Unleash Oz unpacked – by Ainslee Gibbs

WE ACTIVATE, THEN SOOTHE

Report from Attachment-Informed EMDR (AI-EMDR) Online Workshop for Australia, August 2020, with Mark Brayne

The central tenet from this three-day online workshop was that the first thousand days from conception are most important: how we experience self and the world, and the meaning and relationship created between the two is crucial to understand.

Mark stressed that there was still only one basic EMDR protocol, built upon stimulating and processing a disturbing memory bilaterally using dual attention.

But he also noted that attachment-informed target selection is at the heart of this type of work.

John Bowlby pioneered the understanding of attachment in the 1950s, with studies into infant and early child development. He found that attachment is hallmarked by a sense of a safe haven, a secure base, proximity maintenance and successful management of separation distress.

When the relationship between carer and child is healthy and secure, the carer can respond to the distress of a child, helping them to regulate and return to calm.

Conversely, when a carer is triggered and cannot deal with their own distress, the child has to manage their emotional alarm and calm the carer, thus reversing the dynamic.

If this experience is repeated and consistent over time, emotional defence mechanisms emerge for the child, as the awareness of threat, danger or abandonment becomes intolerable.

Fragmenting of the self occurs, and these early, emotional parts of self become locked in the system.

Exiled affect, memory and emotions then break through defences, and show up as coping behaviours in the client (drinking, drug taking, workaholism, gambling, etc).

The work of AI-EMDR therefore, is to repair the ruptured attachment, to integrate the parts as far as possible and reconstruct present reality with a new narrative.

The AI-EMDR model, pioneered since the late 1990s by Dr Laurel Parnell in the USA, emphasizes the importance of imaginative resourcing of the client before processing is begun.

Creative resourcing allows the client step outside their comfort zone, to identify supports when historically they may have had to take care of problems alone.

Resources include Nurturing, Protective and Wise figures as well as EMDR’s usual Calm or Peaceful (in Francine Shapiro’s original language, Safe) place.

These figures can be real or imagined, historical or present, and can be people, animals, spiritual beings, or for example superheroes. Each figure is installed (the self-administered butterfly hug works very well online), then collectively tapped in as a team.

It is important to note any difficulties the client may have in eliciting figures in each of these domains, giving the therapist a clue to where challenges may lie in their attachment history.

Childhood figures who were a source of both comfort and fear to the client (e.g. an abusive carer/family member), or the client’s own children (the desire to choose them can indicate a client’s own childhood need to put a parent’s emotional needs first) are to be avoided.

Moving into Phase Four Desensitizing/Processing, the task can be simplified by asking the client about a present issue that is causing them difficulties.

Once they have elicited an image for that experience, they are asked to identify their emotional and body response and the attendant cognition (always negative without having to be labelled as such), and invited to drop back in time as far as they can, and notice the first place they land, very often around the age of seven or so, a strong developmental and brain-development milestone in a child’s sense of self.

Mark suggests that the nervous system will generate the target naturally, often revealing an experience that continues to hold a pivotal moment of meaning.

It is important to stress that the ‘landing point’ is not always the actual target, but provides a doorway that takes the therapist into the client’s key developmental story.

Therapists can bring the attachment-informed context into conscious awareness by “zooming out” and expanding on the client’s life at that time – what and where was this happening, who else was present (or not), what meaning was created from the experience (e.g. I’m responsible, it’s my fault, etc).

Double or triple target “bouncing” can happen when a client lands in an early memory, and then links spontaneously in the processing to an even earlier or ancillary experience.

Mark was keen to stress that resources should not be brought into the processing phase too early, as therapists need to take care not to rescue the client from their emotions.

The function of the therapist is to address the absence of repair, when there have been significant and long-lasting ruptures in childhood attachment. It is important not to let clients loop for too long, so the use of imaginal and creative interweaves and a more-frequent-than-traditional returning to target is necessary.

When working with a childhood ego state, numbers and cognitions (as when working with real children) can confuse and challenge, blocking access to the emotional and somatic information so necessary for EMDR processing.

Finding a PC or VOC in the assessment phase can be difficult, flipping the client too much into left-brain activation. It’s important to go with the body and emotional state, and not get too hung up on the details. PCs will almost always emerge organically as processing unfolds.

When working in-person (once the pandemic is over), attachment work allows for a different seating position, face-to-face rather than traditional Ships-In-The-Night EMDR.

Mark also stressed tightness and simplicity in the language used with the client – don’t necessarily repeat the client’s words, keep it simple and to the point.

The butterfly hug was used throughout the demonstrations with eyes closed, and sets were often longer to allow deeper awareness, processing and integration for the client.

This was a fantastic workshop, with creative and playful elements, and the instructions for practice in triads were easy to follow and effective.

I was struck by the instinctual nature of the work, as it felt less bound by the usual mechanics of EMDR’s Standard Protocol.

What could not be taught was Mark’s effortless skill in the live demonstrations in the weaving of narrative and meaning from past to present, whilst warmly attending to any emotion that came up.

This style of EMDR is heartstring stuff – both touching and moving to witness.