with symptoms of dissociation and other features of complex PTSD.
Psychological trauma has been shown to be an environmental risk factor for mental disorder, and PTSD is often comorbid with another mental disorder. In recent years, research has begun to investigate whether EMDR can be safely and effectively applied in populations with a mental disorder and comorbid PTSD. This is important as comorbid trauma can negatively impact the course of a severe mental disorder, yet there is scarce evidence for how to treat trauma in these populations. There is preliminary evidence that EMDR may be safely applied in people with a range of psychiatric disorders including psychosis, major depressive disorder, bipolar disorder, and substance use disorder.
Furthermore, there is emerging evidence for the effectiveness of adaptations to the EMDR protocol aimed at dealing with symptoms other than trauma, such as the CravEx protocol, developed by Michael Hase, aimed at working with craving and addiction, the pain protocol, developed by Mark Grant for chronic pain, or the protocol for bipolar disorder developed by Benedikt Amann and colleagues.
Therefore, while there is a strong body of evidence which supports EMDR as a first-line treatment for PTSD in the general population, there is also emerging evidence that suggests it can be used to treat complex PTSD and to treat psychological trauma as a comorbidity with other psychiatric disorders, as well as having other innovative applications.
REFERÈNCIES
- Hogg et al (2023). "EMDR therapy vs. supportive psychotherapy as adjunctive treatment in trauma-exposed bipolar patients: a randomised controlled trial". Span J Psychiatry Ment Health doi: 10.1016/jj.sjpmh.2023.11.005
- Hogg et al (2023). "Psychological trauma as a transdiagnostic risk factor for mental disorder: an umbrella meta-analysis". Eur Arch Psychiatry Clin Neurosci 273(2):397-410. Doi: 10.1007/s00406-022-01495-5.
- Valiente Gómez et al (2020). " A Multicenter Phase II RCT to Compare the Effectiveness of EMDR Versus TAU in Patients With a First-Episode Psychosis and Psychological Trauma: A Protocol Design". Front Psychiatry 11:283. Doi: 10.3389/fpsyt.2019.01023
- Valiente Gómez et al (2019). " A Multicenter Phase II Rater-Blinded Randomised Controlled Trial to Compare the Effectiveness of Eye Movement Desensitisation Reprocessing Therapy vs Treatment As Usual in Patients With Substance Use Disorder and History of Psychological Trauma: A Study Design and Protocol". Front Psychiatry 10:108. Doi: 10.3389/fpsyt.2019.00108