2000 - EMDR and psychotherapy integration - Lipke.pdf - EMDR - psychika1

EMDR and

Psychotherapy

Integration

Howard Lipke, Ph.D.

LEWIS PUBLISHERS

Boca Raton New York London Tokyo

Library of Congress Cataloging-in-Publication Data

Lipke, Howard.

EMDR and psychotherapy integration : theoretical and clinical suggestions with focus

on traumatic stress / Howard Lipke.

p. cm. — (Innovations in psychology)

Includes bibliographical references and index.

ISBN 0-8493-0630-2

1. Eye movement desensitization and reprocessing. 2. Psychic trauma—Treatment.

I. Title. II. Series.

[DNLM: 1. Desensitization, Psychologic—methods. 2. Combat Disorders—therapy.

3. Eye Movements. 4. Psychological Theory. 5. Stress Disorders, Post-Traumatic—therapy.

WM 425.5.D4 L764e 1999]

RC489.E98L56 1999

616.85'210651—dc21

DNLM/DLC

for Library of Congress

99-38186

CIP

This book contains information obtained from authentic and highly regarded sources.

Reprinted material is quoted with permission, and sources are indicated. A wide variety of

references are listed. Reasonable efforts have been made to publish reliable data and informa-

tion, but the author and the publisher cannot assume responsibility for the validity of all

materials or for the consequences of their use.

Neither this book nor any part may be reproduced or transmitted in any form or by any

means, electronic or mechanical, including photocopying, microﬁlming, and recording, or by

any information storage or retrieval system, without prior permission in writing from the

publisher.

The consent of CRC Press LLC does not extend to copying for general distribution, for

promotion, for creating new works, or for resale. Speciﬁc permission must be obtained in writing

from CRC Press LLC for such copying.

Direct all inquiries to CRC Press LLC, 2000 Corporate Blvd., N.W., Boca Raton, Florida 33431.

Trademark Notice:

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and are only used for identiﬁcation and explanation, without intent to infringe.

CRC Press LLC

No claim to original U.S. Government works

International Standard Book Number 0-8493-0630-2

Library of Congress Card Number 99-38186

Printed in the United States of America 1 2 3 4 5 6 7 8 9 0

Printed on acid-free paper

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 Vet-

erans: 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

(1980).

After publishing the ﬁndings of our interviews with Vietnam combat vet-

erans, we produced

Diagnostic and Statistical Manual of Stress Disorders

(Figley

and Leventman 1980). During that year, we helped establish the Readjust-

ment 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 some-

thing 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 associ-

ated 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 differ-

ence. 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.

Strangers at Home: Vietnam Veterans since the War

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 com-

munity. As editor of the

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 repro-

cessed, 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.

Journal of Traumatic Stress,

Charles R. Figley, Ph.D.

Series Editor

2000 - EMDR and psychotherapy integration - Lipke.pdf

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