Treating complex PTSD with EMDR therapy. The stabilization controversy in complex PTSD: Filling the gaps between research and practice

It has been clinically established that EMDR Therapy with individuals suffering from complex PTSD has to be used with caution and includes a stabilization/preparation phase. More recently, researchers have suggested that evidence for a stabilizing phase is not necessary, which has created an important controversy within the EMDR world. This recommendation about the use of an unnecessary prolonged stabilization is based on results of mainly randomized controlled trials (RCTs). Hereby, it is very important to take into account that narrow exclusion criteria in RCTs –such as comorbidity, suicidal ideation or substance use– limits the generalizability of many of those studies to individual real world patients with complex PTSD. Furthermore, no direct comparison trials are conducted which compare treatment of complex PTSD with versus without stabilization phase which would give real evidence for one or the other treatment approach. From a clinical point, the vast majority of therapists have the impression that a stabilization phase is very necessary in this type of patients. So is it truly ethical to skip this step based on non-conclusive scientific evidence? Additional results or case studies from prospective naturalistic studies would add valuable information on how to treat these patients. Meanwhile, it is important to identify the gaps between research and practice and find a balance between too much or too little treatment steps. This will be discussed in this workshop but also how the AIP model can explain and address diverse kinds of dysfunctionally stored information found in those with the most severe forms of traumatization. Clinical case examples and video fragments will be used to illustrate and demonstrate how EMDR clinicians can safely utilize a wide range of EMDR interventions with complex PTSD and when it´s necessary or not to stabilize.

Conference

English

Dolores Mosquera

Mosquera, D. (2017, June). Treating complex PTSD with EMDR therapy. The stabilization controversy in complex PTSD: Filling the gaps between research and practice. Presentation (Roger Solomon, Chair) at the 18th EMDR Europe Association Conference, Barcelona, Spain.