The Effectiveness of Treating a Traffic Accident Trauma with EMDR after Failed Psychofarmacological Treatment - A Case Report.

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