Eye movement desensitization and reprocessing
Eye movement desensitization and reprocessing (EMDR) is a form of psychotherapy developed by Francine Shapiro in the 1980s. According to EMDR negative thoughts, feelings and behaviors are a result of unprocessed memories. EMDR focuses on simultaneously speaking about the traumatic image, event, thoughts, feelings, and body sensations while performing a bilateral movement. Instead of eye movements, I may ask you to perform hand or finger tapping or to wear a set of headphones to listen to tones that alternate from your right ear to your left ear. You will continue to focus on the feelings or memories while you participate in these bilateral eye movements, taps, or tones. There are 8 phases of EMDR Treatment.
Introduction to EMDR Therapy
The 8 PHASES OF EMDR TREATMENT
Phase 1: History and Treatment Planning
In this phase, you share your life history, and we develop a plan for your particular issues or symptoms. We identify past events that created this problem and triggers in the present that cause you distress and the skills needed to manage triggers in the future. If you do not want to recall the disturbing memories, we will use an EMDR protocol that does not require you to recall highly disturbing memories, however, prior to recalling disturbing memories, I will provide you with resources that will support your EMDR work with me.
Resources such as grounding, containment, breathing techniques, calm place imagery, creating a container, and other resourcing strategies. We do this during the Preparation phase. It is best practice to ask you to do the DES Dissociative Experiences Scale (DES-II): Screening for Dissociative Identity Disorder and more (traumadissociation.com). This will allow me to determine if there are dissociative symptoms, and more preparation or resourcing is needed including a longer stabilization phase.
Phase 2: Preparation
In this phase, I will offer you an explanation of the treatment and introduce you to the procedure, for example, I will show you how EMDR is done with your eyes moving left and right to the movement of my finger, or with a buzzer on your hands or music. If this does not work, I will ask you to tap on your knees, left and right or use the butterfly hugs technique. Before we begin, I will assess that you have adequate resources to manage your emotions. I will lead you through a calm place exercise and other grounding techniques. One main goal is that you can take care of yourself. I will make sure that you understand what EMDR is, the theory behind it, and how it is done, and that you know what to expect during and after our work together.
Phase 3: Assessment
In this phase, you will choose a specific event from Phase 1. You chose a scene from it that most represent the worst part. You chose a statement that expresses a negative self-belief with the event, for example, “I am not lovable”. or "I am not safe." Two measures are used during EMDR therapy sessions to evaluate changes in emotion and cognition: The Subjective Units of Disturbance (SUD) scale and the Validity of Cognition (VOC) scale.
You also score your level of distress/disturbance between 1-10 (a SUD score). Then a second statement is chosen by you that represents a positive self-belief that you would prefer to believe. I will ask you to measure this between 1-7 is taken (a V.O.C.) to show just how true you feel that positive statement is now when recalling the scene. You will give a score that reflects how you feel. Finally, you will identify the negative emotions and physical sensations associated with the target.
The validity of Cognition (VOC) scale
I will ask, "When you think of the incident, how true do those words (repeat the positive cognition) feel to you now on a scale of 1-7, where 1 feels completely false and 7 feels totally true?"
Subjective Units of Disturbance (SUD) scale. After you have named the emotion you are feeling, I will ask, "On a scale of 0-10, where 0 is no disturbance or neutral and 10 is the highest disturbance you can imagine, how disturbing does it feel now?"
Phase 4: Desensitization
During this phase, I will ask you to focus on the memory, while engaging in eye movements and other bilateral stimulation known as “BLS” like taping on your knee if you cannot do eye movements. I will bring to your attention a scene from a disturbing event that you chose, your negative self-belief, and the emotional or physical response to the scent. We do a set of eye movements or other forms of BLS and all you must do is notice, just notice what comes up in your body or memories.
I will ask you “What do you notice now?” and you will just let me know what you notice and then we will begin another set of BLS. The hope is that your distress level will reduce to zero on the SUD score and that there is a resolution to the traumatic event. It is common to see that you may discover other aspects of this issue, other associated memories as well and these may need to be resolved.
Phase 5: Installation
During this phase, I will seek to strengthen your preferred positive believes that you identified to replace your original negative belief. We will also use BLS to do this. Again, we will measure how much you accept your positive belief as true. The goal is for you to accept the full truth of your positive belief and reach a 7 on your VOC scale.
The validity of Cognition (VOC) scale
I will ask you, "When you think of the incident, how true do those words (repeat the positive cognition) feel to you now on a scale of 1-7, where 1 feels completely false and 7 feels totally true?"
Phase 6: Body scan Body Scan
Here I will ask you to close your eyes, to bring up the original event and your positive belief, and to scan your body from head to toe for any distress. I will ask you to notice any thoughts, images, physical sensations, memories, and a set of BLS will be performed until all discomfort is cleared.
Phase 7: Closure
If for any reason the process of the traumatic event is not cleared, you will use a self-calming technique to regain your balance. It is important for you to continue once you leave my office. We will use the techniques we used in Phase 2. In between sessions, the process continues, and new material may emerge. Please keep a journal with notes of these experiences to share with me. I will ask you if you have had dreams, thoughts, memories, sensations, or images come forth throughout the week. Usually, we will return to the event, take a SUD, and continue reprocessing until the resolution is achieved. Depending on your needs, this protocol may be modified.
Phase 8: Re-evaluation
I will check in our next session if the positive results have been maintained. Although you may feel the relief it is important to complete this phase.
F. Shapiro & M.S. Forrest (2004) EMDR: The Breakthrough Therapy for Anxiety, Stress and Trauma. New York
“On this sacred path of Radical Acceptance, rather than striving for perfection, we discover how to love ourselves into wholeness.”
“En las profundidades del invierno finalmente aprendí que en mi interior habitaba un verano invencible.”
– Albert Camus
“La vida no es esperar a que pase la tormenta, es aprender a bailar bajo la lluvia.”
– Vivian Greene
EMDR and Schema Therapy are two different therapies, but they blend well together. In Schema Therapy, we review memories that are related to primary trauma and memories that represent your life pattern. First, I teach all my clients' mindful breathing and guided visualizations such as “safe/calm place" and "the container". In the first few sessions, I obtain your life history, as much as you feel comfortable sharing.
We look at events in your life, how you cope with your life issues, and your Schemas. This is accomplished in various ways; you complete a life history questionnaire and the Schema questionnaires which will allow us to discuss the Schemas that are most prevalent in your life, and how you cope when you are triggered. Getting to know you more and more from life history, and the questionnaires allow me to get a sense of your life issues, their origins, and recommended strategies to support you.
In EMDR I ask you about specific events and problems, then obtaining images, your negative thoughts like, "I do not deserve love" (Negative Cognition) and positive thoughts like, "I do deserve love", (Positive Cognitions) and I ask feelings, and body sensations as well as subjective units of distress (SUDs), that is on a scale from 1-7 how strongly do you believe on the positive thoughts (validity of cognition (VoC) scale). Schema Therapy is my foundation, the primary way that I understand what has happened and how to work with you, and EMDR, if needed, becomes an additive strategy to support you.
“Recuerda siempre que eres más grande que tus circunstancias, eres más que cualquier cosa que te pueda ocurrir”.
EMDR, ¿QUÉ ES Y PARA QUÉ SIRVE?
HELLO AND WELCOME!
I came to EMDR through Emotion Freedom Technique (Tapping). I was interested in the differences between them to treat trauma. So, I decided to train in EMDR at the Institute of Francine Shapiro in order to support my clients with a history of trauma.
Although I appreciated my training in EMDR, I realized how deeply inspired I was by the work of Dr. Laurel Parnell, particularly her work on attachment, and Dr. Jamie Marich at the tine Institute for Creative Mindfulness. I appreciated Dr. Marich's integration of mindfulness and expressive arts along with EMDR.
If you are interested in EMDR please reach out to me, I am here to support you.