SHAPIRO SERIES #14
SLIDE # 20
EMDR = REPROCESSING THERAPY
* THERE IS A DIFFERENCE BETWEEN REPROCESSING AND DESENSITIZATION.
* THROUGH MANY INTERVENTIONS YOU CAN GET DESENSITIZATION WITHOUT COMPREHENSIVE REPROCESSING.
* IN EMDR, DESENSITIZATION IS ONLY ONE BYPRODUCT OF REPROCESSING.
So with EMDR there's a difference between desensitization and reprocessing. Clinicians that consider EMDR being used just to "desensitize the trauma" or EMDR is only a ?Trauma Protocol? have a misunderstanding of EMDR. Desensitization may occur in many different therapy approaches and techniques. Desensitization simply means you got down from a 10 to a 0. This is processing. EMDR provides more than that. In EMDR, while desensitization is certainly taking place, learning is also taking place. Emotional, cognitive, and physical changes in body are occurring as we process through past, present and future templates. At the completion of EMDR treatment, the client has an entirely different perception and affect related to their original issue. This is the goal for EMDR and what we're looking for(?Trait? change not just ?State? change) In EMDR, desensitization is only one byproduct of the reprocessing. If you're not seeing cognitive shifts, differences in posture, new senses of self; think about whether you're really doing EMDR or whether you're just doing resource installation and desensitization. And that's why it is so important to reevaluate your work, check on how the client is doing and reacting in the real world. Has ?Trait? change occurred or has your client just been using coping skills or resource more effectively (?State? changing coping skills)? That?s why getting consensus reality feedback from your client is so important.
SLIDE # 21
MODIFICATIONS AND INNOVATIONS TO EMDR
EXPERIMENTAL? ? ETHICAL, INFORMED CONSENT
It is vital that innovations be fostered in combination with appropriate evaluation.
* If based upon understanding of neurobiology: What expert in the field has checked your assumptions?
* If changing tested protocols: What is your data?
* If not, both clients and clinicians are at risk.
* Ethically according to APA guidelines: EMDR is defined by its standardized procedures. You may add but not substitute. Because for all of the EMDR innovations that are coming up, and some of them are great and I really want to honor all clinicians who are innovators for wanting to bring stuff to the party, please make sure that there's some analysis. I've gotten clinicians who have told me, "We don't use the cognitions because according to Dan Siegel's work, children's brains develop at a different rate and for children younger than a certain age, you shouldn't use cognitions. So I took what they said and I asked Dan Siegel to tell me what he thought. He said, "That's not the way the brain works." So there was a misunderstanding they had. So if you're going to be suggesting protocols on the basis of neurobiology please make sure that you've had a consultation with the expert in the field to check your assumptions. Unfortunately, we've already had a couple of instances where assumptions that are being made are just not true.
The other important consideration regarding innovations or changes in the protocol is, if you're changing protocols, what's your data? Because what Amen's results were, what the research results were, were based on the standard protocol. If you're changing the protocol and it feels good in your office, take the time to get the data because as Rosalie Thomas (EMDRIA President) mentioned, ethically according to APA, EMDR, as it is with any other form of therapy, represents a tested set of standard protocols. The more clinical ways of doing the history taking, fabulous! The more ways you know of doing preparation, great. The more ways of evaluating, terrific.
But this is the bottom line: THE EIGHT PHASES, THREE-PRONGED APPROACH IS EMDR. If you are following the EMDR Approach, tell your client, if you are not, tell you clients.
AFFECT MODULATION AND CONTROL MASTERY
INITIAL PREPARATION OFFERING AVAILABLE TECHNIQUES
BLANK IT OUT
ASSOCIATIONS WITHOUT DISTORTION
ALL CHANNELS ACCESSED AND COMPLETED
WHAT DO YOU GET NOW?
EYES OPEN ? BONDING/ATTACHMENT/PRESENT
OPTIMAL SPEED FOR FULL PROCESSING
THE PAST IS PRESENT
- PAST EVENTS ARE STORED IN MEMORY
- CHILDHOOD PERCEPTIONS/SCHEMAS ARE DYSFUNCTIONALLY STORED AND REMAIN UNALTERED
- PRESENT PERCEPTIONS OF SELF AND OTHERS AFFECTED
- DYSFUNCTIONAL CHARACTERISTICS ARE HABITUAL RESPONSES CONGRUENT WITH PERCEPTION
- DYSFUNCTIONAL CHARACTERISTICS ELICIT NEGATIVE RESPONSES CONGRUENT WITH
- DYSFUNCTIONAL CHARACTERISTICS ELICIT NEGATIVE RESPONSES IN OTHERS
NEGATIVE SENSE OF SELF IS REINFORCED
So what is your responsibility as an EMDR clinician?: I want you to have the sense here ? as to what all a client?s targets are. When your client is saying "I'm damaged because of a rape" - just as in many cultures like in Bangladesh, where acid victims were shamed by their culture ? the client may take on a sense of there's something wrong with them. They may be being influenced by their society?s accepted societal mores. This too can and needs to be processed. So we need to target not only the rape, but also all of the trauma?s associated with the impact of the rape. As an EMDR clinician, your responsibility is to provide the most comprehensive and effective treatment options possible and to provide the client with an informed decision regarding how far they want to go.
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