Francine Shapiro Library - EMDR Bibliography Links
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1. Miller, R., & Tay, K. H. (2009, August). Adapting the standard EMDR protocol for clients with mild mental retardation: Some guidelines and implications. Poster presented at the annual meeting of the EMDR International Association, Atlanta, GA .
Language: English
Format: Conference
Abstract:
EMDR as a psychotherapeutic approach has been shown to be effective. However, there is a paucity of studies examining the efficacy of EMDR for clients diagnosed with mild mental retardation. The DSM-IV defines mild mental retardation as below average intelligence (IQ between 70 and 55) along with some deficiencies in adaptive functioning skills demonstrated before age 18. The purpose of our clinical project was to explore the applicability of EMDR for our adult clients (n = 12; mean age 22.5) diagnosed with mild mental retardation by adapting the standard protocol. Studies showed that individuals with mental retardation learn and retain information more effectively when materials are presented to them in a visual, concrete, and interactive manner while utilizing the principles of positive reinforcements.
The prevalence of mental health problems and the wide range of clinical symptoms among these individuals have been reported in several studies. Additionally, these adults are misunderstood as being overly limited in their ability to reap any therapeutic benefit from counseling interventions. Prout and Strohmer (1998), for instance, argued that adults with mental retardation do benefit from counseling interventions. However, they stressed the need for more sophisticated or modified use of psychotherapeutic interventions. Psychotherapeutic techniques and models should be modified, if feasible, in regards to language and cognitive levels commensurate with the clients’ background.
Based on our clinical observations, the following are some examples of proposed guidelines to assist the EMDR clinicians in thinking more creatively when adapting the standard protocol.
1) Considerable amount of preparation at the onset of EMDR is necessary, as it plays a pivotal role in ensuring a successful outcome.
2) Visual depiction of the SUDs and VOCs on a scale of 0 through 5, or 0 through 10, depending on the client’s cognitive abilities is beneficial. Use of “faces” to depict concretely various levels of distress should be made.
3) The concepts of PC and NC may be too abstract for some in this population. We assist clients by operationally defining those concepts with the list of commonly used PCs and NCs in simpler language.
4) Coping resources are sometimes limited for these adults. Clients will benefit from having multiple reinforcements of self-soothing skills thorough the installation of the “safe place” and “resources”.
5) Positive reinforcements (e.g., frequent verbal reminders) should be used regularly in sessions throughout treatment. However, be mindful of clients’ desire to please the clinician.
6) Role-playing should be used when feasible throughout treatment, e.g., during the installation of future templates, as it heightens more sensory, affective, and behavioral modes of learning rather than verbal modality alone.
Based on the treatment outcomes reported by our clients, EMDR is an effective treatment option, as evidenced by sustained reduction in their level of distress to traumatic memories. Findings from this clinical project have practice and research implications. First, the standard protocol should be adapted for use with adults with mild mental retardation to achieve optimal gain. Second, empirical research is needed to provide further evidence for the efficacy of EMDR for adults with mild mental retardation.
Keywords: Mental Retardation
Accuracy Verified: Yes
2. Liotti, G. (2012, June). Attachment, psychotherapy and EMDR [Apego, psicopatología y EMDR]. Keynote presented at the annual meeting of the EMDR Europe Association, Madrid, Spain.
Language: English
Format: Conference
Abstract:
The
defense
system
(freezing-‐fight-‐flight-‐feigned
death),
that
is
set
into
motion
in
every
individual
by
the
exposure
to
any
event
that
threatens
life
or
bodily
integrity
in
the
self
or
in
significant
others,
is
terminated
after
the
event
is
over
by
mental
and
interpersonal
processes
involving
the
soothing
and
security-‐
seeking
system
(attachment).
If
the
functions
of
the
attachment
system
are
hindered
by
memories
(internal
working
model,
IWM)
of
early
attachment
interactions
with
neglecting
or
abusive
caregivers,
the
defense
system
may
remain
active
for
long
periods
of
time
after
the
traumatic
event
is
over.
Insecure
and
especially
disorganized
IWMs
of
early
attachments,
together
with
the
unavailability
of
social
support
after
the
trauma,
are
thus
risk
factors
for
developing
the
symptoms
of
post-‐traumatic
stress
disorders.
This
lecture
dwells
on
the
main
features
of
attachment
disorganization,
on
the
negative
interference
of
attachment
disorganization
in
the
therapeutic
relationship,
and
on
the
reasons
why
the
characteristic
patient-‐therapist
relationship
in
EMDR
interventions
can
be
instrumental
in
by-‐passing
such
negative
interference.
El
sistema
de
defensa
(respuesta
de
inmovilización-‐lucha-‐huída-‐muerte
fingida)
que
se
pone
en
marcha
en
toda
persona
por
la
exposición
a
cualquier
incidente
que
amenaza
su
vida
o
la
integridad
física
o
las
de
sus
allegados
llega
a
su
fin
tras
el
incidente
mediante
procesos
mentales
e
interpersonales
implicados
en
el
sistema
de
tranquilizar
y
la
búsqueda
de
seguridad
(apego).
Si
las
funciones
del
sistema
de
apego
se
ven
impedidas
por
los
recuerdos
(el
modelo
del
funcionamiento
interno,
IWM,
por
sus
siglas
en
inglés)
de
interacciones
precoces
de
apego
con
cuidadores
negligentes
o
abusivos,
es
posible
que
el
sistema
de
defensa
permanezca
activo
durante
períodos
prolongados
después
de
que
el
evento
traumático
haya
terminado.
Así,
los
IWM
inseguros
y
especialmente
desorganizados
del
apego
temprano,
junto
con
la
falta
de
apoyo
social
tras
el
incidente
traumático,
se
convierten
en
factores
de
riesgo
para
el
desarrollo
de
síntomas
de
los
trastornos
postraumáticos.
Esta
conferencia
se
centra
en
los
rasgos
esenciales
de
la
desorganización
del
apego,
en
la
interferencia
negativa
de
la
desorganización
del
apego
en
la
relación
terapéutica
y
en
los
motivos
por
los
cuales
la
relación
característica
entre
paciente
y
terapeuta
en
las
intervenciones
con
EMDR
pueden
ser
instrumentales
para
puentear
dicha
interferencia
negativa.
Keywords: Attachment Keynote
Accuracy Verified: Yes
3. Brin, S. (2009). Butterfly protocol. EMDR Israel.
Language: English
Format: Other
Abstract:
Shula Brin, an EMDR facilitator, sent in her version of the butterfly protocol to our
journal. The butterfly hug was first developed as a self-soothing technique by Lucy
Artigas in 1997, while she was working in Acapulco with groups of survivors of
hurricane “Paulina”. A development of the "butterfly hug" was presented at the
international EMDR conference in Toronto, 2000, by Judith Boel. [Excerpt]
Accuracy Verified: Yes
4. Bar-Sade, E. (2003, May). Early trauma: Revisited and revised through EMDR, the narrative story and the implementation of attachment theory concepts. Presentation at the annual meeting of the EMDR Europe Association, Rome, Italy.
Language: English
Format: Conference
Abstract:
If we regard adult psychotherapy as the basis for a kind of attachment relationship in which the client seeks proximity by having a physical and emotional closeness with the therapist through which the client tries to create a”safe haven” soothing him or her when upset while providing a sense of security, child therapists often regard child-psychotherapy as a means to develop an attachment relationship between child and caregiver, whenever possible. It is a common assumption, that in child-psychotherapy, especially while dealing with trauma, the therapist must stress the importance of empowering the parental figure as an attachment figure and as a “secure base”.
Keywords: Attachment Theory Complex Trauma
Accuracy Verified: Yes
5. Burdett, C. (2011, October). EMDR and British/Irish law. Presentation at the 3rd annual EMDR Autumn Workshop Conference, Durham, England.
Language: English
Format: Conference
Abstract:
f a witness asks for therapy during the
course of prosecution
You must inform the prosecutor and police of the
request.
You must discuss the nature of the therapy with the
prosecutor so decisions may be made on how to proceed.
The prosecutor may object to the use of EMDR to process
memories that are part of the evidence.
The prosecutor may have no objection to the use of
EMDR in developing soothing and safety techniques nor
to its use to reduce anxiety when the witness is in court.
Therapy must not take place before the police have
undertaken a recorded interview.
if new allegations arise in therapy, treatment must stop
so that the witness can make a further statement to the
police. [Excerpt]
Accuracy Verified: Yes
6. Browning, S. (2008, October). EMDR and self soothing. Presentation at the 1st annual EMDR Autumn Workshop, York, UK.
Language: English
Format: Conference
Abstract:
A brief review of what is happening as a physiological neurobiological level and then looking at self soothing techniques to stabilise and strengthen client's resources to tolerate EMDR processing of the trauma. Mindfulness and other techniques demonstrated and explored in a group setting. Be prepared to try it yourself!
Keywords: Self Soothing
Accuracy Verified: Yes
7. Waters, F. S., & Adler-Tapia, R. (2009, November). EMDR for children with trauma and dissociation: Case conceptualization from stabilization to integration. Presentation at the 26th annual meeting of the International Society for the Study of Trauma and Dissociation, Washington, DC .
Language: English
Format: Conference
Abstract: This workshop initially will review the 8 phase EMDR protocol for implementation with severely traumatized and dissociative children and provide advanced skills utilizing the EMDR protocol with this population. The 8 phase EMDR protocol will be described. Therapeutic challenges for therapists in implementing this protocol with young children with complex trauma will be explored with recommendations for clinicians on how to provide efficacious treatment to children. Each phase of the protocol will be discussed identifying specific goals and specialized interventions presented with linguistic sensitivity to maintain adherence to the EMDR protocol with young children. Client History and Treatment Planning Phase, and the Preparation Phase of the EMDR Protocol will be detailed. The assessment of dissociation in young children will include recommendations for specific assessment tools. Stabilization skills for helping children address the phobic response to reprocessing traumatic events with mastery and resourcing while learning self-soothing and calming techniques will be demonstrated. Innovative and creative interventions integrating play and art therapy will be presented with child friendly language using the protocol sequence for effective treatment with children. In addition, adjustments to the EMDR protocol through the trauma processing phases, including integration, will be described and demonstrated with case presentations and videos. Creatively maneuvering these phases with children who display dissociative symptoms will be explored with recommendations for the successful implementation of the protocol throughout the healing process
Keywords: Case Conceptualization Children Dissociation Stabilization Trauma
Accuracy Verified: Yes
8. Purandare, M., Bhagwagar, H., & Tank, P. (2010, July). EMDR on children affected by the earthquake. Presentation at the 1st EMDR Asia Conference, Bali, Indonesia.
Language: English
Format: Conference
Abstract:
Efficacy of EMDR on Children Affected by Earthquake: The aim of the study was to investigate the efficacy of EMDR as an
intervention technique for trauma victims. A sample of 50 students, studying in 10th grade, age ranging from 14 to 16 years
were selected. The Impact of Event Scale (IES) was administered to measure the intensity of trauma experienced. A pre-post
test research design was used in the study. The results were in the predicted direction. EMDR was found to be effective in
reducing avoidance, intrusion and hyper arousal as well as overall impact of trauma.
“Group EMDR With Earthquake Survivors”
The current study is an attempt to understand the impact of a specific traumatic events and its expression in children i.e. the
earthquake that occurred in Gujarat, Western India in January 2001.
This study was a part of the therapy work conducted with the survivors of the earthquake by the group of 40 practitioners
from Mumbai and was over 4 months.
The paper will present the following aspects:
1. The symptoms seen among the children depicting PTSD as per DSM IV criteria. Signs of Hyper-arousal, Avoidance and
Intrusion were clearly seen especially in children
2. The process used. This was a modified version of the standard 8 phase protocol appropriate for use with group work.
Butterfly hugs were used as BLS. Stages of EMDR for this group:
3. Observations and a few unique experiences
These include blocking of trauma image, difficulty in safe place visualizing, difficulty in distancing and using creative
techniques for soothing and relaxation.
4. Impact of the EMDR intervention with this group
More than 16000 children from about 30 schools were seen. based on observations and reports by teachers during the
follow up showed reduction in anxiety, reports of life resembling pre-earthquake, improved attention and concentration,
better sleeping patterns and lowering of somatic complaints.
Impact and expression of trauma in children exposed to the earthquake: The current study is an attempt to understand
the impact of a specific traumatic event and its expression in children i.e. the earthquake that occurred in Gujarat, western
India in January 2001. The Butterfly hug technique for bilateral stimulation was used following 8 steps of EMDR. Drawings
of children were used as their expressions during different phases of EMDR. Drawings during “ Assessment phase” depicted
feelings of insecurity, a sense of vacuum and emptiness, low energy levels, a desire for contact and help, feelings of guilt, poor
body image, hypersensitivity was noticed almost universally and even during therapy. Drawings, following the processing
and installation phases indicated the facial expression changed to a smile. Tears which were present in almost all drawings
were not noted Positive cognitions were reflected in terms of the growth and freshness e.g. the newly growing grass. In spite
of the various symptoms of post traumatic stress disorder, no gross disintegration of personality had been noted.
Keywords: Children Earthquake
Accuracy Verified: Yes
9. Lovett, J. M. (1995, June). EMDR with Children: Eleven months to eleven years. Presentatioj at the EMDR Network Conference, Santa Monica, CA.
Language: English
Format: Conference
Abstract:
There are special considerations when treating children for critical incidents, anxiety, or other "EMDR amenable" conditions.
Especially challenging for EMDR practitioners, young children may not be able to verbalize their thoughts, feelings, or beliefs
children old enough to understand treatment options may choose to keep their symptoms rather than experience temporarily
increased anxiety during treatment. Even cooperative children may not be able to identify a positive cognition because their life
experience and/or cognitive development have not yet permitted resources for self-soothing or making sense of life changing events.
Furthermore, children are dependent on an adult or family for their physical safety and emotional wellbeing. Although the child may
be the "identified patient," the parents' own post-traumatic beliefs may be triggering the child's symptoms, and a successful outcome
for the child may depend on the parents' reprocessing of traumatic material.
Case studies will be presented to illustrate how the EMDR practitioner workmg with children can integrate EMDR techniques with
play therapy, use "EMDR enhanced" games, choose an appropriate positive cognition for a young child, introduce creative
interweaves to reach trauma resolution, and work with parents to separate their PTSD triggers from their child's behavior.
Keywords: Children
Accuracy Verified: Yes
10. Condon, G. (2000, August 22). Eye-opening therapy: Method simulating REM succeeds in soothing painful memories, but nobody knows why. Hartford, CT: The Hartford Courant, Statewide, Life, D3.
Language: English
Format: Newspaper
Abstract: Over time, the memory helped shape the low self-esteem, disturbed sleep, anxiety and depression that brought him to Carole MacKenzie's psychotherapy practice in Hartford last year. MacKenzie, a clinical social worker, used a technique called Eye Movement Desensitization and Reprocessing (EMDR), a controversial but increasingly popular method that has been used for a decade to help heal those suffering the psychological aftereffects of trauma.
Keywords: General Hartford Overview
Accuracy Verified: Yes
11. Forgash, C. (2012, October). The impact of complex PTSD and attachment issues on personal health: An EMDR treatment approach. Presentation at the annual meeting of the EMDR International Association, Arlington, VA.
Language: English
Format: Conference
Abstract:
EMDR treatment will be presented as a successful model for dealing with the attachment deficits and health problems of trauma survivors. The development of an EMDR Treatment Plan to treat both health and attachment problems with a focus on a Health History and specific target selection is highlighted. Specialized techniques will be utilized in phases 1-3 to help the patient experience self soothing, develop emotional regulation, and to avoid re-traumatization in the health care setting. Phases 4-7 will emphasize specific work on past attachment ruptures as well as specific health issues. Skills development such as rehearsal will also be presented.
Keywords: Attachment Issues Complex Posttraumatic Stress Disorder Complex-PTSD C-PSTD Personal Health
Accuracy Verified: Yes
12. Leeds, A. M. (1998). Lifting the burden of shame: Using EMDR resource installation to resolve a therapeutic impasse. In P. Manfield (Ed.), Extending EMDR: A casebook of innovative applications, (1st ed.) (pp. 256-281). New York: W. W. Norton.
Language: English
Format: Book Section
Abstract:
With Meredith, what had seemed an insurmountable impasse using a standard PTSD protocol had become amenable to significant resolution when addressed with a non-standard protocol. The key to this approach was to install multiple positive resources without deliberately activating the distressing emotions and associations of a specific, disturbing memory or current stimuli. I have coined the phrase "EMDR resource installation" to describe this protocol. I have since used this approach with other challenging clients who have childhood histories of significant failures of attachment with their primary caregivers. In these cases, their histories and current functioning led me to conclude that their capacity for self-soothing and affect modulation was not yet developed to the point where they could tolerate directly targeting distressing memories using the standard EMDR protocol. [Text, pp. 276-277]
Keywords: Adults Case Report Child Abuse Defense Mechanisms Diseases Females Neglect Posttraumatic Stress Disorder Psychotherapeutic Processes PTSD Survivors Treatment Effectiveness
Accuracy Verified: Yes
13. Gower, T. (2002, May). The new quick-fix therapy. Health, 98-99.
Language: English
Format: Magazine
Abstract:
Anita Anderson tried all sort of ways to relieve her fear of flying. She listened to soft music before takeoff, make herself think soothing thoughts – nothing worked. Then, two years ago, the 52-year-old from Brewster, Massachusetts, learned that a psychotherapist friend of hers had been trained to perform EMDR, a new treatment that allegedly relieves anxiety quickly. She promptly made an appointment.
Keywords: Fear of Flying General Overview
Accuracy Verified: Yes
14. Gerge, A. (2008, April). Phase I Preparations of severely traumatized women for exposure by extended EMDR-protocols in phase II treatment. Presentation at the 1st Bi-Annual International European Society for Trauma and Dissociation Conference, Amsterdam, The Netherlands .
Language: English
Format: Conference
Abstract:
This presentation offers a description of an integrative approach of group treatment within
phase I treatment leaning on psychodynamic theory, a clear psycho-educative approach
that uses methods as hypnosis/relaxation training/mindfulness training, aims for
enhanced relational capacity and self-regulation by using hypnotic techniques aiming at
enhanced containment capacity (Brown & Fromm, 1986; Kluft, 1993, 1999; Phillips &
Fredericks 1995; Chu 1998; Cardeña et al., 2000). The treatment aims at enhanced
capacity to mentalize, i.e., using the reflective functions in self-organization (Fonagy,
1997). This is considered to offer the participants an enhanced ”self soothing capacity”
(Krystal 1988a,1988b), i. e., the capacity to calm and soothe the self by enhanced self
regulation and capacity to rest, by helping the participants to reach experiential states
where they can contain their own reactions, as well as offering training in order to tolerate
and understand the signals of the body, i. e. the “felt sense” (Gendlin, 1978; Ogden,
Minton, & Pain 2006). The trauma therapy within phase II-work by extended EMDRprotocols
is exemplified with special focus on the restoration of the capacity for adequate
self-care as well as care-giving functions.
Learning Objectives:
1. To show how an integrative group treatment in phase I treatment can be used in
trauma therapy for stabilization with patients with complex PTSD and high levels of
dissociation (psychoform and/or somatoform co-morbidity).
2. Exemplify trauma-therapy within phase II work by extended EMDR-protocols
addressing the special needs of continuous reinforcement of stabilization for the
same population.
3. Focus on restoration of the capacity for adequate self-care as well as care giving
functions.
Accuracy Verified: Yes
15. Lobenstine, F. E., & Shapiro, E. (2010). Pouvez-vous m'indiquer une technique efficace d'auto-apaisement que mes clients puissent utiliser chez eux en cas de stress? [What is an effective self-soothing technique that I can teach my client to use at home when stressed?]. Journal of EMDR Practice and Research, 4(2), 27E-30E. doi:10.1891/1933-3196.4.2.E27.
Language: French
Format: Journal
Abstract:
Une contribution à la "Q & A clinique" colonne, dans laquelle les cliniciens maîtres répondre aux questions posées par les lecteurs qui demandent une assistance à des défis cliniques. La question à laquelle les auteurs sont de répondre est: «Quelle est un moyen efficace d'auto-apaisante technique que je peux enseigner à mon client d'utiliser à la maison lorsque vous êtes stressé?" [Adapté à partir du texte, p. 122] [pilotes]
contribution to the "Clinical Q&A" column, in which master clinicians answer questions posed by readers who are requesting assistance with clinical challenges. The question to which the authors are replying is "What is an effective self-soothing technique that I can teach my client to use at home when stressed?" [Adapted from Text, p. 122][Pilots]
Keywords: Self-Soothing Techniques: Stress
Accuracy Verified: Yes
16. Forrest, M. S. (1995, June). Self-soothing and the multiple trauma survivor. Presentation at the EMDR Network Conference, Santa Monica, CA.
Language: English
Format: Conference
Abstract:
Remember the joke about the doctor who says, "The operation was a success, but the patient died"? That's how some clients feel
about EMDR. They succeed in accessing deep and important material, but find themselves extremely depressed and/or anxious in
the days afterward. For these clients, who are often survivors of multiple trauma such as long-tenn child abuse or incest, the ability
to self-soothe (both during and after an EMDR session) makes the difference between whether they regard EMDR as a useful tool or
a necessary evil.
To find out what self-control techniques work best for such clients, I interviewed EMDR clients (all women) who had experienced
long-term sexual abuse in childhood.
The first thing I learned was that for survivors of multiple trauma, the ability to feel safe starts long before EMDR is ever used.
Many women cited their relationship with their therapist as the foundation of their feeling safe with EMDR: "I trust my therapist
absolutely." One client's therapist told her he had used EMDR himself: "That made a huge difference to me," she said.
Other advance work included planning and taking preventative measures. Planning means picking the right time (and pace) for
doing EMDR: being sure the therapist and/or other support people will be available in the days after the session; not driving or
going back to work afterward (if possible); being able to have plenty of alone time; and going slowly, doing EMDR in small
increments. "I didn't expect myself to go out in the world and be social afterward. I was pretty raw for a few days, sometimes for a
whole week," B. told me.
Planning also means taking preventive measures, such as teaching the client how to find "a safe place." Most clinicians know the
importance of this, but one of the women I interviewed was emphatic that creating a safe place was very different from being able to
go to it when she was in a session and reliving the experience of being a three-year-old overwhelmed by extreme grief or terror. She
said she needed a lot of practice accessing her safe place and some special interventions (see below) to get through the intense times.
Being able to self-soothe between sets of eye movements was very difficult for most clients. "I cry all the time we do it," S. told me.
"I have to sit near the door and not have my therapist sit too close," said M. Another woman said, "We do the eye movements for a
few seconds and we talk in between."One successful intervention, especially for clients overwhelmed by the intensity of their
feelings, involved the therapist asking his client to listen to the sound of his breathing and to breathe along with him. Another
clinician has his client when she gets extremely upset ask her "inner guide or "higher power" whether it's "okay to continue;" a third
asks, "Is there more underneath or is it time to wind down?" Letting the client control the pace and progress of his/her own
processing can be an important way to teach self-trust -- especially to people for whom loss of power was endemic to their abuse.
Some clients are able to repeat special phrases or afirmations over and over between sets to calm themselves. L., a ritual abuse
survivor, said she grounds herself by silently reciting a mindfulness verse from Zen master Thich Naht Hanh in time with her inbreath
and out-breath: "In, out. Deep, slow, Calm, ease. Smile, release. In, out. Deep, slow ......
Different kinds of self-soothing techniques work best after the eye-movement sets are completed.
Immediately afterwards, while still in session, one client said she falls asleep for a few minutes -- she finds this a big help in
countering the dissociated state in which she typically concludes an EMDR session. Another said she and her therapist share a cup
of tea and talk over what happened as a way to "come down" and normalize the experience.
Some clinicians close a session by doing eye movements to reinforce the client's safe place. One woman said her therapist has her
"cement the present in place" by doing eye movements on either a present-day image, an image of her inner child in the safe place, or
a positive statement.
Francine Shapiro has often said that what happens after the EMDR session can be as important as what happens during it. The
women I interviewed felt exactly the same way. They had learned the necessity of talung exquisitely good care of themselves in the
hours and days that follow. "I take time-and time out," declared B., who often has a delayed fear reaction following EMDR.
Most clients said they go home and either curl up in bed or in a favorite rocking chair with their stuffed animals. They cry, sleep,
write in their journals, draw pictures, listen to music, look at favorite photographs, and/or call a support person. M. uses self-talk to
ease her feelings: "I say to myself, 'You know that knot of fear. I know it's only fear. I know that nothing is going to hurt me right
now'." For others, going home immediately is not the best option: D. takes a walk along the shores of Long Island Sound; C., the
mother of three young children, finds solace in a favorite bookstore.
Sometimes all the planning in the world doesn't help: the abreaction seems to launch the client back to the age she was when she
was abused - and she simply can't remember how to calm herself. To counter this, several clients said they carry a list of things
they can do to quiet themselves. S. finds reading mystery stories comforting("At the end you always find out what really happened."), but has to keep two of them on her bedside table at all times: "If they're not in full view, I forget about using them."
One interesting example of "assigned" self-soothing was given by a ritual abuse survivor who was new to EMDR. After a session
when a lot of memories came up about how her sexuality was used and degraded during the abuse, her therapist gave her very
specific instructions on how to care for herself, including buying a romantic nightgown and soaking in bath salts for 45 minutes;
listening to romantic music; and not touching or kissing her partner for 48 hours. "It worked out great!" she told me happily. "I felt
SO pretty and so safe."
The conclusion I reached about how multiple-trauma survivors learn to self-soothe in the face of the intense feelings EMDR can
trigger is not revolutionary. The recipe is: Step 1. Plan for the worst. Step 2. Let the client select the self-soothing techniques that
specifically fit for her or him. Step 3. Make sure s/he is able to use these techniques no matter how intense his/her emotions are.
Sometimes this will call for the therapist to take an active role by either leading the client in specific calming techniques or by
assigning very clear-cut homework.
If the recipe calls for planning and practicing, then the pot in which the ingredients are cooked is labeled "TRUST"-trust before
initiating EMDR, trust during the eye movements, and trust after the sets are completed. Unless the client deeply trusts the
clinician, the method itself, and his or her own capacity to go into the feelings and me out safely, the recipe for success with
EMDR can turn into a recipe for disaster.
Accuracy Verified: Yes
17. Gerge, A. (2012, June). Seven ways to extend the EMDR-protocol based in clinical hypnosis for clients with complex dissociative disorders [Siete maneras de extender el protocolo EMDR basadas en hipnosis clínica para pacientes con trastornos disociativos complejos]. Presentation at the annual meeting of the EMDR Europe Association, Madrid, Spain.
Language: English
Format: Conference
Abstract:
Clients
with
complex
dissociative
disorders
usually
are
in
trauma-‐
induced
wake
trance-‐states.
Due
to
this,
they
might
thrive
from
treatment-‐
strategies,
where
skills
in
clinical
hypnosis,
from
the
side
of
the
therapists,
are
added
to
the
treatment
model.
Clinical
hypnosis
also
offers
excellent
tools
for
working
with
attachment
traumas
and
reinstalls
the
neuroception
of
safety.
This
workshop
highlights
seven
strategies
for
extending
the
EMDR
standard
protocol,
mainly
built
on
clinical
hypnosis.
They
consist
of:
(1)
Formal
hypnotic
induction
of
safe
place/safe
state
BEFORE
introducing
EMDR
under
phase
I
treatment
(2)
Informal
hypnotic
induction
for
ongoing
activation
of
the
social
engagement
system
when
clients
are
in
trance
(3)
Using
hyper-‐empirical
trance
inductions
under
exposure
phase
(ie
helping
the
clients
to
stay
present
with
dual
awareness
by
continuously
inducing
trance,
thus
helping
them
to
titrate
the
trauma-‐material
(4)
Addressing
ego-‐states
that
react
as
if
they
still
are
bound
in
trauma-‐time
(5)
Addressing
resource-‐rich
ego-‐states
and
parts
of
the
self,
f
ex
ISH
(internal
self-‐
helper),
thus
helping
the
client
to
begin
to
metabolize
the
trauma
material
(6)
Installation
of
hope
and
the
“memory
of
the
future”
(7)
Using
post-‐hypnotic
suggestions
for
enhancing
the
neuroception
of
safety
between
sessions.
Learning
objectives:
Demonstrate
how
to
use
EMDR
and
hypnosis
for
stabilization
and
work
with
parts
within
phase
II
work,
addressing
the
special
needs
of
continuous
stabilization
for
this
population.
Develop
an
understanding
of
how
to
enhance
the
integrative
capacity
during
trauma-‐work
with
DD-‐clients.
Apply
structured
techniques
and
rationales
for
calming
and
soothing
patients
related
to
their
integrative
capacity
during
extended
EMDR-‐work.
Los
clientes
con
trastornos
disociativos
complejos
normalmente
se
encuentran
en
estados
de
trance
despierto
inducido
por
el
trauma.
Debido
a
esto,
pueden
crecer
rápidamente
de
estrategias
de
tratamiento,
donde
estrategias
de
hipnosis
clínica
se
añaden
al
modelo
de
tratamiento
por
parte
del
terapeuta.
La
hipnosis
clínica
ofrece
también
excelentes
herramientas
para
trabajar
con
traumas
de
apego
y
reinstalar
la
neurocepción
de
seguridad.
Este
taller
subraya
siete
estrategias
para
extender
el
protocolo
estándar
de
EMDR,
principalmente
basadas
en
la
hipnosis
clínica.
Consisten
en:
(1) Inducción
hipnótica
formal
del
lugar
seguro/
estado
de
seguridad
ANTES
de
introducir
la
fase
I
de
tratamiento
de
EMDR
(2) Inducción
hipnótica
informal
para
la
activación
continuada
de
los
sistemas
de
compromiso
social
cuando
los
clientes
están
en
trance
(3) Uso
de
inducciones
al
trance
hiper-‐empíricas
en
la
fase
de
exposición
(ej,
ayudar
a
los
clientes
a
estar
presentes
con
conciencia
dual
mediante
la
inducción
continua
al
trance,
por
tanto
ayudándoles
a
valorar
el
material
traumático.
(4) Dirigirse
a
los
estados
del
ego
que
reaccionan
como
si
aún
estuviesen
atados
al
tiempo
traumático
(5) Dirigirse
a
estados
del
ego
ricos
en
recursos
y
a
partes
del
yo,
por
ejemplo,
al
ISH
(en
inglés
yo-‐interno
ayudante),
por
tanto
ayudando
al
cliente
a
empezar
a
metabolizar
el
material
traumático
(6) Instalación
de
esperanza
y
la
“memoria
de
futuro”
(7) Usando
sugestión
post-‐hipnótica
para
fomentar
la
neurocepción
de
seguridad
entre
sesiones.
Objetivos
de
aprendizaje:
Demostrar
cómo
usar
EMDR
e
hipnosis
para
estabilizar
y
trabajar
con
las
partes
en
el
trabajo
de
la
fase
II,
dirigiéndonos
a
las
necesidades
especiales
de
estabilización
continua
para
esta
población.
Desarrollar
un
entendimiento
de
cómo
fomentar
la
capacidad
integrativa
cuando
se
trabaja
el
trauma
con
clientes-‐DD.
Aplicación
de
técnicas
estructuradas
y
racionales
para
calmar
y
tranquilizar
a
los
pacientes
en
relación
con
su
capacidad
integrativa
durante
trabajo
extendido
con
EMDR.
Keywords: Dissociative Disorders Hypnosis
Accuracy Verified: Yes
18. Gerge, A. (2012, June). Seven ways to extend the EMDR-protocol based in clinical hypnosis for clients with complex dissociative disorders [Siete maneras de extender el protocolo EMDR basadas en hipnosis clínica para pacientes con trastornos disociativos complejos]. Presentation at the annual meeting of the EMDR Europe Association, Madrid, Spain.
Language: English
Format: Conference
Abstract:
Clients with complex dissociative disorders usually are in trauma-induced wake trance-states. Due to this, they might thrive from
treatment-strategies, where skills in clinical hypnosis, from the side of the therapists, are added to the treatment model. Clinical hypnosis also
offers excellent tools for working with attachment traumas and reinstalls the neuroception of safety.
This workshop highlights seven strategies for extending the EMDR standard-protocol, mainly built on clinical hypnosis. They consist of:
1. Formal hypnotic induction of safe place/safe state BEFORE introducing EMDR under phase I treatment.
2. Informal hypnotic induction for ongoing activation of the social engagement system when clients are in trance.
3. Using hyper-empirical trance inductions under exposure phase (ie helping the clients to stay present with dual awareness by
continuously inducing trance, thus helping them to titrate the trauma-material.
4. Addressing ego-states that react as if they still are bound in trauma-time.
5. Addressing resource-rich ego-states and parts of the self, f ex ISH (internal self-helper), thus helping the client to begin to metabolize
the trauma material.
6. Installation of hope and the “memory of the future”.
7. Using post-hypnotic suggestions for enhancing the neuroception of safety between sessions.
Learning objectives:
Demonstrate how to use EMDR and hypnosis for stabilization and work with parts within phase II work, addressing the special needs of
continuous stabilization for this population.
Develop an understanding of how to enhance the integrative capacity during trauma-work with DD-clients. Apply structured techniques and
rationales for calming and soothing patients related to their integrative capacity during extended EMDR-work.
Los clientes con trastornos disociativos complejos normalmente se encuentran en estados de trance despierto inducido por el
trauma. Debido a esto, pueden crecer rápidamente de estrategias de tratamiento, donde estrategias de hipnosis clínica se añaden al modelo
de tratamiento por parte del terapeuta. La hipnosis clínica ofrece también excelentes herramientas para trabajar con traumas de apego y
reinstalar la neurocepción de seguridad.
Este taller subraya siete estrategias para ampliar el protocolo estándar de EMDR, principalmente basadas en la hipnosis clínica. Consisten en:
1. Inducción hipnótica formal del lugar seguro / estado de seguridad ANTES de introducir la fase I de tratamiento de EMDR.
2. Inducción hipnótica informal para la activación continuada de los sistemas de compromiso social cuando los clientes están en trance.
3. Uso de inducciones al trance hiper-empíricas en la fase de exposición (ej, ayudar a los clientes a estar presentes con conciencia dual
mediante la inducción continua al trance, por tanto ayudándoles a valorar el material traumático.
4. Dirigirse a los estados del ego que reaccionan como si aún estuviesen atados al tiempo traumático.
5. Dirigirse a estados del ego ricos en recursos y a partes del yo, por ejemplo, al ISH (en inglés yo-interno ayudante), por tanto
ayudando al cliente a empezar a metabolizar el material traumático.
6. Instalación de esperanza y la “memoria de futuro”.
7. Usando sugestión post-hipnótica para fomentar la neurocepción de seguridad entre sesiones.
Objetivos de aprendizaje:
Demostrar cómo usar EMDR e hipnosis para estabilizar y trabajar con las partes en el trabajo de la fase II, dirigiéndonos a las necesidades
especiales de estabilización continua para esta población.
Desarrollar un entendimiento de cómo fomentar la capacidad integrativa cuando se trabaja el trauma con clientes-DD. Aplicación de técnicas
estructuradas y racionales para calmar y tranquilizar a los pacientes en relación con su capacidad integrativa durante trabajo extendido con
EMDR.
Keywords: Dissociative Disorders Hypnosis
Accuracy Verified: Yes
19. Matthess, H., & Yang, Y. (2010, July). Social and cultural adaptation. Presentation at the 1st EMDR Asia Conference, Bali, Indonesia.
Language: English
Format: Conference
Abstract:
We know from research that since neurobiology is the same for humans, then the reaction to stress is the same for all human
beings in the world. That is why EMDR works so well with victims of natural disasters and of adverse childhood experiences,
including sexual and physical violence and emotional neglect.
Because of cognitive functioning, e.g., creating metaphors and images for self-soothing, establishing social contact and/
or personal interpretation, or assigning meaning to stressful experiences, we have to emphasize the importance of cultural
influences.
We want to invite people from different cultures to join this open meeting to present, share, and discuss their experiences
and perhaps difficulties with cultural adaptation of trauma-therapy techniques, including EMDR. For example, we may need
to examine where and how the wording of the EMDR-protocol needs to be adapted to recognize and accommodate cultural
differences; perhaps we need to look at the language structure and its accessibility. Let us share our ideas and experiences
so that we may get new insights on how to more effectively implement our trauma-therapy techniques and spread our
knowledge about neurobiology to various cultural backgrounds.
Keywords: Social and Cultural Adaptation
Accuracy Verified: Yes
20. Dworkin, M. (2010, March). Solving transference and counter-transference with dissociative disorders in EMDR. Presentation at the 8th EMDR Association UK & Ireland Annual Conference & AGM, Dublin, Ireland.
Language: English
Format: Conference
Abstract:
Chair, Michael Paterson
This workshop will focus on the types of transference and counter-transference that arise in
EMDR with dissociative clients and teach solutions. Procedural modifications have been the
focus in dealing with pathological dissociation in EMDR treatment. Separately, transference
and counter-transference with dissociative patients have been written about extensively by
experts in the dissociation field. Research findings about the effects of mirror neurons and
embedded simulation on the inter-subjective field of patient and therapist have also been
published. Strategies for dealing with these transference and counter-transference in EMDR
treatment have received little attention even though this population has intense transference,
and can activate intense counter-transference. These issues may begin during an evaluation
of the presenting problems. Strategies for identifying and using transference to enhance
dual awareness during history taking will be demonstrated. An elongated preparation phase
to develop enough trust and stabilization before exploring traumatic memories can limit
induced transference. Different parts of a dissociative patient may have different kinds of
transferences. These transferences may cause the patient to withdraw, cling or attack;
affecting the therapist’s abilities to stay attuned and focused on the work in different phases
of EMDR. Strategies of attunement to the activated part of the client will be demonstrated
in order to repair or prevent ruptures of attunement. Interactions are bi-directional, and
different (transferential) parts may activate dissociative parts of the therapist. Strategies to
somatically identify and use these counter-transferential activations in the therapist will be
taught through body based awarenesses. R/D/I strategies can be used to limit countertransference
to remain grounded and attuned. Transference and counter-transference during
the assessment phase will be identified and solutions presented. During the Desensitization
phase under-accessing or over-accessing target memories; abreaction vs. vehement emotions
will be discussed as unacknowledged dissociative moments with indications for inducing
transference, counter-transference, or both. Decisions need be made collaboratively whether
to process or contain these events. Understanding and dealing with dilemmas of dissociative
enactments are crucial to keeping the healing process going. These inter-subjective issues
may be most intense during the first four phases, but some problems may continue into
Installation and the Body Scan. Problems and solutions during Incomplete Closure and the
Re-evaluation phases will be given. Activated parts in the patient may cling or be angry with
the therapist at the end of an EMDR session. Failure or defectiveness parts of the therapist
may become activated as well. Solutions to these issues that occur during different phases
will be taught so that participants will leave the workshop with additional strategies to use
with their dissociative patients. Attunement to dissociative parts, identifying transference
and counter-transference binds; The Clinician Self Awareness Questionnaire ;
Compartmentalization; use of self soothing skills; using Relational, Empathic, and
Transferential Interweaves; identifying moments of projective identification and enactments,
and then to use them to deepen EMDR will be taught, as well as innovative inter-subjective
strategies . Case examples and awareness exercises will used throughout the workshop to
facilitate intellectual and experiential learning.
Keywords: Counter-transference Dissociative Disorders Transference
Accuracy Verified: Yes
21. Dworkin, M. (2009, August). Solving transference and countertransference with dissociative disorders in EMDR. Presentation at the annual meeting of the EMDR International Association, Atlanta, GA.
Language: English
Format: Conference
Abstract:
This workshop will focus on transference and countertransference problems and solutions in EMDR with dissociative clients. There will be a short literature review on procedural modifications in dealing with dissociation in EMDR, and transference and countertransference with dissociative patients. Research findings on mirror neurons and embodied simulation will be taught to enhance the participant’s understanding of the neurobiological substrates for attunement and resonance, and for solving transference and countertransference with dissociatives in EMDR when ruptures to relatedness occurs. Identifying and using transference reactions to enhance dual awareness will be demonstrated in history taking. Enhancements in preparation phase will be shown through case example to limit induced transference. Transference and countertransference during the assessment phase will be identified and solutions offered. In the Desensitization phase EMDR processing may induce transference, countertransference, or both (even with procedural modifications). Intersubjective challenges seem to be more intense during phases 1 -4 and 7-8. Activated parts in the patient may cling or be angry with the therapist at the end of an EMDR session, or during Re-evaluation. Failure or defectiveness parts of the therapist may become activated then as well. Different parts of a dissociative patient may appear with different kinds of transferences during different EMDR phases. These transferences challenge therapist’s abilities to stay attuned. Strategies of attunement to the activated part of the patient will be demonstrated in order to repair or prevent ruptures to the alliance and to understand the nature of the dissociated communication. Bi-directional interactions may activate parts of the patient and therapist without conscious awareness. Strategies to somatically identify and use these countertransferential activations will be taught through experiential exercises so that the therapist may have a more in depth understanding of the dissociative patient’s communications. R/D/I strategies will be reviewed and applied to the therapist to limit countertransference activations. Dealing with dissociative enactments are crucial to identify ruptures to the therapeutic alliance, restore attunement and resonance, uncover dissociative messages that can be used during EMDR processing.. Solutions to the problems that occur during different EMDR phases will be taught using lecture, discussion, case examples, written and experiential exercises so that participants will leave the workshop with additional strategies. Solutions include how to maintain attunement to dissociative parts during transferential activations while enhancing dual awareness; how to identify transference and countertransference problems during phases 1-4 and 7-8 and use them as additional sources of dissociated communications that can be used in EMDR processing ; how to use the Clinician Self Awareness Questionnaire to identify and process countertransference problems ; how to use compartmentalization strategies using R/D/I to limit countertransference activations; how to develop self soothing skills for the therapist’s dissociated parts; how and when to use Relational, Empathic, and Transferential Interweaves during Desensitization; and how to identify moments of enactments, and using EMDR strategies to deepen the EMDR experience .
Keywords: Countertransference Transference
Accuracy Verified: Yes
22. Gilson, G., & Kaplan, S. (2000). The therapeutic interweave in EMDR: Before and beyond: A manual for EMDR trained clinicians. EMDR Humanitarian Assistance Programs, New Hope, PA.
Language: English
Format: Book
Abstract:
Expands the concept of the cognitive interweave to the broader, more inclusive Therapeutic Interweave. Gives structured framework of 16 categories of Therapeutic Interweave, and strategies that enhance safety, assist with affect regulation, self-soothing, and develop ego-strength. Good supplement to Shapiro's basic didactic book on EMDR. [EMDR-HAP]
Keywords: Cognitive Interweave Therapeutic Interweave
Accuracy Verified: Yes
23. Kaplan, S., & Gilson, G. (2005, September). The therapeutic interweave in EMDR: Responsibility, safety and choices. Presentation at the annual meeting of the EMDR International Association, Seattle, WA.
Language: English
Format: Conference
Abstract:
This workshop presents the expanded concept of the Therapeutic Interweave in EMDR treatment as it relates to responsibility, safety, and choices. It includes cognitive interweaves, as well as affective, body awareness, imaginal, ego state, experiential, dynamic, spiritual, and other interweaves. It offers a format for EMDR clinicians to utilize in decision-making in clinical pracice. The workshop also teaches assessment of the client's need to front-load their system for resourcing and stabilization, i.e., self-soothing, affect modulation, and ego strengthening before beginning or during the EMDR protocol. The workshop is rich in strategies, current case examples and specifically designed practice exercises.
Keywords: Affective Interweave Body Awareness Interweave Dynamic Interweave Ego State Interweave Experiential Interweave Imaginal Interweave Therapeutic Interweave Spiritual Interweave
Accuracy Verified: Yes
24. Wesselmann, D. (2000, September). Treating core attachment issues in adults and children. Presentation at the annual meeting of the EMDR International Association, Toronto, Ontario Canada.
Language: English
Format: Conference
Abstract:
Participants will: 1) be able to describe the specific effects of poor quality attachments on emotional and social functioning in children and adults; 2) be able to describe how problem attachments are transmitted generationally; 3) learn to identify core negative cognitions related to specific types of attachment problems; 4) learn to utilize ego state work in order to strengthen the adult self and develop a self-soothing dialogue prior to the reprocessing of emotionally-laden material; 4) learn to utilize EMDR to help parents understand and change their distorted perceptions and ineffective responses with their children; and 6) learn how to coach parents in providing support and attunement in the child's reprocessing as a way of strengthening the attachment bond.
Keywords: Attachment Ego State Therapy
Accuracy Verified: Yes
25. Tobin, S. (2002, June). Use of therapeutic alliance for resource installation. Presentation at the annual meeting of the EMDR International Association, San Diego, CA.
Language: English
Format: Conference
Abstract:
Dr. Tobin will show why it is important to address the often overlooked therapeutic relationship; how to notice transference and
countertransference issues, how to foster the therapeutic alliance; and how to utilize EMDR to install the alliance, once it has been established, as a resource to foster increased self-support, grounding, enhanced self-esteem
and self-soothing capacities. Relevant psychodynamic theory on transference and countertransference, the applicability of this approach to various diagnostic groups will be discussed, contraindications will be
cited and clinical examples will be presented.
Keywords: RDI Resource Installation Therapeutic Alliance
Accuracy Verified: Yes
26. Shapiro, R. (2005). Using EMDR in couples therapy. In R. Shapiro (Ed.), EMDR solutions: Pathways to healing (pp. 283-292). New York: W W Norton & Co.
Language: English
Format: Book Section
Abstract:
Why would you do EMDR, a decidedly individual therapy, with couples? How do you decide with whom to use EMDR? And is there anything besides trauma processing that EMDR brings to conjoint couples therapy?In 8 out of 10 couples sessions, I use the Standard Protocol to clear trauma from inside and outside the relationship and from before and after the couple met. The partners envision and practice new behaviors with the Future Template. Dual Attention Stimulus (DAS) can enhance self-soothing. Additionally, when a partner sees the other partner do EMDR or is seen doing EMDR, differentiation is enhanced in each. [Text, p. 283] [Pilots]
Keywords: Adults Family Therapy Marital Problems Sex Therapy Stressors Survivors
Accuracy Verified: Yes
27. Lobenstine, F., & Shapiro, E. (2007). What is an effective self-soothing technique that I can teach my client to use at home when stressed?. Journal of EMDR Practice and Research, 1(2), 122-124. doi:10.1891/1933-3196.1.2.122.
Language: English
Format: Journal
Abstract:
A contribution to the "Clinical Q&A" column, in which master clinicians answer questions posed by readers who are requesting assistance with clinical challenges. The question to which the authors are replying is "What is an effective self-soothing technique that I can teach my client to use at home when stressed?" [Adapted from Text, p. 122][Pilots]
Keywords: Psychotherapeutic Processes Self-Help Techniques Stressors Survivors
Accuracy Verified: Yes
28. Wilensky, M., & O'Shea, K. (2013, May). When calm/safe place doesn’t work. Presentation at the annual EMDR Canada Conference, Banff, Alberta CAN.
Language: English
Format: Conference
Abstract:
In the Client Preparation Phase (Phase 2), the client learns self-soothing skills before progressing to trauma
processing. It is essential that the client be able to voluntarily change from a state of high distress to a state of
lower distress. Commonly, this is accomplished through the development of a Calm Place (used to be called
Safe Place). Some clients are unable to do this exercise. This is often a clue about the presence of a Dissociative
Disorder. Generally, they will require a longer Preparation Phase. This workshop will teach how to identify these
clients, what it means and two methods to find resources for self-soothing and self-regulation. These resource
states provide a base of operations for trauma processing.
Learning objectives:
• To identify clients, including those with dissociative disorders, who need more preparation before trauma
processing.
• To learn two methods to increase readiness for trauma processing
• To learn two methods for increased client self-regulation
Keywords: Calm/Safe Place Preparation Phase Self-Soothing Skills
Accuracy Verified: Yes