Use of eye movement desensitization and reprocessing (EMDR) in battle hardy soldiers after sustaining psychological trauma in various suicide bomb blast: A series of cases of post traumatic stress in terrorist acts

Objective: The purpose of the study is to show the impact of the use of EMDR in survivors of suicide bomb blasts in North of Pakistan. Design and Settings: The study involves an ongoing compilation of clinical data and the study of therapeutic responses to various interventions including EMDR, at a tertiary mental health facility and Centre for Trauma Research and Psychosocial Interventions (CTRPI), Rawalpindi /Islamabad, Pakistan. This mental health facility is the catchment area of patients from Northern areas of Pakistan, currently the part of the country, worst affected by series of suicide bombings targeting military and civil population. Method: Families of the victims and those who survive suicide bombings without physical injuries are referred to CTRPI from peripheral areas / hospitals for assessment for psychosocial consequences of facing a man made disaster. Patients are interviewed at the point in time of referral and scoring is done on Impact of Event Scale (IES). Those who fulfill the criteria of Post traumatic Stress Disorder according to ICD-10 are registered for further studies and appropriate interventions. The individuals who fulfil the criteria for PTSD or any other psychiatric morbidity are then enrolled for regular psychiatric follow up. The patients are first offered the use of EMDR and all who give an informed consent are then assigned to a psychiatrist trained in EMDR (Level 2). Sessions of EMDR as per the protocol of 8 stages are carried out. Scoring on IES is recorded serially. According to the degree of improvement and severity of illness, sessions of EMDR are carried out using the bilateral stimulation during the hospital stay. Results: The three individuals who have completed EMDR treatment had survived the suicidal bombing attacks and fulfilled the entry criteria were administered 8 stage protocol EMDR. They all improved in their symptoms of intrusive images, hyper-arousal, autonomic instability and avoidance. Their sleep improved and nightmares diminished. Their social and interpersonal functioning improved. There was marked reduction of basal anxiety levels in all three. Scores on IES done after intervention (EMDR) improved from initial pre EMDR score of 41, 38 and 40 respectively to post EMDR scores of 18, 15 and 14 for the three subjects who completed EMDR protocol of 8 stages. On reporting to their respective units their occupational effectiveness has returned to previous levels of functioning. Conclusions: EMDR proves to be an effective non pharmacological intervention in terms of post traumatic stress disorder in special circumstances of acts of terrorism involving suicide bombing. The data presented is only preliminary and is based on a small number out of a larger sample.

Conference

English

Bilal, M. S., & Rana, M. H. (2008, June). Use of eye movement desensitization and reprocessing (EMDR) in battle hardy soldiers after sustaining psychological trauma in various suicide bomb blast: A series of cases of post traumatic stress in terrorist acts. Presentation at the 9th EMDR Europe Association Conference, London, England