EMDR for Travel Anxiety after RTA

Eye Movement Desensitisation and Reprocessing (EMDR) is a psychological treatment used for improving symptoms of post trauma sequeale. Whilst NICE recommends its treatment for PTSD, newer indications and it’s application as a treatment have increased over the years. Working as a Consultant Psychiatrist in Wales and as part of my medico-legal practice in Personal Injury, recently I have treated someone for Travel Anxiety following a RTA who had been struggling to pass a particular point on the road and had anxiety symptoms when on the road in general. The outcomes were very good as the EMDR phases were very useful and all the symptoms improved within 6 sessions. The desensitisation phase was one phase that was very useful to get past the particular point on the road for the patient and by the end of sessions, the patient had commenced driving, had gone past the struggling point, felt more relaxed on the road in general and scored 0 on all scales used in the therapy.

The crucial element was the use of ‘Eclectic’ tools to help the individual to regain control over the situation and in Neuroanatomical terms, what we now know in Trauma work is that once the ‘Chronic Hyperarousal’ is modulated and regulated, the symptoms begin to improve.

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PTSD- Big ‘T’ or small ‘t’ Traumas

How much force is required to crack an egg?
Many people still harbour this myth that PTSD cannot develop if the traumatic event was trivial. The personal meaning that is attached to the event is an important and fundamental aspect, so the individual’s integrity as a functional being becomes an issue of primacy or a forerunner for symptoms. Thus whether the event was a natural disaster, war (Big ‘T’ Traumas), abuse in its various forms (Big T or small ‘t’ traumas), RTA or something apparently trivial, if personal safety and integrity as a human being is endangered, the individual can become more vulnerable to develop PTSD. Of course there are other factors that may play a role as well such as pre- existing conditions and resilience factors to name a few.

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As a Consultant Psychiatrist practising in Cardiff and Bridgend with special interest in Trauma, I see a lot of patients for medico- legal purposes who suffer with psychological consequences of Trauma. The concepts of PTSD have gradually changed over the years and one common myth that PTSD can only occur in natural disasters has gradually disappeared. The trauma could be one occurring from events which are not natural disasters such as significant Road Traffic Accidents. In fact the new DSM (Diagnostic and Statistical Manual- Classificatory System of Disorders) working group has been looking at revising the criteria for PTSD and hopefully the DSM- V will incorporate these issues. As more research is happening, a new tool has been examined to screen PTSD as well, which hopefully should help in better management of patients suffering from this disorder.

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