Up to sixty delegates were present in the Zoom conference room and more than 140 in total had signed up to the mini conference and regional networking day.
Claire van den Bosch, EMDR Practioner and IFS Level 3 trained therapist, started the day with her presentation and personal manifesto “EMDR for all our Parts”. She presented her passion with her colleague Bethany Parris, EMDR Europe accredited practitioner and certified IFS therapist
Before getting into the IFS framework she uses to guide her work with complex clients, Claire took the delegates through an IFS-informed unblending meditation.
Accompanied by her own beautifully sketched graphics, Claire talked us through different stages of identifying our in-the-moment available parts and unblending them from the core self.
Creating first a ‘glow’ around the physical body and then breathing into an enlarging space around the body, there was eventually enough space for the parts to remain connected to the core self but move out from the felt body, so that calm regard and focus on the task at hand were possible.
The meditation is useful in the preparation phase or as a clarifying moment in any session.
Claire then gave her introduction to Dick Schwartz’s Internal Family Systems.
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.
More than 230 delegates signed up for the day, on the day including colleagues from East Anglia and much wider Trauma Aid network from as far afield as Iraq, Egypt and Bosnia.
Dr Millia Begum, Consultant Psychiatrist and EMDR Consultant and Training facilitator, started the day with a deep dive into EMDR and medication.
Three key areas we focused on during the morning were:
Psychological influences of medications on therapies, specifically EMDR
PTSD specific medications and a video from Dr Ruth Lanius on Dissociation medications
EMDR with Psychedelics
Millia walked us through the key medications; antidepressants, anxiolytics, antipsychotics and mood stabilisers as used in services, as well as the effects on the client and their trauma symptoms.
Interestingly, NICE guidelines from 2018 say that medication should not be a first line treatment for PTSD, highlighting the importance of therapeutic input. Millia offered examples of the difference between a nocebo, where a patient might anticipate and therefore experience negative side-effects to what they believe is a medication but is actually inert, and the more familiar placebo that also uses an inert substance but has a positive impact on a patient thinking they’re being medicated.
Millia explored the familiar dilemma of clients dependent on Diazepam and fearful that if they don’t take it before their EMDR session they will have a panic attack and not be able to attend. Diazepam can of course interfere with processing, and Millia reminded us how important psychoeducation can be, as well as the EMDR installation of resources to maintain a window of tolerance where emotions are appropriately regulated.
Jim Knipe’s very useful suggestions around targeting what he calls the Levels of Positive Affect (LOPA) where clients are reluctant to let go of the upsides of medication that’s now actually dysfunctional.
We then moved on to PTSD-specific medications and the evidence base for the use of alpha-blockers, a group of blood-pressure-lowering drugs.
Millia explored the case of Don, a military veteran with severe nightmares and how alpha-blockers stopped his nightmares completely after two weeks. Prazosin in particular is found to have a positive effect on hyperarousal, nightmares, concentration and irritability.
Interestingly, the higher the blood pressure before application of Prazosin, said Millia, the better the effect – suggesting that in PTSD, raised blood pressure might be a marker of hyperarousal.
Much appreciated by our group, Millia had secured two recorded interviews to run as part of her presentation, the first of them with Dr Ruth Lanius who discussed targeting dissociation with opioid blockers.
We were introduced to the Defence Cascade Model: from hyper- to hypo-arousal with a delineation between defence reactions and dissociative states, with their reflections in the sympathetic or parasympathetic nervous system response.
It was fascinating to hear how chronic developmental trauma can influence the fight-or-flight, and/or the unresponsive immobility responses, the former being an active defence and the latter a passive defence. This is where Dr Lanius suggested opioid blockers can be helpful in reducing trauma and dissociative symptoms.
After a break, we moved to the thoroughly topical issue of EMDR and psychedelics, with studies of ketamine, MDMA or psilocybin (the ingredient in magic mushrooms) being used to lower defences blocking access to trauma memories in the treatment of PTSD and depression.
Ketamine use, we heard, is licensed in the UK for treatment-resistant depression, with MDMA likely to be licensed next year for Complex PTSD.
Randomised Control Trials on Ketamine on its own have shown promising results in the mainly short term, but with a high relapse rate. However, when paired with EMDR, the temporary enhancement of neural plasticity can be used to address deep-seated trauma very effectively, with much longer-lasting effect.
Attendees were thrilled with Millia’s second special recorded interview, with US-based specialist Sunny Strasburg talking us through how she uses ketamine with EMDR and also an Internal Family Systems model.
Sunny also works with the legendary Bessel van der Kolk in Boston, another enthusiast for psychedelics in trauma treatment, and stressed that building therapeutic alliance is exceptionally important in psychedelic therapy, because the ketamine will disable a client’s protector parts.
Interestingly, in psychedelic-assisted therapy the Negative Cognition has to be tweaked, Sunny said, towards a positive affirmation.
Sunny walked us through how she switches to EMDR’s phases 4-7, actually targeting trauma memories only once the client is coming out of the immediate intensity of the psychedelic experience, only using hand tappers rather than eye movements, since EMs are compromised by the effect of the ketamine on the eyes.
Sunny stressed that specific training in psychedelic-assisted therapy is vital before offering this approach to clients. Also, Sunny was very clear that as a therapist one absolutely must have one’s own first-hand experience of taking ketamine in a therapeutic context, to be able to understand a client’s somatic response when it is administered.
Sunny was so inspiring that there’s a strong chance in the near future of a group field trip of delegates going to one of the retreats she so effortlessly sold to us…
A delegate informed us that there is a documentary on Netflix by Michael Pollan exploring the history and uses of psychedelics, including LSD, psilocybin, MDMA and mescaline, titled,’ How to Change Your Mind’.
Another delegate recommended the docudrama Nine Perfect Strangers starring Nicole Kidman, about psychedelics with veterans and including the use of Ayahuasca.
Millia provided a truly fascinating and thought-provoking morning.
In the afternoon, we were joined by Dr Michael Hase, Consultant Psychiatrist, Psychotherapist and EMDR trainer from Germany who took us on a tour of EMDR in the wider Europe, current developments in defining the future of the EMDR protocols, EMDR supervision and research.
We learned from Michael that EMDR Europe now brings together 36 countries, with a total of 33,645 members in national associations.
Europe is a hotspot for EMDR research, focusing particularly the Netherlands, Italy, Spain, Turkey and the UK, trailblazing with some high-profile publications. Currently, said Michael, there appears to be less research happening in the US.
It was reassuring to hear that after Francine Shapiro died in 2019, the EMDR International Association set up a Future of EMDR Therapy (FOET) project with a Steering Committee and Council of Scholars, and active work groups looking into the future of EMDR, research, clinical practice and training and accreditation.
The goal is to preserve the integrity of Shapiro’s vision of EMDR as a comprehensive psychotherapeutic approach, and stay faithful to the application of the Adaptive Information Processing model. The hope is that this will inform robust and best practice, research as well as training, practice and future innovations.
Michael walked us through core elements identified in this process, including a glossary of terms and an understanding of EMDR under three headings: EMDR-derived Techniques, EMDR protocols and full EMDR Psychotherapy.
Moving to the latest scientific research, Michael talked us through the findings of a computational neural network model which accurately predicts which brain centres respond to Bilateral Stimulation (BLS) when compared to real-life brain scanning data.
This study brings us a step closer to understanding the mechanisms of PTSD and EMDR, particularly of how EMDR achieves trauma remission and how EMDR exerts its therapeutic action.
Michael considered the neurobiology of BLS compared to Prolonged Exposure and the role of the ventromedial prefrontal cortex and the dorsolateral prefrontal cortex.
It is suggested that ventromedial prefrontal cortex activation during exposure and the resulting downregulation of the amygdala are key factors in prolonged exposure therapy.
Interestingly the dorsolateral prefrontal cortex is activated following BLS, a key finding being that EMDR–recruited regions of the brain have a higher capacity to inhibit the amygdala compared to the regions activated during prolonged exposure.
Discussion of the AIP model and resources centred fundamentally on the need for balance between the two; positive memory networks need to be present in order for processing to occur. We also need to understand that the therapeutic relationship is a positive memory network in itself – a dimension to EMDR not often explicitly recognised.
The take-home message from Michael? EMDR is a sensitive therapy strongly dependent on the therapeutic relationship, especially when working with attachment-deficit clients. Resourcing can be as powerful as adhering to protocols.
After Michael’s fascinating presentation, we had a quick break and returned to group discussions in groups of 5-6 delegates to discuss our thoughts on the morning or afternoon’s presentation.
The feedback was that there were many thought-provoking discussions and plenty of reflection and assimilation of the two presentations. It was lovely to be in groups with delegates from all over the world and have stimulating conversations that would not have been possible if the event today were in person.
To end the day, we finished off in our traditional Zoom plenary with questions and appreciation for our two presenters, a perfect way to finish a truly informative day.
On a sunny and chilly Saturday, our April 2022 East Anglia Regional Networking day – continuing a tradition going back now a full eight years – was certainly popular, with over 200 colleagues signing up and 120 attendees joining in online in real time from East Anglia, the UK and as far away as Bosnia and South Africa.
Sonya Farrell, co-founder of our EMDR Association regional group and long-time supervisee of the legendary Jim Knipe of EMDR Toolbox fame, started the morning with a case study of client ‘Christine’, presenting with multiple chemical sensiticity as well as Emetophobia, Trichotillomania and Addictions.
Mapping Christine’s trauma with Jim Knipe’s trademark ovals to demonstrate the various parts, Sonya explained how the overwhelm of the human nervous system’s natural processing system can lead to parts remaining unintegrated into an individual’s sense of self.
We look forward to welcoming the redoutable and hugely experienced Gus Murray to our April 2024 regional networking day online to take us through using EMDR with every client.
President of the still relatively newly-formed All-Ireland EMDR Association, Gus is an EMDR Europe Accredited Trainer and Consultant, and Programme Director at the Cork Institute of Technology for the past 25 years.
As Gus explains it, the full potential of the clinical application of EMDR therapy is still compromised in its application to a full range of clinical conditions, with many clinicians struggling or reluctant to use it with more complex and disordered clients.
Sonya is both a founder member of the EMDR Association UK’s regional group in East Anglia, and has worked closely with Jim for many years now, preparing with time to step out as a trainer herself in his Toolbox approach as the Master himself settles slowly into his US retirement.
For the first half of the morning, Sonya took us through some of the essential pillars of the Knipean approach to EMDR, including:
LOUA Level of Urge to Avoid
CIPOS Constant Installation of Present Orientation and Safety
BHS Back of the Head Scale
In the afternoon, our colleague Gary McFarlane brought us an overview of EMDR with clients presenting with sexual addictions and compulsions.
Gary is a Relate-trained relationship counsellor and mediator, and has created a comprehensive Sex/Porn/Love addiction recovery programme online being used by clients internationally.
Gary explored the difference between compulsion and addiction, relating this especially to Attachment theory and AI-EMDR, how best to case conceptualise in EMDR’s Phase One Trauma History taking and then how best to work with what emerges in Phase Four processing.
Our East Anglia Regional Group is focusing more in the next period, online only for the time being, on networking and personal connections between our members, with space as our events unfold for colleagues to present on their own areas of particular passion.
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.
The EMDR Association’s East Anglia Regional Group were delighted on Saturday 24th April 2021 to welcome internationally renowned and legendary EMDR Consultant and Trainer Ana Gomez to take us on a journey on parts and inner systems to explore complex trauma.
Ana is a psychotherapist, author of several books, chapters and articles, and a lecturer internationally known for her innovative work with children and adolescents.
She is an EMDRIA approved consultant, an EMDRIA advanced training provider, an EMDR Institute and EMDR-IBA trainer and a trainer of trainers. Ana has worked with children, adolescents, adults and families affected by trauma and adversity for over 25 years, presenting in more than 40 cities in the USA as well as 30 cities in four continents.
Over 600 delegates signed up to Ana’s workshop, with many attending on the day online and others chossing to watch the recording at a later date. Every delegate received the handouts, recording and certificate for six EMDR UK Association CPD points.
Ana presented to us from across the pond in Phoenix, Arizona, meaning a very early start for her and an afternoon 2pm start for us.
The plan for the day was to explore her theoretical framework along with specific, practical and creative tools and strategies to work with entrenched maladaptive forms of self-protection using parts work.
Justin will join us for the first half of the morning, after which will have the opportunity to break into smaller groups to consider how to apply the learning to our individual practice.
After lunch, when we’ll hold our annual AGM, Mike Rivers will present a case study where he used attachment-informed EMDR to work with a client presenting with decades of debilitating multiple-chemical sensitivity.
This case study provides a foundation for discussion and learning around working with the raft of symptoms that often come under the heading of medically unexplained symptoms (MUS).
Mark Brayne will then present the findings of our research project with Sheffield University exploring therapist and client experiences of online EMDR, after which we want to offer you the opportunity to network and learn in small groups on the following specialist topics:
Q&A with Mike Rivers on the learning from his case study
Q&A with Mark Brayne on what we can take away from the research findings
Delving into Jim Knipe’s toolbox
EMDR and somatic experiences
Working with police and emergency service personnel
Working with dissociation
A space simply to catch up with colleagues
The event will take place on Zoom but with plenty of opportunity to catch up with colleagues we very much hope to have an ‘in-person’ feel to the day.
Indeed, as an afterthought here, our East Anglia Regional Group is going to be focusing more in the next period, definitely online and perhaps once again in-person, on networking and personal connections between our members, with space as our events unfold for colleagues to present on their own areas of particular passion.
Presented by Dr Jamie Marich and reported by Ushma Patel
Saturday 26th June 2021 saw many of us (50 delegates) attend online (from near and far) in an interactive, retreat style workshop for an afternoon of soothing techniques to learn how to keep ourselves safe, sane and healthy in this new world as COVID continues to unfold.
The EMDR Association’s East Anglia Regional Group were delighted to welcome back Dr Jamie Marich, an EMDR therapist and EMDRIA-approved trainer specialising in the treatment of trauma and addictions, and founder of the Institute for Creative Mindfulness, shared with us the importance of mindfulness and meditation in modern living.
The main focus of the afternoon was Mindfulness and Meditation, and on how best we can maintain emotional and physical equilibrium as we work remotely with our clients’ deepest traumas.
Jamie talked us through some practical ideas and strategies for practicing mindfulness as a path for enhancing resilience, with special focus given to issues of workplace wellness. It was interesting to also understand the applicability of these techniques to our EMDR practice particularly the preparation and closure phases.
The online retreat started with a mini mindfulness exercise including ‘palming the face’ which enabled us to focus in further on the heat and energy resting on our face particularly around our eyes and temples incorporating bi-lateral stimulation.
A great technique to use when you have been in front of your computer all day writing up client notes!
After a stretching exercise which can aid in reducing back pain – a common complaint in our occupation – we were invited to sit or lie down to practice Yoga Nidra an exercise that encourages access to a powerful state of consciousness; to connect with ourselves, embrace ease and comfort and let go of effort.
Then, we were given the opportunity to ask questions about Yoga Nidra and its principles. It was fascinating to gain insight in to how Yoga Nidra and EMDR, with their correspondence between intention and Positive Cognitions, complement each other.
We spent some time talking in small groups to develop a basic care plan for staying well and resilient during the coming year of inevitably further transitions.
Through wider group discussion Jamie guided us through first-hand experience of care planning, with a take-home message to use such plans with our EMDR clients.
There was opportunity too to really explore what our body fuses to, whether that be music, sounds or art and colours. The active participation brought a sense of freedom alongside nourishment.
It was a brilliant, exploratory afternoon with opportunity to practise several mindfulness/meditative exercises, with a view to formally or informally apply them to our daily life as an approach for building resilience and cultivating a more balanced life.
We are truly grateful to Jamie for walking us through the relevance of mindfulness to one’s own personal care and burnout prevention, as well as how to translate these skills from our own personal life and practice into our EMDR therapy practice with clients.
The event was recorded so those who couldn’t attend live with us but who have paid and signed up in advance will have full access to the event for a further month.