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Abstract - The Distancing Approach

Sails

Presented by C Paula Krentzel. PhD and Jennifer Tattersall, LCSW

 

The Distancing Approach was initially developed using EMDR targets that had an over-importance of thoughts, the need to control thoughts and the thought-action fusion. It also targeted the misinterpretation of sensation as predictive of future catastrophe.  

The goal of this technique is for the client to become a detached observer to his/her thoughts, sensations, images, and/or urges.  For example, to understand that the obsession is a thought and not real, to gain distance from the thought, and put it aside.   

 

Interweaves, which come from the client’s own words as expressed in the Preparation Phase, are used in the EMDR protocol to process the initial, worst, most recent and current triggers. 

The types of interweaves created by clients are reviewed in detail.  When appropriate, patient cases are examined to highlight how different interweaves are useful in all phases of Distancing.

The presentation goes through all phases of EMDR treatment and uses videos to demonstrate the technique as well as a practicum for participants to practice the Distancing Approach. 

 

The Distancing Technique was developed to enhance the treatment of OCD and anxiety disorders with EMDR. Incorporating Ego State Theory with Distancing the clinician is able to address various parts of the personality and inner conflicts which interfere with treatment.

The presentation reviews Ego State Theory and highlights how to identify a client’s internal conflict, that is, conflicting ego states and/or blocking beliefs. In turn, the presentation instructs participants in how to resolve these conflicts or beliefs such that the therapy can proceed more smoothly. The presentation uses video to demonstrate the resolution conflicting ego states. The video demonstrates the use of Ego State Theory and Distancing with a client diagnosed with dissociative identity disorder (DID).

Knowledge of Ego State Theory and The Distancing Technique are prerequisites for attending this presentation.

 

Abstract   Dual Treatment - OCD and PTSD

Eye Movement Desensitization and Reprocessing (EMDR) is a promising form of treatment for obsessive-compulsive disorder (OCD) (Talbot, 2021). EMDR has been identified as one of the treatments for PTSD with solid research findings. The prevalence OCD onset following potentially traumatic exposure ranges from 30% to 82% (Cromer, et. al., 2007).  Due to the potentially high incidence of developing OCD following a traumatic experience it is essential that clinicians understand the comorbidity between OCD and PTSD symptoms and the difference in the presentations. An example of overlapping symptoms is the urge to reduce anxiety and increase a sense of safety. In addition, avoidance and rituals are present in the behavior of clients with both diagnoses. Studies have suggested that PTSD symptoms decrease as OCD symptoms increase during treatment. The reverse also occurs, there can be a decrease in PTSD with an increase in OCD symptomatology.

This presentation will identify the most common subtypes of OCD; the aggressive dimension, sexual-religious dimension, and the contamination-cleaning dimension. The presentation supplies comprehensive interview questions to use during the assessment phase to determine if the PTSD is fueling the OCD or vice versa. In addition, case conceptualization on when to treat the OCD or the PTSD initially and when to engage in concurrent treatment is reviewed. Understanding how to identify the themes underlying trauma-based OCD can be a complicated and challenging process for both the client and the therapist. Presentation participants will leave the training with new skills to tease out the complex factors in this dual focus treatment.

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