What happens after successful EMDR? Post Traumatic Growth becomes ‘Network Growth’

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What happens after successful EMDR?Post
Traumatic Growth becomes Network Growth

• David Blore
• PhD student
• School of Health and Population Sciences College
  of Medical and Dental Sciences,
• University of Birmingham, England
• 10th EMDR Europe Conference,
• Beurs van Berlage, Amsterdam 2009

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Observation

• Because clients are discharged when symptom
  free, EMDR clinicians rarely get to see what
  actually happens in the weeks, months and even
  years following the installation of positive
  cognitions
• this is hardly surprising given the
  understandable objective of healthcare to reduce
  the suffering of negative symptomatology but
  this has given rise to a lop-sided view
  recognised over 50 years ago

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Maslows criticism of the negative only view
of mental health

• The science of psychology has been far more
  successful on the negative than on the positive
  side. It has revealed to us much about mans
  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)

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Research questions

• What is the lived experience of clients who have
  been in a traumatic experience, subsequently
  undergone a course of EMDR and experienced
  positive outcomes?
• How did they get there?
• What can be learnt about the role of EMDR in that
  process?

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Methodology

• Phenomenological investigation of Road Traffic
  Crash victims, who had reported positive
  outcomes subsequent to receiving EMDR
• Snowball recruitment of participants via treating
  EMDR clinician resulted in n12 interviews of
  experiential experts
• An Interpretative Phenomenological Analysis (IPA)
  framework for data analysis to facilitate the
  generation of hypotheses

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Results

• 1589 Second hermeneutic summary phrases
• Generating 19 Sub themes
• Clustering into
• 2 Super-ordinate themes and
• 1 Over-arching theme

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Collated findings grouped by super-ordinate theme
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Why Navigational Struggle ?

• Because the themes that make this category
  effectively describe the individuals battle to
  get from the traumatic event to some semblance of
  normality and the route taken had to be
  navigated

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Why Network Growth ?

• Because channels of associations (networks) are
  expanding, or as Maslow would put it his
  potentialities, his virtues, his achievable
  aspirations and his full psychological height
  are being achieved

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Figurative Language Use (FLU)

• Metaphor depends largely on encyclopaedic
  knowledge (Griffiths 2006)
• Encyclopaedic knowledge myriads of networks
• The individual who has been traumatised finds
  their existing networks unable to cope with the
  reality of what has happened (see Solomon 2004)
• To comprehend what has happened, the individual
  generates new networks (about 20 of FLU related
  directly to the RTC/ driving/roads etc.)

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Figurative Language Use (FLU)

• But isnt that exactly what EMDR does
• Every time a traumatic memory is linked into an
  adaptive network?
• Every time a cognitive interweave works?
• Every time the client describes an insight?
• Every time the client uses a metaphor so as to
  understand the traumatic event and its aftermath?
• Metaphor is a neural phenomenon neurons that
  fire together wire together (Lakoff Johnson
  1980)

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Where to next?

• 8 Conceptual models of positive change (OLeary
  et al 1998) were reviewed to see if they could
  describe the positive changes reported after EMDR
  none fitted most had helpful elements.
• A model is thus needed to adequately describe the
  lived experience of positive outcomes after EMDR
  for psychological trauma preferably one that
  uses Adaptive Information Processing (AIP) as a
  foundation
• The Network Growth model takes root here

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The Network Growth model to explain positive
outcomes following EMDR (Blore 2009)
RTA
Navigational struggle

Network growth
Figurative Language Use
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Conclusions and implications for EMDR practice

• EMDR treatment outcomes are considerably more
  than merely a reduction in negative
  symptomatology or resolution of diagnostic
  entities
• Assessment of positive assets should be included
  as routine in history-taking
• Secondary traumas were frequently cited in the
  navigational struggle after the road crash by
  those developing positive growth.
• 20 of metaphor use related to the trauma itself
  suggesting adaptive meaning-making as per AIP
  model and therefore growth started within
  treatment itself
• PCs could be usefully viewed as incremental in
  nature to facilitate further reassessment of the
  PC at the end of the first cycle of the
  installation phase. Installation should continue
  until this process is exhausted. This may result
  in the need for an incomplete session protocol
  for Phase 5.
• Post Traumatic Growth (PTG) is too restricting
  a label to fully describe the lived experienced
  of positive outcomes following EMDRinstead
  Network Growth is proposed to describes the
  invisible (i.e. adaptive network expansion
  occurring during EMDR) and visible (akin to the
  visibility of PTG thereafter) processes
  involved in EMDR positive outcomes

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Thank you for listeningPast presentations
relating to this research www.davidblore.co.uk/ne
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