Report from Carsten Dernedde
The day drew 90 attendees from East Anglia, which on this occasion extended as far as Ireland and Scotland.
Justin Havens, EMDR consultant and trainer, made time on his birthday (!) to take us through his passions, the Dream Completion Technique and the Flash Technique and the iterations they have been through to make them potent tools within the 8-Phase framework of EMDR.
As Justin says: start with sorting out nightmares, use flash to take off worst distress…. clean up with EMDR processing! All within the EMDR framework.
After all, dreaming is EMDR! When clients fix their nightmares, they get 2 hours free EMDR every night.
Justin showed how clients can develop adaptive twists for their nightmares while awake. That way, while dreaming, they can stay within their window of tolerance and complete their nightly ‘dream EMDR’, also known as REM sleep, without waking.
For the therapist, the task is all about tuning up the techniques to get good outcomes – a good reason to complete the full DCT training.
Justin was pleased to announce that a RCT to compare standard PTSD therapy with and without DCT in an IAPT setting had just had ethical approval – exciting news!
Moving on to the FLASH technique, Justin walked us through how this had evolved from the original technique introduced in 2018 by Dr Phil Manfield.
In the latest iteration of FLASH, the trauma memory is not even briefly activated; triple blinks are used instead and any questions the therapist asks to assess progress have to be carefully crafted so as to not activate the trauma.
Even the bilateral stimulation element is dispensed with, and Justin gave a fascinating demo with a volunteer where a disturbing memory went from SUD=6 to SUD=0 in the space of five minutes during what on the surface looked like a whimsical chat about pet dogs and pizza.
Again, success comes from careful application, recognising blocks and feeder memories, adapting the positive engaging focus so that the client can’t ‘fail’ – well worth attending the full training.
Justin then answered many questions – what to do when clusters of memories or whole timespans are presented, when trauma memories intrude into the Positive Engaging Focus, whether DCT can be used for night terrors or sleep paralysis.
He bowed out politely when the risk arose that the whole East Anglian region might sing Happy Birthday on zoom.
The attendees were then split into triads in breakout rooms to practice and discuss DCT and FLASH.
During the lunch hour, the AGM was held, attended by the steering group and some attendees of the networking meeting. Always welcome!!
The afternoon kicked off with or own Michael Rivers presenting, interview-style with Sonya Farrell and Mark Brayne, a fascinating case of Multiple Chemical Sensitivity.
This, Michael explained, is an extremely distressing and isolating condition, not recognised in much of the world except Canada, where patients have extreme anaphylaxis-like reactions to everyday chemicals and fumes, in particular formaldehyde which gases out of modern furniture and furnishings.
Experiencing this over years in adult life had created an identity that was deeply entwined with MCS.
As he had not encountered the condition before, Mike informed himself exhaustively and without preconceived ideas, which helped him fully understand the world the patient was inhabiting.
This client’s stabilisation involved a rich gamut of techniques from the widest EMDR toolbox – stay tuned, East Anglia, for Sonya Farrell’s presentation of Jim Knipe’s Toolbox at the April 22 networking meeting!
Only then, it became possible for Mike and his client to deconstruct the illness identity and recognise it for what it was: a survival response of radical withdrawal from a threatening world. In parallel, it became possible to see the symptoms as primarily signs of arousal of the vegetative nervous system.
Bridging back from the moment of symptomatic activation (breathing difficulties, rashes, vomiting etc) led straight into an emotionally absent, abusive, neglectful early childhood, which then became accessible to EMDR processing over 18 months. Mike recalled how stunned he was when the client’s MCS went into complete remission for many years.
Mark Brayne then presented the first large scale study demonstrating the feasibility and efficacy of delivering EMDR online, which was commissioned and financed by this very regional network, thanks to enthusiastic attendance at several online training events laid on by the East Anglian Regional network in 2020.
A few pioneers, among them Mark with his international clients and Mike with the housebound client described above, had been working partly online before the Covid pandemic came along in the spring of 2020.
When the first lockdown came, dire warnings were issued against the perceived risks of working online, requiring intense lobbying. Fortunately, online was pragmatically adopted by a majority and this sparked the idea for and urgent realisation of this research.
The EMDREA study involved 560 therapists from five continents and 148 of their clients and asked about their attitudes toward and experience with online EMDR over time.
By end of the study period, 75% of therapists were not concerned about working online at all and 88% of clients were very comfortable online.
The study also examined details of online working, such as the preferred method for bilateral stimulation, where butterfly taps came out on top (42% of clients).
The next research project already being progressed is a collaboration with the University of the West of England, comparing attachment-informed EMDR with standard protocol EMDR.
Hopefully this will formulate what, in research terms, is attachment-informed EMDR and if it shows promise, in time that may lead to a large RCT of a quality that might lead NICE to take notice. Such a RCT might demonstrate to a wider world the efficacy of EMDR that we as therapists know from our daily practice.
We then split into networking sessions in breakout rooms, themed as Jim Knipe’s EMDR toolbox; EMDR in Primary Care; Research; Attachment-Informed EMDR; EMDR and Somatic Experiencing; working with Police and the Emergency Services, and Multiple Chemical Sensitivity.
The insights from these subgroups were brought together in a plenary session – hopefully the seeds were laid there for interesting workshops at future Regional Meetings.