EMDR BASIC TRAINING MODULE 2 – TRAUMACLINIC INTERNATIONAL

EMDR
Eye Movement Desensitization
and Reprocessing

Module 2

©TraumaClinic International

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Program Content
• Review
• Three-Pronged Protocol
• EMDR Psychotherapy Theory: Hypoactivation and Hyperactivation
• Approach and Distancing Strategies
• Blocked Processing
• Cognitive Interweave
• Blocking and Limiting Beliefs, and Feeder Memories
• Special Protocols: Phobia, Recent Events, RDI, and Pillars of Life
• Supervised Practicum Session
• Case Consultation for Participants

Reminders
• The Certificate of Completion is granted to those who complete all of the course
assignments, including the 50 client sessions.
• Be punctual.
• Place your name on the Zoom picture and keep the camera on.
• Turn off cell phones and background applications.
• Recording is forbidden.

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Review
Knowledge Pre-test.
Review Exercise: Questions. Discuss in the group.

The Eight Phases of the EMDR Protocol

1. Clinical History and Treatment Planning
2. Preparation and Stabilization
- - - - - - - Check your watch - - - - - - -
3. Assessment
4. Desensitization
5. Installation
6. Body Scan
7. Closure
- - - - - - - - Next session- - - - - - - -
8. Reevaluation

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Reevaluation

Next session - Phase 8: Reevaluation

Review events since the last treatment session. Are there any changes?
• Targets/triggers
• Images
• Cognitions
• Emotions
• Sensations
• Actions/Behavior
• Health Issues
• Interpersonal Relationships

Treatment Plan
❑ Organize the targets chronologically within the timeline - 'history of traumas,' from the
oldest to the most recent.
❑ The 10 Positive Memories and the 10 Negative Memories
❑ Identification of the Issue(s) to be addressed (Sherlock Holmes’ magnifying glass, puzzle
pieces) and their targets.
❑ Grouping targets according to the same theme – Memory clusters: (Example: mother
and those targets; School/Professional life and its targets)
❑ Implement the Three-Pronged Protocol: Where do we begin?
❑ Identify the Touchstone Event and additional memories (Direct Questioning, Floating
Back, and Affect Scanning)

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Three-Pronged Protocol
Objective: Identify, focus, and reprocess:
1. The early memories that caused the issue
2. Current experiences that trigger the disturbance and
3. Skills and behaviors required for future adaptive functioning, as well as for incorporating
positive models of future actions. (SHAPIRO, 2020 p. 16)

Past Event: First Prong of the Three-Pronged Protocol

Objective:
• Identify early memories that cause emotional disturbance, avoidance, or activate
maladaptive behaviors.
• Exploring the past events that cause and sustain the disturbance in the present.
o Direct Questioning.
o Floatback and
o Affect Scan.
• Searching for additional past events until the Touchstone Event is identified.

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Present-day Triggers: Second Prong of the Three-Pronged Protocol

Objective:
• Identify current situations that still trigger emotional disturbance, avoidance, or activate
maladaptive behaviors.

Triggers
• Daily events can generate maladaptive responses that require reprocessing.
• Once the previous events, which are the foundation for the current disturbance, have
been reprocessed, most triggers will become inactive.
• Some triggers may still be active because the stimulus in the present is disturbing due to
conditioning.

• Access the current/recent situation that acted as a trigger allows the psychotherapist to
assess whether it is still distressing:
Think about this experience ......... and observe what comes up for you now.
• The goal is to check whether there have been any changes and whether the level of
distress has decreased or not.
• If there is still distress, the experience should be reprocessed until an adaptive
resolution is reached (SUDS=0, VoC=7, Body Scan = no somatic disturbance).

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Future: Third Prong of the Three-Pronged Protocol

Objective:
• Enhance the patient's ability to respond adaptively and flexibly to future situations
related to their current difficulties.
• Develop and strengthen specific skills, behaviors, and emotional responses.
• Address anticipatory anxiety (if present).
• Prepare the client for challenging situations.
• Uncover and reprocess hidden fears, blocking beliefs, inadequate responses, and
unprocessed associations.

Procedures for Implementing the Future Template

Important: Future Template is applied to each trigger.
We have already worked on past experiences and current situations related to your difficulty.
Now, let's work on how you will respond the next time you need to face similar
situations.

STEP 1: Think or imagine a future situation in which you will face this. What would it be like?
[Pause]
Do the words (repeat the PC from the current trigger) ................... Still fit?
(If not, identify the desired PC). PC: ............................................................

STEP 2: When you think about this future situation and the positive belief (repeat the
PC)..............., imagine a video of yourself dealing with it. [Pause]
What do you notice?

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If the patient's response is POSITIVE: use the video as a target and strengthen it with rapid BLS
(one or two sets) along with the Positive Belief (PC) until the VoC reaches 7 (or
adaptive).

If the patient's response is NEGATIVE: Identify the difficulties, negative beliefs, disturbing
emotions, or sensations, and develop the desired response. Use the video as a target
and reprocess until it becomes positive.
► It may be necessary to reprocess blocking or limiting beliefs and/or feeder memories
that arise. In this case, return to Phase 4, 5, and 6 and reprocess.

STEP 3: CHALLENGING SITUATION.

Looking at that same video, imagine a challenge you might face in that situation. What would it
be like? [Pause] Let's go with that: Use the bilateral movements (BLS).

► Offer examples of difficulties if the client cannot imagine them.

► Reprocess along with the PC until the VoC is 7 (or adaptive 6) for each situation.

Resume the treatment plan.

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Window of Tolerance
• This is a model for better understanding our clients, and to find a way to tailor our
• interventions to their needs.
• It can be stated that the client will respond to EMDR reprocessing:
• According to their personal style.
• In accordance with their ability to tolerate intense emotions.
• Depending on the specific memory they are reprocessing at the moment.

Hyperactivation:
• Remember that a hypo-activated person can become hyperactivated because the
extremes touch each other.
• Strategies for dealing with Hyperactivation:
• Begin reprocessing with just a few BLS (for example, just one pair of eye movements);
work very slowly.
• If the patient's emotional reaction is unknown, ask for the SUDS more frequently
between sets of movements.
• Continue with a few, slow BLS until the patient can handle more.
• Evaluate with the patient if the speed of movement is appropriate.
• Sometimes, patients forget to use the stop signal. It's worth reminding them that this
option exists, even during reprocessing.

Strategies for dealing with Hyperactivation:

To continue empowering the patient and evaluate the progress of the work, ask from time to
time: "Is it okay to continue?"

To encourage the patient to proceed, avoid using negative terms such as: "Do you want to
stop?"

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You can also use the ICES:

I (image): Remind the patient of the metaphor to create distance, such as watching the scene
as if it were a landscape observed from inside a bus or on a TV screen; the trauma
picture in black and white or even the perpetrator as a statue.

C (cognition): Change words, conversations, or even mute them so that they produce less
emotion.

E (emotion): Ask the patient to focus on only one emotion to manage it better; or focus on an
emotion that produces less activation; or ask for the SUDS to determine the intensity of
each of the various emotions.

S (sensation): Ask the patient to focus on only one sensation to better deal with it; ask them to
place their hand on the sensation to contain it during reprocessing; use a SUDS to
determine the intensity of each of the various sensations.

Strategies for dealing with Hypoactivation.

Some suggestions for working with people who appear to require additional stimulation:

• Increase the speed and duration of the series of BLS

• Check the Subjective Units of Distress Scale (SUDS) more frequently to understand the
client's emotional state and assess the need to increase activation.
• Evaluate with the patient if the stimulus speed is adequate.

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These patients may also have the following fears:

• Going crazy
• Losing good memories
• Changes
• Losing the respect of the psychotherapist
• Losing their grip on the present

It can be especially helpful with these individuals to occasionally reiterate the value of the STOP
signal, even during BLS, to remind them that they can stop the process at any moment.

For the same reason, ask the client, 'Can we continue?'

If necessary, the client can specify which modality produces greater activation.

The ICES can be used:

I (Image): a close-up color photo or image of the perpetrator in action, etc.

C (Cognition): words that evoke more intense emotions.

E (Emotion): intensify the description of the target to create a stronger connection with the
emotion.

S (Sensation): identify physical sensations that increase the Subjective Units of Distress Scale
(SUDS); focus on one sensation at a time; ask the client to notice weight, texture, color,
temperature, and other aspects of a sensation that enhances awareness. The client can
place their hand on the body part where they perceive the sensation to heighten
awareness.

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Exercise: Vignettes of strategies for dealing with emotional hyper and hypoactivation, with
either approximation or distancing.

1. A 16-year-old girl who experienced a robbery, during EMDR reprocessing, says, "I'm going
crazy." "I can't handle this."

• Is this hyper or hypo-activation?

What are the strategies you can use?

2. A race car driver experiences a serious accident during a competition. As the client begins
EMDR reprocessing, the client says, "It feels like I don't feel anything when I think about it,
but during practice, I can't get into the car."

Is this hyper or hypoactivation?

What are the strategies you can use?

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3. A young adult male who suffered abuse from parents during childhood comments during
reprocessing that he can't control the trembling of his body, says he is "terrified," and "can't
handle it."

Is this hyper or hypoactivation?

What are the strategies you can use?

4. A client who experienced a brief kidnapping starts crying, says there are too many
memories surfacing, can't take it anymore, and then raises their hand.

Is this hyper or hypoactivation?

What are the strategies you can use?

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Blocked Processing

Often, reprocessing flows smoothly, with little or no intervention from the psychotherapist. The
channels of association are accessed, and memories are reprocessed spontaneously.

At other times, processing stalls and requires intervention from the therapist to facilitate access
to the memory network.

Strategies:

Mechanics:

1. Change the direction or modality of the BLS.

2. Change the speed of the BLS.

ICES (Image, Cognition, Emotion, Sensation):

1. Shift the focus of the experience from one component to another (e.g., from an image
to cognition).

2. Change the nature of a specific component of the experience (e.g., from color to black
and white; from action to still image).

3. Return to the Target. Investigate blocking beliefs: Limiting or Feeder

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Cognitive Interweave

• It is used when the spontaneous process proves insufficient to provide a realistic and
updated perspective of the Self.
• Before using it, it should be assessed whether other EMDR therapy strategies have been
implemented.
• We attempt to replicate the spontaneous processing by deliberately adding the next
piece of information that would likely emerge to link elements of past memory to the
adaptive memory network.
• Another function of the cognitive interweave is to provide information that can
strengthen the positive connections the client has already made, optimizing the effects
of generalization or making such information more relevant to the current topic.

The term "cognitive interweave" refers to the therapist's use of the phrase or question, but the
client can also be asked to evoke an image, thought, or movement.

For example: What would you say, think, or do if this were to happen today?

When to use Cognitive Interweaves?

• When the patient is in a looping - circular and repetitive pattern.

• When there is a high degree of abreaction.
• When there is insufficient time.
• When there is no generalization (check for more appropriate beliefs).
• When there is a lack of resources or appropriate information.
• To deepen and confirm the change.
• It allows us to take a shortcut.
• When the patient cannot see beyond what is happening

Important: After presenting an interweave, return to reprocessing with BLS.

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Examples:

• "I don't understand..."

• "What if your child did this?"
• "How do you feel, knowing that I am connected with you here now?"
• Implementing an imaginative cognitive practice: "Let's imagine that..."
• Metaphor/analogy.
• "Let’s imagine..."
• Reminding the client of physical sensations or positive emotions felt in other
circumstances or in their successful experiences.
• Teaching positive resources before desensitization when they are absent or not
accessible.
• Asking the client to repeat their own positive words or expressions.
• Questioning emotional evidence and justifications.
• Decatastrophizing. "The sky is falling!"
• Offering options and alternatives.
• Adding the present moment and thoughts of the "adaptive self."
• Modifying images, perspectives,
and personal references.
• Assigning appropriate responsibility.
• Understanding that past vulnerability is not the same as the present.
• Recognizing possibilities for choices that didn't exist in the past.
• Connecting with personal worth and the right to relate to other people.

How to use a Cognitive Interweave?

• With caution.
• At the right moment.
• With a specific purpose.
• Without imposing it.

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Categories of Information:

• Responsibility
▪ Defect
▪ Action
• Safety/Vulnerability
• Power/Control/Alternatives (Choices)
• Connection/Belonging

1. Responsibility/Fault and Action

• Who am I? vs. What happened to me?

• Confusion between the self and others.
• Differentiating between adult patterns and child patterns.
• The challenge is assigning appropriate responsibility: "Who should have taken care of such a
young child?" "Who should say no, the adult or the child?" "Who should have taken
responsibility for this?" "Who should have taught you about this?"
• Combating low self-esteem and strengthening self-appreciation. "How did you survive until
today?

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2. Safety/Vulnerability

• Using present-time orientation to assess current safety conditions.

• Learn to differentiate between safety conditions in the present and those in the past. "Can
he harm you right now?"
• High levels of fear or numbness due to a blocked fight/flight/freeze response.

3. Power/Control/Alternatives (Choices)

• Internal vs. external locus of control.

• The adult can choose now; the child was powerless to make choices in the past.
• Can make better choices now and in the future.
• Has more options now and in the future.
• Enlist the help of the competent adult client to reparent the child.

4. Connection/Belonging

• Ability vs. inability to trust others.

• Sense of belonging vs. sense of otherness.
• Inclination to connect vs. disconnect from people.
• Healthy self-perception vs. sense of inferiority.

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What Cognitive Interweave is not...

• It is not an extensive verbal search for perspectives before starting the bilateral
movements (BLS).
• It is not an attempt to verbally overcome resistance or objections raised by the patient,
nor is it an attempt to convince them of something.
• It is not simply telling the patient to “get over it”.
• It is not having a conversation with the patient while applying the BLS.
• It is not discontinuing the bilateral movements and switching to cognitive or dynamic
psychotherapy.
• It is not an order.

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Vignettes: Cognitive Interweave

1. A 25-year-old patient seeks treatment because she has difficulty asserting herself at
work. There is a history of domestic violence in the family. The relevant scene was
witnessing her intoxicated mother physically abusing her sibling when she was only 7
years old.

Negative Cognition (NC): "I'm worthless."

Positive Cognition (PC): "I'm not to blame."

Stuck Point: Revolves around the same situation: "I should have done something."

2. A patient who is currently separated has been through numerous relationships and, upon
reflecting on her history, realizes that all of them were toxic. The relevant scene was
overhearing her father tell her brother that she "couldn't make good choices" and was
"a loser."

Negative Cognition (NC): "I'm worthless."

Positive Cognition (PC): "I have value."

Stuck Point: Revolves around the situation: "I can’t do anything right."

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3. A patient catches his partner leaving a motel with someone else.

Negative Cognition (NC): "I can't trust anyone."

Positive Cognition (PC): "I'm okay as I am."

Stuck Point: The negative cognition doesn't change because of the thought: "I deserve all of
this."

4. A 40-year-old aircraft commander, on leave from work, sought treatment after experiencing
an emergency landing during a severe storm. There were no injuries.

Negative Cognition (NC): "I'm not worthy of trust."

Positive Cognition (PC): "I can be reliable."

Stuck Point: High levels of fear and the belief: "I have to be perfect."

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5. A 10-year-old girl came home from school crying and isolated herself in her room. She told
her mother that she overheard three of her classmates saying she couldn't be in their
selfie because she had kinky hair.

Negative Cognition (NC): "I don't belong."

Positive Cognition (PC): "I'm okay as I am."

Stuck Point: High levels of distress and the statement: "I can't be the way I am."

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When processing becomes blocked

Blocking Beliefs:

• Distorted conclusions about oneself, others, or life circumstances.

• May or may not spontaneously arise in the memory network during reprocessing.
• Can hinder the patient's ability to continue reprocessing toward a successful resolution.

Questions the psychotherapist can ask:

What might happen if you overcome this issue?

What is the worst thing that could happen?

Are you afraid to overcome it? What would that fear be?

Perform one or more series of bilateral movements (BLS) to help bring attention or association
into awareness.

Examples of Blocking Beliefs

• It's not safe to overcome the problem.

• If I feel better, I'll forget what happened.
• It would be disloyal to my family or other important people in my life if I overcome this
problem.
• I don't deserve to overcome this problem.
• It's not appropriate to overcome this problem.
• It's not good for others if I overcome this problem.
• If I overcome this, I will dishonor the memory or the significance of important people or
what happened.

Once identified, blocking beliefs can be processed spontaneously. However, if processing

remains blocked, the therapist should invite the patient to explore how they arrived at
that conclusion:

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Ask:

Where did you learn this?

From whom did you learn this?

How did you come to this conclusion?

If the patient agrees, do series of bilateral movements (BLS).

Limiting beliefs can completely block the memory resolution (SUDS=0) or the full installation
(VoC=7).

If SUDS>0 or VoC<7, ask:

What is this (SUDS/VoC)? What is preventing it from being a (0 or a 7)?

Note:

• The memory/memory network responsible for the blocking belief may be too extensive
to be reprocessed in the same session. It may need to be treated as another target to be
reprocessed.
• Sometimes, the blocking belief is part of another memory network that will need to be
addressed as a separate issue to be included in the treatment plan.

Evaluate the need to:

• Simply continue reprocessing within the already activated network (likely in the same
session).
• Create a new ICES (likely in the next session).
• Or add it as a new theme to the treatment plan (general treatment assessment).
• When processing becomes blocked

Feeder Memories:

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• Old memories that don't spontaneously arise in consciousness but fuel emotional
disturbances, blocking reprocessing.
• These memories are more likely to surface when the target is from adolescence or
adulthood.
• Reprocessing is likely to remain blocked until the patient gains access to the older
memories within the activated memory network being reprocessed.

Use Direct Questioning to evoke the nourishing memory.

If necessary, use a Floatback or Affect Scan.

Let's go back again to the recent experience of [repeat the representative recent
experience]. While you keep that in mind, notice the emotions you're having now and
pay attention to what you're feeling in your body. Now, let your mind go back to an
earlier time when you might have felt this way and just observe any memories that
come to mind.

When processing becomes blocked

Other possibilities:

• Go back to the initial target to see if the client notices other disturbing aspects of the
memory.
• Inquire about fears and discuss them.
• Check if the patient needs to install positive resources before continuing with
reprocessing.
• Verify if there are secondary gains or complications that appear in the client's social
system.
• Check if it's appropriate to continue with reprocessing.

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Specific Interventions
and Special Protocols
▪ Specific Approaches: Phobia

▪ Special Protocols: Recent Events,

RDI, and Pillars of Life

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Specific Strategies for Phobia

As presented in Module 1, there are two categories of phobia:

Simple Phobia: When the phobic object is the cause of the emotional impact experienced by
the patient, such as spiders, cockroaches, rats, among others.

Process Phobia: Fear of a situation in which the patient has to participate in a sequence. There
is a memory network associated with the phobia involving the situation, such as fear of
flying, public speaking, sailing, using an elevator, among others.

*The same strategy can be used for the treatment of performance anxiety, such as taking
exams, competitions, and presentations.

Preliminary Steps

• Provide information about the symptoms.

• Assess the presence of secondary gains and, if necessary, reprocess them.
• Specific Strategies for Phobia

Memory Network

• Most significant dysfunctional events: memories that need to be targeted for

reprocessing.
• Beliefs: Fear of fear and fear of physical symptoms, for example: every time my heart
races, I get scared thinking I'm going to die.
• Physical sensations: butterflies in the stomach, racing heart, sweating, and others.
• Specific Strategies for Phobia

Memory Network

• Feeder memories: other events that may have occurred at the time of the initial fear
experience and contributed to the development of the phobia.
• Present stimuli that trigger fear, for example: the need to travel by plane for work or
present work reports at the team meeting.

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Procedure

1. Teach the client self-control procedures so they can manage fear of fear. (Many of these
exercises are described in Francine Shapiro's textbook.)

• Spiral
• Light Stream
• Inner Voice
• Relaxation exercises

2. Possible aspects to be reprocessed:

• Previous events that contribute to the phobia.

• The first time it was experienced.
• The most disturbing experiences.
• The most recent time it was experienced.
• Any present stimulus associated with it.
• Any catastrophic thoughts involving anticipatory fear.
• Physical sensations or other signs of fear, including hyperventilation.

3. Future Template for a future action without fear.

4. Create a mental video of the entire sequence of actions and events

and reprocess any disturbances.

Note: Prepare the client to expect some anxiety during the transitional period of real-life
exposure and use a notebook and self-control techniques. There is no failure, only
feedback.

5. Complete the reprocessing of targets that may arise between sessions.

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Recent Traumatic Events

Objective:

Reprocess a disturbing event that occurred within a period of 3-6 months. There is no need to
wait for memory consolidation to begin treatment.

Patient History (Phase 1):

• Obtain a narrative of the event, starting before it happened and ending at the moment
it concluded.
• Identify the complete event sequence, moment by moment. In addition to the patient's
narrative, the account may come from other individuals.
• Recent Traumatic Events

Phase 3 - Target Assessment:

ICES - Identify the Image, Cognition, Emotions, Physical Sensation, Validity of Cognition, SUDS
(Subjective Units of Distress Scale).

It is preferable to start with the worst part, especially if it is highly intrusive, but assess the
patient's tolerance level ("tolerance gauge").

Otherwise, begin from the beginning of the event as the patient remembers it.

Reprocessing Sequence:

1. Begin reprocessing by targeting the worst part.

2. Complete Phase 3 (ICES), Phase 4 (Desensitization), and Phase 5 (Installation). Do not do the
Body Scan - Phase 6.
3. Target each aspect of the event in chronological order, and complete Phase 3 (ICES), Phase
4 (Desensitization), and Phase 5 (Installation) for each part.
4. Do not do the Body Scan.
5. Ask the patient to visualize the entire event with their eyes closed. If there is any report of
disturbance in any part of the video, reprocess it with the Bilateral Stimulation (BLS) until
SUDS = 0 (or adaptive 6).
6. Repeat this procedure until the entire event can be visualized from start to finish without
disturbance.
7. Phase (5) Installation: install the positive belief (PC) for the entire event and ask the patient
to visualize it from start to finish using the Bilateral Stimulations (BLS).

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8. Repeat the procedure until the entire event is linked to the PC, and the VoC is 7. If any
disturbance comes up, return to Phase 4 of reprocessing, reprocess the target that emerged
until SUDS = 0, and then proceed to Phase 5 again.

9. Perform the Body Scan (Phase 6) while keeping the recent event and the Positive
Cognition in mind.

10. Reprocess any current triggers associated with the recent event.

11. Conduct Future Template to assess potential desired responses.

Alternative Strategy:

Reprocessing Sequence as a Video

Conduct reprocessing as in the standard protocol, working with the traumatic experience in the
form of a video.

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Additional Early Intervention Protocols:

From Elan Shapiro and Brurit Lamb: R-TEP (individual)

From Elan Shapiro: G-TEP (group)

From Philip Manfield, Group adaptation for Early Intervention by Esly Carvalho, the Flash
Protocol.

From Ignacio Jarero:

• PESEA - Acute stress

• PRECI - Recent critical incident with ongoing trauma
• IGTP - Group intervention for disasters

PIPA Program: Professional Intervention Program in Adversity, by Esly Carvalho and Silvia Guz.
Website: [Link]

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Resource Development and Installation (RDI)

The RDI and other stabilization interventions are applied with the aim of helping clients learn to
manage their experience more effectively, assisting them in developing a greater sense
of agency or control, preparing them for trauma processing, and enabling them to
manage their emotional responses in between sessions.

Objective:

• Develop and strengthen the unique qualities or attributes necessary to face specific
challenges.
• Increase access to adaptive memory networks.
• Enhance the ability to tolerate emotions, both positive and negative.
• Strengthen the capacity for state change.

Types of Resources:

1. Resources suitable for RDI are associated with positive emotions (trust, competence, ability,
interest, enthusiasm, satisfaction, pride, victory) and adaptive responses that the client
already possesses but in different contexts.
2. Appropriate resources are based on adaptive states, with no ambiguity regarding the
content or theme to be developed.
3. Resources can also include cultural wealth (Yosso, 2005), such as any positively associated
cultural experiences that highlight the individual's activities as a member of a community. It
refers to a set of knowledge and skills used by a community.

Identify the client's resources within three domains of experience in the following order:

Begin with Mastery resources. If necessary, proceed to the following resources:

Relational or Symbolic.

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1. Mastery resources (internal to the client) include:

The client's own experiences regarding their abilities; previous responses to challenging
situations associated with states of positive emotions (e.g., strength, self-compassion,
trust, competence, pride, victory, among others).

A physical posture or movement that evokes a functional emotional state or the ability to
respond.

2. Relational resources include:

Memories of positive role models who have demonstrated the capabilities the client would like
to incorporate.

Memories of other individuals who have provided support.

3. Symbolic resources include:

Any animal or element from the natural world, such as an eagle, a river, a stone, or a tree, that
symbolizes a specific quality. This can also encompass religious, archetypal, totemic
symbols, among others.

An image of a positive state or a future self that represents the outcome of being successful in
achieving one's goal.

Imaginary figures or symbols that express the client's capacity for adaptive functioning or serve
as inspiration.

Summary of the Sequence:

• Identify the necessary quality.

• Identify the resource experience.
• Image.
• Emotions and Sensations.
• Strengthening.
• Strengthening the resource experience with BLS (Bilateral Movements).
• Keyword.
• Doing it alone.

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Use of RDI:

This process can be repeated for each of the qualities the client wants to develop and
strengthen, as well as for each of the positive images/associations generated by the
client.

Periodically reassess the effectiveness of the resources that have been developed and the
overall stability of the client.

It can be used to assist in closing an incomplete Target session.

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Case Consultation
Aspects of Case Consultation:

• Mechanical difficulties?
• Difficulties in handling EMDR psychotherapy?
• Clinical issues related to psychotherapy?
• Case conceptualization/implementation: where is the difficulty?
• Installation of Positive Resources

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Group Protocol for Pillars of Life

• The aim of this protocol is to bring forth and strengthen the patient's positive resources.
• The pillars should be meaningful to the individual.
• Drawing skills are not relevant. Most people cannot draw better than a 5 year-old.
• It can be used outside of the session to address everyday difficulties.

Pillars of Life: Installation of Positive Resources

Give the Exercise Sheet to the patient.

Instructions:

We've all had positive experiences in life that have allowed us to move forward. In
psychotherapy, we often focus on what doesn't work. In this exercise, we will celebrate
what does work, what has been good, beautiful, and of great value.

I - Think about your life, from the beginning. What was the first person, event, or positive
experience that marked your life, which serves as a Pillar for you? Draw something at
the age line that represents how old you were at that time.

CP (positive cognition). - Looking at the drawing you just made, what positive words come to
mind about yourself now?

E - When you look at this drawing, what positive emotions come to you?

S - What pleasant sensations does your drawing evoke in your body? We'll note them down.

You can also ask: What positive message or advice does this Pillar offer you? Install that with
slow BLMs.

Now, think about the image you drew, the positive words ..................(repeat PC), locate the
positive emotions in your body, and follow the movements.

Install the Pillars of Life with a few slow bilateral movements (4-5), strengthening them one by

Variations:

• Ask them to draw the first pillar and install it, one by one.
• If time is short, ask them to draw only 2-4 Pillars.
• Develop a positive ICES at the end of structuring the Pillars and install them as a whole.

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• In the end, have the person imagine themselves in the middle of the sheet and "listen"
to all the advice/words of wisdom emanating from the Pillars while the therapist
performs 4-5 slow bilateral movements.

When to use the Pillars?

• At the beginning of psychotherapy to assess the person's resources.

• When a lighter session is needed.
• To conclude the psychotherapeutic process.
• Remind them they can be used outside of the session as well.

Example - Pillars of Life

PRACTICE: Pillars of Life Protocol

Closing:

Fill out the course and practicum evaluations.

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