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susanne-leutner PPT STATES

state and healing<br>and more

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susanne-leutner PPT STATES

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  1. Susanne Leutner
 EMDR & Ego-State Therapy: Networking whilst processing ? 2014 EMDR Europe Conference Edinburgh ? ? www.susanne-leutner.de? www.emdria.de? www.est-a.de 1

  2. 1. Ideas behind EMDR and EST 2. Resources in EMDR and EST 3. How to integrate Ego-States into the EMDR process ? 4. What to do when an Ego-State emerges shortly before closure

  3. EMDR: AIP Model Shapiro •unresolved disturbances: •affect inner balance •produce symptoms •are stored in body, physiology, affects and thoughts •have to be detected and processed •balance is re-established •stabilizing before processing Dipl.-Psych. Leutner/Cronauer 8

  4. NK: I am helpless working memory: e.g. trigger 1 2 ! episodiepisodic memeory: it is 2014 now 3 pain comfort inner peace PK: I can do something today Dipl.-Psych. Leutner/Cronauer 7

  5. Ego-State-Theorie (EST) Watkins an organized system of behavior and experience whose elements are bound together by some common principle, and which is separated from other such states by a boundary that is more or less permeable ? • development • trauma • introjection ? possible”covert”, „hidden“ or „silent“ ego-states, somatic or sensory motor ego-states Dipl.-Psych. Leutner/Cronauer 9

  6. EST Relationship four levels: • therapist and greater personality • therapist and inner parts of the client • client and her inner parts • between inner parts ? • inner parts of therapist are also important Dipl.-Psych. Leutner/Cronauer 10

  7. Goals of Therapy EST EMDR • associating the experience stored in dissociated parts ? • access to missing information by contacting ego-states ? ? • promoting integration by imagination and body awareness (trance) ? • resources, mindfulness, self- healing, self-regulation, every part has come to help • associate fragmented memories (disturbing working memory) ? • access to missing information (episodic memory) ? ? • inner images and body sensation are the foundation of healing ? • promoting mindfulness by trusting the process of self healing Dipl.-Psych. Leutner/Cronauer 13

  8. 1. Ideas behind EMDR and EST 2. Resources in EMDR and EST 3. How to integrate Ego-States into the EMDR process ? 4. What to do when an Ego-State emerges shortly before closure

  9. EMDR Resources and Relationship ? Leeds •self-healing of client, therapist as the “midwife” ? •assess client’s attachment style, ego-strength, affect tolerance, ability of self-regulation ? •therapeutic alliance, do not rely on the method/ technique alone Dipl.-Psych. Leutner/Cronauer 8

  10. EST Resources and Relationship are essential for processing (Phillips and Frederick) • find resourceful ego-states • use archetypes and strengths of “core self” • inner healer, inner shaman • inner wisdom • wise woman/man (from the future) etc sensations and experience from the conflict free zone of the ego • Dipl.-Psych. Leutner/Cronauer 11

  11. fear I am helpless knowledge of greater personality pain comfort I can do something today 14 Dipl.-Psych. Leutner/Cronauer

  12. Relationship and Safety significance of resources and self healing only when physiologically calm • change is possible • disturbing material of fight, flight, freeze and submission can be integrated

  13. ProcessingModel
 S.Leutner in Chr.Rost (Hrsg): Ressourcenarbeit mit EMDR techniques of titration and distancing help reduce the weight of traumatic memories activation of resources helps to heighten the weight of resourceful memories traumatic memories xxxxxxxx resourceful memories Intervention Ego-St.-Th. pendulation resource activation processing techniques for traumatic situations EMDR absorption technique CIPOS standard protocol 20 Dipl.-Psych. Leutner/Cronauer

  14. 1. Ideas behind EMDR and EST 2. Resources in EMDR and EST 3. How to integrate Ego-States into the EMDR process ? 4. What to do when an Ego-State emerges shortly before closure

  15. Possible Procedures •activate resources by doing EST, then EMDR •in case of looping or a blockade in EMDR do EST, then go back to EMDR •doing EST first - when a touchstone event becomes clear, do EMDR Dipl.-Psych. Leutner/Cronauer

  16. EMDR + EST more safety • protect ego-states who do not want to or cannot be present while processing ? • interweave: activate ego-states who represent a new aspect, blockages can be dissolved quickly and easily ? • connect with comforting and strengthening ego-states when finishing incomplete sessions Dipl.-Psych. Leutner/Cronauer 30

  17. EMDR + EST ? • a well remembered resourceful situation • helps find a resourceful ego-state • who becomes a helper for processing ? Fractioned processing • client’s attention is focused on resourceful ego-state • then (shortly) to disturbed ego-state • and back to resourceful ego-state ? = CARES: constant activation of resourceful ego-states and safety ? ? cf. orientation to feeling safe in the present in J.Knipe’s CIPOS protocol Dipl.-Psych. Leutner/Cronauer 29

  18. EMDR + EST • finding the touchstone event by working with ego- states (time regression, affect bridge, finger signals) • finding out which inner part may be responsible for certain symptoms • finding out which part may be blocking or obstructing the goals of a person Dipl.-Psych. Leutner/Cronauer 32

  19. case example

  20. EST + EMDR when using EMDR with ego-states •do not let yourself be seduced into trying to have single ego-states process memories just by themselves •it will not work, because with EMDR fragmented memories will be associated •and access to information is facilitated •meaning: separated ego-states will be linked •this joining of ego-states needs to be well prepared Dipl.-Psych. Leutner/Cronauer 27

  21. 1. Ideas behind EMDR and EST 2. Resources in EMDR and EST 3. How to integrate Ego-States into the EMDR process ? 4. What to do when an Ego-State emerges shortly before closure

  22. EMDR an ego-state emerges while processing: similar to affect bridge ? standard intervention in EMDR: accept this “detour” store away the material − − Dipl.-Psych. Leutner/Cronauer 34

  23. EMDR + EST an ego-state emerges while processing: ? • take him/her to a safe or calm place • or: find a special intervention for this ego-state who is he or she? − what does he or she need? − (how) can processing be continued? − criteria: time during session, safety, relationship, resources, regulation of distress Dipl.-Psych. Leutner/Cronauer 35

  24. ? ? ? ? ? ? ? ? ? ? www.susanne-leutner.de ?

  25. EMDR standard protocol - integration of Ego-States Leutner/Cronauer Phases 1 and 2: during history taking and preparation you look for and access ego-states who are crucial to the presenting problem, using various methods and techniques from EST ? Phase 3: it is sometimes easier to find touchstone events and targets when knowing the connected ego-states different ego-states may represent the positive and the negative cognitions emotions can be expressions of (different) ego-states sensations can be expressions of (different) ego-states ? Phase 4 watch the client closely to find out which ego-state may be active. Most of the time you will not have to interfere. If processing is blocked, it can be helpful to - focus closely on a special ego-state who has shown herself/himself - take one or more ego-states to a safe or calm place - activate resourceful ego-states and ask them to help ? Phase 5 an incomplete session can be finished more easily when in touch with a resourceful ego-state sometimes the validity of cognition and the installation are experienced as an integrative process between ego- states ? Phase 6 an unfinished issue of an ego-state can show itself during body scan, as well as an ego-state who has not yet been sufficiently looked after ? Phases 7 and 8 further self awareness of the client may lead to hitherto unknown ego-states 25

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