個人失落與EMDR之介入:個案研究
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2011
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本研究的目的在於探討EMDR療法對有個人失落之當事人的介入效果,藉由深入瞭解當事人在治療過程中的主觀經驗與改變歷程,試圖釐清EMDR療法如何幫助當事人走出個人失落,展現自信與活力。研究者邀請一位願意分享個人生命經驗與EMDR治療經驗的研究參與者,利用半結構式訪談大綱進行訪談,並在研究參與者的同意之下,取得相關治療紀錄。研究者將各類資料彙整後,將研究參與者的生命經驗撰寫為一治療案例,呈現研究參與者接受EMDR療法的經驗。隨後研究者將相關資料進行分析,歸納研究參與者在EMDR治療介入過程中的改變歷程,並進行競爭性解釋之討論。
本研究的研究結果如下:
一、本治療案例之當事人,接受EMDR治療介入為期約12個月、共42次的療程,期間透過EMDR處理11項事件,當事人身心不適之症狀大部分已獲得改善。其後在當事人的要求下進行為期約6個月的後續追蹤。
二、在EMDR治療介入過程中,採BLS處理事件時,當事人的(1)負向認知想皆由正向認知或新詮釋取代;(2)負向情緒大部分能全數消除,或由負向情緒轉為正向情緒;(3)身體不適的感受大多能獲得紓解,進入放鬆而舒服的狀態。
三、當事人在EMDR介入後,對過去的失落經驗已能釋懷,對自己充滿信心,情緒轉為穩定,並能主動維繫夫妻關係。當事人的解離症狀與各種生理不適的症狀幾乎完全消失,在工作上感到游刃有餘,並能運用各種方法安撫自己。
四、本研究無法完全排除其他心理治療介入與精神醫療介入對當事人身心狀態轉變之影響,可看見不同領域的心理助人工作者齊頭並進的幫助當事人。
針對本研究之結果,研究者進行以下討論:(1)失落經驗影響當事人的內在運作模式,進而改變其行為反應;(2)本研究之治療案例,突顯個體適應中年期之重要性;(3)當事人經由身心症狀反映自我保護的需求,治療師對當事人身心症之處遇,符合Van Rood與De Roos(2009)之觀點;(4)治療師是當事人重要的情感支持來源;(5)本研究治療案例之EMDR介入過程,治療師對當事人解離症狀的處遇,符合Forgash與Knipe(2008)、以及Van der Hart、Nijenhuis與Steele(2006)對治療解離症狀的觀點;(6)本研究之EMDR介入過程中,當事人自覺身心不適症狀獲得紓解,生活適應功能逐漸恢復;(7)依據研究結果與上述討論內容,建立本研究之邏輯模型。最後研究者依據上述研究結果與討論,針對未來研究及實務工作提出進一步建議,以供參考。
The purpose of this study is to explore the treatment outcomes from the intervention of Eye Movement Desensitization and Reprocessing (EMDR) with personal loss. Through in-depth understanding of the client’s subjective experiences and changing courses throughout the entire therapeutic process, the researcher intends to prove that EMDR therapy has efficaciously helped the client overcome the trauma from personal loss and regain confidence and vitality. The researcher has interviewed a client who is willing to share his life and EMDR therapy experiences through a semi-structured questionnaire. With the client’s permission, the researcher has obtained the client’s clinical records. After methodically synthesizing the various data, the researcher has developed a case description presenting both the life experience and the intervention of EMDR therapy of the client. The researcher has analyzed the data, generalized the client’s adaptive coping processes throughout EMDR therapy and discussed the effects from the psychiatrist’s and other counselors’ interventions. The research has found that: 1.The client underwent eleven out of forty-two sessions with the intervention of EMDR therapy over a twelve-month period and achieved substantial relief. Upon the client’s request, a follow-up tracking has proceeded for six months. 2.During the EMDR therapy process, the client was helped through the bilateral stimulation (BLS) to deal with the trauma, and the client’s (1) negative cognition either turned to positive or was replaced by new interpretations; (2) negative emotions were removed or turned to positive; and (3) physical symptoms were eased, which provided relief and comfort to the client. 3.After the intervention of EMDR therapy, the client has become able to accept his personal loss, felt confident in himself, and been stable in emotion, as well as has maintained his marital relationship wholeheartedly. Relieving from the dissociation and physical symptoms, the client feels competent on his job and can now use a variety of ways to comfort himself. 4.The research cannot completely eliminate the effects from the interventions of psychological and psychiatric therapies. As a result, the research indicates that helpers from different domains all work hard to help the client. Based on the findings, the researcher proposes the following analyses: 1.The experience from personal loss influences the client’s internal function model and thus transforms the client’s behavior. 2.The case study illustrates the importance of adaptation in the middle age. 3.The somatic and psychological symptoms reflect the client’s needs for self-protection. The intervention of EMDR therapy thus fits Van Rood and De Roos’s perspectives (2009). 4.The EMDR therapist is an important emotional-support source for the client. 5.During the intervention of EMDR therapy, the therapist’s handling of the client’s dissociative symptoms fits the perspectives of Forgash& Knipe (2008) and Van der Hart, Nijenhuis, & Steele (2006) in treating dissociation. 6.During the process of EMDR therapy, the client feels relief from his somatic and psychological symptoms and regains his life function. 7.The researcher has established a logical model for the intervention of EMDR therapy in the cases of personal loss. In conclusion, based on the research outcomes and analytic discussion above, additional suggestions for future research and practice are proposed.
The purpose of this study is to explore the treatment outcomes from the intervention of Eye Movement Desensitization and Reprocessing (EMDR) with personal loss. Through in-depth understanding of the client’s subjective experiences and changing courses throughout the entire therapeutic process, the researcher intends to prove that EMDR therapy has efficaciously helped the client overcome the trauma from personal loss and regain confidence and vitality. The researcher has interviewed a client who is willing to share his life and EMDR therapy experiences through a semi-structured questionnaire. With the client’s permission, the researcher has obtained the client’s clinical records. After methodically synthesizing the various data, the researcher has developed a case description presenting both the life experience and the intervention of EMDR therapy of the client. The researcher has analyzed the data, generalized the client’s adaptive coping processes throughout EMDR therapy and discussed the effects from the psychiatrist’s and other counselors’ interventions. The research has found that: 1.The client underwent eleven out of forty-two sessions with the intervention of EMDR therapy over a twelve-month period and achieved substantial relief. Upon the client’s request, a follow-up tracking has proceeded for six months. 2.During the EMDR therapy process, the client was helped through the bilateral stimulation (BLS) to deal with the trauma, and the client’s (1) negative cognition either turned to positive or was replaced by new interpretations; (2) negative emotions were removed or turned to positive; and (3) physical symptoms were eased, which provided relief and comfort to the client. 3.After the intervention of EMDR therapy, the client has become able to accept his personal loss, felt confident in himself, and been stable in emotion, as well as has maintained his marital relationship wholeheartedly. Relieving from the dissociation and physical symptoms, the client feels competent on his job and can now use a variety of ways to comfort himself. 4.The research cannot completely eliminate the effects from the interventions of psychological and psychiatric therapies. As a result, the research indicates that helpers from different domains all work hard to help the client. Based on the findings, the researcher proposes the following analyses: 1.The experience from personal loss influences the client’s internal function model and thus transforms the client’s behavior. 2.The case study illustrates the importance of adaptation in the middle age. 3.The somatic and psychological symptoms reflect the client’s needs for self-protection. The intervention of EMDR therapy thus fits Van Rood and De Roos’s perspectives (2009). 4.The EMDR therapist is an important emotional-support source for the client. 5.During the intervention of EMDR therapy, the therapist’s handling of the client’s dissociative symptoms fits the perspectives of Forgash& Knipe (2008) and Van der Hart, Nijenhuis, & Steele (2006) in treating dissociation. 6.During the process of EMDR therapy, the client feels relief from his somatic and psychological symptoms and regains his life function. 7.The researcher has established a logical model for the intervention of EMDR therapy in the cases of personal loss. In conclusion, based on the research outcomes and analytic discussion above, additional suggestions for future research and practice are proposed.
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Keywords
EMDR, 失落, 解離, 個案研究, EMDR, loss, dissociation, case study