This book was conceived out of the authors' shared vision to synthesize key neurobiological developments with effective developments in clinical practice to offer both understanding and practical guidance for the many practitioners working to heal people burdened with traumatic sequelae. It is unique in bringing in all levels of the brain from the brainstem, through the thalamus and basal ganglia, to the limbic structures, including the older forms of cortex, to the neocortex. The book looks at the neurochemistry of peritraumatic dissociation (PD) and explores the effects on neuroplasticity and the eventual structural dissociation. Individual chapters focus on the definition of PD and tonic immobility (TI) and their associations with posttraumatic psychopathology, and review disturbances in self-referential processing and social cognition in posttraumatic stress disorder (PTSD) related to early-life trauma. Separate chapters focus on the modulatory role of the neuropetides in attachment as well as autonomic regulation, and highlight mesolimbic dopamine (ML-DA) system as central to the experiences of affiliation, attachment urge when under threat, attachment urge during experience of safety, and to the distress of isolation and/or submission. The book while increasing awareness of different parts of the self and ultimately creating a more stable sense of self, also incorporates psychoanalytic, cognitive behavioral, and hypnotic methods, as well as specific ego state, somatic/sensorimotor therapies, eye movement desensitization and reprocessing (EMDR), and variations of EMDR suitable for working with trauma in the attachment period. The latter methods are explicitly information-processing methods that address affective and somatic modes of processing.

This book is intended to provide to the eye movement desensitization and reprocessing (EMDR) clinician advanced tools to treat children with complex trauma, attachment wounds, and dissociative tendencies. It covers key elements to develop case conceptualization skills and treatment plans based on the adaptive information processing (AIP) model. A broader perspective is presented by integrating concepts from attachment theory, affect regulation theory, affective neuroscience, and interpersonal neurobiology. These concepts and theories not only support the AIP model, but they expand clinicians’ understanding and effectiveness when working with dissociative, insecurely attached, and dysregulated children. The book presents aspects of our current understanding of how our biological apparatus is orchestrated, how its appropriate development is thwarted when early, chronic, and pervasive trauma and adversity are present in our lives, and how healing can be promoted through the use of EMDR therapy. In addition, it provides a practical guide to the use of EMDR within a systemic framework. It illustrates how EMDR therapy can be used to help caregivers develop psychobiological attunement and synchrony as well as to enhance their mentalizing capacities. Another important goal of the book is to bring strategies from other therapeutic approaches, such as play therapy, sand tray therapy, Sensorimotor Psychotherapy, Theraplay, and Internal Family Systems (IFS) into a comprehensive EMDR treatment, while maintaining appropriate adherence to the AIP model and EMDR methodology. This is done with the goal of enriching the work that often times is necessary with complexly traumatized children and their families.

Play therapy has been recognized in the counseling profession as a developmentally appropriate model for working with children and adolescents. This book provides a comprehensive introduction to structured, prescriptive approaches to play therapy to those desiring to gain more information and knowledge about the use of different directive play therapy modalities. It introduces the unique integration of play therapy and different theoretical models and encompasses the essential concepts and practices of directive play therapy. Most importantly, the book shares some guidelines for planning and selecting toys and materials for a directive approach. It also incorporates settings and skills necessary for effective implementation and addresses common questions asked about the use of these. The book provides the exploration and detailed description of various theoretical approaches to directive play therapy: post-Jungian directive sandtray in play therapy, solution-focused play therapy, eye movement desensitization and reprocessing and play therapy, directive play therapy techniques in trauma-focused cognitive behavioral therapy, child parent relationship therapy, creativity in play therapy using technology, directive filial therapy models with very young children, humanistic sandtray therapy with children and adults, and directive approaches to working with parents. The distinctive techniques and processes of each of these approaches are explained. Finally, case examples are given to demonstrate their application and implementation.

The inner subjective world of the mind was historically relegated to the margins of social science, confined instead within the traditional domains of psychology and psychoanalysis. In the seven years since the first edition of this book was written, many developments in the fields of neuroscience and psychotherapy that were just beginning to appear on the horizon have received a massive increase in interest and study. Eye Movement Desensitization and Reprocessing (EMDR) is so profoundly guided by the adaptive information processing (AIP) model, it is crucial to examine how it measures up to researched neurobiological models of consciousness and information processing. The book is written with language that is not only technical but also suitable as an introduction to the neural underpinnings of consciousness and EMDR. It examines pertinent neuroscience research related to the understanding of consciousness, information processing, and traumatic disorders of consciousness. The book first presents with basic research in the neurosciences relevant to online/wakeful information processing, which includes sensation, perception, somatosensory integration, cognition, memory, emotion, language, and motricity. The second section examines the neuroscience research relevant to disorders of consciousness, which include anesthesia, coma, and other neurological disorders. Major focus is given to the disorders of type I posttraumatic stress disorder (PTSD), complex PTSD/dissociative disorders, and personality disorders. The third section presents the reader with an examination of neuroscience research relevant to chronic trauma and autoimmune function. A number of medical illnesses, collectively known as “medically unexplained symptoms”, are examined. These include fibromyalgia, chronic fatigue syndrome, reflex sympathetic dystrophy, systemic lupus erythematosus, type 1 diabetes, Hashimoto’s thyroiditis, Graves’ disease, multiple sclerosis, Sjögren’s syndrome, and rheumatoid arthritis. The final section examines the foregoing material with respect to the AIP model. It explores treatment implications vis-à-vis the various types of PTSD and the presentations of medically unexplained symptoms.

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.

This book on child and adolescent dissociation provides the reader with a window into the fractured minds of traumatized children and adolescents and offers an effective pathway toward healing. It delves into the inner workings of vulnerable children’s use of dissociation. An in-depth discussion of the Star Theoretical Model (STM), an inclusive theoretical model that examines five intersecting theories attachment, neurobiology, developmental theory, family systems, and dissociation provides a solid foundation for understanding how and why children dissociate and also a road map to guide traumatized children toward successful recovery. One of the chapters deals with 16 warning signs such as auditory hallucinations which are suggestive of dissociation in children and adolescents. Familiarity with the warning signs can enhance proper evaluation for dissociation so that children can receive appropriate treatment and care. The Adolescent Dissociative Experiences Scale (A-DES) is a commonly used checklist to assess for dissociative symptoms. A phase-oriented treatment model specifically designed for dissociative children will help them develop integrative functions. Another chapter focuses on helping children to further develop their skills in self-reflection, mindfulness, and somatic awareness, along with managing traumatic triggers and learning to calm down the overactive stress-response system. The book also deals with creative art therapy interventions for adolescents with dissociation and integrating dissociative treatment and eye movement desensitization and reprocessing therapy (EMDR) therapy with children with trauma and dissociation.

With Eye Movement Desensitization and Reprocessing (EMDR) treatment, children can overcome their low self-esteem; control their impulses; modify their behaviors in school; change their relationships with peers, teachers, and family members; organize their lives; and, essentially, change their low opinions of themselves. This book focuses on providing advanced training and support for therapists to be successful in using EMDR with child clients, and documents a standardized protocol for using EMDR with children for training and research purposes. It begins with a review of Adaptive Information Processing (AIP) theory applied to EMDR with children and an abbreviated review of research on using EMDR with child clients. The second chapter explains how to get started using EMDR, before describing the steps in the EMDR protocol in case conceptualization with child clients. Six other chapters explain the goals for the specific phases of the EMDR protocol, with directions for each session, instructions for the therapist, and finally, a script for therapists to use with child clients. The phases include discussions on case conceptualization, preparation, assessment, desensitization, installation, body scan and closure, and reevaluation. The Assessment Phase of EMDR therapy includes specific procedural steps including distilling the core belief schema including negative cognition (NC) and positive cognition (PC). Additional chapters describe advanced management skills for using EMDR with special populations and explore cognitive interweaves (CI) to help the therapist when the child/teen experiences blocked processing.

This book is the result of the author’s 30+ years of military service and extensive experience as an eye movement desensitization and reprocessing (EMDR) therapist, EMDR International Association (EMDRIA) approved consultant, and an EMDR-approved trainer who specializes in training mental health providers who treat military and veteran populations. It includes a lifetime of lessons learned in working with military personnel and veterans. It also includes a paradigm for evaluating the military personnel and veteran’s initial clinical presentation in the opening minutes in the office. The book describes how to use nuances of the military culture to present a motivating treatment plan. It provides numerous case examples to illustrate intervention strategies across the treatment spectrum while treating military personnel and veterans. Illustrations range from single-incident traumas to complex posttraumatic stress disorder (PTSD) and moral injury. The chapters include complex cases, including suicidality, moral injury, military sexual trauma (MST), and dissociative exhibitions. It highlights the use of the EMDR eight-phase standard protocol. The overall goal of the book is to provide a resource for empowering EMDR-trained therapists to provide the most effective treatment available to our military and veteran populations who bring with them a wide range of clinical rules of engagement in the therapist’s office. The book fills the void of many therapists who are trained in EMDR therapy but wish they had a “go-to” manual on how to deal with unique treatment issues in treating military personnel and veterans. The author translates how to present clinical psychotherapy material into an approach that enables this special population to understand and willingly engage in treatment. The book’s intended audience consists of EMDR-trained psychotherapists who treat military personnel, veterans, first responders, and their families including therapists attending EMDR therapy basic trainings, EMDR advanced trainings, EMDRIA conferences, and online EMDR continuing education programs.

This book focuses on the practice of child psychotherapy, the theories and treatment practice. The book is divided into three parts. The first part dwells on the need for developmentally grounded child psychotherapy. It explores theories of human development, also referred to as developmental psychology and educational theory in order to understand how children are challenged to learn, and reviews theories that speculate how love and our earliest relationships impact health and well-being. Part II assimilates the developmental theory into the pragmatics of child psychotherapy. It discusses the pragmatics of providing child psychotherapy with considerations for therapists, focuses on the legal and ethical challenges that arise when providing child psychotherapy, and reviews the types of assessment tools that cover all phases of development, including emotional, social, developmental, educational, and psychological. The third part presents the best practices in child psychotherapy. Here, models of evidence-based practice in child psychotherapy are reviewed with examples of what each model offers to the treatment process. These theories also describe what the therapist brings to psychotherapy based on the therapist’s belief of what therapy looks like and the therapist’s role in the relationship with the client. One of the chapters guides the therapist through case conceptualization that integrates the most efficacious treatment interventions into the eight-phase template of eye movement desensitization and reprocessing (EMDR). Basic issues such as sleeping, feeding, emotional dysregulation, and learning issues are also discussed with common responses and references to provide to parents through a developmentally grounded practice.

This manual distills simple and practical ways to employ eye movement desensitization and reprocessing (EMDR) therapy scripted protocols and forms to effectively utilize the entire EMDR therapy eight-phased treatment with infants, toddlers, young children, preteens, and teens from a developmental perspective. It provides step-by-step directions, session protocols, scripts, and forms for each phase of the protocol, along with instructions for integrating techniques and tools from play, art, sand tray, and other helpful therapies. The various phases of EMDR therapy are: case conceptualization, preparation, assessment, desensitization, installation, body scan, closure and reevaluation. A therapist can use a cognitive interweaves (CI) when reprocessing is blocked, when the child/teen is looping, when time is running out, or when it is necessary to expedite the session so that the client does not remain in a highly activated state. Resource development and installation (RDI) is used when the child/teen does not appear to have adequate tolerance to use EMDR therapy; bilateral stimulation (BLS) is used to install the resource. Mapping and graphing tools help to organize the EMDR therapy, especially with children, and can be integrated into the eight-phases of treatment. While using a fidelity questionnaire, a therapist can monitor his or her own adherence to the phases in order to improve practice and prevent therapist drift, application of a blocking beliefs questionnaire is used to discern the blocking beliefs of children and adolescents.