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49 4 Eye Movement Desensitization and Reprocessing (EMDR) in Family Systems with Deaf Family Members Lieke Doornkate Deaf people, as well as their family members, have higher than average rates of mental health problems (Fellinger, Holzinger, & Pollard, 2012; Schultz Myers, Myers, & Marcus, 1999). An inability to hear can lead to social limitations, stigmatization , and impairments in emotional development. As a result, more deaf and hard of hearing people experience psychopathology than hearing people. In addition , numerous unique, trauma-type experiences appear in deaf adults: an average of 6.18 per person (SD = 2.65) (Schild & Dalenberg, 2012). Eye movement desensitization and reprocessing (EMDR) is a promising technique that addresses the consequences of posttraumatic stress disorder (PTSD) in this group of clients. The method is partly nonverbal and therefore compatible with the visual world of deaf and hard of hearing people. EMDR is a protocolbased method for treating PTSD. It has been empirically validated for adult PTSD and is now administered successfully to hearing adults. Children also appear to benefit from EMDR. EMDR Originated by U.S. psychologist Francine Shapiro in 1989 and used as part of a more comprehensive course of therapy, EMDR, as already mentioned, is considered effective in treating PTSD and trauma-related anxiety disorders. Lauded for its efficiency, as it often produces desired results in one or a few sessions, the method has been empirically validated in use with traumatized adults and children . It has also been used in the treatment of more complex traumas and syndromes . The underlying theory of EMDR assumes that the natural healing process ara86542_04_ch04.indd 49 ara86542_04_ch04.indd 49 12/10/15 6:57 PM 12/10/15 6:57 PM Lieke Doornkate 50 has been stymied by the tremendous amount of cognitive, visual, and emotional information generated by a traumatic event. If dysfunctional meanings are attached to such information as it is stored, PTSD symptoms occur (van der Kolk 1996; Shapiro, 2001). Using the more streamlined EMDR approach, clients often report reductions of debilitating symptoms such as reexperiencing (or reliving), nightmares, irritability, and extreme avoidance behavior. Various explanations have been advanced for the therapeutic action of EMDR. Recent research shows the most empirical evidence for the working-memory hypothesis . The theory posits that retrieving a memory of an event requires limitedcapacity working memory resources. If a secondary task is executed during a retrieval that shares this dependence, fewer resources will be available for recalling the memory, and the latter will be experienced as less vivid and emotional (van den Hout et al., 2011). The eye movements and the recall of a traumatic memory are concurrent; this dual task reduces the vividness and emotionality of the traumatic image (van den Hout & Engelhard, 2011; Gunter & Bodner, 2008). In administering the EMDR protocol, the therapist asks focused questions designed to activate memories of the trauma. Distractive bilateral stimulation (e.g., eye movements, hand taps) is then used to evoke more appropriately functional trauma-related associations, thus helping to neutralize the traumatic memories. The EMDR procedure is protocol driven. In the assessment phase, the therapist helps clients to choose the most distressing image of the traumatic history. Together they identify the negative cognition that the clients still generate about themselves while viewing that mental image. A picture is drawn of the most distressing mental image. The clients are asked what positive cognition they would prefer to have instead, and how valid or believable that cognition is. Then the client is asked what emotion is triggered when looking at the mental image with the negative cognition in mind, where he can feel it in his body and how distressing the image is on a scale from 0 to 10. The desensitization phase can now begin, using the external stimuli. The clients are asked to report the sensations this procedure evokes (e.g., images, sounds, emotions). This sets the healing process sufficiently in motion to enable information processing. During this desensitization phase, the therapist also assesses how much tension the original image still provokes working with scale from 0 to 10. If the memory has been neutralized, the positive cognition is then “installed” by focusing on this cognition and the client is asked for more positive associations. A “body scan” is then made to determine whether the client is still experiencing tension. The EMDR session then ends (ten Broeke & de Jongh, 1999). DEAFNESS AND MENTAL HEALTH PROBLEMS OF DEAF CLIENTS The number of deaf and severely hard of hearing people in the Netherlands has been estimated at 11...


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