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1. Zangwill, W. (1995, June). Beyond the basics:  Conceptual issues and advances in using EMDR. Presentation at the EMDR Network Conference, Santa Monica, CA.

Language: English

Format: Conference

Abstract:
This workshop is designed for those comfortable with the basics of using EMDR. We shall discusses the importance of developing a conceptual framework in which to view the patient and his/her life experiences. Though any framework could potentially be used, the one we shall use is that of Jefiey Young's Schema-Focused Cognitive therapy. This workshop is too brief to go deeply into Jeff's work so let me give you some references. (Books: 1)Cognitive Therapy for Personality Disorders: A Schema Focused Appoach, Professional Resource Exchange, Sarasota, F1, (813) 366-7913 Or 2) Reinventing Your Life, Young and Klosko. Jeff can be reached at the CTC of NY (212) 717-1052). I would like to begin by presenting an overview of how I see the case conceptualization enhancing the effectiveness of EMDR. Next I want to present a case illustrating the points I am going to make. Then, for the remaining two thirds of the presentation, I would like us to share our experiences of cases using either this or your own framework. Why conceptualize the case? Why not just treat the trauma directly? Because I assume that it is the interaction of the events a person has experienced and the way in which they have interpreted, experienced and stored them that is most important in determining the amount and kind of pain that remains. If you took a group of 100 people who had been in serious accidents, were assaulted, etc. They will not all respond the same to the experience. Thus, I think that it is vitally important to "map" each patient's own idiosyncratic set of vulnerabilities, his/her schemas or life themes. One of the ways I do that is by attempting to combine all of the information that I obtain in the first few sessions. This would include history taking, any paper and pencil measures I use, e.g., Lazarus' Multimodal Life History Questionnaire (Research Press, Champagne, IL.); Young's Schema Questionnaire (Jeffrey Young, Cognitive Therapy Center of New York), and my experience of the client in session. My assumption is that we all have specific vulnerabilities. In Young's system such issues as Emotional Deprivation - the feeling that we shall never receive the kind of caring we need - Abandonment, Mistrust/Abuse, Defectives, Vulnerability, Subjugation, Entitlement, etc., are assumed to be organizing themes around which memories and experiences are stored. (Use 'Types of Fruit' metaphor here.) Once you have identified these underlying vulnerabilities and life themes, educating patients as to the role of these early maladaptive schemas in their present life difficulties is quite usefull in a variety of ways. First, is its explanatory power. One of the problems clients often present is the pain of the event itself their subsequent reactions. How many of us have heard from our clients variations on the theme of "What's wrong with me that this is still bothering me? It happened years ago; how come I'm still overreacting?" Explaining that often the event was/is so painful because it taps into a whole series of memories (the childhood file folders that Francine talks about in Level I), frequently increases clients' ability to understand their emotional reactions and reduces their tendency to blame themselves. Second, it alerts you and the client to look for other examples in the past that might be thematically connected and to be aware of situations in the future that might be troublesome. For example, imagine a client who suffered a tremendous loss as a chlld through the death of a parent, divorce, etc. Through your interviews and data collection, you realize that the issue of abandonment is a very pow& for them. Naturally, you would want to use EMDR to clean out any past experiences connected to abandonment. However, you should anticipate that situations involving future separation will need to be addressed. How will they react when their spouse goes on a business trip? The conceptualization around this theme alerts you and the client to be aware of these issues. Also, it can be very helpfull in your couples work. Take the example of the spouse that gets upset about over his wife's upcoming business trip. (Knowing that sometimes the upset shows itself prior to the trip and sometimes it is only after they return that the spouse feels punished). Without knowledge of these underlying schemas and life themes, the wife might interpret the husband's upset as a result of jealousy at her success, fear of her growth, and as being a part of his controlling nature. With these interpretations, her anger and frustration would be understandable. How differently might she respond if she saw his difficulty in her leaving as reflecting his fear of losing her and being abandoned once again. Might this interpretation allow both of them to respond in ways helpful to the relationship? With this brief background, let me present a case and show you how these issues fit together and how by conceptualizing the case accurately I was able to provide better treatment. After if I finish this presentation, I want to open the floor to your comments and questions. I would then like to propose that we take the remaining time for you to present your own cases that illustrate either the usefulness of the conceptualization you did or the problems you ran into when you didn't. Case # 1 Case discussion. Case presentations and discussion by participants.

Keywords: Conceptual Issues  

Accuracy Verified: Yes


2. Herbert, C. (2002, June). A CBT-based therapeutic alternative to working with complex client problems. European Journal of Psychotherapy, Counseling & Health, 5(2), 135-144.

Language: English

Format: Journal

Abstract:
This paper offers a therapeutic alternative to working with complex client problems, based on a cognitive behavioural therapy (CBT) approach, which is informed by a combination of schema-focussed cognitive behavioural therapy (McGinn and Young 1996; Young 1994; Padesky 1994; Pretzer and Fleming 1989), specialized cognitive behaviourally-focussed trauma therapy (Herbert 1996, 2001, 2002a, 2002b; Herbert and Wetmore 1999, 2001), eye movement desensitization and reprocessing techniques (EMDR - Shapiro 1995) and mindfulness techniques (Bennett-Goleman 2001; Teasdale et al. 1995; Kabat-Zinn 1994; Linehan 1993). This paper attempts to illustrate how such an approach might be applied to working with complex client problems, such as Tracey's, by addressing some of the therapeutic issues that have been highlighted in the original case study of Tracey by her therapist and introducing an alternative understanding of these.

Keywords: CBT  Cognitive Behavioral Therapy  Countertransference  Distress  Phenomenology  Physical Manifestations  Psychoanalysis  Psychotherapy  Psychoanalytic Psychotherapy  Psychological Distress  Psychosomatic Phenomena  Self Destructive Behavior  Self Harm  Somatoform Disorders  Thinking  Trauma Therapy  

Accuracy Verified: Yes


3. Herbert, C. (2002, May). A CBT-based therapeutic alternative to working with complex client problems. Presentation at the annual meeting of the EMDR Europe Association, Frankfurt, Germany.

Language: English

Format: Conference

Abstract: This paper offers a therapeutic alternative to working with complex client problems, based on a cognitive behavioural therapy (CBT) approach, which is informed by a combination of schema-focussed cognitive behavioural therapy (McGinn and Young 1996; Young 1994; Padesky 1994; Pretzer and Fleming 1989), specialized cognitive behaviourally-focussed trauma therapy (Herbert 1996, 2001, 2002a, 2002b; Herbert and Wetmore 1999, 2001), eye movement desensitization and reprocessing techniques (EMDR - Shapiro 1995) and mindfulness techniques (Bennett-Goleman 2001; Teasdale et al. 1995; Kabat-Zinn 1994; Linehan 1993). This paper attempts to illustrate how such an approach might be applied to working with complex client problems, such as Tracey's, by addressing some of the therapeutic issues that have been highlighted in the original case study of Tracey by her therapist and introducing an alternative understanding of these.[Taylor-Francis]

Keywords: CBT  Cognitive Behavioral Therapy  Counseling  Psychotherapy  

Accuracy Verified: Yes


4. Young, J., Zangwill, W. M., & Behary, W. E. (2002). Combining EMDR and schema-focused therapy: The whole may be greater than the sum of the parts. In F. Shapiro (Ed.). EMDR as an integrative psychotherapy approach: Experts of diverse orientations explore the paradigm prism (1st ed.) (pp. 181-208). Washington: American Psychological Association. vii, 444 pp.

Language: English

Format: Book Section

Abstract: E
motional processing occurs through specific circuitry and structures in the brain. Unfortunately, much of clinical psychology has neither understood nor sufficiently integrated the treatment implications of this area of research. However, some practitioners have recognized the need for more integrative models of psychotherapy. Two of the best models are Young's Schema-Focused Therapy (SFT) and Shapiro's Eye Movement Desensitization and Reprocessing (EMDR). Although these two approaches arose from different clinical experiences and theoretical backgrounds, they are similar in that they recognize the importance of all the ways in which people process information -- affectively, physiologically, through the senses, and cognitively. Each model can be tremendously beneficial to clinicians and their clients. Combining aspects of each often yields better results than using either one alone. Thus, this chapter first includes a description of Young's model and then an illustration of the way EMDR clinicians can enhance SFT by using the powerful information-processing aspects of EMDR. Last is a brief discussion of the ways SFT can also be valuable to EMDR clinicians. [Adapted from Text, pp. 181-182][Pilots]

Keywords: Cognitive Therapy  Psychotherapeutic Processes  

Accuracy Verified: Yes


5. Paterson, M. J. (2009, March). EMDR and ego state therapy: Healing complex trauma and dissociation. Presentation at the EMDR Association UK & Ireland, Manchester, England UK .

Language: English

Format: Conference

Abstract:
We all display particular patterns of thinking, feeling and acting, depending on the situation. The transition is usually seamless in well-adjusted people, but where there has been disrupted attachment or sustained early life trauma the result is often the formation of particular ego states, also known as alters, parts, or schema modes. These states perform roles usually geared towards survival, but in adulthood they can be dysfunctional. Depending upon a client’s early life experiences some ego states can be malevolent, wanting bad things for the client such as willing them to suffer in some way. It is necessary for clients to remain safe during EMDR sessions and contained between sessions. There is a need, therefore, to learn techniques to work with more difficult clients so they too can benefit from EMDR. It is also helpful to know how to deal with blocked processing due to the interference of an ego-state. This workshop provides an overview of dissociation and a review of models to explain it. There will be an explanation of Ego State Therapy (EST) and how it fits with EMDR. Clinical case material is used to illustrate learning points. Through demonstration and practice participants will learn how to access ego states in a controlled way and effect therapeutic change. In the latter part of the day, participants will see a video of a live case where EST is used effectively to moderate the malevolence displayed by two difficult ego states. Learning objectives  Understand the forms of dissociation  Understand the concept of ego state therapy.  Learn how to access ego states in a controlled way and effect therapeutic change.  Learn techniques to deal with difficult ego states.

Keywords: Dissociation  Ego State Therapy  Trauma  

Accuracy Verified: Yes


6. Paterson, M. (2010, April). EMDR and ego state therapy: Healing complex trauma and dissociation. Preconference presentation at the annual meeting for the European Society for Trauma and Dissociation, Belfast, Northern Ireland.

Language: English

Format: Conference

Abstract:
We all display particular patterns of thinking, feeling and acting, depending on the situation. The transition is usually seamless in well-adjusted people, but where there has been disrupted attachment or sustained early life trauma the result is often the formation of particular ego states, also known as alters, parts, or schema modes. These states perform roles usually geared towards survival, but in adulthood they can be dysfunctional. Depending upon a client’s early life experiences some ego states can be malevolent, wanting bad things for the client such as willing them to suffer in some way. These clients present us with the greatest challenges through what we know as complex trauma and dissociative disorders. It is necessary for clients to remain stable during EMDR sessions and contained between sessions, particularly with complex trauma and dissociative disorders. There is a need, therefore, to learn techniques to work in the Preparation Phase with more difficult clients so they too can benefit from the full EMDR protocol. It is also helpful to know how to deal with blocked processing in the Desensitization Phase due to the interference of an ego-state. This workshop initially provides an overview of dissociation and how it impacts on EMDR processing. There will be an explanation of Ego State Therapy (EST) and how it fits with EMDR to provide the stabilization clients need, as well as dealing with blocked processing. Clinical case material is used throughout to illustrate learning points. Through demonstration and practice participants will learn how to build resources for clients, access ego states in a controlled way and effect therapeutic change. In the latter part of the day, participants will see videos of live cases where EST is used effectively in the Preparation Phase of EMDR to: 1) identify the part-selves and 2) moderate the malevolence displayed by two difficult ego states. Learning objectives Understand how complex trauma and dissociative disorders impact EMDR processing Understand the concept of working with part-selves as a way of preparing clients for the standard EMDR protocol. Learn how to access ego states in a controlled way and effect therapeutic change and stability. Learn techniques to deal with difficult ego states.

Keywords: Dissociation  Ego State Therapy  

Accuracy Verified: Yes


7. Peterson, M. 2010, April). EMDR and ego state therapy: Healing complex trauma and dissociation. Presentation at the 2nd Bi-Annual International European Society for Trauma and Dissociation Conference, Belfast, Northern Ireland.

Language: English

Format: Conference

Abstract:
We all display particular patterns of thinking, feeling and acting, depending on the situation. The transition is usually seamless in well-adjusted people, but where there has been disrupted attachment or sustained early life trauma the result is often the formation of particular ego states, also known as alters, parts, or schema modes. These states perform roles usually geared towards survival, but in adulthood they can be dysfunctional. Depending upon a client’s early life experiences some ego states can be malevolent, wanting bad things for the client such as willing them to suffer in some way. These clients present us with the greatest challenges through what we know as complex trauma and dissociative disorders. It is necessary for clients to remain stable during EMDR sessions and contained between sessions, particularly with complex trauma and dissociative disorders. There is a need, therefore, to learn techniques to work in the Preparation Phase with more difficult clients so they too can benefit from the full EMDR protocol. It is also helpful to know how to deal with blocked processing in the Desensitization Phase due to the interference of an ego-state. This workshop initially provides an overview of dissociation and how it impacts on EMDR processing. There will be an explanation of Ego State Therapy (EST) and how it fits with EMDR to provide the stabilization clients need, as well as dealing with blocked processing. Clinical case material is used throughout to illustrate learning points. Through demonstration and practice participants will learn how to build resources for clients, access ego states in a controlled way and effect therapeutic change. In the latter part of the day, participants will see videos of live cases where EST is used effectively in the Preparation Phase of EMDR to: 1) identify the part-selves and 2) moderate the malevolence displayed by two difficult ego states. Learning objectives Understand how complex trauma and dissociative disorders impact EMDR processing Understand the concept of working with part-selves as a way of preparing clients for the standard EMDR protocol. Learn how to access ego states in a controlled way and effect therapeutic change and stability. Learn techniques to deal with difficult ego states.

Keywords: Complex Trauma  Dissociation  Ego State Therapy  

Accuracy Verified: Yes


8. Shapiro, F. (2002). EMDR as an integrative psychotherapy approach:  Experts of diverse orientations explore the paradigm prism. Washington, DC:  American Psychological Association Books.

Language: English

Format: Book

Abstract:
Beyond the talking cure: somatic experience and subcortical imprints in the treatment of trauma; The developing mind and the resolution of trauma: some ideas about information processing and an interpersonal neurobiology of psychotherapy; EMDR and psychoanalysis; EMDR and cognitive-behavior therapy: exploring convergence and divergence; Combining EMDR and schema-focused therapy: the whole may be greater than the sum of the parts; EMDR: an elegantly concentrated multimodal procedure?; EMDR and hypnosis; EMDR and experiential psychotherapy; Feminist therapy and EMDR: theory meets practice; EMDR in conjunction with family systems therapy; Transpersonal psychology, eastern nondual philosophy, and EMDR; Integration and EMDR.

Keywords: Adults  Psychotherapy  Psychotherapeutic Processes  Stressors  Survivors  

Accuracy Verified: Yes


9. Korn, D. (2010, April). EMDR behandeling bij volwassenen met een verleden van incest en verwaarlozing. Het herstellen van ontwikkelings tekorten en het beschadigde ‘zelf’ [EMDR treatment in adults with a history of incest and neglect. Developmental deficits and restore the damaged self]. Workshop gepresenteerd aan de vierde congres van de Vereniging EMDR Nederland, Nijmegen, The Nederland.

Language: Dutch

Format: Conference

Abstract:
In deze workshop zal er worden ingegaan op het integreren van EMDR in een algemeen behandelingsplan voor volwassenen die incest en verwaarlozing in hun jeugd hebben meegemaakt. De workshop is een verdieping van de keynote van het congres. De werkwijze zal gedetailleerd worden uitgelegd en zal worden geïllustreerd aan de hand van videopresentaties en bespreking van casuïstiek. In eerste instantie wordt uitgelegd hoe de ontwikkelings- en hechtingsbehoeften van de cliënt onderzocht kunnen worden en hoe een betekenisvolle beschrijvende diagnose kan worden ontwikkeld om tot een geïntegreerd, logisch opgebouwd behandelingsplan te komen. Bij deze groep cliënten, waarbij er sprake is van beperkte affect tolerantie, kwetsbaarheid voor hyper- en hypoarousal, en dissociatieve kenmerken, kan het standaard EMDR protocol worden aangepast met specifieke strategieën. Daar zal uitvoerig op worden ingegaan. Ook zal er veel aandacht besteed worden aan het integreren van specifieke EMDR technieken, zoals diverse ego-versterkende protocollen en hulpbron installatie (RDI), in alle fasen van de behandeling. Tevens zullen er technieken besproken worden die cliënten helpen om hun disfunctionele afweermechanismen los te laten, waardoor het veranderen van schema’s met hun kenmerkende kerngedachten en kernaffecten mogelijk wordt Deelnemers aan deze workshop zullen leren om pathogene gevoelstoestanden, (zoals schaamte, wanhoop, onverdraagelijke eenzaamheidsgevoelens), angsten en ‘blocking beliefs’, ego state conflicten te herkennen, zodat de meest effectieve interweaves en hulpbron opties kunnen worden toegepast. Verder zullen er strategieën voor herstel, zoals het verduidelijken van verantwoordelijkheid, het vaststellen van veiligheid en keuze, en het verwerken van rouw, verlangen en woede, worden besproken.

This workshop will address the integration of EMDR into an overall treatment plan for adult incest and neglect in childhood have experienced. The workshop is a deepening of the keynote of the conference. The methodology will be explained in detail and will be illustrated with video presentations and discussion of case studies. Initially, explains how the development and bonding needs of the client can be investigated and how a meaningful descriptive diagnosis can be developed into an integrated, logical plan of treatment. In this group of clients, where there is limited affect tolerance, vulnerability to hyper-and hypoarousal and dissociative characteristics, the standard EMDR protocol to be adapted to specific strategies. As will be discussed in detail. Also, much attention is paid to the integration of EMDR specific techniques, such as various ego-enhancing protocols and resource installation (RDI) in all phases of treatment. Will also discuss techniques that help clients to their dysfunctional defense mechanisms to let go, so changing schedules with their distinctive core ideas and possible kernaffecten Participants in this workshop will learn to pathogenic emotional states (such as shame, despair, unbearable loneliness feelings), and fears "blocking beliefs", ego-state conflicts to recognize that the most effective and interweaves resource options can be applied. Moreover, through strategies for recovery, such as clarifying responsibilities, establishing security and choice, and the process of mourning, desire and anger are discussed.

Keywords: Adults  Developmental Deficits  Incest  

Accuracy Verified: Yes


10. Braun, P., & van Og, A. (2005, November). EMDR bij klinisch opgenomen TBS-gestelden: ”Elk voordeel heb z’n nadeel” [EMDR clinical TBS recorded as such: "Any benefit me his disadvantage"]. Presentatie op het Eerste Congres van de Vereniging EMDR Nederland, Ede, Nederland.

Language: Dutch

Format: Conference

Abstract:
Deze lezing gaat over het implementeren van EMDR in een zeer complexe (TBS) instelling, waarbij beveiliging en onlosmakelijk behandeling verweven zijn, met een diagnostisch zwaar belaste doelgroep: • Meervoudige persoonlijkheidsstoornissen • Meervoudig ernstig getraumatiseerd • Verslavingsproblematiek • Specifieke psychiatrische problematiek • Forensische problematiek • Combinaties
Het TBS systeem van behandelen (met beveiliging als belangrijk punt) verhoudt zich soms moeilijk tot de behandeling met EMDR van de individuele patiënt. Angst voor de beheersbaarheid van een patiënt gedurende de behandeling kan als een contra-indicatie worden gezien voor EMDR-behandeling. Het is de vraag of EMDR gecontraïndiceerd is in een TBS-kliniek vanwege de veiligheid. De inbedding van de behandeling in de TBS-kliniek alsmede het toepassen van zelfcontroletechnieken zijn hierbij belangrijke factoren. Complicerende factor is dat veel TBS-patiënten zowel zelf getraumatiseerd zijn als wel ernstige delicten hebben gepleegd waarmee ze anderen hebben getraumatiseerd.
In deze lezing willen wij vooral aan de orde stellen hoe de behandeling van het daderschap zich verhoudt tot de behandeling van het slachtofferschap van de patiënt. We willen hiervan zowel de inhoudelijke als de ethische kant belichten. Van belang hierbij is ook de discussie rondom de indicatiestelling: richt men zich eerst op het daderschap of juist op het slachtofferschap? Verder willen we de gelaagdheid van de behandeling benoemen: de behandelaar heeft niet alleen te maken met de problematiek van de patiënt maar ook te maken met de gesloten kliniek en verschillende functionarissen daarin. Die gelaagdheid heeft direct gevolgen voor de vorm en inhoud van de behandeling.
Als hypothese willen we naar voren brengen dat de behandeling van trauma’s essentieel kan zijn voor de behandeling van persoonlijkheidsproblematiek. Schemagerichte Cognitieve Therapie (J. Young), sluit in onze ogen naadloos aan op EMDR. Beide stromingen richten zich op dezelfde type existentiële “Ik ben ….“ opvattingen.

This lecture is about the implementation of EMDR In a very complex (TBS) of institution, and security are inextricably intertwined treatment, with a heavily loaded diagnostic target: • Multiple personality disorder • Multiple severely traumatized • Addiction Problems • Specific psychiatric problems • Forensic issues • Combinations
The TBS system of treatment (with security as an important point) does sometimes difficult to EMDR treatment of individual patients. Fear of the manageability of a patient during treatment as may be considered a contraindication for EMDR treatment. The question is whether EMDR is contraindicated in a TBS clinic for security reasons. The embedding of treatment in the TBS clinic and the use of self-control techniques are important factors. Complicating factor is that many TBS patients, both self-traumatized as well have committed serious crimes with which they have traumatized others.
In this talk we mainly discussed how the treatment of the perpetrator is related to the treatment of the victimization of the patient. We wish them both the substantive and ethical angles. Of importance here is the discussion surrounding the needs assessment: the focus is first on the perpetrator or at the very victimization? We also want to appoint the stratification of treatment: the therapist has not only faced with the problem of the patient but also to do with the clinic closed and several officers therein. Such layering has direct implications for the form and content of treatment.
As a hypothesis we want to highlight that the treatment of trauma may be essential for the treatment of personality problems. Schema-Focused Cognitive Therapy (J. Young), close our eyes seamlessly with EMDR. Both schools focus on the same existential type "I am ...." opinions.

Keywords: TBS System of Treatment  

Accuracy Verified: Yes


11. Hagen, H., & Baas, J. (2008, Maart). EMDR binnen de schematherapie voor persoonlijkheidsproblematiek van young enkele overwegingen [Schema therapy EMDR within the personality issues of young a few thoughts]. Presentatie aan de derde congres van de Vereniging EMDR Nederland, Ede, The Netherlands.

Language: Dutch

Format: Conference

Abstract:
De laatste jaren is er veel vooruitgang geboekt in de behandeling van persoonlijkheidstoornissen van met name de borderline persoonlijkheidsstoornis (BPS) met Cognitieve Gedrags Therapie (CGT). Vooral de Schematherapie van Jeffrey Young gooit hoge ogen. Bij een hoog percentage van mensen met persoonlijkheidstoornissen en met name weer bij BPS is er sprake van traumatische gebeurtenissen in de voorgeschiedenis. EMDR gooit hoge ogen in de behandeling van de gevolgen van trauma’s. Een goede vraag is dan ook wat de plaats is van EMDR binnen de Schematherapie. Op deze vraag zullen wij ingaan tijdens onze presentatie. Eerst presenteren we een simpel model hoe je naar persoonlijkheidstoornissen kunt kijken en uit welke componenten een behandeling meestal zal bestaan. Vervolgens kijken we wat EMDR te bieden heeft binnen de verschillende componenten. Bij onze presentatie zullen we steeds praktische voorbeelden geven van succes en falen van EMDR binnen Schematherapie en bezien wat we daar uit kunnen leren. De lezing is niet geschikt voor beginners. Kennis van Schema Focused Therapy wordt aanbevolen.

In recent years there has been much progress in the treatment of personality disorders, especially borderline personality disorder (BPD) and Cognitive Behavioral Therapy (CBT). Especially the Schema Therapy Jeffrey Young gets top marks. In a high percentage of people with personality disorders and BPD in particular, again there is a history of traumatic events. EMDR gets top marks in the treatment of the effects of trauma. A good question is what the site is within the Schema Therapy EMDR. On this question we will discuss during our presentation. First we present a simple model of how personality disorders can look at and which components of treatment will usually exist. Then we see what EMDR has to offer within the various components. In our presentation we will always offer practical examples of success and failure of Schema Therapy EMDR inside and see what we can learn from. The lecture is not suitable for beginners. Schema Focused Therapy knowledge is recommended.

Keywords: Personality Disorder  Schema Therapy  

Accuracy Verified: Yes


12. Leeds, A. M. (1995, June). EMDR case formulation symposium. Symposium conducted at the EMDR Network Conference, Santa Monica, CA.

Language: English

Format: Conference

Abstract:
The focus of this symposium will be on intermediate and advanced topics in EMDR case formulation in more challenging cases. The presentation will include how affect and schema theories can help organize and guide treatment planing and selection of protocols, targets and cognitions. Time will be allowed to discuss problem cases. The symposium will begin with an overview of the EMDR theoretical model and the role of metacognitions in the accelerated information processing paradigm. Guideposts to application will include principles such as: good enough cognitions and warning indicators fiom cognitions and the history taking of potential blocked responses. A model of EMDR case formulation issues will be presented involving treatment planning and selection of protocols, targets and cognitions. A fundamental issue in case formulation will be proposed as the extent to which the case involves simple adult trauma with a good premorbid history or is a more complex case conceptualized as involving some degree of neglect or pervasive failure of the early environment to provide healthy models of self-other interaction. Alternate treatment protocols will be offered for more complex cases presentations where there are insufficient healthy resources present to permit the successfull use of standard EMDR protocols even with creative application of cognitive interweave strategies. Protocols will be offered for "practice" EMDR sessions and for building up healthy internal resources in advance of targeting disturbing memories. Affect theory as developed by Silvan S. Tomkins and reviewed in Donald Nathanson's (1992) Shame and Pride, Affect Sex, and the Birth of the Self, W. W. Norton & Co, New York, and its relationship to EMDR will be considered. Emphasis will be on the biological theory of emotions, the nine innate affects, the central and unique role of shame in human development, and how affect theory supports EMDR theory and application. For example, EMDR theory emphasizes the central role of physiological and emotional responses and views cognitions as "distallations of experience" (Francine Shapiro, 1995, Eve Movement Desensitization and Reprocessing, Basic Principles, Protocols, and Procedures, Guilford Press, NY). Shame and its attendant distorted self concepts is a central problem in PTSD and other pervasive traumageric disorders. Aspects of this case formulation approach have been influenced by members of the EMDR facilitator staff most notably Landry Wildwind's speciality and conference presentations on working with chronic depression and personal communications with Marguerite McCorkle. Case examples will be given in which alternate EMDR protocols were used to successfully work through unresolved developmental issues and massive layers of shame that had blocked previous treatment efforts. A large portion of the symposium will be devoted to a case conference round table where these issues will be explored through a discussion of problem cases offered by participants.

Keywords: Case Formulations  

Accuracy Verified: Yes


13. Terreri, L. (2005). EMDR e crisi d'astinenza [EMDR and withdrawal symptoms]. Bollettino per le Farmacodipendenze e l'Alcolismo del Ministero della Salute, 28(3/4), 25.

Language: Italian

Format: Newsletter

Abstract:
L’EMDR (acronimo di Eye Movement Desensitization and Reprocessing) è un metodo clinico ben strutturato che può integrare i programmi terapeutici aumentandone l’efficacia. Francine Shapiro ha scoperto che alcuni tipi di stimolazione esterna possono aiutare molto efficacemente una persona a superare un evento traumatico o emotivamente disturbante. Il metodo utilizza principalmente i movimenti oculari prodotti in un paziente invitandolo a seguire il movimento della mano del terapeuta (ma anche altre forme di stimolazione destro/sinistra come, ad esempio, il tapping sulle mani). L’EMDR si basa sull’ipotesi che l’evento traumatico “congeli” l’informazione nella sua forma ansiogena originale, nello stesso modo in cui è stato vissuto. L’informazione bloccata, “congelata” nelle reti neurali, continua a provocare vari disturbi psicologici. Pensare ad un evento traumatico mentre contemporaneamente il paziente esegue determinati movimenti oculari, invece, genera l’effetto di riprendere o accelerare l’elaborazione dell’informazione. L’EMDR provoca una migliore comunicazione tra gli emisferi cerebrali ristabilendo l’equilibrio eccitatorio/inibitorio e permette il raggiungimento di una risoluzione adattiva, integrata in uno schema cognitivo ed emotivo positivo, dell’esperienza del paziente. Il metodo, quindi, permette una desensibilizzazione rapida dei ricordi traumatici e una ristrutturazione cognitiva che porta a una riduzione significativa dei sintomi del paziente.

EMDR (which stands for Eye Movement desensitization and Reprocessing) is a well-structured clinical method that can integrate treatment programs increasing effectiveness. Francine Shapiro discovered that certain of external stimulation can help most effectively a person to overcome a traumatic event or emotionally disturbing. The method mainly uses eye movements produced in a patient requesting to follow the movement of the hand therapist (But also other forms of stimulation right / left as, For example, tapping on your hands). EMDR is based on the assumption that the traumatic event "freeze" information anxiety in its original form, the same way it was lived. Information blocked "Frozen" in neural networks, continues to cause various psychological disorders. Think of a traumatic event simultaneously while the patient performs certain eye movements, however, creates the effect of return or accelerate the processing. EMDR leads to better communication between the hemispheres restoring brain balance excitatory / inhibitory and allows the achievement of adaptive resolution, embedded in a positive emotional and cognitive schema, experience of the patient. The method, therefore, allows a rapid desensitization of traumatic memories and a cognitive restructuring that leads to a reduction significant symptoms of the patient.

Keywords: Withdrawal Symptoms  

Accuracy Verified: Yes


14. Rijnders, H. (2006, November). EMDR en schemagerichte therapie: Casusconceptualisate en traumatische kernervaringen [EMDR and schema-focused therapy: Heart and traumatic experiences case conceptilization]. Workshop gepresenteerd aan de tweede congres van de Vereniging EMDR Nederland, Arnhem, The Netherlands.

Language: Dutch

Format: Conference

Abstract:
In deze presentatie zal een conceptueel model gepresenteerd worden voor het vinden van de kerntraumatische ervaringen( targets) die aan de basis liggen van de schema’s van Young. Er zal kort worden ingegaan op de theorie van de schemagerichte therapie van Jeffrey Young. De belangrijkste schema’s in zijn model zullen worden besproken die in veel gevallen verantwoordelijk zijn voor de persoonlijkheidsproblematiek en complexe ptss klachten waar wij als behandelaars mee kunnen worden geconfronteerd. Daarnaast hoe met behulp van het emdr standaard protocol de targets worden opgespoord die ten grondslag kunnen liggen aan de eerdergenoemde schema’s of valkuilen.Het zijn deze traumatische ervaringen die later in de behandeling zullen moeten worden gedesensitiseerd. De integratieve psychotherapeutische behandeling van persoonlijkheidsproblematiek en complexe ptss klachten gaat uit van een fasengericht traumamodel. Het thema tijdens deze presentatie omvat een belangrijk onderdeel van deze behandelingswijze. Het biedt de behandelaar zowel als de cliënt(e) inzicht in de ontwikkelingspsychologische aspecten van de klachten en kan extra motiverend werken voor langer durende behandelingen. Interessant is hoe de voorgestelde cognitieve domeinen van Eric ten Broeke en Ad de Jongh een belangrijk hulpmiddel zijn bij het vinden van de correcte NC’s en PC’s bij bovengenoemde problematiek. De schemagerichte therapie van Young heeft op basis van recent wetenschappelijk onderzoek bewezen een van de meest effectieve behandelvormen te zijn bij ingrijpende persoonlijkheidsproblematiek. De emdr therapie van Shapiro wordt door onderzoek voortdurend genoemd als een van de meest effektieve behandelvormen bij acuut trauma. Experimenteel wordt emdr nu ook aangewend bij complex trauma. Samen vormen zij een gouden duo. Deze presentatie lijkt geschikt voor beginnende emdr therapeuten die zich meer willen gaan bezighouden met complex trauma en persoonlijkheidsproblematiek. Voor gevorderde therapeuten is de presentatie een platform voor discussie aangezien vele wegen naar Rome leiden. Een en ander zal worden toegelicht met casuïstiek en mogelijk met videobeelden.

This presentation will be presented a conceptual model for Finding the key traumatic experiences (targets) that form the basis of the diagrams of Young. It will briefly examine the theory of schema-focused therapy by Jeffrey Young. The main schemes in his model will be discussed in many cases responsible for PTSD complex personality problems and complaints that we clinicians may be faced with. In addition, how to use the EMDR standard protocol targets are identified that may underlie the aforementioned schedules or valkuilen. These traumatic experiences will be desensitized later in treatment. The integrative psychotherapy of personality problems and complex PTSD symptoms is based on a phase oriented trauma model. The theme of this presentation includes an important component of this treatment method. It provides both the therapist and client (e) understanding of the developmental aspects of the complaint and may provide additional motivation to work for longer term treatments. It is interesting how the proposed cognitive domains of Eric ten Broeke and Ad de Jongh an important tool in finding the correct NCs and PCs to the abovementioned issues. The schema-focused therapy for Young, based on recent scientific study proved one of the most effective forms of treatment to be for major personality problems. The EMDR therapy research by Shapiro constantly mentioned as one of the most effective forms of treatment in acute trauma. EMDR is now used experimentally to complex trauma. Together they form a golden combination. This presentation appears to be suitable for beginning EMDR therapists who want to deal with complex trauma and personality problems. For experienced therapists, presenting a platform for discussion, since many roads lead to Rome. This will be illustrated by case studies and possibly video.

Keywords: Schema Focused Therapy  

Accuracy Verified: Yes


15. Kiessling, R. (2013, May). EMDR from a belief focused perspective. Presentation at the annual EMDR Canada Conference, Banff, Alberta CAN.

Language: English

Format: Conference

Abstract:
Beliefs are the meta-perception of life’s experiences (Shapiro 2001). Target Sequence Plans bundled around core belief schema provide an effective, efficient and safe approach to case conceptualization and EMDR treatment. This workshop will clarify questions asked by EMDR Clinicians such as: • Are all NC/PCs Core Belief Schemas? • Are your Targeting Sequence Plans Core Belief Schema Bundled or just a shotgun of targets based upon “What do you want to work on today?” • Does “What does it say about you” really address ‘what it means about you!? • Are you’ staying out of the way’ when you should be ‘leading the way’! These and others questions will be clarified through lecture, case examples and video demonstrations. Through lecture, video demonstration, and practice, participants will: • Name 3 major differences between the Standard EMDR Protocols and Procedures and EMDR from a ‘Belief Schema Perspective.’ • Describe the 4 primary Belief Schemas used in the ‘Belief Schema Perspective’ to EMDR, and how they assist the case conceptualization and processing. • Demonstrate the ability to develop a Belief Focused Targeting Sequence Plan and appropriately process the targets identified within the Standard Three Pronged Protocol.

Keywords: Core Beliefs  

Accuracy Verified: Yes


16. Korn, D. (2013, May). EMDR the next generation: Finding your way in the dark [L’EMDR et la nouvelle génération: Trouvez votre chemin dans l’obscurité]. Presentation at the annual EMDR Canada Conference, Banff, Alberta CAN.

Language: English

Format: Conference

Abstract:
In this workshop, participants will be taught to use their “true” authentic selves as a resource during EMDR processing, and to work to create a secure, responsive, and positive relational environment that supports change and integration. A number of conceptual “maps” that incorporate and build on various ideas and strategies from other trauma-focused models (e.g., AEDP, IFS, Sensorimotor Psychotherapy, Structural Model of Dissociation) will be introduced. These “maps” are provided to guide case conceptualization and moment-to-moment decision-making within a given EMDR session. Video clips will be used to demonstrate how to track a client’s progress with greater precision, using both verbal and non-verbal markers to determine where the client is on a given conceptual map and what type of interweave is needed to facilitate or deepen the client’s processing. Different types of interweaves will be delineated with a clear description of the purpose or function associated with each. Throughout this workshop, Dr. Korn will engage in spirited dialogue with participants as she presents both didactic and video material. Learning Objectives: • Develop a comprehensive AIP-based case conceptualization treatment plan that will guide their moment-to-moment decision-making during an EMDR session. • Effectively identify the informational plateaus or schema categories (responsibility, safety, control/choice) reflected in a client’s presenting issues, choice of targets, and stuck points. • Utilize dyadic regulation in working with clients with limited affect tolerance and self-capacities, with the goal of maintaining and even accelerating processing within a window of tolerance. • Apply advanced interweave strategies to address blocking beliefs, rigid defenses, and fears about internal experiences (i.e. affect, sensation, urges, fantasies). • Utilize various clinical strategies/interweaves for facilitating the expression of adaptive action tendencies, completing incomplete or truncated actions, and addressing various domains of developmental repair.

Dans son atelier, les participants apprendront à utiliser leur ‘vrai’’ et authentique soi comme une ressource durant le traitement en EMDR et à créer un environnement où la relation soit sécurisante, sensible et positive favorisant ainsi le changement et l’intégration. Dr Korn nous parlera de ce modèle conceptuel des ‘cartes’ qui incorporent des idées et des stratégies qui proviennent de d’autres modèles axés sur les traumas (‘AEDP’, ‘IFS’, Psychothérapie Sensorimotrice, Modèle de la Dissociation Structurelle). Ces ‘’cartes’’ sont un guide dans la conceptualisation de cas et la prise de décision ‘’moment par moment’’ durant une session d’EMDR. Des vidéo clips seront présentés afin de démontrer comment suivre le progrès d’un client avec une grande précision, utilisant des repères verbaux et non verbaux pour déterminer où se trouve le client sur une ‘’carte’’ donnée et quel type de tissage est nécessaire pour faciliter ou approfondir le traitement du client. Objectifs d’apprentissage: • Développer un plan de traitement compréhensif basé sur le modèle TAI –et la conceptualisation de cas comme un guide de prise de décision ‘’moment par moment’’ durant une session d’EMDR. • Identifier de manière efficace les plateaux informatifs ou les catégories de schémas (responsabilité, sécurité, contrôle/choix) qui se révèlent dans ce que le client présente comme difficultés, dans le choix des cibles et les blocages. • Utilisation de la dyade pour aider à moduler l’affect chez les clients qui ont une très faible tolérance émotionnelle avec comme but de maintenir et même d’accélérer le traitement à l’intérieur de la fenêtre de tolérance. • Avoir recours aux stratégies avancées du tissage pour traiter les croyances bloquantes, les défenses rigides et les peurs venant de la ‘’vie intérieure’’ (c’est à dire l’affect, les sensations, les pulsions, les fantasmes). • Utilisation de diverses stratégies cliniques et du tissage afin de favoriser l’expression d’action adaptative, de compléter les actions inachevées ou tronquées et d’aborder différents domaines permettant de ‘’réparer’’ les dommages survenus au cours du développement.

Keywords: AEDP  Dyadic Regulation  Informatiional Plateaus  IFS, Interweaves  Sensorimotor Psychotherapy  Structural Model of Dissociation  Trauma-Focused Models  "True" Authentic Self  

Accuracy Verified: Yes


17. Herbert, C. (2003, May). Healing the “inner child” – EMDR imagery rescripting techniques with complex trauma clients. In Attachment and complex trauma. Symposium conducted at the annual meeting of the EMDR Europe Association, Rome, Italy.

Language: English

Format: Conference

Abstract:
EMDR-based imagery re-scripting techniques with a modified concept of Cognitive Schema Modes (Young, 1999). Based on clinical case examples, the use of imagery techniques, which draw on all sensory modalities (involving cognitive, emotional and somatic systems) during the auditory application of EMDR will be described, to help complex trauma clients firstly approach and recognize and subsequently attach to and nurture the image of their own “inner child”. Rather than establishing a sense of unrealistic dependency on the therapist by integrating him or her as the sole nurturer, clients are encouraged to develop an image of their own ‘healthy adult’, who can learn to take on the role of internal re-nurturing, protection and healing of the ‘inner child’. Techniques for overcoming blockages between a client’s ‘healthy adult’ and their ‘inner child’ representations are described. It is proposed that differentiating between ‘child’ and ‘adult’ modes and tuning into these through deep-level EMDR processing, allows clients to re-connect to feelings associated with their earlier experiences of helplessness and dependency during childhood, which can now be re-experienced within a safe and nurturing context. It is suggested that this will allow higher order brain systems, such as the hippocampus, to remain active and therefore enable cognitive and structural re-organization of the stored material in the brain and body cells. Once a positive attachment bond between a client’s internalised ‘inner child’ and ‘healthy adult’ modes has been achieved this can then be utilized further during direct trauma processing work. It is argued that healing of the ‘inner child’ enables healing of the adult client so that a more positive and secure sense of self can be achieved.

Keywords: Attachment Theory  Complex PTSD  Imagery  Inner Child  Rescripting  Symposium  

Accuracy Verified: Yes


18. Zangwill, W. M. (1998, December). Integrating EMDR with schema-focused therapy. EMDRIA Newsletter, 3(4), 16.

Language: English

Format: Newsletter

Abstract:
The following is an overview on the integration of EMDR with schema-focused therapy.

Keywords: Schema-Focused Therapy  

Accuracy Verified: Yes


19. Young, J., & Zangwill, W. M. (1998, July). Integrating schema therapy focused with EMDR. Presentation at the annual meeting of the EMDR International Association, Baltimore, MD.

Language: English

Format: Conference

Abstract:
This workshop will: 1) increase participants’ basic skills in using EMDR; 2) increase participants’ knowledge of, and ability to apply, a conceptual framework to use with EMDR; and 3) increase participants’ ability to work with difficult clients.

Keywords: Schema-Focused Therapy  

Accuracy Verified: Yes


20. Young, J., & Zangwill, W. (1995, June). Integrating schema-focused therapy & EMDR. Presentation at the EMDR Network Conference, Santa Monica, CA.

Language: English

Format: Conference

Abstract:
Dr. Young has developed an integrative model that seems especialy appropriate for combining with EMDR. According to the theory proposed, eighteen Early Maladaptive Schemas (EMS) are at the core of personality disorders. An EMS is defined as an extremely broad, pervasive theme regarding oneself and one's relationship with others, developed during childhood and elaborated throughout one's lifetime, and dysfunctional to a significant degree. Shapiro's concept of childhood file folders would be analogous to the concept of schemas. These eighteen schemas are primarily unconscious but can be brought to awareness through various strategies, especially EMDR. This presentation will demonstrate how to integrate the use of Schema-Focused therapy with EMDR. In this model, Schema- Focused therapy serves as the primary conceptual framework for working with the client while EMDR is seen as the primary change technique. The first step in this process is a thorough history taking looking for both traumatic life events and the client's underlying vulnerabilities and schemas. History taking is accomplished both through client interviews and the use of Lazarus' Multimodal Life History Questionnaire. The Schema Questionnaire and the Parent Questionnaire developed by Young are given and scored. As part of this process, the therapist attempts to help the client discriminate memories representing primary trauma versus memories that represent life long issues. The EMDR model eliciting infonmtion - asking the client about specific events and problems, then obtaining Pictures, Negative and Positive Cognitions, Affect and Body Sensations as well as SUDS and VOC ratings - is used as soon as the client is comfortable. Collecting information this way without the use of Eye Movements has been shown to be a very effective way of tapping into the neural network where related memories are stored. The grouping of these memories often appears to be along such schema lines as Vulnerability, Defectiveness, Abandonment, etc. As the therapeutic relationship develops, clients are educated about EMDR and schemas. The last part of this process is the Case Conceptualization. This involves putting together the information from history taking, the schema questionnaire and the parent questionnaire and the client's in-session behavior to formulate a useful picture of client problems, likely problem origins, and recommended change techniques. Knowing what issues/themes your client is vulnerable to, tells you where to start your EMDR exploration. It also helps suggests where to probe when processing stops, i.e., what blocking beliefs may be present, what type of cognitive interweave to use, etc. Once the case conceptualization is complete, EMDR is used as always. However, the use of Schema Focused therapy with EMDR broadens the scope of EMDR. 1) Cognitive Therapy for Personalitv Disorders: A Schema-Focused Approach. Revised Ed. Professional Resource Press, Sarasota, FL, (813)366-7913; 2) Reinventing Your Life, J. Young and J. Klosko. New York, Plume, 1994.

Keywords: Schema-Focused Therapy  

Accuracy Verified: Yes


21. Young, J., & Zangwill, W. M. (1996, June). Integrating schema-focused therapy with EMDR. Presentation at the annual meeting of the EMDR International Association, Denver, CO.

Language: English

Format: Conference

Abstract:
Dr. Young has developed an integrative model that seems especialy appropriate for combining with EMDR. According to the theory proposed, eighteen Early Maladaptive Schemas (EMS) are at the core of personality disorders. An EMS is defined as an extremely broad, pervasive theme regarding oneself and one's relationship with others, developed during childhood and elaborated throughout one's lifetime, and dysfunctional to a significant degree. Shapiro's concept of childhood file folders would be analogous to the concept of schemas. These eighteen schemas are primarily unconscious but can be brought to awareness through various strategies, especially EMDR. This presentation will demonstrate how to integrate the use of Schema-Focused therapy with EMDR. In this model, Schema- Focused therapy serves as the primary conceptual framework for working with the client while EMDR is seen as the primary change technique. The first step in this process is a thorough history taking looking for both traumatic life events and the client's underlying vulnerabilities and schemas. History taking is accomplished both through client interviews and the use of Lazarus' Multimodal Life History Questionnaire. The Schema Questionnaire and the Parent Questionnaire developed by Young are given and scored. As part of this process, the therapist attempts to help the client discriminate memories representing primary trauma versus memories that represen life long issues. The EMDR model eliciting information - asking the client about specific events and problems, then obtaining Pictures, Negative and Positive Cognitions, Affect and Body Sensations as well as SUDS and VOC ratings - is used as soon as the client is comfortable. Collecting information this way without the use of Eye Movements has been shown to be a very effective way of tapping into the neural network where related memories are stored. The grouping of these memories often appears to be along such schema lines as Vulnerability, Defectiveness, Abandonment, etc. As the therapeutic relationship develops, clients are educated about EMDR and schemas. The last part of this process is the Case Conceptualization. This involves putting together the infonmtion from history taking, the schema questionnaire and the parent questionnaire and the client's in-session behavior to formulate a useful picture of client problems, likely problem origins, and recommended change techniques. Knowing what issues/themes your client is vulnerable to, tells you where to start your EMDR exploration. It also helps suggests where to probe when processing stops, i.e., what blocking beliefs may be present, what type of cognitive interweave to use, etc. Once the case conceptualization is complete, EMDR is used as always. However, the use of Schema Focused therapy with EMDR broadens the scope of EMDR. 1)Cognitive Therapy for Personality Disorders: A Schema-Focused Approach. Revised Ed. Professional Resource Press, Sarasota, FL, (813) 366-7913 2)Reinventing Your Life, J. Young and J. Klosko. New York, Plume, 1994.

Keywords: Schema-Focused Therapy  

Accuracy Verified: Yes


22. McCullough, L., & Andrew, S. (2000, September). Integrating short term dynamic psychotherapy and EMDR. Presentation at the annual meeting of the EMDR International Association, Toronto, Ontario Canada.

Language: English

Format: Conference

Abstract:
Participants will be able to: 1) name the three main components of Malan's conceptual schema of the "Universal Principle of Psychodynamic Psychotherapy" in Short Term Dynamic Psychotherapy: The Two Triangles; 2) describe how EMDR interfaces well with short-term dynamic models of therapy; and 3) describe how exposure to conflicted feelings can be enhanced by EMDR and used to solve "small-t" traumas.

Keywords: Psychoanalytic Psychotherapy  PTSD  Stressors  Survivors  Effects  Treatment Effectiveness  Research Needs  Malan  Universal Principles of Psychodynamic Therapy  Two Triangles  Small t Trauma  

Accuracy Verified: Yes


23. Manfield, P. (1995, June). Narcissistic disorders:  Using EMDR with these difficult clients. Presentation at the EMDR Network Conference Santa Monica, CA.

Language: English

Format: Conference

Abstract:
Definition of client population: Disorder of the self. The narcissistic character is often identified by his or her grandiose facade concealing an underlying sense of emptiness and worthlessness. To experience the underlying emptiness is so painful for them that these people cut off their inner experience and rely instead on external admiration and praise to support their grandiose or superior view of themselves; their condition is often referred to as a "disorder of the self." Because of their dependence on others for their sense of themselves, they are exquisitely sensitive to criticism or disapproval, often warding off deflation by becoming increasingly grandiose, superior, disdainful or demeaning. Many conceal their grandiosity, maintaining a secret sense of superiority which may be based upon their perfectionism or their quiet devaluing of others. View of others: there is a range of severity of the narcissistic character from personality disorders to a narcissistic character style. People with personality disorders, are unable to form a trusting bond with another person; they view people primarily as interchangeable, performing a function which could equally be performed by many others. Less impaired narcissistic characters, however, are able to form varying degrees of attachments to other people, although their ability to trust and care about other people is limited. Most commonly they relate to people they can idealize or be admired by. People tend to be seen in extremes as either superior and powerful or inferior and worthless; supportive and admiring or critical and attacking. Difficulties in using EMDR: Clinically these clients represent a difficult and often frustrating population to treat; they are brittle and easily injured if they to not feel perfectly understood by their therapists, and they will distance at the slightest hint that they are being judged or used. They resist focusing inward and defining their problems as arising within themselves, and find it difficult to sustain any genuine affect, other than perhaps rage. If they feel understood and accepted, however, they will eventually talk about their sense of emptiness and worthlessness and their confusion about who they are and what is truly meaningful and valuable to them. Beck, Young and others have described factors that make it difficult to treat any personality disorder using a cognitive behavioral approach. There have in fact been very few reported "successes" in the literature. Most of the difficulties are related to the self and object splitting characteristic of these clients. These clients have limited access to feelings, limited access to spontaneous thoughts, body sensations, memories, etc., and vague unfocussed presenting problems making targeting difficult. They usually have difficulty with emotional and often intellectual continuity from session to session; they will rarely keep a log or follow through with homework; transference issues often come into central focus and must be addressed before other targets; and their selfdefeating beliefs and behavior patterns are extremely deeply held, pervasive and resistant to change. In addition to varying degrees of these difficulties, narcissistic clients present all of the problems in EMDR that they do in more traditional therapies; including their tendencies to act out, deny, and avoid. These and other defenses interfere with completion of segments of therapeutic work and make it difficult for the clinician to keep work focused within one neural network. Self and object splitting leads to continuity problems within or between sessions and a difficulty maintaining clarity about the reason for being in treatment. The client may feel suicidal one week and declare himself or herself to be fully recovered the next. Perhaps the most confirming aspect of the treatment of these clients, however, is their emotionally impoverished pasts; they have very limited experience of nurturing, loving and caring to draw !?om in order to interweave new meanings and perspectives into traumatic or painful past experiences. Length of treatment: I have found that I have been able to achieve good results with higher level narcissistic clients with whom I have had an established relationship at the time I introduced EMDR into the treatment. My results with clients who have come to therapy asking specifically for EMDR and with whom I have begun using EMDR soon after the beginning of treatment have been generally poorer, varying with the severity of the client's disorder, the less severe doing best. The client needs to be able to establish a meaningful trusting relationship with the therapist; the more severe the client's difficulties with attachment, the more time this process requires. Narcissistic clients do not tend to see their difficulty with vulnerability, trust and intimacy as a problem within themselves. If they are able to recognize personal problems, they are usually in the area of self esteem and obstacles to achievement. When they are able to resolve some of these latter problems fairly rapidly through treatment they tend to terminate, no longer seeing a sufficient purpose for treatment. In a sense, they can become better narcissists; their grandiose view of themselves is enhanced and they are reinforced in their use of self-sufficiency as a defense against interpersonal vulnerability. I view the relative efficiency of EMDR as a problem for deeper treatment of narcissistic clients because there is less time for the therapeutic relationship to develop and consequently a limited opportunity to impact the client's object splitting. I believe that this is why I have found EMDR with narcissistic clients to be most effective when it is introduced after a therapeutic relationship has had time to develop. Negative cognitions: The early maladaptive schemas of narcissistic clients are pervasive in their lives and point to a plethora of negative cognitions. Typical early schemas are: I must control myself (or my feelings, my behavior, my body) at all times; no one cares; my needs will never be met; I can't trust anyone; I am deeply flawed and unlovable; I am dikeable, unattractive to others; I will always fail; my flaws are totally unacceptable to others; I must be perfect or I am worthless; I deserve to be treated more specially than others; I must please others to avoid attack; I'm alone; nobody understands me; I am OK if I am better than others; I am OK only if others admire me. It is often helpful to narrow these cognitions down to make them manageable with EMDR Treatment: In addition to the recommended protocol of establishing a safe space to which the client can retreat if necessary, before doing an EMDR session with one of these clients, the therapist should identify as many of the client's emotional resources possible, in particular expriences if any of having felt loved and accepted ad examples of loving people or relationships the client has observed Among other things, these facilitate more effective copitive interweaves. The initial task in doing an EMDR session with this client population is to establish an appropriate and richly defined target. Since it is more difficult for these clients to access meanm&l memories in an emotionally alive way, the therapist must be more active in helping the client stimulate the associated neural netork as I l l y as possible. In addition to the client's reaction to the plight of children he may be related to or observe (Level I1 training), a rich source of emotional responsiveness and resources is the client's own response to situations he has witnessed in news media, TV, movies or theater. A major challenge in addressing a narcissistic character type using EMDR is tracking the course of the session with these clients and identifying when they drip out of the targeted neural network. This process can be subtle because it requires an ability to differentiate true avoidance hm spontaneous associations which may appear at hat to be irrelevant; it requires a familiarity with and sensitivity to the protective or defensive mechanisms they use to insulate themselves fiom painful memories and affect. As the patterns ofmovement in and out of the targeted network are identified it is important to use interventions that are experienced by the client as supportive but nevertheless make hun or her aware of having wandered. Although the narcissistic client may initiate treatment with the stated goal of improving his performance in specified areas, he will agree upon reflection that the real problem is that he feels an overriding need to perform in order to feel worthwhile. Since he has never known any other way of dealing with his self-worth, he will be skeptical about whether it is possible to feel a sense of worth that is not based upon performance, and it is easy for the therapist to lose perspective and join him in that beliet especially while doing EMDR with its potential for reprocessing with extraordinary precision specific obstacles to performance. The therapist must, however, retain her healthy perspective if the client is to learn to accept himself. For more clinical information about treating disorders of the self: 1.)Beck, Aaron T., et al, Cognitive Therapy Of Personality Disorder Guilford Press, New York, N. Y., 1990 2.)Manfield, Philip, Split Self/Split Object: Understanding And Treating Borderline, Narcissistic And Schizoid Disorders, Jason Aronson Publishers, Northvale, N.J., 1992. 3.)Young, Jeffrey, E, Cognitive Therapy For Personality Disorders: A Schema-Focused Approach, Professional Resource Exchange, Inc., Sarasota, Florida, 1990.

Keywords: Narcissistic Personality Disorder  

Accuracy Verified: Yes


24. Herbert, C. (2005, June). Neither good nor bad, just perfect as you are!  Facilitating emergence of the self. Presentation at the annual meeting of the EMDR Europe Association, Brussels, Belgium.

Language: English

Format: Conference

Abstract:
Clients with traumatic childhood experiences and subsequent diagnoses of Personality Disorder, hold self-identities that may have had adaptive, survival enhancing functions during their upbringing, but may now be hindering and even damaging. As babies their needs for secure attachment and nurturing may have been compromised and as children they may not have experienced unconditional love and acceptance of themselves. As adults, they may carry internalized self-images about either being intrinsically 'bad' or having to be especially 'good' in order to be accepted, valued and loved by others. Subsequently, their Behaviour and their relationships with others are determined by a distorted view of themselves, often causing them to lead lives that involve great compromise and further suffering. They may struggle with their capacity to regulate affect (Siegel, 1999: Shore, 1994, 1996). experiencing little self-control over their various fluctuating mood states. The aim of this workshop is to introduce clinical techniques, involving the interweave between EMDR and Schema-focused, cognitive approaches, which help clients build a more secure and 6nctionally positive sense of Self with healthy mechanisms of affect regulation. Based on current research, clinical practice and Herbert's (2002, 2003) therapeutic framework for working with complex trauma, this workshop will focus especially on two therapeutic ingredients for this work. One is the quality of the therapeutic relationship as a necessary transitory phase for healthy dependency in the client and the second is 'inner child' work as a method to help clients modify and re-script their distorted images of self and repair ruptures in their attachment relationships.

Keywords: Emergence of Self  

Accuracy Verified: Yes


25. Zangwill, W. H. (2008, September). Schema therapy infused EMDR. Presentation at the annual meeting of the EMDR International Association, Phoenix, AZ.

Language: English

Format: Conference

Abstract:
How long should a client be in treatment before you begin EMDR processing? How important is it to get that perfect negative and positive cognition? What should you do when a client wants to talk for a long time between sets of eye movements? The answer to these and other crucial, clinical, conundrums is……it depends. It depends on who the client is; what their underlying issues are; and how they try to defend themselves. This workshop is designed to help you recognize and respond to the underlying schemas and maladaptive coping styles that we and our clients have to improve the effectiveness of your EMDR treatment before, during, and after processing.

Keywords: Schema Therapy  

Accuracy Verified: Yes


26. Young, J. E., Klosko, J. S., & Weishaar, M. E. (2003). Schema therapy: A practitioner's guide. New York: The Guilford Press .

Language: English

Format: Book

Abstract:
Designed to bring about lasting change in clients with personality disorders and other complex difficulties, schema therapy combines proven cognitive-behavioral techniques with elements of interpersonal, experiential, and psychodynamic therapies.

Keywords: Schema-Focused Therapy  

Accuracy Verified: Yes


27. Herbert, C. (2002, May). Tales from clinical practice: The treatment of complex trauma using EMDR in conjunction with schema-focused cognitive behavioural therapy approaches. Presentation at the annual meeting of the EMDR Europe Association, Frankfurt, Germany.

Language: English

Format: Conference

Keywords: Complex Trauma  Schema-Focused Therapy  

Accuracy Verified: Yes


28. Herbert, C. (2003, March). The treatment of complex trauma: EMDR in conjunction with schema-focused Cognitive Behavioural Therapy approaches. Presentation at the 1st annual Conference of the EMDR UK & Ireland Association, London, UK.

Language: English

Format: Conference

Abstract:
Some clients with complex trauma whose experience goes back many years may never learn to form an intact, whole sense of themselves or engaged in health relationships with others. For these people, trust is a major issue and usually time-limited protocols of treatment either fail or are only partially helpful. Drawing on examples from clinical practice with complex trauma clients, this presentation will describe the use of a number of specifc technqiues and introduce a therapeutic framework, combining the use of EMDR and schema-focused cognitive behavioural psychotherapy.

Keywords: Cognitive Behavioral Therapy  Complex Trauma  

Accuracy Verified: Yes


29. Nutting, R. (2002, June). Using EMDR 'interweave' to reprocess 'defectiveness schema' in sexual abuse victims. Poster presented at the annual meeting of the EMDR International Association, San Diego, CA.

Language: English

Format: Conference

Keywords: Cognitive Interweave  Poster  Schema  

Accuracy Verified: Yes