EMDR Protocol , and June 2014

Prologue

In order to carry out the protocol in a responsible way, it is above all very important to have a thorough knowledge of the target group. Secondly, it is recommended to have participated in a workshop practising the protocol. And thirdly, one need knowledge of applying cognitive interweaves (as taught in an accredited EMDR training), because the presented procedure can also be used as cognitive interweave within the EMDR Standard protocol. Applying the protocol as a cognitive interweave: see addendum.

Introduction

The rationale of with Anger, Resentment and Revenge can be explained as follows:

When people are reminded of disturbing memories or certain persons, it can lead to fierce ; sometimes “ the bucket will even overflow”. There are two kinds of emotions which can still be triggered by thinking of those negative experiences or persons. Therefore, there are also two buckets which can overflow.

 draw a bucket titled “Powerlessness and ”  draw another bucket titled “Anger, Resentment and Revenge”

One bucket contains all emotions concerning powerlessness, , fear and fright; all vulnerable, internalized emotions.

The other bucket is filled with emotions like anger, resentment and sometimes even revenge; all ‘external directed’ emotions.

When we look at the Powerlessness and Fear bucket, how full is it at this moment? When we look at the Anger bucket, how full is it at this moment?

 draw the levels indicated by the patient or let the patient draw the indicated levels

Emptying which bucket would give the most relief?

 if the patient chooses the Powerlessness and Fear bucket, use the standard EMDR protocol  if the patient chooses the Anger bucket, follow the next procedure

Inventory

To empty the bucket, we will not discuss the disturbing experiences you had, but we will focus on the persons who have treated you wrongly or who have damaged you. You may say, the people who have messed up your life.

1 It is important to focus the anger during therapy on the person who damaged you. It will not do any good to express your anger towards people who have nothing to do with the past experiences. I will draw a time line on which we can place every person who ever hurt you and still makes you angry.

 draw a horizontal time line and put “0” on the left hand side and the recent age of the patient on the other end of the time line

Starting from your birth, who is the first person who hurt you and still makes you angry?

 draw a little figure on the time line, include name or relation to the patient, but do not ask any further questions

Who is the next person who hurt you and still makes you angry?

 draw the next little figure on the time line, including name or relation to the patient and do not ask further questions. Continue this procedure until every person that should be on the time line according to the patient, is clearly visible.

 In chronological order, you ask the following question for each person on the time line:

Imagine that this person is right in front of you and you look into his or her eyes, how much anger do you feel in your body on a scale of 0 to 10?

 add the number to every little figure on the time line, do not discuss any reasons or experiences, but first ask the same question for every person.

Selection of the person

 if one person clearly stands out:

Just to be sure; is it correct that this person makes you most angry of all?

 -if there are several persons who cause equal anger:

Which of them causes the most anger at this moment?

 if the patient cannot make a clear decision, then work in chronological order

 if the patient persists in another choice, it is advisable to go along with that choice

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Film scenario 1

Very well, we have chosen this person to start with. Your strong of anger, resentment or revenge which you normally cannot express or are not allowed to express, can be ventilated in therapy by means of a self-produced film. It will help to free your body and life of those emotions.

From this moment on, you are the film producer of a film in which you approach the person who caused your anger. You are in charge and decide what will happen in the film and what not. It is a kind of victory film.

Before you approach the person, first consider carefully what it is you need to be sure to have the power when you two meet and to feel absolutely safe at all times.

There are four rules regarding this film: a. You have the power, you are in charge and you alone decide what happens in the film b. You have to be able to feel safe at all times in the film. Therefore you can take along people or accessories that will increase your of safety c. Everything is allowed without consequences. When you just want to say something to the person, that is fine. When you want to attack or hurt this person, that is fine too. It is all allowed in the film, playing in your head right here in the therapy room. d. The anger has to disappear from your body, so it is not allowed to let someone else express the anger.

Tell me: where do you want to meet the other person?

Is there anything you want to bring along? Some bring along something to be sure the other will be listening and obeying...

Anything else you need?

To be sure: close your eyes, look into the other person’s eyes and check if you have all you need to feel powerful and safe.. do you need anything else?

Realize you have the power and decide what will happen in the film. You can stop the film at any point.

 Please note: do not discuss the film scenario, because it will develop based on the patient’s feelings at that time!

1 Some patients have difficulties accepting and expressing their anger in therapy. Read the supplement for an explanation which could be used to help the patient to overcome initial hesitation.

3 Start Sets

 Prepare the patient for eye movements

Now approach the other person and look into his or her eyes.... see what happens... (set)

What comes up?

 Repeat the following cycle unless a situation, described in a., b., c. or d., occurs:

Look him/her in the eyes and follow what your body wants to do or what you want to say and act upon that…. (set)

What comes up? Or: What do you see in the his/her eyes? Or: What do you feel in your body?

a. If the patient seems to lose his or her power:

You have the power, make sure you have everyone and everything you need to feel completely safe... you have the power (set)

b. If the patient feels to much powerless, take him or her out of the film and let the patient decide what is needed more to feel completely safe and powerful (other people, a rope, a knife, tape to prevent the person from talking for instance)

Do you have everything you need to feel safe and powerful at all times? Approach the other person and look into his or her eyes... follow whatever comes... (set)

 continue the cycle above-mentioned

c. If the fear and powerlessness is too overwhelming, take the patient out of the film and focus on reducing the arousel. Application of the standard EMDR protocol is in this situation a better choice.

d. If the patient indicates that the anger bucket is empty:

Once again, look deeply into the other person’s eyes and feel if there is any tension left in your body (set)

What do you notice?

 If the tension, related to the person, is all gone, proceed with the Positive Closure.  If there is still felt some tension, continue the cycle above-mentioned

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Positive Closure (source: standard EMDR protocol, Ten broeke & de Jongh, 2013)

What is the most positive or most worthwhile you have experienced or learned about yourself in the last hour with regard to this person?

 If necessary:

What does that say about you as a person? Or: What do you call someone like that? (set)

Is there another positive thing that comes up?

 Continue at each positive thing that comes up until there are no further (positive) changes.

Completion and follow up

 In case of an insufficient decrease of physical tension, you can consider offering ‘ the safe place’ (‘ safe place’ is not part of the protocol).

 Let the patient know the next couple of days can be unsteady.

 After the session, discuss the difference in physical tension at the beginning and at the end of the film; also discuss a follow up ( continuation of emptying the anger bucket or focusing on dealing with a specific damaging experience using the standard EMDR protocol).

 If necessary, make safety instructions so the patient knows what to do when he or she feels not to be able to handle the anger.

 If necessary, the bucket procedure can be carried out again during the next session, starting with measuring the fullness of the buckets and determining which bucket should be dealt with.

Addendum: EMDR protocol Anger, Resentment and Revenge as Cognitive Interweave

If during the application of the standard EMDR protocol the patient reports a strong feeling of anger or urge to revenge, the following Cognitive Interweave is recommended.

Where in your body do you feel the anger the most?

From now on you have the power.

Look in his or her eyes and follow what your body wants to do or what you want to say and act upon that…. (set)

What comes up? Or: What do you see in the his/her eyes? Or: What do you feel in

your body?

 If the anger tension in the body is processed, proceed with Back To Target (standard EMDR protocol).

5 Supplement: Psycho education for patients having difficulties admitting their anger

We are ruled by two “authorities”: our intellect and our feeling. Feeling contains emotions, what we feel physically but also automatic behavior. A lot we do on autopilot, unconsciously, without realizing. Good for us. One of those reflexes gets activated when we experience a threat or danger. Our body shows a so called fight-or-flight response automatically.

But, for instance, when a child is abused by an adult, the brain realizes that fighting or fleeing has no point. The child could never compete with such a strong adult. However, the fact is that the brain will not forget and will push the body to fight as soon as a possibility comes up. Even for years, a child can feel an automatic urge to strike back, to fight, often against no person in particular. The brain will not be satisfied until the body has completed the action; until the body has won.

Our intellect does not like that at all. towards someone else is not done. It does not fit us; it is not who we want to be.

In order to get rid of this long lasting fight response in our body, we have to switch off our intellect temporarily during therapy. This way we can create the space needed for our body to imaginary achieve victory over the person we are angry with. We know that in real life you would never use violence. That is not the way you are. But if the anger towards the other person has gone, you will feel liberated. You will experience any contact you still may have with this person in a much more positive way.

Leiden, june 2014 © copyright Herman Veerbeek

Email: [email protected]

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