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Being Brief with EMDRanIntegrative, Belief Focused Approach to EMDREMDRStage OneStage TwoStage ThreePhase 1:Target PlanningPhase 3:Access & Activate(Assessment)Phase 8:ReevaluationPhase 2:PreparationPhase 4:Processing(Desensitization)Phase 5:InstallationPhase 6Body ScanPhase 7: Closure3 ProngsPastPresentFuturePhase 1Targeting PlanningPhase 2Resourcing

Standard EMDRBrief, Belief Focused EMDRPhase 1: HistoryPhase 2: Preparation*Stage 1: Case ConceptualizationPhase 1: Target Sequence PlanningPhase 2: ResourcingPhase 3: AssessmentPhase 4: DesensitizationPhase 5: InstallationPhase 6: Body ScanPhase 7: Closure*Stage 2: TreatmentPhase 3: Access & ActivatePhase 4: Linking. Binding, Consolidating NetworksPhase 5: Strengthening Adaptive NetworkPhase 6: Implicit Memory IntegrationPhase 7: ClosurePhase 8: ReevaluationThree Prongs Past Experiences Present Triggers Future Templates*Stage 3: IntegrationPhase 8: IntegrationCompleting the Target Sequence Plan Past Experiences Present Triggers Future Triggers*Janet: 1898 approach to PTSD

Stage 1:Case ConceptualizationAdaptive Information Processing(Emotional Learning)Hebb’s Axiom: Neurons that fire together, wire onsolidationa/BConsolidationAConsolidation

Frozen Memories(Shapiro)1. A natural drive toward adaptivelearningFrozen Memory2. Memory networks are viewed as thebases of dysfunction and healthThalamus3. Disturbing events are dysfunctionallystored: “frozen”4. The Past is Present Influence our Perceptions Attitudes pus

The Development of an Isolated Neural NetworkKiessling: 2012Emotionally charged memories develop into an emotionally charged neural networks Disturbing events are encoded with higher emotions/sensations (amygdala) Repeated exposure leads to an emotionally charged neural networkI’m worthless.I’m worthless. Present triggers activate past emotional/sensorial networks When triggered, past experiences influence perceptions,attitudes, behaviors and Core Belief; e.g., I’m worthless.

Emotionally charged networks may become isolated/unable to link withadaptive networksIsolated NetworkI’m worthlessAdaptive networkI’m worthwhile, regardlessTeacher’s/mentor’s encouragementFamily criticismNegative networks are unable to consolidate with adaptive networks

Stage 1:Case ConceptualizationTargeting:IncidentvsNeural Network Consolidation(Desensitization)(Linking, Binding, Blending, Consolidated)Brief, Belief Focused EMDRNeural NetworkShapiroNodeFrozen(Whole greater then sum of parts)Node (Incident)(First, Worst, Most Recent)Node(Neural Network)Past/OutdatedIsolatedPresent/Functional

Stage 1:Case ConceptualizationPhase 1: Targeting Sequence Plan(Linking, Binding, Blending, Consolidated)Phase 1Targeting PlanningPhase 2Resourcing1. Identify the presenting symptom2. Discover its “Root Cause Core Belief”Brief, Belief Focused EMDRNeural Networks41,2 & 33. Map out experience resonating with thecore belief’s emotions and sensations Past Experiences Present Triggers Future Triggers4. Identify the preferred present,functional adaptive belief that is theadaptive resolution to all theexperiencesNode(Neural ptive Belief

Stage 1:Case ConceptualizationThe Target Sequence PlanBelief Focused Neural Network Mapping (Kiessling, 2018)Standard EMDRBrief, Belief Focused bilityControlSurvival

Adult Core Belief ClustersDevelopmental PlateausNEGATIVE / IRRATIONALI can’t protect myself.I do bad things.I’m not good enough.I’m a failure.I should have done something.I’m unlovable.I’m worthless.I’m inadequate.I’m responsible(for everything).I should have done something.I have to be in control.ADAPTIVE / PREFERREDVulnerabilityGuiltI can protect myself.I can learn from my mistakes.I am good enough.I did the best I could.I did what I could.Worthlessness/LovabilityI’m okay as I am.I’m okay as I am.I can accept myself.ResponsibilityInstinctControl InstinctI can recognize appropriateresponsibility.I did what I could.I can safely let go of some control.I can recognize what I canand cannot control.I can control what I can even when I can control what I can.I can control what I can.I’m powerless.I’m helpless.I’m trapped.I’m discarded.Survival InstinctI’m defective.I’m abandoned.I can survive / exist / get my needs met.I’m alone.I’m okay as I am.I can survive / exist / get my needs met.It’s not safe to feel.I can survive / exist / get my needs met.I’m unimportant.I’m invisible.I’m don’t deserve to existPg 53ToxicShameI can begin to learn when and how to I have value regardless.I can get my needs met.I deserve to exist.

Stage 1:Case ConceptualizationPhase 2: Resource EnhancementPhase 1Targeting PlanningPhase 2ResourcingStandard EMDRBrief Belief Focused EMDRAffect Management Safe PlaceTeach Affect management tools as necessary Secure Place Securing a Place Container Mindfullness Aroma RDIPositive Adaptive Network Enhancement Resource Focusing Extended Resourcing

Stage 2: TreatmentTarget SelectionStandard EMDRIncident SpecificBrief, Belief Focused EMDRNeural Network Focused1. 10 worstChronological1. Symptom: Core Belief2. Symptom: Belief Person Place Thing Emotion Sensation Behavior2. Target Identification Neural NetworkTarget Treatment Plan SummaryName: . Date: / /Negative BeliefAdaptive BeliefFuturePresentPastRoot CauseClosure:[ ] Breathing. [ ] Acupressure.[ ] Butterfly[ ] Secure Place.[ ] Container.[. ] OtherAdditional treatment notes3. Target Identification First, Worst Most Recent4. Processing Touchstone\Clinician Signature3. Processing Any target within the plan What to process Specific incident Part of the neural network

Stage 2: Treatment3 ProngsStandard EMDR Target Specific Reprocessing(1995, 2001, 2017 Shapiro Text)Disturbing ImageNCNodePast(First, Worst, Most Recent)?Channels of AssociationPresent TriggersFuture TemplatesReprocessingSUD 0InstallationVoC 7Clear BSPC

Stage 2: TreatmentBrief Treatment EMDRNeural Network FocusedPhase 1Targeting PlanningLinking, Binding, Consolidation (Kiessling)Phase 2ResourcingNeural Network IdentificationNegativePositiveLinking, Binding and ConsolidationFunctional/AdaptiveI’m lovable regardless!I’m unlovableI’m lovableI’m unlovableI’m lovable

Stage 2: TreatmentPhase 3: Access & ActivateStandard EMDRPhase 3: Assessment(10,20 or more minutes)Brief, Belief Focused EMDRPhase 3: Access & Activate(3-4 minutes)PictureNegative Cognition (identified at this time)Positive Cognition (identified at this time)VoC: 1-7EmotionsSUD: 0-10Body LocationWorst PartNegative Belief (already identified in Target Plan!)Positive Cognition (already identified in Target Plan!)VoC: 1-7EmotionsSUD: 0-10Body Location**EMDR and EMDr, Not EMD Do not challenge the cognitive distortion“Help discover the way” by clarifying beliefs, outliningnegative and adaptive neural networks during TargetingSequence Plan (Phase 1)“Stay out of the way” - Phase 4 Desensitization

Stage 2: TreatmentPhases 4-6: ProcessingStandard EMDRBrief, Belief Focused EMDRNeural NetworksIncidentPhase 4: Desensitization EMDR: Unrestricted Processing24 or more passesChannels of AssociationSUD 0Phase 5: Installation VoC 7Phase 6: Body ScanPhase 4: Processing The Processing Continuum EMD , EMDr, EMDR SUD 0?Phase 5: Strengthening Adaptive Network VoC 7?Phase 6: Implicit Memory Integration The Body Keeps Score

Stage 2: TreatmentThe Processing ContinuumEMD Client cannot manage affect, may dissociate if overwhelmedPhase 3: Access and Activate: No Body LocationEMD : Restricted ProcessingContainerPhase 4: Desensitize a specific incident 5-10 seconds of BLS Breath, Target, SUD 0-10?, Go with that SUD stops decreasing, proceed to StrengtheningPhase 5: Strengthen adaptive belief 5-10 seconds BLS VoC 7NO PHASE 6: BODY SCAN Body is the umbilical cord to the rest of the neuralnetworkAdaptive Neural NetworkIncidentNegative Neural Network

Stage 2: TreatmentThe Processing ContinuumEMDrClient can manage affect, does not want to process the entireneural networkPhase 3: Access and ActivatePhase 4: Process an agreed upon arena 10-15 seconds of BLS Breath, Target, What do you notice? Go with that SUD stops decreasing, proceed to StrengtheningPhase 5: Strengthen adaptive positive belief 5-10 seconds BLS VoC 7Phase 6: BODY SCAN - integrate associated sensations* *If sensations are related to the targeted arenaEMDr: Contained ProcessingAdaptive Neural NetworkContainerIncident’sArenaNegative Neural Network

Stage 2: TreatmentThe Processing ContinuumEMDRClient can manage affect, is willing to process the entireneural network regardless of the incident targetedPhase 3: Access and ActivateTarget is the entry point into the neural networkPhase 4: Process an agreed upon arena DAS paced according to client’s non-verbals Process entire network, not just target SUD 0Phase 5: Strengthen adaptive positive belief 5-10 seconds BLS VoCo7Phase 6: BODY SCAN - integrate associated sensations Implicitly stored sensationsEMDR: Unrestricted e Neural NetworkPositive Neural Network

Stage 3: IntegrationComplete the Targeting Sequence Plan Process Remaining incidents Past Incidents Present Triggers Future TriggersIntegrative PsychotherapyCBT, Solution Focused, Psychodynamic,EMDR, DBT, IFS, Somatic Experiencing, HypnosisEMDRStage 1Case ConceptualizationPhase 2PreparationPhase 1TargetingPhase 1 PlanningTarget PlanningPhase 2ResourcingStageStage22TreatmentProcessingPhase 3Access & ActivatePhase 4DesensitizationPhase 5InstallationPhase 6Body ScanClosureAdaptive(The Sum is Greater than the Parts)Complete the Overall Treatment Plan Teach additional: Skills Behaviors Attitudes Etc.Stage 3IntegrationPhase 8Reevaluation3 Prongs- Past- Present- Future

Integration

Wrap-upFor expanded videos on:Belief Focused EMDRThe Processing ContinuumEMDR Unchainedand much morevisit:Roy Kiessling video links at:www.vimeo.com/emdrconsulting

The Body Keeps Score Neural Networks. The Processing Continuum EMD Client cannot manage affect, may dissociate if overwhelmed . Body is the umbilical cord to the rest of the neural network EMD : Restricted Processing .