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EMDR-Phases 3&4 Eye movement desensitization and reprocessing therapy, commonly known as EMDR, is a mental health therapy approach that works to reduce distressing emotions that are linked to traumatic memories. EMDR treats the mental health conditions, often anxiety, depression or other symptoms, which occur because of the memories we have stored from these traumatic […]
Eye movement desensitization and reprocessing therapy, commonly known as EMDR, is a mental health therapy approach that works to reduce distressing emotions that are linked to traumatic memories. EMDR treats the mental health conditions, often anxiety, depression or other symptoms, which occur because of the memories we have stored from these traumatic events.
In my first article on the phases of EMDR we looked at Phases 1&2-Client History/Treatment Planning and Preparation. Now we will look at Phases 3&4-Assessment and Desensitization.
Phase 3- Assessment
In phase three the client and therapist will work together to identify
the target memory that triggers emotional distress. This includes what incident caused the trauma? (Was it sexual assault, an accident, the death of a relative etc.?),and what is the most consistent image associated with the memory?
The first step is for the client to select a specific image or mental picture from the target event that best represents the memory. Then the client chooses a statement that expresses a negative self-belief associated with the event. Common negative cognitions could be statements such as, “I am helpless,” “I am worthless,” “I am unlovable,” “I am dirty,” “I am bad,” etc.
During phase three of EMDR therapy, a positive belief is also chosen to help counteract the negative emotions caused by the trauma. The client will pick a positive self-statement that he would rather believe. This statement could be “I am worthwhile/lovable/a good person/in control” or “I can succeed.”
The therapist will then ask the person to estimate how true the positive belief feels using the 1-to-7 Validity of Cognition (VOC) scale. “1” equals “completely false,” and” 7″ equals “completely true.” It is important to give a score that reflects how the person “feels,” not” thinks.”
During the Assessment Phase, the person identifies the negative emotions (fear, anger) and physical sensations (tightness in the stomach, headache) he or she associates with the target. The client also rates the level of disturbance, but uses a different scale called the Subjective Units of Disturbance (SUD) scale. This scale rates the feeling from 0 (no disturbance) to 10 (worst) and is uses this score to assess the disturbance that the client feels throughout the processing.
The goal of EMDR treatment, is for SUD scores of disturbance to decrease while the VOC scores of the positive belief to increase.
Phase 4- Desensitization
Phase four is where the processing of the memory and negative beliefs takes place. The therapist will use some form of Bilateral Stimulation (BLS) to stimulate the mind/brain to process whatever trauma is currently being held in the conscious mind. This usually involves instructing the client to follow hand movements back and forth or hold tappers in each hand.
After a number of eye movements or other form of BLS occur, the therapist will stop and ask, “What are you noticing now?” The client will comment in just a few words what they are noticing. This may be part of the memory, a feeling, or a body sensation. Most of the healing happens while the client is reviewing the memory with the BLS. The therapist will ask the client to continue by stating “Go with that”. The process then continues.
Depending upon the intensity of the response to the trauma, your therapist may adjust the length, speed and type of stimulation used to create the eye movements.
The therapist may have to “circle back” to the original memory multiple times depending on how deep or complex the trauma is, but the process remains the same. The therapist will keep asking the client to hold the memory and the belief and the feelings in mind, while also completing the BLS.
Eventually the memory will feel different. It will have less energy.
The therapist will keep offering BLS until the client is able to grade the memory at a much lower level of disturbance on the 1-10 scale, ideally at a zero –now the memory no longer bothers them. This is the goal of EMDR; to get the client from a point where the memory goes from 8 or 9 out of ten for intensity and unpleasantness, down to a 0-1 out of ten.
During reprocessing, maladaptively stored events are desensitized, integrated, and adaptively stored.
In my third and final segment of the phases of EMDR we will look at phases 5-8-Installation, Body scan and Re-evaluation.
If you have experienced trauma of any kind, and feel you could benefit from EMDR to reduce symptoms and to improve quality of life, feel free to reach out to me at Marsh Psychology Group.
Carol Van Kampen, LMSW is an individual private practice psychotherapist who specializes in anxiety, depression, grief, and trauma treatment at Marsh Psychology Group. Carol is EMDR trained. Contact her at marshpsychologygroup.com
cvankampen@marshpsychologygroup.com
” https://marshpsychologygroup.com/carol-van-kampen-lmsw/
Resources:
https://www.emdria.org/public-resources/the-eight-phases-of-emdr-therapy/
EMDR Phase 1&2 Eye movement desensitization and reprocessing therapy, commonly known as EMDR, is a mental health therapy approach. EMDR treats mental health conditions that occur because of the memories we have from traumatic events in the past. In this article I will be addressing phases 1&2 of EMDR. I will follow up with an […]
EMDR Phase 1&2
Eye movement desensitization and reprocessing therapy, commonly known as EMDR, is a mental health therapy approach. EMDR treats mental health conditions that occur because of the memories we have from traumatic events in the past.
In this article I will be addressing phases 1&2 of EMDR. I will follow up with an additional article addressing phase 3&4 and finally in my third and final article, I will address phases 5-7.
Phase 1: History and Treatment Planning
Phase 1 generally takes 1-2 sessions but can continue throughout the therapy process, especially if new issues are revealed. In the first phase of EMDR treatment, the therapist takes a thorough history of the client and develops a treatment plan. This phase will include a discussion of the specific problem that has brought him into therapy, the clients behaviors stemming from that problem, and the symptoms.
The therapist will assess the client’s readiness for EMDR. The client and therapist start toidentify possible targets for EMDR processing. These include distressing memories and current situations that cause emotional distress. Other targets may include related incidents from the past.
Initial EMDR processing often are connected to childhood events rather than to adult-onset stressors. Clients generally gain insight into their situations; the emotional distress resolves and they start to change their behaviors. The length of treatment depends upon the number of traumas and the age of onset.
EMDR therapy is most effective when a client feels a connection with the therapist – a sense that the therapist: 1. Has the client’s best interest in mind (that sense of ‘I’ve got you’): 2. Will help the client to feel safe: 3. Will help the client to feel grounded and present
A big part of Phase 1 and 2 is establishing this relationship between the therapist and client.
Phase 2: Preparation
For most clients this will take 1-4 sessions. For others, with a very traumatized background, or with certain diagnoses, a longer time may be necessary.
During the second phase of treatment, the therapist ensures the client has several different ways of handling emotional distress. The therapist may teach the client a variety of strategies and stress reduction techniques the client can learn and practice during and after sessions. In Phase 2 we are preparing for the worst. We are looking for the client’s ability to regulate, their ability to stay safe, and their ability to connect. We are investigating what they are currently doing and looking for any imbalance. In this phase we are making sure the client has all the tools and resources needed to begin the reprocessing of memories. We are looking for the dangerous issues and safety issues, as well as the annoying things and connection issues, that will impede the healing process. The therapist may talk about the Window of Tolerance and strategies to make your window larger.
Once a client can reduce emotional distress using the tools they were taught, they are generally able to proceed to the next phase
We want the client to get through the processing as quickly and safely as possible. We want to address all questions and concerns the client may have. The therapist’s task here is to understand what it is like to be the client as completely as possible.
An important goal of EMDR therapy is to make sure that the client can take care of him or herself.
In my next article on EMDR, we will look at phases 3&4.
Carol Van Kampen, LMSW is an individual private practice psychotherapist who specializes in anxiety, depression, grief, and trauma treatment at Marsh Psychology Group. Carol is EMDR trained. Contact her at marshpsychologygroup.com
cvankampen@marshpsychologygroup.com
” https://marshpsychologygroup.com/carol-van-kampen-lmsw/
Sources:
https://www.emdria.org/public-resources/the-eight-phases-of-emdr-therapy/
Image: https://britishpsychotherapy.co.uk/emdr-2/
At no other time in history have schools had to face so many challenges. The COVID-9 pandemic required teachers, students, and faculty to quickly pivot and move classes to an online environment during times of great uncertainty. Despite the work involved to keep education going, students of all ages have still been significantly impacted by […]
At no other time in history have schools had to face so many challenges. The COVID-9 pandemic required teachers, students, and faculty to quickly pivot and move classes to an online environment during times of great uncertainty.
Despite the work involved to keep education going, students of all ages have still been significantly impacted by the stress of lockdowns. Many students are dealing with mental health challenges as a result.
A recent study looked at 195 students at a large public university in the United States to understand the effects the pandemic has had on their mental health. The researchers found that 71% of the participants were experiencing increased stress and anxiety as well as depressive thoughts.
While many schools have opened back up, many students are still experiencing symptoms of trauma and mental health issues.
It’s important that teachers and faculty become educated themselves on the indicators of a mental health crisis in their students. What is the best way to recognize those students who may be having issues and need extra support?
All educational institutions should put in place universal screenings to identify those students in need. These screenings may involve brief questionnaires to gauge student emotional concerns.
Schools should also be sure to have enough school-based mental health professionals on staff to provide direct support for at-risk individuals.
Students should recognize their feelings and be open to sharing them with others. Reach out to teachers and staff and get the help you need.
And if you are a student who would like to talk with someone about the stress and anxiety you are feeling, please don’t hesitate to get in touch with me.
SOURCES:
BIPOC Mental Health According to the American Counseling Association: “Black and Indigenous people and other people of color (BIPOC) experience a broad spectrum of ongoing discrimination, oppression, and inequity rooted in America’s colonialist history, all of which foster both collective and individual trauma in those communities.” The American Psychiatric Association reported in […]
BIPOC Mental Health
According to the American Counseling Association:
“Black and Indigenous people and other people of color (BIPOC) experience a broad spectrum of ongoing discrimination, oppression, and inequity rooted in America’s colonialist history, all of which foster both collective and individual trauma in those communities.”
The American Psychiatric Association reported in 2017 that 17% of Black people and 23% of Native Americans live with a mental illness. People who identify as multi-racial are more likely to report any mental illness within the past year than any other racial or ethnic group. According to research performed by the American Counseling Association, BIPOC groups are:
These barriers can be attributed to a variety of factors. Examples include cultural stigma around mental illness, systemic racism and discrimination, a lack of health insurance, language barriers, mistrust of mental health care providers, and a lack of cultural competency on the part of mental health care providers.
Since COVID-19, many BIPOC communities have been impacted in numerous ways. According to the Centers for Disease Control, symptoms of depression were reported 59% more frequently by Hispanic adults than non-Hispanic White adults. It was also reported that a larger percentage of multi-racial and non-Hispanic adults of other races and ethnicities reported stress and worry about stigma or discrimination associated with being blamed for spreading COVID-19 in comparison to White adults.
What can you do to help?
Cultural competency and awareness do not occur in a vacuum. According to the American Psychological Association, the following tips can help in building cultural awareness and competency:
Claudia Coxx, LMSW , is a psychotherapist specializing in depression, anxiety, and BIPOC mental health at Marsh Psychology Group. She can be reached at ccoxx@marshpsychologygroup.com or 248-860-2024.
One only needs to read a few lines from poets such as Frost, Wordsworth, and Thoreau to recognize the love for and connection to nature human beings have always had. Nature stirs our souls and imagination and brings beauty to our everyday lives. But it turns out, nature also brings a slew of benefits to […]
One only needs to read a few lines from poets such as Frost, Wordsworth, and Thoreau to recognize the love for and connection to nature human beings have always had. Nature stirs our souls and imagination and brings beauty to our everyday lives. But it turns out, nature also brings a slew of benefits to our mental and physical health.
Research is now clearly indicating that spending time outdoors can have a positive impact on our health. Whether you bike, hike, or simply sit under a tree enjoying the sights and sounds, time in nature has shown to reduce stress, slow heart rate, improve pain, lower cortisol, and stimulate the immune system by boosting the production of natural killer cells that fight disease and infection.
In addition, time outside means time in the sun, and THAT means getting a nice boost of vitamin D, which can do everything from preventing disease, make our bones and teeth stronger, and improve our mood.
Ecotherapy, which is also sometimes referred to as nature therapy, is a practice in the emerging field of ecopsychology. The idea behind this practice is that many modern people, whether they are aware of it or not, feel a massive disconnect from the natural world. When you think about it, our ancestors spent hundreds of thousands of years living WITH nature, feeling it under their bare feet, being outside, ebbing and flowing with the shifts in seasons.
But today, most of us are only connected to a digital device. Ecotherapy gets us away from our screens and out into the beauty of the natural world. Many clinicians, including myself, believe that the earth has a natural ability to balance us. When we get back in touch with the systems of nature, we can experience improved mental health.
If you are feeling out of sorts and like the idea of trying ecotherapy, you can simply spend more time outside. If you would like someone to help you reconnect with nature, please get in touch with me. I am a big proponent of nature therapy and use it in my practice.
SOURCES:
They say you can wake up on the wrong side of the bed. But many days it feels like you woke up on the wrong side of calm. And who can blame you? Life seems to have gotten more complicated, stressful and chaotic, making it more difficult to feel peaceful and calm. But there are things […]
They say you can wake up on the wrong side of the bed. But many days it feels like you woke up on the wrong side of calm. And who can blame you? Life seems to have gotten more complicated, stressful and chaotic, making it more difficult to feel peaceful and calm.
But there are things you can do each day to get yourself on the right side of calm. Here are 3 of them:
1. Breathe Deeply
Many people are shallow breathers, meaning they take small, short breaths. But did you know shallow breathing is actually part of the “fight or flight” response? It’s an evolutionary adaptation designed to keep us safe from danger, like that angry sabretooth tiger chasing us. When faced with danger, our heartbeat speeds up and we breathe faster in order to get more oxygen for fighting or fleeing.
Our bodies don’t recognize real danger (that tiger) from modern day danger (that stack of bills). And so we spend most days breathing like our life depends on it.
One of the quickest ways to calm yourself is to slow down your breathing. Many people scoff at the idea that breathing deeply and slowly will do much of anything. Those that try it know deep breaths have an incredible calming affect.
2. Get Familiar with Your Acupressure Points
There are key acupressure points located on your hands, face, and head. These points are near bundles of nerves that, when massaged or tapped, can help relax your entire nervous system. This is why we instinctively rub our forehead and temples when we’re feeling stressed. You can subtly apply pressure to the meaty part of the hand between the thumb and forefinger when in a stressful meeting, at the airport, or any public setting when you need to calm down but don’t want to call much attention to yourself.
3. Focus on the Positive Things in Your Life
Every night before you fall asleep, think about three things that happened that day you are grateful for. They can be small, like that parking spot in front of the always-busy post office you got this morning, or big, like your son’s ankle was sprained not broken.
Feeling happy and grateful will naturally calm you down and give you a different perspective on things. And, doing this exercise night after night will train your brain to be more positive.
Have you tried these tips in the past but are still dealing with persistent anxiety and worry? Therapy can help you uncover the root cause of your anxiety and provide tools for coping.
If you or a loved one is interested in exploring treatment, please contact me today. I would be happy to speak with you about how I may be able to help.
It’s rare that any of us will get through life without experiencing anxiety at some point. But some people have the burden of dealing with anxiety on a daily basis. Whether it’s over something big or insignificant, anxiety stops us from living a normal life full of joy and potential. Here are 5 ways you […]
It’s rare that any of us will get through life without experiencing anxiety at some point. But some people have the burden of dealing with anxiety on a daily basis. Whether it’s over something big or insignificant, anxiety stops us from living a normal life full of joy and potential.
Here are 5 ways you can begin reducing your anxiety:
1. Recognize You Are in Control
When you are in the grips of anxiety, it feels very much like it has total control over you. But the reality is, you are in control. While external events can trigger our emotions, ultimately, we have the choice whether we feel those emotions or not. So the good news is, you don’t have to suffer with anxiety, you simply have to decide to show it who’s really boss.
2. Diaphragmatic breathing
This physical strategy is very helpful to relax in stressful situations. While breathing, focus on breathing into the belly while keeping your shoulders down and relaxed. As opposed to expanding your chest, focus on letting your abdomen expand while inhaling.
3. Move Your Body
Exercise is a great way to alleviate the muscle tension that goes along with chronic anxiety. Plus, exercise releases feel good chemicals in your body like serotonin. But don’t sweat it, you don’t have to do a grueling workout at the gym to gain these benefits. Just a half hour a day of walking, biking, swimming or yoga can significantly help reduce your anxiety.
4. Start a Gratitude Journal
Get into the habit of writing down three to five things you are grateful for each night before retiring. This is a simple way to train your mind to focus on all of the good that surrounds you.
5. Speak with a Professional
The cure for any physical or psychological ailment is to get to the root cause of it, not simply manage the symptoms. A therapist can help you access your inner world to uncover what is triggering your fear and also offer coping tools and strategies.
If you or a loved one is interested in exploring treatment, please contact me today. I would be happy to speak with you about how I may be able to help.
Personal Strengths
Positive psychology is the study of well-being and identifies tools and behaviors that increase positive feelings. One area of research is cultivating personal strengths to increase wellness. A personal strength is defined as “a pre-existing capacity for a particular way of behaving, thinking, or feeling that is authentic and energizing to the user, and enables optimal functioning, development, and performance”(Paquette,2018).
Research suggests that people who identify and use personal strengths:
show a decrease in depression,
increased sense of well being,
Increased optimism,
stronger social and romantic relationships,
buffers against stress.
Positive Psychology researchers Martin Seligman and Christopher Peterson identified seven categories of strengths:
Wisdom and Knowledge:
Strengths: Creativity, curiosity, open-mindedness, love of learning, perspective
Humanity:
Strengths: love, kindness, social intelligence,
Courage:
Strengths: bravery, integrity, persistence, vitality
Justice:
Strengths: citizenship, fairness, leadership
Temperance:
Strengths: forgiveness and mercy, humility and modesty, prudence, self-regulation
Transcendence:
Strengths: appreciation of beauty and excellence, gratitude, hope, humor, spirituality
Identifying personal strengths:
Perhaps the easiest way to identify personal strengths is to take Seligman and Peterson’s Values in Action survey at www.viacharacter.org. This free online survey will identify your core strengths.
Incorporating Personal Strengths into daily life:
Once you’ve identified your strengths, take some time to ask yourself the following:
How am I using my strengths in my daily life?
Am I using all my strengths?
Are there new ways to use neglected strengths in my daily life?
Identifying and using your personal strengths increases well being. If you needs help identifying your strengths, psychotherapy can help. Meeting with a psychologist can help you explored blocks to happiness and embracing the best parts of yourself.
Resources:
The Happiness Toolbox by Jonah Paquette(2018)
VIA Character Strengths:
https://www.viacharacter.org/
Pamela Marsh, Psy.D.
Pamela Marsh is a licensed psychologist at Marsh Psychology Group. She can be reached at pmarsh@marshpsychologygroup.com or 248-869-2024.
Positive Psychology is the science of well-being. It focuses on skills that foster good feelings and resilience. One of the most powerful and impactful area of positive psychology is the practice of gratitude.
Gratitude is defined as a sense of wonder, thankfulness, and appreciation for life. It consisted of 2 related steps:
Research shows that regular gratitude practice impacts both our psychology and bodies. First, gratitude has been shown to “ decrease rates of depression and stress, while enhancing positive mental states such as joy, optimism and tranquility”(Paquette, 2018). Second, people who regularly practice gratitude, have overall improved physical health, stronger immune systems, and reduced rates of stress-related illnesses. Third, our brains change structurally and chemically in ways that increase well-being.
Jonah Paquette, Psy.D.(2018) suggests a good place to start is to start noticing positive occurrences in our daily lives. The “Three Good Things” technique is a simple way to start a gratitude practice. You will need a few sheets of paper or a notebook and a pen/pencil for this exercise.
Three Good Things
Instructions: Before bed each night for 2 weeks
1) Write down three things that went well that day. They can be little or big things, there is no right answer. Example: I had a restful day off and feel relaxed.
2) Explain why you think this happened and or your contribution to the event. Example: I had a restful day because I kept the TV turned off and did not check my work email.
Try to challenge yourself not to repeat an entry over the next 2 weeks.
Shifting to a Gratitude Mindset
Once you feel comfortable noticing good things in your life, change your journal entries to reflect what you are grateful for, and explain your reasoning. This subtle adjustment adds a deeper meaning to your practice. It widens the “goodness” in your life to include an acknowledgment of an external source of goodness and an experience of being thankful. This shift deepens the positive impact on your mood and physical health.
References and resources:
The Happiness Tool Box by Jonah Paquette, Psy.D. 2018 PESI Publishing and Media, Eau Claire, WI.
https://greatergood.berkeley.edu/
Be Well,
Dr. Marsh
Pamela Marsh, Psy.D. is a licensed clinical psychologist at Marsh Psychology Group, in Huntington Woods, Michigan. She can be reached at pmarsh@marshpsychologygroup.com
The old saying goes, “Into every life a little rain must fall.” Stress is like rain. A little of it can be a good thing. But too much can cause havoc and devastation. Our bodies are designed to handle a little bit of acute or sudden stress. But when stress is prolonged or becomes chronic, […]
The old saying goes, “Into every life a little rain must fall.” Stress is like rain. A little of it can be a good thing. But too much can cause havoc and devastation.
Our bodies are designed to handle a little bit of acute or sudden stress. But when stress is prolonged or becomes chronic, it can have devastating consequences to our health.
Here are just some of the ways stress can negatively impact your body:
Respiratory Issues
Prolonged stress can lead to respiratory issues such as shortness of breath. Individuals who do not have an underlying respiratory disease may not be very impacted. But for those with pre-existing conditions such as COPD and asthma, stress can dangerously exacerbate the situation.
Heart Health
When we’re stressed we are in fight or flight mode. This causes our heart to beat faster and our blood vessels to dilate. In short-term scenarios, these physical manifestations help get us out of danger.
But for prolonged periods, this can put a lot of stress on our heart and blood vessels, potentially leading to a heart attack or stroke.
Gut Health
Did you know that 80% of your immune system is located in your gut? It’s incredibly important to ensure your gut is healthy!
But chronic stress can wreak havoc on your gut as it changes the beneficial gut bacteria. And a change in this bacteria can negatively impact your mood. And when you’re already feeling stressed, the last thing you need is to also feel depressed.
Sexual Health
Both the male and female reproductive systems are influenced by the nervous system. When we are stressed, our sexual hormones can get out of balance and we can lose sexual desire. Men may find it hard to achieve and maintain an erection. Stress can also make it hard to conceive and affect a woman’s menstrual cycle.
As you can see, stress can really impact your physical health in a negative way. While we can’t stop the rain from falling or stress from entering our lives, we can practice healthy stress management. That means eating right, getting enough exercise, and quality sleep each night.
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