How does EMDR help trauma victims



23.06.2003 10:46

How the trauma becomes a "normal" memory

Dr. Annette Tuffs Corporate communication
Heidelberg University Hospital

Every fourth victim develops a stress disorder / early treatment with rhythmic eye movements and psychotherapy successfully

After serious acts of violence and disasters, an average of one in four victims develops a mental disorder that requires treatment. Otherwise those affected will be forced to relive the terrible event over and over again. A special therapy based on rhythmic eye movements, in connection with conventional psychotherapy, can "defuse" memories of stressful events and integrate them into life. This was determined by trauma experts at the "Ways out of wordlessness" congress, which took place last weekend in Heidelberg with around 800 participants.

Women and foreigners of both sexes are particularly at risk: After an act of violence, they are more likely to develop what is known as post-traumatic stress disorder (PTSD). On the other hand, membership of a certain social class and the age of the person concerned have no influence. On the other hand, the risk is increased if there is a long-term incapacity for work. These are the first results of the Heidelberg Victims of Violence Study, in which 70 people who have recently been victims of a violent crime in the Heidelberg area have taken part. Associate professor Dr. Günter H. Seidler, Head of the Psychotraumatology Section of the Psychosomatic University Hospital Heidelberg, at a press conference on the occasion of the Heidelberg Congress.

Victims of torture and rape usually suffer from stress disorders

About one percent of the population has chronic stress disorder as a result of trauma. It may have happened more recently, but it could also have happened in childhood. Not all people who have had violent, disturbing experiences suffer the consequences for a lifetime if they are not helped therapeutically. Depending on the trauma, around a quarter of those affected cannot process what they have experienced without therapeutic help. Systematically tortured people and raped women are particularly often affected (50 to 80 percent), followed by victims of violent crimes, experiences of war, serious accidents and natural disasters. The more the personality itself and its social ties are attacked, the greater the risk. Children react particularly sensitively to violence that is exercised or threatened.

Victims of trauma can no longer get rid of their tormenting memories: Even slight memory stimuli make what happened like a film without being able to influence it. Many of those affected can no longer cope with everyday life, feel separated from reality, withdraw and also develop other serious mental disorders. "Established psychotherapy alone cannot help here," explained Prof. Dr. Peter Fiedler, Director of the Psychological Institute at Heidelberg University. Because here one tries above all to process what has happened through analysis. Conversations, however, are not sufficient to deal with traumatic events, and without additional therapy they could even lead to further psychological damage: "Traumatic experiences cannot be talked away."

For some years now, EMDR therapy (Eye Movement Desensitization and Reprocessing) has proven to be a scientifically proven, effective therapy: The patient calls the traumatic event in front of their eyes, and its processing is encouraged by rhythmic eye movements or touch. In doing so, dream-like processes are set in motion, the unconnected scraps of memory are fused into holistic memories. What remains is the knowledge of a terrible event; however, the images stop circling and lose their threat. "The patient must first be sufficiently psychologically stabilized in order to be able to expose himself to the dire events again," explained Dr. Arne Hofmann, head of the EMDR Institute Germany in Bergisch-Gladbach. He pointed out that only certified therapists who have learned the procedure under quality control are allowed to practice EMDR. There are around 250 therapists available in Germany.

Evidence of overexcitation and cell destruction in the brain

"We don't know why EMDR works," said Dr. Hofmann. Nevertheless, there is now scientific evidence that psychotraumas leave visible traces in the brain and that therapy is able to partially reverse them. "With the help of imaging methods such as magnetic resonance tomography, it was found in victims of violence that certain brain structures that are responsible for feelings are very excited," said Prof. Dr. Gerhard Roth, Director of the Institute for Brain Research at the University of Bremen. Above all, this includes the almond kernel (amygdala). A brain area that is responsible for memory, the so-called hippocampus, shows damage to its cells in trauma victims, which can be reversed through effective therapy. With long-term stress disorders, parts of this region are destroyed.

"Germany is a developing country in psychotraumatology"

This research is more recent. "Psychotraumatology is a young field," said Dr. Seidler. The USA has a head start: After Vietnam veterans in the 1980s and 1990s could not be cured of their severe psychological disorders with the usual psychotherapeutic methods, intensive research work began there in the 1990s.

"Germany is still a developing country here," stated the experts at the Heidelberg conference. This applies not only to research, but also to the supply status. While the medical disaster care for accident victims is organized nationwide, there is only one other clinic in southwest Germany besides Heidelberg, in which trauma experts are employed. In the event of a "major damage event", e.g. a major railway accident, there would not be enough specialists available to subsequently take care of the victims and their relatives in order to avoid serious long-term damage from the trauma.

Further information on psychotraumatology on the Internet:

* Website of the Psychosomatic University Clinic Heidelberg:
http://www.med.uni-heidelberg.de/psycho/psm/psm.htm
* "The psychologically traumatized patient in the medical practice" (Dr. Günter Seidler, Deutsches Ärzteblatt, February 2002, p. 77):
http://www.aerzteblatt.de/v4/archiv/artikel.asp?id=33257
* AWMF guidelines on post-traumatic stress disorder:
http://www.uni-duesseldorf.de/awmf/ll/psytm010.htm
* EMDR Institute Germany:
http://www.emdr-institut.de
* EMDR Institute USA:
http://www.emdr.com/

This press release is also available online at
http://www.med.uni-heidelberg.de/aktuelles/


Additional Information:

http://www.med.uni-heidelberg.de/psycho/psm/psm.htm
http://www.aerzteblatt.de/v4/archiv/artikel.asp?id=33257
http://www.uni-duesseldorf.de/awmf/ll/psytm010.htm
http://www.emdr-institut.de
http://www.emdr.com/


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