EMDR Pro / Lite / Home treatment and software usage notes
The following assumes an understanding of the basic EMDR Protocols for past and recent traumas. (See forms supplied with EMDR Pro for details).
In summary the basic protocol involves:
- Explanation of process and setup of a safe-place
- The most disturbing or significant image from the event is identified and scaled (0 to 10)
- Limiting beliefs that resulted from that event are identified
- Equivalent positive beliefs are also identified
- Beliefs are scaled to identify how much someone believes in that belief (1 to 7)
- Eye movements are generated at the same time as the person thinks about the most significant image, the limiting belief and any associated bodily sensations at the same time
- After each block of about 24 sets of movement the patient is asked what came up in terms of thoughts, sensations and images
- After some time the level of disturbance that the image generates is rescaled (0 to 10)
- The eye movements continue until the level of disturbance is at a low level (Typically less than 2)
- Generally the internal bodily sensations will have reduced and the level of belief in the limiting belief will have reduced
- The positive belief is then focused upon at the same time as experiencing eye movements
- This typically reinforces the positive belief
- Finally any remaining unwanted internal bodily sensations are removed by focusing on them and experiencing eye movements
Start processing simply - with a neural background colour and a round or square / rectangular standard tracking object. Start by tracking horizontally in the middle of the screen, the auditory plane in NLP terms.
It is advantageous to identify the persons primary modality, note that this can change for the trauma itself. Note the modality of the most disturbing aspect. Was it a sound, an image or a feeling / smell / taste?
If processing seems to be taking longer than it should or becomes blocked or easily side-tracked (see below) then consider using images or audio.
As a rule proceed cautiously to avoid retraumatisation or blocking. Do not expect a linear reduction in the SUDS.
Overcoming blocks to the processing
A block is when the SUDS do not reduce despite continued processing. Persistent side-tracking when used as a form of avoidance also represents a block.
Consider the following to overcome blocks:
- Track in a different plane (visual / kinaesthetic)
- Track between different planes (eg bottom left to top right)
- Use the 'Cycle' option to track sequentially through all planes
- If an image: Use a confrontational or calming background or tracking image
- If a sound: Use a beep or bilaleral background sound
- If a sensation: Use the tactile units
If an image is the cause of the block then consider the Swish technique.
When to use a textual subliminal message
A textual subliminal message can be used when reinforcing positive beliefs, or to direct processing in a particular direction.
- Positive belief: "I survived"
- Directing processing: "Letting go"
There is no advantage in using a textual message to remind someone of their limiting belief because you want processing to shift and evolve negative beliefs into something more useful.
When to use an image as the tracking object
If attention seems to wander you can use a familiar image as the tracking object. This can be especially the case with children, in which case using an image of their favourite cartoon character can be an advantage.
Video training: EMDR Pro: Adding tracking images
Using an image as the tracking object may help to unblock processing.
When using a confrontational image as the background image consider using a calming or safe image as the tracking object or visa versa.
When to use an image in the background
If processing repeatedly shifts off track or the person is easily distracted or side-tracked a relevant background image can be used to encourage the processing to follow the intended course. Background images would be selected that are in some way related to the issues being dealt with. This also has the effect of undoing avoidance and can assist with process of desensitisation.
Background image presentation should be systematic in that care should be taken to not present an image that is likely to create undue distress. In other words whatever is presented should be something that the person has sufficient resources to deal with. Over time more and more literal images can be presented as desensitisation takes place. If an image seems to generate undue distress then select a less confrontational image and try again. Never leave the process on an image that creates undue distress.
It may be helpful to create a SUDS scale (Subjective Units of Disturbance) with images selected to represent each level within the hierarchy. The process of creating the SUDS scale itself can be advantageous. Remember to be flexible when using the scale and do not insist on obtaining all levels from 0 to 10 within the scale. The scale may or may not follow the actual sequence of events. There are however some advantages to following the actual sequence of events (the memory is potentially re-laid in sequence order rather than being fragmented).
For example (0 = least disturbing, 10 = most disturbing) in the case of a motorway accident:
- Car in garage
- Car on minor road
- Map showing the route that resulted in the accident
- Sign saying the name of the motorway
- Joining motorway
- Truck up ahead
- Screeching of tyres
- Car crash itself
- Fire engine
Video training: EMDR Pro: Adding background images
Using an image in the background may help to unblock processing ie when the SUDS do not reduce despite continued processing.
When using a confrontational image as the background image consider using a calming or safe image as the tracking object.
When to use a sound
Sound can be used to unblock processing and can be useful when someone's primary modality or if the main modality used to represent the trauma is auditory.
Beeps: Can unblock processing, can reduce awareness of internal dialogue and can reduce the effect of trigger sounds eg the sound of screeching tyres. Silly beeps can be advantageous to engage the resource of humour and to begin the process of collapsing the negative emotions associated with whatever is being focused upon.
Video training: EMDR Pro: Adding beep sounds
Example: A patient was processing an imagined image of a car crash and processing become blocked. A silly beep sound was added and processing continued. The silly beeps seemed to help obviate the block.
Background music / audio: Can be used to install a positive resource such as calmness or relaxation, or can be used as a calming influence to collapse negative anchors during processing.
Video training: EMDR Pro: Adding background audio
Tracking background music bilaterally ('Track Panning') is an alternative to using beeps. NB: Some music tracks bilaterally better than others.
Example: A patient was processing their ambulance trip to hospital - the memory of the sirens and traffic was strong. Processing had become blocked. Calming background music was selected and processing continued. The calming background music seemed to counteract the blocking effect of the loud ambulance sirens.
When to use the tactile units (Tappers)
The tactile units can be used to unblock processing, to reduce the intensity of physical sensations (somatised memory) and can be useful for those that are primarily kinaesthetic, or where trauma is described or was experienced in kinaesthetic terms.
Start with the gentle setting and move to the stronger setting when the person is familiar with the sensations involved.
Do remember to ensure that the correct tactile unit is in the correct hand.
EMDR Home / Lite
EMDR Lite / Home can be used for home use as part of an ongoing stress and anxiety management programme and / or to continue processing as directed by the person's therapist.
EMDR Home / Lite
EMDR research papers:
© Bill Frost 2006-2012