Trouble Finding an Individual Memory in EMDR Therapy when Trauma was Daily: A Topographic Approach

Using age, space, and topography to find an individual representative memory related to a presenting issue or a theme.

• Identify a negative cognition.
• What age do we need to work related to that theme and negative cognition?
• Home, school, or community?
• Where (what room) in that space do we need to work?
• Put yourself in that space at that age and related to that theme and negative cognition, what memory comes?
• Target that in EMDR Therapy.

Understanding “Deep Breathing Doesn’t Work for Me” and Other Problems of Resourcing with Complex Trauma

“Deep Breathing Doesn’t Work for Me”
  • Understanding that Pervasively Traumatized Nervous Systems are Different than Non-Traumatized Nervous Systems
  • Don’t Tell Clients What they Will or Should Feel in Resourcing, Think of it as an Opportunity to Get Helpful Information
  • Car with a Cinder Block on the Gas Petal Metaphor
  • Pairing Body Scan and Resources
  • The Importance of Asking Permission and How Long Resource will Last
  • Modeling a Single Breath and Using that Information Select a Breath that May be More Tolerable
  • With Some Clients, the Goal is to Find a Resource that Isn’t Actively Triggering
  • Using Body Scans without Much of an Agenda
  • Understanding What a Resource “Working” Looks Like… If it Calms You, It May Only Calm You for a Moment
  • Noticing the Body is Also a Crucial Phase Two Resource
  • Body Scanning is a Good Strategy to Promote Embodiment, So Clients Can be Imbodied Enough to Notice
  • Homework: Practice Resources During the Times of the Day When Anxiety Isn’t Going Straight Up, Noticing the Layer Below is a Good Way to Lower Baseline Anxiety in the Short Term and Prepare for Reprocessing

When Good Resources Go Bad

  • Calm Place
    • Why We Don’t Encourage Other People in Calm/Safe Place
    • When Calm Place Without Someone Specific is Triggering
    • The Problems of Trying to “Borrow Good Memories from a Bad Developmental Era”
    • Calm Place Will Go Bad… And When It Does…
  • Some Completely Expected Reasons Why Resourcing May Go Bad
  • Resources Going Bad Are Rarely the Therapist “Fault”
  • Container as a Powerful Resource for Working with Complex Trauma
  • The Importance of Visualizing or Drawing from Somatic Memory
    • Drive Through Bank Teller as Helpful and Accessible Container
    • Building the Container Larger and Stronger than Needed
    • Photoshop Metaphor for Container
    • Don’t Test the Container with Real Trauma Containered in the Limbic Brain

Understanding the AIP Model: The Whale Metaphor and the Mount Everest Metaphor

The AIP Model

  • The Difficult Stuff Connects to Right Now/Existing Adaptive Information
  • Enough Adaptive Information Must Be Present
  • You Can’t Easily Connect Maladaptive Information to Maladaptive Information
  • What’s Complex About Complex Trauma Related to the AIP Model?
    • A Different Way of Thinking About Complex Trauma
    • Mountain Ranges of Adaptive Information vs Mountain Ranges of Maladaptive Information

The Mount Everest Metaphor

  • You Cannot Metabolize a Trauma the Size of Mount Everest into Adaptive Information the Size of a Walnut—You Can’t
  • Where to Start with Complex Trauma?
    • Where Not to Start
    • Types of Targets that Make Good Early Targets with Complex Trauma

The Whale Metaphor

  • What are the Whales?
  • What is the Size of the Client’s Boat?
  • You Cannot Land a Whale into a Canoe
  • Helping the Client Build a Bigger Boat
  • What Clients Learn when Working with “Smaller” Wounds First
    • Test the Gear
    • Learn How to Notice Effectively
    • They Learn that the Can Heal
    • Healing Builds Adaptive Information/Makes the Boat Bigger
  • If the Client in a Canoe Connects to a Whale we Need a Strong Pair of Scissors to Safely Disconnect

Developing and Using Attachment Figures in Attachment Wounding

  • Problems Communicating Between/Connecting Parts Across the Lifespan
  • The AIP Model and Attachment Wounding
  • Judgements of the Child State in the “Adaptive Self”
  • When the Right Now Selves Isn’t Healthy Enough
  • The Whale Metaphor and Attachment Wounding
  • Attachment Wounds “Sound” Small, but they are Existentially Awful
  • Existential Loneliness
  • Attachment Figures are for the Child State in the Memory
  • Attachment Resources as a Very Powerful Pair of Scissors to Disconnect from the Whale
  • Creating an Attachment Resource
  • Client Obstacles to Creating an Attachment Resource
  • Putting the Attachment Figure in the Neighborhood
  • Attachment Figures are Not Identical to Actual People in Childhood
  • Borrowing Qualities
  • Keeping Difficult Stuff Out
  • Deciding on a Relational Slot
  • Adding Qualities to the Attachment Figures: Food, Presence, Nurture, Reading, Attending, Protection, Guidance
  • Expect that Grief May Appear When You Imagine Getting What Didn’t Happen
  • Using the Somatic Memory of Rocking One of Your Own Children or Grandchildren
  • Leveraging the Capacity to Imagine
  • Naming the Attachment Figure
  • Avoiding Relational Slots that are the Same Slot as an Abuser
  • How to Use an Attachment Resource Between Sessions
  • This is a Resource for Living, Not Just in Session
  • Assessing for Attachment Wounding
  • When You Can and Can’t Borrow Qualities from a Deceased Person

Intro to “Dip Your Toe In” Metaphor

Dip Your Toe In Metaphor

  • Understanding Traumatized Nervous Systems
    • Bodies Can be Triggering
    • Inside Can be Triggering
    • Noticing Can be Triggering
    • Calming or Slowing Down Can be Triggering
    • Paying Attention to the Body Before an Audience Can be Triggering
    • Performance Anxiety Related to All of This Can be Triggering
    • Resistance Not a Useful Concept
  • Dip Your Toe In Provides Needed Information
  • Beware Agendas
    • Beware Informing Clients What the Should Feel or What Mindfulness Will Do
    • Therapist Agendas: Back to How we Teach Mindfulness, and the Cinderblock on the Gas Pedal
    • Many Clients with Complex Trauma Believe that they have Failed Trauma (and are about to Fail EMDR Therapy)
    • Aspirin for a Headache Metaphor

Overheating on the Memory Channel in Complex Trauma

Topics Covered

  • Goal is to Move a Memory
  • Leveraging Generalization
  • The Difference Between Feeder and Adjacent Memories
  • Rethinking Abreactions as Events that Take Offline the Client’s Capacity to Notice
  • A Bit about Dissociation
  • When a Whole “Heard” of Memories Come
  • We Have an Important Navigational Role to Play
  • Existential Loneliness as Abreaction
  • The Dive Metaphor

Normalizing Therapist Anxiety

Topics Covered:
  • The Impulse to Want to Avoid Causing Harm
  • Working with Trauma is Like Working with Lava
  • Normalizing Mistakes and Missteps
  • The Real Risks of Not Doing Trauma Work with Clients
  • We are the Only Professionals on the Planet that Can Do This… Whose Job it is to Do This
  • You Learn to Do This by Doing This
  • The Really Good News About EMDR Therapy: It Breaks in a Very Limited Number of Places

More Reading:

Complex Trauma Modifications Overview: Phases One – Four

This episode is a quick overview of some of the core skills that we will cover in more detail. When I suggest a modification to standard protocol, I try to explain the reasons for the modifications as clearly as possible.

Skills Covered:
  • Additional Questions to Consider in Phase One, Including Assessing for Complex Trauma
  • Conducting a Trauma Sensitive Phase One that Avoids a Detailed or Chronological Trauma Timeline
  • Starting the Process of Developing Attachment Resources for Attachment Wounding
  • Metaphor: Difference Between Walking Across Ohio and Riding in Bus Across Ohio
  • Metaphor: Don’t Tackle Mount Everest First with Clients With Complex Trauma
  • Events Have a Beginning, Middle, and End… Attachment Wounds are About Everything
  • Using the Videotape Approach with Complex Trauma