Interview with Javier Elcarte: what do we know about the trauma?
Trauma is one of the concepts belonging to psychology that arouse the greatest interest generated . Linked to emotional memory, it can end up damaging the quality of life for years because of events that happened long ago.
However, as mental health research evolves, forms of psychological intervention are emerging that help both to offer more well-being to patients and to understand the nature of this kind of disorders. The expert look directed towards the trauma is always interesting, because it allows us to get an idea of the way in which our experiences leave an emotional imprint on us.
- Related article: "Emotional memory: what is it and what is its biological basis?"
Interview with Javier Elcarte: discovering the trauma
In the following lines we interview Javier Elcarte, neuropsychologist and founder of the Vitaliza psychological center in Pamplona, Spain.
Q: Much is said about trauma and how it influences our lives, but what exactly is it?
From Vitaliza, we understand trauma as something that goes beyond the classic concept of post-traumatic stress. Indeed, trauma is spoken of when the person is a witness or experiences a frightening, dangerous or overflowing event.
Recently the concept of trauma has been imposed as something more complex. Van der Kolk and his collaborators express themselves in this line when they propose the concept of "Complex Posttraumatic Stress Disorders" or DESNOS (Disorder of Extreme Stress not Otherwise Specified).
For Van del Kolk Trauma Serious complex: "the experience of one or more adverse traumatic events, chronically and prolonged, in most cases of interpersonal nature, such as physical or sexual abuse, armed conflicts, community violence, etc. and with an origin in childhood. "
Q: What are their effects on the life of the person who suffers?
As I said, the classic post-traumatic stress disorder (PTSD) is a generalized concept in the clinic and among the population in general, as well as its effects, which can be divided into three groups; symptoms of reexperimentation (recurrent nightmares, intrusive memories, activation reactions when remembering trauma, etc.); avoidance symptoms (avoid anything that reminds of trauma, disconnection, hopelessness, amnesia, etc.); and symptoms of overactivation (startle response, insomnia, anticipatory worry, anxiety, etc.).
On the other hand, if we understand the trauma as a continuum, we would cover the whole spectrum, from trauma with a big "T", as explained in EMDR, that is, extraordinary and terribly traumatic life events, to trauma with a small "t", or another way, minor events of low intensity of stress, but which happen on a daily and repeated basis, giving rise to a daily exposure where the experience and the discomfort they generate are normalized. And of course all the possible combinations between both.
Obviously in this case, the effects of the complex trauma are deeper, insidious and persistent and are at the base of a multitude of disorders. According to Cook and collaborators, the complex trauma would be at the origin of Attachment Disorders, Madurative Delays at a Biological Level, Disorders of Affect Regulation, Dissociative Disorders, Behavior Disorder and Impulse Control. Difficulties at Cognitive Level and finally Low Estimation and Distortion of the Self. That is, a huge range of dysfunctions.
Q: How do you work in Vitaliza and what techniques do you use to treat trauma cases?
In our long trajectory of trauma approach, in Vitaliza we have been developing an integrated intervention, which includes a triangle with three vortices; the physiological regulation of the central nervous system through Biofeedback and Neurofeedback on the one hand, the development of resources of self-consciousness and relaxation through mindfulness or another, and to close the triangle, the intervention aimed at the integration of experiences that have led us to the symptomatology of the present through psychotherapies focused on the processing from the body, "botton-up" as EMDR, sensorimotor or others.
Therefore, generally, the therapeutic intervention is accompanied by individual bio-neurofeedback sessions and group minduflness sessions.
Q: Can you explain what Neurofeedback is?
Defining neurofeedback in a few lines is not easy. To talk about Neurofeedback is to talk about neurotherapy, a treatment that seeks to regulate or modify the function of the brain, acting directly on it. It does not address the psychological processes themselves, but the underlying neurobiological states.It seeks regulation of the CNS by means of equipment designed for it, with the consequent impact on the underlying psychological processes.
Technically, therefore, Neurofeedback is a training that acts on the electrophysiological activity that allows the person to be aware of their brain activity and modify it, achieving in a non-invasive way sustained improvements over time with problems of anxiety, stress, lack of concentration and / or memory, attention, hyperactivity, and many others.
Q: And EMDR therapy?
EMDR (Reprocessing and Desensitization Through Ocular Movement) is an integrative psychotherapeutic approach especially aimed at intervention with trauma. It is based on the theoretical model of the Adaptive Information Processing System according to which much of the psychopathology is due to experiences that exceed us well by intensity or continuity or both and that we are able to process them properly.
These incomplete or dysfunctional processing of traumatic or disturbing life experiences weaken the person's ability to integrate these experiences adaptively.
Technically, EMDR seeks to stimulate that adaptive processing system to reprocess and properly integrate such traumatic experiences through structured protocols that include eye movements or other forms of bilateral stimulation.
It is a patient-centered approach. In a way, the therapist stimulates the healing mechanisms that underlie the subject itself. Trauma in this sense would be a badly codified overflowing experience, and through the different phases of intervention, with EMDR the patient would access the processed wound in a dysfunctional way, and would incorporate new information or access information that he was not previously able to access , until integrating the traumatic or disturbing experiences.
Q: Are both Neurofeedback and EMDR effective for the treatment of any psychological disorder?
It is always good to remember that in psychotherapy there are no panaceas and that no intervention serves to alleviate all disorders, and in turn, that all interventions serve to alleviate some. The art of the therapist is to find the most appropriate form and intervention for each patient. Not everyone responds in the same way, knowing how to adapt to the patient and finding a way to reach it is the great challenge of any professional.
As for Neurofeedback, the research confirms it as an effective intervention with ADHD and epilepsy and this is confirmed by institutions such as the American Academy of Pediatrics and others. It is effective as we have already said in everything that has to do with anxiety, stress, lack of concentration and / or memory, attention and hyperactivity. There are encouraging signs also in autism, headaches, insomnia, substance abuse, chronic pain, etc.
As for EMDR, it is a psychotherapeutic model with enormous empirical evidence, in Spain several EMDR research studies have been carried out and are being carried out, among them the research carried out in the bipolar disorder that has had a great international recognition.
It is an approach of choice for numerous treatments, such as trauma (as is obvious), addictions, anxiety and panic, post-traumatic stress disorder, impulse control, psychosomatic problems, pathological duels, etc.
On the other hand, EMDR has been recognized as an effective treatment for PTSD (Post Traumatic Stress Disorder by the American Psychological Association (APA) as well as by the World Health Organization (WHO) and many other clinical guidelines.
Attachment trauma is not outside of this research work, specifically in our center, in Vitaliza, we are carrying out an investigation to check the synergies between both interventions, Neurofeedback and EMDR in abandonment trauma with adopted children.
Q: Do you think these techniques are known in our country? Is it necessary to inform the general public about its benefits?
At the level of disclosure, EMDR has more presence in our country than Neurofeedback, although in both cases there is still much work to be done.
Although the Bio and Neurofeedback already have a long journey, their landing in Spain definitely dates from a few years ago. In this sense the Spanish Society of Bio and Neurofeedback (SEBINE) was born, of which I am president, with the aim of providing this marvelous therapeutic tool with the necessary standards of empirical rigor and conveniently approved clinical practice.
With respect to EMDR, the work of the Spanish EMDR Association has been fruitful and tenacious. Today the association has almost 2000 members (all health) being one of the largest associations in Europe. It offers quality training endorsed and contrasted by thousands of health professionals.
