EMDR研究 第7巻 第1号 2015年5月

抄録：本研究は，日本EMDR学会第9回学術大会で行われた「発達障害で二次障害を負った子への支援─EMDRの役割」と題したシンポジウムを元に，その内容を再構成したものである。本稿では，障害特性のために不快な体験がトラウマ化しやすい自閉症スペクトラム障害を中心に取り上げた。まず，彼らの認知的個性を理解する必要性が論じられた。続いて，支援の在り方として，⑴発達や多様な認知的個性にあう配慮・教育・支援の重要性，⑵とくに，構造化，視覚化，スケジュールなどの重要性，および，⑶認知修正，（EMDRなどを含む）トラウマ治療が，必要性に応じて有効になることが強調された。最後に，二次障害を負う発達障害への支援では，5つの視点と5つの手続きで各事例を整理することが提案された。ここで整理し，提案される手順で進める中で，治療者がEMDRを位置づける必要性について論考された。
EMDR研究，7 ; 3-15, 2015
キーワード：発達障害，二次障害，認知特性，EMDR

abstract
The Supports to Children Who Suffered from Secondary Problems or
Comorbidities with Developmental Disorders : The Role of EMDR
─Looking Back to the Symposium of 9th JEMDRA─
Arifumi Yukita＊1, Tsutomu Hanazono＊2, Masayoshi Ogura＊3
　In this paper, we reconstructed the contents of symposium entitled “The Supports to Children that suffered from Secondary Problems or Comorbidities with Developmental Disorders ─The Role of EMDR” which was held at 9th JEMDRA Meeting. This paper focused on children’s autism spectrum disorder which had the properties of easily traumatized because of this disorder. First of all, we discussed about the necessities of understanding their cognitive individualities. Secondary, we emphasized（1）the importance of the appropriative attention, education and supports according to their cognitive individualities,（2）especially the importance of structured, visualized and scheduled supports, and that（3）cognitive modification or treatment of traumatic disorders（e.g., EMDR）would be effective, if necessary. Finally, in case of interventions to children that suffered from secondary problems or comorbidities with developmental disorders, we suggested to organize each case in five perspectives and five procedures. We discussed that it would be necessary for therapists to position EMDR in the holistic treatment plan with these perspectives and procedures.
Japanese Journal of EMDR Research & Practice, 7 ; 3-15, 2015
Key words：developmental disorder, secondary disorder, cognitive individuality, EMDR
＊1 ‌Arifumi Yukita：Kyoto-shi Child Well-being Center, 910-25 Takeyamachi-Senbon-higashiiru-Shuzeicho, Kamigyo-ku, Kyoto-shi, Kyoto, 604-0802 Japan.
＊2 ‌Tsutomu Hanazono：Shiga Medical Center for Children.
＊3 ‌Masayoshi Ogura：Naruto University of Education.

抄録：「安全な場所」はEMDRにおいて最もよく使われる安定化アプローチの１つである。本研究では「安全な場所」において安全感が構築されない者の特徴を検討することを目的とした。11名の心的外傷性症状を有する患者を対象とした。「安全な場所」により安全感が構築された群（7名）と安全感が構築されなかった群（4名）の「安全な場所」の内容を比較した結果，後者の「安全な場所」は視覚イメージがシンプルかつ静的であり，聴覚，触覚などのイメージも伴わず，身体感覚も賦活されにくいことが示された。また，安全感が構築されにくい群には2つのタイプがあり，イメージ全般が抑制的で安全感が獲得されないタイプと，不快情動が混入するが故に安全感が得られないタイプに分けられた。両者の心理検査の結果を比較したところ，前者は情動や思考が抑制的で自分の状態に気がつきにくく，後者は思考や情動が活性化されやすいが肯定的情動に否定的情動が混在しやすいことが示された。EMDR研究，7 ; 16-25, 2015
キーワード：「安全な場所」，安定化，アセスメント，DES，ロールシャッハ・テスト

abstract
Characteristics of Clients Unable to Construct a Feeling of Safety in Their “Safe Place”
Sanae Aoki＊
　The “safe place” is one of the most common stabilization approaches used in EMDR. The objective of this study is to consider the characteristics of clients who are unable to achieve a sense of safety in their safe places. Eleven persons with symptoms of psychic trauma were the subjects. The “safe places” of the group able to achieve a feeling of safety （7s） were compared with those of the group unable to achieve it （4s）. Results show that the latter had “safe places” that were simple and static. There were no sounds or tactile images, and thus no actively physical sensations. Further, this group lacking a feeling of safety consisted of two types. The first had overall suppressed images that failed to evoke a feeling of safety, and the second had unpleasant emotions mixed into their images that prevented a sense of safety. When the psychological tests of these two types were compared, the first had suppressed emotions and thinking, making it difficult for them to realize their conditions. The second type had more active emotions and thoughts, but they tended to get negative emotions mixed in with positive ones.
Japanese Journal of EMDR Research & Practice, 7 ; 16-25, 2015
Key words：“safe place”, stabilization, assessment, DES, Rorschach test
＊1 University of Tsukuba. 1-1-1, Tenno-dai, Tsukuba, Ibaraki, 305-8574 Japan.

抄録：職場のメンタルヘルス問題は予防医学の視点から介入が行われており，近年では主にうつ病患者を対象とした職場復帰支援が試みられているが，まだ試行錯誤の段階である。本稿では抑うつ状態を呈して出勤不能となり休職療養となった従業員に対しEMDRを行った結果，症状が軽快し，復職と職場再適応が可能になった事例について報告する。本事例に基づき，職場不適応とトラウマ，およびEMDRの適用について考察する。
EMDR研究，7 ; 26-36, 2015
キーワード：職場不適応症，職場復帰支援，仕事関連性トラウマ，EMDR

abstract
Application of EMDR to a Person with Occupational Maladjustment Syndrome
Kuniharu Ogawa＊
　An intervention for mental health problems at the workplace has been conducted from the perspective of preventive medicine. Recently, support has been provided mainly for those who return to work after suffering from depression. However, such support is still provided on a trial and error basis. This paper reports a case of an employee who had a depressive state and became unable to go to work and took sick leave for medical treatment. Eye Movement Desensitization and Reprocessing （EMDR） was applied to the employee and the symptoms improved. As a result, this person was able to get back to work and become readjusted to the old job. Based on this case study, the application of EMDR to job maladjustment and trauma is discussed.
Japanese Journal of EMDR Research & Practice, 7 ; 26-36, 2015
Key words：occupational maladjustment syndrome, supporting return to work, work related trauma, EMDR
＊ Seinan Gakuin University. 6-2-92 Nishijin, Sawara-ku, Fukuoka, 814-8511 Japan.

抄録：本論文では，スクールカウンセラー（以下SC）が登校困難な中学2年生女子に対して学校内の相談室でRDIを実施し教室復帰が可能となった事例について報告する。本事例は，中学2年生の6月頃から頭痛がみられ，夏休み明けには学校に対する漠然とした不安・恐怖感が出現し登校困難となった。その後，SCとの面接の中でEMDRの一技法であるRDIを用いて自我強化と情動の安定化を実施した。RDI実施後に，段階的に現実曝露を実施した結果，徐々に教室へ行ける回数が上昇し，中学3年生の4月以降は，完全に教室復帰が行なえた。RDIは，標準EMDRプロトコルの脱感作の手続きまで進まないため，除反応が生じる可能性が低く，侵襲性も少ないのでスクールカウンセリングにおいて安全に用いることができる介入法であることが示唆された。
EMDR研究，7 ; 37-43, 2015
キーワード：RDI，情動調整，セルフコントロール，セルフエフィカシー

abstract
Examining the Effectiveness of RDI in School Counselling
Mayuko Koyama＊1, 2, Akiko Kikuchi＊1
　In this study we will report on the case of a second grade junior high school student girl who had difficulty going to school but was able to return back to school after receiving RDI in the school consultation room by a school counsellor （SC hereafter）. The subject had symptoms of headache since June in her second year at junior high school and after the summer vacation a vague uncertainty and fear towards school emerged and it became difficult for her to go to school. In the sessions with the SC, one technique of EMDR called RDI was used for ego strengthening and emotional stabilization. After implementing RDI and carrying out graded in vivo exposure, the number of times she was able to go to school gradually increased and after April in her third year she was able to return back to school fully. RDI was found to be an intervention which can be used safely in school counselling with its low occurrence of abreaction and minimal invasiveness since it does not progress to the desensitization phase of the standard EMDR protocol.
Japanese Journal of EMDR Research & Practice, 7 ; 37-43, 2015
Key words：RDI, affect regulation, self-control，self-efficacy
＊1Mayuko Koyama, Akiko Kikuchi：National Institute of Mental Health, National Center of Neurology and Psychiatry. 4-1-1 Ogawahigashi-machi, Kodaira-shi, Tokyo, 187-8553 Japan
＊2‌Mayuko Koyama：medical corporation, Futakotamagawakokorono clinic.

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