1987. Going through a difficult period in life (cancer, divorce from her husband), the American psychologist Francine Shapiro experienced real suffering: she was tormented by obsessive fears and nightmares. One day, while walking in the park, she noticed that quick movements of her eyes from left to right relieved her condition. She continued research that confirmed that the method helps with post-traumatic stress. Shapiro defended her thesis on DPDG and in 2002 she received the Sigmund Freud Prize, the most prestigious award in the field of psychotherapy.
Definition
DPDG is a psychotherapeutic technique that is used in the treatment of emotional trauma. It is designed primarily for the treatment of PTSD, addiction syndrome, or bereavement depression. At the moment of trauma (accident, terrorist attack, natural disaster, physical or mental violence), the human brain remembers all the details related to this event. Memories of them continue to haunt him, throwing him out of balance. The DPDG method helps to improve the client's condition by identifying the feelings and images associated with the painful experience of trauma, and to change the perception of this event.
Operating principle
The DPDG method is based on the neurological concept of psychological trauma and can accelerate word healing. A traumatic event blocks the processes of self-regulation of the psyche: images, sounds or bodily sensations associated with a painful experience seem to "get stuck" in it, so that a person experiences horror, pain, fear and helplessness over and over again. Eye movement helps to synchronize the rhythms of the cerebral hemispheres. And eye movements from side to side cause alternate activation of the hemispheres and synchronous processing of information. Natural self-regulation processes are restored, and the brain shuts down on its own.
Progress
After explaining the plan of action to the client, the therapist invites him to think about something good first. Next, a "target" is selected: some event from the past that haunts him, or the current situation that serves as a subject of concern (phobias or anxiety attacks). By focusing on the painful situation, the client focuses on the therapist's hand moving from left to right. During each session, he must follow 15 such rhythmic movements, wide and precise (the span is about 1 m). In the pauses between exercises, you can talk about this event and evaluate the intensity of the emotion experienced about it. Classes are held until the client notices a decrease in the severity of the experience. During the procedure, the specialist also helps to form new, positive images instead of those associated with the trauma. The memory of the trauma does not disappear, but it stops hurting the person.
Indications for use
For those who experience severe post-traumatic stress (after a terrorist attack, violence or disaster), as well as in the case when an event in the past left a painful memory. This technique can also help with disorders such as drug addiction, anorexia, or depression. Contraindications: severe mental conditions, some diseases of the heart and eyes.
How long? What is the price?
DPDH is more often used in combination with other methods and helps to reduce the severity of the experience and speed up the healing process. DPDG is not used at the first meeting with the client: first, it is necessary to get an idea of the history of the disease and the nature of the symptoms. Sometimes one DPDG session is enough. A session lasts 1 hour and costs from 1500 rubles
“It happens that a certain force pushes us out of our usual life, forcing us to change,” says Francine Shapiro. “But changes can be so drastic and tragic as it happened to me that we ourselves are unable to cope with them.”
At 36, Francine, barely defending her doctoral dissertation in English literature, learned that she was sick with cancer. Operation, divorce from her husband, long treatment - all these events changed her life forever. The disease receded, but Francine seemed to have frozen between life and death: she was tormented by constant fears and obsessive disturbing thoughts, nightmares were haunted at night, and during the day everything fell out of her hands.
One day, while walking in the park, she noticed that some of the thoughts that constantly bothered her had disappeared. Focusing on them again, Francine realized ... she wasn't scared!
As a result of the exercise, the level of anxiety decreased, people could more realistically perceive what worried them.
“I was amazed: as soon as I returned to my disturbing thoughts, my eyes began to involuntarily move from side to side and diagonally up and down,” she recalls. “When I moved them deliberately, the pain from the hard memories disappeared. Moreover, the sensations and thoughts in the style of "I am powerless", "something is wrong with me" were replaced by others: "this is all in the past", "I have a choice."
Shapiro asked friends, colleagues, and participants in a psychological workshop she was attending to do the same exercise. The results were striking: the level of anxiety decreased, people were able to more realistically perceive what worried them. So by chance, in 1987, a new technique of psychotherapy was discovered.
This event prompted Francine Shapiro to receive a psychological education and defend a thesis in clinical psychology. For several years she has been working at the Institute for Brain Research in Palo Alto (USA). In 2002 she was awarded the Sigmund Freud Prize, the world's most important award in the field of psychotherapy.
Shapiro gave a detailed description of the unique psychotherapeutic technique, the DPDG technique, which is especially effective in treating emotional trauma, in the book “Psychotherapy of emotional trauma with the help of eye movements. Basic principles, protocols and procedures ”.
What is DPDG
DPDG (Eye Movement Trauma Desensitization and Treatment) is a psychotherapeutic technique that is most commonly used in the treatment of emotional trauma. Eye movements trigger the natural healing process of the human psyche. Since the traumatic event blocks the processes of her self-regulation, feelings, images, thoughts associated with a painful experience seem to "get stuck" in her. And thanks to DPDG, they begin to be rapidly processed.
DPDG as a way to deal with trauma
Francine Shapiro called her technique the Eye Movement Injury Desensitization and Treatment Technique (EMA). The word “desensitization” can be translated as “desensitization”. Psychotherapists around the world today, in addition to classical methods, use it in their work with those who have experienced emotional trauma, sexual abuse, the horrors of war, became a victim of a terrorist attack, natural disaster, and saw the death of other people.
“Such situations go beyond the ordinary human experience,” explains psychotherapist Natalya Rasskazova. "If such a traumatic event happened at a time when a person was especially vulnerable, his psyche cannot cope with this experience on its own."
Months and even years later, obsessive thoughts and painful memories may haunt him. Their images are so vivid that every time a person feels the realism of what is happening: he does not just remember, but again and again experiences the same horror, pain, fear and helplessness. The DPDG technique can improve the condition in just a few sessions. It also helps in the treatment of various phobias, addictions, depression, anorexia and even schizophrenia at the initial stage of this disease. There are few contraindications: severe mental conditions, some diseases of the heart and eyes.
How DPDG is used at work
Directional eye movement is at the heart of this technique. “Most of us find it difficult to voluntarily control the muscles responsible for eye movements,” explains Francine Shapiro. "It is easier to continue these movements, concentrating on the therapist's hand." He usually holds his fingers, pencil or ruler vertically, 30–35 centimeters from the patient's face. He, focusing on the painful memory or sensation and without interrupting the story, simultaneously watches the therapist's hand with his eyes.
Artem is 22 years old, ten years ago he was walking in the park with his mother and brother when they were attacked by hooligans. “All these years I was tormented by terrible memories,” says Artyom, “and I had the same nightmare: I’m trying to escape from something terrible, but I cannot budge and I feel that I am falling into some deep, narrow hole. ... I began to avoid communicating with new people, it seemed to me that everyone was looking at me with condemnation, as if they were saying: "You are nothing, you could not protect yourself and your family."
Thanks to the DPDG technique, memories are no longer accompanied by strong negative emotions
During the first meeting, the psychotherapist asked Artyom to recall the most terrible episode from that tragic day - when one of the attackers took out a knife. “I focused on this scene, following with my gaze the stick that the therapist held in front of my eyes from left to right. It seemed that I was about to, as it was before, begin to suffocate, but all the time I saw the therapist's hand, and it seemed to hold me back. A few minutes later, the therapist asked again about what I see and what I feel. I once again described the same scene, but I felt that the old emotions had disappeared: I didn't feel so much pain. "
“There is no magic here,” explains Natalya Rasskazova. - Artem continues psychotherapy, but the first meetings, at which the therapist worked with the help of the DPDG technique, made it possible to relieve the acuteness of the experience: in several sessions, the perception of what happened to him changed. His feeling "I am a coward and insignificance" was replaced by confidence: "It is not a shame to survive." Thanks to the DPDG technique, a tragic event becomes one of the many facts of a person's life, memories are no longer accompanied by strong negative emotions.
If working with eyes is difficult
For some eye conditions (for example, with severe myopia) or in a situation where observing the therapist's hand is associated with traumatic memories (for example, how parents beat the child in the face in childhood), the therapist uses hand tapping or sounds as a stimulus ... Taps on the hand are performed as follows: the patient sits down with his hands on his knees, palms up. The psychotherapist (with one or two fingers) alternately taps them rhythmically. During sound stimulation, he clicks his fingers at one or the other of the client's ear at about the same speed as during a series of eye movements.
The principle of operation of DPDG
There is no definite answer to the question of why this technique is so effective. Several hypotheses are studied and tested by psychologists and neuroscientists.
The first is the accelerated information processing model. Francine Shapiro suggests that the psyche, like the body, has an innate ability to self-regulate.
“The brain involuntarily processes all the information about what is happening to us, what worries and worries us,” explains Natalya Rasskazova. - It encodes data, neutralizes it and sends it for storage. This allows the psyche to adapt to a wide variety of situations. But physical and mental trauma, stress block the processes of natural self-regulation. Emotions, images, thoughts, sensations associated with painful memories seem to get stuck in the memory as they were at the moment of traumatic events. As a result, a person not only cannot forget them, but it becomes difficult for him to remember his positive feelings as well ”.
Eye movements activate natural healing by the forces of the body itself: they trigger processes that unblock the neural networks of the brain, in which the traumatic experience is "stored", and it begins to be rapidly processed.
Eye movements from side to side cause alternate activation of the hemispheres and synchronous processing of information
Francine Shapiro does not exclude that the DPDG technique also activates the processes in the brain that occur in it during the REM sleep phase, which is accompanied by active eye movement. At this moment, the brain processes the information received during wakefulness and stores it in memory.
In addition, research shows that the DPDG technique synchronizes the rhythms of the cerebral hemispheres.
“They process emotions in different ways,” continues Natalya Rasskazova. - The left hemisphere deals with what causes positive emotions, the right one processes negative experiences. If we direct our gaze to objects on our right, this will elicit a more positive emotional response than fixing our gaze on objects on the left. And eye movements from side to side cause alternate activation of the hemispheres and synchronous processing of information. "
Controversy around the DPDG
Since its inception, the DPDG technique has become the subject of active scientific controversy.
“Many professionals find it difficult to admit that our brains can be 'rebooted',” explains Jacques Roque, vice president of the French Association of Psychotherapists Practicing DPDG. Until now, psychoanalysts and psychotherapists have assumed that only words that one person uttered and another heard can heal.
Psychological problems were spoken about only in terms of meanings: for those who experienced trauma, it was an encounter with death. But today we understand that the biological work of the brain plays the most important role for healing: the psyche is inseparable from its neurological "carrier". It is possible to restart information processing, sometimes in exotic ways that contradict the conventional wisdom that it takes time to heal. Maybe it's just hard for us to come to terms with the fact that our brain, like any computer, lends itself to reprogramming?
Who can use this technique at work?
As with any psychotherapy, the client's condition can change between sessions. He may "come up" memories of other unpleasant events, for example, from early childhood. That is why the DPDG technique should only be used by psychotherapists or clinical psychologists who, if necessary, can provide emergency assistance, including medical.
“But even a well-trained technician cannot guarantee success when using the DPDG technique with every person,” warns Francine Shapiro. - It is not a panacea and is most often used in combination with other therapies. But, of course, the DPDG helps to relieve the acuteness of the experience in just a few meetings. "
Ecology of life. Psychology: An uncomplicated but rather effective technique by Francine Shapiro - the DPDG (desensitization through eye movement) method, initially worked well for psychotherapy of post-traumatic stress disorder. Sometimes, the DPDG technique is used independently, as a method of erasing emotional memories that bring mental suffering to a person.
Erasing negative emotional memories
EMDR (EMDR) is a quick and painless method of psychological assistance, thanks to which you can easily and reliably get rid of fears, anxiety, the consequences of trauma and negative attitudes towards life. The efficacy of EMDR has been scientifically proven through clinical research and MRI (magnetic resonance imaging) studies.
The EMDR method is based on the idea of bilateral stimulation:
- The movements of the eyeballs at a certain pace and according to a certain pattern stimulate the alternating work of different hemispheres of the brain.
- Rapid eye movements make one or the other hemisphere "turn on".
- This sequential work has a positive effect on the emotional state, eliminating and reducing the negative impact of traumatic events, fears and worries.
EMDR stands for Eye Movement Desensitization and Reprocessing. In Russian, the name of the EMDR - method is translated as "desensitization with the help of eye movements and reprocessing", or in short - "DPDG".
What is DPDG?
Like many other remarkable scientific discoveries, EMDR (DPDG) was discovered by accident. Clinical psychologist Francine Shapiro (USA) was very worried about the consequences of chemotherapy: not only her body suffered, but also her soul. The American was very nervous, worried and, of course, afraid. However, Frances noticed that her nervousness was significantly reduced, and her fear receded if she moved her eyeballs in a certain order. The psychologist became interested in this phenomenon and began to study it carefully.
In the course of scientific research, scientists explained the phenomenon of the positive psychological impact of special eye movements using the model of adaptive information processing.
What is this model?
Let's say you inadvertently touch a hot frying pan. It is painful and unpleasant. The memory of this event should be good for you: you will become more accurate, more prudent, more careful. Normally, this is adaptive, correct, information processing. Stress, malaise and other factors reduce our adaptability, and then information is not absorbed adaptively. For example, we begin to panic fear of all the pans, instead of adjusting our behavior based on experience.
Memory is a collection of neural connections. It is believed that the memory of a traumatic event can be "encapsulated": neurons form a capsule, and outside this capsule they do not interact. If the memory is encapsulated, the slightest reminder of the traumatic event is sufficient to elicit a powerful, often destructive emotional response. This reminder is called a “trigger,” a trigger that takes us back to the original experience of pain, fear, and disgust.
Let's give one more example. It was raining, it was slippery, the man was in a hurry, as a result he slipped and fell, broke his leg. The fracture has long and successfully grown together, but as soon as it rains, a wave of experiences rolls over a person: fear, severe pain, despair and a feeling of helplessness. Perhaps due to inadaptive processing of information, a neural capsule of the memory of the fracture was formed, and the rain became a "trigger" that triggers a strong emotional reaction.
Specially organized eye movements provide safe bilateral stimulation of the brain hemispheres, thereby destroying the neural memory capsule, which contains information about a tragic event or difficult experience. For simplicity, a neuronal memory capsule can be compared to a muscle spasm. EMDR helps to destroy this neural capsule, in the same way that a good professional massage helps to relax a muscle that is tightly compressed by a spasm. EMDR (DPDG) Is a kind of health-improving "massage for the soul" that removes pain and discomfort.
Uncomplicated, but quite effective Francine Shapiro technique - DPDG method(desensitization through eye movement), has initially proven itself well in psychotherapy for PTSD. Sometimes, the DPDG technique is used independently, as a method of erasing emotional memories that bring mental suffering to a person.
As can be seen from the figure, the method of DPDG, desensitization and processing of psychotrauma by eye movement, resembles the principles of NLP (Neuro Linguistic Programming), where each eye movement (gaze direction) is directly related to the human representative systems (vision, hearing, kinesthetics). However, the Shapiro method (DPDG) does not focus on human sensors (sense organs).
How to use the DPDG method on your own to recycle trauma, severe stress from the past
Experienced in the past serious stress, emotional distress, psychotrauma, such as, for example, rape, military action, natural disasters, accidents and disasters, leave a deep mark on the human psyche.
The DPDG method will help you erase emotional, traumatic memories on your own. by reworking them through eye movements into something neutral, or even positive.
DPDG is independently used in those cases when you clearly realize that the cause of your current (here and now) experiences, reactions to stress, fears and phobias ... and other neurotic conditions is psychotrauma, experienced severe stress from the past.
Applying the DPDG technique on your own - step by step instructions
So, to use the DPDG technique on your own, you need to sit comfortably against a free wall. You can turn on relaxing music, the lighting should not be bright, for better relaxation, you can breathe a little deep in your stomach.
Take a small flashlight or a laser pointer in your fingers, which you will drive along the wall opposite.
Prepare in advance your traumatic memory that you want to process by means of eye movement ("hanging" in a psychotrauma, in order to avoid activation of strong feelings, until it is necessary, just know what you will be working with).
There will be three steps in DPDG, by performing which you will be able to independently process your traumatic events from the past, thereby improving your psycho-emotional state in the present.
Step 1: Relaxing and directing a light pointer (flashlight) to the wall opposite, you, with a slight movement of some fingers (not the entire hand), slowly move the beam along the wall to the left-right (straight gaze), fix your eyes on the light spot and move them together with the beam - left-right ...
Your gaze is focused on the spot of light - this is the foreground. At the same time, try to see in the background, as if looking through the wall, what happened to you in the past. At the same time, processing psycho-traumatic information, imagining something neutral or positive in fantasy.
Continue doing DPDG for 3-5-10 minutes until you feel that the negative past gradually dissipates. turning into something normal.
Take a sharp deep breath, and look around the room, alternately focusing on different objects. Rate your emotional state on a 100% scale: 0 - no negative emotion at all - 100% - strong emotion.
You can move on to the next step after rest, or the next day, depending on your energy and emotionality.
Step 2: You do all the same, only the movement of the flashlight and with it the eye - in the form of a recumbent figure eight (infinity sign).
Step 3: The same DPDG technique, but the eye movements are now in a circle (counterclockwise).
Since you will apply the method of desensitization through eye movement on your own, it may not be possible to completely recycle the trauma and erase negative emotional memories the first time. Progress, of course, will be, but to completely recycle the stress from the past, it is worth repeating the DPDG technique again.
Also, you can ask a loved one to direct the flashlight beam for you, being behind you, out of sight, thereby freeing you from unnecessary psychoenergetic costs.
Attention! If you have had multiple traumas in the past, you should create a hierarchical list of problems before processing your emotions. And start working with the simplest stressful situations captured in the psyche. published by
(Eye Movement Desensitization and Reprocessing therapy, EMDR) was developed by an American Francine Shapiro and is very successfully used in the treatment of PTSD. In 1987, while walking, she noticed that eye movements reduced stressful memories.
The method is based on the idea that any traumatic information is unconsciously processed and absorbed by the brain during sleep- v REM sleep(other names: rapid eye movement sleep, REM sleep, REM from rapid eye movement). It is during this phase of sleep that we dream. Severe trauma disrupts the natural process of information processing, which leads to repeated nightmares with awakenings and, of course, distortions of REM sleep. Treatment with repeated series of eye movements unblocks and accelerates the processing of traumatic experiences.
Performed from 1-2 to 6-16 sessions of treatment lasting 1-1.5 hours. The average frequency is 1-2 times a week.
Standard desensitization and recycling procedure eye movements contains 8 stages.
1) Safety assessment
Psychotherapist analyzes the entire clinical picture and highlights the goals of treatment... Use the DPDH method only in those patients who are able to cope with the possible high levels of anxiety during the session. For this reason, the psychotherapist first helps to cope with current problems and only then tackles long-standing trauma. At the end, the future is also worked out by creating and fixing in the patient's imagination " positive example»Behavior.
At this stage, patients also teach to reduce stress levels by using:
- imaginations safe place,
- technicians luminous flux(presentation of a healing ray of light that enters the body),
- independent using eye movements or neuromuscular relaxation.
2) Preparation
Establish productive trusting relationship with the patient, explain the essence of the desensitization and processing method by eye movements. Figure out what types of eye movements of the proposed are the most comfortable for the patient. The appearance of pain in the eyes when performing movements requires immediate discontinuation of treatment with the consultation of an ophthalmologist to clarify possible contraindications to loads on the oculomotor muscles.
For testing the psychotherapist shows 2 touching fingers of his hand at a distance of 30-35 cm from the patient's face, and then, with gradual acceleration, moves the fingers left and right to the edge of the visual field. The optimal distance to the fingers, the height of the hand, and the speed of movement are selected (maximum is required, but without discomfort). If the patient is unable to keep track of the fingers or a malfunction occurs (stop, involuntary eye movements), it is usually sufficient for the patient to press their fingers against their closed eyes. Check the effectiveness of other eye movements - in a circle, diagonal, figure eight. Vertical eye movements (up and down) soothe and reduce anxiety, dizziness and nausea.
One eye movement is a full cycle back and forth. The desensitization and eye movement processing techniques use series of 24 movements, the number of which can be increased to 36 or more.
If eye movements are impossible or uncomfortable, use alternative stimulation methods:
- alternately tapping on the patient's kneeling and upward palms,
- alternately doctor snapping fingers near the ears.
To reduce anxiety, the patient is taught Safe Place technique... It is suggested to remember a calm place where he felt completely safe, and to focus on this image. The image is enhanced by the suggestion of the psychotherapist, as well as 4-6 series of eye movements. In the future, if necessary, the patient can on one's own return to safety in imagination.
It is also explained to the patient that he can interrupt the procedure at any time by raising your hand or giving another prearranged signal. This serves as an additional factor for patient safety.
3) Determination of the subject of influence
The psychotherapist defines target of impact... In PTSD, the goals of exposure can be a traumatic event, nightmares, and other experiences.
After choosing the target of exposure, the patient is offered pick an image that reflects the most unpleasant part traumatic event, and then asked to express in words painful self-images(in the present tense and on his own behalf), for example: “ I am nothing», « i did something bad», « i can't trust myself», « i don't deserve respect" and etc.
Next, you need to define positive presentation- what the patient wants to be at the present time, when he remembers the traumatic situation: “ I am good the way I am», « i can trust myself», « i control myself», « i did the best i could», « i can handle it". This positive idea is used later, in the 5th stage (installation). A positive self-image makes it easier to re-evaluate events correctly and contributes to a more adequate attitude towards them. The patient is invited to intuitively assess the adequacy of such a self-presentation using a 7-point score (SSP). If 1 (minimum) point is scored, meaning “ complete disagreement with the true image of yourself”, The psychotherapist must weigh the realistic wishes of the patient.
After that, the patient aloud calls negative emotions, which arise when he focuses on trauma and painful ideas about himself, and also assesses the level of anxiety by Subjective Anxiety Scale(SBR) from 0 (complete rest) to 10 points (maximum anxiety).
4) Desensitization
The goal is to reduce the patient's anxiety level.
At this stage, the patient should follow the movements of your fingers with your eyes psychotherapist, while remembering the most unpleasant part of the traumatic event and at the same time repeating to himself (not aloud) painful ideas such as “ I am nothing», « i did something bad". After each series of eye movements, the patient is told: “ Now rest. Inhale and exhale. Let everything go as it goes". Then they ask if there are any changes in visual images, thoughts, emotions and physical sensations (these are indicators of internal processing of psychotrauma).
Usually, alternating these series of eye movements with rest results in a decrease in emotional and physical stress, and memories become more comfortable. The goal of the desensitization stage is to reduce the patient's level of anxiety during the memory of trauma to a minimum level of 0 or 1 on the SBR (Subjective Anxiety Scale).
During treatment with desensitization and processing by eye movements, it is possible short-term amplification of negative emotions or response (abreaction). However, the response is slightly different than with hypnosis because the patient persists double focus(on psychotrauma and on a sense of security in the present) as opposed to complete immersion with hypnosis. During the DPDG session, registration occurs 4-5 times faster than in trance... If a response has begun, the therapist increases the number of eye movements to 36 or more in order to complete the response as possible during the current series.
If, after 2 consecutive series of eye movements, the patient does not feel any changes in thoughts and emotions, it is necessary change the direction of eye movements... The ineffectiveness of changing 2-3 directions of eye movement indicates blocked processing (additional strategies.
Additional strategies for blocked processing:
1) Change in direction, duration, speed, or span eye movements. It is more optimal to combine these techniques.
2) During the selection of eye movements, the patient is asked focus only on sensations in the body(without the image of trauma and positive self-presentation).
3) Stimulating the patient express suppressed emotions openly and move freely. In parallel, eye movements are carried out.
4) Pressure by the patient (finger, hand) in the place of discomfort, while negative sensations decrease or associative images appear, which are influenced in the future.
5) Focusing on another aspect of the event(think about another image of psychotrauma, change the brightness of the performance, repaint it in black and white). Or focus on the most disturbing sound stimulus.
6) Cognitive intertwining- combine the thoughts and feelings of the patient with the psychotherapist's auxiliary information. Various cognitive intertwining options are possible:
- the therapist explains to the patient correct understanding of past events and his role. The patient thinks about what was said during a series of eye movements.
- redefining the traumatic situation through addressing significant persons for the patient... For example, a participant in the hostilities felt guilty for the fact that his best friend in battle did not follow the command of the commander to duck and was killed, while the patient himself ducked and remained alive. The psychotherapist advised to think about what the patient would tell to do if the patient's 16-year-old son was in the friend's place. After answering "duck!" and a series of eye movements, the feeling of guilt was significantly reduced, and the study of the situation was completed.
- usage suitable analogies(metaphors) in the form of parables, stories or real life examples. The psychotherapist draws parallels with the patient's situation and provides hidden clues to solve the problem. This can be done both during a series of eye movements, or before it with a suggestion to ponder during the series.
- Socratic dialogue(named after the ancient Greek philosopher Socrates). During the conversation, the therapist consistently asks questions, leading the patient to a certain logical conclusion. After the suggestion to ponder, a series of eye movements are performed.
During the processing of the main psychotrauma in the patient's mind, additional negative memories... They should be made the subject of focus on the next series of eye movements. During the treatment of PTSD in combatants, it is necessary to process all the associative material (combat episodes, memories, sounds, sensations, etc.).
When all associations are revised, you should return to the initial goal(psychotrauma) to perform an additional series of eye movements. If within 2-3 episodes no new memories appear, and the level of anxiety according to the SSS is not higher than 1 point out of 10 (ideally 0 points), then proceed to the next (5th) stage - installation.
5) Installation
The goal is to increase and consolidate the patient's self-esteem by linking positive self-image with trauma.
After desensitization (stage 4), the patient is asked to recall his positive presentation(how he wanted to see himself in the 3rd stage) and ask if it works now. Many patients refine or even change the self-concept that is meaningful to them.
Then the patient is offered think about trauma taking into account the voiced positive self-image and answer how much it corresponds to the truth. The patient is asked to recall the trauma from the position of a positive self-image, while the psychotherapist conducts the number of eye movements required to consolidate the effect.
If the consolidation was crowned with complete success (7 points on a subjective 7-point The scale of correspondence of representations), then go to the stage of scanning the body (6th stage). If, due to incomplete processing of additional memories and negative beliefs, the desired (maximum) level of consolidation cannot be achieved, then the treatment of DPDH is postponed to the next session, and this one is completed (7th stage - completion).
6) Body scan
The goal is to eliminate residual discomfort in the body.
If the fixing at the installation stage was successful (6-7 points on a subjective 7-point scale), scan is performed. The patient is asked to close his eyes and, presenting trauma and positive self-image, mentally walk all parts of your body from head to toe.
Any places of discomfort or unusual sensations should be reported. If discomfort is found somewhere, it is worked through with new series of eye movements. If there are no sensations at all, then a series of eye movements are performed. When pleasant sensations arise, they are enhanced with an additional series of DPDG. Sometimes you have to go back several stages to work through new negative memories that have surfaced.
7) Completion
The goal is the patient's achievement of emotional balance, regardless of the completion of the processing of psychotrauma.
For this, the therapist uses hypnosis or the Safe Place technique(described in the 2nd stage). If processing is not completed, then after the session, an unconscious continuation of processing is likely. In such cases, the patient is advised to write down (remember) disturbing thoughts, memories and dreams. They can become new targets for exposure to DPDG sessions.
8〉 Revaluation
The goal is to test the effect of the previous treatment session.
Reevaluation is carried out before each new desensitization and processing session with eye movements. The psychotherapist evaluates the patient's response to previously revised targets... It is possible to rework new goals only after complete reworking and assimilation of the previous ones.
Features of the DPDG method in the treatment of combatants
Many war veterans suffer from excruciating feelings of self-blame in connection with their actions during hostilities. Need to explain to the patient:
- if the patient was really as bad a person as he thinks, then would not suffer so much... Conscience does not torment bad people for decades.
- suffering already will not help the victims in any way, but will greatly interfere with the full life of the survivors.
- painful symptoms of PTSD are the result of trauma being trapped in the neural networks of the brain, and treatment will help get rid of the "stuck" of the negative... It is important to pay attention to the fact that the acquired combat experience will be retained in memory, because the treatment is aimed only at getting rid of suffering and anxiety, and not at the loss of memory for military events. Treatment will help to live a more fulfilling life, give more opportunities to honor the memory of the victims and help former colleagues in difficult times.
Beyond self-blame, a big problem is outbursts of uncontrollable anger... They can lead to family breakdown and problems with the law. Treatment with a psychotherapist will help you better control your behavior. Additionally patients are educated:
- technique "Safe place",
- relaxation exercises,
- self-use of eye movements to calm down.
Treatment of PTSD patients with DPDH is highly effective and can completely eliminate unpleasant symptoms. It is possible to combine DPDG with other psychotherapeutic techniques, as well as with medications.
Using the DPDG method in the treatment of sexual dysfunctions
Minimum 11% former combatants need sexological help. In the presence of PTSD, this level is even higher, but most of them, for various reasons, do not go to a sexologist. Most common the following problems:
- anxious anticipation of sexual failure (psychogenic erectile dysfunction),
- the consequences of alcohol abuse,
- problems in relationships with people due to symptoms of PTSD.
Against the background of sexual failures, such people increase jealousy, a outbursts of anger are becoming more destructive and unpredictable. Based on the foregoing, the treatment of sexual dysfunctions should be included in the rehabilitation program for people with PTSD, which will allow them to increase their self-esteem, achieve psychological comfort and harmonize relationships in marriage.
You can help patients who:
- can't forget their failures in bed,
- received negative information about their potency,
- have false beliefs about sexuality,
- remember any events that cause anxiety and fear of intercourse.
2-6 sessions are carried out with a frequency of 1-2 per week. The duration of each is 1-1.5 hours.