The application of EMDR to critical incident trauma

A critical incident is a situation that results in an overwhelming sense of vulnerability or lack of control. These are situations that violate basic assumptions about how the world works. Clinical issues often revolve around themes of responsibility (e.g. irrational self-blame); present safety and lack of control and self-efficacy. This workshop will define critical incident trauma, discuss the phases of the emotional aftermath, and the application of EMDR. Appropriate negative and positive cognitions, and cognitive interweaves will be presented. Patterns of resolution will be discussed, including assimilation and accommodation of new information, recognition and attribution of an appropriate level of responsibility, regaining a sense of present safety, and recapturing of empowerment and self-efficacy. A variety of interventions will be discussed including critical incident stress debriefing (CISD). A CISD is a psycho-educational group meeting or discussion about a traumatic incident which ideally takes place within a few days of the event. The CISD can help to normalize and legitimize emotional reactions; provide education about trauma and coping; and facilitate constructive ways of thinking about the event. The goals of a CISD are to mitigate the psychological impact of a traumatic event, accelerate recovery, and serve as an early identification mechanism for people who need further follow-up, including EMDR. EMDR is a useful follow-up to a CISD for people suffering significant symptoms due to single episode trauma. Although EMDR is generally effective in one to three 90 minute sessions, the therapeutic gains are even more rapid when EMDR is used in tandem with CISD. This may occur because the prior crisis intervention and peer support initiates a constructive processing of the event, which primes the person for further processing with EMDR. Examples of the use of EMDR and CISD following critical incidents will be presented. Appropriate screening needs to take place before EMDR is initiated. Follow-up is crucial to ensure stable treatment effects.

Conference

English

Roger M. Solomon
Vincent McNally

Solomon, R. M., & McNally, V. (1997, July). The application of EMDR to critical incident trauma. Presentation at the 2nd EMDR International Association Conference, San Francisco, CA