All posts by Mark Brayne

Dr Jamie Marich thrills at Norwich on EMDR Made Simple – April 22 2017

Dr Jamie Marich in Norwich – author of EMDR Made Simple, using EMDR with Every Client

Report by Shirley Young

This was a well-attended and inspiring networking day and, without the usual focus on Powerpoint presentations, a relationally engaging experience!

Jamie started the day experientially by bringing us into presence in the way she starts her client sessions, guiding us to pay attention to the sensory experiencing of the room we were in: the sights, sounds, smells, physical sensations of touch and physical connection to chair and floor, and then our breathing, and finally encouraging us to move and stretch so we were bodily connected before she began engaging with us.

Norwich Sports Park audience paying rapt attention to Jamie Marich

Jamie began by sketching out her personal journey of how she came to work with EMDR, both personally and professionally.

She highlighted the difference between having knowledge and understanding from participating in personal therapy and the 12-steps programme, and the effects of experiencing EMDR, allowing her to move into “becoming” as a result of a therapy that addressed bodily experiencing.

Jamie worked as an English teacher in post-war Bosnia-Hercegovina in the early 2000s, and was supported by a trauma-informed influential mentor who helped her ask “what role is trauma playing in this”.

Focusing her attention on noticing students’ difficulties with learning and her own triggering from seeing how the system interacted unhelpfully with the children in their care, Jamie found herself engaged with the treatment of trauma (her own and others’), moving away from the understanding that trauma only affects military veterans.

Jamie noted that the English word ‘trauma’ is a direct translation of the Greek word for wound – and that all wounds need care.

Life’s knocks may be more bruising for some than others, and different levels of care are needed depending on the individual. But recognition and treatment of wounds at whatever level needs attending to rather than being dismissed as “just life”.

Jamie then explored her EMDR training and her motivation for writing EMDR Made Simple.

Small group work in Norwich

She noticed, as many of us probably have too, that many therapists trained in EMDR do not go on to practice because they feel bogged down in complexity and paralysed by the fear of damaging a client by not doing things correctly. She also highlighted how EMDR in its original research was for clients with a single trauma – as if this was the norm.

In clinical practice, however, complex trauma is more often the rule, and Jamie emphasised how Francine Shapiro allowed in her writings for modifications to the Standard Protocol when working with difficult presentations.

She also noted that EMDR was developed through trial and error, posing the question whether anyone had considered how walking (also a bilateral activity after all) as well as eye movements might have been part of Francine’s reprocessing insight during her famous walk in the park.

Setting out how she came to the concept of the Four Faces of EMDR in her first book EMDR Made Simple, Jamie recalled St Augustine’s definition of the four voices of God – a concept familiar to her from her own Catholic upbringing, adding how tempting it is for individuals to believe that their own personal relationship to God is an absolute rather than an experience that matches their own personality, and to feel therefore threatened by other styles of worship.

These Augustinian styles can be classified under four headings:

  1. God as Truth – Seeking after theological truth and its right expression, and the importance of using the right words in the right way and being grounded in Biblical knowledge.
  2. God As Good and Action-Centred – doing good works to bring about real change in the world.
  3. God as Beauty – symbol-based and via artistic expression, with the experience of the transcendent beauty and pleasure in the world around us.
  4. God as One – emotionally- and relationally-based

Taking this idea, Jamie suggested that within the EMDR community there are different style preferences (reflecting also cultural influences) and to be aware of the potential for gospel-based EMDR – as in, only my way is the right way.

She described her Four Faces of EMDR as being:

  1. Those who are most comfortable sticking to the protocols.
  2. Those whose approach to EMDR is flexible – the eight phases are largely adhered to, but not necessarily in order, and used flexibly and responsively, often employing a rich variety of resources in Phase 2 preparation.
  3. EMDR as a technique used as an adjunct to other things. (This was in fact Shapiro’s original idea, although no longer the current view). A Gestalt therapist may thus continue to see themselves primarily as a Gestalt Therapist, but one who also uses EMDR within the context of their own modality
  4. EMDR-inspired interventions. These in Jamie’s overview would be the breakaway therapies that have developed from EMDR, in the grand tradition of psychotherapy modalities birthing new developments. She suggested Brainspotting was a current example.

Jamie noted Janet’s original 19th century understanding of the phases of trauma treatment being Stabilisation, Reprocessing, and Integration. This had the downside of sometimes holding clinicians back from work with a client because they might feel that sufficient stabilisation is impossible.

EMDR’s description of a preparation phase rather than a stabilisation phase was, she felt, a more helpful way of viewing what is helpful for a client, providing the tools to ride one’s instability in order to reprocess and then move towards stability and new growth.

Jamie also encouraged us to discuss issues with ‘Safe Place’ – the need to be aware of how this can be used as to avoid necessary work rather than a containment strategy, allowing also for the choice of Safe Place to actually lead to triggers that the client had been unaware of, with difficulties with visualisation making the creation of a safe place problematic for some.

Jamie highlighted the need to recognise that all resources can lead to complications, and how important it is to have one’s own resources and possibilities in order to respond with a change of plan.

Jamie posed the question, is it necessary to sit still in order to process, introducing the idea that one might as therapist encourage the client to amplify a movement as an interweave – going with that – if they were already doing this during processing. In cultures that are more movement-based, such as Brazil, movement interventions could be culturally appropriate.

Some helpful reminders and ideas about what could be used in the preparation phase were considered, such as Mindfulness-based skills to learn to tolerate emotions/body sensations etc.

Jamie even suggested listening to pieces of music in styles that you hadn’t heard before and that might cause discomfort, learning to stay with your response. She encouraged us to create playlists associated with helpful emotions, for use when the clients need help with emotional management.

DBT (Dialectical Behavioural Therapy) for example supports the idea of teaching surfing the waves of emotions rather than drowning in them.

Jamie noted that in some settings, Phase 2 may be all that is possible, and that these tools can be effective even if reprocessing is unable to be achieved. This is also EMDR.

Jamie suggested we look at resources for therapists on www.instituteforcreativemindfulness.com and for therapists and clients www.traumamadesimple.com.

Jamie referred to a book by Scott Miller re-published in 2009 called the Heart and Soul of Change – Delivering What Works In Psychotherapy. This is a review of all the research literature across the board about psychotherapy and does not cherry-pick research.

She went on to describe the four factors essential for any therapeutic method to work, factors initially noted by Carl Rogers.

  1. A client present in the room (with their psychological baggage);
  2. Methods and strategies that “engage and inspire” the participants. If what you are offering is not engaging the client, then it’s not going to work. (This, Jamie noted, goes back to individual styles and the need for there to be a match between modality and the style of therapist, and their ability to adapt to the client’s presentation);
  3. The relationship: trusting, cooperative, unconditional positive regard etc
  4. The Therapist (and our psychological baggage) and our ability to manage our own triggering while dealing with a client (and seeking our own treatment if necessary).

Jamie then took us through a guided meditation based on a client we had identified.

What did they look like, how did they present etc in their first session? How were they referred? What transport did they use to get to therapy?

She then asked us to do the same exercise but as if we were the client. How did they experience us and communicating with us? Were they able to say no to a question? What did they need at the end of the session?

When the meditation was finished, we were asked to reflect on what we had learnt.  This can be a helpful exercise when working with clients we feel stuck with.

We ended with an exercise of rubbing our hands together and then using the generated heat applied to our temples, repeated and applied to the back of the neck, repeated and placed on our breast bone, repeated and then placed on one of the places we liked the best.  We were asked to notice whether there was a difference. Jamie uses this as a technique for grounding and support.

We then stopped for lunch and also had time to network, buy books and support Trauma Aid by buying raffle tickets and EMDR-related material.

When we resumed in the afternoon we split into five networking groups focusing on

  • Intensive Work
  • Yoga, Spirituality and Mindfulness
  • Military
  • NHS & Complex Clients
  • Working Online.
Dr Marich inspiring and entertaining her small group on EMDR, Yoga, and Spirituality.

Following these groups and the drawing of the raffle on behalf of Trauma Aid, we had our usual Question-and-Answer session.

Jamie joined us in her Consultant capacity supporting our resident Consultants Mark Brayne, Valerie Halbinger and Sonya Farrell, and two of our consultants in training.

Questions explored were:

  • The Future of EMDR – emphasis on the need for research, and reference to the outcome of a small trial in the Middle East comparing Blind to Therapist Protocol and Standard Protocol;
  • Intensive EMDR (as in, many hours over a shorter period of days);
  • Use of smartphone apps and bilateral music (there is, noted Jamie, some useful bilateral music for EMDR on Spotify) and managing BLS online.

Jamie showed us a way of clients doing bilateral stimulation themselves when they are adverse to the feeling of tapping by putting the thumbs and first fingers together, creating the O-shape seen when you hold your hands in a meditation pose, and then rubbing the thumb tip across the first fingertip.

All in all, it was a very satisfying and enriching day, helping us look forward to November 11th for our next regional networking day which we hope will be in Ipswich.

Regional Networking Day Nov 26 2016 | Quy Mill Hotel & Spa, Cambridge

cambridge-attentive-listeners
Quy Mill Hotel conference room, with gorgeous views.

Report by Shirley Young, Regional Group Secretary

Around 70 of us met for a fascinating day of networking and helpful presentations and the usual opportunities for asking questions. The Q&A section and networking groups were enhanced by having the expertise of several EMDR Association Board members available to us.

Regional Co-Chair Mark Brayne introduced the day and welcomed the EMDR Association President Derek Farrell, President-Elect Lorraine Knibbs, co-ordinator on the Board for the regions Paul Keenan, and our first speaker (and himself also past President of the Association) Robin Logie.

robin-logie-presenting-flashforward-technique
Robin Logie introducing the Flash Forward Procedure

Robin’s presentation introduced us to the FlashForward Procedure (FFP) or, as Cindy Browning named it in an EMDRIA newsletter, the float-forward technique.

Unlike the Future Template, which targets a predictable feared event, the FFP targets an imagined catastrophic event that is unlikely to occur but may preoccupy the client sufficiently to impair full re- engagement with their life.

Robin explained that while EMDR’s AIP model is about unprocessed traumatic events, our conditioned fear stimulus makes us susceptible to react to conditions that in some way remind us of the original trauma.

Our reaction to, or avoidance of, the trigger can be associated with our unrecognised belief about the imagined consequences of our most catastrophic outcome.

Targeting this imagined catastrophic event can uncover fundamental issues and even unresolved events that may have been missed in processing past and present events.

In describing the FFP Robin encouraged us to keep asking “what is the worst thing that could happen” and then “what would be the worst thing about that happening”. Dying isn’t enough!

It is important to illicit the full meaning of the catastrophic event following the scenario to its ultimate conclusion. Sometimes this uncovers surprising meanings for the client and may be helpful as an exercise even without processing.

The standard protocol is then used to process the catastrophic meaning of the event.

Robin shared the example of a lady frightened of being killed as a result of being knocked off her bike.  Although the original trauma had been processed and she had attempted to re-engage with cycling, she was still too frightened to cycle.

Using the FFP her catastrophic outcome was not dying but that dying would mean she would lose her family, who would no longer be around her.  When asked to choose what was worse – dying or losing her family – the client identified the latter. “Going with that” choice, she realised that dying actually wasn’t so bad!

Aside from Robin’s main presentation on the FlashForward, we explored also a number of other useful techniques. These included the narrative approach for helping process a child’s story, where the therapist writes down the story in appropriate language, drawing on all appropriate sources including the child and the parents, and reads it back to the child, with BLS as it unfolds.

We heard too of the vertical hand technique for helping calm arousal, and for soothing headaches/migraine. (I know that one delegate experimented with this during one of the breaks and reduced her headache with good effect!)

derek-farrell
Dr Derek Farrell in full flow…. President of the Association

Our second presenter of the day was Derek Farrell. Before fielding EMDR questions from the floor, he was able to give us a helpful overview of EMDR internationally, drawing on his experience as vice-president of EMDR Europe and his involvement with Trauma Aid UK and Trauma Aid Europe.

Despite our frequent frustration with psychological services in the UK and the gap between what we know could be possible with the right funding and what is actually available, Derek helped us realise that we are, in fact, quite privileged.

Countries which have experienced violence and even genocide such as Cambodia, Iraq, and Pakistan have poor mental health services, and lack understanding about trauma and its effects. Our understanding that there is a correlation between adverse childhood experiences and poor physical health outcomes is now being clearly observed in these countries.

Derek conveyed the difficulties of introducing training in countries where one is not building on previous psychotherapeutic knowledge. Instead training involves building trauma capacity. This involves providing education about what constitutes trauma, and then how to assess risk, manage psychological triage, provide trauma first aid and identify who requires treatment.

Derek also noted that progress is often hampered by established professionals who struggle to allow para-professionals to work in new ways that challenge the status quo.

After this introduction Derek fielded a variety of EMDR-related questions.

A key theme that Derek highlighted was the need for research that moved away from practice-based to research-based evidence. The possibility of moving EMDR training to university-based training could address this issue.

He also noted that it was important to identify what data was required beyond purely psychological data if funding was to be forthcoming and the effectiveness of EMDR as applied to different situations was to compete with the research base for CBT.

EMDR Europe is trying to address the research issue by encouraging small RCT trials in different countries, with the view to pooling outcomes.

Mid-afternoon we split, as usual, into network groups well supported by the wealth of expertise on hand. Groups included DID, OCD, Accreditation, Depression, Accumulated trauma and Psychosis.

emdr-consultants-q-a
Robin Logie, Walid Abdul-Hamid and Mark Brayne, Consultants exploring best practice in response to questions from the floor

Before the day concluded Derek, Lorraine & Paul joined Consultants from our own network to provide a panel to explore further questioning from the floor.

All in all, this was a most satisfying day in a splendid venue with good food and the occasional amusement supplied by Treasurer Joe Kearney taking photos from the back and Mark fielding the technical problems caused by computers packing up and power disturbance.

A raffle in aid of Trauma Aid UK (TAUK) had more meaning after hearing Derek’s earlier presentation, and Robin has let us know that we made a total of £363.50, including £189.50 in sales of books and support materials, and £174 on the raffle.

Regional Co-Chair Sonya Farrell also let us know that Walid Abdul-Hamid, Chelmsford regional rep and accredited Consultant, had only just arrived back from Gaziantep in Turkey where he had been training for TAUK, and yet managed despite jetlag and lack of sleep to participate in our Q&A. There’s dedication and commitment!

We look forward to our next regional networking day in Norwich on Saturday April 22nd, with Dr Jamie Marich from the USA, being as enjoyable and fruitful.

Jim Knipe stars at Chelmsford Regional Networking Day – and new date for Nov 26 2016

With upwards of 70 colleagues attending from across the South-East, we had a fabulous local EMDR East Anglian regional networking day on May 7, with the renowned US-based EMDR guru Jim Knipe presenting and answering questions on Skype for a good hour and a half, focusing especially on working with complex trauma.

Sonya accepting flowers of thanks...
Sonya accepting flowers of thanks…

Credit and thanks to Sonya Farrell and the regional steering group for getting the day together, at Chelmsford Cathedral’s Chapter House.

We enjoyed stimulating presentations also from James Thomas on Acceptance and Commitment Therapy, from Roger Kingerlee on the importance of qualitative research into EMDR, and from Ulf Jarisch of EMDR Equipment Europe on the best and latest technology (buzzers, lightbars etc) to deliver bilateral stimulation.

Roger Kingerlee, EMDR Consultant, addressing the Chelmsford networking day on qualitative research.
Roger Kingerlee, EMDR Consultant, addressing the Chelmsford networking day on qualitative research.

Click the various links in this note to access PDFs of the presentations, and a minuted summary of the day and its concluding AGM, at which Sonya and Mark Brayne were confirmed as regional group co-chairs for the coming period, with Joe Kearney taking over as Treasurer and Shirley Young our new Secretary.

Warm thanks to Kerry Hebdon for getting the group’s finances up and running in the two years since we were formed, and to Annabel Hare and Maeve Allison for their sturdy minute-taking over the months.

Christine Habermehl accepting (reluctantly!) flowers of gratitude for her support for the day.
Christine Habermehl accepting (reluctantly!) flowers of gratitude for her support for the day.

Christine Habermehl from our Bedfordshire sub-group has also stepped back from the Steering Group, and will be replaced in due course with another local rep. James Thomas joins the committee as a member.

Read on for the feedback on the day, for the minuted summary, and note also for your diary that our next regional networking day will be in Cambridge, on Saturday November 26.

Details will be posted closer to the day, and click here to register.

Minutes and Summary

Mark Brayne welcomed everyone to the event and introduced the East Anglia Region Committee members.  He encouraged participants to stay for the AGM at the end of the day and advised that the Chair, Secretary, Treasurer and some member positions were becoming vacant.

Sonya Farrell explained the format for the day and welcomed the first speaker, James Thomas, EMDR Therapist.

James introduced himself and his presentation, EMDR with Chronic and Complex Trauma.

James has 25 years experience working with mental health issues in the NHS.  He is a CBT and EMDR Therapist now working mainly with OCD and trauma in tier 4.  James explained the different approaches that he utilises to promote engagement with EMDR, recovery and change.

These include 3rd wave CBT, ACT (acceptance commitment therapy) and mindfulness along with thorough EMDR resource installations.  James provided examples by talking through two client cases and showed short videos on ‘Making a choice’ and ‘Values v Goals’.

Mark thanked James for his presentation and invited questions from the audience.

Sonya welcomed the next presenter, Ulf Jarisch, Managing Director of EMDR Equipment Europe. Ulf Jarisch introduced himself and provided the history behind the formation of his business. He explained how the EMDR light bars, audio and tactile sensors work and their adaptability to suit each individual client (different colours, brightness levels, speed, volume and add on toy characters for working with children etc…).

Ulf talked through the Pros and Cons of using EMDR equipment and noted that equipment was not essential for effective EMDR and in certain situations it may be better to use physical hand movements/taps.  Ulf explained that he is in the process of developing a combined EMDR/ bio feedback machine that will give a print out reading and he talked about how this may be used in the future.

Ulf finished his talk by sharing details of his humanitarian aid work with refugees.

Mark thanked Ulf for his presentation and invited questions from the audience.

IMG_20160507_121318Participants were then invited to split into specialist groups for a networking and sharing session.  These groups were Children & Adolescent, IAPT, PTSD, OCD, Military, Psychosis, Attachment and Pain.

Afternoon Session

Roger Kingerlee gave us a presentation on EMDR Through the Qualitative Lens”.  There is a respected tradition of qualitative research leading to quantitative investigation.  Qualitative research is a method of “capturing the invisible” e.g. the known effects of meditation.

EMDR research, because it began soon after the discovery of EMDR, promoted its swift growth, and proved beyond doubt that EMDR qualitative research i.e. an exploration of what people actually experience during EMDR (rather than what the clinician is doing) has been overlooked. It could open doors to an expanded understanding of how EMDR works.  Anecdotal evidence suggests that the therapeutic effects of EMDR are curious and probably unique to this form of treatment.

Roger plans to do this research over the next few years, using semi-structured interviews with about 10 people who have had EMDR.  The aim is to create a model of what happens in EMDR.

Open Forum with Consultants Mark Brayne, Walid Abdul-Hamid and Roger Kingerlee

There was a lively and informative discussion between the consultants and the audience on a range of topics.

Dr Jim Knipe on “EMDR-related methods of targeting and resolving avoidance defences

We were very fortunate to have a video link to Jim Knipe in the States, who gave a presentation on working with the client who says, “I don’t want to think about it”. The comprehensive handout gives details.  Jim generously allowed extra time afterwards for questions.

The next Networking Day will be on Saturday 26th November 2016 in Cambridge (venue to be arranged).

 AGM

The AGM was attended by 19 people.  The 9 committee members present were introduced at the beginning of the meeting, and the Minutes of the last AGM (Ely) were approved. There were three officers resigning from their posts – Kerry Hebdon as Treasurer, and Annabel Hare and Maeve Allison as joint Secretaries. Sonya Farrell has been acting temporarily as Acting Chair.

Mark gave the Chair’s Report, and Kerry presented the Treasurer’s Report – both approved.

Elections for Officers:

Treasurer – Joe Kearney, Secretary – Shirley Young, Co-Chairs – Mark Brayne, Sonya Farrell

James Thomas joined the committee as a new member.  It was agreed that the number of committee members would be limited to 10, with volunteers being co-opted when necessary.

AOB  Walid said that there is a need for supervision for English-speaking Turkish therapists, and suggested that our members who are training to be consultants might consider providing this.

Next AGM : May 2017

Chelmsford Networking Day Sat May 7, 2016 – with Jim Knipe of EMDR Toolbox fame, and much more

The EMDR Association East Anglia is excited  to invite EMDR therapists to our next regional regional conference, in Chelmsford on Saturday May 7 –  a fabulous day lined up with four presentations including a live video link presentation with Dr Jim Knipe.

The day is open to EMDR therapists in the region whether members of the Association or not (though we encourage all our colleagues to join up) – click here to book a place, as they’ll go fast. Just £50, with CPD points applied for.

Jim    Tbox

Plan for the day:

10.00am – 10.30am – Registration (Refreshments provided)

10.30am – 10.45am – Introductions

10.45am – 11.15am – Presentation:  ‘EMDR with chronic and complex trauma ‘ : When clients present with complex trauma  we often need to draw on diverse approaches to promote recovery and change  – the presentation will outline some ways I have engaged trauma clients using a blend of approaches from CBT and EMDR –  James Thomas, EMDR Therapist.

11.15am – 11.30am – Short break

11.30am – 12.00pm – Presentation: ‘The Pro’s & Con’s of using EMDR Equipment’ –

Ulf Jarish, Managing Director from EMDR Equipment Europe.

12.00pm – 12.45pm – Networking in small groups by speciality i.e. EMDR with Children & Adolescents, EMDR with OCD etc

12.45pm – 1.45pm – Lunch & Refreshments provided

1.45pm – 2.15pm – Presentation: ‘EMDR Through the Qualitative Lens’, Qualitative research has a venerable history, in which simple clinical description and observation play key parts. This presentation will show how a qualitative take on EMDR could be both scientifically illuminating and useful – Roger Kingerlee, EMDR Consultant.

2.15pm – 2.35pm – Break & Refreshments

2.35pm – 3.20pm – Questions & Answers with 3 regional Consultants.

3.20pm – 4.20pm – Live video link with Dr Jim Knipe – Targeting the  ‘Avoidance Response’  working with defences with clients and how these need to be modified with dissociative clients.

4.20pm – 4.45pm – Discussion (optional) & CPD certificates given out.

Where?

St Cedd’s Hall, Chapter House, New Street, Chelmsford, Essex, CM1 1TY

Please see maps and car park information attached below.  Chapter House is next to the Cathedral approximately a 4 minute walk from the train station.

Cost?

£50 including lunch & refreshments.

Area map showing Car parks

Cathedral Area & Chapter House

Bedford Networking Day Thursday Oct 15 2015

‘Revisiting the Standard Protocol: Trauma as a Time Disorder and a Primary Dissociation’

with EMDR Consultant Nel Walker

0930-1500, Thursday 15th October 2015

Priory Methodist Church, 63 Newnham Avenue, Bedford MK41 9QJ

The EMDR Association East Anglia is delighted to confirm that we now we have five official CPD points for our first Bedfordshire regional networking event, organised by our colleague Christine Habermehl.

The programme will comprise clinical training followed by the opportunity to network and take part in group discussions.
Many who have recently trained in EMDR as well as other more experienced practitioners find that establishing the protocol with its search for negative and positive cognitions can feel rather clumsy and uncomfortable at times.  The aim of this session is to bring two linked concepts together that will form a template enabling a more natural flow for setting up the protocol.

The cost of  the day is £25 and you can download a Booking Form EMDR here if you are interested in attending.

Christine writes further that she intends to set up a local group list and would like to invite those interested to ‘opt in’ to further communications by emailing her the following details: Name, address, contact email, EMDR level and work location.