In my experience over the past twelve years of training psychotherapists in EMDR basic training, most report having difficulty working with clients who have very complex trauma in their background. The difficulty arises in identifying when and how to proceed with EMDR processing. Therapist report concerns about their clients becoming overwhelmed by the EMDR process. They report receiving little or no education in their graduate program on recognizing dissociation. Therefore, it is not surprising that the greatest criticism of EMDR is that it can be overwhelming to the client. The powerfulness of the process makes EMDR so effective and yet very scary for some therapist when they are not sure of what they are observing and have no frame of reference.
While EMDR does not cause dissociation, it does act as a lightning rod if dissociation is present in the client. Paulson and the EMDR task force created strategies using EMDR with ego state work. While the DES is a helpful tool to identify dissociation other tools are available to identify core beliefs that guide the client’s decision-making and coping skills. Van der Hart identified that dissociation occurs on a spectrum, which may not be identified by the DES.
Jeffery Young’s schema approach conceptualizes a model of treatment for complex cases that can be combined with EMDR to get the most profound results. Theses additional tools help with making the approach to processing more strategic and smoother for therapist and client. These tools give therapist quick feedback and confidence in how to proceed in the case conceptualization and history-taking phase.
In my advanced training,"For Complex Trauma Found in Personality, Addictive and Dissociative Disorders", I help to increase the therapist's skills in processing EMDR with complex cases. Course objectives include: providing tools to the therapist to quickly assess the emotional needs of the client and develop personal resources designed for that patient. Learn the inner psychic experiences of their patients through schema testing for targeting and processing core beliefs that interfere with functioning and happiness. Gain skills on how to stabilize addictive disorder patients and weave EMDR into their treatment plan. Address the phobia of attachments and affect that interferes in developing healthy relationships with complex trauma and dissociative clients. This 14 hr course was developed from research applications and clinical case studies reported by myself and other EMDR therapist. The workshop is a EMDRIA credit approved workshop. For more information, to register for a workshop, go to www.emdrtrainer.com
Wednesday, April 10, 2013
Wednesday, July 28, 2010
Applications In Using EMDR
EMDR is the most effective psychotherapy I have found in my 31 years of practice. As I teach new students I continue to learn from them in their application of EMDR. Consultation for 10 hours is offered through web conferencing with the training. In 09, one of my students, a sex therapist used EMDR with a gentleman that had a problem with premature ejaculation. After completing a few sessions of EMDR the problem was resolved.
Another therapist, who was running a detoxification program for substance abuse, started using some techniques used in the preparation phase in EMDR in “detox “and found that this better prepared people for substance abuse treatment. The holidays are usually times where patients leave against medical advice. In his experience people stopped leaving treatment when they had developed a safe place and learned to relax. This student also used EMDR on people who had relapsed and found that people were better able to reengage in treatment when they had worked through the guilt and shame associated with relapse. It is very exciting to receive such positive feedback from the effects of EMDR.
Complex trauma is the most difficult to treat. One must go slowly with people that have suffered complex trauma. Many people have different levels of dissociation with a fragile ego structure. EMDR may be used with this population but only after extended preparation, and for the therapist, more education on using EMDR with complex trauma. Like many EMDR trained therapists, I jumped too quickly in using EMDR and had people dissociate in session. This can be quite a scary experience, one must screen for dissociation and that does not always work. So going slowly, and combining EMDR with ego state therapy helps complex cases really make progress, not just band aide with medication.
As a therapist you learn many techniques but some are more helpful than others. Certainly over the years cognitive behavioral therapy has proven to be effective and is science based. EMDR combines so many different therapies such as cognitive behavioral, mindfulness, psychodynamic, gestalt, body work, just to name a few. The application and timing is so important to help a client move from a state of powerlessness to feeling empowered. Seeing people take power, control, and responsibility for their life and no longer experiencing life as a victim is what sold me on this therapy and changed the course of my career.
Another therapist, who was running a detoxification program for substance abuse, started using some techniques used in the preparation phase in EMDR in “detox “and found that this better prepared people for substance abuse treatment. The holidays are usually times where patients leave against medical advice. In his experience people stopped leaving treatment when they had developed a safe place and learned to relax. This student also used EMDR on people who had relapsed and found that people were better able to reengage in treatment when they had worked through the guilt and shame associated with relapse. It is very exciting to receive such positive feedback from the effects of EMDR.
Complex trauma is the most difficult to treat. One must go slowly with people that have suffered complex trauma. Many people have different levels of dissociation with a fragile ego structure. EMDR may be used with this population but only after extended preparation, and for the therapist, more education on using EMDR with complex trauma. Like many EMDR trained therapists, I jumped too quickly in using EMDR and had people dissociate in session. This can be quite a scary experience, one must screen for dissociation and that does not always work. So going slowly, and combining EMDR with ego state therapy helps complex cases really make progress, not just band aide with medication.
As a therapist you learn many techniques but some are more helpful than others. Certainly over the years cognitive behavioral therapy has proven to be effective and is science based. EMDR combines so many different therapies such as cognitive behavioral, mindfulness, psychodynamic, gestalt, body work, just to name a few. The application and timing is so important to help a client move from a state of powerlessness to feeling empowered. Seeing people take power, control, and responsibility for their life and no longer experiencing life as a victim is what sold me on this therapy and changed the course of my career.
Tuesday, January 6, 2009
Strategies using EMDR with Borderline Personality Disorders
Developmentally borderline personalities tend to be fixated between two or three years of age. Higher functioning persons with this diagnosis fall within the three year old range.
Traits
identity confusion
splitting
emotionally labile
Feeling abandoned by primary caregiver.
rage attacks
all or nothing thinking, black or white
double bind in family reinforced for failing, need continued rescuing, helps defends against fear of abandonment
intense unstable relationships
Cutting
Recent research indicates EMDR using eye moments will help reduce or stop cutting behavior.
Strategies
Stabilization- Usually a broken relationship triggers abandonment anxiety and will bring a person into treatment. Use Resource Development created by Andrew Leeds to enhance functioning and stabilization. When you install the safe place have the client recall their highest level of functioning when their self esteem was high and they felt good about themselves. Anchor the moment, so the individual has access and can replay in moments of feeling labile.
Since abandonment is an underlying issue, target earliest memories of abandonment and have the anchored adult self go back in time and rescue the hurt abandoned child. Take time with this process going too fast may destabilize the client.
Take time with resourcing the patient before you start targeting the early deprivation and abandonment issues.
Target the different traits for processing using EMDR. For example use the float back technique to identify the earliest memories of rage attacks process past, present and future. Abandonment anxiety when the client started to experience success.
Traits
identity confusion
splitting
emotionally labile
Feeling abandoned by primary caregiver.
rage attacks
all or nothing thinking, black or white
double bind in family reinforced for failing, need continued rescuing, helps defends against fear of abandonment
intense unstable relationships
Cutting
Recent research indicates EMDR using eye moments will help reduce or stop cutting behavior.
Strategies
Stabilization- Usually a broken relationship triggers abandonment anxiety and will bring a person into treatment. Use Resource Development created by Andrew Leeds to enhance functioning and stabilization. When you install the safe place have the client recall their highest level of functioning when their self esteem was high and they felt good about themselves. Anchor the moment, so the individual has access and can replay in moments of feeling labile.
Since abandonment is an underlying issue, target earliest memories of abandonment and have the anchored adult self go back in time and rescue the hurt abandoned child. Take time with this process going too fast may destabilize the client.
Take time with resourcing the patient before you start targeting the early deprivation and abandonment issues.
Target the different traits for processing using EMDR. For example use the float back technique to identify the earliest memories of rage attacks process past, present and future. Abandonment anxiety when the client started to experience success.
Thursday, December 18, 2008
Differences in EMDR Training Workshops
How is my training different or the same as other EMDR workshops?
In order to be a trainer, a therapist must be approved by EMDRIA as a Basic Training Provider. Each trainer’s manual has been approved with preset specifications according to EMDRIA requirements. The Basic Training has been accredited for 40 CEU’s.
How we differ is in format, length and price.
As a single provider, I am allowed to train a max of 10 students at a time. In some locations, there may be more than one trainer on site allowing for more participants.
I decided on a 5 day format rather than over 2 weekends. I have found this better equips the therapist and improves success in the early stages of using EMDR. It’s important to fully discuss and practice the process and techniques in great depth. This helps to build the therapist’s confidence and comfort level in facilitating the treatment process with the client.
I have kept the fee within the standard rate, and included the ten hours of group consultation for no addition cost. To complete the training, one must complete the ten hours of group consultation. This ensures all students will have the opportunity to totally complete the training requirements. The consultation group meets every other week after the workshop via internet conferencing to go over case studies and answer any questions. This makes it convenient and speeds up the completion process. After the required 10 hours of group consultation your certificate of completion is mailed to you. For those that wish to a certified EMDR Therapist an additional 20 hours of consultation is required with completing 50-75 EMDR sessions with at least 25 clients. As a consultant, I can further assist with that process via web conferencing or by phone. I am always just a phone call away to answer any of my students’ questions.
In order to be a trainer, a therapist must be approved by EMDRIA as a Basic Training Provider. Each trainer’s manual has been approved with preset specifications according to EMDRIA requirements. The Basic Training has been accredited for 40 CEU’s.
How we differ is in format, length and price.
As a single provider, I am allowed to train a max of 10 students at a time. In some locations, there may be more than one trainer on site allowing for more participants.
I decided on a 5 day format rather than over 2 weekends. I have found this better equips the therapist and improves success in the early stages of using EMDR. It’s important to fully discuss and practice the process and techniques in great depth. This helps to build the therapist’s confidence and comfort level in facilitating the treatment process with the client.
I have kept the fee within the standard rate, and included the ten hours of group consultation for no addition cost. To complete the training, one must complete the ten hours of group consultation. This ensures all students will have the opportunity to totally complete the training requirements. The consultation group meets every other week after the workshop via internet conferencing to go over case studies and answer any questions. This makes it convenient and speeds up the completion process. After the required 10 hours of group consultation your certificate of completion is mailed to you. For those that wish to a certified EMDR Therapist an additional 20 hours of consultation is required with completing 50-75 EMDR sessions with at least 25 clients. As a consultant, I can further assist with that process via web conferencing or by phone. I am always just a phone call away to answer any of my students’ questions.
Please feel free to email me with any questions.
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