Promoting Engagement in EMDR for Trauma James Thomas CBT / EMDR Therapist
Introduction My history What informs my approach to trauma therapy?
Session Aims Discuss 2 clients with complex trauma. Present an overview of ACT, and using Values as a way of engaging trauma clients. Discuss my learning.
Susan 52 year old survivor of childhood sexual abuse. Referred for help with contamination based OCD. Social isolation. Lots of back pain.
Andrew 45 year old military veteran. No prior therapy - cracking on. Lots of present day trauma activity. Withdrawal from family / social life.
Where to begin? Establish safety Therapy relationship Supervision and time Resources
Healing Resources Calm / safe / special place. Wise / nurture and protector figures. Container. Loving kindness resources. Mindfulness based exercises. ACT Values.
Intro to Acceptance and Commitment Therapy (ACT) 3rd Wave CBT Metacognitive Awareness Teasdale and Barnard - work on MBCT The ability to experience negative thoughts and feelings as mental events instead of being synonymous with oneself Acceptance - adopting an intentionally open receptive and non judging posture to aspects of experience. Commitment - Taking action guided and motivated by our values service of a rich and meaningful life
How does ACT approach problematic Anxiety? Attempts to control experience have become the problem Acceptance (as opposed to struggle) is a viable alternative agenda. Mindfulness can be used not to feel good but to fully experience. The focus on overcoming anxiety leads to a restricted life+ suffering (Values) Committed Action
Making a Choice
Some thoughts about Values The Purpose of life is not to be happy - but to matter, to be productive, to be useful, to have it make some difference that you have lived at all Leo Rosten A sense of knowing what is good and healthy for you in the long run Joanne Dahl
Values vs Goals
Values and Goals Values Develop a healthy eating pattern Caring for your body Supporting your family To be loving and respectful Live courageously Goals Lose ten pounds of weight Join a gym Get a big house To get love and respect from others Feel less anxious
How ACT values can help during therapy When motivation is lacking. As a precursor to goal setting. To facilitate acceptance. To add richness, fulfilment and meaning to life. When therapy seems stuck.
Bringing values to life How to clarify Can be very emotive Animate values Search for the qualities
How clarifying Values helped Susan and Andrew
Homework Consider your Values
References Dahl, J. An introduction to Values with Joanne Dahl - from ACT in Context (Podcast - available from i tunes store at time of writing 05/05/2016) Harris, R. (2009) ACT Made Simple: An Easy to Read Primer on Acceptance and Commitment Therapy. New Harbinger Publications, Inc. Hayes, S. (2005) Controlling Anxiety is the Problem, not a Solution In: Acceptance and Commitment Therapy for Anxiety Disorders : A Practitioners treatment Guide to using Mindfulness, Acceptance and Values Based Behaviour Change Strategies. Eifert, GH. &Forsyth, J.P. New Harbinger Publications Inc. Knipe J. The Method of Constant Installation of Present Orientation and Safety (CIPOS) in: EMDR Toolbox - Theory and Treatment of Complex PTSD and Dissociation. Springer Publications Company. Mansell. W. (2008) What is CBT Really, and How Can We Enhance the Impact of Effective Psychotherapies such as CBT? In: Against and Fot CBT - Towards a Constructive Dialogue. R. House & D. Lowenthal (Eds). PCCS Books Ross - on - Wye. Omaha, J. (2004) Skill1: Containment. In: Psychotherapeutic Interventions for Emotion Regulation: EMDR and Bilateral Stimulation for Affect Management. W.W. Norton & Company, New York. Parnell, L. (2013). The Four Most Important Resources. In: Attachment Focused EMDR - Healing Relational Trauma. W.W. Norton & Company. New York. Wilson, K.G., & Murrell, A.R. (2004). Values Work in Acceptance and Commitment Therapy: Setting a course for Behavioural Treatment In: S.C.Hayes, V.M. Follett, & M.M. Linehan (Eds) Mindfulness and Acceptance: Expanding the Cognitive - Behavioural tradition (pp. 120-151). New York, NY : Guilford Press. For more information, ideas and resurces on how to use ACT please visit : https://contextualscience.org/acbs Video in todays session was courtesey of Russ Harris, Authour of The Happiness Trap, https://www.youtube.com/watch?v=tw6vwkvrmlc See also http://www.thehappinesstrap.com for worksheets and othee free resources for working with clients.