Pathways to Healing
W. W. Norton & Co. 2005
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Clients
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Robin's Book:
EMDR Solutions
Copyright 2005 Robin Shapiro
All Rights Reserved
EMDR clinicians live for the moments when transformation occurs, when the trauma fades from frightening reality to mere memory, and when the chronic, unbearable pain suddenly disappears. EMDR Solutions: Pathways to Healing contains elegant and easy to learn EMDR-related protocols and procedures that create those moments for specific client populations. Nearly all of the methods have been taught at EMDR conferences, freestanding workshops or Level II trainings. Some have been published, in other forms, in journals and newsletters but none have been collected in a book. As an EMDR therapist, trainer, and consultant, I’ve used and taught many of these techniques. For this book, I asked the inventors of each technique to create a chapter that explains how to, when to, and why to do their procedure. Each chapter gives some background, in, for instance, dissociation, and then describes exactly how EMDR can fit in the course of a complete treatment. Each chapter includes typical case examples.
Who is it for?
EMDR Solutions: Pathways to Healing is for the more than 50,000 psychotherapists who practice EMDR. Each chapter alludes to the standard protocol of EMDR. Many of the techniques in the book are already being used by hundreds of clinicians, resource enhancement is used by thousands. The variety of techniques and client populations, the "how-to" focus, as well as the fame and esteem of many of the writers makes this book a must-have for EMDR clinicians. Independent EMDR trainers will use it for a textbook for Level II classes. People who are not EMDR therapists will be interested in the book to for its protocols from their area of specialty; for example phantom limb pain, dissociative clients or Dialectical Behavior Therapy groups.
The chapters
Maureen Kitchur’s Strategic Developmental Model is a meta-model for EMDR practice that encompasses all of the phases of the Standard Protocol. Using Ericksonian utilization language and attachment-enhancing practices to motivate and contain her clients, she has created a clear order for EMDR processing, a way to process wordless, implicit experience and the best intake system that I’ve ever used.
Roy Kiessling gives his take on Resource Development, a Preparation Phase procedure useful for externally or internally disorganized clients. His hierarchy of resource installation strategies is easy to learn and very helpful for clients in crisis. I especially like the way he turns resources into Cognitive Interweaves.
EMDR therapists keep finding ways to use this powerful tool with different kinds of clients and clinical issues. Joanne Twombly and Ulrich Lanius teach two very different preparations for doing EMDR with people with dissociative disorders. Many of Twombly’s techniques are derived from hypnosis and ego-state work. Lanius shows how to use medication to allow EMDR to work with dissociated clients. Sandra Wilson and Robert Tinker have continued to develop a very effective treatment for phantom limb pain. Much of their protocol focuses on the History-Taking and Preparation Phases of EMDR. Susan Schulherr takes on the Binge/Starve cycle from History Taking through Installation. Andrew Seubert teaches the language and procedures necessary to use the Protocol in working with mentally retarded clients. I point out useful targets for people with anxiety disorders.
In 1993, when I took the EMDR Level I training from Francine Shapiro, she said that EMDR could be used with any other treatment modality. Many people have taken her at her word. Elizabeth Turner fluidly engages children with art therapy, play therapy and story telling in all phases of EMDR. Carole Lovell unites Dialectical Behavior Therapy, EMDR and EMDR offshoots for effective therapy groups for women with Borderline Personality Disorder. I bring together Narrative Therapy questions and Object Relations theory to target culturally and generationally transmitted issues. Later, I talk about using EMDR with differentiation-based couple’s therapy. Jim Cole uses a reenactment tool from guided imagery for a quick and painless way to remove discreet trauma and pain.
Some of us have created variations on the EMDR theme. A. J. Popky and Jim Knipe turn the SUDS scale on its head by targeting inappropriate positive affect. Popky shares his DeTUR protocol with its Level of Urge to Use (LOUU) for the treatment of addictions and compulsive behavior. Knipe clears love-sickness, procrastination, avoidance and codependence using the Level of Urge to Avoid (LOUA). I write about the Two-Hand Interweave, a simple exercise of discernment, often used in the Preparation Phase.
Using EMDR Solutions
You might think about reading about your specialties and skipping the rest of the chapters. Yet, I hope you read them all. There are gems in every chapter. I don’t want any of you to miss Andrew Seubert’s four M’s of representational resources: Memories, Mirrors, Models, iMaginings, just because you don’t think you need to know about working with mentally disabled people. Tinker and Wilson’s Phantom Limb Pain Protocol can be used for many kinds of pain. You may not work with groups, but if you have even one borderline client, read Lovell’s chapter. In it, you’ll find a hundred things to do with your client. Even if you’re not working with a binge-eater, you might be able to adapt Schulherr’s protocol to a client with another cycling compulsive behavior. Start each chapter; skim through the ones that don’t seem to fit your clients. Even if you never see kids, do not miss the dog story at the end of Turner’s chapter. It will heal your separation anxiety!
Here’s how this material works for me: I use Kitchur’s Strategic Development Model including Ericksonian language, the genogram, attachment-enhancing procedures and, if necessary, First Order Processing, on nearly every client (except the rare car-accident-client-with-no-prior-trauma). Every attachment-impaired client receives at least three resources: first, a Safe Place that includes a mythic or supernatural mother/nanny/angel/bodhisatva/immortal dog or caretaker; second, the circle of people and beings that have ever loved (and not hurt) the client and third, Kiessling’s Conference Room of Resources. I use Kiessling’s simpler resources with people who are having trouble getting through their days. My Two-Hand Interweave pops into several sessions each week to help clients delineate between feeling states or choices. If I’m working with substance or behavioral addictions or compulsions, I measure and target the clients "urge to use" with Popky’s DeTUR protocol. With procrastinators, it’s Knipe’s "urge to avoid". At an "Introduction to EMDR" class, I spent ten minutes using the LOUA protocol to cure thirty-five EAP therapists of paper-work avoidance. Several of them signed up for EMDR training on the spot. I’ve used the Phantom Limb Pain Protocol on all kinds of chronic pain. It works like a charm. Living in Seattle, I’ve been sending borderline people to Marsha Linehan’s Dialectical Behavior Therapy groups for years, while I provided containment, resource-building and trauma-processing in individual sessions. It was delightful to see that Lovell had combined all those functions into one treatment. When the trauma is huge, but singular, and the client has no affect tolerance I’ve been using Cole’s Reenactment Protocol. I love the part when the client begins to giggle. I use many of Twombly’s tools for working with dissociative people. One of my clients is using Lanius’s Naloxone treatment. He no longer floods or loses his adult self while doing EMDR.