Emdr for Trauma_ Eye Movement Desensitization and Reprocessing With Francine Shapiro

8/9/2019 Emdr for Trauma_ Eye Movement Desensitization and Reprocessing With Francine Shapiro

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EMDR FOR TRAUMA: EYE MOVEMENT DESENSITIZATION ANDREPROCESSING with Francine Shapiro PhDItem # 4310440$69.95 members/affiliates$99.95 non-members

P!rpo"e o# the Serie"

The American Pscholo!ical Association Pschothera" ieo %eries II "resents istin!&ishe"schothera"ists of ifferent theoretical orientations emonstratin! s"ecific treatments for s"ecific "roblemsan "o"&lations. 'esi!ne for clinical trainin! as (ell as for contin&in! e&cation) the *ieota"es sho(s"ontaneo&s an &nscri"te sessions) t"icall re"resentin! the thir or fo&rth session in an on!oin! co&rse of"schothera" an t"icall lastin! 40 to 50 min&tes. The clients are "ortrae b "rofessional actors on thebasis of real case materials.

The session o& (ill *ie( attem"ts to ca"t&re the thera" a""roach an clinical stle in as close to realcirc&mstances as "ossible.

To(ar this en) a n&mber of ste"s (ere ta+en to ens&re that both the thera"ist an the client (ere anchore)conce"t&all an e,"erientiall) in the clinical material) each other) an "re*io&s sessions. irst) thera"istsinicate the t"e of client an clinical "roblem (ith (hich the t"icall (or+ or belie*e allo(e the bestemonstration of their a""roach. %econ) a client "rofile (as ine"enentl e*elo"e that incl&eemo!ra"hic ata) clinical histor) "resentin! "roblem) "reci"itatin! e*ent) an other bac+!ro&n information.Thir) the thera"ist re*ie(e this "rofile for its re"resentati*eness an then escribe (hat he or she t"icall(o&l o an (o&l ha*e ho"e to accom"lish in the first t(o or three sessions. o&rth) "rofessional actorsae"t at im"ro*isation (ere immerse in this clinical histor an "resentation thro&!h formal role in&ction ofthe actors b an ine"enent "ractitioner) to ens&re that the actor ha both a co!niti*e &nerstanin! an ane,"eriential sense of (hat the client (as str&!!lin! (ith) thin+in!) an feelin!. inall) the actor in role anthe thera"ist re*ie(e the content an "rocess of their earlier sessions immeiatel before the *ieota"in! sothat the (ere both anchore in conte,t of the co&rse to ate of the "artic&lar thera"e&tic relationshi".

A$o!t Dr% Shapiro

Francine Shapiro PhDis the ori!inator an e*elo"er of '2 e o*ement 'esensitiation an2e"rocessin!) an is a senior research fello( at the ental 2esearch Instit&te in Palo Alto) alifornia. %heser*es as the ,ec&ti*e 'irector of the '2 Instit&te in Pacific ro*e) alifornia) an of the '2&manitarian Assistance Pro!ram) a non"rofit or!aniation that coorinates isaster res"onse an "ro*ies"ro bono trainin!s (orl(ie.

'r. %ha"iro has (ritten o*er 30 articles an boo+ cha"ters an 7 boo+s abo&t '2) e o*ement'esensitiation an 2e"rocessin! 1995 an '2 1998. %he has been an in*ite "resenter at maor"scholo! conferences o*er the "ast 10 ears an (as a(are the 1993 'istin!&ishe %cientificAchie*ement in Pscholo! A(ar b the alifornia Pscholo!ical Association.

'r. %ha"iro:s "rimar area of interest o*er the co&rse of her career has been e*elo"in! a com"rehensi*e

treatment a""roach that inte!rates the &e contrib&tions of the maor "schothera"e&tic orientations. As aclinical "scholo!ist) she belie*es that the maor challen!e confrontin! the "rofession is to fin a (a to closethe !a" bet(een science an "ractice. To(ar this en) she has lon! a*ocate for the stanar incor"orationof acce"te clinical stanars into "schothera" o&tcome research.

EMDR #or Tra!&a ' S(nop"i" o# Therap( Approach

'2 e o*ement 'esensitiation an 2e"rocessin! is a com"le, treatment a""roach that combinessalient elements of the maor thera"e&tic schools e.!.) co!niti*e) beha*ioral) "schonamic) "hsiolo!ical)


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an interactional. Altho&!h the ee mo*ement stim&lation an other forms of &al stim&lation &se in thea""roach ha*e !arnere the most attention "rofessionall an "&blicl) '2 act&all in*ol*es a m&chbroaer s"ectr&m of inter*entions) (hich are or!anie into ei!ht "hases of thera". &rrentl) 13 com"letecontrolle st&ies of '2 ma+e it one of the most researche methos of "schothera" &se in thetreatment of tra&ma. Its efficac has been s&""orte b these st&ies< the fo&r most recent st&ies of *ictims(ho ha*e s&ffere sin!le tra&mas ha*e emonstrate that after the e;&i*alent of three 90-min&te sessions)=4> to 90> of "atients no lon!er ha*e sm"toms of "osttra&matic stress isorer PT%'? 2othba&m) 1998?

@ilson) ec+er) B Tin+er) 1995.

'2 is base on the ass&m"tion that s"ecific e,"eriences from the "ast contin&e to !&ie the client:sres"onses in the "resent. These e,"eriences can be the Cbi! TC tra&mas that res&lt in PT%' or the Csmall tCtra&mas that are the &bi;&ito&s e,"eriences +no(n to ha*e a less ramatic b&t still ne!ati*e im"act on"ersonalit an beha*ior.

To infl&ence s&ch e,"eriences from the "ast) '2 ra(s on an information "rocessin! moel of beha*ior.once"t&all) ist&rbin! tra&ma-relate information is belie*e to be hel in the "atient:s ner*o&s sstem instate-e"enent form e.!.) the "erce"tions an sensations e,"erience at the time of the tra&ma are encoein the ner*o&s sstem. '2 allo(s the "rocessin! of this information in an aa"ti*e fashion so that (hat is&sef&l from the e,"erience can be learne? store a""ro"riatel) co!niti*el) an affecti*el? an maea*ailable for beha*ioral !&iance in the f&t&re. @hat is &seless to aa"tation) s&ch as e,cess ne!ati*eemotions) irrational self-assessments) an ist&rbin! "hsical sensations) can be iscare.

Assessment is foc&se not on !lobal ia!noses b&t rather on s"ecific elineations of "roblematic beha*iors)attit&es) an affects that nee to be transm&te to allo( for aa"ti*e resol&tion of tra&ma or conflict.%"ecificall) the '2 clinician as+s) (hat is the "atient bein! infl&ence b "ast e,"eriences to o in the"resent that is sf&nctional an (hat is he or she "re*ente from oin! that (o&l be aa"ti*eD

Altho&!h ori!inall a""lie to PT%') '2 sho(s "romise in a *ariet of clinical com"laints that are base onearlier life e,"eriences that &nerlie the "atholo! an c&rrent e,"eriences an that restim&late theist&rbance. '2 allo(s clients to access an re"rocess these e,"eriences as (ell as to learn ne( s+illsan beha*iors for mana!in! f&t&re life e*ents. In all cases) the !oal of '2 is to "ro&ce the mostcom"rehensi*e an "rofo&n treatment effects in the shortest "erio of time) (hile hel"in! the client to remainreasonabl stable.

'2 as an ei!ht-"hase inter*ention a""roach can be consiere a com"lete treatment in some clinical

cases) or it ma be "art of a more com"le, treatment "lan that incl&es other more traitional a""roaches totreatin! a s"ecific "atholo! e.!.) borerline "ersonalit isorer. @ithin this latter inte!rati*e conte,t) '2a""ears to be &sef&l for a broa ran!e of clinical com"laints an seems to "ro*ie more ra"i achie*ement of"ositi*e treatment effects than o these more traitional a""roaches alone.

'r. %ha"iro ientifies her a""roach as Cee mo*ement esensitiation an re"rocessin!.C @hat oes this im"lto o&D ore s"ecificall) (hat o o& e,"ect of herD @ill 'r. %ha"iro be acti*e or "assi*eD @ill the session bestr&ct&re or &nstr&ct&reD 'irecti*e or nonirecti*eD @ill it foc&s on the "ast or on the "resentD @ill thesession foc&s on beha*iors) on tho&!hts) or on feelin!sD @hat o o& e,"ect to be the relati*e balancebet(een attention to techni;&e *ers&s the inter"ersonal interactionD

C)ient *ac+,ro!n- an- Precipitatin, E.ent"


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Matthew /Matt0 1a$o+a"A,e:47Se2:aleRace:a&casianMarita) Stat!":arrieChi)-ren:T(o a&!hters 1= an 70 ears ol) both in colle!eE-!cation:i!h school !ra&ate

Occ!pation:2etire Police Efficer? c&rrentl (or+in! sec&rit in ae"artment storeParent":ather ecease? mother ali*e an li*in! (ith "atient:so&n!est sisterSi$)in,":Three brothers o&n!er? Ene sister o&n!er

att entere treatment 6 months after he ha retire from the "olice force) (hen his (ife insiste that heobtain a ob an see+ "scholo!ical hel" or she (as !oin! to lea*e him. e tol her he (o&l !et a ob firstan if that in:t hel") he (o&l see+ treatment. e starte (or+ as a sec&rit !&ar) b&t 7 (ee+s later he feltas if his (orl (ere fallin! a"art. e (as ha*in! iffic&lt mana!in! a ob that &ner other circ&mstances he(o&l see as a Cno brainer.C e ha iffic&lt slee"in!) ha ni!htmares (hen he i slee") an (as s&bect tofre;&ent "anic attac+s at (or+. At the en of those 7 (ee+s he (as con*ince that he neee hel".

att:s retirement from the "olice force:s homicie i*ision occ&rre after 74 ears of eicate) o&tstanin!ser*ice. e ha (or+e lon! ho&rs thro&!ho&t his career an too+ !reat "rie in the cases that he ha sol*e?ho(e*er) he also felt relentless !&ilt for those cases to (hich he (as assi!ne that (ent &nsol*e. Altho&!h heha al(as "romise his (ife he (o&l retire after 70 ears) it too+ the line-of-&t eath of his "artner to"reci"itate his lea*in! the force.

A thir-!eneration Fith&anian) an the olest of fi*e chilren) att !re( &" (ith a father (ho (as a "oliceofficer an a mother (ho (or+e at home raisin! the chilren. Accorin! to att) there C(as ne*er eno&!htmone)C as his father ha a "enchant for rin+in! an !amblin! e.!.) "lain! the n&mbers) b&t he (as aha"" r&n+ an !enero&s (hene*er his n&mber "ai off. att:s father ha not (ante att to become a"olice officer beca&se of the an!er an the relati*el lo( "a. @hen att !ra&ate from hi!h school) thestr&c+ a bar!ain that att (o&l !o to colle!e for 7 ears. If) after that) he (ante to oin the "olice force) hisfather "romise to s&""ort the ecision. o(e*er) his father ie of a s&en heart attac+ the s&mmer afteratt !ra&ate hi!h school. att ecie to oin the "olice force immeiatel) at a!e 1=.

att marrie his (ife) F&c) 7 ears after oinin! the force) an 7 ears later the ha the first of their t(oa&!hters. att starte as a "atrolman) li+e his father. e (as ner*o&s on enterin! the force an (as !ratef&l(hen he (as assi!ne a "artner) Gohn) se*eral ears his senior) (ho too+ him &ner his (in!) ta&!ht him (hat(as im"ortant on the ob an (hat (as not) an socialie (ith him after ho&rs. att iealie Gohn for theirfirst 7 ears as "artners? Gohn:s onl fa&lt seeme to be his "re&ice a!ainst is"anics) (ho forme a lar!e"ro"ortion of the "o"&lation on their beat.

Ene ni!ht att an Gohn res"one to a brea+in! an enterin! call from a ho&se in a (ealth nei!hborhoo.The a""rehene a o&n! is"anic male scalin! the fence aro&n the s(immin! "ool) his "oc+ets fille (ithe(elr. Gohn "inne o(n the s&s"ect) then hanc&ffe him an le him to the fence. att (ent to raio forhel". efore att !ot to the "atrol car) he hear a !&nshot. e hesitate for a moment before t&rnin! bac+) an(hen he hear a secon shot he raioe ;&ic+l an ran bac+. The "risoner la face o(n) 50 feet from thes(immini! "ool) (ith a b&llet in his bac+.

att:s first feelin! (as relief that it (as the "risoner) not his "artner) (ho (as ea. &t his secon tho&!ht(as a more s&s"icio&s one< is last memor (as of Gohn hanc&ffin! the "risoner? ho( i the "risoner en&" eaD att t&rne to Gohn) (ho loo+e ol &nemotional !i*en (hat ha &st occ&rre. C@hat the hellha""eneDC as+e att.

CI (as hanc&ffin! him to the fence)C Gohn sai) Can the son of a bitch bro+e free an ran. I sho&te for him tosto" b&t he in:t so I shot a (arnin!. e +e"t r&nnin!) so I fire at him. I in:t mean to +ill him) man) onl tosto" him. Ges&s) I:m !oin! to catch hell for this one.C


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%omethin! abo&t the (a Gohn a*oie loo+in! at him att feel sic+. If the man han:t been is"anic) atttho&!ht) mabe he (o&l still be ali*e. att contin&e to (or+ (ith Gohn for the ne,t se*eral (ee+s b&t fo&nhe co&l no lon!er tal+ or o+e (ith him. e finall as+e Gohn to re;&est a chan!e in "artners. The fact thatGohn a!ree to o this (itho&t ;&estion seeme to confirm att:s (orst fears abo&t Gohn. att ne*er tolanone abo&t the shootin! incient) an) (hen ;&estione b Internal Affairs) he i not share his s&s"icions(ith them) altho&!h he later felt !&ilt for not s"ea+in!.

%oon after) att ecie to o (hat (as neee to become a homicie etecti*e. e (ante Cto be "art of thesol&tion)C he tol his (ife F&c) Cinstea of "art of the "roblem.C is e*otion to this ne( as"iration +e"t hima(a from home e*en more) b&t F&c (as &nerstanin!) es"ite &st ha*in! ha a secon chil. e (asoin! it in "art) the both tho&!ht) so that their financial f&t&re (o&l be bri!hter.

A fe( ears later) att (as assi!ne to the homicie i*ision) (here he (as hi!hl s&ccessf&l. is rate ofsol*in! m&rers (as abo*e a*era!e) in "art &e to his (or+in! man ho&rs o*ertime) al(as !oin! the e,tramile to fin the "er"etrator of (hat (o&l "ro*e to be man heino&s crimes. @ith t(o o&n! a&!hters to carefor) F&c (as less &nerstanin! of his absences from home. she (as) ho(e*er) "ro& of his s&ccess an thefact that) (hen he (as home) he s"ent as m&ch time as "ossible (ith their a&!hters. @hene*er F&c (o&lcom"lain) att (o&l "romise that he (o&l retire as soon as he ha 70 ears. @hen 70 ears came an(ent) an he (as still (or+in! o*ertime) their marria!e became e,tremel straine. oth a&!hters (ere incolle!e) an att &se this as a reason for not retirin!< no( more than e*er the neee the mone.

F&c s&!!este that she ta+e a f&ll-time ob as mana!er of the retail store (here she ha (or+e "art-timesince their a&!hters (ere in hi!h school. That (a) att co&l affor to retire. @hen att ref&se to e*enconsier this) F&c tol him that she (o&l (or+ f&ll-time if she (ante to) since he ha al(as one (hat he(ante.

After an initial tense "erio) F&c:s ne( ob act&all seeme to ecrease tension in the ho&se? her self-esteem!re( as her s&ccess as mana!er (as confirme. %he no lon!er com"laine abo&t att:s lon! ho&rs on theob.

In his 71st ear on the force) att (as assi!ne a ne( "artner) %am) (ho (as o&n!er than att b&t (ho habeen a s&ccessf&l homicie etecti*e on the east coast? his s"ecialt ha been or!anie crime. att hane*er met s&ch a bri!ht) effecti*e) b&t frienl etecti*e. %am enco&ra!e att to (or+ fe(er ho&rs on the ob)s&!!estin! that if he learne to (or+ CsmarterC he (o&ln:t ha*e to (or+ lon!er. To!ether) their s&ccess rate(as m&ch hi!her than either ha achie*e (ith "re*io&s "artners.

In a of att:s last ear on the force) he an %am (ere (or+in! on a r&!-relate case) (hich (as not&n&s&al. @hat (as &n&s&al (as %am:s intensit abo&t this "artic&lar case. %am seeme to see it as his casealone) an he +e"t att in the ar+ abo&t certain information) abo&t (hich att (o&l learn a fe( as later.The ar!&e abo&t this) (hich (as also &n&s&al. Ene ni!ht) %am) actin! alone an (itho&t tellin! att) set &"a stin! o"eration that (ent ba. is bl&!eone bo (as fo&n floatin! in the ri*er the ne,t a. att insisteon seein! %am:s cor"se in the mor!&e. *en after all his ears of seein! ea boies) he left the mor!&e*omitin!.

Thereafter) att became e,tremel e"resse an contem"late s&icie. rin! in be) after he tho&!ht F&cha !one to slee") att hear her ;&ietl sa) Catt) on:t o& thin+ o&:*e ha eno&!h) that (e:*e haeno&!hD Isn:t it time for &s to ha*e a lifeDC These (ors seeme a mirac&lo&s sol&tion to him) an he hearthe o"tion of retirement as if for the first time. is e"ression lifte? he felt li+e a ne( man. @ithin a month) heha retire (ith f&ll benefits.

The honemoon (ith retirement laste onl 7 (ee+s) ho(e*er. att then became irritable an morose) an hefoc&se his com"laints on the amo&nt of time F&c (or+e. *en tho&!h she (as a(a onl 40 ho&rs a (ee+)it seeme m&ch lon!er to him) an he be!an harassin! her to ;&it her ob. @hen she ref&se) the ar!&eheatel. After these ar!&ments) att (o&l s&enl feel an,io&s for F&c:s safet an be!an insistin! that heri*e her to an from (or+. This relie*e some an,iet an !a*e some str&ct&re to his a. &t soon he be!an(orrin! abo&t her safet on the ob) an he (o&l chec+ on her m&lti"le times &rin! a a. At first tolerant)F&c became embarrasse an an!r as the fre;&enc of his *isits increase. That is (hen she finall tol himthat he neee to !o to (or+ an see+ "scholo!ical hel" or she (o&l mo*e o&t.


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e a""lie for a ob in the H-art near his (ife:s store. %he (as not ha"" abo&t his "ro,imit) b&t at least he(as occ&"ie &rin! the a. att) ho(e*er) (as s&r"rise that he felt com"letel inae;&ate on the ob. eco&ln:t thin+ clearl or a""l his "olice e,"erience to the ne( sit&ation. The store ha a lar!e is"anicclientele) an he felt *er &ncomfortable (hen he s&s"ecte one of the is"anic c&stomers of sho"liftin!.Ima!es of the lon!-for!otten is"anic male his "artner ha shot came to him &nbien. e be!an to ha*e"anic attac+s) (hich he tho&!ht at first (ere heart attac+s &ntil that (as r&le o&t. is slee") ne*er normal)became e*en (orse) an he (as &s&all &" at 3 a.m.) a(a+enin! from a ni!htmare in (hich %am) loo+in!

"hsicall li+e he i in the mor!&e) +e"t trin! to sa somethin! that att co&l ne*er ma+e o&t in the ream.att (as left onl (ith the sense that if he co&l &nerstan (hat his "artner (as sain!) %am (o&l be ali*etoa.

These reams an a ima!es (ere so *i*i that att be!an to C(orr that he (as !oin! cra.C is (ife)seein! this) remine him of his "romise to !et "rofessional hel". This time) he amitte that he co&l not o itb himself an lon!er. Call an shrin+ o& (ant)C he sai) CI:ll !o.C

F&c ha calle the m"loee Assistance Pro!ram at the "olice force o*er a month earlier. The harecommene that att see 'r. rancine %ha"iro) an F&c calle her immeiatel. att ha an a""ointment(ithin 4= ho&rs.

3!e"tion"@hat is o&r im"ression of attD o( t"ical or at"ical are his life e,"eriences an his c&rrent beha*iorD

@hat o o& belie*e are the core iss&es for attD @hat is the &tilit of these initial form&lationsD

efore reain! the ne,t section) (hat to"ics an iss&es o o& thin+ (ill be aresse in the initial sessionsD

Proce"" Note" on Initia) Se""ion"

Se""ion 4:This 11/7 ho&r session (as e*ote to !ettin! a histor of the "resentin! "roblem an att:sf&nctionin! to etermine (hether he (as s&itable for '2 treatment< le*el of ist&rbance) "ersonal stabilit)an life constraints (ere e*al&ate. @hen s&itabilit (as ascertaine) the remainer of the session (ase*ote to !ettin! a com"lete clinical "ict&re of his sf&nctional beha*iors) sm"toms) an characteristics that(o&l nee to be aresse in treatment.

e,t) the s"ecific tar!ets that neee to be re"rocesse (ere efine< the is"anic "risoner:s eath in*ol*in!his ori!inal "artner) the mahem att ha (itnesse in his ears as a homicie officer) an the eath of his last"artner. Time (as also s"ent efinin! the "resent tri!!ers that stim&late the sf&nctional beha*iors.inall) the '2 "rocess (as e,"laine) incl&in! its effects) an rela,ation techni;&es for co"in! (ith hi!hstress (ere o&tline.

Se""ion 5:A (ee+ later) the secon session "ro*ie an o""ort&nit for att to as+ ;&estions abo&t thetreatment an isc&ss an sm"toms that ha occ&rre since the first meetin!. eca&se att ha been ha*in!intr&si*e tho&!hts of %am:s eath thro&!h the (ee+) an ha e,"erience hi!h an,iet o*er F&c:s safet) thetar!et 'r. %ha"iro selecte (as %am:s eath. 'r. %ha"iro as+e att to select the ima!e that best re"resentethis tra&ma) (hich att re"orte as seein! %am:s bo in the mor!&e. 'r. %ha"iro assiste att in ientifin!the ne!ati*e self-attrib&tion relate to this ima!e. This (as) sim"l) that CI:m to blame.C Then 'r. %ha"irohel"e att to ientif a "ositi*e co!nition that (as more rational) realistic) an em"o(erin!. This (as) &st as

sim"l) CI i the best that I co&l.C To "ro*ie a baseline meas&rement) 'r. %ha"iro as+e att to re"ort ho(*ali the "ositi*e co!nition felt on a 8-"oint aliit of o!nition E %cale) (ith 1 J it feels totall false an 8J it feels totall tr&e. e re"orte a le*el of 3 on this %cale.

'r. %ha"iro an att also isc&sse the emotions an the "hsical sensations associate (ith the tra&matice,"erience. The "rimar feelin! (as !&ilt. 'r. %ha"iro as+e att to rate the intensit of the emotion on a 11-"oint %&becti*e Knits of 'ist&rbance %K' %cale) (ith 0 J ne&tral an 10 J the (orst it co&l be) to "ro*ie abaseline from (hich to assess chan!es &rin! the "roce&re. att rate his !&ilt as a 9. e also note that heha feelin!s of "ain an a!itation in his stomach an arms.


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The act&al re"rocessin! of the tra&ma be!an 70 min&tes after this assessment. The threa of associationsatt comm&nicate (as CI let e*erone o(n.C e re"orte flashes of seein! his (ife) his first "artner) hisfather:s eath. att tal+e abo&t not ha*in! !i*en his father (hat he (ante L his father ie before he co&lma+e him "ro&. att be!an crin! an feelin! the !rief he ha ne*er let himself feel before. In s&ccessi*ere"rocessin! sets att sai sal) CI trie to be a !oo co" L I trie to be a !oo son L I i the best I co&l.C'r. %ha"iro ene the session b &sin! a stress re&ction techni;&e) ebriefin! att on the "otential for more"rocessin!) an "ro*iin! instr&ctions for +ee"in! a lo!.

Se""ion 6:To be ta"e.

3!e"tion"@ere the initial sessions as o& e,"ecteD

As o& rea this s&mmar of the "recein! sessions) (ere there an areas or to"ics that o& tho&!ht sho&lha*e been co*ere b&t (ere notD @hat other information (o&l o& see+ to assess the "atientD

efore *ie(in! the ta"e) (hat o o& thin+ (ill &nfol in the ta"e sessionD @hat iss&es (ill be isc&sseD@hat (ill the relationshi" bet(een 'r. %ha"iro an att be li+eD

%tim&l&s M&estions Abo&t the ieota"e %ession

In the be!innin! of the session) 'r. %ha"iro as+s att ho( his "re*io&s (ee+ (ent an attenti*el follo(s hislea (ith occasional ;&estions relate to their "re*io&s session.

@hat are the a*anta!es an isa*anta!es of be!innin! a session this (aD As a thera"ist) (o&l o& ha*eenco&ra!e att to contin&e e,"ressin! his concerns abo&t the "ast (ee+D @o&l o& ha*e create morestr&ct&re or e*elo"e an a!ena for the session b this "ointD

Abo&t 5 min&tes into the session) att escribes a rec&rrin! ream abo&t his ecease "olice "artner) %am)lin! in the mor!&e trin! to s"ea+ to him.

o( oes 'r. %ha"iro res"on to att:s ream an relate feelin!sD o( mi!ht "schothera"ists of othertheoretical orientations res"on to the ream materialD

Abo&t 6 min&tes into the session) 'r. %ha"iro elicits att:s *is&al ima!es) boil sensations) an ne!ati*eco!nitions associate (ith %am lin! in the mor!&e. %he then "rocees (ith '2 C"rocessin!C of the tar!etima!e b (a*in! her fin!ers in front of att:s *is&al fiel.

o( o o& antici"ate most clients (o&l initiall res"on to the fin!er (a*esD If o& (ere the client) ho((o&l o& reactD If o& (ere the thera"ist) (hat alternati*e methos mi!ht o& consier to C"rocessC the tar!etima!eD

After each ee mo*ement set) att e,"resses the tho&!hts) ima!es) feelin!s) or sensations that occ&r to him&rin! the ee mo*ements. 'r. %ha"iro rarel comments irectl on the content an instea briefl enco&ra!eshim to Csta (ith thatC or C&st thin+ of that.C Pscholo!ists traine in traitional forms of "schothera" areacc&stome to !reater *erbal "artici"ation in res"onse to a client e,"ressin! feelin!s.

As a thera"ist) (o&l o& be tem"te to res"on to a client:s feelin!sD As a client) (o&l o& be comfortable(ith this minimal amo&nt of thera"ist s"eechD

@hat are the thera"e&tic "ros an cons of s&ch minimal thera"ist s"eech after each set of ee mo*ementsD

Abo&t 71 min&tes into the session) att escribes a foreboin! sense of somethin! ne!ati*e ha""enin! to his(ife. e e,"resses an Cintense constrictionC in his chest an an an,io&s feelin!. 'r. %ha"iro contin&es the'2 "rocessin!.


7/8

Kner (hich circ&mstances) if an) (o&l o& as an '2 thera"ist iscontin&e the esensitiation "rocess infa*or of alternati*e methos of re&cin! a "atient:s an,ietD @hat other an,iet-re&ction methos mi!ht o&consierD

ollo(in! each set of ee mo*ements) 'r. %ha"iro instr&cts the "atient to Cblan+ it o&tC an to ta+e Ca ee"breath.C

@hat thera"e&tic "&r"oses o these instr&ctions ser*eD o( o o&) "ersonall) res"on to the irecti*e toCblan+ it o&t.C o( mi!ht clients *ario&sl inter"ret s&ch a irecti*eD

'r. %ha"iro:s closin! (ors of the session are Can I:m here if o& nee me. G&st call.C

er !enero&s offer stri+es ifferent *ie(ers in ifferent (as. o( i o& "ercei*e itD o( i att seem to"ercei*e itD or (hich "atients mi!ht her offer be ta+en as carin! a*ailabilit an for (hich "atients mi!ht it beta+en as an inicator that the e"enentl nee the thera"istD

In this emonstration session) 'r. %ha"iro &ses '2 to tar!et an "rocess att:s tra&ma of %am:s eath. the en of the session) att re"orts re&ce aro&sal) ecrease !&ilt) a sense of rela,ation) an feelin! Ca lotmore comfortable.C e concl&es) CNeah) I i (hat I co&l o.C

o( o o& acco&nt for these ra"i chan!es in one sessionD @hat ca&sal mechanisms or chan!e "rocessesseeme to o"erateD o( mi!ht a beha*ior thera"ist) a "schoanalst) or an e,istential thera"ist e,"lain thesechan!esD

Genera) 3!e"tion"

'i the session "ro!ress as o& antici"ateD @as att as o& e,"ecteD @as 'r. %ha"iroD

@hat are o&r !eneral reactions to the sessionD @hat i o& feel (as effecti*e in the thera"D @hat o o&thin+ (ere the stren!ths an the (ea+nesses of this a""roachD

If o& (ere not informe that this thera" is C'2C (hat (o&l o& ha*e calle itD

o() after reain! abo&t the "atient an *ie(in! this session) (hat are o&r ia!nostic im"ressions orcharacteriations of his "roblemD

o( (o&l o& "rocee (ith att:s thera"D @hat !oals (o&l o& setD o( man sessions o o& thin+ it(o&l ta+e to achie*e these !oalsD

S!,,e"te- Rea-in,"

arlson) G. .) hemtob) . .) 2&sna+) H.) el&n) . F.) B &rao+a) . N. in "ress. e mo*ementesensitiation an re"rocessin! for combat-relate "osttra&matic stress isorer. Go&rnal of Tra&matic %tress.

ensterheim) . 1996. e mo*ement esensitiation an re"rocessin! (ith com"le, "ersonalit "atholo!

Documents

Emdr for Trauma_ Eye Movement Desensitization and Reprocessing With Francine Shapiro