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Table of Contents Acknowledgments ..................................................................................................................................................... ix Preface ........................................................................................................................................................................ xi Introduction ............................................................................................................................................................. xiii Chapter 1 The Challenge of EMDR Trauma Treatment ......................................................................................... 1 Adaptive Information Processing ............................................................................................................................................................ 1 Definition of Trauma ..................................................................................................................................................................................... 1 My Early Experience with EMDR .............................................................................................................................................................. 1 My Paradigm Shift ......................................................................................................................................................................................... 2 My Take on Childhood Wounding ......................................................................................................................................................... 3 Foundational Stability versus Foundational Instability .................................................................................................................. 4 Preparing Clients with Childhood Wounding for EMDR ............................................................................................................... 5 Importance of Assessing Readiness ....................................................................................................................................................... 6 Other Factors Relevant to Treatment Success ................................................................................................................................... 7 Chapter 1 Summary ...................................................................................................................................................................................... 7 Chapter 2 Ego State Theory and Therapy Overview .............................................................................................. 9 Ego State Theory Overview ........................................................................................................................................................................ 9 Healthy Ego States ..................................................................................................................................................................................... 10 Wounded Ego States ................................................................................................................................................................................. 10 Types of Wounded Ego States .............................................................................................................................................................. 11 Olivia: An Example of How Ego States Form ................................................................................................................................... 12 The Self-System ........................................................................................................................................................................................... 13 Storage of Wounding Experiences ...................................................................................................................................................... 14 Executive Control ........................................................................................................................................................................................ 14 Getting Triggered ....................................................................................................................................................................................... 15 Resourcing ..................................................................................................................................................................................................... 16 Talking to Wounded Parts ...................................................................................................................................................................... 16 Overview of DNMS Stabilization .......................................................................................................................................................... 19 Alternating Bilateral Stimulation (ABS) for Stabilizing Wounded Parts ............................................................................... 20 Chapter 2 Summary ................................................................................................................................................................................... 21 Chapter 3 Treating Adults Wounded in Childhood ............................................................................................. 23 Attachment Styles ....................................................................................................................................................................................... 23 Childhood Wounding from Unmet Developmental Needs ...................................................................................................... 24 Types of Childhood Wounding Graphed on a Grid ..................................................................................................................... 25 Little or No Childhood Wounding ....................................................................................................................................................... 27 Nonprimary-Caregiver Relational Trauma Wounding ................................................................................................................ 27 Nonrelational Trauma Wounding ........................................................................................................................................................ 28 Attachment Wounding without Trauma Wounding .................................................................................................................... 29 Nonprimary-Caregiver Trauma + Attachment Wounding ........................................................................................................ 30 Primary-Caregiver Trauma + Attachment Wounding ................................................................................................................. 31 Stabilization Interventions before EMDR .......................................................................................................................................... 33 Stabilization Interventions after EMDR .............................................................................................................................................. 33 Chapter 3 Summary ................................................................................................................................................................................... 34 Chapter 4 Getting a History .................................................................................................................................... 35 Getting Acquainted .................................................................................................................................................................................... 35 Getting a Genogram .................................................................................................................................................................................. 35 Getting a History ......................................................................................................................................................................................... 36 Taking a History with Empathy and Attunement .......................................................................................................................... 39 iv Ego State Therapy Interventions to Prepare Attachment-Wounded Adults for EMDR Listening for Positives................................................................................................................................................................................ 39 Managing Intense Emotions ................................................................................................................................................................... 40 Assessing Foundational Stability .......................................................................................................................................................... 41 Sample Client-Therapist Dialogue: Getting a History .................................................................................................................. 42 Chapter 4 Summary ................................................................................................................................................................................... 65 Chapter 5 Introducing DNMS Ego State Therapy to Clients .............................................................................. 67 The Main DNMS Ego State Therapy Concepts ............................................................................................................................... 67 Sample Client-Therapist Dialogue: Introducing Ego State Therapy ...................................................................................... 69 Chapter 5 Summary ................................................................................................................................................................................... 72 Chapter 6 Mobilizing Healing Circle Resources ................................................................................................... 75 Protocol Overview ....................................................................................................................................................................................... 75 Nurturing and Protective Adult Self Resources .............................................................................................................................. 76 Spiritual Core Self Resource ................................................................................................................................................................... 80 Ten Steps to Mobilizing Healing Circle Resources ........................................................................................................................ 82 Pairing the Resource Team with a Scent, Object, or Music ....................................................................................................... 87 Resourcing Complications and Processing Blocks ........................................................................................................................ 88 Sample Client-Therapist Dialogue: Mobilizing Healing Circle Resources ......................................................................... 103 Chapter 6 Summary ................................................................................................................................................................................. 113 Chapter 7 Mobilizing Provisional Resources ...................................................................................................... 115 Mobilizing Provisional Resources ....................................................................................................................................................... 115 Three-Star Rating Scale Caveat ........................................................................................................................................................... 118 Establishing a Provisional Resource Team ...................................................................................................................................... 118 Caveat About Naming Provisional Resources ............................................................................................................................... 120 Iffy Resources .............................................................................................................................................................................................. 120 Formal and Informal Ways to Mobilize Provisional Resources .............................................................................................. 120 How Provisional Resources Compare to Healing Circle Resources ..................................................................................... 121 Resourcing Complications and Processing Blocks ...................................................................................................................... 121 Sample Client-Therapist Dialogue for Mobilizing a Team of Provisional Resources ................................................... 125 Chapter 7 Summary ................................................................................................................................................................................. 130 Chapter 8 Establishing a Special Safe Place ........................................................................................................ 131 What Is a DNMS Special Safe Place? ................................................................................................................................................ 131 Establishing a Special Safe Place ........................................................................................................................................................ 131 Other People in the Special Safe Place ............................................................................................................................................ 133 Warning: Special Safe Place Is Not Exile .......................................................................................................................................... 133 How to Use the Special Safe Place to Manage Stress ............................................................................................................... 133 Sample Client-Therapist Dialogue: Establishing a Special Safe Place ................................................................................. 134 Chapter 8 Summary ................................................................................................................................................................................. 135 Chapter 9 Setting an Effective Therapy Goal ...................................................................................................... 137 Discovering the Importance of an Effective Therapy Goal ...................................................................................................... 137 Two Types of Therapy Goals ................................................................................................................................................................ 138 Checking for Objections to the Therapy Goal ............................................................................................................................... 138 Inviting Parts to Talk about Their Objections ................................................................................................................................ 139 Validating Wounded Parts’ Objections to the Goal ................................................................................................................... 139 Suggesting an Alternative Goal........................................................................................................................................................... 140 Checking for Objections to the New Goal ...................................................................................................................................... 141 Inviting Wounded Parts to Settle In .................................................................................................................................................. 141 Sample Client-Therapist Dialogue: Setting an Effective Global Therapy Goal ................................................................ 141 Sample Client-Therapist Dialogue: Setting an Effective Session Therapy Goal .............................................................. 143 Chapter 9 Summary ................................................................................................................................................................................. 145 Table of Contents v Chapter 10 Nurturing Interventions .................................................................................................................... 147 Status Categories of Wounded Parts ............................................................................................................................................... 147 Selecting a Target Issue ......................................................................................................................................................................... 147 Planning the Invitation............................................................................................................................................................................ 148 Connecting to Resources ....................................................................................................................................................................... 149 Inviting Wounded Parts to Approach the Resources ................................................................................................................ 149 Welcoming Parts and Starting a Dialogue ..................................................................................................................................... 150 Connecting Wounded Parts to the Resources ............................................................................................................................. 152 Getting the Story ....................................................................................................................................................................................... 152 Full Contextual Validation ..................................................................................................................................................................... 153 When Parts Refuse to Talk to Us ........................................................................................................................................................ 153 Working with Very Triggered Parts ................................................................................................................................................... 153 Working with Intrusive Parts ................................................................................................................................................................ 154 Strengthening Positives with ABS ...................................................................................................................................................... 155 Sample Client-Therapist Dialogue: Nurturing a Currently Triggered Part ........................................................................ 155 Sample Client-Therapist Dialogue: Nurturing a Recently Triggered Part ......................................................................... 159 Chapter 10 Summary ............................................................................................................................................................................... 163 Chapter 11 Providing Needed Information ........................................................................................................ 165 Ways to Provide Needed Information ............................................................................................................................................. 165 Metaphors to Explain the Processing ............................................................................................................................................... 169 Scripts and Metaphors to Validate and Empathize .................................................................................................................... 170 Scripts That Fill In Missing Information ........................................................................................................................................... 172 Scripts That Clear Up Misunderstandings ...................................................................................................................................... 174 Neural Networks, Ego States, and How We Make Interpretations ...................................................................................... 178 Chapter 11 Summary ............................................................................................................................................................................... 180 Chapter 12 Managing Enmeshment .................................................................................................................... 181 What is Enmeshment? ............................................................................................................................................................................ 181 Enmeshment Reversal Intervention ................................................................................................................................................... 181 Octopus Pictures Intervention ............................................................................................................................................................. 182 Other Helpful Interventions .................................................................................................................................................................. 183 Present-Day Enmeshments ................................................................................................................................................................... 183 Sample #1 Client-Therapist Dialogue: Managing Enmeshment ........................................................................................... 183 Sample #2 Client-Therapist Dialogue: Managing Enmeshment ........................................................................................... 184 Chapter 12 Summary ............................................................................................................................................................................... 185 Chapter 13 Orienting to Present Time ................................................................................................................. 187 Invitation to See Evidence of the Present ....................................................................................................................................... 187 Adult Body Intervention ......................................................................................................................................................................... 189 Filling in Lifespan Details ....................................................................................................................................................................... 190 Explaining Sharing Adult Body with the Resources .................................................................................................................... 191 When Parts Protest Orientation to the Present Time ................................................................................................................ 192 A Caution about Fictional Rescues .................................................................................................................................................... 192 A Caution about Retrievals ................................................................................................................................................................... 193 Sample #1 Client-Therapist Dialogue: Orienting to Present Time ....................................................................................... 193 Sample #2 Client-Therapist Dialogue: Orienting to Present Time ....................................................................................... 194 Chapter 13 Summary ............................................................................................................................................................................... 195 Chapter 14 Explaining about the Harmless Recording ..................................................................................... 197 Significance of Important Life Events Getting Recorded ......................................................................................................... 197 Types of Wounding Messages ............................................................................................................................................................ 198 Mental In-Box ............................................................................................................................................................................................. 198 vi Ego State Therapy Interventions to Prepare Attachment-Wounded Adults for EMDR Explaining about the Harmless Recording ..................................................................................................................................... 199 Metaphors to Explain about the Harmless Recording............................................................................................................... 199 Sample #1 Client-Therapist Dialogue: Explaining about the Harmless Recording ....................................................... 200 Sample #2 Client-Therapist Dialogue: Explaining about the Harmless Recording ....................................................... 201 Chapter 14 Summary ............................................................................................................................................................................... 203 Chapter 15 Wrapping Up a Session ..................................................................................................................... 205 Coming Out of Trance ............................................................................................................................................................................. 205 Checking for Changes in the Wounded Parts’ Reactivity ......................................................................................................... 206 Inviting Wounded Parts to Settle In .................................................................................................................................................. 206 Getting the Adult Self Front and Center Again ............................................................................................................................ 207 Checking In with the Adult Self ........................................................................................................................................................... 207 What to Expect Next ................................................................................................................................................................................ 208 Sample #1 Client-Therapist Dialogue: Wrapping Up a Session ............................................................................................ 208 Sample #2 Client-Therapist Dialogue: Wrapping Up a Session ............................................................................................ 209 Chapter 15 Summary ............................................................................................................................................................................... 210 Chapter 16 Controlling Reactive Parts ................................................................................................................ 211 What are Controlling Reactive Parts? ............................................................................................................................................... 211 Encountering Controlling Reactive Parts......................................................................................................................................... 212 Building Rapport with Radical Acceptance .................................................................................................................................... 212 Mimicking Reactive Parts ....................................................................................................................................................................... 215 Mimicking Reactive Parts versus Old Harmless Recordings ................................................................................................... 215 Caution About Persuading Controlling Parts to Change Jobs ............................................................................................... 216 Clarifying Common Terminology ....................................................................................................................................................... 216 Sample Client-Therapist Dialogue: Working with a Controlling Reactive Part ............................................................... 217 Sample Client-Therapist Dialogue: Working with a Mimicking Reactive Part ................................................................. 223 Chapter 16 Summary ............................................................................................................................................................................... 227 Chapter 17 Attunement ......................................................................................................................................... 229 Detecting Subtle Signals of Distress ................................................................................................................................................. 229 Following Up on Subtle Signals of Distress ................................................................................................................................... 229 Paranormal Signals ................................................................................................................................................................................... 230 Misattunement ........................................................................................................................................................................................... 231 Being Authentic, Animated, and Accepting ................................................................................................................................... 232 Getting Hidden Information by Asking the Body ........................................................................................................................ 232 Confusion Is Our Friend .......................................................................................................................................................................... 233 Holding a Mental Picture ....................................................................................................................................................................... 236 Window of Nurturing Attunement .................................................................................................................................................... 237 Attuned Grief Processing ....................................................................................................................................................................... 238 Keeping Track of Who We’re Talking To ......................................................................................................................................... 240 Challenges in Talking to Wounded Parts ........................................................................................................................................ 241 System-Wide Announcement .............................................................................................................................................................. 243 Talking to Parts Indirectly ...................................................................................................................................................................... 244 Chapter 17 Summary ............................................................................................................................................................................... 244 Chapter 18 Overcoming Processing Blocks ........................................................................................................ 245 Importance of an Effective Therapy Goal ........................................................................................................................................ 245 Detecting a Concern ................................................................................................................................................................................ 245 Eliciting a Concern .................................................................................................................................................................................... 246 Validating a Concern ............................................................................................................................................................................... 247 Handling Blocking Concerns ................................................................................................................................................................ 247 Resource-Related Concerns .................................................................................................................................................................. 249
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