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Jim
Dr. Jim Psychologist Mentor Guide
http://www.drjimpsychologist.com
Dr. Jim Leonidas Ph.D., C. Psych.
Registered Clinical Counselling Psychologist
Canadian Register Health Service Providers Psychology
1.416.484.9912 voice mail
Skype Name: drjimpsychologist.com
10 MCNAIRN Avenue Suite H1 Toronto Ontario Canada M5M 2H5
Nearest major Intersection LAWRENCE and YONGE Streets LAWRENCE PARK NORTH TORONTO Neighborhood GREATER TORONTO AREA GTA
Be kind, for everyone you meet is fighting a hard battle. Plato
Summary
Development of a Style and Approach to Counselling Over 36 Years
Eye Movement Desensitization and Reprocessing (EMDR)
Eye Movement Desensitization and Reprocessing: The Breakthrough Therapy for Overcoming Anxiety, Stress and Trauma
Eye Movement Desensitization and Reprocessing (EMDR), Second Edition: Basic Principles, Protocols, and Procedures
EMDR Web Resources
Integrating EMDR and Focusing. Mary K. Armstrong
You suppose you are the trouble. But you are the cure. You suppose that you are the lock on the door. But you are the key that opens it. It's too bad that you want to be someone else. You don't see your own face, your own beauty. Yet, no face is more beautiful than yours. Rumi
Development of a Style and Approach to Counselling Over 36 Years
The development of my own style and approach to counselling over 36 years has been strongly influenced by the Experiential Humanistic and Person-Centered traditions, represented by such people as Carl Rogers, Eugene Gendlin, Clarke Moustakas and Abraham Maslow, the teachings of Psychosynthesis developed by Roberto Assagioli, David Grand’s Brainspotting, and the EMDR method originated by Francine Shapiro.
The following will describe the nature and purpose of one, among many, different methods used in the counselling process, for the purpose of inviting a profound, organic, evolving, and unfolding of the life forward direction of the person
These pain's you feel are messengers. Listen to them. Rumi
A full explanation of the nature, purpose, benefits and outcomes of Eye Movement Desensitization and Reprocessing (EMDR) can best be understood by reading selected pages from the following books written by Dr. Francine Shapiro, and various sections of 5 web sites devoted to the method.
You give birth to that on which you fix your mind. Antoine de Saint Exupery
"Eye Movement Desensitization and Reprocessing: The Breakthrough Therapy for Overcoming Anxiety, Stress and Trauma" Dr. Francine Shapiro and Margot S. Forrest (ISBN 0-465-04301-1) Basic Books published 1997, paperback available in most bookstores, libraries and from Caversham Booksellers, 98 Harbord Street, Toronto 1 (800) 361-6120 or (416) 944-0962.
Chapter 1, Journey of Discovery, pages 1-12;
Chapter 2, Laying the Foundation, pages 13-29;
Chapter 4, The fabric of Treatment: Uncovering the Hidden Depths of Pain, pages 49-64.
This easy to read book can be used as a basic overview of the clinical applications of EMDR. Each of the following chapters covers a different applications: combat trauma, phobias, panic,
sleep disorders, childhood trauma, attachment disorders, rape, grief, addiction, disease, disability and death. Appendix B on page 247, overviews the efficacy of EMDR.
God comes to us disguised as our life. Richard Rohr
"Eye Movement Desensitization and Reprocessing (EMDR), Second Edition: Basic Principles, Protocols, and Procedures" by Dr. Francine Shapiro (ISBN 1-57230-672-6) Guilford published 2001, available by special order in most book stores and from Caversham Booksellers, 98 Harbord Street, Toronto 1 (800) 361-6120 or (416) 944-0962.
This highly recommended book provides the most comprehensive and systematic description of the method, and it’s theoretical convergences with other approaches. The Adaptive Information Processing Model is outlined. All chapters are well written and organized, with introduction, summary, and conclusion. 8 phases of treatment are explained. The components, phases, protocols for implementation of EMDR are discussed. Procedures for special situations and selected populations are examined. The final chapter discusses theory, research and clinical implications.
There's nothing worse than to walk out along the street without you. I don't know where I'm going. You're the road, and the knower of roads, more than maps, more than love. Rumi
EMDR Web Resources
EMDR Institute web site provides general information http://www.emdr.com/index.htm; a description of EMDR http://www.emdr.com/briefdes.htm; 30 frequently asked EMDR questions and answers http://www.emdr.com/qanda.htm; A brief description of the EMDR method and the 8 phases of treatment http://www.emdrnetwork.org/description.html; Information for clients http://www.emdrnetwork.org/; EMDR books http://www.emdr.com/books.htm videos, manuals; EMDR efficacy/validation research studies http://www.emdr.com/efficacy.htm; Research overview and a comprehensive bibliography of EMDR research; Information about Dr. Francine Shapiro http://www.emdr.com/shapiro.htm; EMDR Europe web site http://www.emdr-europe.org/ has a brief overview of EMDR and numerous full text research articles online; Articles from newspapers, magazines and other publications regarding EMDR: http://www.emdria.org/displaycommon.cfm?an=1andsubarticlenbr=216 EMDR international organizations are located in 20 countries http://www.emdr.com/organizations.htm; EMDR Canada http://www.emdrcanada.org/en/home.aspx; EMDR International Association (EMDRIA) http://emdria.org/displaycommon.cfm?an=3.
I wish I could show you, when you are lonely or in darkness, the sstonishing light of your own being. Haifa
Integrating EMDR and Focusing. Mary K. Armstrong
EMDR was devised in 1987 by Francine Shapiro, a behavioural psychologist. Noticing how her own eyes moved side to side as she thought of a personal trauma, and realizing that she subsequently felt relieved, Shapiro began to explore eye movement with her colleagues. She would ask them to hold a troubling thought in their minds while she directed their eyes from side to side. The procedure she stumbled on is validated by the recent research findings on EMDR.
Shapiro describes EMDR's effectiveness this way:
Disturbing events can be stored in the brain in an isolated memory network. This prevents learning from taking place. The old material just keeps getting triggered over and over again. In another part of your brain in a separate network, is most of the information you need to resolve it. It's just prevented from linking up to old stuff. Once we start processing with EMDR, the two networks can link up. New information can come to mind and resolve old problems. (Shapiro, 1995, pp.124-125)
Focusers will be very comfortable with Shapiro's organismic explanation of the brain as part of the body's self-righting healing system. EMDR also reflects Gendlin's emphasis on having both client and therapist trust the organism's wisdom to move towards psychological healing. It is the body, not the intellect, that knows how to move most directly towards healing.
There are parallels to Gendlin's blueprint theory in Shapiro's discussion of EMDR's effectiveness:
...there is a system inherent in all of us that is physiologically geared to process information to a state of mental health. The system may become unbalanced due to a trauma or through stress engendered during a developmental period, but once it is appropriately activated and maintained in a dynamic state by means of EMDR, it transmutes information to a state of therapeutically appropriate resolution. Desensitization and cognitive restructuring are viewed as byproducts or the adaptive reprocessing taking place on a neurological level. (p.13)
EMDR as Focusing is client-centred. Shapiro says, "Because of EMDR's emphasis on self-healing, any premature attempt by the therapist to intervene may slow or stop the client's information processing.. when we open the information processing system, we allow the train to proceed down the line. The clinician's job is, whenever possible, to stay off the tracks." (p.142)
Before starting the eye movement, the therapist reminds the client, "Now remember, it is your own brain that is doing the healing and you are the one in control." (p.142)
The client should always feel empowered and in control of the treatment session. EMDR is a client-centred approach in which the clinician acts as a facilitator of the client's self-healing process. (p.140)
Shapiro, as Gendlin, encourages the client to let go of intellectual analysis so they can use "their gut feeling" to access new knowing. (p.5) Shapiro comes close to recognizing Focusing's felt sense in her inclusion of the body scan in her model. (p.72) She says "there appears to be a physical resonance to dysfunctional material, which may be related to the way it is stored physically." (p.73)
Shapiro recognizes the body's physical response as the entry point into memory:
As the eye movements begin and the information starts processing through the channels (of information), new memories can rise to consciousness. These new memories may appear to the client in flashes (as though the event were suddenly caught in a spotlight), they may appear as a collage of events all at once, or they may come to consciousness as a body sensation. (My italics) (p.77)
Shapiro reminds us that the physical sensations experienced at the time of the events are stored in the nervous system and may constitute the dominant thread of the associative sequence. (p.79) She instructs clinicians to ask clients to concentrate on the attendant physical sensations while the eye movements are systematically altered. (p.178)
Those familiar with Focusing will recognize how Shapiro again touches on the importance of the felt sense when she instructs clients "to close their eyes and fix their entire attention on the location of the sensation. Whatever image or thought appears should then be targeted." (p.180)
In her contribution to the internet's Focusing Discussion List, Kathleen McGuire points out that by asking "where in your body do you feel this situation?" EMDR actually elicits the felt sense. She says:
I see the possibility of bringing together two traditions, the client-centred, humanistic, process research people and the cognitive/behavioural scientists. The unfolding that happens in EMDR is the same (although, indeed, "jump started" in powerful ways) that happensin good Rogerian therapy or, more recently, Gendlin's focusing process. It's very interesting for me to bring together the phenomenological descriptions of the process with the "brain/nervous system" explanations, two lenses on, I think, the same phenomenon.
...Looking at EMDR sessions through Gendlin's experiential theory lets one see that it's not just desensitization, or even reprocessing, but forward life steps, the creation of new meanings out of which solutions and action steps appear, healing as growth into a new way of seeing, and being in the experiencing scale...
Empowerment is central to both Focusing and EMDR. Shapiro wants "to convince the client that she is larger than the pathology and can effectively remain an observer of its previously overwhelming effects." (p.138) In Focusing, too, clients are taught to find ways of getting an appropriate distance between themselves and their situations, so that they can observe their issues rather than being overwhelmed. (Armstrong, 1988) The helpless, out of control state of the trauma survivor is further addressed by integrating client-centred EMDR into the therapy.
In EMDR the client can stop the proceedings immediately at any time. (Shapiro, 1995, p.80) This is out of respect for the client's integrity. Stopping is possible because EMDR dips into the past, then comes back to the present reality of two adults, the client and the therapist, exploring together some impressions from the past. The client is never left alone to fall into a flashback or revivification of the trauma.
Integration
As a Focusing Oriented Psychotherapist, I view EMDR as a compatible avenue to integrate into my work with traumatized clients. EMDR is a specific intervention to be used in the larger context of Focusing Oriented Psychotherapy when an experience is stored in the oranism as trauma. Biochemically, the body has been sensitized by constant overuse of its fight or flight mechanisms. (van der Kolk, 1994) Neurologically, trauma is held in the lower brain where it does not have access to the pre-frontal cortex's rational understanding. EMDR serves to "jump start" the brain's overwhelmed attempt to process trauma. With EMDR the traumatic material is changed so that the memory can be reprocessed in the light of current knowing.
When I was first learning EMDR I carefully observed each of the steps in the protocol, just as I once did with the six steps of Focusing. My clients took to EMDR very easily. Soon they were asking me to "do some EMDR to jump start" a stuck place. Once the traumatically held material begins processing again, we return to Focusing.
Are there some more precise guidelines for the integration of EMDR into Focusing Oriented Psychotherapy?
EMDR is what Gendlin calls an "avenue", something that carries forward the client's felt sense. "If we think of ourselves as working with the client's felt sense then each avenue becomes a way to lead to a felt sense. And, once there is a felt sense, all avenues are ways to carry it forward." (Gendlin, p.171)
EMDR then, is an avenue meant to allow for the opening of the client's felt sense when the felt sense is blocked by the organism's response to trauma. The felt sense is also carried forwardby EMDR's effect on the organism.
Gendlin reminds us that "procedures and theories are vital, but they need to be used in relation to our contact with the person." (p. 172) Our approach in any given client hour will relate to the person in front of us; and not to some tightly held orientation theory. (p.170) If we think of ourselves as working with the client's felt sense, then, I think the use of EMDR could vary with each client and with each client's hour.
It is easy for Focusers to appreciate how the brain, as a part of the organism knows how to move toward psychological health and emotional wholeness. Clients are also familiar with the need to get their analytical thinking out of the way so that the organism is free to go about its healing.
Focusers are also accustomed to being in charge of their own experience. EMDR assures clients that they can stop the intervention at any time. Also, the clinician is meticulous about not interpreting the client's experience. In fact, in EMDR even reflecting back what the client says is not allowed because of the possibility of therapist contamination.
Conclusion
Focusing Oriented Psychotherapy is the orientation to which I belong as a therapist, and the way I choose to work, providing it is right for the person in front of me; and providing the person's felt sense is moving forward.
Many of my clients have been traumatized by childhoods where the biochemical/neurodegenertive damage to the organism makes it impossible to access their adult cortical processes and reinterpret the trauma in present day terms.
EMDR enables the organismic holding to change so that the traumatically held material can finally be processed from the perspective of the current reality.
References
Armstrong, Mary K. MSW, CSW, Traumatic Memory: New Research. The Social Worker Volume 65 (3) Fall 1997, pp.9-15
Gendlin, E. (1996) Focusing Oriented Psychotherapy. New York: Guilford Press
Perry, B. (1995) Childhood Trauma, the neurobiology of adaptation and "use dependant" development of the brain: How "states" become "traits". Infant Mental Health Journal, Winter 271-291
van der Kolk, B. (1994) The Body Keeps the Score The Harvard Review of Psychiatry Jan-Feb 250-260
Shapiro, F. (1995) EMDR. New York: Guilford
Steed, J. (1994) Our Little Secret. Toronto: Random House of Canada
"Treating Trauma with Focusing and EMDR", The Folio.
Imagine a light beam emanating from your heart, then spend at least five minutes with your eyes closed, feeling the light extend outward to all living things. Marianne Williamson
Jim
Dr. Jim Psychologist Mentor Guide
http://www.drjimpsychologist.com
Dr. Jim Leonidas Ph.D., C. Psych.
Registered Clinical Counselling Psychologist
Canadian Register Health Service Providers Psychology
1.416.484.9912 voice mail
Skype Name: drjimpsychologist.com
10 MCNAIRN Avenue Suite H1 Toronto Ontario Canada M5M 2H5
Nearest major Intersection LAWRENCE and YONGE Streets LAWRENCE PARK NORTH TORONTO Neighborhood GREATER TORONTO AREA GTA
Be kind, for everyone you meet is fighting a hard battle. Plato
This being Human is a guest house. Every moment a new arrival; a joy, a depression, a meanness, some momentary awareness comes as an unexpected visitor. Welcome and entertain them all! Even if they are a crowd of sorrows, who violently sweep your house empty of all its furniture. Still treat each guest honorably, he many be clearing you out for some new delight. The dark thought, the shame, the malice, meet them at the open the door laughing and invite them in. Be grateful for whomever comes, for each has been sent as a guide from beyond. Rumi