0:00:18.542,0:00:19.751
Thank you Mark.

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Ladies and gentlemen,

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you will probably wonder why I,[br]as a development economist,

0:00:28.013,0:00:31.817
am here today to talk[br]about treating trauma.

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It's because I've come[br]to see that trauma is

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not only a huge global problem[br]of truly epidemic proportions

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but traumas also have a devastating impact

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on human development,[br]economic development,

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and even on the possibility of peace.

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Given the importance of trauma worldwide,

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it's actually rather surprising[br]to see the invisibility,

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it's almost like the problem is hidden.

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In fact, most traumas worldwide[br]remain unrecognized,

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undiagnosed, and therefore untreated.

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That's particularly true[br]for the developing countries.

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I'm here today to make a plea,

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to make available treatment services

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to the hundreds of millions[br]of people worldwide who are in need,

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and to do so not in small doses,

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but rather as a quantum jump.

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I believe that that is now possible[br]for the first time in history,

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with a new treatment called EMDR,

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for Eye Movement[br]Desensitization and Reprocessing.

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Ladies and gentlemen,

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I have this picture on my desk at home,

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to remind me of the human face of trauma.

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Look at this man's eyes,[br]look at the anguish,

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the vulnerability, the hopelessness.

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I first came to realize[br]the importance of trauma,

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when I was UNICEF representative[br]in Bangladesh in the 1990s.

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And I was pondering

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the development challenges[br]of the country,

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its grinding poverty, their regularly[br]recurring natural disasters;

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they've just gone through[br]a punishing war of liberation.

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I could not believe[br]that anyone in that country

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had actually been able[br]to escape being traumatized

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because the signs[br]and the sources of trauma

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were everywhere to be seen.

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So I was wondering what can we do[br]about a problem at such a large scale.

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The answer came to me rather unexpectedly.

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I was taking a brief sabbatical[br]in San Francisco,

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I was in a book store,

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and inexplicably, my hand reached out

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to a book with the title EMDR.

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I'd never heard of EMDR, I didn't know[br]why my hand was doing this.

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Nonetheless, I sat down[br]on the floor, began to read,

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and about an hour later when I reemerged,

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I realized that I had just read

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about a treatment facility,

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a treatment modality,[br]that was rapidly scalable,

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and that was very effective[br]in treating people

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in a very short period of time.

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So that was exactly the kind of treatment

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that we could very well use in Bangladesh.

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So I called the author,[br]Dr. Francine Shapiro

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- who also is the developer of EMDR -

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I asked for an appointment,[br]and the next day, I was in her home

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negotiating a contract for EMDR trainers[br]to come to Bangladesh

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and to begin to treat[br]the many people there.

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The training would be given

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to the 54 Bangladeshi psychologists[br]and psychiatrists in that country.

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So that way I learned first hand

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about the amazing,[br]almost magical effectiveness of EMDR.

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Most of you probably have heard[br]or know someone,

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who has been traumatized,

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perhaps even suffer from PTSD,[br]post traumatic stress disorders.

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In fact, statistically speaking,

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there should be a good number[br]of you here in this audience

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who actually have suffered PTSD yourself.

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The PTSD symptoms include three sets:[br]the first is the hyper-arousal,

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that means you can't sleep,[br]you can't concentrate very well.

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There is also easily being angered,[br]or getting into a panic,

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or even feeling[br]intense feelings of hatred.

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Then there is the reliving[br]of the traumatic event,

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and that comes in nightmares,

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invasive, intrusive flashbacks.

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And thirdly, there is[br]the avoidance and numbing,

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you avoid any situation[br]that reminds you of the traumatic event.

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You avoid certain relationships.

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And there is also the growing

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distrust of anyone around you,

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your isolation, the hopelessness,

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and that can go all the way[br]to outright depression.

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So, from these symptoms,

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you can see that PTSD is[br]a very severe and disabling illness

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that has very serious consequences

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for both the ability to learn,

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the creativity of people,

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the productivity,[br]and the general well being.

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There is also new evidence to show

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that if people have suffered[br]even a minor trauma

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there are heightened chances there

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that you would get ill[br]with substance abuse,

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with cardiac conditions,[br]and even with cancer.

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There's a saying that says[br]"Violence begets violence."

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What we don't often realize is

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that the trauma is the 'trait d'union'[br]between violence and violence.

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Because, if somebody gets traumatized

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as a result of violence,

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then that person is at a heightened risk

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of himself or herself[br]become a perpetrator of violence.

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That's actually[br]quite a scary understanding.

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If PTSD is left untreated,

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then it will last a life time.

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Ladies and gentlemen,

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we don't have[br]a very good statistics worldwide,

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about trauma and PTSD.

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But if we look at the number of people

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who are exposed to[br]traumatic circumstances and events,

0:08:04.794,0:08:07.802
we may be able to get[br]an order of magnitude.

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For example, take a look[br]at these numbers here.

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They're all taken[br]from authoritative sources.

0:08:14.545,0:08:18.155
1.5 billion people worldwide live

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in situations of political[br]and criminal violence.

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That includes the Syrias and the Congos,[br]and Somalias, and all the other countries.

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Then 42 million people worldwide

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are either refugees[br]or internally displaced people,

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and displacement itself[br]is a big risk factor for trauma.

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Some 200 million people have been exposed[br]to natural disasters in 2011 alone.

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And so, this becoming an annual feature

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with the global climate change

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more and more people getting traumatized.

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Then some 1.3 billion people[br]are living in absolute poverty.

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I don't think that we can imagine[br][more] traumatizing circumstances

0:09:06.352,0:09:10.813
in which these people[br]live their day to day life.

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And then get this,

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one in every three women worldwide

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actually suffer during their lifetime

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from sexual, physical or emotional abuse.

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These are staggering numbers[br]you will agree.

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Most of these traumas[br]are called Big "T" traumas

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because they are the results[br]of extreme events.

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They are the results[br]of loud emergency, if you could say,

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But there are also the small "t" traumas.

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And they are well known to all of us,

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they are caused by[br]everyday traumatizing events,

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usually we call them normal events,

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but they are accidents, they are bullying,

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they are child abuse, divorce[br]and many other circumstances like that.

0:10:08.534,0:10:10.543
These are silent emergencies

0:10:10.544,0:10:16.393
but they affect literally millions[br]and millions of people at any given time.

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If you add big "T" trauma[br]and small "t" trauma together,

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you end up with a staggering[br]global burden of trauma.

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Now, let me hasten to say

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that not all traumatic experiences[br]also lead to PTSD.

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Thankfully, humans are,[br]by and large, remarkably resilient

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and usually, after traumatic experience

0:10:42.383,0:10:48.478
get better all by themselves[br]without any medical or psychological help.

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If we took

0:10:52.698,0:10:56.867
the PTSD prevalence,[br]life time prevalence of the United States,

0:10:56.868,0:10:58.791
which is between 7 and 8%,

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and we apply that number[br]to the world as a whole,

0:11:03.052,0:11:08.483
we would end up with[br]at least 500 million cases of PTSD.

0:11:09.283,0:11:14.588
That's like the total population[br]of the European Union.

0:11:14.589,0:11:19.856
And the question could be asked:[br]"Is this problem not too big to tackle?"

0:11:19.857,0:11:22.898
I think a mere 30 years ago,

0:11:22.899,0:11:24.996
I would have said,[br]yeah, this can't be done.

0:11:24.997,0:11:28.471
We didn't have the means, we didn't have[br]the technology at that time.

0:11:28.472,0:11:33.138
But today I think, with EMDR,[br]we actually have a good chance.

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In a way, I believe that, you know,

0:11:35.520,0:11:38.961
this is not rocket science[br]to begin to deal with this problem,

0:11:38.962,0:11:41.771
even at that very large scale.

0:11:41.772,0:11:43.731
How does EMDR work?

0:11:43.732,0:11:48.136
EMDR resolves the emotional distress,

0:11:48.137,0:11:51.872
but the precise mechanism is probably

0:11:51.873,0:11:56.573
a good topic for the next TED talk.

0:11:57.753,0:12:00.735
Meanwhile, let me just say

0:12:00.736,0:12:05.595
that the psycho-neuro[br]physiological processes

0:12:05.596,0:12:10.604
that lead to the healing[br]are set in motion by bilateral stimulation

0:12:10.605,0:12:14.933
and that is usually[br]rapid eye movement, from left to right.

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It seems as simple and magical as that.

0:12:19.495,0:12:24.778
As soon as that process has happened,

0:12:24.779,0:12:29.557
the trauma memory is healed

0:12:29.558,0:12:33.967
and all the symptoms of PTSD disappear.

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And they disappear for good.[br]They won't come back.

0:12:37.736,0:12:40.946
And all of this can be done[br]in a matter of few sessions.

0:12:40.947,0:12:43.286
This is why the World Health Organization

0:12:43.287,0:12:47.485
recently gave official recognition to EMDR

0:12:47.486,0:12:52.316
as one-evidence based[br]and scientifically validated

0:12:53.476,0:12:56.364
treatment modality for trauma.

0:12:57.154,0:13:02.529
We now have the possibilities[br]of rapidly scaling up

0:13:02.530,0:13:06.195
with this new treatment called EMDR.

0:13:06.196,0:13:10.066
EMDR can treat[br]in a matter of hours and days,

0:13:10.067,0:13:13.067
as opposed to the conventional therapy

0:13:13.069,0:13:18.981
that took weeks, months,[br]and sometimes years of therapy.

0:13:18.982,0:13:24.539
It can also be administered to groups[br]of people not just individuals.

0:13:24.540,0:13:28.899
It is more easily accepted,[br]because unlike the conventional treatment,

0:13:28.899,0:13:30.880
you don't have[br]to talk about your trauma,

0:13:30.881,0:13:34.710
people who have been traumatized[br]don't want to talk about their trauma.

0:13:34.711,0:13:38.391
And then there's a possibility[br]of using paraprofessionals

0:13:40.581,0:13:46.837
to provide services[br]of psychological first aid,

0:13:46.838,0:13:51.750
thereby relieving the psychologists[br]and psychiatrists

0:13:51.751,0:13:55.200
from the more mundane kind of work.

0:13:55.201,0:14:00.616
So based on my profession[br]as a development economist,

0:14:00.617,0:14:02.858
I'm convinced that it is now possible

0:14:02.859,0:14:08.709
to begin to scale up[br]these trauma services.

0:14:10.279,0:14:11.440
Ladies and gentlemen,

0:14:11.441,0:14:13.971
you will agree with me

0:14:16.041,0:14:20.882
that this woman[br]and all the millions of people

0:14:20.883,0:14:24.034
who have been traumatized like her,

0:14:24.035,0:14:26.863
at least deserve their peace of mind.

0:14:26.864,0:14:28.626
They deserve actually much more,

0:14:28.627,0:14:33.916
they deserve to get back[br]their laughter and their self confidence,

0:14:33.917,0:14:38.197
and be able to make[br]a contribution to society again,

0:14:38.198,0:14:41.107
and be part of their community.

0:14:41.108,0:14:45.419
What would the world look like

0:14:45.420,0:14:50.190
if we were able to[br]systematically heal all the traumas?

0:14:51.246,0:14:57.616
I believe that that world[br]would be a lot less violent

0:14:58.712,0:15:03.522
because we would finally begin[br]to interrupt the insidious,

0:15:03.523,0:15:10.233
interpersonal and inter-generational[br]transmission of violence and abuse.

0:15:10.992,0:15:14.820
So, that world, I believe, would be

0:15:14.821,0:15:19.586
a lot more peaceful,[br]and also a lot more prosperous.

0:15:20.732,0:15:24.892
I believe that that world is within reach.

0:15:26.802,0:15:28.350
I am convinced

0:15:28.351,0:15:32.711
that EMDR has the power and the potential

0:15:33.806,0:15:36.186
to help treat and heal

0:15:37.469,0:15:41.529
the humanity's wounded memories.

0:15:42.715,0:15:45.155
Do you think that that will happen?

0:15:47.450,0:15:48.403
Thank you.

0:15:48.404,0:15:49.600
(Applause)