Brainspotting

“Brainspotting Is Based On The Profound Attunement Of The Therapist With The Patient, Finding A Somatic Cue And Extinguishing It By Down-Regulating The Amygdala. It Isn’t Just PNS (Parasympathetic Nervous System) Activation That Is Facilitated, It Is Homeostasis.”

— ROBERT SCAER, MD, “THE TRAUMA SPECTRUM”

EMDR therapy & Brainspotting

Brainspotting was discovered by David Grand, Ph.D. in 2003. Since then, Brainspotting has developed into an in-depth therapeutic process that can be integrated with psychotherapy sessions in either individual or couples therapy. Dr. Grand believes that “Brainspotting taps into the body’s natural self-scanning and self-healing abilities”.

Brainspotting therapy is a new and powerful method of healing developed from EMDR. Brainspotting as a technique is used in psychotherapy and trauma resolution therapy to help release depression, fear, anxiety, grief, loss, phobias and addictions. It is possible to release the trauma or traumatic event from either a distressed or calm place in the body. The power of BSP is that one does not necessarily have to relive the traumatic event at the same level of intensity as the original trauma. BSP is especially helpful for pre-verbal traumas, that is, trauma that occurred before the child had language to organize the experience. Because of this, it is possible to resolve the trauma in a safe and contained manner. Trauma and stress can often overwhelm the nervous system. With the support of an experienced EMDR and Brainspotting therapist, BSP helps the client discharge the trauma and calm the nervous system. BSP helps clients identify, process, and release core neurophysiological sources of emotional or physical pain, trauma, dissociation and a variety of other challenging psychiatric and somatic symptoms.

Brainspotting (BSP) functions as a neurobiological tool to support the therapeutic relationship in which the therapist’s mature, nurturing presence and ability to engage the client creates a healing space. It is theorized that Brainspotting, like EMDR, triggers the body’s innate self-scanning capacity to process and release focused areas (systems) which are in a maladaptive (frozen primitive survival modes). This may also explain the ability of Brainspotting to often reduce and eliminate body pain and tension associated with chronic physical conditions.

Generally, the brainspot is located by finding an eye position where the emotion is most strongly felt. A brainspot can also be located from the calmest place in the body. Pinpointing the brainspot is done through noticing an increase in reflexive eye or body movements, such as blinking, swallowing, yawning, head or body twitches. Neurologists state that the location of the brainspot “is related to the area or region of the patient’s experience or perception of the traumatic event and represents procedural memory for that somatic experience”.

Brainspotting can be accompanied by the use of biolateral sounds. Biolateral sounds can be music, tones or even nature sounds that move from ear to ear alternately in order to activate each hemisphere of the brain. Dr. Grand developed a series of biolateral CDs that can be used during a Brainspotting session.  They were initially developed for use with EMDR. These sounds help to calm the sympathetic nervous system (which is the fight or flight response), and engage the calmer parasympathetic nervous system.

Brainspotting is unique from other therapeutic techniques in that it is being used not only in trauma and healing work, but also in the areas of performance enhancement and sports psychology. Therapists are utilizing BSP with professional athletes, actors, writers, musicians, as well as with clients who experience stress during public speaking. Meditation practices can also be enhanced through the use of Brainspotting.

David Grand, PhD, the developer of Brainspotting, is an internationally recognized trauma expert. He has devoted his life to advancing, expanding, and communicating about state-of-the-art tools available for healing trauma and enhancing performance. He is the author of Emotional Healing at Warp speed: the Power of EMDR and trains health care professionals around the US, Europe, South America and the Middle East

EMDR therapy & somatic experiencing

“All Successful Healing Methods Help People Establish A Connection To Their Body. Those Methods That Do Not Help People Connect To Their Body Have Limited, If Any, Success.” — PETER LEVINE, PHD

Somatic Experiencing is a form of therapy aimed at relieving and resolving the symptoms of post-traumatic stress disorder (PTSD) and other mental and physical trauma-related health problems by focusing on the client’s perceived body sensations (somatic experiences). It was introduced in Dr. Peter Levine's 1997 book "Waking the Tiger." In it, he discusses at length his observations of animals in the wild, and how they deal with and recover from life-threatening situations. He concludes that their behavior gives us "an insight into the biological healing process" (p.98), and that "the key to healing traumatic symptoms in humans lies in our being able to mirror the fluid adaption of wild animals" (p.17-18) as they avoid traumatization in reacting to life-threatening situations. The theory postulates that the symptoms of trauma are the effect of a dysregulation of the autonomic nervous system (ANS). It further postulates that the ANS has an inherent capacity to self-regulate that is undermined by trauma, and that the inherent capacity to self-regulate can be restored by the procedures of Somatic Experiencing or SE.

The procedure, which is normally done in a face-to-face session similar to psychotherapy, involves a client tracking his or her own "felt-sense" experience. SE is considered by its practitioners to be effective for Shock Trauma in the short term (typically one to six sessions). It is also considered effective for Developmental Trauma as an adjunct to more conventional psychotherapy that may span years. Somatic Experiencing is very effective when combined with EMDR sessions and traditional talk therapy or psychotherapy.

Somatic Experiencing attempts to promote awareness and release of physical tension that proponents believe is stored and remains in the body in the aftermath of trauma. This occurs when the survival responses (which can take the form of orienting, fight, flight or freeze) of the ANS are aroused, but are not fully discharged after the traumatic situation has passed. The process involves a guided exploration of the nature and extent of the physical dysregulation that is harbored in the body as a result of trauma. Another notion is that the client's experience should be "pendulated."  "Pendulation" refers to the movement between regulation and dysregulation. The client is helped to move to a state where he or she is believed to be somewhat dysregulated (i.e. aroused, distressed or frozen) and then helped to return to a state of regulation (loosely defined as not aroused or frozen). "Resources" are defined as anything that helps the client's autonomic nervous system return to a regulated state.  In the face of arousal, "discharge" is facilitated to allow the client's body to return to a regulated state. Through this process the client's inherent capacity to self-regulate is believed to be restored.

Somatic Experiencing is considered by its practitioners to be useful for two broad categories of trauma: shock trauma and developmental trauma. Shock trauma is loosely defined as a single-episode traumatic event such as an accident, natural disaster, battlefield incident, etc. Developmental trauma refers to various kinds of psychological damage that occur during child development, such as: chronic abuse; insufficient attention and neglect from the primary caregivers; insufficient nurturing relationship with the parent.

The history of EMDR Therapy 

Eye Movement Desensitization and Reprocessing (EMDR) is a therapy developed by psychologist Dr. Francine Shapiro.  She made the chance observation that eye movements can reduce the intensity of the disturbing thoughts when she noticed her own stress reactions diminished when her eyes swept back and forth as she walked through a park one day.  EMDR involves recalling a stressful past event and “reprogramming” the memory in the light of a positive, self-chosen belief, while using rapid eye movements to facilitate the process. Theories as to why EMDR works are still evolving, but many people have found EMDR to be extremely beneficial.

8 phases of treatment

The amount of time the complete treatment will take depends upon the history of the client. Complete treatment of the targets involves a three pronged protocol (1-past memories, 2-present disturbance, 3-future actions), and are needed to alleviate the symptoms and address the complete clinical picture. The goal of EMDR therapy is to process completely the experiences that are causing problems, and to include new ones that are needed for full health. "Processing" does not mean talking about it. "Processing" means setting up a learning state that will allow experiences that are causing problems to be "digested" and stored appropriately in your brain. That means that what is useful to you from an experience will be learned, and stored with appropriate emotions in your brain, and be able to guide you in positive ways in the future. The inappropriate emotions, beliefs, and body sensations will be discarded. Negative emotions, feelings and behaviors are generally caused by unresolved earlier experiences that are pushing you in the wrong directions. The goal of EMDR therapy is to leave you with the emotions, understanding, and perspectives that will lead to healthy and useful behaviors and interactions.

Phase 1: History and Treatment Planning

Generally takes 1-2 sessions at the beginning of therapy, and can continue throughout the therapy, especially if new problems are revealed. In the first phase of EMDR treatment, the therapist takes a thorough history of the client and develops a treatment plan. This phase will include a discussion of the specific problem that has brought him into therapy, his behaviors stemming from that problem, and his symptoms. With this information, the therapist will develop a treatment plan that defines the specific targets on which to use EMDR. These targets include the event(s) from the past that created the problem, the present situations that cause distress, and the key skills or behaviors the client needs to learn for his future well-being. One of the unusual features of EMDR is that the person seeking treatment does not have to discuss any of his disturbing memories in detail.

Phase 2: Preparation

For most clients this will take only 1-3 sessions. For others, with a very traumatic background, or with certain diagnoses, a longer time may be necessary to create a sense of safety. Basically, your clinician will teach you some specific techniques so you can rapidly deal with any emotional disturbance that may arise. If you can do that, you are generally able to proceed to the next phase. One of the primary goals of the preparation phase is to establish a relationship of trust between the client and the therapist.  During the Preparation Phase, the clinician will explain the theory of EMDR, how it is done, and what the person can expect during and after treatment. Finally, the clinician will teach the client a variety of relaxation techniques for calming himself/herself in the face of any emotional disturbance that may arise during or after a session. Learning these tools is important for everyone and especially and EMDR client. One goal of EMDR therapy is to make sure that the client learns self care, self soothing techniques and relaxation.

Phase 3: Assessment

Used to access each target in a controlled and standardized way so it can be effectively processed. Processing does not mean talking about it.  The therapist identifies the aspects of the target to be processed. The first step is for the person to select a specific picture or scene from the target event (which was identified during Phase One) that best represents the memory. Then the client chooses a statement that expresses a negative self-belief associated with the event. Even if he intellectually knows that the statement is false. These negative beliefs are actually verbalizations of the disturbing emotions that still exist. Common negative cognitions are "I am helpless," " I am worthless," " I am unlovable," " I am dirty," " I am bad," etc. The client then picks a positive self-statement that he would rather believe. This statement should incorporate an internal sense of control such as "I am worthwhile/ lovable/ a good person/ in control" or "I can succeed." "I am in danger" can be considered a negative cognition, because the fear is inappropriate - it is locked in the nervous system, but the danger is actually past. The client will then be asked to rate the cognitions as well as identify any body sensations associated with these cognitions.

Reprocessing

For a single trauma reprocessing is generally accomplished within 3 sessions. If it takes longer, you should see some improvement within that amount of time.  Phases One through Three lay the groundwork for the comprehensive treatment and reprocessing of the specific targeted events. Although the eye movements (or taps, or tones) are used during the following three phases, they are only one component of a complex therapy. The use of the step-by-step eight-phase approach allows the experienced, trained EMDR clinician to maximize the treatment effects for the client in a logical and standardized fashion. It also allows both the client and the clinician to monitor the progress during every treatment session.

Phase 4: Desensitization

This phase focuses on the client's disturbing emotions and sensations as they are measured by the SUDs rating. This phase deals with all of the person's responses (including other memories, insights and associations that may arise) as the targeted event changes and its disturbing elements are resolved. This phase gives the opportunity to identify and resolve similar events that may have occurred and are associated with the target. During desensitization, the therapist leads the person in sets of eye movement (or other forms of stimulation) with appropriate shifts and changes of focus until his SUD-scale levels are reduced to zero (or 1 or 2 if this is more appropriate). Starting with the main target, the different associations to the memory are followed. For instance, a person may start with a horrific event and soon have other associations to it. The clinician will guide the client to a complete resolution of the target. Examples of sessions and a three-session transcript of a complete treatment can be found in F. Shapiro & M.S. Forrest (2004) EMDR. New York: Basic Books.

Phase 5: Installation

The goal is to concentrate on and increase the strength of the positive belief that the person has identified to replace his original negative belief. For example, the client might begin with a mental image of being beaten up by his father and a negative belief of "I am powerless." During the Desensitization Phase he will have reprocessed the terror of that childhood event and fully realized that as an adult he now has strength and choices he didn't have when he was young. During this fifth phase of treatment, his positive cognition, "I am now in control," will be strengthened and installed. How deeply the person believes his positive cognition is then measured using the Validity of Cognition (VOC) scale. The goal is for the person to accept the full truth of his positive self-statement at a level of 7 (completely true). Fortunately, just as EMDR cannot make anyone shed appropriate negative feelings, it cannot make the person believe anything positive that is not appropriate either. So if the person is aware that he actually needs to learn some new skill, such as self-defense training, in order to be truly in control of the situation, the validity of his positive belief will rise only to the corresponding level, such as a 5 or 6 on the VOC scale.

Phase 6: Body scan

After the positive cognition has been strengthened and installed, the therapist will ask the person to bring the original target event to mind and see if he notices any residual tension in his body. If so, these physical sensations are then targeted for reprocessing. Evaluations of thousands of EMDR sessions indicate that there is a physical response to unresolved thoughts. This finding has been supported by independent studies of memory indicating that when a person is negatively affected by trauma, information about the traumatic event is stored in motoric (or body systems) memory, rather than narrative memory, and retains the negative emotions and physical sensations of the original event. When that information is processed, however, it can then move to narrative (or verbalizable) memory and the body sensations and negative feelings associated with it disappear. Therefore, an EMDR session is not considered successful until the client can bring up the original target without feeling any body tension. Positive self-beliefs are important, but they have to be believed on more than just an intellectual level.

Phase 7: Closure

Ends every treatment session The Closure ensures that the person leaves at the end of each session feeling better than at the beginning. If the processing of the traumatic target event is not complete in a single session, the therapist will assist the person in using a variety of self-calming techniques in order to regain a sense of equilibrium. Throughout the EMDR session, the client has been in control (for instance, he is instructed that it is okay to raise his hand in the "stop" gesture at anytime) and it is important that the client continue to feel in control outside the therapist's office. He is also briefed on what to expect between sessions (some processing may continue, some new material may arise), how to use a journal to record these experiences, and which techniques he might use on his own to help him feel more calm.

Phase 8: Reevaluation

Opens every new session At the beginning of subsequent sessions, the therapist checks to make sure that the positive results (low SUDs, high VOC, no body tension) have been maintained, identifies any new areas that need treatment, and continues reprocessing the additional targets. The Reevaluation Phase guides the clinician through the treatment plans that are needed in order to deal with the client? s problems. As with any form of good therapy, the Reevaluation Phase is vital in order to determine the success of the treatment over time. Although clients may feel relief almost immediately with EMDR, it is as important to complete the eight phases of treatment.

Past, Present and Future

Although EMDR may produce results more rapidly than previous forms of therapy, speed is not the issue and it is important to remember that every client has different needs. For instance, one client may take weeks to establish sufficient feelings of trust (Phase Two), while another may proceed quickly through the first six phases of treatment only to reveal, then, something even more important that needs treatment. Also, treatment is not complete until EMDR therapy has focused on the past memories that are contributing to the problem, the present situations that are disturbing, and what skills the client may need for the future.

Above excerpt from: F. Shapiro & M.S. Forrest (2004) EMDR: The Breakthrough Therapy for Anxiety, Stress and Trauma. New York: BasicBooks.

Books about EMDR

Calm and Confident:  Overcome Stress and Anxiety With EMDR -Mark Grant. Two guided visualizations, soothing music, and EMDR combine to help listeners relax and feel more confident about dealing with stress and anxiety-producing situations. A instruction booklet included.

EMDR: The Breakthrough Therapy for Overcoming Anxiety, Stress, and Trauma -Francine Shapiro, & Margot Silk-Forrest. EMDR explained and includes many case histories.

EMDR: Transforming Trauma - Laurel Parnell. Basic EMDR information for the general public as well as psychotherapists. Dr.Parnell writes from a transpersonal perspective about her experiences with EMDR.

Small Wonders: Healing Childhood Trauma with EMDR - Joan Lovett, M.D. Collection of stories about children, adolescents and adults who have puzzling symptoms and anxiety. It offers therapists who treat children and do inner child work, a unique look at the EMDR process and valuable clinical histories. EMDR information is explained in a easily understandable way for clients. She is adept at integrating EMDR into multidimensional therapeutic contexts.

Helpful Books for EMDR Clinicians:

Finding the Energy to Heal: How EMDR, Hypnosis, TFT, Imagery, and Body-Focused Therapy Can Help Resolve Health Problems - Maggie Phillips. An excellent book for EMDR practitioners. The author explains concepts like positive image installation, positive target image, conflict free image, resource interweave, ego state therapy during EMDR without hypnosis, re-nurturing interweaves, developmental learning interweaves, concepts and procedures related to the safe place and safe place image, temporal resource interweaves, and many concepts and resources that can be useful to the EMDR clinician.

EMDR in the Treatment of Adults Abused as Children - Laurel Parnell, Ph.D

A Therapist's Guide to EMDR:  Tools and Techniques for Successful Treatment - Laurel Parnell, PhD.

EMDR and Psychotherapy Integration: Theoretical and Clinical Suggestions With Focus on Traumatic Stress - Lipke, H.  Lipke integrates EMDR practice with behavioral, dynamic, and humanistic psychotherapy.

EMDR Solutions:  Pathways to Healing - Robin Shapiro

EMDR Solutions II:  For Depression, Eating Disorders, Performance, and More -  Robin Shapiro

Eye Movement Desensitization and Reprocessing: Basic Principles, Protocols, and Procedures - Francine Shapiro. Theoretical conceptualization of EMDR is outlined by Dr. Shapiro. Most of the information presented at the Level I and II EMDR trainings.

Eye Movement Desensitization Reprocessing EMDR) in Child and Adolescent Therapy - Ricky A. Greenwald, PsyD.

Extending EMDR: A Casebook of Innovative Applications - Philip Mansfield.

Healing the Divided Self: Clinical and Ericksonian Hypnotherapy for Post-Traumatic and Dissociative Conditions - Maggie Phillips & Claire Frederick. This book doesn't discuss EMDR, specifically but it does discusses Ego State Therapy as well as dissociation, hypnosis, and other relevant topics to EMDR Therapists.

Pain Control With EMDR - Mark Grant. Designed to minimize all kinds of pain, including chronic, postoperative, and migraine, the cassette and booklet contain two visualizations of pain-relieving imagery. (audio cassette)

Trauma in the Lives of Children: Crisis and Stress Management Techniques for Teachers

Counselors, and Student Service Professionals - Kendall Johnson. This book is for the professionals who treat children and adolescents. The second edition includes information about the advances in the understanding of memory and Post-traumatic stress in children. Includes a chapter on EMDR therapy.

Transforming Trauma: EMDR: The Revolutionary New Therapy for Freeing the Mind, Clearing the Body, and Opening the Heart - Laurel Parnell, Ph.D. Dr. Parnell takes the reader into her own experience as a EMDR therapist and her clients abuse histories sharing how traumatic events frozen in time are released by using EMDR method.

Through the Eyes of a Child: EMDR with Children - Robert H. Tinker, Sandy A. Wilson, Robbie Dutton, Sandra D. Wilson.  This books shows how EMDR can be successfully applied to helping children over come childhood trauma. The EMDR protocol is modified so it can be applied to children as young as two years old. There are many case examples including, phobias, auto accidents, breavement, ADHD, anxiety, depression and reactive attachment disorders and eating disorders.

Neurobiology & Attachment Books

Affect Regulation and the Origin of the Self: The Neurobiology of Emotional Development - Allan N. Schore

The Developing Mind: Toward a Neurobiology of Interpersonal Experience - Daniel Siegel Skills Training Manual for Treating Borderline Personality Disorder - Marsha M. Linehan. DBT solutions and support for psychotherapists working with clients diagnosed with Borderline Personality Disorder