Introduction to EMDR and the EEI Protocol
The standard EMDR protocol consists of a three-pronged approach in which past, present, and future events are targeted in therapy. The processing of past situations is usually the starting point when it comes to the processing phase of EMDR, and it is considered to resolve current mental health issues. According to Shapiro, the standard three-pronged protocol is a guide in the overall EMDR treatment of the client. According to the aforementioned protocol, each reprocessing session has to be directed at a certain target.Online EMDR clinic is located in Melbourne and works with client’s 15 years and above.
The generic target categories are described in the three-pronged protocol as follows. Initially, the past events which are the cause of pathology need to be fully processed. Then, the processing of particular triggers that are presently disturbing for the client needs to be completed. However, some triggers can remain active despite the processing of the original traumas. Shapiro indicated that these triggers may persist due to residual information from past events which have not been fully processed, or they may be the result of second order conditioning. The triggers could be either internal sensation, or an external event(e.g., symptoms of anticipatory fear, such as dizziness).
Lastly, the treatment allows the client to successfully visualise dealing with an anticipated future situation. In conformity with the standard procedure, if there are any fears, anxieties, or blocks which appear when a client actively thinks about a future event, they will be asked to focus on these limits and the therapist should introduce several sets of eye moments. If the client is unable to overcome the blocks, they have to be provided with appropriate resources, information, and skills that allow them to comfortably think about the future coping scene or with certain methods to discover old targets linked with anxieties, fears, or blocks. The therapist then applies the standard protocol in order to address the aforementioned targets. If there are no identifiable blocks and the client can visualize the future event clearly and confidently, the third prong is applied. This is achieved by helping the client focus on the positive beliefs, sensations, and images associated with the future experience, and by introducing eye movement sets to help them assimilate the information and incorporate it into a positive template.
Due to a growing body of research on the adaptation of the most used EMDR protocols to a wide range of mental health issues, elements of the three-prong protocol were used in the Recent Traumatic Episode Protocol (R-TEP), which describes an integrative approach incorporating and extending the main EMDR protocols with further measures for safety and containment. The R-TEP has introduced four essential procedural concepts by adapting the eight phases in EMDR therapy:
The Traumatic Episode (T-Episode) is a concept that presents the original traumatic event and its consequences as atrauma continuum (Traumatic Episode) from the past situation until the present, and it is comprised of several disturbance targets which have to be integrated.
The second concept is called The Episode Narrative. During the first two phases, only general information regarding the trauma is evoked, and the client is purposely not asked to recall the details of the traumatic event in order to avoid a premature trigger activation. The treatment phases begin with the Episode Narrative, which involves recounting the T-Episode story out loud, together with bilateral stimulation.
The third concept, Google Search (G-Search), is named after a metaphor used for a mechanism that can help identify the disturbance targets within the T-Episode. In order to achieve this, the client is asked to silently perform a non sequential scanning of the T-Episode with bilateral stimulation. When they identify a disturbance, it is used as a target for processing.
Lastly, Telescopic Processing introduces the idea of a “telescopic processing” strategy for each known target, which allows the expansion of the association focus (if needed). Association regulation is seen as a continuum which has the EMDR standard protocol without associative chain regulation at one end and the EMD protocol strategy with precise associative chain regulation at the other end. The intermediate between the two is called the EMDR strategy, which maintains the association chains of the client within a present trauma focus. This allows managing the focus of the processing without addressing other clinical issues, as it is normally done when using the standard EMDR protocol. Therefore, telescopic processing is a staged approach through which the focus is adjusted to the level where the information processing has stopped, for minimal intervention. The G-Search and Telescopic processing phases are repeated until there is no more disturbance in the T-Episode.
If traumatic memories accumulate, EMDR could facilitate prevention with early intervention as a comparatively short treatment focusing on the adaptive processing of traumatic events. In terms of advantages, EEI could simply be conducted over multiple consecutive days. The AIP model predicts that inappropriately stored memories are the cause of numerous current psychological disorders. As a consequence, it is anticipated that EEI could promote resilience and mental health and prevent both sensitization and accumulation of negative associative links before these traumatic memories become inadequately consolidated into negative theme networks. The idea that recent traumatic memories lack consolidation is a disadvantage which can become an advantage. This can be seen as an appropriate time to assure the occurrence of adaptive processing. Before the consolidation of the traumatic memory, the therapist may be able to facilitate adaptive integration, encourage positive coping (particularly if this is does not occur spontaneously),promote resilience, and reduce the effects of disturbances and subsequent complications.
Another advantage of EEI is that it could prevent the development of dysfunctional withdrawal and avoidance from seeking professional help,which tend to grow in intensity later on in life. It is suggested that EEI can successfully facilitate adaptive processing and may have the potential to remove obstacles that preempt the release of spontaneous processing. It can be used by clinicians to diminish distress by checking for sub clinical blocks which can obstruct AIP and do not always appear on the DSM radar.