Phase 3: Assessment (aka ACCESSment)
- Accesses and activates the maladaptively stored memory as it is currently stored
• Specific target was tentatively identified during case conceptualization and treatment
planning that began in Phase 1: History-taking - Maladaptively stored elements of the memory are activated in a place of safety and security
- Determine baseline levels of currently held positive and negative beliefs as they relate to the
stored experience as well as the intensity of feelings
• Brief and specific stimulation of the target memory promotes activation of associated
memory networks ultimately allowing adaptive processing and learning to occur
• Asking the activating questions in specific order begins the bilateral stimulation of the
brain
Client Instructions
We will be processing the memory (bothersome / icky thing) we’ve agreed on. I’ll start by asking seven specific questions to ‘turn on’ the memory, then I’ll start the back-and-forth. Remember, this will be like that train ride or watching a movie, just notice what comes up for you. You may have pictures, smells, sounds, tastes, thoughts, emotions, body sensations or other memories that come up. Just notice. There is no right or wrong way to do this. Just be curious.
Initially, it will be like we’re learning to dance together, so it’s important for you to tell me what is working or not working for you. I can adjust the speed and the length of the sets based on your personal experience. I’ll start with sets that are about 30 seconds or so – that’s like putting something that’s frozen into the microwave to speed up the thawing and we’ll adjust the length from there.
At the end of each set, I’ll ask you to notice the first thing that comes into your awareness when I stop – kinda like playing musical chairs. Remember, EMDR is different from traditional talk therapy, so I don’t need to know where you started, where you’ve been, or how you got to where you are, just what you are aware of (what comes up) in that moment. Give me a little bullet of information then I’ll say, ‘Go with that, start with that, or notice that’ and begin the bilateral again. We’ll continue to follow this pattern through your processing until the disturbance is down to a zero, your positive belief is strong, and there’s no disturbance in your body when you think about the memory. Remember, if anything feels like it’s too much, you’ve got your stop signal. Ready?
Seven Magic Questions & the Brain
- What’s the worst part of the memory (experience / incident)?
- Sensory elements activate the right brain
• image, sound, smell, taste, touch - What’s the negative belief (rat talk, yucky thought) you have about yourself now when you think about it? [NC]
• Thought activates left brain
• Childlike “I statement” that is generalizable, irrational and feels true - What would you rather believe about yourself now? [PC]
• Imagination activates right brain
• “I statement” with an adult perspective that is generalizable, adaptive and focuses on the same theme as the NC - On a scale of 1-7, where one is completely false, and seven is totally true, how true does [PC] feel now?
• Quantitative analysis activates left brain by quantifying the client’s meaning-making
• Osgood’s semantic differential – 7 being strongest adaptive belief - When you put the worst part of the memory [preferably an image] together with the [NC] what emotion(s) do you feel now?
• Emotion activates right brain - When you put the worst part of the memory together with [NC], on a scale of 0-10, where zero is ‘nothing” or ‘neutral,’ or ‘I can talk about it calmly’ and 10 is the worst you can imagine, how disturbing does it feel right now?
• Quantitative analysis activates left brain by measuring intensity
• Wolpe’s Subjective Units of Distress Scale – with 10 being most intense
• Where are you feeling the disturbance (upset) in your body right now?