Life Transformation - evidence-based

Evidence-based Psychotherapy
- Methods to enhance results from psychotherapy

Psychotherapy - Principles of Life Transformation
By George Hartwell M.Sc.
 
The anniversary is 100 years since Sigmund Freud first published his work. The cluster of events outlined here constitute a significant paradigm shifts in the theory and practice of psychotherapy.
 
In the last 40 years evidence-based psychotherapy has been established. There is now  much more hope that permanent changes and significant change can occur in psychotherapy.
 
To provide some background to these changes, let us remember that although Freud's thinking has infiltrated the mind-set of contemporary Western Thought, there has been much skepticism as to the therapeutic efficacy of psychoanalysis.
 
Some observe that persons with years of analysis gain great insight into their unconscious self, but significant change in their lives or personalities is not evident. Most therapists have come to believe that insight alone does not change lives.
 
Twenty years ago, researchers were ready to conclude that emotional learning was impossible to erase or change. Evidence seemed to show that emotion-based behaviour, even after strong efforts tried to change them, would return. Permanent change in root issues seemed out of our reach.
 
However, even researchers can change their mind. That is what happened in 2003 when experimental evidence showed that permanent change in memory, and especially emotional learning, was possible. A new science of Memory Reconsolidation emerged and outlined the specific conditions that, when met, produce permanent changes in emotional learning.
 
One book that outlined the details of Memory Reconsolidation with specific application to psychotherapy is Unlocking the Emotional Brain by Bruce Ecker, Robin Ticic, and Laurel Hulley (2012). The authors select existing therapies that meet or can be realigned to meet the specific conditions found in Memory Reconsolidation research.
 
Psychotherapy now can be accountable to empirical science. There are scientific principles to guide us in dealing with deeply rooted beliefs and memories. Footnotes #1
 
Psychotherapists can also now be confident that our efforts are not in vain. Permanent change in core issues has been proven to be possible. We can have hope in our enterprise.
 
Francine Shapiro discovers EMDR 
Then there is the strange case of EMDR - eye movements providing highly significant relief from PTSD. Francine Shapiro discovered and began testing Eye Movement Desensitization and Reprocessing (EMDR) in the 1980’s. The testing showed that more people cleared from PTSD after a major disaster  than any other therapy.
 
PTSD is a form of emotional learning that is normally resistant to change. From the start EMDR showed great promise in healing PTSD. In the initial studies, “84 to 90 percent of the people using EMDR-victims of rape, natural disaster, loss of a child, catastrophic illness, and other traumas-have recovered from post traumatic stress in only three sessions. Other psychological methods for healing trauma have achieved no more than a 55% success rate in seven to fifteen sessions.” (Shapiro, EMDR, page 5, 1997.)
 
 During the process of EMDR, which uses bilateral stimulation, core beliefs shift to a healthier form. Results are stable over time. 
 
The first book on EMDR - EMDR by Francine Shapiro and M. S. Forrest - was published in 1997. Footnote #2
 
Application to Christian Inner Healing 
For many years I made regular use of Christian prayer therapy in psychotherapy (when it suited the client.) Although there are now several models for doing this, early models were not aligned with the principles of Memory Reconsolidation. As a result the outcomes I saw were often not consistent with permanent emotional healing.
 
That changed when I adapted more recent models of prayer therapy, models that are aligned with the principles of Memory Reconsolidation. Now my clients reported faster and more permanent results.
 
Previous models involved identifying sinful life patterns, confessing those patterns and praying for the end of those patterns.
 
 The newer models of prayer therapy models are characterized by the practice of :

1. Discover and explore the root event/memory and the emotions connected with it. This ensures the emotional learning is activated.
2. Discover on the belief lodged in the memory and Express it in prayer.
3. Take time to listen / meditate. One option is to visualize an encounter with Jesus and asking him for God’s truth. Allow oneself to receive an epiphany - the revelation of God to you received when listening or visualizing.
4. Use the epiphany as the counteracting emotional truth as one would when following the guidelines of Memory Reconsolidation. This involves experiencing them alternately 3 or 4 times.
5. In the final step return to the original painful memory to assess if their has been significant change in the memory and the attitudes and feelings in it.

 
In this way Christian therapists who are familiar with the principles of Memory Reconsolidation align their Inner Healing or Prayer Therapy practice with principles based on research and can deliver permanent change to their clients. Memory consolidation provides evidence-based principles to be used in professional prayer therapy.
 
What are the evidence-based principles of Life Transformation based on the our present state of knowledge?

1. Deal with memories because emotional learning is embedded in our memories.
2. Deal with activated memories recalled with feeling not just factual memories.
3. Deal with the beliefs that are connected to the feelings in the memory. They create the deep foundations of our actions, attitudes and habits.
4. To change an activated memory and associated belief there must be another experience with an alternate perspective to initiate and bring about editing of the emotional learning.
5. When real change in an emotional memory has occurred it will be revealed by recalling the original memory and discovering changed perspectives.

 
In summary, psychotherapists are now able to facilitate significant emotional breakthroughs; core beliefs get permanently changed, personalities shift and we can observe an outcome that we can call Life Transformation - permanent and significant changes in behaviour and personality. This is accomplished by implementing the above principles. The exact implementation may differ within different therapeutic models and methods.
 
Footnote #1 Even well consolidated emotional learning is labile and subject to disruption when activated. When activated, and during the destabilized state, the de-consolidated target learning can be radically unlearned. As a result, the emotional learning no longer exists in the emotional memory. This is a transformational change in the acquired memory.
 This transformational change can occur to a destabilized memory if any one of the following occurs. 
1. if a second experience experience occurs that is a mismatch that contradicts the original learning, or
2. If EMDR is used to force processing, or
3. In Listening Prayer, if a divine revelation occurs that contradicts the initial learning.
 
Footnote #2  A review of studies by NIMH found “Seven of 10 studies reported EMDR therapy to be more rapid and/or more effective than trauma-focused cognitive behavioral therapy.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3951033/
 
A 2009 review of rape treatment outcomes concluded that EMDR had efficacy.  Vickerman, K. A.; Margolin, G. (2009). "Rape treatment outcome research: Empirical findings and state of the literature". Clinical Psychology Review. 29 (5): 431–448. doi:10.1016/j.cpr.2009.04.004. PMC 2773678. PMID 19442425.
 
Both a 2005 and a 2006 meta-analysis suggested that traditional exposure therapy and EMDR have equivalent effects immediately after treatment and at follow-up. Bradley, R.; Greene, J.; Russ, E.; Dutra, L.; Westen, D. (2005). "A multidimensional meta-analysis of psychotherapy for PTSD". The American Journal of Psychiatry. 162 (2): 214–227. doi:10.1176/appi.ajp.162.2.214. PMID 15677582.
 
A 2017 meta-analysis of randomized controlled trials in children and adolescents with PTSD found that EMDR was at least as efficacious as cognitive behavior therapy (CBT), and superior to wait list or placebo. Moreno-Alcázar, A.; Treen, D.; Valiente-Gómez, A.; Sio-Eroles, A.; Pérez, V.; Amann, B.L.; Radua, J. (2017). "Efficacy of Eye Movement Desensitization and Reprocessing in Children and Adolescent with Post-traumatic Stress Disorder: A Meta-Analysis of Randomized Controlled Trials". Frontiers in Psychology. 8: 1750. doi:10.3389/fpsyg.2017.01750. PMC 5641384. PMID 29066991.
 
Bio: George Hartwell M.Sc. Is a registered psychotherapist and one of the founders of the Life Transformation Group with office at #123 1454 Dundas Street East, Mississauga, Ontario, Canada. L4C 1L4. Www.Life-TransformationGroup.com, Phone 416-939-0544. Skype georgehartwell.