Eye Movement Desensitization and Reprocessing (EMDR) · 2nd Edition by Shapiro, Francine -- Read -- Imperial Library of Trantor

Index

Cover Title Page Copyright Dedication About the Author Acknowledgments Acknowledgments for the Second Edition Preface 1. Background A C HANCE D ISCOVERY T HE F IRST C ONTROLLED S TUDY F URTHER C LINICAL AND E XPERIMENTAL O BSERVATIONS S HIFT IN P ARADIGM A DAPTIVE I NFORMATION P ROCESSING T HEORETICAL C ONVERGENCES Posttraumatic Stress Disorder Psychodynamic Approaches Behavioral Approaches Cognitive–Behavioral Approaches Integrative Approach S UMMARY AND C ONCLUSIONS 2. Adaptive Information Processing: The Model as a Working Hypothesis I NFORMATION P ROCESSING Dual Attention Stimulation M EMORY N ETWORKS A S AMPLE EMDR S ESSION Partial Transcript of the Sample Session Evaluation of the Sample Session D YSFUNCTIONAL TO F UNCTIONAL D ISPARATE N EURO N ETWORKS A PPLICATIONS OF EMDR TO O THER D ISORDERS S TATIC E XPERIENCE : A FFECT AND B ELIEF S TATEMENTS R ESOLUTION F ROZEN IN C HILDHOOD “T IME -F REE ” P SYCHOTHERAPY T ARGETS Access Restricted to Negative Material Memory Lapses Dissociation I NTEGRATED P SYCHOTHERAPY S UMMARY AND C ONCLUSIONS 3. Components of Emdr Treatment and Basic Treatment Effects B ASIC C OMPONENTS OF THE EMDR P ROCEDURE The Image The Negative Cognition The Positive Cognition The Emotions and Their Level of Disturbance The Physical Sensations A CTIVATING THE I NFORMATION -P ROCESSING S YSTEM Eye Movements Alternative Forms of Stimulation T HE E IGHT P HASES OF EMDR T REATMENT Phase One: Client History and Treatment Planning Phase Two: Preparation Phase Three: Assessment Phase Four: Desensitization Phase Five: Installation Phase Six: Body Scan Phase Seven: Closure Phase Eight: Reevaluation S TANDARD T HREE -P RONGED EMDR P ROTOCOL C HOOSING A T ARGET P ATTERNS OF R ESPONSE Multimemory Associative Processing The Belief Inherent in the Trauma The Major Participant or Perpetrator The Pronounced Stimuli The Specific Event The Dominant Physical Sensations The Dominant Emotions Single-Memory Processing Effects Changes in Image Changes in Sounds Changes in Cognitions Changes in Emotions Changes in Physical Sensation D IFFERENTIAL E FFECTS S UPERVISED P RACTICE S UMMARY AND C ONCLUSIONS 4. Phase One: Client History C LIENT R EADINESS C LIENT S AFETY F ACTORS Level of Rapport Emotional Disturbance Stability Life Supports General Physical Health Office Consultation versus Inpatient Treatment Neurological Impairment Epilepsy Eye Problems Drug and Alcohol Abuse Legal Requirements Systems Control Secondary Gains Timing Medication Needs Dissociative Disorders T REATMENT P LANNING H ISTORY -T AKING T RANSCRIPT S UPERVISED P RACTICE S UMMARY AND C ONCLUSIONS 5. Phases Two and Three: Preparation and Assessment P HASE T WO : P REPARATION Adopting a Clinical Stance Forming a Bond with the Client Explaining the Theory Testing the Eye Movements Creating a Safe Place Describing the Model Setting Expectations Addressing Client Fears P HASE T HREE : A SSESSMENT Selecting the Picture Identifying the Negative Cognition Developing a Positive Cognition Rating the Validity of Cognition Naming the Emotion Estimating the Subjective Units of Disturbance Identifying Body Sensations I MPORTANCE OF THE C OMPONENTS S UPERVISED P RACTICE S UMMARY AND C ONCLUSIONS 6. Phases Four to Seven: Desensitization, Installation, Body Scan, and Closure A CCELERATED R EPROCESSING OF THE M EMORY P HASE F OUR : D ESENSITIZATION Associative Processing Imagery

New Memory; Image Changes; Incident Unfolds; Appearance Changes

Sounds and Thoughts

Negative Statements; Mismatches; Positive Thoughts; Insights

Sensation and Affect

New Emotions ; Shifting Sensations

Assessment P HASE F IVE : I NSTALLATION P HASE S IX : B ODY S CAN P HASE S EVEN : C LOSURE Visualization Safety Assessment Debriefing and Log S UPERVISED P RACTICE S UMMARY AND C ONCLUSIONS 7. Working with Abreaction and Blocks A BREACTION Guidelines for Facilitating Abreaction If Abreaction Persists S TRATEGIES FOR B LOCKED P ROCESSING Primary Target Altering the Eye Movement Focusing on Body Sensation

All Sensation ; The Primary Sensation ; Unspoken Words ; Using Movement ; Pressing the Location

Scanning

Visual Cues ; Sound Effects ; Dialogue

Alterations

Appearance of Image ; No Action ; Hierarchy ; Redirecting to Image ; Redirecting to Negative Cognition ; Adding a Positive Statement ; Checking the Positive Cognition

Return to Target Ancillary Targets Feeder Memories Blocking Beliefs Fears

Fear of Going Crazy ; Fear of Losing the Good Memories ; Fear of Change

Wellsprings of Disturbance S UPERVISED P RACTICE S UMMARY AND C ONCLUSIONS 8. Phase Eight: Reevaluation and Use of the EMDR Standard Three-Pronged Protocol P HASE E IGHT : R EEVALUATION T HE S TANDARD EMDR P ROTOCOL Working on the Past Single-Target Outcome Recycling through Multiple Targets

Primary Events; Past Events ; Progressions ; Clusters ; Participants

Working on the Present Using the Log to Report Systems Issues Working on the Future Significant People Significant Situations Incorporating a Positive Template C ONCLUDING T HERAPY Follow-Up Terminating Therapy S UPERVISED P RACTICE S UMMARY AND C ONCLUSIONS 9. Protocols and Procedures for Special Situations T HE 11-S TEP S TANDARD P ROCEDURE P ROTOCOL FOR A S INGLE T RAUMATIC E VENT P ROTOCOL FOR C URRENT A NXIETY AND B EHAVIOR P ROTOCOL FOR R ECENT T RAUMATIC E VENTS P ROTOCOL FOR P HOBIAS P ROTOCOL FOR E XCESSIVE G RIEF P ROTOCOL FOR I LLNESS AND S OMATIC D ISORDERS S ELF -D IRECTED U SE OF E YE M OVEMENT S ETS FOR S TRESS R EDUCTION Caveats and Suggestions Technical Considerations S ELF -C ONTROL /C LOSURE P ROCEDURES Safe-Place Imagery Taped Visualizations The Light-Stream Technique Vertical Eye Movements D EBRIEFING AND S AFETY A SSESSMENT S UMMARY AND C ONCLUSIONS 10. The Cognitive Interweave: A Proactive Strategy for Working with Challenging Clients F OUNDATION OF THE I NTERWEAVE R ESPONSIBILITY , S AFETY, AND C HOICES F ITTING THE I NTERVENTION TO THE C LIENT I NTERWEAVE C HOICES New Information “I’m Confused” “What If It Were Your Child?” Metaphor/Analogy “Let’s Pretend” Socratic Method A SSIMILATION V ERBALIZATIONS AND A CTIONS E DUCATION S UPERVISED P RACTICE S UMMARY AND C ONCLUSIONS 11. Selected Populations I SSUES OF N ONCOMPLIANCE C HILDREN Concrete Definitions of Feelings Holding the Child’s Attention Cognitions Generalizing Treatment Effects Creative Therapy C OUPLES Early Sexual Abuse in a Marital Partner Joint versus Individual Sessions Infidelity S EXUAL A BUSE V ICTIMS Appropriate Goals Client Readiness Structure Integration Information Plateaus Emotional Stages False Memory Cautions Regarding Memory Work Hypnosis The Fallibility of Memory C OMBAT V ETERANS Dealing with Feelings of Lack of Control Secondary Gain Issues Affiliation and the Fear of Forgetting Dealing with Denial and Transition States Dealing with Anger Using the Cognitive Interweave Anniversary Dates Special Populations D ISSOCIATIVE D ISORDERS O VERALL E VALUATIONS S UMMARY AND C ONCLUSIONS 12. Theory, Research, and Clinical Implications T HEORETICAL E XPLANATIONS P ROCEDURAL E LEMENTS Interrupted Exposure Perceived Mastery Attention to Physical Sensation Cognitive Reframing Alignment of Memory Components Free Association Mindfulness Eye Movements and Alternative Dual Attention Stimuli O RIENTING R ESPONSE D ISTRACTION H YPNOSIS C ELLULAR AND B RAIN -L EVEL C HANGES D REAM S LEEP R ELAXATION R ESPONSE H EMISPHERIC S YNCHRONIZATION C ORTICAL F UNCTION I NTEGRATIVE E FFECT C ONTROLLED R ESEARCH G ENERAL S CARCITY OF PTSD T REATMENT S TUDIES S UGGESTED C RITERIA FOR C LINICAL O UTCOME R ESEARCH Method Validity Selection of Psychometrics Participant Selection Comparative Research Component Analyses Civilian Studies Studies of Combat Veterans Methodological Problems in EMDR Outcome Studies Treatment Fidelity and Protocol Adherence Evaluation Tools Treatment Time The Comparison of EMDR and Other PTSD Treatments Suggested Criteria for Comparative Clinical Outcome Studies D IVERSE C LINICAL A PPLICATIONS W EIGHTING OF A CTIVE C OMPONENTS Component Analyses Suggested Parameters for Component Analyses in Clinical Outcome Component Studies A Review of Extant Clinical Component Analyses The Utility of Single-Subject Design Discerning Testable Hypotheses Testing a Variety of Existing Hypotheses Hypothesis Regarding the Autobiographical Nature of the Targeted Disturbance Hypothesis Regarding the Etiological Nature of Memories Hypothesis Regarding Orienting Response Mechanism Hypothesis Regarding Bilateral Stimulation Mechanism Hypothesis Regarding the Distractive Level of Stimuli Hypothesis Regarding Free Association Summary of Recommendations for Component Research B ROADER C LINICAL AND P ROFESSIONAL C ONCERNS Inadequate Standards of Research and Review Clinical Responsibility Global Responsibility S UMMARY AND C ONCLUSIONS References Appendix A: Clinical Aids

EMDR Screening and Data Checklist EMDR Treatment Planning Checklist Recommended Format for Weekly Log Report Selecting Negative and Positive Cognitions Additional Examples of Cognitions EMDR Procedural Outline Form for Identifying the EMDR Target Form and Sequence for Floatback Technique to Identify Past Event Guidelines and Procedures for EMDR Resource Development and Installation Indications of a Need to Extend Client Preparation and Stabilization Phase Characteristics and Types of Resources Appropriate for Resource Development and Installation Prolonged Resource Development May Need to Precede EMDR-RDI Procedures Precautions in Considering Resource Development and Installation The Basic EMDR Resource Development and Installation Protocol Use of Resource Development and Installation

Appendix B: Client Safety

Section I—EMDR Dissociative Disorders Task Force Recommended Guidelines: A General Guide to EMDR’s Use in the Dissociative Disorders Additional Training Suggested Reading Section II—EMDR Professional Issues Committee Recommended Guidelines Client Welfare Training Section III—Professional Standards and Training Committee of the EMDR International Association

Appendix C: EMDR Resources

The EMDR International Association EMDR Humanitarian Assistance Programs Training Availability The EMDR Institute

Appendix D: Diverse Clinical Application and Evaluation

Section I—Additional Protocols and Manualized Resources Section II—The Adaptive Information Processing Model

Index About Guilford Publications From the Publisher

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