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An Overview

EMDR. An Overview. 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 it?.

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An Overview

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  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. 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 • 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. Video of EMDR Session NLP Eye Movement Integration with a Vietnam Veteran http://www.youtube.com/watch?v=GnoqWqijYvQ

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

  30. The EMDR Population

  31. Special Populations

  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

  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

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