Beyond Trauma: Proven and Effective Applications of EMDR · Beyond Trauma: Proven and Effective...

Beyond Trauma: Proven and Effective Applications of EMDR


Earth, Wind, Water, Fire



• The Opening

• Say, “Let’s take a current reading of your

stress level where 10 = the most stress

and 0 no stress at all, where are you now

with stress with our 0-10 scale”?


Earth, Wind, Water, FireEARTH : GROUNDING , SAFETY in the PRESENT /REALITY

Say, “Take a minute or 2 to “land”… to be here now.

Place both feet on the ground, feel the chair

supporting you. Direct your attention outwards.

Look around and notice 3 new things. What do you see? What do you hear? (notice 3 things)

(Don’t ask this if it draws attention to on-going dangers e.g. if there are explosions still going on)


Earth, Wind, Water, FireWIND: BREATHING for STRENGTH, BALANCE and CENTERING

(Anxiety = excitement without oxygen and you stop breathing. When you start breathing your anxiety reduces).

Say, “As you continue feeling the SECURITY NOW of your feet on the GROUND, take 3 or 4 deeper slower breaths from your stomach, making sure to breathe all the way out to make room for fresh energizing air. As you breathe out, imagine that you are letting go of some of the stress and breathing it out. Direct your attention inwards to your center.”



WATER : CALM and CONTROLLED -switch on the RELAXATION RESPONSE

Say, “As you continue feeling the SECURITY NOW of your feet on the GROUND and feelCENTERED as you BREATHE in and out, notice if you have saliva in your mouth? Make moresaliva because when you are anxious, or stressed your mouth often “dries” because part ofthe stress emergency response (which has to do with the Sympathetic Nervous System) is toshut off the digestive system. When you start making saliva, you switch on the digestivesystem again (or the parasympathetic nervous system) and the relaxation response. This isthe reason why people are offered water or tea or chew gum after a difficult experience. ASpanish surgeon uses this production of saliva to train his patients to ignore pain while heperforms surgery without anesthetics. When you make saliva, your mind can optimallycontrol your thoughts and your body. Direct your attention up to making saliva”.


Earth, Wind, Water, FireFIRE: LIGHT/FIRE up the path of your IMAGINATION• Say, “As you continue feeling the SECURITY NOW of your feet on the GROUND and feel

CENTERED as you BREATHE in and out and feel CALM and in CONTROL as you produce more and more SALIVA, bring up the image of your SAFE PLACE (or some other RESOURCE). Where do you feel it in your body? Install with brief slow BLS / butterfly hugs. Direct your attention to feeling good in your body.” Say, “As you continue feeling the SECURITY NOW of your feet on the GROUND; and feel CENTERED as you BREATHE in and out; and feel CALM and in CONTROL as you produce more and more SALIVA; you can let the FIRE LIGHT the path to your IMAGINATION to bring up an IMAGE of a place where you feel SAFE /or a memory in which you felt good about yourself. Go with that (using BLS). Now touch your bracelet (or sticker, etc), thinking about earth, air, water and fire and go with that “(to install your bracelet). Now, let’s take a current reading of your stress level where 10= the most stress and 0 no stress at all, where are you now with stress with our 0-10 scale”? Repeat 3 to 4 times or as needed until the SUDS level decreases to 0 or a tolerable amount.

• Option: this can be a way of introducing the Safe Place exercise as the 4th element, especially


EMDR Basics


• EMDR Defined

• EMDR Adaptive Information Processing Model

• EMDR Treatment Approach

• Case Examples & Other Applications

• Origin and Hypothesized Mechanisms

• Research on Effectiveness


• Eye Movement Desensitization and Reprocessing(EMDR) is an integrative psychotherapy approach thathas been extensively researched and proven effectivefor the treatment of trauma.

• EMDR is a set of standardized protocols thatincorporates elements from many different treatmentapproaches with the use of bilateral stimulation usingeye movements, tons and/or tapping.

• To date, EMDR therapy has helped millions of people ofall ages relieve many types of psychological stress.


• EMDR is an evidence-based psychotherapy forPosttraumatic Stress Disorder (PTSD). In addition,successful outcomes are well-documented in theliterature for EMDR treatment of other psychiatricdisorders, mental health problems, and somaticsymptoms.

• It is a client centered approach that allows the clinicianto facilitate the mobilization of the client’s own healingmechanism which stimulates an innate informationprocessing system in the brain.


• In 1987, psychologist Dr. Francine Shapiro made the chanceobservation that eye movements can reduce the intensityof disturbing thoughts, under certain conditions.

• Dr. Shapiro studied this effect scientifically and, in 1989, shereported success using EMDR to treat victims of trauma inthe Journal of Traumatic Stress.

• Since then, EMDR has developed and evolved through thecontributions of therapists and researchers all over theworld. Today, EMDR is a set of standardized protocols thatincorporates elements from many different treatmentapproaches.


• The model on which EMDR is based, AdaptiveInformation Processing (AIP), posits that muchof psychopathology is due to the maladaptiveencoding of and/or incomplete processing oftraumatic or disturbing adverse lifeexperiences.

• This impairs the client’s ability to integratethese experiences in an adaptive manner.


• EMDR is a psychotherapy approach that is guided bythe Adaptive Information Processing Model andcomposed of integrative protocols and procedureswhich include the use of bilateral stimulation (BLS).

• Eight Phases of Treatment

• Three Pronged Protocol (Past, Present, Future)

• Forms of BLS – Eye Movement, Tones, Taps

• Incorporates elements of other theoretical orientations:• - Psychodynamic, Cognitive, Behavioral, Client centered,

Mindfulness


• Psychodynamic Therapy- Foundation of problem: Intrapsychic conflicts

• Cognitive Behavioral Therapy– Foundation of problem: Dysfunctional beliefs,

behaviors

• EMDR Therapy– Foundation of problem: Unprocessedmemories of disturbing events that are dysfunctionally stored in neural networks.


• When a traumatic or disturbing event happened, thenatural system for processing a memory was interruptedbecause of high arousal and/or encoded as survivalinformation.• Information that occurred at the time of the upsetting event is

stuck or frozen in the memory.

• Present day triggers or experiences can activate the feelingsand responses in the stored memory.• Persistent, intrusive thoughts• Negative emotions• Negative perceptions of self• Physical sensations


• Generally in individuals who are healthy and have amore secure sense of self, new experiences are takenin, sorted through in terms of what useful informationis learned, linked to the appropriate emotions and isaccessible for the person to utilize in the future.

• For individuals who may not be as healthy, newexperiences are taken in and sorted through with amore elevated limbic or emotional response notallowing adequate processing to complete to anadaptive resolution.


• Traumatization has been described as the disruption of the inherent processingsystem that normally leads to integration and adaptive resolution following upsettingexperiences. (van der Kolk, Fisler, 1995)

• Under normal circumstances, this information processing may occur duringthinking, talking, expressive/artistic activities, and/or dreaming.

• In trauma, however, a malfunction of this natural information processing systemoccurs such that the experience of the trauma remains “frozen”, manifesting inpersistent intrusive thoughts, negative emotions and self-referenced beliefs, andunpleasant body sensations.

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• When a disturbing event occurs, it can get locked or frozen in thebrain with the original pictures, sounds, thoughts, feelings and bodysensations. Present day experiences can activate those originalfeelings, thoughts, images, sensations.

• EMDR seems to stimulate that frozen information and allows thebrain to process the experience by connecting that stuck memorywith other information in your brain.

• Similar to what may be happening in REM (rapid eye movement)sleep when we dream. The eye movements or other forms ofbilateral stimulation (tones, taps) may help to process theunconscious material.


• Access the dysfunctionally stored information.

• Stimulate the information processing system and maintain it in adynamic form.

• Move the information by monitoring the free association processand initiate procedures to facilitate adaptive (appropriate, positive,functional) resolution.

• Desensitize: Reduce the Subjective Unit of Distress (SUD) to 0.

• Reprocess: Learning takes place so client adapts theirunderstanding of the event and shifts negative cognitions topositive cognitions.


• Client internally generates “corrective information”about the event rather than that information beingexternally generated through discussion with therapist.

• Therapist does not reflect, interpret, reframe orintervene in other traditional ways• Client Centered - Follow the client’s processing

• Mindfulness – “Just notice”, “Go with that”

• Cognitive Interweaves – ask questions that link

statements made by client and only when needed to

move processing forward


• 8 Phase Protocol1. Client History and Treatment Planning

2. Client Preparation

3. Assessment

4. Desensitization (Processing)

5. Installation (Processing)

6. Body Scan (Processing)

7. Closure

8. Reevaluation


• Three Pronged Approach

- Process Past Event• Identify Core Memories – earliest memories that laid the foundation

for the presenting problems.• Identify Clusters/Themes – single event to represent many similar

incidents

- Process Present Event• Current Triggers, Stressors, Recent Event

- Process Future Event• Template of desired thoughts, emotions, actions for future events that

typically have been avoided or uncomfortable


• Typically 90 minute sessions for processing.

• A targeted memory can require more than one 90minute session for processing to adaptive resolution.

• Number of processing sessions needed varies based onclient, issues, trauma history• 1-4 processing sessions for a single traumatic event

• Processing may or may not continue after session

• Target Past, Present, Future to get full resolution


• Client: A 40-year old man who was laid off during the economicrestructuring of his company.

• Presenting Problems: Sleep-onset insomnia, loss of appetite, self-medicating with alcohol, irritable, worried about the future,“paralyzed” in efforts to seek other work, fighting with his childrenand sometimes his wife.

• Negative Cognitions: I’m not good enough to retain at mycompany so they let me go. I’m worthless.

• Positive Cognitions: I have value to offer and can find anorganization that recognizes this about me and is a ‘good fit’ withmy skills and who I am.


• Picture: The Human Resources Director comes into my cubicle andtells me that I have 15 minutes to clear out my desk and downloadmy computer files before my exit interview.

• Negative Cognition: I’m worthless.• Positive Cognition: I have value.• Validity of Positive Cognition (VOC) = 3 out of 7

• Emotions/Feelings: Irritable, worried• SUD Now = 7 out of 10• Body Sensation: Nausea, tightness in chest, tingling in arms


• Responsibility: Client considers whether he is at “fault”, forbeing on the list for layoffs.

• Client considers history of performance reviews and that allwere average or above average.

• Client comes to understand that he is not at “fault.” Herecognizes that this layoff had more to do with the company’seconomic pressures than his worth.

• The client acknowledges that he has performed well, asevidenced by his written reviews, but nevertheless, he hasbeen let go.


• Safety: Client explores, “Will I be okay?”

• He assesses his strengths and, he arrives at the idea.

• I will find another position because of the skills andwork experiences I have accumulated.

• I do have the financial resources to last 6 months whileI search for another position.

• I can borrow money from my brother if I have to.


• He questions whether he must remain in thesame industry and concludes that he can look atother industries hiring people with his skill set.

• He assesses the time and costs needed to changecareers and decides that he will stay in the sameline of work but search within several differentindustries.

• He feels more encouraged for having arrived atthis greater sense of choice


• EMDR is not a cure all or magic bullet. Studies report positivetherapeutic results for a wide range of populations and issues:

• Depression and Other Mood Disorders• Generalized Anxiety Disorders, Panic Attacks, Phobias• PTSD, Grief, Traumatic Bereavement• Abuse and Neglect – Emotional, Physical, Sexual• Accidents, Medical Treatments, Natural Disasters• Addictions, Dissociative Disorders• Somatic Problems – chronic pain, phantom limb pain,

gastrointestinal, migraines, eating disorders, body image• Vicarious Trauma• Performance Enhancement (work, art, sports)• Children, Couples, Veterans, Police Officers, Firefighters


• 20 controlled studies have consistently found EMDR effectivelydecreases / eliminates symptoms of PTSD for the majority of clientsin studies.

• EMDR designated effective for PTSD by:• American Psychiatric Association• Substance Abuse and Mental Health Services Administration

(SAMHSA)• International Society for Traumatic Stress Studies• U.S. Department of Veteran Affairs, U.S. Department of Defense• Many international health and government agencies

• Other studies on many other symptoms, disorders

• For research summaries, visit www.emdria.org and www.emdr.com


Feeling-State Addiction Protocol

EMDR Augmented by Mindfulness as a Treatment for Trauma

MBCT –Created by Teasdale, Segal and Williams (1991); based on MBSR created by Jon Kabat-Zinn

Specifically designed for treatment ofrecurrent depression

Combines CBT methods with mindfulness


MBCT –

Functions on theory that depressed

individuals, when stressed, return to

automatic cognitive processes that

trigger a depressive episode


MBCT –

Negative mood and negative thinking form

a connection during depression

Recurrence of negative mood triggers

negative cognition



Predicated on addictions being created when a desired feeling and a given behavior become associated together.

Or

Intense Desired Feeling + Positive Event = Addictive Fixation or Feeling State



Addiction can be triggered by an internal or external stimulus

yielding

Addictive Fixation (Feeling State) + Trigger Event (External or Internal) = Addictive Behavior



Feeling-State Theory

1) Positive feelings linked with specific objects or behavior form a state-dependent

memory

2) The state-dependent memory, composed of feelings and the event, form a

“feeling-state”

3) Feelings are defined as the totality of sensations, emotions and thoughts

4) The creation of a feeling state is theorized to be similar to the way traumatic

memories become fixated



Beliefs and the Impulse-Control Disorder

Preexisting negative beliefs – “I’m a failure”

Positive feelings generated by the feeling-state – “I’m the life of the party”

Negative beliefs generated by the out-of-control behavior – “I mess up everything”



Resolving a Feeling-State

Cognitive change – once the fixated FS is reprocessed the rationalizations and justifications to support the out-of-control behavior are no longer needed and begin to subside

Behavioral change – as the FS is processed, destructive behaviors subside and the person automatically begins to seek appropriate ways to obtain the desired feeling



First session

History of compulsive behavior.

What part of the compulsive behavior has greatest emotional intensity

What compulsive behavior is linked with that positive feeling – rate it on the PFS.

As with standard EMDR, locate and identify physical sensations created by the positive feelings.

Have client combine image of behavior, the positive feeling, and the physical sensations.

Eye movement sets are performed while the client focuses on material (e.g., memory, feeling, image, sensation, thought) that was elicited during the prior set.

When the PFS is ≤1, identify the related NC and use the PC, SUDS, emotions, VOC, and body location according to the standard EMDR protocol (unlike the standard protocol, no specific memory is identified and no visual image is used).



Homework

Assign homework to experience the behavior and judge progress. When applied to substances, many have the client picture doing activities other than the substance use to achieve the same positive feelings.



Second session

As in standard EMDR, reevaluate behavior for both the feeling identified in the first session as well as identifying other positive feelings related to the ICD.

Repeat 2 - 8 again if necessary.

Continue reevaluation and processing in further sessions until the person’s drive toward the compulsive behavior has been eliminated and the behavior has changed.

When all FS processed, determine the negative belief that was created as a result of the compulsive behavior. Use the standard EMDR protocol for processing.

Note: PFS=Positive Feelings Scale; NC=negative cognition; PC=positive cognition; SUDS=Subjective units of Disturbance Scale; VOC=Validity of Cognition Scale; EMDR = eye movement desensitization and reprocessing; ICD = impulsive-control disorder; FS = feeling-state

Beyond Trauma: Proven and

Effective Applications of EMDR

Dysfunctional Positive Effect



Dysfunctional Positive EffectTheory

Designed to work with an ambivalent client (“I want to work on the issue but I’m too

afraid.”

Most effective way to address this issue may be to target the feeling of relief associated

With avoiding that problem.

NOT used to ‘force’ a client to work an issue they don’t want to work

IS used with clients who have an unwanted avoidance impulse



Dysfunctional Positive EffectTheory

Partially derived from Popky’s Desensitization of Triggers and Urge Reprocessing

(DeTUR)

Theorizes avoidant behaviors tend to be maintained and reinforced by the stress relief

associated with avoiding

Scaling done 1-10 on the Level of Urge to Avoid (LoUA)

Extends Popky’s approach to substance abuse to those habitually using mental tactics

to avoid disturbing material. Exact knowledge of the disturbing material not required; just

the client report of changes to the urge to avoid



Dysfunctional Positive EffectProtocol

Make an image of what is to be avoided

Scale the image 1-10 as to how much the client wants to avoid the issue

Determine where the urge to avoid is in the body

Perform BLS while client holds image and stays with the feeling of wanting to avoid the

image

As the LoUA goes down, client usually spontaneously begins to directly address the

incident and standard EMDR protocols are then used



Phobia Protocol – Single Traumatic EventPhobiaSpecific Phobia – person is fearful or anxious about or avoidant of circumscribed objects

or situations

Specific cognitive ideation not featured in this disorder as it is in other anxiety disorders

The fear, anxiety or avoidance is almost always immediately induced by the phobic

situation

Intensity of reaction is to a degree that is persistent and out of proportion to the actual

risk posed



Phobia Protocol – Single Traumatic EventTypes of Phobia

Animal type – spiders, insects, dogs, cats, snakes, etc.

Natural Environment – heights, water, storms, etc.

Situational type – enclosed spaces, driving, flying, elevators, bridges

Blood, injury, injection type – getting an injection, seeing blood, watching surgery, etc.

Other types – choking, vomiting, contracting an illness, etc.



Phobia Protocol – Single Traumatic EventTreatment of Phobia

In Vivo exposure is proven treatment of choice

Uncontrolled and controlled case reports indicate EMDR efficacy in treating fears and

phobias with improvement in a limited number of sessions

EMDR may be particularly useful in high-anxiety phobias with a traumatic origin or clear

beginning (target memory)



Phobia Protocol – Single Traumatic EventPhobiaSpecific Phobia – person is fearful or anxious about or avoidant of circumscribed objects

or situations

Specific cognitive ideation not featured in this disorder as it is in other anxiety disorders

The fear, anxiety or avoidance is almost always immediately induced by the phobic

situation

Intensity of reaction is to a degree that is persistent and out of proportion to the actual

risk posed


• Group Traumatic Events Protocol (GTEP)


Integrating EMDR into Couples Therapy


Integrating EMDR into Couples TherapyTheoretical Underpinnings

Connects a trauma model of relationships with Bowen’s concept of differentiation

Trauma impacts relational assumptions

Couples where one or both have experienced trauma are likely to be highly reactive



Bowenian Differentiation

“Families and other social groups tremendously affect how people think, feel, and act, but individuals vary in their susceptibility to a “group think” and groups vary in the amount of pressure they exert for conformity. These differences between individuals and between groups reflect differences in people’s levels of differentiation of self. The less developed a person’s “self,” the more impact others have on his functioning and the more he tries to control, actively or passively, the functioning of others. The basic building blocks of a “self” are inborn, but an individual’s family relationships during childhood and adolescence primarily determine how much “self” he develops. Once established, the level of “self” rarely changes unless a person makes a structured and long-term effort to change it.”



Reactivity in couples usually includes:

Rapid escalation in negative emotion

Escalation in overt conflict

Withdrawal-pursuit

Conflict Avoidance

Dominance-submission

EMDR can reduce negative reactivity and phobic response to emotional engagement


Integrating EMDR into Couples TherapyApplication of EMDR

In trauma - EMDR clinicians look for change specific to the trauma and it’s PTSD

symptoms

In couples therapy – EMDR clinicians look for generalized effects; lowered state of

arousal and less reactivity

Multiple scripts including conjoint and individual scripts, processing and future template

scripts


“EMDR Scripted Protocols” edited by Marilyn Luber

Topics by Section

EMDR with Children and Adolescents

EMDR and Couples

EMDR, Dissociative Disorders, and Complex Post-Traumatic Stress Disorder

EMDR and Clients with Addictive Behaviors

EMDR and Clients with Pain

EMDR and Specific Fears

EMDR and Clinician Self-Care


• Recent Traumatic Events Protocol – (RTEP)

– Comprehensive current trauma focused

protocol

– Extends existing EMD and Recent Event

protocols

– Usually requires 2-4 sessions, optionally

conducted on successive days



– Glossary of key terms• Traumatic Episode (T-episode) – the original traumatic episode with it’s

aftermath that is comprised of multiple Points of Disturbance (PoDs) from

the original incident until today

• Episode Narrative + continuous BLS (Bilateral stimulation) – telling the story

out loud with continuous BLS. This integrates the fragments of the story.

Recounting details is discouraged

• Google search (G-search) – mechanism to identify the various PoDs by non-

sequential scanning of the T-episode, without talking, together with BLS

• Focused processing. EMD strategy is narrow focused processing of the

PoDs by limiting association to the PoDs. This is a good brief strategy.

EMDr2 is a wider focused processing of the PoD by going with the AIP

chains of associations relating to the T-episode. This is the main strategy.



– Adapted 8 Phases

• Phase I: History/Intake – brief history taking, evaluate readiness

• Phase II: Preparation, attention to safety and containment

• Points of Disturbance (PoD) level: Identification, assessment, and Focused Processing of target fragments (PoDs) within the Traumatic Episode


• Recent Traumatic Events Protocol – (RTEP)– Point of Disturbance – cont’d

• 1. Traumatic Episode Narrative = continuous BLS –telling the story (as on a TV) out loud with BLS

• 2. Episode Google search = BLS – identifying Points of Disturbance relating to the T-episode from the original incident to today

• 3. Assessment (Phase III of each PoD) identified from the Google search

• Focused processing (Desensitization – Phase IV) – EMD and EMDR2


• Recent Traumatic Events Protocol – (RTEP)– Point of Disturbance – cont’d

• 5. Installation (Phase V) of PC if SUD is ecological• 6. Repeat steps 2-5 to identify and process remaining

PoDs, until none are found• 7. Body scan (Phase VI)• 8. Strong closure (Phase VII) at the end of each session

– Follow-up (Phase VIII)


• Recent Traumatic Events Protocol (RTEP)– Contrasting EMDR and RTEP

• Phase I (History)

– EMDR – full Intake, 3 pronged orientation (past, present, future) Targets identified for Treatment Plan

– RTEP – Briefer intake history to assess SMS (Severity/Motivation/Strengths, current trauma focused priority, concept of T-episode, only general information about T-episode (details only requested later during episode Narrative + BLS)


• Recent Traumatic Events Protocol (RTEP)

– Contrasting EMDR and RTEP

• Phase II (Preparation)

– EMDR – safe place (more if needed)

– Extended preparation (4 elements, includes safe place and resource connection)




• Phase III (Assessment)

– Target: event image; negative cognitions, positive cognitions, Validity of Cognition (VOC), emotion, Subjective Units of Distress (SUD)

– A) episode narrative +BLS; b) G-search with BLS to identify target fragments/points od disturbance (PoD); c) for each PoD, image, NC, PC, VoC, emotion, SUD, body




• Phase IV (Desensitization)

– EMDR – Processing with BLS, no limitations of association as long as there is change

– RTEP – focused processing (EMD and EMDr) EMD for processing intrusive fragments; EMD is narrow focus on associations relating to PoD; EMDr is wider focus processing associative chains relating to the T-episode




• Phase V (Installation)

– EMDR – Install PC when SUD = 0/1

– RTEP – Install PC (for each target when SUD is ecological)




• Phase VI (Body Scan)

– EMDR – Body Scan

– RTEP – no body scan until all the targets of the T-episode are processed




• Phase VII (Closure)

– EMDR – Closure

– RTEP – Strong closure at the end of each session (Usually requires several sessions)




• Phase VIII (Reevaluation)

– EMDR – next session

– RTEP – Check for remaining PoDs using G-search at next session; follow-up at end



– Group format (6 people) with no narrative

• Resource install first (Use EAWF) and date today

• Draw a picture (Date then)

• Resource connection envelope (Draws out positive resources)

• Desired future – Positive Cognition


• Group Traumatic Events Protocol (GTEP) worksheet



– Cont’d

• Google search while tapping worksheet with one hand and following that hand with the eyes (double BLS)

• Client gets PoD and draws or writes it in PoD 1

• 3 sets of BLS (hand and eye)

• Refocus on PoD 1, get SUD score

• If not 0, then repeat for another 3 sets of double BLS


• Group Traumatic Events Protocol (GTEP) worksheet


• REFERENCES• Van den Hout, M., Engelhard, I., Beetsma, D., Slofstra, C., Hornsveld, H., Houtveen, J., Leer, A.

(2011), EMDR and mindfulness. Eye movements and attentional breathing tax working memory and reduce vividness and emotionality of aversive ideation: Journal of Behavior Therapy and Experiential Psychiatry, 42, 423-431.

• Sun, T-F, M.D., Wu, C-K, M.D., Chiu, N-M, M.D. (2004), Mindfulness Meditation Training Combined with Eye Movement Desensitization and Reprocessing in Psychotherapy of an Elderly Patient: Chang Gung Med J, 27, 464-469.

• Kabat-Zinn, J. Mindfulness meditation: what it is, what it isn’t and it’s role in health care and medicine. In: Haruki, Y., Suzuki, M., eds. Comparative and Psychological Study on Meditation. Delft, Netherlands: Eburton, 1996; 161-170.

• Shapiro, F. Efficacy of the eye movement and desensitization procedure in the treatment of traumatic memories. Journal of Traumatic Stress 1989;2: 199-223.

• Shapiro, F. March 2, 2012. The Evidence on E.M.D.R. Consults New York Times Blog. Retrieved February 28, 2014. From http://consults.blogs.nytimes.com/2012/03/02/the-evidence-on-e-m-d-r/

• Kabat-Zinn J. Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. New York. Dell Publishing. 1990.

• Shapiro F. EMDR 12 years after its introduction: past and future research. Journal of Clinical Psychology. 58:1:1-22.

http://consults.blogs.nytimes.com/2012/03/02/the-evidence-on-e-m-d-r/


• Segal ZV, Mark J, Williams G, Teasdale D. Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse. New York. The Guilford Press, 2002.

• Mindfulness-Based Cognitive Therapy. Retrieved February 28, 2014. From http://www.mbct.com.• University of Massachusetts Medical Center. Stress Reduction Program. Center for Mindfulness.

Retrieved February 28, 2014. From https://www.umassmed,edu/cfm/stress/index.aspx• Bullis JR, Boe HJ, Asnanni A, Hofmann SG. The benefits of being mindful: Trait mindfulness predicts

less stress reactivity to suppression. Journal of Behavior Therapy and Experimental Psychiatry. 45: 57-66.

• Live Mindfully. Mindful Breathing and EMDR. Integrative Health Partners. Retrieved February 28, 2014. From http://livemindfully.blogspot.com/2011/04/mindful-breathing-and-emdr.html.

• Zangwill WM, PhD, Kosminsky, P, PhD. The Need to Strengthen the Mindfulness Component of EMDR. Retrieved February 28, 2014. From EMDRandMeditation.com.

• Scientific American. Can Eye Movements Treat Trauma? Retrieved February 28, 2014. From http:/ www.scientificamerican.com/article/can-eye-movements-treat-trauma/

• Weil. Spirit and Inspiration. Retrieved February 28, 2014. From http://www.drweil.com/drw/u/ART00521/three-breathing-exercises.html

• Luber , M., PhD, ed. (2009). Eye Movement Desensitization and Reprocessing (EMDR) Scripted Protocols (1). New York, New York: Springer Publishing Company.

http://www.mbct.com/

https://www.umassmed,edu/cfm/stress/index.aspx

http://livemindfully.blogspot.com/2011/04/mindful-breathing-and-emdr.html

http://www.scientificamerican.com/article/can-eye-movements-treat-trauma/

http://www.drweil.com/drw/u/ART00521/three-breathing-exercises.html


?’s

Gary D. Hees MA. LPC

Decision Point Center

[email protected]

928-925-5156

mailto:[email protected]

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