Elements of psychoed that covers EMDR and trauma (3)
- Trauma is stored in unhelpful ways in the brain because it was in panic mode and processing was impaired, giving us unhelpful beliefs, emotions and reactions
- EMDR helps unlock the nervous system and allow your brain’s natural mechanisms to reprocess the event
- Bilateral stimulation activates both halves of the brain so the event can be fully processed
3 Reasons why we do bilateral stimulation
- Promotes dual attention
- Eye movements elicit orienting response
- Eye movements stimulate process similar to REM sleep
EMDR procedures to discuss in preparation phase (3 parts)
- EMDR seating arrangement
- Eye movement or other forms of BLS - how long is set, what happens after each set
- Explain window of tolerance and importance of pausing if things get intense/intolerable. Do not push through
Do we want to specify an order when asking for ALES?
Yes, ask client for first to last
7 key elements of light stream
- Scan the body to identify any discomfort and where it is in the body
- Get a sense of size, shape, color, texture of the discomfort
- Ask if there is a color associated with soothing
- Ask them to imagine soothing light in this color shining down and on top of head and through the entire body
- Let it surround the uncomfortable
- Notice it for a while and breathe it in
- Take another deep breath and open eyes
Why is it important to emphasize clients going with what first comes up when doing a floatback?
Because clients tend to dismiss what doesn’t make sense
How to handle situations where client touches on something that could be its own target (e.g. parents don’t love me)
Help client just scope it during that particular target and see how far you can get it. 6 should be possible even with complex trauma.
How do we use EMDR in working with psychosis?
Negative voices can be targets or address trauma as that’ll help reduce voices intensity and maybe shift them to positive
When doing TICES on early memory, how do we handle multiple parts (e.g. adult and child)
Ask them to focus on child part. If they don’t know how child feels, ask them to think about how it would make them feel.
How do we time EMDR work with somebody who has BPD
Have them track cycles so we can avoid doing phase 4 if they’re in an intense place on their cycle
What should we do immediately after collecting ALES
Nervous system soothing practice
Two signs of dissociation
- Stop looking/doing BLS
- Stop giving material
5 Orienting/Grounding techniques
- Checking the corners of the room
- Hand sweeping across brow, down side of neck, arm and out the fingers
- Hand on chest, hand on stomach - noticing breath
- Orienting to present - where is client now, how old are they?
- EFT tapping (karate chop to crown, face triangle, upper lower lip and then clavicle)
What does TICES stand for
Target
Image
Cognitions - what does that say about you? negative, positive and validity of positive
Emotions
Subjective unit of distress
Somatic - where do you feel that in your body
What are the 8 phases
History taking and tx planning
Preparation
Assessment (TICES)
Desensitization and reprocessing
Installation
Body scan
Closure
Re-evaluation
Phase 4 script parts (4)
- Let them know we’re about to start eye movements/tapping
- Bring up the image, negative condition and where you felt it
- Ask if they’re ready
- Then begin 24-30 passes
Nervous system shifting technique involving cold water
Splash it on your face or cold wash cloth on back of the neck
New somatic resource involving self touch (hint: finger paint)
imagining paint on fingers and coating your face with it starting at the forehead.
What do we do when we first have got a 0 after clearing all the channels
Tell them to go with that and another round. Little better, little worse or about same? Once about the same 2x then proceed
What do we do after we’ve cleared the target and they’ve had about the same twice?
Go to phase 5: installation
Container Part 1: Pre-tapping parts
- Psychoed - practice a skill to help you put this away for now.
- Think of a container that could hold this. What is it? How would you close it and possibly secure it?
- Now think of a place where you might want to put it?
Container Part 2: Tapping script parts
- Notice materials and size and any other attributes that make it a good container
- Visualize putting the thing in
- Visualize closing the lid/securing it
- Take a breath and notice how it feels to have it no longer inside you
- Imagine putting container in its place and walk away, leaving it behind
- How does it feel to leave it there and no longer carry?
- Remember that you can keep those things there until if and when you want to take something out.
- If things start to come up before next session you can put those away too
Steps of phase 5 (8 parts)
- Check original positive cognition still fits or does something else sound better
- Hold the incident in your mind and check validity 0-7
- Target incident and PC for BLS and then check if it feels more true, less true or the same
- Stay with BLS sets until no change
- If less than 7 what keeps it from being more true - if they can identify blocking belief repeat on that until back to 7
- If less than 7 and they can’t identify blocking belief - go back to target to check for unresolved channels
- After about the same 2x, do body scan and DONE!
- If earlier memory comes up that blocks resolution of target, note that and get as far as we can here (ecological 6).
Steps of Phase 6
- Hold the image and positive cognition in mind
- Mentally scanning their entire body starting from head for lingering tension or discomfort “anything at all” - name what they find
- Target “nothing” / clear body scan for 1-2 sets of BLS to reinforce
