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Eye Movement Desensitization and Reprocessing (EMDR) : Basic Principles, Protocols, and Procedures - Francine Shapiro

Eye Movement Desensitization and Reprocessing (EMDR)

Basic Principles, Protocols, and Procedures

Hardcover

Published: 11th October 2001
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This volume provides the definitive guide to Eye Movement Desensitization and Reprocessing (EMDR), the psychotherapeutic approach developed by Francine Shapiro. EMDR is one of the most widely investigated treatments for posttraumatic stress disorder, and many other applications are also being explored. Presenting background on EMDR’s development, theoretical constructs, and possible underlying mechanisms, the volume also contains detailed descriptions and transcripts that guide the clinician through every stage of therapeutic treatment, from client selection to the administration of EMDR and its integration within a comprehensive treatment plan.

Among the many clinical populations for whom the material in this volume has been seen as applicable are survivors of sexual abuse, crime, and combat, as well as sufferers of phobias and other experientially based disorders. Special feature: Two online-only appendices were added in 2009. These appendices comprehensively review current research on EMDR and its clinical applications.

EMDR is now recognized by the American Psychiatric Association as an effective treatment for ameliorating symptoms of both acute and chronic PTSD (APA Practice Guidelines for the Treatment of Patients with Acute Stress Disorder and Posttraumatic Stress Disorder).

New to This Edition:
*Updated neurobiological data, findings from controlled clinical studies, and literature on emerging clinical applications.
*Updated protocols and procedures for working with adults and children with a range of presenting problems.

About the Author

Francine Shapiro, PhD, the originator and developer of EMDR, is a senior research fellow at the Mental Research Institute in Palo Alto, California.

WRITE A REVIEW

Essential reading for Weekend 1 training.

4

Its a professional resource for people who will be doing EMDR treatment with clients Ide recommend it to people looking at doing this type of therapy with clients, not useful for people who just want to know about EMDR really. Better books out there for that.

Sydney

true

Eye Movement Desensitization and Reprocessing

4.0 1

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"EMDR, arising out of a cognitive-behavioral orientation, has increasingly become a rather strikingly integrative approach. Its potential fascination for psychodynamically oriented therapists is considerable. In my own experience, it has seemed to generate 'deep' material rapidly and to provide access to a wider range of associations and of sensory/affective connections. I am personally eager to conduct research further investigating these impressions, and hope other psychodynamically oriented clinician-researchers will join in this investigative effort."--Paul Wachtel, PhD, City College and the Graduate Center, City University of New York

"Since the introduction of EMDR in 1989, over 40,000 clinicians have been trained in its practice and a large volume of scientific work has established its remarkable, and unusually rapid, capacity to treat the effects of psychological trauma. Despite the fact that EMDR brings together aspects of many major psychological orientations, it appears to have unique treatment effects that are still only partially understood. Francine Shapiro, has consistently promoted the highest standards of clinical rigor and scientific efforts to further the understanding of this unique procedure. This book lucidly presents the method and the accumulated scientific knowledge, and spells out the puzzles and controversies that continue to be resolved in the context of the ongoing evolution of neuroscience and outcome research. Personally, I have been amazed by the effectiveness of EMDR. I would no longer know how to treat my patients without having this tool available. It has changed my whole notion about how well we can help traumatized people."--Bessel A. van der Kolk, MD, Professor of Psychiatry, Boston University School of Medicine

Backgroundp. 1
A Chance Discoveryp. 7
The First Controlled Studyp. 8
Further Clinical and Experimental Observationsp. 11
Shift in Paradigmp. 13
Adaptive Information Processingp. 16
Theoretical Convergencesp. 20
Posttraumatic Stress Disorderp. 20
Psychodynamic Approachesp. 21
Behavioral Approachesp. 22
Cognitive-Behavioral Approachesp. 24
Integrative Approachp. 26
Summary and Conclusionsp. 27
Adaptive Information Processing: The Model as a Working Hypothesisp. 29
Information Processingp. 30
Dual Attention Stimulationp. 32
Memory Networksp. 33
A Sample EMDR Sessionp. 35
Partial Transcript of the Sample Sessionp. 37
Evaluation of the Sample Sessionp. 40
Dysfunctional to Functionalp. 41
Disparate Neuro Networksp. 41
Applications of EMDR to Other Disordersp. 42
Static Experience: Affect and Belief Statementsp. 43
Resolutionp. 46
Frozen in Childhoodp. 47
"Time-Free" Psychotherapyp. 48
Targetsp. 50
Access Restricted to Negative Materialp. 51
Memory Lapsesp. 51
Dissociationp. 52
Integrated Psychotherapyp. 53
Summary and Conclusionsp. 54
Components of EMDR Treatment and Basic Treatment Effectsp. 57
Basic Components of the EMDR Procedurep. 57
The Imagep. 58
The Negative Cognitionp. 58
The Positive Cognitionp. 60
The Emotions and Their Level of Disturbancep. 64
The Physical Sensationsp. 64
Activating the Information-Processing Systemp. 65
Eye Movementsp. 65
Alternative Forms of Stimulationp. 69
The Eight Phases of EMDR Treatmentp. 69
Client History and Treatment Planningp. 70
Preparationp. 71
Assessmentp. 72
Desensitizationp. 72
Installationp. 73
Body Scanp. 74
Closurep. 75
Reevaluationp. 75
Standard Three-Pronged EMDR Protocolp. 76
Choosing a Targetp. 76
Patterns of Responsep. 78
Multimemory Associative Processingp. 80
The Belief Inherent in the Traumap. 80
The Major Participant or Perpetratorp. 81
The Pronounced Stimulip. 81
The Specific Eventp. 81
The Dominant Physical Sensationsp. 82
The Dominant Emotionsp. 82
Single-Memory Processing Effectsp. 83
Changes in Imagep. 83
Changes in Soundsp. 85
Changes in Cognitionsp. 85
Changes in Emotionsp. 86
Changes in Physical Sensationp. 86
Differential Effectsp. 88
Supervised Practicep. 88
Summary and Conclusionsp. 89
Phase One: Client Historyp. 91
Client Readinessp. 91
Client Safety Factorsp. 93
Level of Rapportp. 93
Emotional Disturbancep. 94
Stabilityp. 95
Life Supportsp. 95
General Physical Healthp. 95
Office Consultation versus Inpatient Treatmentp. 96
Neurological Impairmentp. 96
Epilepsyp. 97
Eye Problemsp. 97
Drug and Alcohol Abusep. 98
Legal Requirementsp. 98
Systems Controlp. 99
Secondary Gainsp. 100
Timingp. 101
Medication Needsp. 102
Dissociative Disordersp. 103
Treatment Planningp. 104
History-Taking Transcriptp. 108
Supervised Practicep. 119
Summary and Conclusionsp. 119
Phases Two and Three: Preparation and Assessmentp. 121
Preparationp. 121
Adopting a Clinical Stancep. 122
Forming a Bond with the Clientp. 122
Explaining the Theoryp. 123
Testing the Eye Movementsp. 124
Creating a Safe Placep. 125
Describing the Modelp. 127
Setting Expectationsp. 129
Addressing Client Fearsp. 131
Assessmentp. 132
Selecting the Picturep. 133
Identifying the Negative Cognitionp. 133
Developing a Positive Cognitionp. 136
Rating the Validity of Cognitionp. 137
Naming the Emotionp. 138
Estimating the Subjective Units of Disturbancep. 139
Identifying Body Sensationsp. 139
Importance of the Componentsp. 140
Supervised Practicep. 142
Summary and Conclusionsp. 142
Phases Four to Seven: Desensitization, Installation, Body Scan, and Closurep. 144
Accelerated Reprocessing of the Memoryp. 144
Desensitizationp. 149
Associative Processingp. 151
Imageryp. 151
New Memoryp. 152
Image Changesp. 152
Incident Unfoldsp. 153
Appearance Changesp. 153
Sounds and Thoughtsp. 154
Negative Statementsp. 154
Mismatchesp. 155
Positive Thoughtsp. 155
Insightsp. 156
Sensation and Affectp. 156
New Emotionsp. 157
Shifting Sensationsp. 158
Assessmentp. 158
Installationp. 160
Body Scanp. 162
Closurep. 163
Visualizationp. 164
Safety Assessmentp. 164
Debriefing and Logp. 165
Supervised Practicep. 168
Summary and Conclusionsp. 169
Working with Abreaction and Blocksp. 171
Abreactionp. 172
Guidelines for Facilitating Abreactionp. 174
If Abreaction Persistsp. 180
Strategies for Blocked Processingp. 181
Primary Targetp. 181
Altering the Eye Movementp. 182
Focusing on Body Sensationp. 182
All Sensationp. 182
The Primary Sensationp. 182
Unspoken Wordsp. 182
Using Movementp. 184
Pressing the Locationp. 184
Scanningp. 184
Visual Cuesp. 185
Sound Effectsp. 185
Dialoguep. 185
Alterationsp. 186
Appearance of Imagep. 186
No Actionp. 186
Hierarchyp. 187
Redirecting to Imagep. 187
Redirecting to Negative Cognitionp. 187
Adding a Positive Statementp. 187
Checking the Positive Cognitionp. 188
Return to Targetp. 188
Ancillary Targetsp. 188
Feeder Memoriesp. 189
Blocking Beliefsp. 192
Fearsp. 193
Fear of Going Crazyp. 194
Fear of Losing the Good Memoriesp. 195
Fear of Changep. 195
Wellsprings of Disturbancep. 197
Supervised Practicep. 198
Summary and Conclusionsp. 198
Phase Eight: Reevaluation and Use of the EMDR Standard Three-Pronged Protocolp. 200
Reevaluationp. 201
The Standard EMDR Protocolp. 202
Working on the Pastp. 202
Single-Target Outcomep. 203
Recycling through Multiple Targetsp. 205
Primary Eventsp. 206
Past Eventsp. 206
Progressionsp. 206
Clustersp. 206
Participantsp. 207
Working on the Presentp. 207
Using the Log to Report Systems Issuesp. 209
Working on the Futurep. 210
Significant Peoplep. 211
Significant Situationsp. 211
Incorporating a Positive Templatep. 211
Concluding Therapyp. 215
Follow-Upp. 215
Terminating Therapyp. 216
Supervised Practicep. 218
Summary and Conclusionsp. 219
Protocols and Procedures for Special Situationsp. 221
The 11-Step Standard Procedurep. 222
Protocol for a Single Traumatic Eventp. 223
Protocol for Current Anxiety and Behaviorp. 223
Protocol for Recent Traumatic Eventsp. 224
Protocol for Phobiasp. 227
Protocol for Excessive Griefp. 231
Protocol for Illness and Somatic Disordersp. 234
Self-Directed Use of Eye Movement Sets for Stress Reductionp. 241
Caveats and Suggestionsp. 241
Technical Considerationsp. 242
Self-Control/Closure Proceduresp. 243
Safe-Place Imageryp. 243
Taped Visualizationsp. 244
The Light-Stream Techniquep. 244
Vertical Eye Movementsp. 246
Debriefing and Safety Assessmentp. 246
Summary and Conclusionsp. 246
The Cognitive Interweave: A Proactive Strategy for Working with Challenging Clientsp. 249
Foundation of the Interweavep. 251
Responsibility, Safety, and Choicesp. 252
Fitting the Intervention to the Clientp. 261
Interweave Choicesp. 262
New Informationp. 263
"I'm Confused"p. 263
"What If It Were Your Child?"p. 264
Metaphor/Analogyp. 265
"Let's Pretend"p. 265
Socratic Methodp. 266
Assimilationp. 267
Verbalizations and Actionsp. 267
Educationp. 273
Supervised Practicep. 275
Summary and Conclusionsp. 275
Selected Populationsp. 277
Issues of Noncompliancep. 278
Childrenp. 281
Concrete Definitions of Feelingsp. 283
Holding the Child's Attentionp. 283
Cognitionsp. 284
Generalizing Treatment Effectsp. 285
Creative Therapyp. 286
Couplesp. 286
Early Sexual Abuse in a Marital Partnerp. 287
Joint versus Individual Sessionsp. 287
Infidelityp. 289
Sexual Abuse Victimsp. 290
Appropriate Goalsp. 290
Client Readinessp. 291
Structurep. 292
Integrationp. 293
Information Plateausp. 294
Emotional Stagesp. 295
False Memoryp. 296
Cautions Regarding Memory Workp. 297
Hypnosisp. 297
The Fallibility of Memoryp. 298
Combat Veteransp. 301
Dealing with Feelings of Lack of Controlp. 302
Secondary Gain Issuesp. 303
Affiliation and the Fear of Forgettingp. 303
Dealing with Denial and Transition Statesp. 304
Dealing with Angerp. 305
Using the Cognitive Interweavep. 307
Anniversary Datesp. 307
Special Populationsp. 307
Dissociative Disordersp. 308
Overall Evaluationsp. 311
Summary and Conclusionsp. 312
Theory, Research, and Clinical Implicationsp. 315
Theoretical Explanationsp. 315
Procedural Elementsp. 317
Interrupted Exposurep. 318
Perceived Masteryp. 319
Attention to Physical Sensationp. 320
Cognitive Reframingp. 320
Alignment of Memory Componentsp. 321
Free Associationp. 321
Mindfulnessp. 322
Eye Movements and Alternative Dual Attention Stimulip. 323
Orienting Responsep. 324
Distractionp. 325
Hypnosisp. 326
Cellular and Brain-Level Changesp. 327
Dream Sleepp. 332
Relaxation Responsep. 333
Hemispheric Synchronizationp. 334
Cortical Functionp. 336
Integrative Effectp. 338
Controlled Researchp. 339
General Scarcity of PTSD Treatment Studiesp. 339
Suggested Criteria for Clinical Outcome Researchp. 340
Method Validityp. 341
Selection of Psychometricsp. 342
Participant Selectionp. 343
Comparative Researchp. 343
Component Analysesp. 344
Civilian Studiesp. 345
Studies of Combat Veteransp. 351
Methodological Problems in EMDR Outcome Studiesp. 353
Treatment Fidelity and Protocol Adherencep. 353
Evaluation Toolsp. 354
Treatment Timep. 355
The Comparison of EMDR and Other PTSD Treatmentsp. 356
Suggested Criteria for Comparative Clinical Outcome Studiesp. 359
Diverse Clinical Applicationsp. 360
Weighting of Active Componentsp. 363
Component Analysesp. 364
Suggested Parameters for Component Analyses in Clinical Outcome Component Studiesp. 365
A Review of Extant Clinical Component Analysesp. 368
The Utility of Single-Subject Designp. 370
Discerning Testable Hypothesesp. 371
Testing a Variety of Existing Hypothesesp. 373
Hypothesis Regarding the Autobiographical Nature of the Targeted Disturbancep. 373
Hypothesis Regarding the Etiological Nature of Memoriesp. 373
Hypothesis Regarding Orienting Response Mechanismp. 374
Hypothesis Regarding Bilateral Stimulation Mechanismp. 374
Hypothesis Regarding the Distractive Level of Stimulip. 374
Hypothesis Regarding Free Associationp. 375
Summary of Recommendations for Component Researchp. 375
Broader Clinical and Professional Concernsp. 377
Inadequate Standards of Research and Reviewp. 377
Clinical Responsibilityp. 380
Global Responsibilityp. 382
Summary and Conclusionsp. 385
Referencesp. 387
Clinical Aidsp. 427
EMDR Screening and Data Checklistp. 427
EMDR Treatment Planning Checklistp. 428
Recommended Format for Weekly Log Reportp. 429
Selecting Negative and Positive Cognitionsp. 429
List of Generic Negative and Positive Cognitionsp. 430
EMDR Procedural Outlinep. 431
Form for Identifying the EMDR Targetp. 433
Form and Sequence for Floatback Technique to Identify Past Eventp. 433
Guidelines and Procedures for EMDR Resource Development and Installationp. 434
Indications of a Need to Extend Client Preparation and Stabilization Phasep. 434
Characteristics and Types of Resources Appropriate for Resource Development and Installationp. 435
Prolonged Resource Development May Need to Precede EMDR-RDI Proceduresp. 436
Precautions in Considering Resource Development and Installationp. 436
The Basic EMDR Resource Development and Installation Protocolp. 437
Use of Resource Development and Installationp. 440
Client Safetyp. 441
EMDR Dissociative Disorders Task Force Recommended Guidelines: A General Guide to EMDR's Use in the Dissociative Disordersp. 441
Additional Trainingp. 445
Suggested Readingp. 445
EMDR Professional Issues Committee Recommended Guidelinesp. 446
Client Welfarep. 446
Trainingp. 447
Professional Standards and Training Committee of the EMDR International Associationp. 449
EMDR Resourcesp. 451
The EMDR International Associationp. 451
EMDR Humanitarian Assistance Programsp. 452
Training Availabilityp. 453
The EMDR Institutep. 453
Diverse Clinical Application and Evaluationp. 454
Additional Protocols and Manualized Resourcesp. 454
The Adaptive Information Processing Modelp. 456
Indexp. 458
Table of Contents provided by Syndetics. All Rights Reserved.

ISBN: 9781572306721
ISBN-10: 1572306726
Audience: Professional
Format: Hardcover
Language: English
Number Of Pages: 472
Published: 11th October 2001
Publisher: Guilford Publications
Country of Publication: US
Dimensions (cm): 23.3 x 15.8  x 3.6
Weight (kg): 0.83
Edition Number: 2
Edition Type: New edition