Category: Eye Movement Desensitization and Reprocessing

By Jeff Dwarshuis LMSW ACSW 

Integrated EMDR

Eye Movement Desensitization and Reprocessing (EMDR) is a treatment method that dramatically reduces or eliminates the negative impacts of traumatic memory leading to Posttraumatic Stress Disorder (PTSD). Therapists have expanded the use of EMDR to include other presenting concerns besides PTSD such as depression, anxiety and relational hardship by addressing the underlying negative experiences leading to the problem. EMDR, when combined with other treatment suggestions such as cognitive therapy or psychoeducational work, is called Integrated EMDR since it is a combination of approaches to meet the needs of the client. (For a description on EMDR and Integrated EMDR see my articles “What is EMDR?” and “Integrated EMDR”)

Codependency Defined 

Codependency is a psychological and relational problem that causes an individual to feel compelled to focus on the needs of others while ignoring or neglecting their own needs. Often times the person shows an overreliance on the approval of others to develop or hold a sense of identity.

Codependency can be described as a disease of the loss of self and codependent relationships consist of unhealthy communication, poor boundaries, reactivity and problems in intimacy. Relationships are often unbalanced with the codependent person attaching themselves to people who are in need due to the effects of substance abuse, poor health or dependency. These unbalanced relationships serve the need of the codependent person to continue their compulsion to over help. For this reason, codependents often times take the role of being a rescuer, confident and supporter in relationships. Codependent relationships happen mainly in families but they also exist in friendships, romantic relationships and the workplace.

Codependency is not a formal disorder listed in the Diagnostic and Statistical Manuel of Disorders but is a term that has been created through literature having to do with substance abuse and dysfunctional relationships. Because of this it does not have a formal and universally accepted definition or treatment approach. In general, however, people with codependency come to therapy most often with the primary concerns of depression, anxiety and relational hardship. Physical problems and psychosomatic problems are also very common. Often times clients in the midst of chaotic codependent patterns do not realize the existence of the disorder or know they have it. They generally see their emotional and relational patterns as normal.

Codependency and Causes

The development of codependency has a variety of possible causes. Each cause might exist in a single person. The most common understanding of the development of codependency is that it occurs as the result of emotional abuse. This may have happened in childhood, a close adult relationship or both. Because of abuse the individual‘s self esteem is challenged and the person develops patterns of pleasing others to increase their own sense of worth and esteem. Since the effort is based on external acceptance and not self acceptance the person continues to feel empty. The individual will easily solidify a pattern of this behavior since they receive reward for what they are doing. Helping behavior is generally self rewarding and feels good. Also, society highly rewards individuals who are helpful. This relational and social cycle combined with the person’s challenged esteem and identity perpetuates a negative cycle of need and overworking.

Codependency also can develop through longstanding family expectations that a child take on inappropriate family roles. Specifically a child might have the expectation that he or she take the role of the fixer, emotional support or pseudo parent. This family cycle occurs in homes where there is substance abuse with a parent. In this case, the child may have to pick up the pieces for the overwhelmed enabling parent and take on family tasks beyond his or her age. Also the child could develop emotionally reactive behavior to the substance abusing parent’s core defenses of denial and blame projection which often times causes the child to develop patterns of self blame, low self esteem, undue personal responsibility and personal denial of self needs.  This codependent pattern can also occur in families that are overwhelmed with physical illness, financial hardship or parental limitations and incapacities. In these families the development of codependency is possible but not likely. In families with substance abuse however, the development of codependency is both predictable and expected.

Codependency is also developed by an addictive pattern that serves to help the person avoid their emotional pain, emptiness and hopelessness of their social life. Behaviorally the individual uses the excessive behavior of helping others as a method of distraction from their own problems. Due to this need to distract the codependent can grow irritated when others do not accept their offers of help and then maintains a controlling nature that can lead to perfectionism. Generally the person is completely unaware they are doing these things.

EMDR and Brain Functioning 

Eye Movement Desensitization and Reprocessing (EMDR) is a treatment method used to quickly and effectively eliminate the negative impacts of traumatic memory. EMDR is a neurobiological intervention that makes use of eye movements to facilitate a physiological impact on brain functioning which creates permanent emotional and cognitive change in an individual when thinking about or visualizing traumatic memory.

Recent studies on brain scans of individuals indicate that traumatic experience and traumatic recall negatively impact brain functioning and that EMDR corrects it. Specifically, during trauma a part of the brain called the amygdala, which controls many of our emotions and is responsible for autonomic responses associated with fear and fear conditioning, becomes over activated and this creates an impasse between itself and the hippocampus. The hippocampus plays an important role in the consolidation of information from short term memory to long term memory and spatial memory which is responsible for recording information about one’s environment and spatial orientation.

It is recognized that this impasse between the hippocampus and the amygdala creates symptoms found in generalized anxiety, panic attacks and posttraumatic stress disorder. During EMDR, this impasse is corrected as eye movements will both enlarge and activate the hippocampus so it can receive the overwhelming amount of information coming from the amygdala and then sort it. The hippocampus then completes the proper brain processing by sending information to the anterior cingulate cortex which is involved in aspects such as attention, decision making, reward anticipation, ethics, morality, impulse control and emotion. The impact of opening this impasse and restoring proper brain functioning means that a negative memory, once too overwhelming to manage, is put into the proper context of time and space, has affective and cognitive aspects of the memory merged, is viewed with more rational thought, reason and control and exists in a clear distinction between the past and the present.

During the EMDR procedure, which is administered by a psychotherapist, a client experiences two primary reactions to the traumatic memory. First there is a distancing from the memory that includes an elimination of the negative emotional reactions related to the trauma. Second, the client experiences an increased level of rational perception related to the memory. This increased rational thinking is called Adaptive Information Processing (AIP). AIP is the result of successful EMDR reprocessing and allows the client to hold a more rational view of personal safety, personal responsibility and personal choice while visualizing or discussing a trauma memory. AIP also allows the client to hold an accurate positive self perception or cognition while visualizing the trauma. This allows the client to problem solve how he or she would react or prefer to react differently in a similar situation.

EMDR for Codependent Behavior

The EMDR Protocol for the treatment of codependency targets memories of abuse, patterns of addictive behavior and negative cognitions leading to low self esteem. Typically the memories of abuse involve emotional or verbal abuse such as negative talk from an addicted parent or spouse, feelings of loss due to excessive demands for caring for the family or longstanding patterns of self blame in the face of hopelessness to change a bad situation. In some cases codependent behavior is linked to all forms of child abuse including verbal, sexual, physical abuse and neglect and the person additionally has symptoms of posttraumatic stress disorder.

To create a list of traumatic memories in preparation for EMDR it may be important for the therapist to discuss specific aspects of the client’s childhood as well as discuss clear definitions of what qualifies as abuse. It is not uncommon for people with codependency to have been abused in many ways yet have no understanding or consideration that what they endured was abusive in any way. Clients may also have a history of abuse from adult relationships. These memories also must be listed as topics of EMDR reprocessing.

A cognitive ranking can be helpful for targeting EMDR memories. Due to patterns of emotional avoidance, clients with codependency have difficulty creating associations between life events and the development of low self esteem. Evaluating cognitive thought patterns can assist. The therapist verbally states a list of negative cognitions and the client responds by indicating how much they believe the negative cognition by applying a number ranking. Referring to the most challenged cognitions reviewed the therapist then asks when the person started believing the negative cognition and how they learned it. This process then begins to illustrate to the client and therapist which life events have impacted self esteem. The event then is a target for EMDR processing.

Once the memories are listed the client follows the EMDR Protocol. As stated previously, successful EMDR will create a distance from the memory as well as create a more rational perspective of self and others. The distance from the memory allows the individual with codependency to be less emotionally reactive to recalls of the memory as well as to situations that are like the memory such as repeated relational patterns. Also, a decrease in emotional reactivity allows the person to remain more thoughtfully present when using learned skills of management.

The increase in rational perception resulting from successful EMDR creates a more realistic perspective of one’s self and abilities. In general this creates an increase in self esteem. As self esteem increases the need to please others to aid one’s self esteem decreases. Additionally the client is more able to rationally distance themselves from unfair self blame and begin to create a broader narrative applied to personal choice and management of personal safety. The distance from emotional reactivity combined with increased rational thinking will cause the client’s symptoms of anxiety and depression and posttraumatic stress to decease or end.

As stated, people will use codependent behavior as a method to avoid what they are feeling. As this cycle of need and partial reward intensify the behavior becomes additive. The EMDR protocol can be used to break this cycle. For more information on this see my article “EMDR for Addictions” to see how it can be used for codependency.

As the client continues to experience success with these topics there are typical times of crisis when an old pattern might occur. These instances are treated as a trauma memory and reprocessed with EMDR.

Integrated EMDR and Codependency

Typically clients with codependency will need additional objectives to the EMDR for proper treatment since many skills commonly developed in childhood have not been provided. For example, clients generally need communication exercises to formulate and manage their increasing assertion. Parenting material is also commonly needed as well as tools for relational management. Following EMDR processing treatment should consist of problem solving therapy as the client will be faced with the many challenges of restructuring their family and social life to parallel their increased need of self care and deceased focus on others. Eventually the client ends codependent behavior, the anxiety and depression disappear and the times of relational stress grow both less frequent and less intense. The client then is able to manage.

By Jeff Dwarshuis LMSW ACSW

Imago Therapy 

Imago Therapy was developed by Harville Hendrix as a type of Marital Therapy. It is recognized as a highly effective relational intervention because of its unique approach to understanding the nature of human attraction as well as its practical methods of relational change. Imago Therapy maintains that people are attracted to individuals who have both the negative and positive qualities of their own parents, that people try to get in their relationships the things they didn’t receive as children and that people attempt to repeat the joys of youth by reliving the same events that brought pleasing emotions as children.

Childhood Disappointments and Behavioral Reactions

Imago Therapy also asserts that people negatively impact their relationships by repeating the same reactive behaviors they did as children in response to parental disappointment. For example, if a child’s parents were not available to them and they reacted with aggression to this disappointment they will most likely repeat the behavior of aggression in their marriage during times of conflict. Another example is if a child is abused physically and as a child they responded to this aggression with avoidance and self blame they then will continue this reaction in their marriage in a more adult form such as using substances and self denigrating language.

The Imago Setup 

In Imago Therapy the word Imago means “Image” and represents the type of person to whom we are attracted. An individual can find their “Imago” by completing an Imago worksheet that elicits information about one’s childhood family. This worksheet is shown below. Completing sections A- E provides information that can be applied to the frame sentence found at the end of the setup and this gives a description of unconscious attraction. The form is as follows –

1. List the bad qualities of your mother and father.
2. List the good qualities of your mother and father
3. Complete the sentence – “What I wanted and needed most as a child was…”
4. List good memories of your childhood and how you responded emotionally.
5. List the disappointments of your childhood and how you responded behaviorally.

After sections A- E are completed the client uses the corresponding answers from the statements above to fill in the blanks below get a complete description of their relational tendencies.

I am trying to find a person who is (A) to always be (B) so I can get (C) and feel (D). I stop myself from getting this sometimes by (E).

Completing this worksheet allows one to understand the type of person to whom they are attracted as well as the things they are hoping to resolve, repeat and enjoy in their adult relationship(s). For the purpose of Integrated EMDR, the primary interest is the last section (Section E) which states the person’s behavioral responses in reaction to disappointments. These behavioral responses are a description of the counterproductive and reactive behaviors which continue into adult relationships.

Integrated EMDR

Eye Movement Desensitization and Reprocessing (EMDR) is a treatment method that dramatically reduces or eliminates the negative impacts of traumatic memory leading to Posttraumatic Stress Disorder (PTSD). Therapists have expanded the use of EMDR to include other presenting concerns besides PTSD such as depression, anxiety and relational hardship by addressing the underlying negative experience leading to the problem. EMDR, when combined with Imago Therapy, is a type of Integrated EMDR since it is a combination of approaches to meet the needs of the client.

EMDR for Reactive Reduction

As stated in prior articles, EMDR eliminates the negative impacts of traumatic or negative memories that lead to negative emotions, self concept, body reactions and related behaviors. (See “What Is EMDR’ and “What Is Integrated EMDR?”) The client seeking help with their relationship can refer to the Imago worksheet section E on childhood disappointments and create a list of specific memories of disappointment leading to reactive behavior. These memories can be used as EMDR targets and reprocessed using EMDR. The reprocessing of these memories takes away any negative emotions, self concept or behavior reaction in response to repeated themes of childhood disappointment happening in their adult relationship. This allows the client to remain objective rather than reactive during times of emotional conflict. A client can then respond in their relationship with problem solving or listening or being in a better position to use treatment objectives such as communication skills.

 

By Jeff Dwarshuis LMSW ACSW 

When Eye Movement Desensitization and Reprocessing (EMDR) was developed by Francine Shapiro in 1989 it was used as a method of treatment for Posttraumatic Stress Disorder (PTSD). EMDR dramatically reduced or eliminated the negative impacts of traumatic memory leading to PTDS. Today it is recognized as the treatment of choice for PTSD and thousands of people have benefited from its use. (See blog article “What is EMDR?”) 

Since that time, researchers and therapists have expanded the use of EMDR to include a number of other mental health diagnoses besides PTSD. It was discovered that not only did EMDR eliminate the impacts of acute memories leading to PTDS but it also eliminated the negative impacts and irrational self perceptions caused by bad memories and bad experiences in general. With this discovery, EMDR treatment could be applied to depression, anxiety, relational problems, performance problems or any problem or mental health diagnosis that was caused by negative life experiences. Due to the complexities of many of these problems, treatment needed to include other suggestions besides EMDR Therapy such as cognitive therapy, psychoeducational reading or communication exercises. This multifaceted approach to treatment is called “Integrated EMDR”. 

The Two Primary Responses 

When using Integrated EMDR it is important that the therapist be able to predict how EMDR will impact a particular client. Having this understanding, the therapist can determine if other treatment suggestions are necessary. 

With each EMDR session there are two primary responses by the client. First, the client experiences a distancing from the negative memory and a decrease in related negative emotions, body reactions and negative cognitions that accompany the memory.  These changes are permanent and the therapist can expect the client be able to discuss, investigate, and revisit any part of the negative experience with an objective view.  Also, the decrease in negative reaction quickly eliminates PTSD symptoms as well as related symptoms of depression and anxiety. 

The second distinct response to EMDR is Accelerated Information Processing (AIP). AIP is best described as a fast cognitive restructuring of the irrational thoughts that occur with the recall of negative memory. During EMDR the client has an acceleration of reasonable thoughts, perceptions and considerations related to the event and sees the memory (and sometimes related memories) in a reasonable, rational manner. 

AIP is what allows the traumatized war veteran, who once felt helpless during memory recall, to say “I did the best I could and I am a good soldier” and the sexual assault victim who experiences intrusive flashbacks to say “It is over and I am OK”. 

AIP is found to work also on future pictures that cause negative reactions such as performance topics, workplace assignments, athletic competitions or personal assertions. AIP, in these cases, allows the client to look ahead to the future performance picture with a rational and reasonable perspective on their ability to successfully complete the task. 

The distancing from traumatic memory and AIP are both an expected result of each successful EMDR session. Knowing that these responses occur allows the therapist to predict how a client will think, feel and act after EMDR is completed and this can aid the therapist in considering other client needs. 

The Best Expected Level 

In addition to knowing the responses to EMDR, it is also helpful to know that EMDR will bring a client to what is known as their “best expected level”. For example, a client who was abused at a young age may have carried negative memories and related complications for a lifetime. EMDR will bring this person to their “best expected level” which means all symptoms and negative physical, emotional and cognitive reactions should be reduced or eliminated. The client is likely to feel better than they ever have felt before. However, if that person was raised in an environment of conflict, they may not have the skills to communicate their needs or their progress. For this client the treatment plan would require added suggestions for communication skills. A similar client may experience all of the benefits listed above. However, if that client has a history of neglect, the client may not be able to explain their internal changes. This client would benefit from cognitive therapy exercises designed to help one pay attention to specific changes in thoughts and feelings. In general, EMDR will bring someone to their “best expected level” but will not teach things that have not been learned. Recognizing this specific quality of EMDR, the therapist and client can address additional needs and the treatment objectives can be suggested as necessary. 

Therapeutic Considerations 

Integrated EMDR is a highly effective method of treatment for most all mental health diagnoses and can be used often. Clients who use Integrated EMDR complete treatment more quickly than traditional therapy (3-4 times more quickly) and are in a better position to not have to return to therapy. 

Many therapists will find that Integrated EMDR is different from traditional therapy. With EMDR, the therapist acts as a “technical manager” over a treatment process and offers little feedback or interpretation. In this way, the therapist’s role is diminished and there is more reliance on a treatment method and client participation. Also, therapists traditionally make suggestions and interpretations to clients. However, with EMDR and the impact of AIP, the best interpretations are done by the client. Therapeutic interpretations are best done during times of review. 

Also, the process of evaluation for positive change in Integrated EMDR can be difficult. Often times the client experiences a dramatic shift in their life. However, since EMDR will bring someone to their “best expected level” the client experiences life as they should and at times will not recognize the differences. Successful EMDR is a comparable to the person who has felt the pain of a sore foot for weeks and wakes one morning with no pain and not recognizing that anything is different. EMDR is the same. Often times the client is unaware of changes until the therapist reviews symptoms and cognitive self beliefs. 

Jeff Dwarshuis LMSW, ACSW is a licensed psychotherapist in private practice specializing in EMDR therapy. For contact call (616) 443-1425 or send an email to jeffsemdr@gmail.com.

Also see Dwarshuis’ webpage at http://www.jeffdwarshuis.com/  for free clinical information and blog entries on EMDR, performance strategies, upcoming presentations and family health.

 

 

 

By Jeff Dwarshuis LMSW, ACSW 

All people have difficult times and employees at all levels of leadership will carry stress to the workplace. The result can be a less than optimal performance. Employees can be stressed by financial hardship, marital discord, parenting or past issues of divorce, family loss, bereavement or child abuse. All can dramatically impact an employee’s work performance.

Eye Movement Desensitization and Reprocessing (EMDR) is a treatment that can quickly and effectively assist with workplace stress. EMDR has its beginnings as a treatment for Posttraumatic Stress Disorder and has been very effective with performance, depression and anxiety as well. Created by psychologist Francine Shapiro PhD, EMDR uses a blend of cognitive, emotive and client centered therapies in combination with neurobiological interventions. Since its beginning in 1995, EMDR has dramatically changed the lives of thousands of people.

EMDR, REM and Memory Reprocessing 

To understand EMDR it is helpful to first know about the impact of Rapid Eye Movement (REM). After 30-60 minutes of sleep an individual begins REM sleep. During REM, one involuntarily moves their eyes back and forth. The eye movements cause a neurobiological reaction which stimulates a reprocessing of the day’s memories and makes recent memories into old memories. If someone has a negative memory in their day, the REM process facilities making this recent bad memory no longer bothersome.

REM and Posttraumatic Stress Disorder

Traumatic memories occur when one is overwhelmed by either witnessing or enduring something that is horrific beyond the typical human experience. This might include combat, child abuse, domestic violence, personal assault, traffic accidents or traumatic medical procedures. Because of the severity of these memories, the REM mechanism described does not work. In these cases, the individual remains aware of the memory and continues to experience its negative impacts. The memory is not reprocessed and the individual could go on for decades terrorized by their own memory. This is called Posttraumatic Stress Disorder.

Negative Memories and the “Three Point Power Supply”

All negative memories create three things which exist interdependently and make a memory seem unpleasant. These three things are a negative emotion, an unpleasant body sensation and a negative self belief. Say for example someone went to a social gathering and said something foolish in front of a group of people. When thinking about this memory, the person would experience embarrassment, flushing and a self belief of “I am so stupid!” During REM, eye movements create an even stimulation of the right and left hemispheres of the brain and cause a tremendous and fixated calm in the body. Since the body is so relaxed, it does not react during the subconscious reprocessing of daily negative memories. The body reaction is separated from the two other interdependent “power supplies’ and the negative impacts of the memory fade. The individual can recall the event but no longer experiences embarrassment, flushing or a negative self belief.

EMDR Procedure as REM Simulation

EMDR is a simulation of REM used in a therapeutic setting and applied to a traumatic memory. During an EMDR session, a client visualizes a trauma while recognizing the negative emotion, body sensation and self belief. The therapist measures the negative response levels and leads the client through sets of eye movements by use of a light bar or “eye scan”. After 45-60 minutes, the negative impacts of the trauma are gone…permanently.  

EMDR, Performance Enhancement and the Workplace

All individuals are functioning below their potential because of a history of mistakes, criticisms, self questioning or relational abuse. A therapist can uncover these performance interferences by asking someone a detailed list of questions to help the person visualize an ideal state. The ideal state may have to do with performance in school, the performing arts, sports, relationships or in the workplace. The therapist asks what memories or experiences get in the way of the individual being able to live up to their ideal. Those memories are then treated as EMDR memory targets, the EMDR procedure is done in the office and the client is free to return to their goals without the interference of negative memories.

For example, imagine an employee who is highly skilled and committed and his boss wants to promote him to a manager position. The employee, however, has a number of problems relating to employees including having a temper and not listening. The CEO very much wants to promote him but without the necessary relational skills, the CEO would have to hire from outside the company.

Using the EMDR performance protocol, that potential manager would be asked a series of questions to assist him in seeing his ideal work state. For example…”In the ideal state what are you doing that you are not doing now?” “What personal characteristics or qualities are improved?” “What are you feeling in the ideal picture?” “What do you believe about yourself?” After the potential manager sees this ideal picture of himself interacting with his employees he then is asked to identify a memory that interferes with his being able to live the ideal picture. Most of the time the employee will describe negative memories related to their relationship with their parents. This may be in the form of criticism, neglect or abuse. Most all stated and volunteered answers regarding interfering memories are from childhood. Then the employee would be asked to visualize the bothersome memory and do the set up for the EMDR procedure. The person follows the EMDR procedure described above, eliminates the negativity of the old memory and visualizes himself in the ideal state. Simply doing this one procedure, the employee returns to work that day and begins to improve and act differently.

The employee may have a series of memories that interfere with the ideal performance picture and each memory is reprocessed using the EMDR procedure. Each one hour session will cover 1-2 memories. The treatment processes is brief and intense lasting 8-12 sessions. Unlike traditional therapy that requires time between sessions, EMDR can be completed as quickly as one would like.

What are some typical work performance problems addressed by EMDR?

1. Public speaking

2. Managing difficult people

3. Increased effectiveness in sales

4. Increased believably in short and long-term success goals

5. Increased ability to communicate with potential business partners

6. Increased success in working on a team

7. Increased ability to manage time

8. Increased ability to manage workplace crisis

9. Increased ability to manage job stress

10. Increased physical health due to fewer symptoms of stress

 

 The EMDR performance enhancement procedure has allowed employees to get past personal issues, better use their skills and knowledge and be promoted. Also, employers have been able to retain valued employees who otherwise would have been terminated because of ongoing behavioral and emotional problems carried to the workplace.

 

Jeff Dwarshuis LMSW, ACSW is a licensed psychotherapist in private practice specializing in EMDR therapy. For contact call (616) 443-1425 or send an email to jeffsemdr@tds.net.

Also see Dwarshuis’ webpage at http://www.jeffdwarshuis.com/  for free clinical information and blog entries on EMDR, performance strategies, upcoming presentations and family health.

 

 

Improving your performance begins with identifying areas of desired change, recognizing the problem in each area and then creating an idealized picture of change.

Begin by addressing the area(s) in your life that you would like to see improvement. Identify the category in your life needing change and briefly list what you see as the problem. For example, under profession one might identify the problem as “fear of improvement” or “lack of confidence.”

Relationships__________________________________________________________________

Profession or Work______________________________________________________________

Spiritual Life___________________________________________________________________

Parenting_____________________________________________________________________

Marriage______________________________________________________________________

Social Life_____________________________________________________________________

Extended Family_______________________________________________________________

Family of Origin________________________________________________________________

Education or Advancement Training____________________________________________

The Arts and the Performing Arts________________________________________________

Hobbies_______________________________________________________________________

Community and Neighborhood_________________________________________________

Retirement_____________________________________________________________________

Confronting Hardship(s) ________________________________________________________

Other__________________________________________________________________________

With each identified problem rank them as the most important to the least important.

Imagine an ideal picture that you would rather be doing then the problem. To help you imagine more easily, think about and write both role models and heroes both real and fictional. For example, if someone thinks they need to do better parenting they might think of a friend or peer who shows good parenting skills. An artist, musician or performer who is striving for maximum performance may think about their heroes in the field or people who have inspired them to achieve in this area.

Role Models__________________________________________________

Heroes______________________________________________________

Also, to develop your ideal picture you might think back to a time in your life when you were more able to accomplish these ideal tasks.

List time and place of the representing picture of being more able to accomplish this goal______________________________________________________

Next, starting with the number one identified problem, read through and carefully answer each of the questions below. This should help you to describe and imagine your ideal picture in great detail and on many levels. Remember this should be fun. Think big and give yourself as much credit as you can. Remember the idea that it is hard to get somewhere unless you first can see it, write it and say it.

Ideal Vision Questions 

In the ideal picture what are you successfully creating, achieving, and/or accomplishing? _______________________________________________________________

In the ideal picture what are you able to do that you think you can’t do now? _______________________________________________________________________________

In the ideal picture what do you stop doing that you are doing now? _______________________________________________________________________________

In the ideal picture what are you able to do differently, do better and/or do more effectively? ____________________________________________________________________

In the ideal picture how are you acting and behaving on a moment by moment basis? _________________________________________________________________________

In the ideal picture how are you relating to and interacting with other people (or any particular person/persons)? ________________________________________________

In the ideal picture what personal traits or characteristics have you strengthened or developed? _______________________________________________________________

In the ideal picture how are you feeling physically? ___________________________

In the ideal picture how are you feeling emotionally? _________________________

In the ideal picture what are you thinking? ________________________________

Now take some time to clearly see the ideal picture. Do this by closing your eyes and imaging all of the specific details. Allow yourself to solidify the picture by repeatedly reading through your answers and descriptions.

After this picture is clear, ask yourself “What memories or experiences have I had that keep me from getting this picture?” Think back as far as possible, the earlier the better. Often times the barriers to success lie in memories of past mistakes, criticisms, hardships or trauma.

Blocking Memory List___________________________________________________________

                                          ___________________________________________________________

                                          ___________________________________________________________

The EMDR standard protocol is used on each interfering memory. Using EMDR to reprocess the memory will eliminate its negative impact on performance. This procedure is meant to be used in the context of performance psychotherapy however some individuals can use self administered EMDR described in Francine Shapiro’s book “Getting Past Your Past”. Also watch for blog articles on self administered EMDR and see my blog article “What is EMDR?”. Self administered EMDR is not suggested for people who currently have PTSD or unresolved memories of trauma since EMDR will likely increase the level of clarity and recall of those memories.

 

Jeff Dwarshuis LMSW, ACSW is a licensed psychotherapist in private practice specializing in EMDR therapy. For contact call (616) 443-1425 or send an email to jeffsemdr@tds.net. 

By Jeff Dwarshuis LMSW, ACSW 

All people have difficult times and employees at all levels of leadership will carry stress to the workplace. The result can be a less than optimal performance. Employees can be stressed by financial hardship, marital discord, parenting or past issues of divorce, family loss, bereavement or child abuse. All can dramatically impact an employee’s work performance.

Eye Movement Desensitization and Reprocessing (EMDR) is a treatment that can quickly and effectively assist with workplace stress. EMDR has its beginnings as a treatment for Posttraumatic Stress Disorder and has been very effective with performance, depression and anxiety as well. Created by psychologist Francine Shapiro PhD, EMDR uses a blend of cognitive, emotive and client centered therapies in combination with neurobiological interventions. Since its beginning in 1995, EMDR has dramatically changed the lives of thousands of people.

EMDR, REM and Memory Reprocessing 

To understand EMDR it is helpful to first know about the impact of Rapid Eye Movement (REM). After 30-60 minutes of sleep an individual begins REM sleep. During REM, one involuntarily moves their eyes back and forth. The eye movements cause a neurobiological reaction which stimulates a reprocessing of the day’s memories and makes recent memories into old memories. If someone has a negative memory in their day, the REM process facilities making this recent bad memory no longer bothersome.

REM and Posttraumatic Stress Disorder

Traumatic memories occur when one is overwhelmed by either witnessing or enduring something that is horrific beyond the typical human experience. This might include combat, child abuse, domestic violence, personal assault, traffic accidents or traumatic medical procedures. Because of the severity of these memories, the REM mechanism described does not work. In these cases, the individual remains aware of the memory and continues to experience its negative impacts. The memory is not reprocessed and the individual could go on for decades terrorized by their own memory. This is called Posttraumatic Stress Disorder.

Negative Memories and the “Three Point Power Supply”

All negative memories create three things which exist interdependently and make a memory seem unpleasant. These three things are a negative emotion, an unpleasant body sensation and a negative self belief. Say for example someone went to a social gathering and said something foolish in front of a group of people. When thinking about this memory, the person would experience embarrassment, flushing and a self belief of “I am so stupid!” During REM, eye movements create an even stimulation of the right and left hemispheres of the brain and cause a tremendous and fixated calm in the body. Since the body is so relaxed, it does not react during the subconscious reprocessing of daily negative memories. The body reaction is separated from the two other interdependent “power supplies’ and the negative impacts of the memory fade. The individual can recall the event but no longer experiences embarrassment, flushing or a negative self belief.

EMDR Procedure as REM Simulation

EMDR is a simulation of REM used in a therapeutic setting and applied to a traumatic memory. During an EMDR session, a client visualizes a trauma while recognizing the negative emotion, body sensation and self belief. The therapist measures the negative response levels and leads the client through sets of eye movements by use of a light bar or “eye scan”. After 45-60 minutes, the negative impacts of the trauma are gone…permanently.

EMDR, Performance Enhancement and the Workplace

All individuals are functioning below their potential because of a history of mistakes, criticisms, self questioning or relational abuse. A therapist can uncover these performance interferences by asking someone a detailed list of questions to help the person visualize an ideal state. The ideal state may have to do with performance in school, the performing arts, sports, relationships or in the workplace. The therapist asks what memories or experiences get in the way of the individual being able to live up to their ideal. Those memories are then treated as EMDR memory targets, the EMDR procedure is done in the office and the client is free to return to their goals without the interference of negative memories.

For example, imagine an employee who is highly skilled and committed and his boss wants to promote him to a manager position. The employee, however, has a number of problems relating to employees including having a temper and not listening. The CEO very much wants to promote him but without the necessary relational skills, the CEO would have to hire from outside the company.

Using the EMDR performance protocol, that potential manager would be asked a series of questions to assist him in seeing his ideal work state. For example…”In the ideal state what are you doing that you are not doing now?” “What personal characteristics or qualities are improved?” “What are you feeling in the ideal picture?” “What do you believe about yourself?” After the potential manager sees this ideal picture of himself interacting with his employees he then is asked to identify a memory that interferes with his being able to live the ideal picture. Most of the time the employee will describe negative memories related to their relationship with their parents. This may be in the form of criticism, neglect or abuse. Most all stated and volunteered answers regarding interfering memories are from childhood. Then the employee would be asked to visualize the bothersome memory and do the set up for the EMDR procedure. The person follows the EMDR procedure described above, eliminates the negativity of the old memory and visualizes himself in the ideal state. Simply doing this one procedure, the employee returns to work that day and begins to improve and act differently.

The employee may have a series of memories that interfere with the ideal performance picture and each memory is reprocessed using the EMDR procedure. Each one hour session will cover 1-2 memories. The treatment processes is brief and intense lasting 8-12 sessions. Unlike traditional therapy that requires time between sessions, EMDR can be completed as quickly as one would like.

What are some typical work performance problems addressed by EMDR?

1. Public speaking

2. Managing difficult people

3. Increased effectiveness in sales

4. Increased believably in short and long-term success goals

5. Increased ability to communicate with potential business partners

6. Increased success in working on a team

7. Increased ability to manage time

8. Increased ability to manage workplace crisis

9. Increased ability to manage job stress

10. Increased physical health due to fewer symptoms of stress

 

The EMDR performance enhancement procedure has allowed employees to get past personal issues, better use their skills and knowledge and be promoted. Also, employers have been able to retain valued employees who otherwise would have been terminated because of ongoing behavioral and emotional problems carried to the workplace.

 

By Jeff Dwarshuis LMSW ACSW

Background

A Vietnam Veteran with chronic Posttraumatic Stress Disorder (PTSD) and Major Depression was referred to the writer from the treating staff of a local psychiatric hospital. The veteran had a history of numerous inpatient hospitalizations for PTSD and despite decades of individual, group and psychotropic therapy the client could not find relief from his traumatic memories of Vietnam. The referral source thought Eye Movement Desensitization and Reprocessing (EMDR) could be of benefit. (For a description of EMDR see blog article “Eye Movement Desensitization and Reprocessing”.)

EMDR Treatment

Following an assessment the client agreed to EMDR therapy but due to past treatment failures the client felt hopeless of any change.

EMDR treatment began with complications. During the treatment of the first identified disturbing memory the client quickly responded with intense fear that caused frequent occurrences of nausea. With the treatment disrupted the possibilities for success were in question.

The Puzzle Method

Because of the complications the writer developed “The Puzzle Method” which is an extension of the EMDR Safe Place exercise combined with techniques of Ericksonian Hypnotherapy.

Milton Erickson is the father of modern hypnotherapy and developed a unique method of hypnosis that concentrates on multilevel communication and client capacity. Regarding trace states involving memory he explained that deepening a trance state occurs when the therapist deliberately limits their own helping directives and instead teaches the client to themselves move in and then out of a trance state using their own abilities.

Erickson also taught that client safety is increased when the client has more choice regarding both self disclosure and the extent to which they want to think about something that is disturbing. Within this framework Erickson argued that the client should be given choice about treatment pace and the self disclosure of memory. Based on Erickson’s understanding of client resistance to change he also suggested the therapist intensify the client’s sense of safety by instructing the client to “hold back” from focusing on particular memories thus eliciting the client’s natural opposition which indirectly influences the client to focus more on their memory.

The Puzzle Method combines Erickson’s techniques of self initiated focus and increased safety with the EMDR Safe Place exercise in an effort to increase the likelihood of success for clients dealing with intense reactions to traumatic memories. This is done by telling the client to imagine that the traumatic picture is broken into several pieces like a puzzle and to focus only on a few pieces of the puzzle at one time. If the client becomes emotionally overwhelmed by the traumatic memory they should stop their focus on the memory and return their thoughts to the safe place picture until they feel relaxed. Following the relaxation the client should return their focus to the traumatic memory, focus on a little more than before and continue this process until the whole traumatic memory can be imagined. When using this method the client is in charge of their level of traumatic exposure as well as their level of relaxation.

The client returned to EMDR therapy, followed the steps of the Puzzle Method and was able to successfully reprocess the first memory in thirty minutes without any disturbance of nausea. The client returned to treatment for six more sessions to reprocess other traumatic memories of Vietnam using the EMDR Protocol and the Puzzle Method only when needed. The client ended therapy after seven EMDR sessions with no symptoms of PTSD or Major Depression. Follow up sessions showed a continuation of symptom reduction. The client reported that he had not felt so good since before going to Vietnam.

 

By Jeff Dwarshuis LMSW ACSW

Eye Movement Desensitization and Reprocessing (EMDR) is a treatment that quickly and effectively eliminates the impacts of negative memory. EMDR has its beginnings as a treatment for Posttraumatic Stress Disorder and has been very effective with depression and anxiety as well. Created by psychologist Francine Shapiro PhD, EMDR uses a blend of cognitive, emotive and client centered therapies in combination with neurobiological interventions. Since its beginning in 1995, EMDR has dramatically changed the lives of thousands of people.

EMDR, REM and Memory Reprocessing 

To understand EMDR it is helpful to first know about the impact of Rapid Eye Movement (REM). After 30-60 minutes of sleep an individual begins REM sleep. During REM, one involuntarily moves their eyes back and forth. The eye movements cause a neurobiological reaction which stimulates a reprocessing of the day’s memories and makes recent memories into old memories. If someone has a negative memory in their day, the REM process facilities making this recent bad memory no longer bothersome.

REM and Posttraumatic Stress Disorder

Traumatic memories occur when one is overwhelmed by either witnessing or enduring something that is horrific beyond the typical human experience. This might include combat, child abuse, domestic violence, personal assault, traffic accidents or traumatic medical procedures. Because of the severity of these memories, the REM mechanism described does not work. In these cases, the individual remains aware of the memory and continues to experience its negative impacts. The memory is not reprocessed and the individual could go on for decades terrorized by their own memory. This is called Posttraumatic Stress Disorder.

Negative Memories and the “Three Point Power Supply”

All negative memories create three things which exist interdependently and make a memory seem unpleasant. These three things are a negative emotion, an unpleasant body sensation and a negative self belief. Say for example someone went to a social gathering and said something foolish in front of a group of people. When thinking about this memory, the person would experience embarrassment, flushing and a self belief of “I am so stupid!” During REM, eye movements create an even stimulation of the right and left hemispheres of the brain and cause a tremendous and fixated calm in the body. Since the body is so relaxed, it does not react during the subconscious reprocessing of daily negative memories. The body reaction is separated from the two other interdependent “power supplies’ and the negative impacts of the memory fade. The individual can recall the event but no longer experiences embarrassment, flushing or a negative self belief.

EMDR Procedure as REM Simulation

EMDR is a simulation of REM used in a therapeutic setting and applied to a traumatic memory. During an EMDR session, a client visualizes a trauma while recognizing the negative emotion, body sensation and self belief. The therapist measures the negative response levels and leads the client through sets of eye movements by use of a light bar or “eye scan”. After 45-60 minutes, the negative impacts of the trauma are gone…permanently.

EMDR and Mental Health

In the therapeutic setting, EMDR is a tremendous tool for eliminating mental health symptoms. Most all mental health diagnosis have their origins in life events and the memories of these events cause symptoms. The impacts of negative memories are most obvious in PTSD but also are very much a part of depression, anxiety and behavioral disorders. Using EMDR, the therapist and client are open to eliminating the negative thoughts, feelings and self perceptions created by any memory. The possibilities for healing are enormous. Additionally, EMDR is user friendly since it is quick and highly effective. Clients utilize a well established and highly effective technique that works and the average length of therapy, compared to traditional therapy, can be reduced by 60% to 80%.

EMDR and Performance Enhancement

EMDR also is used effectively with personal performance. All individuals are functioning below their potential because of a history of mistakes, criticisms, self questioning or relational abuse. A therapist can uncover these performance interferences by asking someone a detailed list of questions to help the person visualize an ideal state. The ideal state may have to do with performance in school, the performing arts, sports, relationships or in the workplace. The therapist asks what memories or experiences get in the way of the individual being able to live up to their ideal. Those memories are then treated as EMDR memory targets, the EMDR procedure is done in the office and the client is free to return to their goals without the interference of negative memories.