Episode 41: Q & A
We are back from the holidays and ready for 2021! Listen in to hear Jen, Melissa and Bridger answer the questions received from our listeners during the holiday break.
Q & A
“I’m working with a client with ADHD symptoms and has anger issues. It has been difficult to pinpoint a target because things that really bothered him outside of a session are no longer bothersome by the time he sees me. The only thing that we could come up with as distressing is his inability to make decisions within a score of 10. Is this an appropriate target?
- The idea that things don’t bother him once he’s in session gives the indication that this client has a very charged nervous system.
- In a moment of reactivity, the system will burst and then subside because the stimuli that caused the outburst is no longer present once they’re in therapy.
- The score of 10 with inability of making decisions may be a result of childhood experiences with parental figures.
- His worth could have been determined by is ability to make the “right” decision.
- There might have been a lot of messaging around emotionalism.
- Shame cycle: shameful with how he responded to his activation
- Likelihood that shame was mixed in with resentment
- Help the client understand his own emotions; pain, loss, fear, sadness etc. All of these are choosing anger to hide behind.
- If it’s a target, it’s more of a top-down target. It’s not the core target.
Choosing the Right Target
- There’s no right or wrong target.
- It’s one possible door inside the mind.
- Any target can be the right one for that time.
- If we are confident with the target, the client will feel that.
Installing a Mastery Resource of Decision Making:
- Help the client find a moment when he was able to make a decision and install that.
- This creates a felt sense that the client is really able to make a decision, and here’s the proof.
- This is enhancing and developing part of the client’s nervous system that is able to do that.
- Building confidence, skill and regulation around decision making
- Two-handed interweave
“One question I have is about EMDR with BPD and if you have any information on combining it with DBT? I am also wondering about EMDR with schizophrenia when the patient doesn’t have extensive trauma history and whether hallucinations could be desynthesize?”
Answer: (Part 1) BPD
- DBT is phenomenal for BPD
- Creates a strong connection/relationship between the client and the therapist
- Facilitates deep attachment resourcing, which can be used for interweaves
- Enhances attachment skills and ability to begin to repair attachment rupture
- It also strengthens window of tolerance, which is important for preparation for future sessions
- BPD is always testing attachment figures, which will create a push-pull feel
- Intimacy can be triggering for the client
Answer: (Part 2) Schizophrenia
- The traumatization that we are used to is not the same as the trauma for individuals with schizophrenia. Their system is overly sensitized and much more likely to respond to the normal adverse experiences because of how their nervous system interprets them.
- Traumatization is coming within; the hallucinations and paranoia are the trauma
- Can you target a hallucination? Absolutely
- If their nervous system perceives a hallucination as real, then we process it as if it is real
- Article “Treating Trauma and Psychosis with EMDR A Pilot Study”
- Book “EMDR Therapy for Schizophrenia and Other Psychoses”
“My main modality before learning EMDR has been emotionally-focused therapy for couples and for individuals, which is more of a bottom-up perspective. There are many places these modalities go together, but I’m finding EMDR is more from a belief-focus perspective and EFT is more from an emotion up and running. Anything that helps merge these two modalities would be so helpful.”
- This is a common misconception
- EMDR is a bottom-up approach
- The conceptualization of EMDR in training had a much stronger cognitive focus than we believe is necessary.
- The cognitive focus in EMDR can be as intense as the therapist wants to make it
- Somatic therapist don’t have to focus on the cognitive piece as much
- Can be beautifully done with couples
- EFT and EMDR can go together quite well. EMDR is integrating the mind and the body
Thank you for listening to our Q & A episode!