Putting a Human Face on AIP
Francine Shapiro, Ph.D.
The adaptive information processing (AIP) model that guides EMDR therapy was formulated in the early ‘90s and described in detail when the first textbook appeared (Shapiro, 1995). One of the guiding tenets was that a wide range of disturbing life experiences could have effects similar to those of major trauma, and result in lasting negative impacts upon self and psyche. It was also maintained that these disturbing unprocessed events were the foundation of a wide range of diagnoses.
In support of these tenets, research has now indicated that general life experiences can cause even more posttraumatic stress symptoms than major trauma (Mol et al., 2005). Other research has revealed wide spread mental health implications, including: “Harsh physical punishment [i.e., pushing, grabbing, shoving, slapping, hitting] in the absence of child maltreatment is associated with mood disorders, anxiety disorders, substance abuse/dependence, and personality disorders in a general population sample” (Affifi et al., 2012); “Exposure to adverse, stressful events . . .has been linked to socioemotional behavior problems and cognitive deficits.” (Obradovic´, et al., 2010); “ . . . childhood adversity is strongly associated with increased risk for psychosis” (Vares et al., 2012).
These studies have contributed greatly to our knowledge base. However, I believe the most important research on this topic is the adverse childhood experience (ACE) study by Felitti et al., (1998). The survey examined patients in the Kaiser Permanente Medical Care system and “ . . . found a strong dose response relationship between the breadth of exposure to abuse or household dysfunction during childhood and multiple risk factors for several of the leading causes of death in adults.” While this research had been largely ignored for a decade, it has recently been garnering greater attention.
While clinicians trained in EMDR therapy through programs certified by national associations such as EMDRIA are well versed in AIP and its clinical implications, the general public and medical practitioners are in need of additional education on this important topic. EMDR therapy and trauma-focused CBT are the only research supported treatments of trauma. However, EMDR therapy offers focused treatment of unprocessed memories without the need of detailed description of the trauma, reliving of the event or daily homework (Shapiro, 2012). A recent meta-analysis has also demonstrated the significant effects of the eye movement component in both clinical and laboratory randomized trials (Lee & Cuijpiers, 2013). However, misinformation about the therapy and ignorance about the pronounced effects of unprocessed memories of adverse life experiences still abounds. How many people are medicated for conditions you know could be helped through EMDR therapy? How many children are being derailed through drugs that treat anxiety and sleep disturbances, rather than being liberated through memory processing? The work of EMDRIA, the EMDR Research Foundation and HAP, in addition to conference and local presentations by those who practice EMDR therapy, are vital keys to the education process.
As therapists you save lives daily. Research evaluation that substantiates clinical observations can open the doors to ensure that all can be treated. The letter below, written by a patient, puts a human face on the intensity of the needless suffering caused by the lack of understanding, and highlights the important role that the EMDR therapy community can play in both clinical and research outreach. While EMDR therapy is not mentioned in the letter, we all know the power of its focused treatment approach. Although other approaches helped her during her painful five-year journey of recovery, imagine how treatment would have proceeded if you were conducting EMDR therapy with her. Also imagine what the world would be like if all physicians and laypeople were educated about both the negative effects of these unprocessed adverse life experiences and the potential for healing.
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Afifi, T.O., Mota, N.P., Dasiewicz, P., MacMillan, H.L. & Sareen, J. (2012). Physical punishment and mental disorders: Results from a nationally representative US sample. Pediatrics, 130 DOI: 10.1542/peds.2011-2947
Lee, C.W. & Cuijpers, P. (2013). A meta-analysis of the contribution of eye movements in processing emotional memories. Journal of Behavior Therapy & Experimental Psychiatry, 44, 231-239
Felitti, V. J., et al. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The adverse childhood experiences (ACE) study. American Journal of Preventive Medicine, 14, 245–258.
Mol, S. S. L., Arntz, A., Metsemakers, J. F. M., Dinant, G., Vilters-Van Montfort, P. A. P., & Knottnerus, A. (2005). Symptoms of post-traumatic stress disorder after non-traumatic events: Evidence from an open population study. British Journal of Psychiatry, 186, 494–499.
Obradovic´, J., Bush, N.R., Stamperdahl, J., Adler, N.E. & Boyce, W.T. (2010). Biological sensitivity to context: The interactive effects of stress reactivity and family adversity on socioemotional behavior and school readiness. Child Development, 1, 270–289.
Shapiro, F. (1995). Eye movement desensitization and reprocessing: Basic principles, protocols and procedures. New York: Guilford Press.
Shapiro, F. (2012). EMDR therapy: An overview of current and future research. European Review of Applied Psychology, 62, 193-195.
Varese et al. (2012). Childhood adversities increase the risk of psychosis: A meta-analysis of patient-control, prospective- and cross-sectional cohort studies. Schizophrenia Bulletin, doi:10.1093/schbul/sbs050