Transcriber: Ido Dekkers Reviewer: Denise RQ
Thank you Mark.
Ladies and gentlemen,
you will probably wonder why I, as a development economist,
am here today to talk about treating trauma.
It's because I've come to see that trauma is
not only a huge global problem of truly epidemic proportions
but traumas also have a devastating impact
on human development, economic development,
and even on the possibility of peace.
Given the importance of trauma worldwide,
it's actually rather surprising to see the invisibility,
it's almost like the problem is hidden.
In fact, most traumas worldwide remain unrecognized,
undiagnosed, and therefore untreated.
That's particularly true for the developing countries.
I'm here today to make a plea,
to make available treatment services
to the hundreds of millions of people worldwide who are in need,
and to do so not in small doses,
but rather as a quantum jump.
I believe that that is now possible for the first time in history,
with a new treatment called EMDR,
for Eye Movement Desensitization and Reprocessing.
Ladies and gentlemen,
I have this picture on my desk at home,
to remind me of the human face of trauma.
Look at this man's eyes, look at the anguish,
the vulnerability, the hopelessness.
I first came to realize the importance of trauma,
when I was UNICEF representative in Bangladesh in the 1990s.
And I was pondering
the development challenges of the country,
its grinding poverty, their regularly recurring natural disasters;
they've just gone through a punishing war of liberation.
I could not believe that anyone in that country
had actually been able to escape being traumatized
because the signs and the sources of trauma
were everywhere to be seen.
So I was wondering what can we do about a problem at such a large scale.
The answer came to me rather unexpectedly.
I was taking a brief sabbatical in San Francisco,
I was in a book store,
and inexplicably, my hand reached out
to a book with the title EMDR.
I'd never heard of EMDR, I didn't know why my hand was doing this.
Nonetheless, I sat down on the floor, began to read,
and about an hour later when I reemerged,
I realized that I had just read
about a treatment facility,
a treatment modality, that was rapidly scalable,
and that was very effective in treating people
in a very short period of time.
So that was exactly the kind of treatment
that we could very well use in Bangladesh.
So I called the author, Dr. Francine Shapiro
- who also is the developer of EMDR -
I asked for an appointment, and the next day, I was in her home
negotiating a contract for EMDR trainers to come to Bangladesh
and to begin to treat the many people there.
The training would be given
to the 54 Bangladeshi psychologists and psychiatrists in that country.
So that way I learned first hand
about the amazing, almost magical effectiveness of EMDR.
Most of you probably have heard or know someone,
who has been traumatized,
perhaps even suffer from PTSD, post traumatic stress disorders.
In fact, statistically speaking,
there should be a good number of you here in this audience
who actually have suffered PTSD yourself.
The PTSD symptoms include three sets: the first is the hyper-arousal,
that means you can't sleep, you can't concentrate very well.
There is also easily being angered, or getting into a panic,
or even feeling intense feelings of hatred.
Then there is the reliving of the traumatic event,
and that comes in nightmares,
invasive, intrusive flashbacks.
And thirdly, there is the avoidance and numbing,
you avoid any situation that reminds you of the traumatic event.
You avoid certain relationships.
And there is also the growing
distrust of anyone around you,
your isolation, the hopelessness,
and that can go all the way to outright depression.
So, from these symptoms,
you can see that PTSD is a very severe and disabling illness
that has very serious consequences
for both the ability to learn,
the creativity of people,
the productivity, and the general well being.
There is also new evidence to show
that if people have suffered even a minor trauma
there are heightened chances there
that you would get ill with substance abuse,
with cardiac conditions, and even with cancer.
There's a saying that says "Violence begets violence."
What we don't often realize is
that the trauma is the 'trait d'union' between violence and violence.
Because, if somebody gets traumatized
as a result of violence,
then that person is at a heightened risk
of himself or herself become a perpetrator of violence.
That's actually quite a scary understanding.
If PTSD is left untreated,
then it will last a life time.
Ladies and gentlemen,
we don't have a very good statistics worldwide,
about trauma and PTSD.
But if we look at the number of people
who are exposed to traumatic circumstances and events,
we may be able to get an order of magnitude.
For example, take a look at these numbers here.
They're all taken from authoritative sources.
1.5 billion people worldwide live
in situations of political and criminal violence.
That includes the Syrias and the Congos, and Somalias, and all the other countries.
Then 42 million people worldwide
are either refugees or internally displaced people,
and displacement itself is a big risk factor for trauma.
Some 200 million people have been exposed to natural disasters in 2011 alone.
And so, this becoming an annual feature
with the global climate change
more and more people getting traumatized.
Then some 1.3 billion people are living in absolute poverty.
I don't think that we can imagine [more] traumatizing circumstances
in which these people live their day to day life.
And then get this,
one in every three women worldwide
actually suffer during their lifetime
from sexual, physical or emotional abuse.
These are staggering numbers you will agree.
Most of these traumas are called Big "T" traumas
because they are the results of extreme events.
They are the results of loud emergency, if you could say,
But there are also the small "t" traumas.
And they are well known to all of us,
they are caused by everyday traumatizing events,
usually we call them normal events,
but they are accidents, they are bullying,
they are child abuse, divorce and many other circumstances like that.
These are silent emergencies
but they affect literally millions and millions of people at any given time.
If you add big "T" trauma and small "t" trauma together,
you end up with a staggering global burden of trauma.
Now, let me hasten to say
that not all traumatic experiences also lead to PTSD.
Thankfully, humans are, by and large, remarkably resilient
and usually, after traumatic experience
get better all by themselves without any medical or psychological help.
If we took
the PTSD prevalence, life time prevalence of the United States,
which is between 7 and 8%,
and we apply that number to the world as a whole,
we would end up with at least 500 million cases of PTSD.
That's like the total population of the European Union.
And the question could be asked: "Is this problem not too big to tackle?"
I think a mere 30 years ago,
I would have said, yeah, this can't be done.
We didn't have the means, we didn't have the technology at that time.
But today I think, with EMDR, we actually have a good chance.
In a way, I believe that, you know,
this is not rocket science to begin to deal with this problem,
even at that very large scale.
How does EMDR work?
EMDR resolves the emotional distress,
but the precise mechanism is probably
a good topic for the next TED talk.
Meanwhile, let me just say
that the psycho-neuro physiological processes
that lead to the healing are set in motion by bilateral stimulation
and that is usually rapid eye movement, from left to right.
It seems as simple and magical as that.
As soon as that process has happened,
the trauma memory is healed
and all the symptoms of PTSD disappear.
And they disappear for good. They won't come back.
And all of this can be done in a matter of few sessions.
This is why the World Health Organization
recently gave official recognition to EMDR
as one-evidence based and scientifically validated
treatment modality for trauma.
We now have the possibilities of rapidly scaling up
with this new treatment called EMDR.
EMDR can treat in a matter of hours and days,
as opposed to the conventional therapy
that took weeks, months, and sometimes years of therapy.
It can also be administered to groups of people not just individuals.
It is more easily accepted, because unlike the conventional treatment,
you don't have to talk about your trauma,
people who have been traumatized don't want to talk about their trauma.
And then there's a possibility of using paraprofessionals
to provide services of psychological first aid,
thereby relieving the psychologists and psychiatrists
from the more mundane kind of work.
So based on my profession as a development economist,
I'm convinced that it is now possible
to begin to scale up these trauma services.
Ladies and gentlemen,
you will agree with me
that this woman and all the millions of people
who have been traumatized like her,
at least deserve their peace of mind.
They deserve actually much more,
they deserve to get back their laughter and their self confidence,
and be able to make a contribution to society again,
and be part of their community.
What would the world look like
if we were able to systematically heal all the traumas?
I believe that that world would be a lot less violent
because we would finally begin to interrupt the insidious,
interpersonal and inter-generational transmission of violence and abuse.
So, that world, I believe, would be
a lot more peaceful, and also a lot more prosperous.
I believe that that world is within reach.
I am convinced
that EMDR has the power and the potential
to help treat and heal
the humanity's wounded memories.
Do you think that that will happen?
Thank you.
(Applause)