Saturday January 14, 2023
A summary of the day by Ushma Patel
On Saturday 14th January 2023 over 100 delegates came together online for our latest EMDR East Anglia regional networking day to learn about the basics of integrative, attachment–informed EMDR.
We jumped straight in with the recognition that AI-EMDR is not going off-piste, and that it is compliant with standard mainstream EMDR and officially endorsed by the EMDR authorities.
The morning began with Christine Ramsey-Wade, Senior Lecturer in Counselling Psychology at the University of the West of England in Bristol and EMDR therapist, highlighting the need for further research as EMDR, now more than 30 years old, evolves beyond the Standard Protocol especially now to embrace attachment.
With our presenter Mark Brayne’s first paper on AF-EMDR now published, using Laurel Parnell’s original term Attachment-Focused, (Kaptan and Brayne, 2022) Christine focused particularly on a current feasibility trial for EMDR and AI-EMDR funded by our own East Anglia EMDR Regional Group through the national EMDR Association UK.
The plan is to create a team of co-researchers – EMDR therapists and Consultants working with either the Standard or the Attachment-Informed Protocol – with at least 40 client participants presenting with what the project is terming attachment-informed complexity, rather than the full and formal diagnosis of Complex PTSD.
Those clients will then be randomised to receive either 10 sessions of Standard EMDR or 10 sessions of AI-EMDR – an exciting project that is now actively being recruited to.
Mark then walked us through the goals of EMDR and the survival response that underpins any effective use of this powerful therapy, building on the notion that every dysfunctional ego state, every part, every presentation began life with a survival response and is therefore welcome in the work.
This led us to explore how, in the words of Dr Gabor Mate, ‘Trauma is not what happens to you but what happens inside you’. Mark shared a beautifully poetic video by Dr Mate illustrating the childhood tragedy of having to choose between secure attachment and authenticity.
Mark encouraged us to be curious and not over-pathologise, asking ourselves the essential question: ‘How did this person get to be this way? What is this really about?’ and honing in therefore on the importance of case conceptualisation –resolving as we go the age-old EMDR question of ‘which protocol do I use for…’
The answer? There is only one EMDR protocol.
Using Shapiro’s basic EMDR protocol with radical attachment-informed curiosity, it’s the ability to learn the basic steps and then learning to dance that makes the difference. AI-EMDR complements the standard protocol.
Mark offered us a couple of super-helpful mnemonics to remember the eight basic steps:
For History-Taking, Preparation, Assessment, Desensitisation, Installation, Body Scan, Closureand Re-evaluation, it’s Harry Potter And Dumbledore In Big Cheesy Relationship.
Mark added his own special take on the six principles of AI-EMDR: Charlie Chaplin (Case Conceptualisation) Recognises (Rich and Imaginal Resourcing) That (AI-informed Target Identification) Attachments (Appropriate Activation in Phase 3) aRe (Repair and Rewire) Seriously Salient (Session Structure).
Throughout the day, Mark walked us through the detail of the six core conditions of AI-EMDR, with the opportunity to engage in experiential learning of target identification, finding the root target with bridging from a presenting moment to a much earlier attachment-informed memory.
Mark demonstrated live with a delegate how to do case conceptualisation, target Identification and the bridge. We were able to see how it can be done with ease and the attachments that come up. The reduced affect in the client is almost an instantaneous ‘Aha’ moment.
Throughout the day we engaged in stimulating and inspiring conversations about AI-EMDR and bridging in breakout rooms, sharing our own experiences and understanding of attachments as well as intergenerational attachments.
We had an opportunity to ask Mark questions that came up in our breakout room discussions, listing a few:
- If the client has abusive parents, would you do intergenerational EMDR with them? How do you work with a client whose trauma is centred on abuse from their biological mother?
- If we cannot complete all the generations needed in one session, where is it safe to break?
- When not to use IG EMDR?
- Working with a client with DID who may not have an adult part/ANP to attend the session, who could maybe do the intergenerational work – is that something that one could work with?
- When the adult client starts to take on the persona of the parent (interpreter role) and the therapist works with the adult client as if they were the mum etc, supposing they cannot imagine the mother’s experiences or feelings? What do you do then?
- If the client can only afford a limited number of sessions or is working in an NHS/IAPT context, how do you chose what to work on? Is intergenerational EMDR possible within 12 sessions for example? Considering that the preparation phase may take quite a few sessions…
- What if client was adopted and has no experience of biological mother/father?
For the answers – which we explored in detail on the day – I guess the reader is best invited to do Mark’s training in full, on his Unleash your EMDR online workshops.
But as a hint on the latter really important issue, when working for example with adoption, every infant is programmed by evolution to put the caregiver’s needs first to ensure they are literally kept alive. So, yes, the root trauma of separation of infant from birth mother is absolutely targetable, and as Mark explained, it can astonish how much in adopted children is still live in their epigenetics.
The day ended with an inspiring, uplifting and poignant story of “Samuel” with whom Mark worked, a Rabbi triggered into panic attack when leading a Saturday service in the synagogue.
Samuel is himself an EMDR therapist, and Mark explained how they had bridged back to the four-year old self and a memory of reading from the Torah as part of his journey from boyhood to the status of rabbi.
This point they landed was where Samuel dropped the book – terrified how mother in the audience would respond and the shame that would come with that.
EMDR gave Mark and Samuel the opportunity to bring the mother into the therapeutic arena.
They first ensured that little Samuel in their shared imagination was safely and separately looked after by his resource team (a central element of the AI-EMDR approach.)
Then, returning to Samuel’s mother in the community centre where the Torah had just been dropped, mother-in-imagination is asked how she felt at that moment, bridging from there back in time to when mother was a little girl and being shouted at by her own father, Samuel’s grandad.
The grandfather had come to England as part of the Kindertransport in 1938 to get Jewish children out of Germany as the Holocaust was brewing, offering an EMDR point to process where the little 6-year-old is having to stay goodbye to his parents (he will never see them again) at the train station, and cue BLS processing.
Mark and Samuel then found themselves working in a kind of shared imaginal journey seeking the bodies of his great grandparents lost in Nazi-occupied Eastern Europe, and needing, as they both realised all these decades later, if “only” in the imagination a proper funeral.
Adult Samuel, knowing of course now as fully-fledged rabbi how this is done, sings the Kaddish over their imagined graveside, an intensely moving moment for both client and therapist.
It’s important to note the reflective awareness with which Samuel’s grandfather can now – rewiring and repairing the past and bridging all the way back from there to the present – come to England with a different sense of self, no longer needing to be so stern with his little girl, who then as a mother to boy Samuel in turn no longer needs to panic with shame as he drops the Torah. As little boys might do.
It was a beautiful ending to this brilliant piece of IG-EMDR, as adult Samuel in the shared client/therapist imagination was able to visit Auschwitz where at least one of his great-grandparents had indeed died and place stones on their headstone grave in the Jewish tradition of tribute to memory.
Thank you to Mark and all the delegates who attended a fascinating and informative day. No doubt there will be a waiting list to attend Mark’s Unleash your EMDR training where the learning from this day can be truly expanded on.