This chapter aims to help clinicians learn stabilization interventions for use in the Preparation Phase of eye movement desensitization and reprocessing (EMDR) treatment. Using these interventions will aid clients in developing readiness for processing trauma, learning how to manage symptoms of dissociation, dealing with affect regulation, and developing the necessary internal cohesion and resources to utilize the EMDR trauma-processing phase. Earlier negative experiences stored dysfunctionally increase vulnerability to anxiety disorders, depression, and other diagnoses. When assessing a client with a complex trauma history, clinicians need to view current symptoms of post-traumatic stress disorder (PTSD) or depression as reflections of the earlier traumas. The chapter outlines the strategies dealing with dissociative symptoms, ego state work, and internal stability that help clinicians to develop an individualized treatment plan to successfully guide the client through the EMDR phases of treatment.

Child psychotherapy requires case conceptualization through the lens of developmental psychology in a multimodal approach to assessment, diagnosis, treatment planning, and clinical interventions. This chapter outlines a blueprint for therapists to provide treatment for children by integrating these fundamental principles while collaborating with the other people in the child’s life. The chapter 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). Adaptive information processing (AIP) theory drives treatment with EMDR throughout the eight phases of that protocol and provides a template for case conceptualization and treatment planning. The use of the EMDR approach to psychotherapy is well documented and approved as evidence-based practice in Substance Abuse and Mental Health Administration (SAMHSA) and California Evidence-Based Clearinghouse for Child Welfare (CEBC).

This chapter describes maneuvers to access the internal system of the patient as well as means to accelerate or decelerate the work in that process of accessing the self-system. Eye movement desensitization and reprocessing (EMDR), ego state therapy, and somatic therapy fit together like hand and glove. An extended preparation phase is often necessary before trauma processing in complex traumatic stress presentations and attachment-related syndromes, particularly when dealing with the sequelae of chronic early trauma. Clinical practice suggests that the adjunctive use of body therapy and ego state interventions can be useful, during stabilization and later on in increasing the treatment response to EMDR. Traditional treatment of complex posttraumatic stress disorder (PTSD) and dissociative disorders has usually included hypnoanalytic interventions, during which abreaction is considered an important part of treatment.

The basic goals of phase one are to develop a working relationship and a therapeutic alliance and to determine if the level of expertise of the eye movement desensitization and reprocessing (EMDR) clinician is adequate for the complexity of the case. Other goals are to develop a comprehensive treatment plan and case formulation. EMDR therapy was developed as a form of treatment to ameliorate and heal trauma. Clinicians working with complex trauma must have substantial understanding of the adaptive information processing (AIP) model and the EMDR methodology. During phase one, the clinician works on creating an atmosphere of trust and safety so a therapeutic alliance can be formed with the child and the caregivers. This chapter shows an example of how medical issues can affect the quality of the parent-child communications. The adult attachment interview (AAI) gives us the view of the presence of the experiences in the parent’s life.

International Society for the Study of Trauma and Dissociation (ISSTD)’s professional training institute offers comprehensive courses on childhood dissociation that are taught internationally and online. This chapter briefly cites some of the theories that have emerged in the dissociative field. One system, the apparently normal personality (ANP) enables an individual to perform necessary functions, such as work. The emotional personality (EP) is action system fixated at the time of the trauma to defend from threats. As with the Adaptive Information Processing Model (AIP) in eye movement desensitization and reprocessing (EMDR), each phase brings reassessment of the client’s ability to move forward to effectively process trauma. There are many overlapping symptoms with Attention Deficit Hyperactive Disorder (ADHD) and dissociation that often mask the dissociation. The rate of diagnosis of pediatric bipolar disorder has increased 40 times in the last ten years.

This chapter focuses on case studies of installation, body scan, closure, and reevaluation of eye movement desensitization and reprocessing (EMDR). The installation phase is concerned with integrating the positive cognition (PC) with the targeted memory. The PC should be checked for ecological validity and rated on the validity of cognition (VOC) scale. Closure is important at the end of any therapy, and particularly so after EMDR desensitization. As such, it is important to allow sufficient time for closure, debriefing, safety assessment, and homework. As with any therapy, clients will sometimes find that something occurs that disrupts the therapeutic plan. Modeling, education on social skills, and testing out new behaviors will now be the focus of therapy. This may be an unexpected crisis, such as a relationship breakdown or being diagnosed with cancer, and clients will need support in making adjustments in their present life.

The work directed toward increasing the child’s ability to tolerate and regulate affect, so that the processing of traumatic material can be achieved, is initiated during the preparation phase. The process of providing the neural stimulation to improve the child’s capacity to bond, regulate, explore, and play should begin during the early phases of eye movement desensitization and reprocessing (EMDR) therapy. The Polyvagal theory presents a hierarchical model of the autonomic system. In complexly traumatized children, the development of this system has been compromised due to the early dysregulated and traumatizing interactions with their environments and caregivers. When describing the various forms of bilateral stimulation (BLS), go over the different options and practice with the child. If the child went through the calm-safe place protocol successfully, motivating the child to actually use it when facing environmental triggers is an important goal.

Clients need to be aware that the process of eye movement desensitization and reprocessing (EMDR) treatment can be disturbing and that dissociated material may surface during therapy. Because EMDR has the potential for rapid uncovering of this unsuspected material, some of which may be extremely distressing an assessment needs to be made of the client’s ability to handle strong emotions. For some clients there may be ambivalence about recovery from their dysfunction or distress. Common secondary gains include the loss or reduction of a compensation claim or disability pension. It is strongly recommended that EMDR is not used with clients who have dissociative disorders (DD) unless therapists are confident and competent in their EMDR practice as well as in working with this client population. The chapter also presents a snapshot of Emma’s assessment that should be gathered to determine suitability for EMDR.

The most critical therapeutic work with dissociative clients is stabilization. This chapter describes the modified Resource Development Installation (RDI) procedures that can help such clients slowly develop skills that lead to this kind of stabilization. There are many reasons stabilization is a central facet of work with the dissociative disorders. Frequently, there are physical symptoms, visual intrusions, sleep difficulties, nightmares, barraging inner voices, and other negative affects. The chapter conceptualizes the cause of the particular kinds of negative affect listed above as consequent to intrusions from or responses to activated traumatic memory. Managing the intense negative affects associated with eye movement desensitization and reprocessing (EMDR) is not yet part of the client’s repertoire. Such capacities must be developed for the client to use EMDR effectively. Learning how to support and provide self-care can result in present time satisfactions and the decrease in the experience of negative affect.

The Butterfly Hug was originated and developed by Lucina Artigas during her work performed with the survivors of Hurricane Pauline in Acapulco, Mexico, 1997. For the origination and development of this method, Lucina Artigas was honored in 2000 with the Creative Innovation Award by the eye movement desensitization and reprocessing (EMDR) International Association. By 2009, The Butterfly Hug had become standard practice for clinicians in the field while working with survivors of man-made and natural catastrophes. The “Butterfly Hug” provides a way to self-administer dual attention stimulation (DAS) for an individual or for group work. This chapter explains many uses for the Butterfly Hug. During the EMDR Standard Protocol, some clinicians have also used it with adults and children to facilitate primary processing of a fundamental traumatic memory or memories. Use of the Butterfly Hug in session with the therapist can be a self-soothing experience for many trauma-therapy clients.

David Blore, the author, has now been providing Eye Movement Desensitization and Reprocessing (EMDR) to traumatized miners since 1993. As with other specialized client groups, the Single Trauma (STP) and Recent Trauma Protocol (RTP) have required modifications. David has collated the modifications made, and presented them here as the Underground Trauma Protocol (UTP). The UTP is intended to provide a rapid and effective method of conducting EMDR with traumatized miners and other similar, very specific, client groups. David Blore recommends that the treatment of this client group only be undertaken by fully trained EMDR clinicians who have experience with modifying protocols and existing clinical experience of using cognitive interweave. Important information to ask for during history taking is to be clear how much of the underground environment was involved in the incident. If the integrity of the underground environment is affected, in essence, the whole underground world is affected.

This chapter presents sets of questionnaires are helpful in working with fertility treatment. Infertility clients often carry within them a strong sense of blame and misplaced personal responsibility. The two primary negative cognitions that appear most often are: “There’s something wrong with me”, and “I must have done something wrong”. The chapter also presents a construction of a Time Line. Each Time Line corresponds to only one theme: responsibility, trust or control. It is important that the client have general information about the Adaptive Information Processing (AIP) Model in order to ensure optimum participation in treatment. The client is informed about what to expect relative to the process and effects of Eye Movement Desensitization and Reprocessing (EMDR). Based on client needs, risk considerations may include: poor self-care and nutrition, side effects of hormone or drug therapy consistent with fertility treatment, marital strain, or weakness in support system.

When the perpetrator is the client’s own body, the Illness and Somatic Disorders Protocol can be used. It is important to note that this protocol addresses both psychological and physical factors related to somatic complaints. For many, addressing the psychological dimensions will cause partial or complete remission of the physical symptoms. When primarily organic processes are involved, the psychological issues may be exacerbating the physical conditions. While physical symptoms may not remit, the clinical emphasis is on improving the person’s quality of life. Eye Movement Desensitization and Reprocessing (EMDR) has also been used in the hospital to assist clients who are suffering from intractable pain to let go of the guilt they feel about wanting to die and be released from the pain. There are many ways to bolster the immune system in order to facilitate the healing process, however, death may be inevitable for some clients.

This chapter demonstrates the methodology for formulating cases using the adaptive information processing (AIP) and Indicating Cognitions of Negative Networks (ICoNN) models in conjunction, with clinical case material. Engaging and holding a client with psychosis in the safe intersubjective dynamic requires a biopsychosocial container to be generated within a robust therapeutic alliance. The AIP model of eye movement desensitization and reprocessing (EMDR) therapy invites us to acknowledge that psychosis has meaning that is driven by the dysfunctional memory network (DMN), which is the core pathogen. In ICoNN 1, psychotic phenomena are present on examination and distress the person, causing a functional impairment. The psychological pathogen (DMN) is identified and is acknowledged by the person as holding strong emotion with a negative valence, which is etiologically connected to the psychosis. This DMN may be targeted with the standard EMDR therapy model and reprocessed.

This chapter serves as a one-stop resource where therapists can access a wide range of word-for-word scripted protocols for Eye Movement Desensitization and Reprocessing (EMDR) practice. The rationale behind the creation of “The Four Elements Exercise for Stress Management” is to address the cumulative effect of external and internal triggers that occur over the course of the day. The heart of the exercise consists of four, brief, self-calming and self-control activities. The idea is to take a quick reading of the current stress level using the simple 0 to 10 subjective units of disturbance scale (SUD scale) where 10 = the most stress and 0 = no stress at all. This can occur every time clients observe their bracelets. Working on the Safe Place separately during the session gives it more space and impact. It is then practiced with the bracelet reminder frequently, together with the other elements.

The desensitization of triggers and urge reprocessing (DeTUR) method is an urge reduction protocol used as the center of an overall methodology for the treatment of a wide range of chemical addictions and dysfunctional behaviors. It was initially introduced as a stop smoking protocol at the first eye movement desensitization and reprocessing (EMDR) conference. The basis or foundation is the adaptive information processing (AIP) using bilateral stimulation (BLS) as outlined in EMDR to uncover and process the base trauma(s) or core issues as the underlying cause behind the addiction. DeTUR accesses positive experience through positive body states while the EMDR protocol addresses positive experience through affect and positive and negative cognitions. The cognitive or therapeutic interweave as taught in the EMDR Institute basic training is the therapist’s best tool to aid clients during this desensitization or reprocessing phase.

Protocol for excessive grief is to be used when there is a high level of suffering, self-denigration, and lack of remediation over time concerning the loss of a loved one. Eye Movement Desensitization and Reprocessing (EMDR) does not eliminate healthy appropriate emotions, including grief. The protocol is similar to the Standard EMDR Protocol for trauma. The goal of this work is to have clinicians’ client accept the loss and think back on aspects of life with the loved one with a wide range of feelings, including an appreciation for the positive experiences they shared. Francine Shapiro often brings up the issue: How long does one have to grieve? She asks us to not place our limitations on our clients as this would be antithetical to the notion of the ecological validity of the client’s self-healing process.

This chapter explores several approaches in helping a client develop an Eye Movement Desensitization and Reprocessing (EMDR) targeting sequence plan to address the presenting problem(s). As with all psychotherapy approaches, it is important to obtain a full clinical history to identify stabilization needs, environmental management skills, and symptoms where EMDR reprocessing will be appropriate. The client’s presentation may fall into either being simple or comprehensive. For simple presentations, several possible targeting sequence plans are possible, depending upon the client’s dominant symptom. For those presenting with a dominant irrational belief, clustering all incidents within that belief will lend itself to a very efficient targeting sequence plan that addresses all prongs, past incidents starting with the Touchstone Event, present triggers, and future issues anticipating anxieties. The chapter presents Intake Questionnaire, guidelines for creating a Targeting Sequence Plan, and the Worksheets that are invaluable tools in assisting therapists in gathering the client’s information.

Clients are ready to begin preparation for working on traumatic material when they have some internal communication and cooperation and have developed coping skills, which they are able to use during their daily lives to manage symptoms. It is helpful to use the standard resources frequently used with clients with a dissociative disorder (DD) during processing, for instance, the affect dial to modulate painful affect; container imagery; and deep-trance dreamless sleep; or any other techniques that are applicable for therapist client. Concern for client stability requires leaving out some steps from the standard eye movement desensitization and reprocessing (EMDR) procedure, and adding others. In the initial stages of developing coping skills, teams often developed to help with daily life functions such as: work, parenting, and driving.

The Absorption Technique for Children is a protocol that was derived from the work of Arne Hofmann who based his work on an adaptation of “The Wedging Technique”. The absorption technique for children is a resource technique that supports children in creating resources for present issues and future challenges such as dealing with a difficult teacher or handling a disagreement with a classmate and so forth. This chapter uses resource installation for stressful situations. It includes summary sheets to facilitate gathering information, client documentation, and quick retrieval of salient information while formulating a treatment plan. The absorption technique, and the constant installation of present orientation and safety (CIPOS) technique, are excellent ways to encourage children to work with eye movement desensitization and reprocessing (EMDR) step-by-step even if they are not prepared to work with the worst issue in the beginning.

The purpose of the constructive avoidance script is to assist clients in dealing with their anxiety or stress-provoking present day situations. Dissociative clients generally are phobic or avoidant of many activities such as medical procedures, going to the dentist, taking examinations, going for job interviews, and so forth due to the complex nature of their traumas, panic, anxiety, and other trauma-related problems. When the client is going to encounter a situation that has caused high stress or triggering in the past and has not completed eye movement desensitization and reprocessing (EMDR) target focusing on that issue, chances are that the ego states involved are not yet ready to deal with the situation. The client can practice with the parts before the upcoming event in sessions and as homework between sessions. This protocol assumes that clients have already established a Home Base and Workplace.

This chapter describes the procedural steps of the Assessment Phase and Desensitization Phase of the Eye Movement Desensitization and Reprocessing (EMDR) Standard Protocol with detailed scripts for steering a child through each phase. It includes summary sheets to facilitate gathering information, client documentation, and quick retrieval of salient information while formulating a treatment plan. Assessment phase note section starts with Target Identification; this is a continuation of what began during the Client History and Treatment Planning Phase. The therapist should already have some idea of what the child may choose given previous target identification procedures such as Mapping and Graphing or other procedures for eliciting targets with children. Once the target has been selected, the therapist continues with Image, negative cognition (NC), positive cognition (PC), validity of cognition (VOC), emotion, subjective units of disturbance (SUD), and body sensation to move on to the desensitization phase.

This protocol was developed to help clients with childhood-onset complex post-traumatic stress disorder (PTSD) who have difficulty moving from the negative cognition (NC) to the positive cognition (PC) and instead, experience persistent looping. Packed dilemmas usually require and respond to a protocol comprising a particular sequence of Socratic cognitive interweaves (CI), which disentangles two clusters of confusion in turn: first, responsibility and entitlement, and then responsibility and loyalty. Ordinarily, as eye movement desensitization and reprocessing (EMDR) therapists, the authors attempt to stay out of the way of the client’s processing, and since CIs can influence processing, they use them sparingly. In a packed dilemma, however, they may need to influence the processing because the family attachment patterns are woven into issues of responsibility, which contribute to the embedded immobility of the NC.

According to Korn and Leeds, the main goal of developing and installing resources is to increase the client’s capacity for self-regulation by enhancing their ability to access memory networks that contain adaptive and functional information. The Resource Development and Installation (RDI) Protocol should only be considered based on specific criteria that suggest it is needed for the individual child. The purpose of doing RDI is to increase the child’s ability to change state adaptively and tolerate disturbance so the child can prepare for trauma reprocessing. Traumatized children deserve to be treated with the full eye movement desensitization and reprocessing (EMDR) reprocessing protocol so that they can make a complete recovery. Because of the short attention span in children, this protocol may take two sessions to complete. Often, school-aged children can do the protocol in one session.

The Resource Connection for Children is a search to support children in finding their own unique ways to feel the safety, confidence, and relief of making a solid connection with their therapists in the here and now of the therapeutic session. These are their principle supports as they enter and go through the eye movement desensitization and reprocessing (EMDR) processing. The term Resource Connection, as well as the idea of a continuation of resources threaded through the EMDR Standard Protocol, was first used by Brurit Laub in her work with adults. Instead of asking the child to remember an event as people do with adults, the therapist’s task is to be aware of the child’s resources throughout the protocol. The therapist then focuses and installs sensory, emotional, and cognitive aspects of this resource immediately with bilateral stimulation (BLS).

The importance of the functioning of mind and the limitations of medication has encouraged some clinicians to advance the use of psychotherapy. In the present period this is mostly in the form of cognitive behavioral therapy (CBT) for schizophrenia and psychosis, and this is strongly promoted in the British Psychological Society (BPS) publication “Understanding Psychosis and Schizophrenia: Why People Sometimes Hear Voices, Believe Things That Others Find Strange, or Appear Out of Touch With Reality, and What Can Help”. Although this document has not been received without criticism, it makes some very interesting reading for us as eye movement desensitization and reprocessing (EMDR) therapists and students of the Indicating Cognitions of Negative Networks (ICoNN) model. The meta-analyses that showed the most encouraging effect sizes were looking at two groups: treatment-resistant schizophrenia, and forms of psychotherapy that were highly specific and tailored according to case formulation, targeting delusions and auditory hallucinations.

The Wedging or Strengthening Technique has been modified in Germany and is called the Absorption Technique to create resources to deal with what the client is concerned about in the future, or having stress about working with eye movement desensitization and reprocessing (EMDR) in the future, a present trigger or even an intrusive memory. Having clients imagine a strength or skill that would help them during the problem often helps them to reduce their anxiety. Focusing on a specific strength or coping skill may create a wedge of safety or control that will assist clients with the difficult situation in the future. During the Future Phase of the Inverted Protocol for Unstable complex post-traumatic stress disorder (C-PTSD) use the Absorption or Wedging Technique to develop as many different resources for the different issues about which the client might be concerned.

Eye movement desensitization and reprocessing (EMDR) Standard protocol connects a trauma model of relationships to Bowen’s concept of differentiation. In addition to those couples where a traumatic episode, prior to or during the relationship, has had a clear impact on the relationship, highly reactive couples are those who profit most from integrating EMDR into their couples work. EMDR can play an important role when reactivity in sessions blocks therapist interventions or resists routine interventions; when one or both partners are so reactive as to be abusive. When EMDR is used to treat trauma, therapists generally look for treatment change specific to the trauma and its posttraumatic stress disorder (PTSD)-like symptoms. In couples therapy, the desired outcomes are more the generalized effects of EMDR and those we might expect from EMDR performance enhancement.

This chapter looks at dissociation, psychosis, and schizophrenia from a phenomenological standpoint. Phenomenology is the lens through which psychiatrists look at mental illness, and psychiatry as a specialty has looked at people in this way from its earliest days. In taking a phenomenological view of dissociation and psychosis, the chapter reiterates some of the dissonance brought by Laing when he invited people to understand schizophrenia as a theoretical model and not a biological entity. Extreme dissociation is the most primitive form of survival, where a human being is confronted with events that are impossible to process. Treating schizophrenia by formulating it within a trauma and dissociation paradigm allows for the application of eye movement desensitization and reprocessing (EMDR) therapy, which is one of the current international gold-standard psychotherapies for posttraumatic stress disorder (PTSD).

This chapter serves as a one-stop resource where therapists can access a wide range of word-for-word scripted protocols for Eye Movement Desensitization and Reprocessing (EMDR) practice, including the past, present, and future templates. These scripts are conveniently outlined in an easy-to-use, manual style template for therapists, allowing them to have a reliable, consistent form and procedure when using EMDR with clients. As part of the author, Sheila Sidney Bender, discussion with her patients about their mind and the adaptive information processing (AIP) system, she find that patients are sometimes unable to find responses when asked about a picture representing the worst part of the event. It is her opinion that it is advantageous for the clinician to attempt to get all the pieces to the protocol and she recommend the scripts, such as Negative Cognition (NC), Positive Cognition (PC), and Validity of Cognition (VoC) as possible ways to do so.

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.

This chapter describes the eye movement desensitization and reprocessing (EMDR) protocol for dissociative identity disorder (DID). It help readers to understand how aspects of the Standard EMDR Protocol need to be adapted to work well with DID clients during the Assessment, Desensitization, and Installation Phases, in particular how to set up the Standard Protocol, establish the subjective units of disturbance (SUD) level, and acquire the negative cognition (NC), positive cognition (PC), and validity of cognition (VoC). An amnestic trauma is by definition a trauma that, when activated, is experienced as happening now. In other words, an amnestic trauma is not over but continues in the present when recalled. The chapter presents an explanation of EMDR and an explanation of three issues critical for successful EMDR processing: not reliving trauma, remaining aware of the present while processing the past, and going through a trauma from start to finish.

Eye movement desensitization and reprocessing (EMDR) therapy offers an efficient method to digest the toxic psychological pathogen, which we hypothesize to be the dysfunctional memory network (DMN). This, in turn, according to the adaptive information processing (AIP) model, ought to result in a diminution or resolution of psychosis. This chapter outlines the customary intention of the treatment phase in the standard model before noting the relevant Indicating Cognitions of Negative Networks (ICoNN) modifications. Treatment planning sets the route for the therapeutic journey. In a standard case, careful history taking acquires one or more targets that relate to DMNs. These DMNs are triggered for the person by internal and/or external stimuli, and when triggered they result in unfortunate emotional, cognitive, and behavioral reactions. These reactions are essentially the phenomena that have brought the person into therapy at this point in his or her.

This chapter serves as a one-stop resource where therapists can access a wide range of word-for-word scripted protocols for Eye Movement Desensitization and Reprocessing (EMDR) practice, including the past, present, and future templates. These scripts are conveniently outlined in an easy-to-use, manual style template for therapists, allowing them to have a reliable, consistent form and procedure when using EMDR with clients. Whenever an EMDR treatment session becomes problematic, consider clinician awareness questionnaire self-administered instrument when reflecting on this session. EMDR consultants can also use this measure in their consulting groups to assist consultees in understanding when work with clients have an impact on the clinician. Often times, the clinician’s triggers are from old memories. These memories may be explicit; at other times, implicit. As clinicians begin to notice these moments in themselves, they may aid themselves and their clients in continuing productive processing by using the Clinician Awareness Questionnaire.

This chapter helps the reader to understand the justifiable optimism when applying eye movement desensitization and reprocessing (EMDR) therapy to psychosis and to equip clinicians with the skills to identify those people experiencing psychosis who are most suitable for EMDR therapy. The adaptive information processing (AIP) model and the dysfunctional memory network (DMN) are paradigms that have validity beyond posttraumatic stress disorder (PTSD); they are just as valid for addictions, obsessive-compulsive disorder, depression, and psychosis. The chapter explores the people who are suitable for EMDR therapy for psychosis, using the Indicating Cognitions of Negative Networks (ICoNN) model, in two groups: first, people with psychosis who have a clear trauma history or comorbid PTSD; and second, those who meet current criteria for schizophrenia within the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD) classification systems in addition to the proposed criteria for dissociative schizophrenia.

Studies have evaluated the usefulness of Eye Movement Desensitization and Reprocessing (EMDR) following disaster events finding that this approach could be effective in significantly reducing post-traumatic symptoms. EMDR has been reported as effective in the treatment of children following a hurricane in Hawaii. Group therapy is a well-proven form of treatment for traumatized children and adolescents. The EMDR-Integrative Group Treatment Protocol (IGTP) was developed by members of AMAMECRISIS when they were overwhelmed by the extensive need for mental health services after Hurricane Pauline ravaged the western coast of Mexico in 1997. This protocol combines the Standard EMDR Treatment Phases 1 through 8. Designed initially for work with children, the EMDR-IGTP has also been found suitable for group work with adults. The protocol is structured within a play therapy format and has been used with disaster victims ages 7 to 50 +.

The eye movement desensitization and reprocessing (EMDR) method represents a significant advance in psychotherapy. While most of the empirical research on EMDR demonstrates its efficacy as a treatment for posttraumatic stress disorder (PTSD), including relational traumas. Dysfunctional patterns of relating in the family of origin can imprint themselves on the relational template of adults, only to be reenacted in the contemporary couples relationship. Because EMDR can be effective at transforming these earlier relational traumas, adults can become less reactive, enjoy greater distress tolerance, and have a more resilient ego boundary. Thus, EMDR is an invaluable tool in couples therapy. A 5-step protocol is proposed that can guide therapists to develop an EMDR treatment plan within the context of couples therapy. This protocol can and should be applied to both partners in most cases, but of necessity, the therapist must choose one partner to begin with.

This chapter serves as a one-stop resource where therapists can access a wide range of word-for-word scripted protocols for Eye Movement Desensitization and Reprocessing (EMDR) practice, including the past, present, and future templates. These scripts are conveniently outlined in an easy-to-use, manual style template for therapists, allowing them to have a reliable, consistent form and procedure when using EMDR with clients. The rationale for creating the Resource Map consists of a structured format and record of the resources that have been identified and installed that can be collected and used again in the future. It also consists of multiple resources that empower the client and Level of Connection (LoC) scale, which is designed to overcome the limitations of trying to guess if the installation is working from qualitative signals. It is inspired by the validity of cognition (VoC) and attempts to better gauge progress in nonverbal domains.

This chapter serves as a one-stop resource where therapists can access a wide range of word-for-word scripted protocols for Eye Movement Desensitization and Reprocessing (EMDR) practice. It discusses phobia protocol script notes. The fear is generated by the sight of the object and is independent of further participation. When targeting a process phobia, the clinician must address all the pertinent aspects of the experience, including the decision-making and anticipatory anxiety. Although the procedures for the simple phobia may eliminate the client’s self-perceived fear, they may not overcome the evolutionary biases challenged by a Behavioral Avoidance Test (BAT). Although the Simple Phobia Protocol may be sufficient in many instances, some phobia researchers believe that the division is not useful and that the Process Phobia Protocol should be used exclusively. Eye movement desensitization and reprocessing EMDR, simple phobia protocol, process phobia protocol, decision-making, anticipatory anxiety, self-perceived fear, and behavioral avoidance test BAT.

In this third category of presentations in the Indicating Cognitions of Negative Networks (ICoNN) model, the psychotic phenomena are evident, causing distress and a functional impairment. However, the psychological pathogen cannot be identified in the standard way and strong emotions cannot be tracked back across an affect bridge. The main phenomena that characterize this category of ICoNN cases are “heard voices” that can be spoken with. They act as a proxy for the dysfunctional memory network (DMN). Reprocessing is ultimately accomplished using an ego-state approach/voice dialogue approach with the facilitation of the dual attention stimulation/bilateral stimulation (DAS/BLS) elements of the eye movement desensitization and reprocessing (EMDR) therapy method. It is vitally important that the therapist work to develop the first three features of effective psychotherapy: an emotionally charged relationship, a therapeutic environment, and a rationale/myth that provides a plausible explanation for the symptoms.

It is helpful to introduce the concept of Adaptive Information Processing, to help Eye Movement Desensitization and Reprocessing (EMDR) clients understand the nature of how our brains work. The second phase of EMDR is called the Preparation Phase. When EMDR first started, practitioners often went from Phase 1-Client History Taking to Phase 3-Assessment Phase with just a brief moment to introduce the client to the specifics such as the mechanics of EMDR, including bilateral stimulation (BLS), sitting position, and stop signals. For some clients, this has worked well, however, as time went on, practitioners often reported that something more was needed before beginning desensitization and reprocessing. The idea of tapping into the client’s natural resources began within the Standard EMDR Protocol itself. In the face of man-made or natural catastrophes, practitioners have found that building resources are essential aspects of working with recent trauma, especially for children.

The Eye Movement Desensitization and Reprocessing Performance Enhancement Psychology Protocol (EMDR-PEP) addresses performance anxiety, self-defeating beliefs, behavioral inhibition, posttraumatic stress, and psychological recovery from injury for creative and performing artists, workplace employees, and athletes. The EMDR-PEP can be very useful with everyday nonpathological complaints such as procrastination, fear of failure, setbacks, and life transitions. The EMDR-PEP encompasses a full spectrum viewpoint regarding optimal functioning at work and in life. This perspective inspires clients to identify their strengths as well as areas to improve and to prioritize their work accordingly. Reduced anxiety and increased self-confidence were reported for mature performing artists launching an existing repertoire into a new arena and in a controlled study of master swimmers. The following forms are included in the clinical intake for performance work: Trauma History and EMDR Readiness, Relationship History, School History, Employment History, Problem History, and a Performance Inventory.

This chapter presents a summary of the Current Anxiety and Behavior Protocol. For current anxiety and behavior problems, the Standard Eye Movement Desensitization and Reprocessing (EMDR) Protocol should be applied to the certain targets, including the past, present, and future templates. The chapter serves as a one-stop resource where therapists can access a wide range of word-for-word scripted protocols for EMDR practice. These scripts are outlined in an easy-to-use, manual style template for therapists, allowing them to have a reliable, consistent form and procedure when using EMDR with clients. After clients have processed their issue(s), they might want to work on positive templates for the future in other areas of their lives using the future templates. If new material comes ups during the Reevaluation Phase after the current anxiety and behavior were processed, target this material as soon as possible to make sure that the whole event have been reprocessed.

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.

Since people with dissociative disorders (DD) rely on autohypnotic defenses, this version of Safe Space Imagery (SSI) uses hypnotic language to teach the client to block out intrusive thoughts and feelings and learn how to get their body to a state of deep relaxation. Regular practice of SSI supports the client’s stability and becomes a coping skill used for self-soothing, symptom management, and eventually as an integral part of trauma processing. The SSI method is different from the Safe Place Protocol that is routinely taught in the eye movement desensitization and reprocessing (EMDR) Institute Basic Training. The SSI protocol is useful for many clients with trauma histories and for those with DDs. In SSI exercise one part volunteers to go first while the others watch. This approach works well when one want to teach a client SSI and there are protective or suspicious parts that need to stay hypervigilan.

This chapter serves as a one-stop resource where therapists can access a wide range of word-for-word scripted protocols for Eye Movement Desensitization and Reprocessing (EMDR) practice, including the past, present, and future templates. Client history taking is an important part of well-prepared clinicians’ understanding of their clients. The Time Line Script is based on a number of personal communications with other EMDR clinicians. Start with the best events and ask for the negative events in the session. When all of the memories are gathered, it is helpful to plot them onto a “Positive and Negative Memories Map”. This Map allows for a visual presentation along the time line of the client’s life and offers a window into what the important landmarks of the client’s life were for the clinician and client to see together.

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.

The standard Safe Place Protocol uses a word for cuing and self-cuing. For the last 3 years, the author has used olfactory stimulation with more than 30 children and adolescents to cue the Safe Place and resources installed with the Resource Development and Installation (RDI) Protocol. The effectiveness of olfactory cues to assist traumatized children in accessing previously installed resources for self-regulation may be associated with the relationship between trauma and thalamic activity. Individuals with simple post-traumatic stress disorder (PTSD) might show an increase in thalamic activity and those with complex PTSD, a decrease in thalamic activity. For many years, aromatherapy has been used as an adjunctive form of therapy in mental health. Before establishing the Safe Place, it is important that you explain to the child and the caregivers what eye movement desensitization and reprocessing (EMDR) is and how it works, especially the different forms of bilateral stimulation (BLS).