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DeTUR

Treatment of Addiction with EMDR
by

Hwallip Bae

on 9 November 2011

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Transcript of DeTUR

Treatment of Addiction with
EMDR
St.Andrew’s Neuropsychiatric Hospital
Bae Hwallip MD,PhD
Adaptive Information Processing (AIP) model
Developed to explain the rapid change toward positive resolution seen in the EMDR treatment process
AIP system
Reduction in distress and/or negative emotions that can be stored as a result of upsetting experiences
Integrating upsetting information into a more adaptive, positive memory network
May be hindered or blocked:
trauma, other severe stress, influence of psychoactive drugs
EMDR
Gain access to and reprocess dysfunctionally stored information & memories
Facilitates an association process
Integration within appropriate contextual memory networks
Francine Shapiro
Eye movement desensitization and reprocessing: Treating trauma and substance abuse. Journal of Psychoactive Drugs, 26(4), 379-391, 1994
Target
1) the memories that precipitate and drive substance abuse

2) the relapse triggers and craving to use drugs

3) future healthy and adaptive coping

4) treatment motivation and compliance
Addiction Treatment Protocols
Resource Development and Installation (RDI) protocol
Used to enhance the preparation or stabilization phase
Purpose
Increase clients’ abilities to change (affective and behavioral) state adaptively by enhancing their access to functional memory network
Resources
Associated with positive affect (interest, excitement, enjoyment, pride), and adaptive responses (speaking the truth, protecting oneself from danger, or containing impulses)
Types of resources
Case Example
M/34
Pathological gambling
1. Mastery resources
자기자신의 기억으로 스스로 성공했던 경험
효과적인 자기 관리와 자기 위로 경험

2. Relational resource
긍정적인 역할 모델의 기억
개인적으로 아는 사람
책, 이야기, 만화, 영화, TV의 인물
지지적 주위 인물의 기억
위로, 돌봄, 사랑 혹은 보호를 제공했던 보호자, 친척, 선생님, 긍정적인 권위 인물, 또래

3. Symbolic resources
자연 세계의 사물의 기억
종교, 원형, 토템, 자아 초월적 상징과 경험 뿐 아니라 바다, 바위 혹은 나무 같은 것
CravEx Protocol
Target “Addiction Memory”
Activating this memory will lead to drug-taking behaviors
Protocol is similar with standard protocol
Level of Urge (LOU) instead of Subject Units of Disturbance Scale (SUDS)
Hase, Schallmayer, and Sack (2008)
EMDR reprocessing of the addiction memory: Pretreatment, posttreatment, and 1-month follow-up. Journal of EMDR Practice and Research, 2(3), 170-179
Randomized controlled trial
34 patients with chronic alcohol dependency
“treatment as usual”(TAU) with or without EMDR
Obsessive-Compulsive Drinking Scale (OCDS)
Pre-, Post- and 1 month after treatment.
EMDR with TAU group significant reduction in Craving post- treatment and 1 month after treatment.
Desensitization of Triggers and Urge Reprocessing (DeTUR) protocol
Popky, A. J. (2005). DeTUR, an urge reduction protocol for addictions and dysfunctional behaviors. In R. Shapiro (Ed.), EMDR solutions. New York: W.W.Norton
Twelve Protocol Steps

1. Rapport

2. History

3. Support resources

4. Internal resource state

5. Positive treatment goal

6. Associated positive state

7. Identify urge triggers

8. Desensitize triggers

9. Install positive state to each trigger

10. Test & future check

11. Closure & self work

12. Follow on sessions
Case Example
F/27
Alcohol dependence
"
(cc) image by anemoneprojectors on Flickr
7. Triggers Identification
Location
LOU
8. Desensitization

Clinical Studies
Study for Internet Addiction
Study for Pathological Gamblings
Assessment
Study for Alcohol Dependence
Assessment
Conclusion
Effective as adjunctive therapy of addiction treatment
Future direction
Randomized controlled study
대조군 연구
Follow up
Relapse 까지의 기간 조사
Other substance dependency등 적용
Patient’s attention: 긍정적, 매력적, 달성가능하며 끌리는 목표; NOT AWAY from a negative behavior

Positive goal: 환자가 기술한 것이며, 긍정적인 방법으로 대처 기능하는 것

Employs ego strength and empowerment to build coping skills

Relapse: 새로운 목표가 주어지는 기회

환자의 의식적 수준 밖에서 일어남

각각의 유발인자를 목표화하여 탈감작 시킴, 회복 초기에 사용
Full transcript