1. EMDR
An Overview

2. 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

3. What is EMDR?

4. 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

5. 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

6. How does it work?

7. 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

8. 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.

9. The Eight Phases

10. 1. Taking History Genograms Thorough Assessments
Following your instincts
Other methods???
Balancing Trauma with Strengths

11. 2. Preparation A Strong skill for the EMDR therapist, as well as, therapists not working with EMDR. It will be emphasized both in presentation and group exercise
Containment
Grounding
Safe/Calm Place
Allies/Protectors
Inner advisor
IFS

12. 3. 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

13. 4. Desensitization Introducing Bilateral Stimulation
Checking in on awareness of experience
Auditory
Tactile
Visual (research based)

14. 5. Installing The desired positive cognition Installation
Checking the client’s belief in the positive cognition
Past
Present
Future
Contain

15. 6. Body Scan Checking for full clearing
Sometimes finding new information/feelings
Emphasizing the experiental nature

16. 7. Closure
Safe/Calm Place
Containment

17. 8. Re-evaluation The next session Checking the SUDS and the VOC
May find more information/feelings
Sometimes find feeder memories

18. QUESTIONS?
???

19. What is the experience like for the client???

20. History Taking Can feel unearthing Can be moderately disruptive
Therapist is to emphasize the data collection and not encourage the client to re-experience
Experienced clinician decreases disruptions and increases hope

21. Preparation A period where the client learns better skills for coping
Usually a period marked with self soothing (for some the first time)
Empowered and/or recognizing strengths
Sometimes frustrating

22. Assessment
Agitating
Intense emotions
Awareness of physical sensations

23. Desensitization A myriad of sensations and emotions
The goal is to keep the sensations moving and changing
Therefore creating multiple shifts for the client
Eventually ending in a lack of emotion and sensation around the target memory

24. Installation (and closure)
The Fun Part!
Usually marked by smiles and sometimes laughter
The client often experiences empowerment, relief, and joy

25. Body Scan Usually very little to no discomfort
Sometimes additional issues and “feeder memories” found here

26. Re-evaluation Usually very little to no discomfort
Sometimes additional issues and “feeder memories” found here

27. QUESTIONS?
???

28. NLP Eye Movement Integration with a Vietnam Veteran
Video of EMDR Session
NLP Eye Movement Integration with a Vietnam Veteran

29. What different kinds of clients does EMDR work for
Target Populations
What different kinds of clients does EMDR work for

30. The 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

31. Special Populations Chronic Pain Conjoint Couples Therapy
Children and Adolescents
Sports and performance

32. Ascertaining Duration
Single incident trauma
Multiple incident trauma
Big T and Small t Trauma
Feeder Memories
The importance of taking a thorough history

33. Considerations and when to beware
Power of the technique
Disruptive to Pregnant women
Legal Involvement

34. Group Exercise

35. 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

36. 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)

37. 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

38. Internal Family Systems

Internal Family Systems

39. The Anatomy of our “Selves”
The child or exile
The critic or manager
The firefighter (this is when we get to see most people)
The Self

40. The Internal Family Dynamics The effects “Parts” have on one another
Common Dynamics
Child/Critic cycle
Firefighter Intervention
Firefighter engaging the critic, hence the child

41. Common Early Communication Dynamics
Self to child
Anger
Abandonment
Lack of trust in the Self to maintain contact
Relief and assurance
Calming
The importance of consistency

42. Common Early Communication Dynamics
Self to Critic
Resistance to stopping communication with the child
Struggle for power
Relief from the critic role
Calm around a true leader

43. Fire Fighters Addictions Anger Behavioral Issues Eating Disorders
Others???

44. Methods to Work with Clients
Journaling
Meditating
In Session discussions
Empty chair with internal parts
Internal discussions
Talking out loud

45. Intervention in Cases of Extreme Emotional Distress
Panic attacks (child)
Waves of depression (critic)
Extreme Confusion (various)
Rage (child)

46. Story of Debra and IFS Trauma History One year of therapy
Daily Journaling
Imprisonment

47. Story of Sherri and EMDR
Home Invasion
Panic with Agoraphobia
Pre and post treatment

48. IFS 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 answer
Ask the child “How do you feel right now?” let the child answer candidly
Reassure 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