EMDR and Psychotherapy Integration: Theoretical and Clinical Suggestions with Focus on Traumatic Stress PDF

Series Preface

The first time I visited a Veterans Administration facility was after I had completed and published my first book Stress Disorders among Vietnam Veterans: Theory, Research, and Treatment (Figley 1978). The facility was a VA Medical Center in Indiana that specializes in mental health treatment. My guide at the facility explained that their role was more associated with "caring for the poor" than caring for those who "bore the battle."

Yet, I believed that it was the right thing to do, even though the nation was serving the health care needs of its poor under the guise of veterans services. I couldn't see why we were so confident that the care would be superior to the care of a neighborhood doctor. Back then, in the late 1970s, few therapists were familiar with combat-related PTSD. The diagnostic category was not invented until 1980, thanks to the American Psychiatric Association and its Diagnostic and Statistical Manual of Stress Disorders (1980). After publishing the findings of our interviews with Vietnam combat veterans, we produced Strangers at Home: Vietnam Veterans since the War (Figley and Leventman 1980). During that year, we helped establish the Readjustment Counseling Program within the VA; the Vet Center Program became a reality. It became one of the most successful programs in VA history because it was designed and applied for the exact purpose of doing something more than the neighborhood doctor could.

Even with the knowledge we gained in the 1970s and 1980s, a colleague of mine, who sees and treats war veterans all day long, looks back over his many years of experience and reports that his clients can be classified into three groups. He observes that about one third, Group A, gets better; another third, Group B, gets worse; and the final third, Group C, does not change. What must it be like to try, day in and day out, to help clients stay out of Group B or C and join those in Group A, who improve significantly? Those who do this often experience compassion fatigue, a form of burnout associated with resigning to the belief that clients will never get much better.

Eye Movement Desensitization and Reprocessing (EMDR) has given hope to good therapists who, like Dr. Howard Lipke, want to make a difference. They have found that EMDR is a category changer. EMDR has been studied more than any other treatment of the psychological effects of trauma, and the results show that EMDR treatment should be a priority.

Now comes this fine book by Dr. Lipke on the subject of EMDR and its role in psychotherapy in general and in trauma treatment in particular.

It has been 11 years since EMDR was introduced to the practice community. As editor of the Journal of Traumatic Stress, where Francine Shapiro published the first controlled research article on EMDR, I was struck by the enthusiasm, both negative and positive, of the reviewers. Two reviewers thought that a treatment approach that involved waving your hand in front of a client was sheer nonsense. Two other reviewers were quite excited and impressed with the results. Forty thousand trainees later, EMDR has been adopted more quickly by therapists than any other new psychotherapy approach. This was in large part due to Shapiro's ability to translate her clinical observations into an understandable approach that clarifies the life experiences the client wanted to review and clearly taps all of the aspects of the effects of the experience.

In his book, Dr. Lipke shares his considerable experience with the use of EMDR and helps readers translate and transcend their own paradigm to and from the EMDR approach. This book is about what he has learned about EMDR and its clinical use, particularly with combat veterans.

The heart of this important book is Lipke's Four-Activity Model, an extension of Shapiro's (1995) Accelerated Information Processing (AIP). Lipke offers a conceptual framework on psychotherapy in general by which to integrate Shapiro's theory on how dysfunctional memory can be reprocessed, provides the clinical findings on EMDR, and discusses the theory and findings of the broad range of other approaches to psychotherapy. This model also provides guidelines for practitioners in the use of EMDR. In providing these guidelines, Lipke applies his nearly 30 years of clinical experience using more traditional treatment approaches, along with his 10 years of using and teaching EMDR. It is an extension of, rather than an introduction to, EMDR.

The benefits of this book to practitioners working with distressed clients will quickly become obvious. Read it, and see what can now be done for our clients, veterans, and non-veterans suffering the effects of trauma.