One way of thinking about procrastination is to regard it as a form of addiction; an addiction to putting things off. As with other addictive patterns, the client will choose a short-term gratification instead of going for a long-term result that might, in the end, be more satisfying or empowering. As with other addictions, a procrastinating client often suffers ongoing erosion of her self-esteem. Quite often, procrastination may function as a defense as a way to avoid other life issues that are disturbing. With this type of problem, we can use a variation of Popky’s addiction protocol, and the level of urge to avoid (LoUA) procedure. It is also important to use resource installation procedures to help the client develop an image of the benefits that would come with being free of this problem.
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Feeling the pain of rejection by someone we love is one of the most difficult experiences that we can have as human beings. Often, this terrible feeling is, in part, based on an unrealistic idealization of the lost lover. Eye movement desensitization reprocessing (EMDR) Standard Protocol assists our client in focusing on those aspects of the remembered love relationship that retain the intense positive affect, so that a disinvestment process can occur, and the client can come to see the former relationship more realistically, with all its good and bad aspects. The level of positive affect or (LoPA) score is a scale of 0 to 10 that is used instead of the subjective units of disturbance (SUD) scale for this protocol. When setting up this protocol, the positive representative image, the LoPA for the positively felt emotion, and the location of that number in positive body sensations, are elicited.
When working with ambivalence, it is helpful to identify the two or more sides of the ambivalence, such as the client who wants to work on a disturbing memory but is too afraid. Sometimes, if the client impulsively uses avoidance and is frustrated with her ambivalence, the most accessible point of entry into effectively using eye movement desensitization and reprocessing (EMDR) to process a problem may be to target the feeling of relief associated with avoiding that problem. The procedures for unwanted avoidance defenses script notes were partially derived from Popky’s Desensitization of Triggers and Urge Reprocessing (DeTUR) Protocol for using EMDR to treat addictive behaviors. Usually, when this procedure is used, the level of urge to avoid (LoUA) scores will go down with continuing sets of bilateral stimulation (BLS), until the client spontaneously begins direct targeting of the memory or issue.
The Constant Installation of Present Orientation and Safety (CIPOS) method can be used to extend the healing power of eye movement desensitization and reprocessing (EMDR) to many clients who are potentially vulnerable to dissociative abreaction because of a dissociative personality structure, or because of the client’s intense fear of their own memory material. By constantly strengthening the person’s present orientation through bilateral stimulation (BLS) and carefully controlling the amount of exposure to the trauma memory, the individual is more easily able to maintain dual attention. At the start of the procedure, when the client is most vulnerable to being overwhelmed by disturbance, BLS is not paired with information directly related to the traumatic disturbance. The CIPOS interventions are continued until the client is able to report, using the Back of the Head Scale (BHS), that she is oriented once again toward the present reality of the therapist’s office.
- Go to chapter: Dysfunctional Positive Affect: Codependence or Obsession With Self-Defeating Behavior
This chapter outlines script in an easy-to-use, manual style template, consistent format for use with eye movement desensitization and reprocessing (EMDR) clients. The scripts distill the essence of the Standard EMDR Protocols. They reinforce the specific parts, and language used to create an effective outcome, and illustrate how clinicians are using this framework to work with a variety of medical related issues while maintaining the integrity of the adaptive information processing (AIP) model. The chapter includes summary sheets for each protocol to facilitate gathering information, client documentation, and quick retrieval of salient information while formulating a treatment plan. When there is a repetitive interaction pattern in a client’s life that is difficult to resolve because the codependent behavior in question has become part of the client’s identity or a lifetime way of connecting, it can be helpful to use a protocol that targets this positive affective urge.
This book provides a standard that reflects the basic elements of the 11-Step Standard Procedure; and the Standard 3-Pronged EMDR Protocol as they are applied to different populations. The diverse population includes children and adolescents; couples; clients suffering with complex post-traumatic stress disorder and dissociative disorders; clients with anxiety; clients who demonstrate addictive behaviors; clients who deal with pain; clinicians themselves. The book serves as a basis to encourage research into these various applications for EMDR. It is divided into seven parts. Part I is devoted to the scripted EMDR protocols such as olfactory stimulation, which are used to develop resources for children and adolescents who may have suffered traumatic events in their life. The protocols take into account the particular difficulties of this developmental group and help minimize common difficulties and major hurdles. Part II describes scripted EMDR protocols designed by couples therapists and sex therapists to further the progress of their patients precisely targeting templates of relational interaction, anxiety, or sexual dysfunction. Part III concerns the scripted protocols for dissociative disorders and complex post-traumatic stress disorder. The protocols represent the structured scripted efforts of many trauma therapists over a considerable number of years. Parts IV and V of the book address the concretization of much needed scripts for the EMDR treatment of addictions and pain—two interconnected public health worries. Part VI looks at the world of people’s adaptation to fears and tackles the usage of scripted protocols to detoxify the impact of specific phobias. Part VII demonstrates the usage of scripted EMDR protocols in clinician care and in the management of secondary post-traumatic stress disorder and vicarious traumatization.
This book has two main goals: to provide descriptions of specific eye movement desensitization and reprocessing (EMDR) therapeutic “tools” and, by incorporating these tools, to develop an overview of an Adaptive Information Processing (AIP) model of the treatment of complex PTSD. The development of EMDR-related tools has been ongoing since the introduction of EMDR three decades ago. What will EMDR be in 2030? Unfortunately, the field—the field of psychotherapy for trauma-related disorders—has at times had a kind of dissociative disorder. Some therapists identify with one theoretical approach, and others are strong adherents of another identity. Often, these two “identities” do not communicate sufficiently, and sometimes they mistakenly think they have to fight with each other. Clearly, the author’s primary identification as a therapist is with EMDR-related methods based on an AIP approach, but the author attempting in the following chapters to also integrate the concepts and methods of cognitive approaches—approaches that are not only useful, but at times essential in the treatment of dissociative clients. The chapters of this book are divided into four parts. The first, comprising Chapters 1 and 2, is an overview of the application of the AIP model to complex PTSD and other dissociative conditions. The second part, Chapters 3 to 6, presents ways of treating (i.e., resolving) psychological defenses that are often linked intrinsically to disturbing memories but can be conceptually defined as separate entities because defenses typically contain dysfunctional positive affect, as opposed to the disturbing affect within memories of traumatic events. The third part, Chapters 7 to 14, focuses on several issues important in the EMDR treatment of dissociative conditions. And Chapters 15 to 17 are detailed case reports illustrating how these AIP “tools” can be employed in actual treatment sessions.
Eye Movement Desensitization and Reprocessing EMDR Therapy Scripted Protocols and Summary Sheets:Treating Eating Disorders, Chronic Pain, and Maladaptive Self-Care Behaviors
This book focuses on applying eye movement desensitization and reprocessing (EMDR) scripted protocols to medical related conditions. It delivers a wide range of step-by-step protocols that enable beginning clinicians as well as seasoned EMDR clinicians, trainers, and consultants alike to enhance their expertise more quickly when working with clients who present with medical-related issues. The scripts are conveniently outlined in an easy-to-use, manual style template, facilitating a reliable, consistent format for use with EMDR clients. The scripts distill the essence of the standard EMDR protocols. They reinforce the specific parts, sequence, and language used to create an effective outcome, and illustrate how clinicians are using this framework to work with a variety of medical related issues while maintaining the integrity of the Adaptive Information Processing model. Following a brief outline of the basic elements of EMDR procedures and protocols, the book focuses on applying EMDR scripted protocols to key medical issues. The book is organized into four parts comprising ten chapters. Chapter one presents protocol for EMDR therapy in the treatment of eating disorders. Chapter two describes EMDR therapy protocol for the management of dysfunctional eating behaviors in anorexia nervosa. Chapter three discusses EMDR therapy protocol for eating disorders. Chapter four presents the EMDR therapy protocol for body image distortion. Chapter five discusses EMDR therapy and physical violence injury: “best moments” protocol. Chapter six describes EMDR therapy for chronic pain conditions. Chapter seven presents EMDR therapy treatment for migraine. Chapter eight discusses EMDR therapy for fibromyalgia. Chapter nine describes the impact of complex posttraumatic stress disorder and attachment issues on personal health. The final chapter presents the EMDR therapy self-care protocol.
It appears that sets of bilateral stimulation (BLS) have the potential to invite unfinished traumatic experience into awareness. This can be a problem for clients who are dissociative, or who are on the verge of being overwhelmed by a traumatic memory. The memory can feel more real than the real situation the patient is in, and the experience can be one of nontherapeutic retraumatization. For clients who are potentially dissociative, the degree of orientation to the present situation can be assessed through the use of the back of the head scale (BHS). This procedure allows both therapist and client to be able to closely monitor and maintain the dual attention aspect of successful trauma processing; the simultaneous co-consciousness of the safe present and the traumatic past. The use of the BHS throughout a therapy session can be very useful in insuring that client is staying present while reprocessing disturbing memories.