Report by Shirley Young
This was a well-attended and inspiring networking day and, without the usual focus on Powerpoint presentations, a relationally engaging experience!
Jamie started the day experientially by bringing us into presence in the way she starts her client sessions, guiding us to pay attention to the sensory experiencing of the room we were in: the sights, sounds, smells, physical sensations of touch and physical connection to chair and floor, and then our breathing, and finally encouraging us to move and stretch so we were bodily connected before she began engaging with us.
Jamie began by sketching out her personal journey of how she came to work with EMDR, both personally and professionally.
She highlighted the difference between having knowledge and understanding from participating in personal therapy and the 12-steps programme, and the effects of experiencing EMDR, allowing her to move into “becoming” as a result of a therapy that addressed bodily experiencing.
Jamie worked as an English teacher in post-war Bosnia-Hercegovina in the early 2000s, and was supported by a trauma-informed influential mentor who helped her ask “what role is trauma playing in this”.
Focusing her attention on noticing students’ difficulties with learning and her own triggering from seeing how the system interacted unhelpfully with the children in their care, Jamie found herself engaged with the treatment of trauma (her own and others’), moving away from the understanding that trauma only affects military veterans.
Jamie noted that the English word ‘trauma’ is a direct translation of the Greek word for wound – and that all wounds need care.
Life’s knocks may be more bruising for some than others, and different levels of care are needed depending on the individual. But recognition and treatment of wounds at whatever level needs attending to rather than being dismissed as “just life”.
Jamie then explored her EMDR training and her motivation for writing EMDR Made Simple.
She noticed, as many of us probably have too, that many therapists trained in EMDR do not go on to practice because they feel bogged down in complexity and paralysed by the fear of damaging a client by not doing things correctly. She also highlighted how EMDR in its original research was for clients with a single trauma – as if this was the norm.
In clinical practice, however, complex trauma is more often the rule, and Jamie emphasised how Francine Shapiro allowed in her writings for modifications to the Standard Protocol when working with difficult presentations.
She also noted that EMDR was developed through trial and error, posing the question whether anyone had considered how walking (also a bilateral activity after all) as well as eye movements might have been part of Francine’s reprocessing insight during her famous walk in the park.
Setting out how she came to the concept of the Four Faces of EMDR in her first book EMDR Made Simple, Jamie recalled St Augustine’s definition of the four voices of God – a concept familiar to her from her own Catholic upbringing, adding how tempting it is for individuals to believe that their own personal relationship to God is an absolute rather than an experience that matches their own personality, and to feel therefore threatened by other styles of worship.
These Augustinian styles can be classified under four headings:
- God as Truth – Seeking after theological truth and its right expression, and the importance of using the right words in the right way and being grounded in Biblical knowledge.
- God As Good and Action-Centred – doing good works to bring about real change in the world.
- God as Beauty – symbol-based and via artistic expression, with the experience of the transcendent beauty and pleasure in the world around us.
- God as One – emotionally- and relationally-based
Taking this idea, Jamie suggested that within the EMDR community there are different style preferences (reflecting also cultural influences) and to be aware of the potential for gospel-based EMDR – as in, only my way is the right way.
She described her Four Faces of EMDR as being:
- Those who are most comfortable sticking to the protocols.
- Those whose approach to EMDR is flexible – the eight phases are largely adhered to, but not necessarily in order, and used flexibly and responsively, often employing a rich variety of resources in Phase 2 preparation.
- EMDR as a technique used as an adjunct to other things. (This was in fact Shapiro’s original idea, although no longer the current view). A Gestalt therapist may thus continue to see themselves primarily as a Gestalt Therapist, but one who also uses EMDR within the context of their own modality
- EMDR-inspired interventions. These in Jamie’s overview would be the breakaway therapies that have developed from EMDR, in the grand tradition of psychotherapy modalities birthing new developments. She suggested Brainspotting was a current example.
Jamie noted Janet’s original 19th century understanding of the phases of trauma treatment being Stabilisation, Reprocessing, and Integration. This had the downside of sometimes holding clinicians back from work with a client because they might feel that sufficient stabilisation is impossible.
EMDR’s description of a preparation phase rather than a stabilisation phase was, she felt, a more helpful way of viewing what is helpful for a client, providing the tools to ride one’s instability in order to reprocess and then move towards stability and new growth.
Jamie also encouraged us to discuss issues with ‘Safe Place’ – the need to be aware of how this can be used as to avoid necessary work rather than a containment strategy, allowing also for the choice of Safe Place to actually lead to triggers that the client had been unaware of, with difficulties with visualisation making the creation of a safe place problematic for some.
Jamie highlighted the need to recognise that all resources can lead to complications, and how important it is to have one’s own resources and possibilities in order to respond with a change of plan.
Jamie posed the question, is it necessary to sit still in order to process, introducing the idea that one might as therapist encourage the client to amplify a movement as an interweave – going with that – if they were already doing this during processing. In cultures that are more movement-based, such as Brazil, movement interventions could be culturally appropriate.
Some helpful reminders and ideas about what could be used in the preparation phase were considered, such as Mindfulness-based skills to learn to tolerate emotions/body sensations etc.
Jamie even suggested listening to pieces of music in styles that you hadn’t heard before and that might cause discomfort, learning to stay with your response. She encouraged us to create playlists associated with helpful emotions, for use when the clients need help with emotional management.
DBT (Dialectical Behavioural Therapy) for example supports the idea of teaching surfing the waves of emotions rather than drowning in them.
Jamie noted that in some settings, Phase 2 may be all that is possible, and that these tools can be effective even if reprocessing is unable to be achieved. This is also EMDR.
Jamie referred to a book by Scott Miller re-published in 2009 called the Heart and Soul of Change – Delivering What Works In Psychotherapy. This is a review of all the research literature across the board about psychotherapy and does not cherry-pick research.
She went on to describe the four factors essential for any therapeutic method to work, factors initially noted by Carl Rogers.
- A client present in the room (with their psychological baggage);
- Methods and strategies that “engage and inspire” the participants. If what you are offering is not engaging the client, then it’s not going to work. (This, Jamie noted, goes back to individual styles and the need for there to be a match between modality and the style of therapist, and their ability to adapt to the client’s presentation);
- The relationship: trusting, cooperative, unconditional positive regard etc
- The Therapist (and our psychological baggage) and our ability to manage our own triggering while dealing with a client (and seeking our own treatment if necessary).
Jamie then took us through a guided meditation based on a client we had identified.
What did they look like, how did they present etc in their first session? How were they referred? What transport did they use to get to therapy?
She then asked us to do the same exercise but as if we were the client. How did they experience us and communicating with us? Were they able to say no to a question? What did they need at the end of the session?
When the meditation was finished, we were asked to reflect on what we had learnt. This can be a helpful exercise when working with clients we feel stuck with.
We ended with an exercise of rubbing our hands together and then using the generated heat applied to our temples, repeated and applied to the back of the neck, repeated and placed on our breast bone, repeated and then placed on one of the places we liked the best. We were asked to notice whether there was a difference. Jamie uses this as a technique for grounding and support.
We then stopped for lunch and also had time to network, buy books and support Trauma Aid by buying raffle tickets and EMDR-related material.
When we resumed in the afternoon we split into five networking groups focusing on
- Intensive Work
- Yoga, Spirituality and Mindfulness
- NHS & Complex Clients
- Working Online.
Following these groups and the drawing of the raffle on behalf of Trauma Aid, we had our usual Question-and-Answer session.
Jamie joined us in her Consultant capacity supporting our resident Consultants Mark Brayne, Valerie Halbinger and Sonya Farrell, and two of our consultants in training.
Questions explored were:
- The Future of EMDR – emphasis on the need for research, and reference to the outcome of a small trial in the Middle East comparing Blind to Therapist Protocol and Standard Protocol;
- Intensive EMDR (as in, many hours over a shorter period of days);
- Use of smartphone apps and bilateral music (there is, noted Jamie, some useful bilateral music for EMDR on Spotify) and managing BLS online.
Jamie showed us a way of clients doing bilateral stimulation themselves when they are adverse to the feeling of tapping by putting the thumbs and first fingers together, creating the O-shape seen when you hold your hands in a meditation pose, and then rubbing the thumb tip across the first fingertip.
All in all, it was a very satisfying and enriching day, helping us look forward to November 11th for our next regional networking day which we hope will be in Ipswich.