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emdr renewal...and beyond day one

emdr renewal...and beyond day one. with Andrew Seubert, LPC, NCC ClearPath Healing Arts Center, Mansfield, PA www.clearpathhealingarts.com email: seuberta@mac.com. The eight phases. Evaluation (history taking and treatment plan) Preparation Assessment Processing Installation Body scan

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emdr renewal...and beyond day one

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  1. emdr renewal...and beyondday one • with Andrew Seubert, LPC, NCC • ClearPath Healing Arts Center, Mansfield, PA • www.clearpathhealingarts.com • email: seuberta@mac.com

  2. The eight phases • Evaluation (history taking and treatment plan) • Preparation • Assessment • Processing • Installation • Body scan • Closure • Re-evaluation

  3. evaluation • Frontloading resources/skills • History taking • The “fulcrum”: case formulation for the client • Looking for the themes (NC)

  4. Practice:Case formulation • This is what I’ve learned about you... • Strengths and resources • “Worst things...” • Negative beliefs • Stuffed feelings • Trigger situations • Quick relief (problem) behaviors... • Does this seem to fit? • Ricky Greenwald: EMDR within a Phase Model of Trauma Informed Treatment

  5. cognitions- A. Leeds • Negative,self-referencing • Presently held • Irrational, subject to change with tx • Focuses presenting issue • Global/generalized • Affective resonance • Positive, self-referencing • Realistically adaptive for client • May be same theme as NC • Accurately focuses desired direction of change • Generalizes to other issues • Positive affective resonance • aa

  6. NC - Research • Shapiro (2001): safety, responsibility, choice • Earl Grey: esgrey@gmail.com • Research subjects: no “T” trauma • Question: is EMDR effective with those who present with small “t” experiences?

  7. cognitive themes expanded • Instinctual forces: survival and attachment • Responsibility: I have DONE bad (doing) • Safety: I am threatened (external locus) • Value: I AM bad (being) • Power: I am powerless (internal locus) • Choices: I have options • c

  8. Overly responsible • It is ALL my fault • I deserve what I get

  9. Un-safe • I am vulnerable • I am in danger • I am going to die

  10. Value-less • I am inadequate • I am unlovable • I am defective • I am damaged • I am worthless

  11. Powerless • I am helpless • I am trapped • I have no control

  12. target sequencing • Beginning with the “big one”, what brought the client in to see you. Caveats. • Processing memories from the list of worst things in chronological order • Processing memories in order of increasing SUDs • “Personal trainer” approach - R. Greenwald

  13. Symptom driven sequencing • Debbie Korn, Roy Kiessling, EMDR Institute • Presenting complaint/symptom • Recent example of it • Image, NC, PC • Floatback or direct questioning • Earliest memory, worst, other outstanding examples of this theme

  14. symptom driven- 2 • Present triggers • Future template (preferred behaviors) • Future difficulties/triggers • Complete past-present-future for the one theme before proceeding to another • Deborah Korn: Journal of EMDR Practice and Research, Vol.3, No. 4, 2009. p. 272.

  15. Phase ii - preparation

  16. three part preparation • Stabilization, safety and case management • Resources and skills • Quick successes • Frontloading

  17. skills and resouces • The response cycle • Resource Development and Installation (Andrew Leeds and Deborah Korn)

  18. Awareness Components • Outside (visual, auditory, tactile) • Inside (breath, body, thoughts, body sensations, feelings, open awareness) • Who am I?

  19. Affect Education: the Courage to Feel • Why bother? • 1. Our radar in the world • 2. Motivators • 3. Connectors

  20. the four steps - A-b-c-d • Be AWARE of the feeling • BE with the feeling • CHECK the message of the feeling • DECIDE to express, act or not from The Courage to Feel, 2008

  21. the guest house - Rumi This being human is a guest house.Every morning a new arrival.A joy, a depression, a meanness,some momentary awareness comesas an unexpected visitor.Welcome and entertain them all!Even if they're a crowd of sorrows,who violently sweep your houseempty of its furniture,still, treat each guest honorably.He may be clearing you outfor some new delight.The dark thought, the shame, the malice,meet them at the door laughing,and invite them in.Be grateful for whoever comes,because each has been sentas a guide from beyond.

  22. Movies-skill rehearsal • Goal: to build up short-term successes • Target: past (corrective) or future (desired) • Elements: situation, internal cues, resources/skills, next steps, desired ending

  23. phases 3-7/Processing

  24. got emdr? • How often do you use EMDR? • Countertransference: therapist anxiety/self-doubt • Client preparation - RDI: too much of a good thing

  25. the power of process • Client process - what does the healing? When in doubt...follow, follow, follow. • The story of “John” • Self-confidence and the beginner’s mind - know what you know AND getting out of the way • The more complex, the more involved the therapist. The therapeutic relationship as attachment repair.

  26. Changing focus • Direct client attention from cognitive (left pre-frontal cortex) to emotions (limbic), to body (reflex complex), or any combination of these • Change client attention from past or future (left pre-frontal cortex) to here and now (right pre-frontal cortex), and vice-versa • Earl Grey: 2010 • Power of mindful awareness (medial pre-frontal cortex.

  27. Levels of cognitiveinterweave • Deany Laliotis: Dlaliotis@aol.com • Validating • Clarifying/mirroring • Focusing • Accessing/Questioning • Informing/education • Challenging • Integrating • Resourcing

  28. phase 5 • Does the original PC still fit? • Hold the PC and the original memory • Process with usual speed and number of EMs • VOC of 7 or ecologically valid 6

  29. phase 6 • Body scan without EMs while holding the PC and the original memory • Process any disturbance with usual set length and speed of EMs until clear • Repeat body scan with slow, short set to reinforce the positive experience • Rule of thumb: slow or fast? short or long?

  30. Phase 7 • Closure • What to expect • What to do in between

  31. phase 8 • General experiences and observations: triggers, dreams, thoughts, feelings, body sensations, different responses • Revisit the memory you finished or are still working on: disturbance? what kind? 0-10? Go with that. • If no disturbance, check the PC. • Where to next? past? present? future? new theme?

  32. Protocol variations • Recent Events Protocol • Anxiety/phobias • Other? • Cases

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