DERMATOLOJİK BOZUKLUKLARIN TEDAVİSİNDE GÖZ HAREKETLERİYLE DUYARSIZLAŞTIRMA VE YENİDEN İŞLEMENİN (EMDR) KULLANIMI

Yıl 2024, Cilt: 12 Sayı: 25, 190 - 208, 30.12.2024

Hilal Nur Kaçmaz , Melike İlerisoy

https://doi.org/10.55483/cekmece.1597202

Öz

Stres ve kaygı benzeri yaşantıların dermatolojik bozuklukların etiyolojisinde yer alan önemli faktörler olması nedeniyle bu rahatsızlıkların tedavisinde psikoterapötik müdahalelerin kullanımı giderek yaygınlaşmaktadır. Bu çalışmada EMDR yöntemi ile ele alınan deri yolma bozukluğuna ilişkin bir olgu sunumuna yer verilmiştir. Danışanın karşı koyamadığı deri yolma isteğinden dolayı yüz bölgesinde bulunan sivilceleri kaşıması, kaşıma sonrası oluşan yara ve morluklar sebebiyle danışmaya gelmesi üzerine sorun, EMDR odaklı dört oturum ve bir kontrol seansı olmak üzere toplam beş seansta ele alınmıştır. Her seansa ilişkin danışanın geribildirimleri ve kontrol seansındaki izleme bulguları çerçevesinde EMDR’nin danışanın deri yolma davranışının azalması ve kontrol altına alınmasında etkili olduğu, genel iyilik halinin artmasına yardımcı olduğu görülmüştür. Psikodermatolojik bir hastalık olan deri yolma bozukluğunun olası ruhsal faktörler açısından ele alınarak EMDR tekniğinin uygulandığı bir olgu çerçevesinde değerlendirilmesini amaçlayan bu çalışmanın multidisipliner tedavi yöntemlerinin geliştirilmesi bağlamında ilgili alana katkı sağlayacağı düşünülmektedir.

Anahtar Kelimeler

EMDR, dermatolojik bozukluklar, deri yolma, psikoterapi, olgu sunumu

Etik Beyan

İstanbul Ticaret Üniversitesi Rektörlüğünün 4.06.2024 tarih E-65836846-044-320497 sayılı Etik Onay yazısı ile Etik Kurulu Onayı alınmıştır.

Destekleyen Kurum

-

Teşekkür

-

USE OF EYE MOVEMENT DESENSITIZATION AND REPROCESSING (EMDR) IN THE TREATMENT OF DERMATOLOGICAL DISORDERS

Öz

Since stress and anxiety-like experiences are important factors in the etiology of dermatological disorders, the use of psychotherapeutic interventions in the treatment of these disorders is becoming increasingly common. In this study, a case report regarding skin picking disorder addressed with the EMDR method is included. The problem was addressed in a total of five sessions, including four EMDR-focused sessions and one control session, when the client came to counseling due to scratching the acne on the face due to the irresistible desire to pick the skin and the wounds and bruises that occurred after scratching. Within the framework of the client's feedback regarding each session and the monitoring findings in the control session, it has been observed that EMDR is effective in reducing and controlling the client's skin picking behavior and helps increase general well-being. It is thought that this study, which aims to evaluate skin picking disorder, which is a psychodermatological disease, in terms of possible psychological factors and within the framework of a case to which the EMDR technique is applied, will contribute to the relevant field in the context of the development of multidisciplinary treatment methods.

Anahtar Kelimeler

MDR, dermatological disorders, skin picking, psychotherapy, case report

Kaynakça

• American Psychiatric Association. (2022). Diagnostic And Statistical Manual Of Mental Disorders (5th Ed., Text Rev.). https://doi.org/10.1176/appi.books.9780890425787
• Arnold, L. M., McElroy, S. L., Mutasim, D. F., Dwight, M. M., Lamerson, C. L. ve Morris, E. M. (1998). Characteristics Of 34 Adults With Psychogenicexcoriation. J Clin Psychiatry. 59, 509-514. https://doi.org/10.4088/jcp.v59n1003
• Aydın, P. Ç. ve Gülseren, L. (2014). Deri Yolma Bozukluğu. Psikiyatride Güncel Yaklaşımlar. 6(4), 401-428. https://doi.org/10.5455/cap.20140425062934
• Bach, M. ve Bach, D. (1993). Psychiatric And Psychometric Issues In Acné Excoriée. Psychother Psychosom, 60(3–4), 207–210. https://doi.org/10.1159/000288694
• Cengiz, S. ve Peker, A. (2020). Obsesif Kompulsif Bozuklukta EMDR Terapinin Etkisi: Olgu Sunumu. Türk Eğitim Bilimleri Dergisi, 18(1), 201-217.
• Connor, C. J., Liu, V. ve Fiedorowicz, J. G. (2015). Exploring The Physiological Link Between Psoriasis And Mood Disorders. Dermatol Res Pract, 1-11. https://doi.org/10.1155/2015/409637
• Cullen, B. A., Samuels, J. F., Bienvenu, O. J., Grados, M., Hoehn-Saric, R. ve Hahn, J., (2001). The Relationship Of Pathologic Skin Picking To Obsessive-Compulsive Disorder. J Nerv Ment Dis. 189, 193-195. https://doi.org/10.1097/00005053-200103000-00010
• Cumurcu, B. E. ve Kaya, B. (2004). A Case With Trichotillomania, Psychogenic Excoriation And Pathological İnternet Use. J Clin Psy. 7, 127-131. https://doi.org/10.5505/kpd.2018.48403
• Duman, R. N., Bayram, S. ve Demirtaş, B. (2018). EMDR: Olgu Sunumları. Türkiye Bütüncül Psikoterapi Dergisi, 1(1), 142-164.
• Ferreira, B. I., Abreu, J. L., Reis, J. P. ve Figueiredo, A. M. (2016). Psoriasis And Associated Psychiatric Disorders: A Systematic Review On Etiopathogenesis And Clinical Correlation. J Clin Aesthet Dermatol. 9(6), 36–43.
• Flessner, C. A. ve Woods, D. W. (2006). Phenomenological Characteristics, Social Problems, And The Economic Impact Associated With Chronic Skin Picking. Behav Modif. 30(6), 944–963. https://doi.org/10.1177/0145445506294083
• Gupta, M. ve Gupta, A. (2002). Dermatolojik Bozuklukların Tedavisinde Göz Hareketleriyle Duyarsızlaştırma ve Yeniden İşleme (EMDR) Kullanımı. Kutanöz Matıpen ve Cerrahi Dergisi, 6(5), 415-421.
• Gupta, M. (2016). Body-Focused Repetitive Behaviors (BFRB) (Trichotillomania, Skin Picking, Onychophagia) And Eating Disorders (ED): Preliminary Fndings In A Nondermatologic Sample. J Am Acad Dermatol. 74(5), 46. https://doi.org/10.1016/j.jaad.2016.02.182
• Hajcak, G., Franklin, M. E., Simons, R. F. ve Keuthen, N. J. (2006). Hairpulling And Skin Picking In Relation To Affective Distress And Obsessivecompulsive Symptoms. J Psychopathol Behav Assess. 28, 179-187. https://doi.org/10.1007/s10862-005-9001-x
• Hayes, S. L., Storch, E. A. ve Berlanga, L. (2009). Skin Picking Behaviors: An Examination Of The Prevalence And Severity In A Community Sample. J Anxiety Disord. 23(3), 314–319. https://doi.org/10.1016/j.janxdis.2009.01.008
• Hekmat, H., Groth, S. ve Rogers, D. (1994). Pain Ameliorating Effect Of Eye Movement Desensitization. J Behav Ther Exp Psychiatry, 25, 121-129. https://doi.org/10.1016/0005-7916(94)90004-3
• Houghton, D. C., Alexander, J. R., Bauer, C. C. ve Woods D. W. (2018). Body-Focused Repetitive Behaviors: More Prevalent Than Once Thought? Psychiatry Res. 2(270), 389–93. https://doi.org/10.1016/j.psychres.2018.10.002
• İlgar, M. Z. ve Coşgun-İlgar, S. (2019). Bilişsel Davranış Değiştirme ve Motivasyonel Görüşme. Eğitimde Kuram ve Uygulama, 15(1), 47-73. https://doi.org/10.17244/eku.489855
• Jafferany, M. ve Patel, A. (2019). Skin-Picking Disorder: A Guide To Diagnosis And Management. CNS Drugs, 33, 337–346. https://doi.org/10.1007/s40263-019-00621-7
• Karadağ, M., Gokcen, C. ve Sarp, A. S. (2020). EMDR Therapy İn Children And Adolescents Who Have Post-Traumatic Stress Disorder: A Six-Week Follow-Up Study. International Journal Of Psychiatry In Clinical Practice, 24(1), 77-82. https://doi.org/10.1080/13651501.2019.1682171
• Kavakçı, Ö., Doğan, O. ve Kuğu, N. (2010). EMDR: Psikoterapide Farklı Bir Seçenek. Düşünen Adam Psikiyatri ve Nörolojik Bilimler Dergisi, 23(3), 195-205. https://doi.org/10.5350/DAJPN2010230307
• Keuthen, N. J., Koran, L. M., Aboujaoude, E., Large, M. D. ve Serpe, R. T. (2010). The Prevalence Of Pathologic Skin Picking In US Adults. Compr Psychiatry. 51(2), 183–186. https://doi.org/10.1016/j.comppsych.2009.04.003
• Koblenzer, C. S. ve Gupta, R. (2013). Neurotic Excoriations And Dermatitis Artefacta. Semin Cutan Med Surg. 32(2), 95–100. https://doi.org/10.12788/j.sder.0008
• Lochner, C., Roos, A. ve Stein, D. J. (2017). Excoriation (Skin-Picking) Disorder: A Systematic Review Of Treatment Options. Neuropsychiatr Dis Treat. 14(13), 1867–1872. https://doi.org/10.2147/NDT.S121138
• Lovato, L., Ferrao, Y. A., Stein, D. J., Shavitt, R. G., Fontenelle, L. F., Vivan, A., Miguel, E. C. ve Cordioli A. V. (2012). Skin Picking And Trichotillomania In Adults With Obsessive-Compulsive Disorder. Compr Psychiatry. 53, 562-568. https://doi.org/10.1016/j.comppsych.2011.06.008
• Machado, M. O., Köhler, C. A., Stubbs, B., Nunes-Neto P. R., Koyanagi, A., Quevedo, J., Soares, J. C., Hyphantis, T. N., Marazziti, D., Maes, M., Stein, D. J. ve Carvalho, A. F. (2018). Skin Picking Disorder: Prevalence, Correlates, And Associations With Quality Of Life In A Large Sample. CNS Spectr. 23(5), 311–320. https://doi.org/10.1017/S1092852918000871
• Mukba, G., Tanrıverdi, S., ve Tanhan, F. (2020). Deprem Travmasında EMDR’nin Etkinliğinin Araştırılması: Olgu Sunumu. Çukurova Üniversitesi Eğitim Fakültesi Dergisi, 49(1), 477-500. https://doi.org/10.14812/cuefd.567439
• Neziroglu, F., Rabinowitz, D., Breytman, A. ve Jacofsky, M. (2008). Skin Picking Phenomenology And Severity Comparison. Prim Care Companion J Clin Psychiatry. 10(4), 306–12. https://doi.org/10.4088/pcc.v10n0406
• Odlaug, B. L., Lust, K., Schreiber, L. R., Christenson, G., Derbyshire, K., ve Grant, J. E. (2013). Skin Picking Disorder In University Students: Health Correlates And Gender Differences. Gen Hosp Psychiatry, 35(2), 168-173. https://doi.org/10.1016/j.genhosppsych.2012.08.006
• Piacentini, J. C. ve Chang, S. W. (2006). Behavioral Treatments For Tic Suppression: Habit Reversal Training. Advances In Neurology. 99, 227–233.
• Ricketts, E. J., Snorrason, Í., Kircanski, K., Alexander, J. R., Thamrin, H., Flessner, C. A., Franklin, M. E., Piacentini, J. ve Woods, D. W. (2018). A Latent Profle Analysis Of Age Of Onset In Pathological Skin Picking. Compr Psychiatry. 87, 46–52. https://doi.org/10.1016/j.comppsych.2018.08.011
• Rosenbaum, M. S. ve Ayllon, T. (1981). The Behavioral Treatment Of Neurodermatitis Through Habit-Reversal. Behav Res Ther. 19, 313-318. https://doi.org/10.1016/0005-7967(81)90052-8
• Sampaio, D. G. ve Grant, J. E. (2018). Body-Focused Repetitive Behaviors And The Dermatology Patient. Clin Dermatol. 36(6), 723–727. https://doi.org/10.1016/j.clindermatol.2018.08.004
• Schuck, K., Keijsers, G. P. ve Rinck, M. (2011). The Effects Of Brief Cognitive-Behaviour Therapy For Pathological Skin Picking: Arandomized Comparison To Wait-List Control. Behav Res Ther. 49, 11-17. https://doi.org/10.1016/j.brat.2010.09.005
• Semiz, M., Atik, S. ve Erdem, M. (2016). Treatment Augmentation Effects Of EMDR Intervention After Traumatic Experiences İn Patients With Major Depression: A Case Series. Düşünen Adam - Psikiyatri Ve Nörolojik Bilimler Dergisi, 29(1), 91 - 95.
• Shapiro, F. (1996). Eye Movement Desensitization And Reprocessing (EMDR): Evaluation Of Controlled PTSD Research. J Behav Ther Exp Psychiatry. 27, 209-218. https://doi.org/10.1016/s0005-7916(96)00029-8
• Shapiro, F. (2002). EMDR 12 Years After Its Introduction: Past And Future Research. Journal Of Clinical Psychology, 58, 1-22. https://doi.org/10.1002/jclp.1126
• Shapiro, F. ve Maxfield, L. (2002). Eye Movement Desensitization And Reprocessing (EMDR): Information Processing In The Treatment Of Trauma. Psychotherapy İn Practice, 58(8), 933-946. https://doi.org/10.1002/jclp.10068
• Shapiro, F. (2014). The Role Of Eye Movement Desensitization And Reprocessing (EMDR) Therapy In Medicine: Addressing The Psychological And Physical Symptoms Stemming From Adverse Life Experiences. Perm J, 18(1), 71-77. https://doi.org/10.7812/TPP/13-098
• Shapiro, F. (2016). EMDR: Göz Hareketleri İle Duyarsızlaştırma ve Yeniden İşleme Temel Prensipler, Protokoller Ve Prosedürler, Okyanus Yayınları.
• Snorrason, I., Smári, J. ve Olafsson, R. P. (2010). Emotion Regulation In Pathological Skin Picking: Fndings From A Non-Treatment Seeking Sample. J Behav Ther Exp Psychiatry. 41(3), 238–245. https://doi.org/10.1016/j.jbtep.2010.01.009
• Solley, K. ve Turner, C. (2018). Prevalence And Correlates Of Clinically Significant Body-Focused Repetitive Behaviors In A Non-Clinical Sample. Compr. Psychiatr. 86, 9–18. https://doi.org/10.1016/j.comppsych.2018.06.014
• Torales, J., Páez, L., O’Higgins, M. ve Arce, A. (2016). Cognitive Behavioral Therapy For Excoriation (Skin Picking) Disorder. Telangana Journal Of Psychiatry, 2(1), 27-30. https://doi.org/10.4103/2455-8559.314432
• Ünveren, G. ve İzci, F. (2017). Travma Sonrası Stres Bozukluğunda Bilişsel Davranışçı Terapi ve Göz Hareketleri ile Duyarsızlaştırma ve Yeniden İşleme. Bilişsel Davranışçı Psikoterapi ve Araştırmalar Dergisi , 6(1), 31 - 38.
• Wilson, E. (1875). Lectures On Dermatology. Delivered In The Royal College Of Surgeons Of England 1874–1875, J And A Churhil.