Facilitates internal teamwork by understanding of roles of the parts
Each part exists for the greater good of the system
Facilitate communication and compassion
Grounding in present time orientation
Allows linkage of adaptive information
Military & First Responders
Normal reactions to abnormal events
Constant danger becomes dysfunctionally stored
Earlier childhood events may form the foundation of maladaptive memory networks
Follow EMDR standard procedures and protocols (eight phases and three prongs) unless specific modifications are indicated
Some additional processing issues • Culture of the profession, e.g., self-sacrifice • Perception that emotion is a sign of weakness • Maladaptive self-soothing behaviors, e.g., substance use/abuse, addictive behaviors • Survivor guilt • Avoidance • Anger / explosiveness • Classified experiences • Secondary gain, e.g., disability compensation, legal issues, redeployment • Anniversary dates • Transitions • Sexual assault on-the-job • LGBT and race • Couple / family struggles • Time limits on treatment
May be triggered by the idea of relaxing state change exercises in Phase 2
Psychoeducation, e.g., stress reduction, affect tolerance, role of emotional numbing
Important to have a variety of state change tools in place
Client may under-report SUD due to emotional numbing
Don’t have to report details, brain is doing the processing
Remind client of stop signal
EMD, Recent Event, or Inverted protocol (future, present, past) may be helpful
Reduces the possibility of over-accessing
Gives client a sense of control over the process
Remind client that emotional and physiological disturbances are the result of the brain processing the memory
Your brain is doing what it needs to do to get rid of the disturbance. You are here with me and the only place this (the memory) is actually happening is in your brain. Allow it to do its job. Once it’s been able to process all the ick, it will have much better access to the positive things again.
May need to remind client s/he can access resources to remain in the affective window of tolerance so s/he can continue to process
Remind client of importance of using stop signal if s/he needs it
If needed, return to target more frequently and use shorter sets to limit potential of associative links flooding the client
Possible cognitive interweaves
How does holding on to all of this help you/ him / her / them now?
If the roles were reversed and it had been you who died (was injured), what would you think about your brother / sister / partner? What would you want him / her to know?
What do you want to say to him / her that you haven’t been /weren’t able to say? Say it now. Have the conversation.
You’re home. It’s over. You’re safe now.
What can you do now to make things better – to make amends?
Body Scan may activate unprocessed memory elements
Make sure there’s enough time to stabilize if that were to happen
Check for any discomfort the client may “live with,” e.g., headaches or physical pain due to injury