August 20, 2021

EMDR 1
Distress to Psychological Crisis to Psychotrauma
Assessment Counseling (psycho)Therapy

• Severity • Promotive • Reprocessin

(symptoms • Preventive g of thoughts
) • Purposive and
emotions
• Frequency • Recovery or
& duration psychologica
• Disruption l adequacy
or • Reconstructi
Impairment ve change
Go, E., Lu, M. Mauricio, C., Medina, L. Mercado, A.(2021). E.M.P.O.W.E.R. – MHPSS Certification Training. CML Centre For Mastery and Life-long
Learning. 
Memory Storage Process

memory,
properly
event possibly
stored
learning

3
Memory Storage Process:
The Pathological Variant

stored in Psycholo-
state- gical
event specific form disturbance
(disturb- in the
ing form) present

4
Severe psychological
trauma
Original
Dysnfunc- material
Imbalance in the tional held in
nervous system information distressing
processing form; easily
triggered

5
 Memory Networks
× A memory network represents an associated
system of information
× the goal of therapy is for the client to react
calmly to the target, it is necessary to “clean
out” each channel by reprocessing all of the
dysfunctionally stored material connected to that
node.

6
 People die of depression
everyday. Or at the very
least, they live through it as
dead souls.
-Andrew Solomon, writer and diagnosed with
depression
Multiple causative factors of
depression

biological
psychosocial traumatic
factors/
factors experiences
genetics
Cognitive theory of depression (Beck,
1972)
world

Cognitive Triad
of Depression
EXPERIENCE DEPRESSION

self future
NEGATIVE
SCHEMATA
Pathogenesis of depression as predisposed by a
network of irrational belief systems

NC

ADAPTIVE
INFERENTIAL/
THINKING
STYLES NEGATIVE
COGNITIONS NC
“I AM”
(IRRATIONAL
EXPERIENC NEGATIVE BELIEF SYSTEM)
SCHEMA
E TEX
T
DEPRESSION EMDR
(Beck, 1972)
MALADAPTIV (Hofmann, 2016)
E
INFERENTIAL/
THINKING
STYLES
NC

NC NC
TRAUMA IMPACT
MODEL
Personality

Traumatic
Trauma Impact
Experience Coping
Support
System Mechanism
TREATMENT TRIANGLE
Life Enhancement
Envisioning the actualization
Future (late stage)
3

Trauma
processing and grieving trauma
(middle stage)
Processing 2
Resource Development
Installation stabilization
(early stage)
Attachment to Others and Self
1
WAYS OF PSYCHOTHERAPY
1960 Psychoanalysis and Psychodynamics

1960 - 1970 Client-Centered Therapy

1962 - 1980 Behavior Therapy

1975 Cognitive Therapy and CBT

1990 Interpersonal Therapy

1986 Francine Shapiro’s EMDR

EMDR
Francine Shapiro, PhD
t June 16, 2019
SOME TERMS
BLS Bilateral Stimulation
(EM/Tapping/Auditory; set = 24 to 30)

SUDs Subjective Units of

Disturbance
(0 = no disturbance; to 10 =
Validity of Cognition
VoC maximum)
(1 = false; or 7 = true)
See glossary of
terms.
COGNITIONS
THREE THEMES
1 responsibility See common
positive
cognitions
2 safety / vulnerability and negative
cognitions
listing.
3 control / choice
 TICES-S
GRID
T triggering E emotion/s
event /
traumatic
image body
I event S sensation/s
(worst)
negative level of
C cognition/s S disturbance
(0 to 10)
 TIMELINE / TICES-S GRID
NE PE
• 24 years old (EMDR Therapy) Childhood (0 to 11 years old)
• 7 years old to 11 years old
sexually fear,
T E shame,
abused by
father anger
father on top legs
I of her S

I am dirty. I 1
C S
want to die. I 0
am damaged
goods.
EMDR EMDR EMDR
WORLD FORUM
OF ASSOCIATION
EMDRI EMDR IBERO
•
ASIA
Australi • Indones
•
EUROPE A AERICA
a ian Austria • Netherla
• Bangla- • Palestin • Belgium nds • USA • Brazil • Puerto Rico
desh e • Denmar • Norway • Canada • Colombia • Portugal
• Cambo • Philippi k • Poland • Costa Rica • Uruguay
dia nes • Finland • Portugal • Ecuador • Venezuela
• China • Singapo • France • Spain • El Salvador
• Hong re • German • Slovakia • Guatemala
Kong • Sri y • Sweden • Mexico
• India Lanka • Greece • Switzerl • Nicaragua
• Japan • Thailan • Ireland and • Panama
• Korea d • Israel • Turkey • Peru
• Pakista • Taiwan • Italy • UK
 Eye Movement Desensitization
1
and Reprocessing (EMDR)
Therapy
A trauma-focused approach
BASIC EMDR

EMDR AIP

freedom from disturbing

memories in the BLS
blink of an eye?
HOW DOES
IT WORK?
When the brain is upset, it does
not process the same way as
when it is in a stable state.
The average daily information is
stored in the midbrain
(amygdala), then shifted into the
neocortex during REM sleep.
When trauma occurs, it is “too
big” to be processed and stays
in the amygdala where it can be
felt.
Similar memories form in
clusters, so others will attach to
like-memories in both the
neocortex and the amygdala.
HOW DOES
IT WORK? The neurobiological effect
EMDR works to break up
created during EMDR is not
this information and process
fully understood, however.
it into the long-term
It is currently theorized that
memory. So you can
EMDR recreates the
remember, but not re-
processing similar to what
experience.
happens during REM sleep.
 GOAL OF
EMDR THERAPY
To produce the most comprehensive
treatment effects in the shortest period of
time, while simultaneously maintaining a
stable client within a balanced system.
 EMDR Therapy
◉ Primarily designed for trauma-focused
conditions (ex. GAD and PTSD)
◉ Established as effective in eliminating
disturbances caused by traumatic
experiences (which is the basis of
pathology)
◉ The psychotherapy whose techniques are
adapted for this study

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 EMDR AIP
negative
cognition
Dual Attention / Bilateral
negatively- Stimulation
charged positive
emotions brain cognition
 EMDR’s view of pathology

Past
Adaptive
experiences Present events
networks are
lead to the drive
developed to
development of maladaptive
guide future
present responses
responses
disturbances

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EMDR’s 3-pronged approach

Targets past Desensitizes Establishes

traumatic present templates of
materials triggers future self

28
 EMDR Therapy: 8-Phase
Protocol

Client history Preparation Assessment Desensitization Installation Body Scan Closure Re-evaluation
Standard EMDR Treatment

traumatic memories
 Reconceptualized view of pathology

Negative schema
creates system of Irrational beliefs Adaptive schema
irrational beliefs drive onset and is developed to
that leads to the progression of establish
development of symptoms normalcy
symptoms

31
 EMDR Therapy: 8-Phase
Protocol
Client
Preparation Assessment
history
Phase 1: History-taking
Focuses on: Ruling out trauma
and establishing presence of
depressive condition.
Desensitization Installation Body Scan
Assessment tools: Hopkins
Symptom Checklist, PROMIS
Depression Short Form, Harvard T
Scale, Trauma Symptom Inventory
Others: Trauma Map/EMDR
Timeline
Closure Re-evaluation
Intake interview: Intake
Questionnaire Script based on
Hofmann, et al. (2016) which
integrates the following sections:
Inventory of Triggers Script,
Targeting Sequence for Current
Episode Triggers, Dominant
Belief, and Depressive Symptoms
Scripts
 EMDR Therapy: 8-Phase
Protocol

Client history Preparation Assessment Desensitization Installation Body Scan Closure Re-evaluation

Phase 2: Preparation Tool:

Focuses on: Skill or strength-
building against trigger/s or
symptoms
Revised Absorption Technique
Script (Hofmann, 2009a;
Hofmann, 2014) which
emphasizes on cognitions and
symptoms instead of memories
 EMDR Therapy: 8-Phase
Protocol

Client history Preparation Assessment Desensitization Installation Body Scan Closure Re-evaluation

Phase 3: Assessment Tool:

Focuses on: Initial assessment is Assessment part of Hofmann, et al.
done on the dominant (2016)
cognitions/irrational beliefs that
are assumed to have triggered or
are driving the present depressive
episode.
 EMDR Therapy: 8-Phase
Protocol

Client history Preparation Assessment Desensitization Installation Body Scan Closure Re-evaluation

Phase 3: Desensitization Tool:

Focuses on: Desensitization of
maladaptive thoughts and the
uncovering of dysfunctional beliefs
that drive depressive symptoms
To be created based on
Desensitization script of original
protocol (p. 118) but with
emphasis on present negative
thoughts and their accompanying
feelings
 EMDR Therapy: 8-Phase
Protocol

Client history Preparation Assessment Desensitization Installation Body Scan Closure Re-evaluation

Phases 5-8
Follows script provided by
Hofmann, et al., 2016
SESSIONS 3-8
Identification of the triggers of the present depressive episode.

STEP 2. Each participant will be given 8 individual EMDR sessions which should
be divided as follows:
Session 1 - History Taking
Session 2 - History-taking + preparation
Session 3 to 8 - Assessment , Desensitization to Re-evaluation
Session 8 - Posttesting

STEP 3. Collation and gathering of data using graphing method (see p. 68).

STEP 4. Visual inspection of graphed data and satistical analysis of pretest and
posttest scores, as well as trends of the SUDs and VoCs gathered.
37
Identification of Negative Cognition → VoC
the triggers of
current Emotions → SUDs Post-processing
depressive scores
episode Positive Cognition → VoC

Desensitization

Sessions 3 to 8
EMDR VIDEO
Contributions:
EMDR Research
Empirical support for the applications of EMDR in the
treatment of depression and possibly other conditions that
were not predisposed or driven by traumatic experiences.
Thus. generating impetus for new directions in EMDR
research.
Contributions:
EMDR Research
A revised protocol that remains faithful to the standard
EMDR approach but which circumvents targeting of
traumatic memories to help depressed patients recover from
symptoms without necessarily accessing memories with
disturbing content/s.
Contributions:
EMDR Research
New dimensions in the understanding of the Adaptive
Information Processing (AIP) model that is based on
cognitions rather than unprocessed memories.
Specifically, greater understanding of how the brain
generates state-specific forms of cognitions (ex. Negative
self-beliefs like “I am worthless.”) when its inherent
information processing system is interrupted.
Contributions: Depression
Literature
A greater understanding of the roles maladaptive and
adaptive cognitions play in the progression of or recovery
from depressive symptoms.
Empirical proof/s supporting the assumption that negative
cognitions do not appear in isolation, but comprise a
network of maladaptive irrational belief systems that drive
depressive symptoms.