Chang, S. H., & Lee, Y. C. (2003). Eye Movement and Emotionality: The Role of Eye Movement in the Therapeutic Mechanism of EMDR. Poster presented at the 42nd Annual Conferences on Chinese Psychological Association, October, Fu-Jen Catholic University.
Chang, S. H., & Chen, K. P. (2004). Saccadic eye movement and change of semantic associations: Possible therapeutic mechanisms of EMDR.
Chen, C. H., & Chang, S. H. (2004). Dismantling effect of eye movement and positive cognition components of EMDR on the treatment of cockroach phobias. (Manuscript submitted)
Chang, S. H., & Chen, K. P. (2004). Saccadic eye movement and change of semantic associations: Possible therapeutic mechanisms of EMDR. Poster presented at the 2004 Hawaii International Conference on Social Science, July 16-July 19, Honolulu, Hawaii. (Manuscript submitted)
Chen, C. H., & Chang, S. H. (2004). The efficacy of eye movement and positive cognition components of EMDR on the treatment of cockroach phobias. Paper presented at the 43rd Annual Conferences on Taiwan Psychological Association, Symposium on Anxiety Disorders: Diatheses, Mediators and Therapeutic Implications. Chengchi University, September 26.
Chang, S. H., & Lin, C. P. (2004). From REM to EM in EMDR: Saccadic eye movements and change of strength of semantic associations. Paper presented at the 43rd Annual Conferences on Taiwan Psychological Association, Symposium on Anxiety Disorders: Diatheses, Mediators and Therapeutic Implications. Chengchi University, September 26.
Chang, S. H. (2005). Mechanism of EM in EMDR: Change strength of semantic association. Presented at the 2005 American Psychological Association Annual Convention, August 18-August 21, Washington, D. C.
Chang, S. H. (2007) Role of EM and Stimulus Valence Presentation Order in the Return of Fear: Possible Implications for the Therapeutic Mechanism. Presented at the 2007 EMDRIA Conference, September 27-30, Dallas, Texas.
Chang, S. H. (2008) Role of Eye Movements in the Therapeutic Mechanism of EMDR. Paper presented at the 2008 TACP (Taiwan Association of Clinical Psychology) Annual Conference （第三屆第二次會員大會）, Symposium on Evidence-Based Research in Taiwan; Section of Mental Disorders, March 8-9, Chengchi University, Taipei.
Wu, P. L., Hsieh, H. Y., Chu, P. C., & Huang, C. H. (2011)The Use of EMDR to the Middle-Aged Men in Taiwan: A Case Study. Poster presented at the 2011 EMDRIA Conference.
本研究之PTSD案主在接受美國總會認可之EMDR治療師參與治療，於結案後，由研究者邀請成為研究參與者。研究者於EMDR治療結案後四個月及六個月，與研究參與者及其太太進行訪談、並進行觀察，並在徵得研究者參與者同意之情況下，蒐集治療過程中的相關紀錄以及案主自我觀察紀錄。研究者將PTSD案主於接受EMDR介入前後之歷程撰寫成為一治療案例，並且將有關資料進行整合與分析，歸結出 PTSD 案主在參與 EMDR 治療過程中的經驗，以及 PTSD 案主在接受EMDR 介入過程及治療前後的差異，並進一步討論PTSD案主使用精神用藥之影響。
(4) EMDR合併藥物治療，打破案主生心理的惡性循環；(5) EMDR介入與案主自陳之進步情形，療效呈現一致上升的現象。
The Efficacy of EMDR in the Treatment of PTSD: A Case Study
Regarded as one newer therapy originated from Western countries, Eye Movement Desensitization and Reprocessing (EMDR) has been proven efficient by numerous researches. However, due to the fact that there is not much related research in Taiwan, this study aims at a psychological therapy practice applying EMDR in Taiwan for the future exploration. Via a client’s positive result from the therapy and the comparison before and after the intervention of EMDR to the Post Traumatic Stress Disorder (PTSD) therapy, it is anticipated that EMDR will be practiced more in the psychotherapeutic field and thus dispersed in Taiwan.
The researcher invited the interviewee for this study after the closure of his therapy with an EMDR therapist certified in the USA. The researcher interviewed the interviewee and his wife after the closure of the therapy had passed four months and six months respectively. With the interviewee’s permission, all related records to the process and the interviewee’s self-observation are collected as the reference material for this study. The case description developed by the researcher contains the process before and after the intervention of the EMDR therapy. The research has also collaborated pertinent materials to analyze the interviewee’s experience during the process of therapy and to distinguish all differences before and after the intervention of the EMDR therapy, as well as to discuss the effects caused by psychiatric medication to the interviewee.
The procedure and the findings of this study are listed as follow:
1. The interviewee and his wife had totally been through a four month therapy with nineteen sections, in which three traumas the interviewee had experienced were targeted by the EMDR therapy. During the therapy, the interviewee stably adjusted and benefited a lot. In the follow-up tracking, the interviewee was found to have adapted and recovered well afterward.
2. Also during the therapy, the interviewee’s cognition turned positive along with the ease of the negative motions. The interviewee was insensitive but could usually relax himself when the section came to an end.
3. After the interviewee went through the severe morbidity and underwent the intervention of the EMDR therapy, most of the interviewee’s symptoms were eased even though the aspects of physical arousal and daily functions differed from those before the morbidity. However, when facing the source of pressure, the interviewee could adopt new skills learned from the EMDR therapy to comfort and balance himself both mentally and physically.
4. The case study has revealed that that the interviewee’s improvement is an effect mutually caused by the intervention of EMDR and the psychiatric medication; the key to the success of this case should be attributed to the trust established between the EMDR therapist and the interviewee that serves as a critical turning point for the interviewee to accept the combined treatment from psychological and pharmaceutical therapies.
Based on the result mentioned above, the researcher has proposed the following discussions:
1. The interviewee’s physical condition and consultation channel reflect the Taiwanese people’s reactions to pressure and help-seeking behaviors.
2. The intervention of EMDR helps the interviewee face and deal with the trauma, and the process of the intervention meets the principles and strategies of the trauma remedy.
3. The intervention of EMDR not only effectively helps the clients in Taiwan ease emotional and physical symptoms, but also significantly leads to the clients’ cognitive transformation. This explains that EMDR contains cross-cultural effects. In addition, the improvements seen on the interviewee meet the treatment goal and the new issues mentioned in Practice Guidelines for the International Society for Traumatic Stress Studies.
4. The combination of the interventions of EMDR and medication breaks the vicious stress cycle between the interviewee’s body and mind.
5. The interventions of EMDR and the self claims by the interviewee have shown the consistent positive effect.
Based on the study result and pertinent discussions, the researcher has established a logic model for the intervention of EMDR to the PTSD therapy and proposed further academic and clinical suggestions for future study.
Keywords: EMDR, PTSD
針對本研究之結果，研究者進行以下討論：（1）失落經驗影響當事人的內在運作模式，進而改變其行為反應；（2）本研究之治療案例，突顯個體適應中年期之重要性；（3）當事人經由身心症狀反映自我保護的需求，治療師對當事人身心症之處遇，符合Van Rood與De Roos（2009）之觀點；（4）治療師是當事人重要的情感支持來源；（5）本研究治療案例之EMDR介入過程，治療師對當事人解離症狀的處遇，符合Forgash與Knipe（2008）、以及Van der Hart、Nijenhuis與Steele（2006）對治療解離症狀的觀點；（6）本研究之EMDR介入過程中，當事人自覺身心不適症狀獲得紓解，生活適應功能逐漸恢復；（7）依據研究結果與上述討論內容，建立本研究之邏輯模型。最後研究者依據上述研究結果與討論，針對未來研究及實務工作提出進一步建議，以供參考。
The Intervention of Eye Movement Desensitization and Reprocessing:
A Case Study on Coping with Personal Loss
The purpose of this study is to explore the treatment outcomes from the intervention of Eye Movement Desensitization and Reprocessing (EMDR) with personal loss. Through in-depth understanding of the client’s subjective experiences and changing courses throughout the entire therapeutic process, the researcher intends to prove that EMDR therapy has efficaciously helped the client overcome the trauma from personal loss and regain confidence and vitality. The researcher has interviewed a client who is willing to share his life and EMDR therapy experiences through a semi-structured questionnaire. With the client’s permission, the researcher has obtained the client’s clinical records. After methodically synthesizing the various data, the researcher has developed a case description presenting both the life experience and the intervention of EMDR therapy of the client. The researcher has analyzed the data, generalized the client’s adaptive coping processes throughout EMDR therapy and discussed the effects from the psychiatrist’s and other counselors’ interventions.
The research has found that:
1. The client underwent eleven out of forty-two sessions with the intervention of EMDR therapy over a twelve-month period and achieved substantial relief. Upon the client’s request, a follow-up tracking has proceeded for six months.
2. During the EMDR therapy process, the client was helped through the bilateral stimulation (BLS) to deal with the trauma, and the client’s (1) negative cognition either turned to positive or was replaced by new interpretations; (2) negative emotions were removed or turned to positive; and (3) physical symptoms were eased, which provided relief and comfort to the client.
3. After the intervention of EMDR therapy, the client has become able to accept his personal loss, felt confident in himself, and been stable in emotion, as well as has maintained his marital relationship wholeheartedly. Relieving from the dissociation and physical symptoms, the client feels competent on his job and can now use a variety of ways to comfort himself.
4. The research cannot completely eliminate the effects from the interventions of psychological and psychiatric therapies. As a result, the research indicates that helpers from different domains all work hard to help the client.
Based on the findings, the researcher proposes the following analyses:
1. The experience from personal loss influences the client’s internal function model and thus transforms the client’s behavior.
2. The case study illustrates the importance of adaptation in the middle age.
3. The somatic and psychological symptoms reflect the client’s needs for self-protection. The intervention of EMDR therapy thus fits Van Rood and De Roos’s perspectives (2009).
4. The EMDR therapist is an important emotional-support source for the client.
5. During the intervention of EMDR therapy, the therapist’s handling of the client’s dissociative symptoms fits the perspectives of Forgash & Knipe (2008) and Van der Hart, Nijenhuis, & Steele (2006) in treating dissociation.
6. During the process of EMDR therapy, the client feels relief from his somatic and psychological symptoms and regains his life function.
7. The researcher has established a logical model for the intervention of EMDR therapy in the cases of personal loss.
In conclusion, based on the research outcomes and analytic discussion above, additional suggestions for future research and practice are proposed.
The Healing of Relational Trauma -EMDR Case Study of Dissociation
The purpose of the study was to explore the applicability and efficacy of EMDR with relational trauma and dissociation. Subjects were two clients who shows signs of dissociative part, having compulsive behavior and sudden shift of emotion, behavior and attitude. It’s a multiple case study expanding the current study of EMDR through the use of qualitative approach. The treatment was administered by an EMDR therapist following the adaptive EMDR standard protocol. Description of the life story, related treatment procedures and changes were analyzed from clinical records, observer’s records, interview of the clients, and the documents provided by the clients during and after the treatment.
The results show the impact of significant improvement on the clients, such as the integration of dissociative parts, the decreasing of emotional and compulsive behaviors, the disappearance of the disturbance, the self-concept turned more positive from negative, more easily to sooth themselves when feeling frustrated, more energy to release from the overwhelming past experience, standing firmer toward future life, and getting along well with other. Results maintained after 6 months follow-up. Based on the results and discussions, further clinical and academic suggestions are proposed.
Keywords: EMDR Therapy, Relational Trauma, Dissociation.