an overview emdr. outline of today’s presentation g what is emdr g what is the goal g how does it...
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An OverviewAn Overview
EMDR
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Outline of Today’s
Presentation
Outline of Today’s
Presentation What is EMDR What is the goal How does it work The phases of EMDR The client’s experience of EMDR The Populations EMDR works with Special populations Considerations Group exercise
What is EMDR What is the goal How does it work The phases of EMDR The client’s experience of EMDR The Populations EMDR works with Special populations Considerations Group exercise
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What is EMDR?
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What is it?What is it?
A psychological method for treating experientially based disorders
It includes various orientations to treatment
An eight phase approach that views pathology as based upon perceptual information that was maladaptively stored
A psychological method for treating experientially based disorders
It includes various orientations to treatment
An eight phase approach that views pathology as based upon perceptual information that was maladaptively stored
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What’s the Goal?What’s the Goal?
To facilitate resolution of traumatic early life experiences
Desensitize stimuli that causes present day distress
Incorporate adaptive attitudes, skills, and desired behaviors for enhanced future functioning
To facilitate resolution of traumatic early life experiences
Desensitize stimuli that causes present day distress
Incorporate adaptive attitudes, skills, and desired behaviors for enhanced future functioning
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How does it work?
How does it work?
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How does it work? When the brain is upset it does not process
the same way as when it is in a stable state The average daily information is stored in
the midbrain (amygdala) and then shifted into the neocortex during REM sleep
When trauma occurs, it is “too big” to be processed and stays in the Amygdala where it can be felt
Similar memories form in clusters so others will attach to like memories in both the neocortex and the amygdala
When the brain is upset it does not process the same way as when it is in a stable state
The average daily information is stored in the midbrain (amygdala) and then shifted into the neocortex during REM sleep
When trauma occurs, it is “too big” to be processed and stays in the Amygdala where it can be felt
Similar memories form in clusters so others will attach to like memories in both the neocortex and the amygdala
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How does it work? (continued)
How does it work? (continued)
EMDR works to break up this information and process it into the long term memory… So you can REMEMBER but not RE-EXPERIENCE.
The Neurobiological effect created during EMDR is not fully understood, however, it is currently theorized that EMDR recreates the processing similar to what happens during REM sleep.
EMDR works to break up this information and process it into the long term memory… So you can REMEMBER but not RE-EXPERIENCE.
The Neurobiological effect created during EMDR is not fully understood, however, it is currently theorized that EMDR recreates the processing similar to what happens during REM sleep.
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The Eight PhasesThe Eight Phases
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1. Taking History1. Taking History
GenogramsThorough AssessmentsFollowing your instinctsOther methods???Balancing Trauma with Strengths
GenogramsThorough AssessmentsFollowing your instinctsOther methods???Balancing Trauma with Strengths
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2. PreparationA Strong skill for the EMDR therapist, as well as,
therapists not working with EMDR. It will be emphasized both in presentation and group
exercise
2. PreparationA Strong skill for the EMDR therapist, as well as,
therapists not working with EMDR. It will be emphasized both in presentation and group
exercise
ContainmentGroundingSafe/Calm PlaceAllies/ProtectorsInner advisorIFS
ContainmentGroundingSafe/Calm PlaceAllies/ProtectorsInner advisorIFS
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3. Assessment3. Assessment
This goes hand in hand with Desensitization
Setting up the target image Assessing emotions Assessing Somatic/Sensations Assessing the Negative Cognition Uncovering the desired positive
cognition SUDS VOC
This goes hand in hand with Desensitization
Setting up the target image Assessing emotions Assessing Somatic/Sensations Assessing the Negative Cognition Uncovering the desired positive
cognition SUDS VOC
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4. Desensitization4. Desensitization
Introducing Bilateral StimulationChecking in on awareness of
experienceAuditoryTactileVisual (research based)
Introducing Bilateral StimulationChecking in on awareness of
experienceAuditoryTactileVisual (research based)
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5. Installing5. Installing
The desired positive cognitionInstallationChecking the client’s belief in the
positive cognitionPast PresentFutureContain
The desired positive cognitionInstallationChecking the client’s belief in the
positive cognitionPast PresentFutureContain
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6. Body Scan6. Body Scan
Checking for full clearingSometimes finding new
information/feelingsEmphasizing the experiental
nature
Checking for full clearingSometimes finding new
information/feelingsEmphasizing the experiental
nature
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7. Closure7. Closure
Safe/Calm PlaceContainment
Safe/Calm PlaceContainment
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8. Re-evaluation8. Re-evaluation
The next sessionChecking the SUDS and the VOCMay find more information/feelingsSometimes find feeder memories
The next sessionChecking the SUDS and the VOCMay find more information/feelingsSometimes find feeder memories
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QUESTIONS?QUESTIONS?
??????
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What is the experience like for the client???
What is the experience like for the client???
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History TakingCan feel unearthingCan be moderately disruptiveTherapist is to emphasize the data
collection and not encourage the client to re-experience
Experienced clinician decreases disruptions and increases hope
History TakingCan feel unearthingCan be moderately disruptiveTherapist is to emphasize the data
collection and not encourage the client to re-experience
Experienced clinician decreases disruptions and increases hope
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PreparationA period where the client learns better skills for
copingUsually a period marked with self soothing (for
some the first time)Empowered and/or recognizing strengthsSometimes frustrating
PreparationA period where the client learns better skills for
copingUsually a period marked with self soothing (for
some the first time)Empowered and/or recognizing strengthsSometimes frustrating
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AssessmentAgitatingIntense emotionsAwareness of physical sensations
AssessmentAgitatingIntense emotionsAwareness of physical sensations
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DesensitizationA myriad of sensations and emotionsThe goal is to keep the sensations moving and
changingTherefore creating multiple shifts for the clientEventually ending in a lack of emotion and
sensation around the target memory
DesensitizationA myriad of sensations and emotionsThe goal is to keep the sensations moving and
changingTherefore creating multiple shifts for the clientEventually ending in a lack of emotion and
sensation around the target memory
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Installation (and closure) The Fun Part! Usually marked by smiles and sometimes laughter The client often experiences empowerment, relief, and
joy
Installation (and closure) The Fun Part! Usually marked by smiles and sometimes laughter The client often experiences empowerment, relief, and
joy
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Body ScanUsually very little to no discomfortSometimes additional issues and “feeder
memories” found here
Body ScanUsually very little to no discomfortSometimes additional issues and “feeder
memories” found here
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Re-evaluationUsually very little to no discomfortSometimes additional issues and “feeder
memories” found here
Re-evaluationUsually very little to no discomfortSometimes additional issues and “feeder
memories” found here
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QUESTIONS?QUESTIONS?
??????
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Video of EMDR SessionVideo of EMDR Session
NLP Eye Movement Integration with a Vietnam Veteran
http://www.youtube.com/watch?v=GnoqWqijYvQ
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Target PopulationsWhat different kinds of clients does EMDR work for
Target PopulationsWhat different kinds of clients does EMDR work for
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The EMDR PopulationThe EMDR Population
Personality Disorders
Panic Attacks
Complicated Grief
Dissociative Disorders
Phobias
Pain Disorders
Eating Disorders
Performance Anxiety
Stress reduction
Addictions
Disturbing Memories
Body Dysmorphic
Disorders
Post Traumatic Stress Disorder
Sexual/Physical/Verbal
Abuse
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Special PopulationsSpecial Populations
Chronic Pain
Conjoint Couples Therapy
Children and Adolescents
Sports and performance
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Ascertaining DurationAscertaining Duration
Single incident traumaMultiple incident traumaBig T and Small t TraumaFeeder MemoriesThe importance of taking a
thorough history
Single incident traumaMultiple incident traumaBig T and Small t TraumaFeeder MemoriesThe importance of taking a
thorough history
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Considerations and when to bewarePower of the techniqueDisruptive to Pregnant womenLegal Involvement
Considerations and when to bewarePower of the techniqueDisruptive to Pregnant womenLegal Involvement
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Group ExerciseGroup Exercise
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Practicing Resource Building
Practicing Resource Building
Research indicates we learn to execute actions through doing more than we do through listening or seeing
Some clinicians become tentative around using a technique due to a lack of experience
Today’s exercise is an effort to become more comfortable enacting some of the resource building discussed thus far today
Research indicates we learn to execute actions through doing more than we do through listening or seeing
Some clinicians become tentative around using a technique due to a lack of experience
Today’s exercise is an effort to become more comfortable enacting some of the resource building discussed thus far today
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Practicing Resource Building
Practicing Resource Building
Please take one of the handouts being passed around
Then break up into groups of three Once settled choose one of the three
exercises (one person acting as therapist, the other as client, and the final as observer)
“Therapist” will walk the client through the exercise with the “client”, once finished move onto the next Therapist, client, observer
Please take about five minutes per exercise and then at the end take another five minutes to discuss your experience (total 20 minutes)
Please take one of the handouts being passed around
Then break up into groups of three Once settled choose one of the three
exercises (one person acting as therapist, the other as client, and the final as observer)
“Therapist” will walk the client through the exercise with the “client”, once finished move onto the next Therapist, client, observer
Please take about five minutes per exercise and then at the end take another five minutes to discuss your experience (total 20 minutes)
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Practicing Resource Building
Practicing Resource Building
Take your time as there is no need to rush through
Feel free to add to the exercise with processes you feel comfortable with
Choose a the one you feel would be most challenging for you to approach with a client
Take your time as there is no need to rush through
Feel free to add to the exercise with processes you feel comfortable with
Choose a the one you feel would be most challenging for you to approach with a client
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The Anatomy of our “Selves”
The Anatomy of our “Selves”
The child or exileThe critic or managerThe firefighter (this is when we get to
see most people)The Self
The child or exileThe critic or managerThe firefighter (this is when we get to
see most people)The Self
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The Internal FamilyThe Internal Family
DynamicsThe effects “Parts” have on one
anotherCommon Dynamics
Child/Critic cycleFirefighter InterventionFirefighter engaging the critic, hence
the child
DynamicsThe effects “Parts” have on one
anotherCommon Dynamics
Child/Critic cycleFirefighter InterventionFirefighter engaging the critic, hence
the child
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Common Early Communication Dynamics
Common Early Communication DynamicsSelf to child
AngerAbandonmentLack of trust in the Self to maintain
contactRelief and assuranceCalmingThe importance of consistency
Self to childAngerAbandonmentLack of trust in the Self to maintain
contactRelief and assuranceCalmingThe importance of consistency
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Common Early Communication Dynamics
Common Early Communication DynamicsSelf to Critic
Resistance to stopping communication with the child
Struggle for powerRelief from the critic roleCalm around a true leader
Self to CriticResistance to stopping
communication with the childStruggle for powerRelief from the critic roleCalm around a true leader
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Fire FightersFire Fighters
AddictionsAngerBehavioral IssuesEating DisordersOthers???
AddictionsAngerBehavioral IssuesEating DisordersOthers???
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Methods to Work with Clients
Methods to Work with Clients
JournalingMeditatingIn Session discussionsEmpty chair with internal partsInternal discussionsTalking out loud
JournalingMeditatingIn Session discussionsEmpty chair with internal partsInternal discussionsTalking out loud
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Intervention in Cases of Extreme Emotional
Distress
Intervention in Cases of Extreme Emotional
DistressPanic attacks (child)Waves of depression (critic)Extreme Confusion (various)Rage (child)
Panic attacks (child)Waves of depression (critic)Extreme Confusion (various)Rage (child)
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Story of Debra and IFSStory of Debra and IFS
Trauma HistoryOne year of therapyDaily JournalingImprisonment
Trauma HistoryOne year of therapyDaily JournalingImprisonment
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Story of Sherri and EMDRStory of Sherri and EMDR
Home InvasionPanic with AgoraphobiaPre and post treatment
Home InvasionPanic with AgoraphobiaPre and post treatment
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IFS ExerciseIFS Exercise
Journal: If you were a child, how old would you be?Ask the child “what is your favorite thing to
eat?” and let the child answerAsk the child “How do you feel right now?”
let the child answer candidlyReassure the child if experiencing difficulty Ask the child “Would you like me to write
with or talk with you more often?”Go from there!! What would you ask if you
wanted to get to know any child
Journal: If you were a child, how old would you be?Ask the child “what is your favorite thing to
eat?” and let the child answerAsk the child “How do you feel right now?”
let the child answer candidlyReassure the child if experiencing difficulty Ask the child “Would you like me to write
with or talk with you more often?”Go from there!! What would you ask if you
wanted to get to know any child