There seems to be growing evidence of ‘schools’ of therapy becoming more harmonious. Is the human, if unprofessional search to be ‘top-dog’ lessening? Through reaching out, ‘schools’ of therapy may yet see the larger picture telling us more about the client-and-therapist communication. This page provides an example of this in action, even if you will see how ‘schools’ still retain loyalty. This may be a well regarded quality, but one less helpful to clients making and maintaining change in their lives.
A colleague of mine, on reading my page on Eye Movement Desensitisation and Reprocessing EMDR), prompted me to consider the marriage between traditional attachment therapies and traditional EMDR. He has termed his perspective:
Integrative, Attachment-Informed EMDR (AI-EMDR)
Mark Brayne undertakes work committed to research and practice. His approach, summarised here, seeks to integrate several approaches to therapy. This can provide clients with well-informed treatment, supported by current knowledge. His own Manual relating to this topic gives acknowledgement to key personnel such as:
Francine Shapiro, Laurel Parnell, Jim Knipe, Jamie Marich, Janina Fisher, Bessel van der Kolk and the Internal Family Systems model (IFS), as well as Stephen Porges and his Polyvagal Theory. Some are familiar names as you look through this website. These acknowledgements, on their own, are refreshing to see in light of other criticisms I have made! Mark’s work goes out of its way to respect the original EMDR model to which he is visibly committed.
Kemal Kaptan, S., & Brayne, M. (2021). A qualitative study on clinicians’ perceptions of Attachment- Focused eye movement desensitisation and reprocessing therapy.
Counselling and Psychotherapy Research, 00, 1–12.
and you can access it on: https://doi.org/10.1002/capr.12479
As Mark’s approach is protocol-driven (manualised, in effect), the rationale for those protocols may not be obvious. You would need to work with a practitioner trained in this approach to gain some deeper insight. Mark’s approach is structure around six principles, and you would need knowledge and exposure to each one to use his model.
That said, there are parallels between AI-EMDR and other more empirical, or practical, methods of stimulating change in your life. Let’s explore some of them.
Implications for small, safe experiments?
Some of the safe experiments found on this website can be seen in the AI-EMDR approach. These include versions of the Safe Place, Case Conceptualisation, ‘Parts’ work, Socratic questioning and the rewriting of our Script (or narrative, as it is named these days) all explicitly mentioned in Mark’s manual. The importance of preparing ourselves – to make change – remains central to AI-EMDR. I particularly liked the attention given in Mark’s manual to creating curiosity. Neuro-Linguistic Programming (NLP) gets a look-in with its interest in the use of visualisation – more specifically its Cinema Technique or, in Mark’s words, the Video Interweave (an interweave, here, is any intervention you can use to help move things on, e.g. to get out of any ‘looping’ phenomenon). Looping is behaviour that repeats the same old …. and generates feelings of frustration when nothing appears to be changing after all.
I am going to give a further mention to case conceptualisation as a way to understand how I get to be the way I am. The Road Map and Ecogram safe experiments help complete an orderly understanding of who I am, and how I got to be where I am today. Also, the vertical axis on the Road Map enables me to record the changing ‘temperature’ of my emotional experiences from my early years. All this work may provide an insight into the way I managed ‘ups and downs’ in my formative years.
Of equal importance, is the use of the Road Map to think ahead, just a little. I am aware that EMDR, in general, pays attention to Past – Present – Future in order to integrate the past with what is to come. In this respect, it makes explicit use, in its own way, of the ‘inverted tree’. Furthermore, AI-EMDR sets out to work with Ego States where they block change. This ‘nod’ to Transactional Analysis (TA) is connected to the view of The Adult in the Executive, that is, in charge of events, when making change now.
New lines of experimentation
Now I will mention a few new directions for experimental design that emerge from Mark’s work; possibilities not be mentioned elsewhere on this website.
This is a useful notion and one in keeping for a model that does, indeed, ‘bridge’ between the stages of change. Two specific techniques in EMDR worth research into ‘bridges’ are the Floatback and the Affect Bridge. Both are central to standard EMDR but with their therapeutic origins predating Francine Shapiro’s work.
“Bridging” was developed by Laurel Parnell in 2007 as part of the EMDR process of ‘target identification’. In practice, you can use the notion of ‘bridging’ to manage your own scenic route (it’s one way to get around those rocks on the road!). You will meet a number of junctions on your own road to change. How do you decide which road to follow especially where there is no sign-post immediately in front of you. A small, safe experiment might enable you to take a look up more than one road. After all, it’s no big deal to step back and take a look up the alternative road if you’ve gone just a short distance.
Also, I recommend you to value the random selection of possibilities; after all, curiosity may be enhanced if you take some time to examine more than one option. Just as ‘bridges’ move clients between one stage of the EMDR protocol to another, so you may need to know when you are ready to move on, or when a small, safe experiment may need re-designing. Keeping a record of events will help here. As stated, outcomes need to be recorded to minimise ‘looping’, or getting stuck. Even so, this can be a problem; most models of change identify that we may need to go around in circles to get somewhere, e.g. when we need to take some time to reflect on events. Careful preparation may minimise time spent going round in circles, but that does not mean it’s a ‘bad thing’ to do so for a little while! Notice how the presentation of Prochaska and di Clemente’s model includes circular pathways in the illustration.
Top-Down and Bottom-Up, as well as Side-to-Side
AI-EMDR gives attention to the neuroscience behind the change process. For example, Mark mentions “what might be termed right-brain intuition rather than left-brain analytical or remembered assumptions where and how the client learned their limbic-system survival patterns very much earlier in life“. This is a prompt to keep in mind the workings of our autonomic nervous system (ANS), and our often under-estimated ability to alter the way it works. AI-EMDR gives close attention to the impact of Flight-Fight and the more modern material on offer from Stephen Porges and others.
Image, Emotion, Body and Belief
Here is another integration that Mark attributes to Laurel Parnell. He reminds me that her simplifying of EMDR protocols, particularly the Phase 3 Standard Protocol, can improve our grasp of the EMDR approach. All four lines of enquiry can be used to foster small, safe experiments. In older models, there was a tendency to be focused on one element of change, e.g. our thoughts, our beliefs or our feelings, or our sensations. Nowadays, the need for ‘or’ has been supplanted by encouragement to integrate. I take this to be ‘integration’ in the way Dan Siegel uses the term in his working definition of the Mind.
Don’t interpret, inquire
I liked this phrase used by Mark. Although he was aiming it at therapists, it is a point you can keep in mind when viewing the outcomes of your own small, safe experiment. The aim of learning from the experience is to stay curious and to inquire further; to take further steps. Interpretation involves a judgment and this assumes I’ve enough options at my finger-tips to permit me to make that judgment. Traditional models permit interpretation by trained therapists but there is a danger that the unequal power existing between client and therapist fosters an unquestioning acceptance of any interpretation. Be wary of interpretation. As I say in my website – that include things I say! It’s surprising how easy it is to fall into this trap; even EMDR has a tendency to interpret what is, or is not, the reason the client is now in therapy. Please keep questioning the conclusions you reach – as well as those of any therapists you meet.
Mark’s third and fourth stages use visualisation to promote change. This way of working is drawn from the a number of older traditions, in particular, clinical hypnotherapy. I hope that the mystique around hypnotherapy is fading these day. There is a lot of visualisation material on the Internet but a trained person may give you confidence to discriminate visualisations that will work for you. Trained personnel can offer a greater range of possibilities and they should have additional training to ensure your safety when doing visualisation work. In particular, be aware that debriefing from some visualisations is important, if you are to get the full value from the exercise. For instance, it’s easy to rush things; to want to get the job done only to miss an important experience.
Keep It Simple
.. is another phrase Mark uses. This phrase recurs a lot of the field of personal development and organisational psychology. It’s worth keeping in mind. Only recently, I was working with someone and I was very taken by the practical and concrete things she described to demonstrate the changes she had made. It is very easy to use complex language when faced with complex theories. On a day-to-day basis, however, it is is the small and very visible step that provides the best evidence.
…. and kindness to self and others
I doubt there are few people today who will see technique as the necessary and sufficient approach to use in therapy. My website contains many ‘techniques’ but I think it is clear that any strategy or technique is only as good as it works for you. In the end, do any small, safe experiment that help you improve self-respect and self-confidence. Even the most avowed behaviourist is willing, in the twenty-first century, to accept that relationship, rather than technique, sits at the heart of effective therapy. This may mean more than providing a safe place, or a supportive, kind and warm manner. It can involve offering genuine respect through direct speaking.
There is a whole argument around about Carl Rogers’ core conditions. I suggest they are necessary, but not sufficient. Research over the years has consistently confirmed that ultimately it is the relationship that heals. That said, this assumes a client and therapist have the capacity and inclination to participate in that relationship and to collaborate in the work.
Transfer of Perspective (ToP)
Although this phrase sounds like jargon, it offers you a straightforward aim. It invites you to shift your perspective; your point of view. Paying attention to ‘Parts’ therapy, AI-EMDR identifies that we all possess different parts. Some are less integrated with others and you can take this into account when working on your own Internal Dialogue.
Psychodrama has a lot to offer if our point of view is to shift. Gestalt, with particular reference to its Empty Chair technique, is relevant here as well. Can you remain open to a change of perspective, especially if it relates to an idea or belief that you cherish? In my business, attitudes and beliefs are said to be the more difficult things to change. The safe experiment of ‘Standing Back’ , at the very bottom of the page, may help here.
More on ‘Parts’ work
Mark draws particular attention to ‘parts work’ described by the EMDR specialist, Dr Laurel Parnell. Her three ‘parts’ are described as the Nurturing, the Protector and the Wise figure. He points out that notions of ‘parts’ can confuse when different models are compared. He emphasises that Parnell’s parts are not the ‘parts’ that emerge in childhood as a survival response unprocessed experience.
Tricky thing, language, but notice how terms used by therapists might not impact on you and your own small, safe experiments. Your outcomes do not have to fit into categories defined by me, or other folk in my line of business! As long as there is something to build on, or something different to notice, then enough is enough.
The Karpman Triangle has a different perspective to offer here as do many schools – attachment and body psychotherapies, Internal Family Systems, TA, and John Omaha, amongst others. Note the close connection of the ‘parts’ perspective to clinical hypnosis, as well as NLP. In particular, the Wise figure has been important from the dawn of time (legends are full of them) and it figures a lot in much visualisation work.
You can create your own Wise figure and seek to consult it at any time. That’s a safe experiment. All that said, I would highlight Mark’s Health Warning. Visualisation work is but a step on the scenic route. Our visualised figures can be aids to integration. In effect, internal objects can provide the temporary anchor so we can access the security that was not activated during our childhood.
Use of metaphor
I have commented on the helpfulness of metaphors and stories a few times. As some readers know, I value the poem that John Roedel offers and there is so much more you can seek out. It’s a bottomless pit, but I have offered some practical metaphors to explore including a discussion around lions! Furthermore, there is the whole area of expressive arts that you might like to explore further.
Do I have reservations about AI-EMDR? Yes: similar concerns that I have about other approaches to therapy. I have reservations about any model that seeks to ‘instruct’ the therapist and client about the ‘right’ way to work. True, Mark places emphasis on active collaboration of the client, but EMDR model is still his first port of call; a model that complicates the picture with ‘protocols’. This adds to the ‘mystery’ behind therapy rather than dissolving it.
There is a potential for disempowerment of the client – doubtless unintended. I get troubled when some-one attends a free initial consultation saying that so-and-so has told them “I need EMDR“. This message is not good for the reputation of EMDR, and it is likely to misdirect my own, and any client’s, attention to the important process of collaborative negotiation.
To find out where we stand, means that a ‘client’ needs to know where I stand, as much as I need to know where they stand (as compared to that person standing behind them).
True, Mark sets himself the aim “to identify and repair early attachment ruptures ….supporting the client’s …… capacity to rework and rewire their implicit response circuits to stress“. He invokes the metaphor of a ‘dance’ to give a picture of how this aim is achieved. Even so, I would want to know which ‘dance’ is being done, and who is leading! One model may offer a waltz and another, a flamenc
Finally, I will mention that there are limitations in any ‘stage’ models of therapy. They give the impression that there is a way in which things should be done. They can even infer there is an order in which things are ‘best’ done even if a manual may say this need not be so.
Mark’s AI-EMDR model does address these integrating features to some degree. He has a respect for ‘systems’ thinking. Even so I conclude that EMDR, in general, is not so attentive to its own limitations here. What we say we do, is not the same as what we actually do!
Look at ‘PART TWO: AN EXPERIMENT’ at the bottom of this page for more on this phenomenon.