WEBVTT 00:00:18.542 --> 00:00:19.751 Thank you Mark. 00:00:22.790 --> 00:00:24.236 Ladies and gentlemen, 00:00:24.237 --> 00:00:28.012 you will probably wonder why I, as a development economist, 00:00:28.013 --> 00:00:31.817 am here today to talk about treating trauma. 00:00:33.557 --> 00:00:36.553 It's because I've come to see that trauma is 00:00:36.554 --> 00:00:43.658 not only a huge global problem of truly epidemic proportions 00:00:43.659 --> 00:00:49.308 but traumas also have a devastating impact 00:00:49.309 --> 00:00:52.604 on human development, economic development, 00:00:52.605 --> 00:00:56.365 and even on the possibility of peace. 00:00:58.810 --> 00:01:01.999 Given the importance of trauma worldwide, 00:01:02.000 --> 00:01:08.423 it's actually rather surprising to see the invisibility, 00:01:08.424 --> 00:01:12.094 it's almost like the problem is hidden. 00:01:14.260 --> 00:01:20.590 In fact, most traumas worldwide remain unrecognized, 00:01:21.460 --> 00:01:25.223 undiagnosed, and therefore untreated. 00:01:26.573 --> 00:01:29.853 That's particularly true for the developing countries. 00:01:30.735 --> 00:01:33.114 I'm here today to make a plea, 00:01:33.115 --> 00:01:36.959 to make available treatment services 00:01:36.960 --> 00:01:42.087 to the hundreds of millions of people worldwide who are in need, 00:01:43.117 --> 00:01:45.836 and to do so not in small doses, 00:01:45.837 --> 00:01:48.454 but rather as a quantum jump. 00:01:48.455 --> 00:01:52.024 I believe that that is now possible for the first time in history, 00:01:53.083 --> 00:01:56.450 with a new treatment called EMDR, 00:01:56.451 --> 00:02:01.682 for Eye Movement Desensitization and Reprocessing. 00:02:04.032 --> 00:02:05.572 Ladies and gentlemen, 00:02:05.573 --> 00:02:10.058 I have this picture on my desk at home, 00:02:10.059 --> 00:02:16.269 to remind me of the human face of trauma. 00:02:18.062 --> 00:02:21.575 Look at this man's eyes, look at the anguish, 00:02:21.580 --> 00:02:24.562 the vulnerability, the hopelessness. 00:02:25.739 --> 00:02:30.865 I first came to realize the importance of trauma, 00:02:30.866 --> 00:02:35.562 when I was UNICEF representative in Bangladesh in the 1990s. 00:02:35.563 --> 00:02:38.012 And I was pondering 00:02:38.013 --> 00:02:42.163 the development challenges of the country, 00:02:43.613 --> 00:02:49.658 its grinding poverty, their regularly recurring natural disasters; 00:02:50.671 --> 00:02:54.931 they've just gone through a punishing war of liberation. 00:02:55.958 --> 00:02:58.908 I could not believe that anyone in that country 00:02:59.878 --> 00:03:03.844 had actually been able to escape being traumatized 00:03:03.845 --> 00:03:07.080 because the signs and the sources of trauma 00:03:07.081 --> 00:03:09.111 were everywhere to be seen. 00:03:13.554 --> 00:03:19.314 So I was wondering what can we do about a problem at such a large scale. 00:03:20.121 --> 00:03:22.791 The answer came to me rather unexpectedly. 00:03:23.831 --> 00:03:27.844 I was taking a brief sabbatical in San Francisco, 00:03:27.845 --> 00:03:30.414 I was in a book store, 00:03:30.415 --> 00:03:34.335 and inexplicably, my hand reached out 00:03:34.336 --> 00:03:38.097 to a book with the title EMDR. 00:03:38.098 --> 00:03:42.551 I'd never heard of EMDR, I didn't know why my hand was doing this. 00:03:42.552 --> 00:03:45.831 Nonetheless, I sat down on the floor, began to read, 00:03:45.832 --> 00:03:49.265 and about an hour later when I reemerged, 00:03:49.266 --> 00:03:55.015 I realized that I had just read 00:03:55.016 --> 00:03:58.367 about a treatment facility, 00:03:58.368 --> 00:04:03.610 a treatment modality, that was rapidly scalable, 00:04:03.611 --> 00:04:08.030 and that was very effective in treating people 00:04:08.031 --> 00:04:09.586 in a very short period of time. 00:04:09.587 --> 00:04:12.781 So that was exactly the kind of treatment 00:04:12.782 --> 00:04:15.715 that we could very well use in Bangladesh. 00:04:15.716 --> 00:04:20.945 So I called the author, Dr. Francine Shapiro 00:04:20.946 --> 00:04:24.827 - who also is the developer of EMDR - 00:04:24.828 --> 00:04:28.161 I asked for an appointment, and the next day, I was in her home 00:04:28.162 --> 00:04:32.474 negotiating a contract for EMDR trainers to come to Bangladesh 00:04:32.475 --> 00:04:36.971 and to begin to treat the many people there. 00:04:36.972 --> 00:04:39.601 The training would be given 00:04:39.602 --> 00:04:46.452 to the 54 Bangladeshi psychologists and psychiatrists in that country. 00:04:47.959 --> 00:04:50.501 So that way I learned first hand 00:04:50.543 --> 00:04:55.534 about the amazing, almost magical effectiveness of EMDR. 00:04:59.744 --> 00:05:04.743 Most of you probably have heard or know someone, 00:05:04.744 --> 00:05:07.326 who has been traumatized, 00:05:07.327 --> 00:05:12.377 perhaps even suffer from PTSD, post traumatic stress disorders. 00:05:13.407 --> 00:05:15.207 In fact, statistically speaking, 00:05:15.208 --> 00:05:19.218 there should be a good number of you here in this audience 00:05:19.219 --> 00:05:22.265 who actually have suffered PTSD yourself. 00:05:25.035 --> 00:05:30.734 The PTSD symptoms include three sets: the first is the hyper-arousal, 00:05:30.735 --> 00:05:34.676 that means you can't sleep, you can't concentrate very well. 00:05:34.677 --> 00:05:39.147 There is also easily being angered, or getting into a panic, 00:05:39.148 --> 00:05:42.757 or even feeling intense feelings of hatred. 00:05:43.947 --> 00:05:47.412 Then there is the reliving of the traumatic event, 00:05:47.413 --> 00:05:50.369 and that comes in nightmares, 00:05:51.769 --> 00:05:54.799 invasive, intrusive flashbacks. 00:05:55.702 --> 00:05:58.862 And thirdly, there is the avoidance and numbing, 00:05:58.863 --> 00:06:04.972 you avoid any situation that reminds you of the traumatic event. 00:06:04.973 --> 00:06:07.163 You avoid certain relationships. 00:06:08.043 --> 00:06:11.553 And there is also the growing 00:06:11.569 --> 00:06:14.995 distrust of anyone around you, 00:06:14.996 --> 00:06:17.955 your isolation, the hopelessness, 00:06:17.956 --> 00:06:21.587 and that can go all the way to outright depression. 00:06:22.827 --> 00:06:24.963 So, from these symptoms, 00:06:24.964 --> 00:06:31.613 you can see that PTSD is a very severe and disabling illness 00:06:31.614 --> 00:06:35.314 that has very serious consequences 00:06:35.315 --> 00:06:39.395 for both the ability to learn, 00:06:40.665 --> 00:06:42.475 the creativity of people, 00:06:43.485 --> 00:06:47.290 the productivity, and the general well being. 00:06:47.291 --> 00:06:49.899 There is also new evidence to show 00:06:49.900 --> 00:06:54.217 that if people have suffered even a minor trauma 00:06:55.347 --> 00:06:58.231 there are heightened chances there 00:06:58.232 --> 00:07:02.511 that you would get ill with substance abuse, 00:07:02.512 --> 00:07:07.278 with cardiac conditions, and even with cancer. 00:07:08.128 --> 00:07:11.787 There's a saying that says "Violence begets violence." 00:07:11.788 --> 00:07:14.708 What we don't often realize is 00:07:14.709 --> 00:07:20.876 that the trauma is the 'trait d'union' between violence and violence. 00:07:20.887 --> 00:07:24.507 Because, if somebody gets traumatized 00:07:24.508 --> 00:07:28.298 as a result of violence, 00:07:28.299 --> 00:07:31.478 then that person is at a heightened risk 00:07:31.479 --> 00:07:37.002 of himself or herself become a perpetrator of violence. 00:07:37.003 --> 00:07:40.538 That's actually quite a scary understanding. 00:07:42.348 --> 00:07:45.027 If PTSD is left untreated, 00:07:45.028 --> 00:07:48.840 then it will last a life time. 00:07:50.090 --> 00:07:51.660 Ladies and gentlemen, 00:07:52.698 --> 00:07:55.227 we don't have a very good statistics worldwide, 00:07:55.228 --> 00:07:57.713 about trauma and PTSD. 00:07:57.714 --> 00:08:00.473 But if we look at the number of people 00:08:00.474 --> 00:08:04.793 who are exposed to traumatic circumstances and events, 00:08:04.794 --> 00:08:07.802 we may be able to get an order of magnitude. 00:08:07.803 --> 00:08:10.794 For example, take a look at these numbers here. 00:08:10.795 --> 00:08:14.544 They're all taken from authoritative sources. 00:08:14.545 --> 00:08:18.155 1.5 billion people worldwide live 00:08:18.156 --> 00:08:22.166 in situations of political and criminal violence. 00:08:22.167 --> 00:08:27.793 That includes the Syrias and the Congos, and Somalias, and all the other countries. 00:08:27.818 --> 00:08:30.547 Then 42 million people worldwide 00:08:30.548 --> 00:08:34.783 are either refugees or internally displaced people, 00:08:34.784 --> 00:08:39.011 and displacement itself is a big risk factor for trauma. 00:08:39.013 --> 00:08:45.833 Some 200 million people have been exposed to natural disasters in 2011 alone. 00:08:45.843 --> 00:08:50.462 And so, this becoming an annual feature 00:08:50.463 --> 00:08:54.141 with the global climate change 00:08:54.142 --> 00:08:56.911 more and more people getting traumatized. 00:08:56.912 --> 00:09:01.670 Then some 1.3 billion people are living in absolute poverty. 00:09:02.960 --> 00:09:06.351 I don't think that we can imagine [more] traumatizing circumstances 00:09:06.352 --> 00:09:10.813 in which these people live their day to day life. 00:09:10.814 --> 00:09:12.612 And then get this, 00:09:12.613 --> 00:09:17.050 one in every three women worldwide 00:09:17.051 --> 00:09:21.700 actually suffer during their lifetime 00:09:21.701 --> 00:09:26.340 from sexual, physical or emotional abuse. 00:09:26.341 --> 00:09:30.287 These are staggering numbers you will agree. 00:09:31.459 --> 00:09:34.335 Most of these traumas are called Big "T" traumas 00:09:34.367 --> 00:09:39.458 because they are the results of extreme events. 00:09:40.478 --> 00:09:43.874 They are the results of loud emergency, if you could say, 00:09:43.875 --> 00:09:46.827 But there are also the small "t" traumas. 00:09:46.828 --> 00:09:49.247 And they are well known to all of us, 00:09:49.248 --> 00:09:55.066 they are caused by everyday traumatizing events, 00:09:55.067 --> 00:09:58.216 usually we call them normal events, 00:09:58.217 --> 00:10:02.147 but they are accidents, they are bullying, 00:10:02.150 --> 00:10:07.670 they are child abuse, divorce and many other circumstances like that. 00:10:08.534 --> 00:10:10.543 These are silent emergencies 00:10:10.544 --> 00:10:16.393 but they affect literally millions and millions of people at any given time. 00:10:16.394 --> 00:10:20.894 If you add big "T" trauma and small "t" trauma together, 00:10:20.895 --> 00:10:25.334 you end up with a staggering global burden of trauma. 00:10:25.335 --> 00:10:27.029 Now, let me hasten to say 00:10:27.030 --> 00:10:32.239 that not all traumatic experiences also lead to PTSD. 00:10:32.240 --> 00:10:37.873 Thankfully, humans are, by and large, remarkably resilient 00:10:39.253 --> 00:10:42.382 and usually, after traumatic experience 00:10:42.383 --> 00:10:48.478 get better all by themselves without any medical or psychological help. 00:10:49.248 --> 00:10:50.428 If we took 00:10:52.698 --> 00:10:56.867 the PTSD prevalence, life time prevalence of the United States, 00:10:56.868 --> 00:10:58.791 which is between 7 and 8%, 00:10:58.792 --> 00:11:03.051 and we apply that number to the world as a whole, 00:11:03.052 --> 00:11:08.483 we would end up with at least 500 million cases of PTSD. 00:11:09.283 --> 00:11:14.588 That's like the total population of the European Union. 00:11:14.589 --> 00:11:19.856 And the question could be asked: "Is this problem not too big to tackle?" 00:11:19.857 --> 00:11:22.898 I think a mere 30 years ago, 00:11:22.899 --> 00:11:24.996 I would have said, yeah, this can't be done. 00:11:24.997 --> 00:11:28.471 We didn't have the means, we didn't have the technology at that time. 00:11:28.472 --> 00:11:33.138 But today I think, with EMDR, we actually have a good chance. 00:11:33.139 --> 00:11:35.519 In a way, I believe that, you know, 00:11:35.520 --> 00:11:38.961 this is not rocket science to begin to deal with this problem, 00:11:38.962 --> 00:11:41.771 even at that very large scale. 00:11:41.772 --> 00:11:43.731 How does EMDR work? 00:11:43.732 --> 00:11:48.136 EMDR resolves the emotional distress, 00:11:48.137 --> 00:11:51.872 but the precise mechanism is probably 00:11:51.873 --> 00:11:56.573 a good topic for the next TED talk. 00:11:57.753 --> 00:12:00.735 Meanwhile, let me just say 00:12:00.736 --> 00:12:05.595 that the psycho-neuro physiological processes 00:12:05.596 --> 00:12:10.604 that lead to the healing are set in motion by bilateral stimulation 00:12:10.605 --> 00:12:14.933 and that is usually rapid eye movement, from left to right. 00:12:14.934 --> 00:12:19.494 It seems as simple and magical as that. 00:12:19.495 --> 00:12:24.778 As soon as that process has happened, 00:12:24.779 --> 00:12:29.557 the trauma memory is healed 00:12:29.558 --> 00:12:33.967 and all the symptoms of PTSD disappear. 00:12:34.737 --> 00:12:37.735 And they disappear for good. They won't come back. 00:12:37.736 --> 00:12:40.946 And all of this can be done in a matter of few sessions. 00:12:40.947 --> 00:12:43.286 This is why the World Health Organization 00:12:43.287 --> 00:12:47.485 recently gave official recognition to EMDR 00:12:47.486 --> 00:12:52.316 as one-evidence based and scientifically validated 00:12:53.476 --> 00:12:56.364 treatment modality for trauma. 00:12:57.154 --> 00:13:02.529 We now have the possibilities of rapidly scaling up 00:13:02.530 --> 00:13:06.195 with this new treatment called EMDR. 00:13:06.196 --> 00:13:10.066 EMDR can treat in a matter of hours and days, 00:13:10.067 --> 00:13:13.067 as opposed to the conventional therapy 00:13:13.069 --> 00:13:18.981 that took weeks, months, and sometimes years of therapy. 00:13:18.982 --> 00:13:24.539 It can also be administered to groups of people not just individuals. 00:13:24.540 --> 00:13:28.899 It is more easily accepted, because unlike the conventional treatment, 00:13:28.899 --> 00:13:30.880 you don't have to talk about your trauma, 00:13:30.881 --> 00:13:34.710 people who have been traumatized don't want to talk about their trauma. 00:13:34.711 --> 00:13:38.391 And then there's a possibility of using paraprofessionals 00:13:40.581 --> 00:13:46.837 to provide services of psychological first aid, 00:13:46.838 --> 00:13:51.750 thereby relieving the psychologists and psychiatrists 00:13:51.751 --> 00:13:55.200 from the more mundane kind of work. 00:13:55.201 --> 00:14:00.616 So based on my profession as a development economist, 00:14:00.617 --> 00:14:02.858 I'm convinced that it is now possible 00:14:02.859 --> 00:14:08.709 to begin to scale up these trauma services. 00:14:10.279 --> 00:14:11.440 Ladies and gentlemen, 00:14:11.441 --> 00:14:13.971 you will agree with me 00:14:16.041 --> 00:14:20.882 that this woman and all the millions of people 00:14:20.883 --> 00:14:24.034 who have been traumatized like her, 00:14:24.035 --> 00:14:26.863 at least deserve their peace of mind. 00:14:26.864 --> 00:14:28.626 They deserve actually much more, 00:14:28.627 --> 00:14:33.916 they deserve to get back their laughter and their self confidence, 00:14:33.917 --> 00:14:38.197 and be able to make a contribution to society again, 00:14:38.198 --> 00:14:41.107 and be part of their community. 00:14:41.108 --> 00:14:45.419 What would the world look like 00:14:45.420 --> 00:14:50.190 if we were able to systematically heal all the traumas? 00:14:51.246 --> 00:14:57.616 I believe that that world would be a lot less violent 00:14:58.712 --> 00:15:03.522 because we would finally begin to interrupt the insidious, 00:15:03.523 --> 00:15:10.233 interpersonal and inter-generational transmission of violence and abuse. 00:15:10.992 --> 00:15:14.820 So, that world, I believe, would be 00:15:14.821 --> 00:15:19.586 a lot more peaceful, and also a lot more prosperous. 00:15:20.732 --> 00:15:24.892 I believe that that world is within reach. 00:15:26.802 --> 00:15:28.350 I am convinced 00:15:28.351 --> 00:15:32.711 that EMDR has the power and the potential 00:15:33.806 --> 00:15:36.186 to help treat and heal 00:15:37.469 --> 00:15:41.529 the humanity's wounded memories. 00:15:42.715 --> 00:15:45.155 Do you think that that will happen? 00:15:47.450 --> 00:15:48.403 Thank you. 00:15:48.404 --> 00:15:49.600 (Applause)