The EMDR Podcast

Helping the Predictive Brain Update Bad MemoriesTurns out, the story that we’ve been telling ourselves about the neurobiology of trauma doesn’t make sense anymore based on what we have learned the past twenty-five years about brain evolution, function, structure, memory reconsolidation, neuroplasticity, and the predictive brain. How we understand perception of our external world and internal worlds and has changed profoundly. There is growing consensus around the core idea that our nervous system is predicting and constructing our reality for us. And while this has some really disturbing implications related to things like our felt sense of free will and our illusion of objective observation, it has potentially remarkable implications for how humans might heal. Predictive processing might be able to do what no other theory of mind has: explain how we construct reality and possibly even our own selves. Central to this understanding is the role that prediction error plays at all levels of abstraction. And for the purposes of what I’m talking about now, the vast majority of predictions and prediction errors occur outside of direct consciousness and awareness. Prediction errors are central to perception, memory formation, learning, movement of all types, and every experience imaginable. We can think of consciousness, awareness, experience, and our own identities as floating on top of our predictive system the way a foam mat floats in a pool.

When Complex Clients Insist on Doing EMDR Processing Immediately Clients often urgently need to heal. Their lives are probably unmanageable and they may have significant relational, occupational, or functional stressors that need urgent attention. We can align with that urgency. However, urgency is not a substitute for preparation. If you have a complexly traumatized nervous system, your recovery is not going to be brief and the needed preparation probably isn’t going to be short. Your relief of the current stressors may not come in the short term, when those stressors are the direct result of your allostatic load. EMDR therapy is different than our regular coping and survival strategies. It is not culturally intuitive. It asks you to sit in the states that you may have spent much of your life organizing against or put a needle in your arm to avoid. It requires a window of tolerance. EMDR therapy starts a fire in your nervous system and when that fire starts to get better, I encourage you to put more logs on it. You have to have the capacity to be set on fire, but not consumed by it. To do this work safely with complex trauma, EMDR typically requires careful preparation and execution. Client urgency replaces none of that need for preparation and care in execution. I have told clients that they can fire me, but I’m not doing EMDR reprocessing with them if they clearly are not prepared to do the core things that EMDR therapy requires. That isn’t going to go well for them and the consequences of that would be on me. Because I knew better. I’m happy to do some parts work or some Flash with clients who are prepared to work in those ways, but I’m just not going to do EMDR therapy because of the client’s insistency and urgency when I can clearly see that is a horrible idea.

Full text of this podcast is at the EMDR Podcast and EMDR365.com

EMDR Therapy shifts how you think about yourself and the world related to the memory we are working on. Why does it do this? Because that’s a lot of what healing is. Healing shifts how you think about yourself and the world, as well as lots of other things. Wounding is experiential learning and vast regions of our nervous system are organized around meaning-making in the foreground, midground, and background. Healing is also experiential learning. Broadly, in EMDR therapy and other transformational trauma therapies, it is not that difficult to help clients shift an individual memory and the cognitions associated with it. Sometimes consultees will ask why a particular cognition that clients have worked on across multiple sessions isn’t showing up in how they broadly believe about themselves and how they actually live. The consultee may say, we have successfully worked on three different memories around the belief, “What I need doesn’t matter,” and they still don’t believe it broadly about themselves. How much wounding has this client had, where the take-home message was that cognition? Hundreds of experiences? Thousands? Tens of thousands of individual experiences that redundantly placed and reinforced that reality of the world? Saliently learned information in the service of survival isn’t meant to be shifted easily. That wouldn’t be evolutionarily wise. A parent who has the capacity to treat you as though your needs don’t matter will do that consistently. There are 154,000 hours in childhood and those hours may contain an enormous amount of salient, somatic, and deeply redundantly-placed learning. It is entirely possible that you can work on a handful of memories with some clients with complex trauma and the broad belief about themselves may start to soften. That is remarkable. But for many, processing a handful of memories isn’t nearly enough disconfirmation to shift a whole cosmology. Three hours isn’t enough to offset the bedrock reality of 154,000 hours. But keep at it. And by that, I don’t mean endlessly hammering away at that individual cognition until it is fully resolved. In fact, to make good progress with it you may need the client to work in adjacent memory contexts and other categories of learning for a while. Return it. Check in on it. And the first clues probably aren’t going to be the client coming to session and telling you that they have arrived and the positive belief suddenly feeling true. You may see the emergence of a new belief in small things. You may hear the client reporting, almost offhand, that they set and defended a boundary with someone who has never respected theirs. When broad change happens with complex trauma, it often happens slowly, because the learning that we are trying to change isn’t small and limited, it is global and cosmological and has been reinforced across many developmental eras. The fact that EMDR therapy can help shift such deeply held beliefs at all

A summary of why attachment wound targets in EMDR therapy are a uniquely difficult place to start.

The full text of this episode is available on the EMDR Podcast here: https://emdrpodcast.com/2023/12/13/lettingthingsgo/ The script for the videotape approach mentioned in the podcast is here: https://emdrthirdweekend.com/posts/videotape-approach-script-with-complex-trauma-phases-three-and-four

A child's toy metaphor for the need to adjust your interventions to the nervous system you are working with.

When a SUDS of One, Two, or Three May Not be Ecological You are technically correct, quoting Dr. Shapiro in EMDR Therapy when you say that a SUDs of one can be ecological if it “sounds right.” Shapiro's example of an Uncle who died. Shapiro worked with really healthy people and what’s in a one with her clients may be different than what’s in a one or a two with clients with really complex trauma. With really healthy people, you can go to installation if the SUDs is a one if it “sounds right” and the debris will likely get cleared up in Phases Five and Six. You may be tempted to say that because I’m working with a complex client, a two is pretty good. Especially if we are starting at an eight to ten SUDs. And it is. Yes, we don’t want to make the perfect the enemy of the good. However, a lot can be hiding in that one or two with a client with complex trauma. If I had $5 every time the client said that the SUDs was a one, two, or three and it wasn’t going to go lower and it immediately went lower once they noticed it, I’d be able to go on a nice vacation. Out of the country. It’s simply good practice to identify what makes it that one, two, or three and ask the client to notice it a few rounds. And you know what happens, 97%+ of the time? It goes lower within a few sets of the client saying that it isn’t going to go lower. And yes, there are ways to do this respectfully what the client says to you, but also lets them fully and adaptively resolve that memory. Really good things happen when clients fully and adaptive resolve memories. Generalization occurs. Installation isn’t junky. Body scan isn’t leaving debris. A one or a two may also be an ember that may ignite other things between sessions. Don’t want to run the marathon and then sit in the lawn chair within sight of the finish line. If we can, finish it. Get your time. Get that race in the books. Whatever it is that makes it a one, two, or three, or whatever it is that makes the Validity of Cognition a five or six, notice that and it is highly to movie in a positive direction… unless it’s about something in the future or about other things from the past. That’s not your target. We’re in the business of resolving memories, not whole themes all at once and we don’t work in the past and the future at the same time. We have the future prong and future template for that. What is it that makes it a two? Notice that. If it doesn’t go lower, that’s okay. But it’s also okay to notice whatever that two is a few rounds before you assume that it’s good enough for this client on this day.

You May Do the Least Reprocessing with the Clients Who Need it the Most

Full text of this episode is at: https://emdrpodcast.com/2023/11/29/parts-work-is-central-to-emdr-therapy/

• The Impulse to Want to Avoid Causing Harm • Working with Trauma is Like Working with Lava • Confessions about Difficult Sessions • Most Basic Training Programs Can’t Train You to Work Effectively with Severely Complex Trauma in EMDR, You Will Need to Learn the Nuances of this On Your Own, But There is an Enormous Amount of Help Out There • Normalizing Mistakes and Missteps • The Real Risks of Not Doing Trauma Work with Clients • We are the Only Professionals on the Planet that Can Do This… Whose Job it is to Do This • It’s Like Everything Else… You Learn to Do This by Doing This • The Really Good News About EMDR Therapy: It Breaks in a Very Limited Number of Places • When Clients Struggle, There is Information in that Struggle • You can Dip Your Toe into Every Phase of EMDR Therapy • You will Develop More Trust in the Process • You will Get Better at Intuiting when the Client is Stuck and Strategically and Effectively Intervening • Not Everyone is Prepared to Do EMDR Therapy Right Now: We Can Help them Prepare

There is so much to say here. Broad overview. Each point could easily be a chapter. Very little of this is mine, the metaphors are mine, but this is a collection ways of seeing that are helpful for me in understanding where clients get stuck in reprocessing, why, and what might be helpful in getting them unstuck, and what we subsequently do with that information. When clients encounter difficulties in any phase of EMDR Therapy, that isn’t failure and it isn’t evidence that you have done something wrong. It’s important information about the client’s nervous system and means of survival. That information needs to come so that we can use the lessons in it in the service of the client’s recovery. We train you to stay out of the way, but if a client is stuck, your obligation is to try to help them get unstuck. EMDR Therapy with a client with complex trauma is a complicated task. We’ll explore some of the reasons why and how you might intervene when someone is struggling. How do you know when someone is stuck when they have really complex trauma? Sometimes it is ambiguous. Because they are often connecting something big with a small amount of adaptive information, the metabolization can be slow. Questions to ask. Clients can be stuck in high anxiety near panic that won’t shift, clients can be stuck in a shutdown response (100 amp breaker), they can be stuck in the big existential loneliness of childhood (particularly if working on an attachment wound), they can be stuck trying to figure something out that is existential, or they can be stuck noticing on channels that just aren’t productive right now (thoughts, memory, etc), where things aren’t moving and shifting and changing. Defining looping. When someone is stuck, they are probably stuck in a perspective. Office shortcut metaphor. Interweaves help clients change their perspective. Ideally, when we intervene, our interventions should match where the client is stuck. We shouldn’t just randomly throw something out. Car metaphor. They are not sure what their role in this dance is. Blocking beliefs. Hopefully, you will pick up on these in your Phase Two. Phase Two is the canary in the coal mine for blocking beliefs. What is a blocking belief and why is it a problem? Too big of a target too soon. The target memory is an attachment wound. Why attachment wounds are about everything. What might you do. Long resonance after sessions is common when not working with attachment resources. If the core of EMDR Therapy is activate a piece of difficult stuck information, notice what comes, while the brain gets a left-right stimulation, let’s evaluate potential stuck places. Activate: Are they activating in ways that are tolerable? Is the activation from the memory or from an agenda? Are they allowing too much memory content to connect too soon. We need memory content to come, but we need it to come at digestible rat

Many new EMDR therapists misunderstand where the magic is in EMDR Therapy. Trainings and training practicum experiences often send the impression that simply following the script is likely to result in memory resolution with the vast majority of clients. EMDR can be seen as a kind of magic wand that allows us to go up to almost any person and “dink” their memory. Some trainees may be left with the impression that most of the magic in EMDR Therapy is in the bilateral alone. While this is a key part, I describe it elsewhere as one of the three wheels of the EMDR tricycle. It takes all three wheels. Otherwise drummers would be the healthiest people on the planet. And, they are not. EMDR Therapy is a combination of activation, noticing, and left-right stimulation, but what is happening in EMDR is perfectly described in the Adaptive Information Processing model. This combination of elements helps connect old stuck information into right-now existing adaptive information… if you have enough of it. And Shapiro is very clear that if you do not have enough of the needed adaptive information for the target that you are connected to, there is nothing in the Eight-Phase Protocol that is going to generate the missing information. I have used the metaphor of a boat fishing in an ocean. The boat is the needed adaptive information and the fish you are hooked onto is the memory. You can’t land a bigger fish than your boat. You don’t simply get a bigger boat because you are hooked to a big fish. You have the boat you launched with today. Again, the magic of EMDR Therapy is that you can metabolize almost any old stuck information into existing adaptive information and we do this by using the Eight-Phase Protocol. Inside that understanding contains the logic and the worldview to account for when this therapy doesn’t work. Many of the episodes in this podcast focus on this core understanding of the Adaptive Information Processing model. It explains almost everything beautiful in working with clients who have adaptive information the size of a cruise ship and almost everything challenging in working with clients whose adaptive information is the size of a leaky intertube. This understanding explains why parts work is an important element in what we do as trauma therapists. It explains why we need to support adaptive information about what it means to have been born human. And, why our resources need to involve more than a few core mindfulness skills when working with clients with pervasively traumatized nervous systems. This understanding is the foundation, I think, to doing EMDR Therapy really well with clients with complex trauma—who have been saturated with the tasks of surviving, rather than bumping against the world and learning who they are, what they’re worth, and how they deserve to be treated.

A shocking amount of talk online about EMDR and grief goes against everything we know about both. This episode highlights effective ways to use EMDR with grief-saturated targets.

In EMDR Therapy, the pathway for healing is that stuck information has to connect to right now adaptive information.  The process that facilitates that linkage is the Eight Phase Protocol. You can connect almost any old and stuck maladaptive information into right now existing adaptive information. But, a lot of what we know about complex trauma is that clients lack adaptive information.  They were too busy surviving to figure out who they are, what they value, how the deserve to be treated… and they need enough of it for the difficult stuff to connect to. The Boat and the Whale Metaphor The boat is the amount of the needed adaptive information that is have accessible right now.  The fish that you want to hook and land is the trauma.  You cannot land a fish bigger than your boat.  However, you can get a bigger boat by catching smaller fish.  You can also build a bigger boat through developing relationships—including the therapeutic relationship, through parts work, through resourcing, by expanding the window of tolerance, through psychoeducation [particularly psychoeducation about what it means to be born human], and through a wide assortment of other means. Implications of this metaphor: If we can only land what we have space in boat to fit, we should consider both the size of the memory (as best we and the client can intuit) and the amount of accessible adaptive information. If we have adaptive information the size of a canoe and this is the first time we are in the ocean, we should consider testing the gear before we go trying to hook whales.  It is really easy to capsize in a canoe. Developmental trauma targets, targets about identity, and targets where we’re the abuser in the memory tend to be the whales of memory, particularly when we’re first starting. If the client has a small boat, we will be lucky to land whatever we hook... even if we are trying to catch something small.  If the client is already connected to a mid-size shark, does it make sense to also hook onto multiple whales and multiple other sharks?  Again, our boat size does not change based on what we hook onto.  The boat size we launch with is the boat we have.  Clients overheat on the memory channel in EMDR when too much memory content is coming into awareness or when that content is coming in at an intensity beyond our capacity to metabolize through noticing.  EMDR Therapy was not particularly developed for complex trauma.  It was developed using people who have adaptive information the size of cruise ships.  And how did they get that cruise ship?  By life Phase Two resourcing them really well.  If you have adaptive information the size of a cruse ship, I know that you can hook and land almost every fish in your ocean.  That’s the privilege of the non-pervasively traumatized… your ocean is not filled with monsters.  People in canoes… their oceans are filled massi

Understanding the Difference Between A Complexly Traumatized Nervous System and a Non-Pervasively Traumatized Nervous System Via the AIP Lens In the AIP model, the difficult stuff has to connect with right-now existing adaptive information.  One of the key things that we appreciate about complex trauma is the large size of the trauma and the typically small amount of adaptive information that the difficult stuff must connect with and metabolize into.  Again, back to the boat metaphor.  If client’s have adaptive information the size of a canoe, we really need to be careful about what they hook.  You can’t land a fish bigger than your boat.  Clients that are really healthy, but who have had some trauma have adaptive information the size of a cruise ship (the privilege in The Field and the Municipal Dump Metaphor There is another metaphor that I like here related to following memory content or maybe taking a restricted approach to memory content.  Imagine a space about the size of large sports stadium.  The field of this sports stadium is the entire lifespan of the client up until this point.  Almost all of it is clear and open.  But even as we survey the field, there are some piles of things.  If this is the client’s system that we are working with, we want the client to just walk around the field and pick up things, sort them a little, and put them in a knapsack.  We don’t want to micromanage that.  The client can walk around, form connections, knapsack the needed things, and everything in that knapsack can be resolved.  If we over intervene, we are interfering with the client’s work. Imagine another stadium and this is the stadium of the complexly traumatized.  Except instead of piles of things, it has been used for 46 years as a municipal dump.  In fact, old garbage bags, mattresses, food disposal, packaging, are piled so high that the whole inside of the stadium is filled to the highest seats at the very top of the stadium.  Now, we’re going to drop the client into the 37th yard line and put them 25 feet down, with a knapsack.  Do you see the problem?  Everything connects to everything else there.  There is the impuse to try to knapsack it all, but there isn’t the means.  And this is one of the things that is really unfair about being on the receiving end of other people’s stuff for decades.  The mistake we make is that we consistently underestimate how much there is and the client can only carry what the client can carry. What’s the Problem with Too Much Memory Content Coming In? They very quickly get outside of their window of tolerance.  If you want to have a big window of tolerance, start with having a really good life.  Absent that, it’s a lot work.  Other podcast episodes cover how the ways that we help clients develop a bigger window of tolerance often ask the client to sit with things that go (or feel like they go) directly against their survival strategies. Deciding: First, Ti

Client and therapist agendas are frequent blocks in EMDR Therapy reprocessing.

Using age, space, and topography to find an individual representative memory related to a presenting issue, theme, current trigger or emotional state. • Identify a negative cognition.• What age do we need to work related to that theme and negative cognition?• Home, school, or community?• Where (what room) in that space do we need to work?• Where in that room or space (what chair at the table) do we need to work?• Put yourself in that space at that age and related to that theme and negative cognition, what is the first memory that comes? • Target that in EMDR Therapy.

Introduction to the next handful of episodes.

Many clients with complex trauma will come to us convinced that they have already failed mindfulness and that they are about to fail EMDR.  Some of the approaches that I have seen to teaching mindfulness to clients assume a non-pervasively traumatized nervous system. Which is simply something we should not assume. Many approaches throw the client into the deep end of the present, the body, or noticing without much preparation or guidance almost as though they are running every client through the same mindfulness machine.  How we approach a client system with severe trauma needs to be different than how we approach a system that relatively healthy.  Our interventions should match the client we are working with. So, maybe the problem isn’t that many clients simply can’t do mindfulness. Maybe they can’t do it the way we have been teaching it. Complex trauma is not a special case. It’s nearly the only case we see in community mental health contexts globally. A large percentage of pervasively traumatized clients struggle with even the most basic forms of mindfulness for reasons that we will explore, but also because of how we teach it. And, the easiest thing to change in this equation is how we teach it.  Even in EMDR Therapy, the assumption that “Ok, now we’re in Phase Two and I’m going to teach you these resources so that you can calm down when you get activated.”  This is true, but do you hear the therapist agenda in the way we may be introducing it?  As you will see, when we are working with clients with extreme trauma what we are looking for is information about the client’s nervous system and not necessarily the relaxation response.  I want to show you how to use that information that surfaces in the service of the client’s recovery. What We are Asking Clients to Do in Mindfulness Feels Like it Goes Against Common Survival Strategies The Present Bodies Noticing The Mind is Taxed with Survival Tasks There is Performance Anxiety in What they Know We’re about to Ask Add to all of these things the performance anxiety of trying a skill focused on these places of discomfort and knowing that the therapist is going to ask them about their experience with it.  These are clients that are accustomed to being what other people need them to be and performance anxiety associated with “Is this working?” “Am I doing this right?”  “What does it mean that I don’t find this relaxing?”  Etc. Step One of One Way to Do this Differently: Normalize the Difficulties Normalize the difficulty using all of the information above and all of the information you have learned about the client’s survival. You know how to do that.  Do it.  “Of course mindfulness and the way we have been approaching it hasn’t worked well for you.  Would you be interested trying this differently?” <stro

Trauma has the potential to promote disconnection from the present, from experience, from the body, from the self, and from more full engagement with the broader world.  These responses were in the service of survival. They may have been essential.  Sensory grounding is a go-to resource in trauma work because our senses bring us home.  They can help bring us into the “safety” of the present when we want to be or when we need to be more present. Sensory grounding is a needed resource in trauma work, where we ask clients to “glance” at a traumatic memory, but advise them not to fall into a memory.  Sometimes, simply interacting with the memory in any way can cause it can cause us to fall or dissociate into it.  Sensory grounding in the present brings you home.  It brings you into a place where the bad thing isn’t happening right here, right now. Script: When we have difficult experiences, those experiences may be stored in the part of the brain that doesn’t or can’t know that the experience is over.  Sometimes, accessing a memory takes us out of the present and puts us into an experience when we did not feel safe.  I’d like to show one strategy that you can use to find your way back into the present.  Often the present may not feel “safe,” but it is likely to be safer than the experience from the bad memory.  The exercise will ask you to very briefly engage your senses, one at a time.  We will spend only a few seconds at a time getting information from each of the senses. If we keep it very brief, many people are able to tolerate this exercise well.  If anything difficult comes up, we can stop.  Is this an exercise that any part of you might object to, assuming that we do it quickly and that you can stop anytime you like? If there is an objection. Stop and explore that objection.  See if there is a way to do this that is not objectionable to that part that allows us to continue.  Otherwise, full stop (parts will need to know that they can stop). Vision: I invite you to look around the room and notice several things you see.  Notice several objects and notice the color of those objects.  Also notice that if you were to go up and touch these objects, would they be hard, soft, or some other texture?  [Wait 5-10 seconds] Touch: Place an open hand on the table or furniture next to you for just a moment and notice if it is colder, warmer, or the same temperature as your hand.  [Wait 2-5 seconds]  Good.  Move your fingertips across the surface and notice if it is completely smooth or has a texture.  [Wait 2-4 seconds]  Good.  Move your fingertips across the texture of that surface and just notice if the temperature changes as you move.  [Wait 2-5 seconds]  Good. Hearing: I’m going to be very quiet, notice whatever you hear in order of loudest first.  [Wait 5-8 seconds]  Good.</

Full script for this is at: https://emdrthirdweekend.com/posts/dip-your-toe-in-approaches-to-body-scan

In this podcast, I propose a very simple modification to your calm scene mindfulness exercise when clients have struggled with exercises like this: outsource the calm scene to a YouTube video.  We may be able to use the video as a bridge resource.  Bridge resources are accommodations to standard resources that take into account the difficulties that clients may have with visualization, focus, self-judgment related to the visualization, and allow us to do a version of the resource that lets clients “get to the other side” of the resource rather than falling into the “canyon” of the resource. What’s important, eventually in a resource, is that the client has a shift in affective state in a way that feels safe and tolerable to their parts.  When clients struggle to visualize, a video library of 17 billion videos immediately accessible to the client’s computers, laptops, tablets, and smartphones is a portable resource we should have been teaching for a while.  When it comes to calm scenes or calm processes, there is no inherent reason why that experience has to be fully imagined in order for it to be experienced.  We want to appreciate the difficulty of the cognitive “ask” of having a client with severe trauma conjure water, waves, sky, clouds, sand, buildings, breeze, smell of ocean air, seagulls, etc, etc.  It’s a heavy lift, as has been discovered by many therapists who try to develop an imaginary calm scene with clients with severe trauma. What are the Goals of Calm Scene? Help the client develop a brake pedal that can be used in reprocessing and between sessions to help manage and regulate whatever may come up. Widen window of tolerance.  A client that has skills to manage distress may have the ability to tolerate some distress. Develop and support adaptive information, including agency, adaptive dissociation, and the ability to purposefully disconnect from an activating process.  Pivot to something more adaptive. What are the Difficulties of Calm Scene? Imagination can be difficult when their heads are running like a jet engine. Slowing down and not attending to the therapy room can be triggering. For some clients, positive affect (particularly positive affect in the presence of a therapist can cause parts to respond strongly with a counterreaction). Classic problem with the calm scene is that abusers show up in imagination. How Can Outsourcing the Calm Scene to YouTube Help Us? It may let us do one version of the resource when the client has struggled to do the resource at all. It may be less dissociative and more focused since what the client is “tuning into” is actually happening (as a video) in the present. Clients are accustomed to this type of distraction from rumination, so their nervous system probably has already flagged it as relatively safe. Depending on how it

Scripts for these breaths are at: https://emdrthirdweekend.com/posts/dip-your-toe-in-approaches-to-breath-blue-smoke-and-hand-breathing

Assessing for attachment wounding: When you were young, who was really and consistently there for you? At the core of EMDR therapy and the AIP model, the difficult stuff has to connect to and metabolize into right now adaptive information.  Shapiro is clear that enough of the needed adaptive information must be present for the difficult stuff to metabolize into it.  You cannot connect a lie to a lie.  Attachment figure resources can help rehearse and model what it might look like for more adult parts to connect with and bring information to younger parts.  Of course, everything that we know about attachment wounding is that starting life in survival mode often increases the chances that survival mode will continue well after childhood finally ends.  Absent opportunities to learn disconfirming information in tolerable ways, the most adult parts often share judgment, blame, or disgust toward child parts. Attachment figure resources have something important to bring to the most mature and right now parts, but the main point is to bring the possibility of what didn’t happen to the child parts.  The deficits of attachment trauma may be neurobiological.  The absence of attachment may not have allowed the creation of the very pathways that are needed and leveraged by EMDR Therapy.  EMDR Therapy is always parts work. While this can be a powerful resource, there are a wide range of protective responses against its introduction and absorption as a resource.  My attachment figure script, which is referenced in the notes below anticipates and tries to get ahead of many of these difficulties.  But, there are some categories of blocking beliefs that may make it nearly impossible to develop attachment resources without additional work: I am dispositionally bad, I don’t deserve love/kindness/to get my needs met, and I don’t want to be loved/receive kindness/get my needs met. With these clients, we may need to try the exercise from the perspective of meeting the needs of someone else other than the client.  This is a dip your toe in modification.  I may ask if the client has a niece or nephew, or knows of a child (or can imagine a child) that could use some additional support.  I try to avoid the client’s own children, since this can bring up a lot of parenting guilt and reinforce themes of defectiveness or unworthiness.  We then develop the attachment figure script using the proxy of this other child, in place of the client’s younger parts.  We are “trying on” these qualities using a less triggering personae than the client himself, the way a child in sand-tray therapy may perform his or her emotional experiences through the persona of a dinosaur figure. To review, attachment figure resources are a dip your toe in resource that can help facilitate healing in EMDR Therapy and other approaches.  If the client simply can’t resource the selves, find something that it can resource as a substitute for the selves can be helpful whi

Strategies for working with problems visualizing.

Detailed scripts for this approach are at: https://emdrthirdweekend.com/posts/videotape-approach-script-with-complex-trauma-phases-three-and-four

Strategies for a gentler closure when things are heading in a good direction.

This episode focuses on different types of distress that may appear in trauma work and explores the types of distress that are most productive to metabolize. In many transformational trauma therapies, at least part of what we are doing is transforming the distress encoded in the memory.  There is distress in almost any individual traumatic memory. However, that’s not the only distress that may be present.  One question that the therapist may want to ask is: what distress is productive to try to metabolize and what might be a goose chase.  Cleary, we want to metabolize the distress that is in the memory, but if too much memory comes into awareness or if memory comes with too much intensity, the system—which is designed for protection and containment—may have strong defenses against that much memory content showing up. Prisoner scenario #1 Warden goes to a specific jail cell, unlocks it, and slowly walks that prisoner down the corridor They walk one step at a time As long as no one panics everything is fine The warden, if desired, can wall the prisoner straight out of the prison Prisoner scenario #2 Warden goes to a specific jail cell, unlocks it, and they start walking down the hallway The prisoner starts running The system is designed to protect against that Now, the prisoner has to deal with everything that stinks about his current situation AND now has to deal with the defenses that resulted from moving too quickly How this looks in Flash Therapy Overactivation or opening too many adjacent memories causes problems with containment Problems with body activation Problems experiencing the calm scene as a disconfirming experience How this looks in EMDR Therapy When we are working with clients with complex trauma, we are often working with clients with a very narrow window of tolerance… even after extensive resource development Clients with complex trauma have well-developed and automatic survival strategies that kick in when too much distress is activated in too short of a time Noticing the distress or shut down from the defenses against the trauma is not as productive as noticing the content in the actual memory. We need that content to come at a digestible rate.  If it doesn’t we have a goose chase.  And you client is the goose and the chaser. Other forms of distress that don’t tend to be productive in either EMDR of Flash: existential questions or agendas.  Example: divorce memory turns into “Why do all my relationships not work out?”  “Why does everyone I have ever loved hurt me?”  “Will I every find love?” Strategies to more effectively “walk a memory out” with clients with complex trauma In EMDR: Work at the intersection of what is productive and tolerable

What Do Container Resources Do? Long story short, containers help you expedite the process of returning difficult content to the limbic brain.   Library metaphor. Containers very often are a cognitive strategy or intention not to engage with something right now.  A container can also be a somatic strategy, because if we only address the cognitive aspects of rumination we may be leaving a lot of distress in the body, which can reactivate the mind. Containers are also a helpful ritual in pivoting away from activation.  It’s a ritual that signifies something to parts.  However, the reasons why we need to container matter.  Many, many, problems with containment come from the assumptions that clients make about what containment means… what it means to current functioning, what it means for their past, and what it means for their recovery.  For example, many clients say “wait a minute, Tom… I have locked this stuff up all of my life… I come to see you to get it all out… and you’re telling me to do something I’m coming to you stop doing.” Again, we need to explain that the reasons why we container are very important.  All of these are good/healthy/adaptive reasons for containing something that has been activated: We have been trying to solve the problem using strategies that have a very long history of being ineffective (rumination, allowing lots of memories/cognitions/themes to connect) Now is not a good time to try to resolve the problem or issue The issue is intruding on our ability to function at the present time The problem is actively contributing to current instability We would like to exercise control over what is getting our attention in the current moment Adaptive containment is ultimately about client agency… deciding on purpose what to attend to in this moment and what to defer, because we are not wired to attend to everything past/present/future in every moment. Containment is the beginning of stability. Ultimately, we want to emphasize that it’s okay to container because we have a plan to resolve this issue in an effective way at a later date (a transformational psychotherapy) Ways that are not a good idea to use in containment, since parts may react to the implications of these approaches (although clearly these are preferred methods by some parts): Diaper Genie Rocket Incinerator Trash can Explosive Containment is one of the best adaptations of human evolution.  The limbic brain is a container.  I tell my clients that the reason we’re not all in the psychiatric hospital all of the time is because of the containering qualities of the limbic brain.  We are information processing systems and when we encounter information that we cannot assimilate because we were too shut down, too overwhelmed, or lacked the needed adaptive information at the time, i

Strategies for managing flashbacks in session and between sessions.

Effective time management strategies in EMDR Therapy.