Monday, November 3, 2014

Alternative Resourcing: Thinking Outside the EMDR Protocol Box

For years I have used Eye Movement Desensitizationand Reprocessing (EMDR) as a major weapon in my battle against complex trauma. My therapist, a well-rounded social worker who understands the importance of a client-centered approach, was trained in EMDR nearly six years ago and I was fortunate enough to be offered this treatment right after her training. In the years to come we have both learned a lot from the processing I have done.

Before I get into the meat of it, let me take a minute to define some basic EMDR terms. Bilateral stimulation: outside stimulation that causes both sides of the brain to engage, which may include: following a finger or light source back and forth with your eyes, hearing binaural tones through headphones, plastic eggs that are held in the hands and alternate pulsations, and alternating left and right tapping on the upper arms, hands, or knees. Processing: use of bilateral stimulation with the goal of changing a target (image/memory) from a negative experience with a negative belief (i.e.- memory of abuse with the belief "I am a horrible person") to a neutral/less horrible experience with a neutral or positive belief (i.e.- memory of abuse now with the belief "It wasn't my fault"). Resourcing: use of shorter sets of bilateral stimulation with the goal of installing positive attributes via memory or image, positive emotions, and positive belief (i.e. the memory of being held as a child, feeling calm/safe, and the belief "I am safe and cared for"). Tapping in: tapping oneself on the arms, legs, knees, alternating left and right. Normally only a short series (3-6 sets) of taps to reinforce a resource. Keeping it short is key so that you don't end up processing. Personally, I recommend practicing tapping in to yourself with your clinician so that you get the feel for how short the taps should be and you learn your body's response to this technique.

One of the things my therapist and I found out right away is that I am very sensitive to processing and need some resourcing after processing in order to ensure that I am back to a better mindset after processing. Even when I felt good after processing, I found that without resourcing I would go home and experience dreams and flashbacks days after the session. Another thing I found is that sometimes just resourcing was enough to get me through the trauma responses I was having. A lot of my needs surrounded feeling uncertain, vulnerable, and unsafe; something most trauma survivors can relate to. With resourcing I was able to reinforce the confidence and competence I had already in me. At any given time I was able to think of the images I resourced and feel better, often tapping in the feeling to deepen the connection.

Lately I have started in on a trauma that has literally haunted me for years. Nightmares, flashbacks, and panic attacks plagued me on and off along with feelings of shame, guilt, embarrassment, and hopelessness.  My recent increase in these trauma symptoms has not surprised me as I know some of the deep emotional and spiritual work I have been doing in and out of therapy the last year has lead me to a place where I am ready to begin to work through this trauma. When I began the prep work with my therapist we both knew that this was not going to be like any other trauma I have processed. This trauma in itself was complex, held many core issues for me, and was going to take time to work through. As we talked about what I needed and what ground work needed to be done, it became obvious that I was going to need some new resources.

Ever the diligent client, I went and reached out to others who have experienced similar issues. Most reported that they needed a lot of varied resources in order to feel confident enough to start their processing, but I knew just adding traditional resources was not going to be enough. I went back and reread Dr. Jamie Marich's book EMDR Made Simple, after having a long discussion with Jamie about my situation. In addition to helping me map out a plan for processing secondary gains prior to trauma processing (which I will share in another post), Jamie also lead me to the idea of what I like to call alternative resourcing.

I use the term "alternative" not because I think of this as a new-agey, out-there type of resourcing, but because it provides a viable alternative to what many EMDR practitioners consider the holy grail of resources: the Safe Space. Not to say that the safe space isn't a valid option, it just is not the only option. Having a place, either real or imagined, that you can bring up in your mind that feels safe is GREAT. However, what if safety isn't what you really need? What if you need confidence, a feeling of happiness, joy, or competence? There are more traditional resourcing strategies for these emotions; you can use imagery or memories that create these feelings and resource those. Alternative resourcing goes a little further- it uses more than just images to access the emotional state you want to build a stronger connection to.

The basic idea behind alternative resourcing is to use other senses to either enhance a resourced image or in place of an image. Before I delve too far in, let me first explain that the approach my therapist and I use for resourcing is slightly different than "traditional" methods. Instead of setting up the image, where I feel it in my body, the emotions behind it and then attempting to hold it all together, my therapist just lets me talk. I describe the image, often closing my eyes, talking about how it made me feel and my therapist alternately taps on my left and right knees at intervals she sees as pertinent based on my affect. She may ask questions to clarify or encourage me to go deeper, but overall I lead the resourcing, which seems to add a lot of meaning and makes it easier for me to connect my memories/images with my emotions.  This confirms a feeling I have had for a long time- the protocols set forth by Dr. Shapiro and EMDRIA are wonderful, but a good therapist who knows her client will be able to tweak EMDR in order to meet the client where they are at and to obtain the maximum benefit.

The first thing my therapist and I attempted to alternatively resource was a lotion that I use to help me sleep and that carries happy memories. I alternated between taking deep breaths and describing the feelings that came with the scent. Before the bilateral stimulation I was already feeling deeply calm and relaxed. Adding the tapping lead me to a much deeper place where suddenly I was able to leave the nagging fears and thoughts behind and just enjoy the scent and my experience. After several series of taps, I was able to smell the lotion and bring up the feeling without trying. I could already feel the power behind this alternative resource. Since the first time resourcing this, I have started every resource session re-tapping in the lotion scent and the calm it brings. It helps me relax and fully engage with any other resourcing I may be doing.

The second thing I resourced was a small, furry kitty-shaped tape measure. It's an orange tabby, resembling my cat, Bodhi, who has been with me for the past 7 years. As I closed my eyes and focused on rubbing/petting the mini-Bodhi I felt compelled to talk about getting my cat and the joy he brings me. I talked about how he always seems to know when I'm upset and how petting him brings me a feeling of peace, calm, and safety. As I talked, I petted the kitty tape measure, and my therapist did the alternate knee tapping. Again, I found myself transported into a deep sense of security and calm, much stronger than any image I had resourced previously.

With both the lotion and mini-Bodhi, I found that I was combining sensation, emotion, memory/image, and body reactions without having to be prompted. They were natural combinations and I think that is what made the resourcing so successful. In the days to come I found that I was able to transfer the calm/serene/safe feelings from the targets (lotion/mini-Bodhi) to a broader range of items. I get an immediate sense of deep calm when smelling anything similar to the lotion I initially used (though the closer to the scent, the deeper the connection it seems). Also, when I pet the real Bodhi, I find myself right back to the happy and calm place I was in on my therapist's couch. I continue to tap in every time I activate these alternative resources and the results have been amazing.

The after-effects of nightmares no longer plague me as I am now able to use resources that not only comfort but help me to stay grounded and in the moment. Panic attacks and emotional flashbacks are easier to navigate and the daily living issues I have had are dulled now that I have these defenses in place. 

I still use other images I have resourced in addition to the lotion and mini-Bodhi, sometimes I combine them in order to relax even further. This has been a major blessing, as current events in my life have prevented me from being able to process trauma, but the resourcing I'm doing is helping me to maintain and live without letting PTSD symptoms control my life.  It is amazing to me what happens when clinicians are willing to allow their clients to mold therapeutic modalities to fit what they need.