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Ibn Sina (Avicenna) is primarily known for his philosophy and medicine, but there is almost no scientific discipline in which this great man didn't leave a significant mark. This paper gives a brief overview of his contribution to medicine and psychology through which his unique scientific and religious approach to the study of the phenomena of human being can be best seen. Medical works of Ibn Sina represent a pinnacle of most important medical achievements of his time. These works contain synthesis of all Greek, Indian and Iranian medical schools, but also new breakthroughs achieved by Muslim scholars through their own experimentation and practice. Although he wrote many medical works, his most important one is El-Kanun fit-tib, which can be translated as The Canon of Medicine. It's made out of five books which systematically show everything known in the area of medicine up until that point in time. In it, Ibn Sina discusses, among other things, the structure of psychological apparatus of human being and the connection of psychological functions with the brain. He considered psychology to be very important for medicine, so in his psychological works he discusses, in great detail, the essence of human soul, consciousness, intellect and other psychological functions. He observed a man in his entirety, taking into consideration all aspects of his existence, paying special attention to spiritual knowledge and spiritual perfection, religiosity, and methods of achieving inner peace and well-being.
Eye Movement Desensitization and Reprocessing (EMDR) therapy is an integrative psychotherapy approach that has been extensively researched and proven effective for the treatment of trauma. EMDR is a set of standardized protocols that incorporates elements from many different treatment approaches. As EMDR is a mental health intervention, it should only be offered by properly trained and licensed mental health clinicians (Anonymous 2018). An EMDR International Association (EMDRIA) approved EMDR Training provides trained clinicians with the knowledge and skills to utilize EMDR therapy, a comprehensive understanding of case conceptualization and treatment planning, and the ability to integrate EMDR therapy into their clinical practice. Also, an EMDRIA approved EMDR Training provides, at a minimum, instruction in the current explanatory model, methodology, and underlying mechanisms of EMDR through lecture, practice, and integrated consultation. While the EMDRIA Approved EMDR Training Curriculum outlines the minimum requirements which need to be met, the developer of a specific curriculum can enhance or expand any portion as they see fit. This minimum training requirements include: 20 hours instruction material, 20 hours supervised practicum, and 10 hours consultation. Supervised Practicum which needs to be realized in 20 hours has the goal to facilitate the demonstration and practice of the EMDR therapy methodology by trainees (Ališahovi -Gelo 2017, 2018). One cohort consisted of three parts of EMDR training. The first level was realized through three days where trainees were introduced to basic principles of EMDR therapy in interactive lectures about the history of EMDR, eight phases of EMDR protocol, practicing in a small group, in couples and triads under the supervision of trainer and facilitators. The second part of training is intermediate level, and it consisted of practicing of eight phases of EMDR protocol, practicing in small groups, in couples and triads under the supervision of trainer and facilitators, additional theoretical learning, with supervision of case reports that trainees brought from their practice after the first level. Finally, the third part of EMDR training needs three days for realization where trainees were introduced to advanced principles of EMDR therapy and work with the complex medical conditions in interactive lectures following the eight phases of EMDR protocol, practicing in small groups, in couples and triads under supervision of trainer and facilitators, with group supervision of case reports that trainees brought from their practice after the intermediate level. For those who completed all three theoretical parts of EMDR training, they accomplished the condition for the process of supervision, whether in person or by Skype, for acquiring accreditations for European accredited EMDR practitioners, which lasts a minimum of two years under the supervision of accredited EMDR consultants, accredited from EMDR Europe (Hasanovi et al. 2017, 2018). The aim is to describe some personal impressions and self-experience gained during EMDR training and 18 implemented group supervision.
Anxiety is generally defined as a response of the human body to danger or threat. It usually occurs when, on the one hand, a person does not expect that in the future everything will be alright, and on the other hand, does not feel ready for such a future. It can be more precisely defined as a feeling of apprehension, which occurs as a response to a threat that a person considers vital for his/her existence. Anxiety is an unpleasant emotion of fear and apprehension. The main difference between fear and anxiety is that, with fear, there is a real threat in the present. Whereas with anxiety, this threat is anticipated in the future. The purpose of anxiety is explained with the evolution theory (Bujas 2014, Crnkovi 2017). During human evolution, anxiety has served to enable the protection of the system, namely to motivate the adaptive functions inducing the flight-or-flight response in potentially dangerous situations. (Beck et al. 1985, Hawton et al. 2008). Anxiety is an inevitable part of life in the modern world. There are many situations in our everyday life in which it is appropriate to react with a certain level of anxiety. Anxiety becomes a problem when it occurs at times when there is no real danger or when it continues long after the stressful situation had passed. When the acceleration of processes in the body is delayed at the time when no action is needed, a person will notice only the bad sides of anxiety, unpleasant aspects of body changes. After that, anxiety starts affecting a person’s everyday life and it is necessary to learn how to control it. In a later stage of his thinking about anxiety, Freud linked the appearance of anxiety itself to "traumatic situations" in which anxiety develops automatically because the psyche is overwhelmed by an excessive influx of stimuli that it can no longer control and can be relieved of "dangerous situations" in which a person learns to anticipate danger before it becomes traumatic. In anticipation of a dangerous situation, signal anxiety arises, which serves to mobilize forces under the guidance of the Ego, to make the person more prepared to face the traumatic situation or to avoid it. Given that the function of the Ego is to control incoming stimuli or to relieve them effectively, it is to be expected that traumatic situations will occur more frequently in early childhood, when the ego is still relatively weak and underdeveloped (Rudan 2017). Anxiety affects the entire being because it is simultaneously a physiological, behavioral, and psychological reaction. On a physiological level, it can include bodily reactions such as palpitations, muscle tension, nausea, mouth dryness, or sweating. On a behavioral level, anxiety can decrease a person’s ability to act, to express himself/herself, or to deal with everyday situations. Psychologically speaking, anxiety is a subjective state of apprehension and anguish. By itself, anxiety is not an abnormal reaction but a normal manifestation of human nature which is a part of a hereditary repertoire (Born 2012). However, being in a prolonged state of anxiety is a self-devastating tendency in humans. People have a choice to leave the state of anxiety when they realize it is dysfunctional, that is, when it hinders solving problems (Ellis & Harper 1996). Although not abnormal, the state of anxiety does not contribute to efficient problem solving, on the contrary, it interrupts it. Generalized anxiety disorder is characterized by chronic anxiety that lasts for at least six months. Dealing with generalized anxiety disorder is followed by a worry whose intensity and frequency are always excessive compared with the probability that the events a person is afraid of will ever occur. Generalized anxiety disorder, according to the view that Beck and Emery suggest (according to Born 2012), is manifested with ‘basic fears’ which are more general in nature than specific phobias. Examples of basic fears are: fear of loss of control, fear of not being able to overcome difficulties, fear of rejection or abandonment, fear of death, or illness.
Car accident victims can suffer from an acute stress reaction and post-traumatic stress disorder. In the therapeutic method of desensitization and reprocessing with eye movements (Eye Movements Desensitizing Reprocessing EMDR), trauma with a large "T" includes events that a person perceives as a life-threatening. These events are so saturated, stressful, that they can overcome our usual capacity to fight (Herman 1992). They result in intense fear, extreme feelings of helplessness, and complete loss of control. Symptoms of post-traumatic stress disorder (PTSD) manifest in two types of simultaneous and diametrically opposed behaviors. In one type, the traumatized person cannot escape their trauma, they are forced to get rid of the original event through intrusive symptoms such as flashback episodes, nightmares, panic attacks, and obsessive thoughts. In the second, they, again, must not approach trauma: they are completely isolated from the recollection of trauma by avoiding symptoms and anything that can be associated with the event, such as social isolation, emotional stiffness, and substance dependence. Victims of trauma also have physiological reactions such as insomnia, hypervigilance, and a tendency to be easily intimidated by any recollection of an event, such as a single sound or touch (Shapiro 1997). In the approach to the treatment of PTSD, physicians most often opt for psychopharmacotherapy by combining antidepressants such as selective serotonin reuptake inhibitors, anxiolytics, mood stabilizers, hypnotics, and atypical antipsychotics (Hasanovi et al. 2011, 2013). The relative short-term efficacy and long-term benefits of pharmacological and psychotherapeutic interventions have rarely been studied for posttraumatic stress disorder (PTSD). Different types of psychological therapy have been proposed in the treatment of trauma, including exposure therapy, cognitive therapy, psychodynamic therapy, and EMDR. EMDR is currently an effective psychological treatment, recognized and recommended as the first line of trauma treatment in a number of international guides (Boccia et al. 2015). In Bosnia and Herzegovina, education for mental health workers EMDR was organized in 2009, and in 2014 Association of EMDR Therapists in Bosnia and Herzegovina was established (Hasanovi et al. 2018, 2021). Accordingly, our capacities to use EMDR in everyday treatment of traumatized patients became a reality (Ališahovi -Gelo & Hasanovi 2018, Hrvi & Hasanovi 2018, Imširovi & Hasanovi 2018, Kokanovi & Hasanovi 2018, Pašali & Hasanovi 2018, Omeragi & Hasanovi 2018, Smaji -Hodži & Hasanovi 2018, Siru i & Hasanovi 2018). The aim is to show the case of a patient who responded favorably to EMDR therapy but did not respond favorably to pharmacotherapy and superficial supportive treatment
Eye movement desensitization and reprocessing (EMDR) is an integrative psychotherapy that has been extensively evaluated in its approach to trauma and posttraumatic stress disorder (PTSD). In brief, the AIP model is based on the idea that the neurobiological system naturally attempts to process current perceptions in a manner that promotes associations to relevant stored information, to facilitate learning, and to relieve emotional distress. The resulting transfer of information from implicit to explicit memory systems (Shapiro 2001) allows disturbing thoughts, emotions, and bodily sensations to be resolved by facilitating access to the stored material and linking it with more adaptive information. However, the intense effect and subsequent dissociation that accompany trauma may interfere with this process, causing the information (e.g., images, thoughts, emotions, and sensations) to be dysfunctionally stored within the memory network. Because the event is isolated within the network, preventing associations with adaptive information, the unresolved material is easily triggered during similar encounters, often leading to intrusive thoughts, emotions, and somatic responses. The consequent habitual response patterns can manifest in characterological difficulties, psychopathology, and the avoidance behaviors associated with phobias and panic disorders (Shapiro 2001, 2002). EMDR s ability to access and target an etiological conditioning event is appreciated and it is also possible to address past, present, and future symptoms in the absence of a known etiological event. Thus, EMDR has the ability to address panic and phobia regardless of the method by which the symptoms, or fear, were acquired. Once the appropriate targets are chosen, the EMDR protocol addresses all experiential components (images, thoughts, emotions, bodily sensations) to stimulate the information processing system as explained by the AIP model (Shapiro 2001, 2002). EMDR was introduced in Bosnia and Herzegovina (BH), in 1998 just three years after the war (19921995). The first training was organized in 2009, and in 2014 Association of EMDR Therapists in Bosnia and Herzegovina was established (Hasanovi et al. 2018). So the mental health workers who were properly educated started to use EMDR therapies in everyday helping to BH citizens in need (Trlin & Hasanovi 2018, Hasanovi et al. 2021). The aim of the following case to present how EMDR treatment was used to successfully address panic disorder with agoraphobia.
A good/beautiful word in creative psychopharmacotherapy offers: an environment for purposeful activities, such as creative work, structured work, enjoying the nature of essence and existence; and a feeling of security and safety, according to which it is necessary to act with respect and dignity, and permit the development of a feeling of belonging, value and trust; it is necessary to have time to express one's feelings to other members with sympathy, and active listening; the opportunity and encouragement for developing feelings and drawing conclusions from experience, including illness and its treatment; receiving permission and encouragement to develop a relationship with God or the Absolute; enable people to experience holiness, regardless of the time, place and privacy for prayer and worship; spiritual education, encouragement in faith, a feeling of universal connection and forgiveness.
Resilience is a complex multidimensional psychobiological concept that researchers define differently depending on the context of their research and theoretical orientation. Resilience indicates the ability of a child or adolescent (person) to adequately deal with problems, to continue to improve, grow and develop, and to successfully adapt to a new situation, regardless of the threats and challenges that characterize the environment. Salutogenesis is a sociomedical concept that focuses on factors that support human health and feelings of satisfaction, rather than on factors that cause disease. Through the salutogenic model, through the sense of coherence as a basic concept and a central resource, through generalized and specific resources of resilience, a person manages to preserve his physical and mental health even in the most difficult life circumstances. Promoting salutogenesis and the search for health factors, not diseases, in the study of children and young people and the importance of the salutogenic health model in times of wars, economic crises, social change, major changes on the planet can be a significant goal of treatment.
Modern psychiatric treatment is largely dictated by national and international guidelines rested on evidence-based data, including psychopharmacotherapy and psychotherapy. An alternative to the rigid application of official guidelines and criterion for the standards of treatment in psychiatric practice is the concept of creative psychopharmacotherapy. It is a concept based on the integration of different approaches to a person as whole, mental disorders and their treatment into person-centered clinical practice. In this sense, group psychotherapy and creative psychopharmacotherapy today are part of the overall integrative efforts in psychiatry. Neuroscientific discoveries suggest that they share similar neural pathways that lead to changes in brain function and symptoms relief. Various integrative elements make group psychotherapy and psychopharmacotherapy in combination more effective and efficient. The integration of the concept of creative psychopharmacotherapy and group psychotherapy into everyday clinical practice can improve treatment options as well as clinical practice by creating opportunities for research and development of new modalities of overall treatment.
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