Feedback from recent attendees:
“What an interesting collection of techniques! Rajani provides clear explanation and demonstrations of practical skills that I can use everyday”
“I loved everything about this workshop and will certainly attend any workshop by Rajani: sign me up!”
“I wanted it to go on longer. I love these highly usable techniques that will benefit my clients and myself.”
Surprises from the EMDR Toolkit: Ready to use techniques for clinicians of all levels
“Do you sometimes find yourself overwhelmed in session, wishing you could do more for your client? Do you notice anxiety, panic or fear as you sit with your client? Or perhaps you find yourself helpless, hopeless or bored sometimes. Do you wish you could wave your magic wand and fix it all?”
If you are ready to let go of the struggle and embrace the gift of your own creativity, this workshop is for you. Through live demonstrations, we will explore some of the traditional & innovative possibilities that lay the groundwork for Eye Movement Desensitization & Reprocessing (EMDR). Attendees will learn about and practice some key experiential tools to work with stress, dissociation, anxiety, panic, depression, self-regulation and internal resource development. You will leave here inspired by the possibilities, excited by the latest additions to your toolkit, and reinforced by a boost to your self-confidence.
Note: This is not an EMDR basic training, but an introduction to the resource-building & preparation phase of this therapeutic approach.
You can click here to read more about EMDR. Here are a few easy-to-use tools that can be woven into a session to assist in increased body-awareness, reducing dissociation, anxiety and tension. As always, use your best clinical judgment to determine whether these activities are appropriate for your client at this time.
With special thanks to Francine Shapiro, Gerald Puk, Cynthia Kong, Robin Shapiro, Carol Forgash, and Jim Knipe. Please note that these are not original ideas, and where possible, credit has been given to the originator.
In EMDR, our goal is to help support the client so that they feel adequately resourced in order to confront the traumatic material. Our goal is to reduce dissociation, and allow the client to be present in the here-and-now. These are some techniques that I find particularly helpful in my practice. In addition to using them with my clients, I find that it has practical application for helpers, caregivers and therapists, so that we can stay present with those who entrust us with their worries, problems and their care.
As the Buddha said, “You can travel the world and never find another being more worthy of compassion than yourself.” So feel free to use the tools and see how they work for you, before trying them with a client. And of course, feel free to write back with any comments, questions, suggestions to therapy (at) levistherapy (dot) com.
- Jim Knipe’s Back of the Head Scale.
This is a method to help dissociative clients “stay present”. It also helps both client and clinician know when a client is drifting into depersonalization and losing a sense of the shared reality and present safety.
- It may be helpful to ask the client: “With your eyes closed, do you have a sense of where your toes are? Can you feel them without wiggling? It is okay to wiggle them, in order to feel where they are.” When a client does not have an internal sense of their toes, it is not helpful to try to process trauma and may lead to increased dissociation.
- Rubbing our legs, pressing our palms together while gently pushing them against each other, progressive muscle relaxation, bringing focused attention to any one part of the body; all of these can be ways to increase present time here-and-now awareness. For clients who seem very anxious or have very pressured speech, sometimes I will ask the following questions:
Can you feel where your back/thighs make contact with the couch and where they don’t?
Can you pay attention to the soles of your feet and the way they rest inside your shoes as you continue to speak?
- A note about Breathwork: Although awareness of breath and mindful breathing practices help us to be more present, some caution must be exercised. When a client does not know how to breathe properly, they may become breathless, spacey, or hyperventilate.
It is important to help a client learn how to breathe more fully. If your client is uncertain how to do that, suggest that they place a hand on their stomach and attempt to push their hand out by inhaling and pushing their stomach out. This may take patience and practice.
- It is very important to be aware of our own breathing while we sit in the room with clients. I will often make a conscious effort to slow down my breathing or to keep it very even, and sometimes I will make my breathing loud or obvious, so that the client can mirror my breathing.
- Breathing Shift: Ask the client to bring up a positive memory. You can also use the image of the safe, calm space from below. Ask them to notice where the breath starts in the body and to put their hand over that area.
Once this is established, ask the client to bring up a memory with a low-level of disturbance. Ask them to notice how their breathing has changed and to put their hand over that location in the body.
Now ask them to put their hand over the previous location and deliberately change their breath accordingly. This will often help the disturbance to dissipate over the course of a few deep breaths.
- Sometimes I may ask a client who is experiencing physical discomfort: “How would you know if this discomfort went away?” or “How would it feel in your body if the pain/itchiness/tightness was gone?” Building upon their answer, we will create a template for how the client would like to feel, and how they will know when they get there. This exercise can go a long way in reducing physical discomfort as well.
- Safe Calm Space: The goal of this exercise is to create a powerful visual image of a relaxing and peaceful scene that you can use to just get away from the stress of the moment ( i.e., when I have to go to the dentist) or just as a quick battery charge whenever you have a few minutes to vicariously enjoy a place that feels so relaxing. It is analogous to a virtual tour in today’s world and rather delightful. It also helps build your relaxation muscle to offset stress and anxiety.
To use this technique, first you need to think of a space that feels really good to you. If it is a real space, it should be a space in which nothing bad ever happened. For example, you could use a memory of grandmother’s kitchen, with grandmother baking cookies. However, if grandmother ever spanked you, or anything else bad happened in her kitchen, you don’t want to use grandmother’s kitchen as your safe space.
Some people use a memory of a perfect vacation or a special experience in their life as their image of a safe space. Other people use an image of nature — sitting on the beach or walking in the woods. You can also create a totally imaginary safe space — like a castle in the clouds with a moat and a drawbridge.
Once you think of a safe space, you want to visualize that space in great detail. Make sure to engage all five senses to make the place come alive in your body. You may want to visualize that the safe space has everything you might need or want — nice food and drinks, a comfy place to sleep, music, plants, books, hot tub, etc. It is your safe space, so feel free to furnish it!
- Happy Bubble: This can be a good one to do with younger clients. Imagine that you can build a bubble around you, of any color you like. Inside this bubble, you can place your favorite toys, books and anyone who makes you feel safe and happy. You can take this bubble with you wherever you go, and you can practice it every night before you go to sleep.
- A container is an imaginary device that provides temporary storage for negative thoughts, feelings, images, events etc. It is best to avoid putting people in the container.
Wooden trunks, airtight Tupperware, storage lockers, ornate Ming vases, bank storage locker are all examples of containers. It is helpful to have the client describe the container in detail and to put unfinished and potentially traumatizing content in the container between sessions.
Additional Notes on the container:
1: Container should not be one they see frequently in day to day life, or it may be triggering, because the material is so ready to be cleared.
2: Container should have a lock or lid or a method to keep material inside it.
3: Clients with chronic health conditions may find it helpful to “send pain” or “send some part of the pain” to the container.
- Lucina Artigas’ Butterfly Hug
- Constructive Avoidance: Helping a client to tolerate confronting a difficult or feared situation is an important part of our work together. Breath work and mindfulness techniques are important tools on this journey. Safe Calm Space and Container are two of my favorite resources. In addition, I find it very helpful to use Carol Forgash’s Constructive Avoidance technique.
Help the client to build an entertaining, engaging, enjoyable place for their younger/wounded/frightened states to be in, while their more capable adult state engages in the required task. Validate the adult state as capable and normalize that any child would be afraid of going to court/having surgery/presenting at a conference etc.
- Cross-crawl: Make contact between alternate knee and alternate elbow. Inhale on one side, exhale on the other. Standing and Sitting variation.
Demonstrate for client, make sure to go slow and to keep your breathing very even.
If the video does not load, you can click here to view on Vimeo
- Another great resource to explore is HeartMath.
- At the end of a session, I often find it helpful to ask some questions that may sound silly, but that help to ground the client. As you may have noticed, many of the above exercises force the client to switch focus, to change their attention, and to go back-and-forth between here-and-now and then-and-there. This ability to hold a dual awareness is part of the EMDR protocol.
Here are a few examples of questions that I use at the end of a session to shift focus and awareness, but I am sure you can come up with your own.
o Can you name 3 blue colored objects in the room
o Can you name five things above eye level in this room
o What is your favorite flavor of icecream and name three toppings that you would like on it.
o What is one dish that you enjoy cooking? Now tell me the first three steps in preparing this dish.
o Visualize your closet in your mind’s eye. Now pick out an outfit with accessories and describe one of the accessories to me.
“Healing is simply attempting to do more of those things that bring joy
and fewer of those things that bring pain.”
~ O. Carl Simonton