Basic Training

Question 1

Elements of psychoed that covers EMDR and trauma (3)

Answer 1

1. Trauma is stored in unhelpful ways in the brain because it was in panic mode and processing was impaired, giving us unhelpful beliefs, emotions and reactions
2. EMDR helps unlock the nervous system and allow your brain’s natural mechanisms to reprocess the event
3. Bilateral stimulation activates both halves of the brain so the event can be fully processed

Question 2

3 Reasons why we do bilateral stimulation

Answer 2

1. Promotes dual attention
2. Eye movements elicit orienting response
3. Eye movements stimulate process similar to REM sleep

Question 3

EMDR procedures to discuss in preparation phase (3 parts)

Answer 3

1. EMDR seating arrangement
2. Eye movement or other forms of BLS - how long is set, what happens after each set
3. Explain window of tolerance and importance of pausing if things get intense/intolerable. Do not push through

Question 4

Do we want to specify an order when asking for ALES?

Answer 4

Yes, ask client for first to last

Question 5

7 key elements of light stream

Answer 5

1. Scan the body to identify any discomfort and where it is in the body
2. Get a sense of size, shape, color, texture of the discomfort
3. Ask if there is a color associated with soothing
4. Ask them to imagine soothing light in this color shining down and on top of head and through the entire body
5. Let it surround the uncomfortable
6. Notice it for a while and breathe it in
7. Take another deep breath and open eyes

Question 6

Why is it important to emphasize clients going with what first comes up when doing a floatback?

Answer 6

Because clients tend to dismiss what doesn’t make sense

Question 7

How to handle situations where client touches on something that could be its own target (e.g. parents don’t love me)

Answer 7

Help client just scope it during that particular target and see how far you can get it. 6 should be possible even with complex trauma.

Question 8

How do we use EMDR in working with psychosis?

Answer 8

Negative voices can be targets or address trauma as that’ll help reduce voices intensity and maybe shift them to positive

Question 9

When doing TICES on early memory, how do we handle multiple parts (e.g. adult and child)

Answer 9

Ask them to focus on child part. If they don’t know how child feels, ask them to think about how it would make them feel.

Question 10

How do we time EMDR work with somebody who has BPD

Answer 10

Have them track cycles so we can avoid doing phase 4 if they’re in an intense place on their cycle

Question 11

What should we do immediately after collecting ALES

Answer 11

Nervous system soothing practice

Question 12

Two signs of dissociation

Answer 12

1. Stop looking/doing BLS
2. Stop giving material

Question 13

5 Orienting/Grounding techniques

Answer 13

1. Checking the corners of the room
2. Hand sweeping across brow, down side of neck, arm and out the fingers
3. Hand on chest, hand on stomach - noticing breath
4. Orienting to present - where is client now, how old are they?
5. EFT tapping (karate chop to crown, face triangle, upper lower lip and then clavicle)

Question 14

What does TICES stand for

Answer 14

Target
Image
Cognitions - what does that say about you? negative, positive and validity of positive
Emotions
Subjective unit of distress
Somatic - where do you feel that in your body

Question 15

What are the 8 phases

Answer 15

History taking and tx planning
Preparation
Assessment (TICES)
Desensitization and reprocessing
Installation
Body scan
Closure
Re-evaluation

Question 16

Phase 4 script parts (4)

Answer 16

1. Let them know we’re about to start eye movements/tapping
2. Bring up the image, negative condition and where you felt it
3. Ask if they’re ready
4. Then begin 24-30 passes

Question 17

Nervous system shifting technique involving cold water

Answer 17

Splash it on your face or cold wash cloth on back of the neck

Question 18

New somatic resource involving self touch (hint: finger paint)

Answer 18

imagining paint on fingers and coating your face with it starting at the forehead.

Question 19

What do we do when we first have got a 0 after clearing all the channels

Answer 19

Tell them to go with that and another round. Little better, little worse or about same? Once about the same 2x then proceed

Question 20

What do we do after we’ve cleared the target and they’ve had about the same twice?

Answer 20

Go to phase 5: installation

Question 21

Container Part 1: Pre-tapping parts

Answer 21

1. Psychoed - practice a skill to help you put this away for now.
2. Think of a container that could hold this. What is it? How would you close it and possibly secure it?
3. Now think of a place where you might want to put it?

Question 22

Container Part 2: Tapping script parts

Answer 22

1. Notice materials and size and any other attributes that make it a good container
2. Visualize putting the thing in
3. Visualize closing the lid/securing it
4. Take a breath and notice how it feels to have it no longer inside you
5. Imagine putting container in its place and walk away, leaving it behind
6. How does it feel to leave it there and no longer carry?
7. Remember that you can keep those things there until if and when you want to take something out.
8. If things start to come up before next session you can put those away too

Question 23

Steps of phase 5 (8 parts)

Answer 23

1. Check original positive cognition still fits or does something else sound better
2. Hold the incident in your mind and check validity 0-7
3. Target incident and PC for BLS and then check if it feels more true, less true or the same
4. Stay with BLS sets until no change
5. If less than 7 what keeps it from being more true - if they can identify blocking belief repeat on that until back to 7
6. If less than 7 and they can’t identify blocking belief - go back to target to check for unresolved channels
7. After about the same 2x, do body scan and DONE!
8. If earlier memory comes up that blocks resolution of target, note that and get as far as we can here (ecological 6).

Question 24

Steps of Phase 6

Answer 24

1. Hold the image and positive cognition in mind
2. Mentally scanning their entire body starting from head for lingering tension or discomfort “anything at all” - name what they find
3. Target “nothing” / clear body scan for 1-2 sets of BLS to reinforce

Question 25

Phase 7 Closure psychoed on what to do/expect post session (3 parts)

Answer 25

1. Brain/body still processing - may come up more often or less, things may feel different 2. Notice anything unique/unusual (dream content, responses to various situations, how you feel) and take note for next session, then do container or grounding if you'd like 3. No need to put any deep thought in before next session

Question 26

Nice way of initiating phase 7

Answer 26

You just did a lot of work. How do you feel?

Question 27

Steps of phase 8 - reevaluation

Answer 27

1. Ask about what they noticed since last session 2. Ask if anything comes up now as they think about the incident 3. If something does come up - do TICES and BLS on that

Question 28

Addressing abreaction (3 parts)

Answer 28

1. Stay in the set to help them process through the abreaction until you see it settling or them leaving the window of tolerance 2. Can prompt client to focus on different faces of the memory when necessary (image, sensation, etc) 3. If session intense, reinforce the importance of client giving space to rest and integrate after session

Question 29

3 signs of blocking

Answer 29

1. Tension appears unrelated to the target 2. Client stops BLS during a set and may start talking 3. Other avoidance behaviors

Question 30

What leads to blocking?

Answer 30

Fear based beliefs, such as fear they cannot handle their emotions or fear of change

Question 31

How does Lizy adjust the set length for really intense trauma memories

Answer 31

She shorts the set length

Question 32

How do we work with fear based beliefs that can lead to blocking?

Answer 32

Use BLS on that so we can hopefully add more adaptive information

Question 33

Two reasons other than client preference to switch to tapping

Answer 33

1. Client gets dizzy 2. Client has a hard time visualizing the target

Question 34

What are three signs to implement cognitive interweaves?

Answer 34

1. Looping -- same thought, image or SUD level 2. Lack of generalization -- adaptive information not connecting to overarching cognitive themes 3. Client leaving window of tolerance

Question 35

Cognitive interweave strategies (4)

Answer 35

1. Psychoeducation 2. Clarifying what was developmentally appropriate for that child (e.g. their understanding of the world, their access to resources) 3. Increasing empathy for self through view of others - e.g. what would they say to a friend or what would their support person say to them 4. "Two handed interweave" - identify two parts at odds with each other

Question 36

What is a future template (3 key parts)

Answer 36

1. Imagine a situation where this new positive cognition or other change could be useful. Notice any challenges and any resources that might be needed to get to a successful outcome. 2. Client raises any issues we use BLS to address them 3. Then we have them play the move from start to finish using BLS

Question 37

Lizy's EMDR dream escape sequence (3 parts)

Answer 37

1. What would you need in that dream? 2. Who would you want with you? 3. See that all play out and tap it in