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letting steam out of the pressure cooker the emdr life stress protocol deanylaliotis emdrinstitute inc washington dc the standard protocol of eye movement desensitization and reprocessing emdr therapy has been ...

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                                                                                                                                                     Letting Steam Out of the Pressure Cooker:
                                                                                                                                                                                                 The EMDR Life Stress Protocol
                                                                                                                                                                                                                                                                                          DeanyLaliotis
                                                                                                                                                                                                                                              EMDRInstitute,Inc., Washington, DC
                                                                                                              The standard protocol of eye movement desensitization and reprocessing (EMDR) therapy has been well
                                                                                                              established as an efficacious brief treatment for posttraumatic stress disorder (PTSD), addressing past,
                                                                                                              present, and future aspects of a traumatizing event. This article provides instruction in the administration
                                                                                                              of the EMDR Life Stress Protocol, which targets a significant recent experience or a life scenario that is
                                                                                                              not necessarily remarkable as a stand-alone event (getting up every morning with dread, feeling anxious
                                                                                                              about leaving the house) and which causes distress and impaired function such as has been commonly
                                                                                                              reported during the COVID-19 crisis. This protocol involves minor but significant modifications within
                                                                                                              EMDR therapy’s standard procedures. It uses the present-day experience as the Target Memory while
                                                                                                              accessing briefly, the memory network of historical experiences that inform the client’s reactions to their
                                                                                                              present circumstances. Successful processing is immediately followed by a Future Template to generate
                                                                                                              an alternative pattern of response, optimizing the client’s capacity to respond adaptively to continued
                                                                                                              life demands. The EMDR Life Stress Protocol differs from EMDR’s various recent events protocols, which
                                                                                                              seektoreduceposttraumaticsymptomsfollowingarecenttraumaticeventorcrisis.Thoseprotocolsfocus
                                                                                                              on the critical incident and ancillary events, and typically do not intend to activate memory networks of
                                                                                                              related historical experiences. The article describes case conceptualization to offer a rationale for this
                                                                                                              approach and provides a detailed description of this protocol, illustrated with case examples, highlighting
                                                                                                              its application both as a psychotherapy approach and as a brief intervention.
                                                                                                              Keywords: eye movement desensitization and reprocessing (EMDR) therapy; EMDR Life Stress Protocol;
                                                                                                              crisis intervention; brief treatment; recent traumatic events; attachment
                                                                                                       his article describes a way to work with recent                                                                                                                                                                                are adaptively stored in memory networks, the learn-
                                                                                                       traumatic events or ongoing life stress using                                                                                                                                                                                  ingthatcomesfromthesememoriescanbeeffectively
                                                                          Teyemovement desensitization and reprocess-                                                                                                                                                                                                                 applied to current stressors that resemble these past
                                                                          ing (EMDR) therapy (Shapiro, 2018). Originally, the                                                                                                                                                                                                         experiences. When past experiences are inadequately
                                                                          EMDR Life Stress Protocol was developed to work                                                                                                                                                                                                             processed and maladaptively stored due to high levels
                                                                          with complex clients who struggle with attachment                                                                                                                                                                                                           of distress and arousal at the time, or the failure of sig-
                                                                          issues as part of a more comprehensive EMDR                                                                                                                                                                                                                 nificant others to respond appropriately, the learning
                                                                          psychotherapy (Laliotis, 2007, 2010). This modified                                                                                                                                                                                                         that comes from these experiences is also maladap-
                                                                          approach has been more recently applied as a stand-                                                                                                                                                                                                         tive, informing the individual’s reactions to similar sit-
                                                                          aloneEMDRtreatmentprotocolforclientsstruggling                                                                                                                                                                                                              uations in the present. Since memory and learning
                                                                          with the current COVID-19 crisis (Laliotis, 2020).                                                                                                                                                                                                          are associative, the brain automatically makes these
                                                                                      Shapiro’s (2018) Adaptive Information Processing                                                                                                                                                                                                past–presentconnectionswhichinformhowwethink,
                                                                          (AIP) model asserts that an individual’s response to                                                                                                                                                                                                        feel, behave, and perceive situations in the present.
                                                                          their current situation is informed by past experiences                                                                                                                                                                                                     Based on this foundational tenet, it stands to reason
                                                                          thataresimilarinnature.Whenthesepastexperiences                                                                                                                                                                                                             that treatment of current stressors that allows access
                                                                          Pdf_Folio:150
                                                                          150                                                                                                                                                                                                                                               Journal of EMDR Practice and Research, Volume 14, Number 3, 2020
                                                                                                                                                                                                                                                                                                                ©2020EMDRInternational Association http://dx.doi.org/10.1891/EMDR-D-20-0003
                                                            to some of the earlier memories driving the client’s                                                                                                                                                                                                        to think, feel, and behave appropriately in response
                                                            reactions will facilitate generalization of treatment                                                                                                                                                                                                       to daily life tasks and demands. Without addressing
                                                            effects and memory consolidation. This can then be                                                                                                                                                                                                          the sources or the effects of stress, the cumulative
                                                            expectedtoincreasetheclient’sstabilityandresiliency                                                                                                                                                                                                         result over time impacts one’s physical, mental, and
                                                            in responding to similar circumstances in the future,                                                                                                                                                                                                       emotionalhealth,sometimeswithdireconsequences,
                                                            especially if the stressors are ongoing, as is the case                                                                                                                                                                                                     overwhelmingresourcesandexacerbatingunderlying
                                                            with COVID-19.                                                                                                                                                                                                                                              weaknesses.
                                                                                                                                                                                                                                                                                                                                    The current COVID-19 crisis is a stressful time
                                                                                                                                                                                                                                                                                                                        for most everyone and is inherently challenging for
                                                                                                                                                                                                                                                                                                                        many reasons. The fear of contracting the virus or
                                                            Crises and Stressors
                                                                                                                                                                                                                                                                                                                        infecting others, particularly family and coworkers,
                                                            Crisesandstressorsareapartoflifeandcantakemany
                                                                                                                                                                                                                                                                                                                        looms large, especially for those who are in jobs
                                                            forms.Whiletheyareinherentlytaxingduetothedis-
                                                                                                                                                                                                                                                                                                                        that require them to leave home in order to perform
                                                            ruption they cause, the danger they may pose, or the
                                                                                                                                                                                                                                                                                                                        their duties (Cava, Fay, Beanlands, McCay, & Wig-
                                                            ongoing challenges about the present and future, our
                                                                                                                                                                                                                                                                                                                        nall, 2005). Some develop catastrophic reactions to
                                                            ability to respond adaptively determines the degree
                                                                                                                                                                                                                                                                                                                        physical symptoms experienced during the quaran-
                                                            of impact these stressors will have (Lehrer, Woolfolk,
                                                                                                                                                                                                                                                                                                                        tine period (Rubin et al., 2016). The financial strain
                                                            &Sime,2007, 2020). From an AIP-informed perspec-
                                                                                                                                                                                                                                                                                                                        caused by unemployment, loss of a small business,
                                                            tive, when previously stressful experiences are inad-
                                                                                                                                                                                                                                                                                                                        or greatly reduced income generates fear and uncer-
                                                            equately processed, a person will likely have more
                                                                                                                                                                                                                                                                                                                        tainty about the future. Parents who work and have
                                                            difficulty responding adaptively to their current life
                                                                                                                                                                                                                                                                                                                        to attend to their children while quarantined at home
                                                            stressor(s), decreasing their capacity to cope, increas-
                                                                                                                                                                                                                                                                                                                        are managing competing demands without access to
                                                            ingtheirdistressandthelikelihoodofrespondingmal-
                                                                                                                                                                                                                                                                                                                        their usual resources (Sprang & Silman, 2013). The
                                                            adaptivelyinthefuture(Solomon,Laliotis,&Shapiro,
                                                                                                                                                                                                                                                                                                                        isolation of social distancing and stay-at-home orders
                                                            2020). With one’s capacity to respond adaptively fur-
                                                                                                                                                                                                                                                                                                                        can be a significant stressor (Manuell & Cukor, 2011),
                                                            ther diminished, there is a greater likelihood of suffer-
                                                                                                                                                                                                                                                                                                                        particularly for people who have a complex trauma
                                                            ing from a physical or mental disorder, such as acute
                                                                                                                                                                                                                                                                                                                        history or live alone without any physical contact.
                                                            stress disorder, posttraumatic stress disorder (PTSD),
                                                                                                                                                                                                                                                                                                                        Given that our neurobiology is geared for social con-
                                                            anxiety, or depression.
                                                                                                                                                                                                                                                                                                                        tact and human connection, over time these stressors
                                                                        It is well established that the ability to respond to
                                                                                                                                                                                                                                                                                                                        will likely have a significant negative impact for many
                                                            life changes, challenges, and obstacles is central to
                                                                                                                                                                                                                                                                                                                        people (Wu et al., 2008). We also know from previ-
                                                            maintaining a sense of psychological and emotional
                                                                                                                                                                                                                                                                                                                        ousstudies on the effects of quarantine (Brooks et al.,
                                                            well-being. A person’s premorbid level of function-
                                                                                                                                                                                                                                                                                                                        2020) that additional stressors such as extended stay-
                                                            ing predicts to some degree one’s ability to respond
                                                                                                                                                                                                                                                                                                                        at-homeorders and inadequate supplies and informa-
                                                            adaptively to stress, particularly if they have a his-
                                                                                                                                                                                                                                                                                                                        tion provided by authorities add considerable stress
                                                            tory of psychiatric illness (Jeong et al., 2016). Life
                                                                                                                                                                                                                                                                                                                        to the inherent uncertainties of a public health cri-
                                                            stress, especially if it persists for prolonged periods,
                                                                                                                                                                                                                                                                                                                        sis. Perhaps a less obvious effect of quarantine is the
                                                            can have a negative impact on anyone’s sense of
                                                                                                                                                                                                                                                                                                                        disappearance of “place” or the loss of “place attach-
                                                            well-being. Symptoms of stress include but are not
                                                                                                                                                                                                                                                                                                                        ment,”anemotionalbondtoaphysicalspacethatwe
                                                            limited to mood fluctuations, such as anxiety and
                                                                                                                                                                                                                                                                                                                        assign meaning to (Moser, Moser, & McNaughton,
                                                            depression; bouts of anger, irritability, or restless-
                                                                                                                                                                                                                                                                                                                        2014). The importance of a sense of place has been
                                                            ness; feelings of overwhelm or shut down; lack of
                                                                                                                                                                                                                                                                                                                        observed across cultures and offers significant psy-
                                                            motivation or focus; excessive worry, sometimes
                                                                                                                                                                                                                                                                                                                        chologicalbenefits.NeuroscientificresearchbyMoser
                                                            accompanied by catastrophic thinking; sleeping too
                                                                                                                                                                                                                                                                                                                        et al. identified certain neurons described as “place
                                                            much or not enough; difficulty concentrating; hav-
                                                                                                                                                                                                                                                                                                                        cells” and “border cells,” that help us manage auto-
                                                            ing trouble with memory, loss of appetite or eat-
                                                                                                                                                                                                                                                                                                                        biographical memory through memories of people
                                                            ing too much (Marroquin, Tennen, & Stanton, 2017).
                                                                                                                                                                                                                                                                                                                        and events that occurred in the places we frequent.
                                                            Other manifestations of stress include somatic com-
                                                                                                                                                                                                                                                                                                                        It explains the common experience of one day being
                                                            plaints, such as digestive issues, headaches, stom-
                                                                                                                                                                                                                                                                                                                        the same as the next, combined with a subsequent
                                                            ach aches, chest pains, and muscle tension, as well
                                                                                                                                                                                                                                                                                                                        loss of identity that we derive from being in a famil-
                                                            as changes in heart rate and blood pressure. Ongo-
                                                                                                                                                                                                                                                                                                                        iar place, such as going to work, school, or a place of
                                                            ing stress can also have an impact on one’s ability
                                                                                                                                                                                                                                                                                                                        worship.
                                                            Pdf_Folio:151
                                                            Journal of EMDR Practice and Research, Volume 14, Number 3, 2020                                                                                                                                                                                                                                                                                                                                                                                                                   151
                                                            Laliotis
                                                                          CommonInterventions for Life Stress and Crisis                                                                                                                                                                                                              experienced and taking baseline measurements of
                                                                          Intervention                                                                                                                                                                                                                                                the salient components. These components include
                                                                                                                                                                                                                                                                                                                                      theimagethatrepresentsthemostdisturbingpart,the
                                                                          Typically, when a client is in a crisis, the general con-
                                                                                                                                                                                                                                                                                                                                      negative belief about self as it pertains to the mem-
                                                                          sensus is to offer interventions that are specifically
                                                                                                                                                                                                                                                                                                                                      ory, the desired belief about self, and the degree of
                                                                          designed to stabilize the individual (Roberts, 2005).
                                                                                                                                                                                                                                                                                                                                      believability the desired belief holds at the outset. The
                                                                          Commoninterventions include generic skill develop-
                                                                                                                                                                                                                                                                                                                                      validity of the desired belief is rated using the Valid-
                                                                          ment, such as affect regulation, breathing exercises,
                                                                                                                                                                                                                                                                                                                                      ity of Cognition (VOC) scale, from 1 (completely false)
                                                                          relaxation, meditation, yoga, tai chi, and other mind-
                                                                                                                                                                                                                                                                                                                                      to7(absolutelytrue).Theclient’scurrentemotionsand
                                                                          fulnesspractices.Thepurposeoftheseinterventionsis
                                                                                                                                                                                                                                                                                                                                      sensations are identified and measured with the Sub-
                                                                          to help the client tolerate the situation and to provide
                                                                                                                                                                                                                                                                                                                                      jective Units of Disturbance (SUD), using a scale from
                                                                          momentary relief. In some treatment approaches,
                                                                                                                                                                                                                                                                                                                                      0(calmorneutral)to10(mostdisturbing).Theclientalso
                                                                          such as cognitive behavioral therapy (CBT), the ther-
                                                                                                                                                                                                                                                                                                                                      identifies the location of body sensation.
                                                                          apist may prescribe specific strategies to counteract
                                                                                                                                                                                                                                                                                                                                                  During EMDR processing, sets of bilateral stim-
                                                                          maladaptive thoughts and behaviors with the goal of
                                                                                                                                                                                                                                                                                                                                      ulation (BLS) are administered using visual, audi-
                                                                          helping the client cope with the situation more effec-
                                                                                                                                                                                                                                                                                                                                      tory, and/or tactile modalities, while the client is
                                                                          tively (Datillio & Freeman, 2007). In either case, the
                                                                                                                                                                                                                                                                                                                                      instructed to focus on the memory and the associ-
                                                                          techniques or interventions applied provide tempo-
                                                                                                                                                                                                                                                                                                                                      ations that spontaneously arise. Simultaneously, the
                                                                          rary relief but do not address the underlying causes of
                                                                                                                                                                                                                                                                                                                                      client is instructed to maintain dual attentionbetween
                                                                          the individual’s reaction to their life stress. Therefore,
                                                                                                                                                                                                                                                                                                                                      thepresentandpastthroughouttheprocess.Oncethe
                                                                          the client’s underlying vulnerability and susceptibility
                                                                                                                                                                                                                                                                                                                                      Target Memory has been successfully reprocessed, as
                                                                          remainandarelikelytobetriggeredagain.
                                                                                                                                                                                                                                                                                                                                      reported by the client and measured using the SUD
                                                                                                                                                                                                                                                                                                                                      scale (calm, no disturbance reported), the therapist
                                                                                                                                                                                                                                                                                                                                      linksthedesiredpositivebeliefwiththenewlyneutral-
                                                                          EMDRTherapy
                                                                                                                                                                                                                                                                                                                                      ized memory until the emotional linkage to the pos-
                                                                          EMDR therapy (Shapiro, 2018) is recognized as                                                                                                                                                                                                               itive belief is strong and congruent with the body as
                                                                          an efficacious treatment for PTSD and is consid-                                                                                                                                                                                                            measuredbytheVOC.Aclearbodyscanindicatesno
                                                                          ered by many international associations as a front-                                                                                                                                                                                                         somatic disturbance as the client holds the memory
                                                                          line trauma treatment (e.g., International Society for                                                                                                                                                                                                      andthepositivebeliefinmind,ensuringcompleteres-
                                                                          Traumatic Stress Studies [ISTSS], 2018). It is also                                                                                                                                                                                                         olution of the targeted memory. The three-pronged
                                                                          applicable to a broad range of clinical issues across                                                                                                                                                                                                       protocolofpast,present,andfutureensurestreatment
                                                                          a variety of different treatment contexts (Shapiro                                                                                                                                                                                                          generalization for present triggers and similar situa-
                                                                          & Laliotis, 2011). As a comprehensive psychother-                                                                                                                                                                                                           tions in the future.
                                                                          apy approach informed by the AIP model, it theo-
                                                                          rizes that difficulties in the present are informed by
                                                                                                                                                                                                                                                                                                                                      EMDRTherapy for Recent Events and Ongoing
                                                                          past experiences that are inadequately processed and
                                                                                                                                                                                                                                                                                                                                      Trauma
                                                                          maladaptively stored. EMDRtherapy’sthree-pronged
                                                                          protocol addresses past, present, and future by                                                                                                                                                                                                             Numerous EMDR treatment protocols have been
                                                                          treating the neurophysiological storage of memory,                                                                                                                                                                                                          developed to reduce symptoms of acute stress that
                                                                          allowing the targeted memory and other, similar                                                                                                                                                                                                             follow a critical incident, with at least seven ran-
                                                                          memories to be reprocessed and successfully inte-                                                                                                                                                                                                           domized controlled trials showing their effectiveness
                                                                          grated with other, adaptively stored experiences. This                                                                                                                                                                                                      in decreasing posttraumatic symptoms (see Shapiro
                                                                          ensurescomprehensivetreatmenteffectsbyreprocess-                                                                                                                                                                                                            &Maxfield, 2019, for a review). These recent event
                                                                          ing disturbing past experiences that inform current                                                                                                                                                                                                         protocols have also been used to treat posttraumatic
                                                                          difficulties, targeting present triggers that remain dis-                                                                                                                                                                                                   symptoms in situations where the trauma is ongo-
                                                                          turbing due to second-order conditioning, and gen-                                                                                                                                                                                                          ing. The types of trauma patients included cancer sur-
                                                                          erating future templates of action to optimize one’s                                                                                                                                                                                                        vivors (e.g., Jarero, Artigas, Montero, & Lena, 2008;
                                                                          capacity to respond adaptively to future challenges                                                                                                                                                                                                         Roberts, 2018); bombing victims (Shapiro & Laub,
                                                                          (Shapiro, 2018).                                                                                                                                                                                                                                            2008);andrefugees(e.g.,Korkmazlar,Bozkurt,&Tan
                                                                                      There is an 11-step procedure for memory pro-                                                                                                                                                                                                   Tunca, 2020; Lehnung, Shapiro, Schreiber, & Hof-
                                                                          cessing that includes Phases 3–7 and is standard in                                                                                                                                                                                                         mann, 2017; Lempertz et al., 2020). These protocols
                                                                          EMDRtherapy(Shapiro,2001,p.222).Itinvolvesfully                                                                                                                                                                                                             have been administered to both adults and children
                                                                          accessing the targeted memory as it is currently being                                                                                                                                                                                                      and in group and individual settings. Outcomes are
                                                                          Pdf_Folio:152
                                                                          152                                                                                                                                                                                                                                               Journal of EMDR Practice and Research, Volume 14, Number 3, 2020
                                                                                                                                                                                                                                                                                                                                                                                                                                                Letting Steam Out of the Pressure Cooker
                                                            promising, showing significant reductions in symp-                                                                                                                                                                                                          past–present collisions are the source of the client’s
                                                            tomsofposttraumaticstress.                                                                                                                                                                                                                                  symptoms and the corresponding memories are the
                                                                                                                                                                                                                                                                                                                        focal point of EMDR therapy.
                                                                                                                                                                                                                                                                                                                                    The goal of this protocol is not only to address
                                                            EMDRTherapy for Life Stress and Ongoing
                                                                                                                                                                                                                                                                                                                        the client’s reaction to the current situation that is
                                                            Crisis
                                                                                                                                                                                                                                                                                                                        generating symptoms, but to decrease the emotional
                                                            The EMDR Life Stress Protocol was initially devel-                                                                                                                                                                                                          load from some of the earlier memories that inten-
                                                            opedbythisauthortoaddressmaladaptivepatternsof                                                                                                                                                                                                              sify the client’s reactivity to the current situation. By
                                                            response related to attachment styles rooted in devel-                                                                                                                                                                                                      titrating access to these channels of associations, the
                                                            opmental trauma (Laliotis, 2007, 2010). Clients with                                                                                                                                                                                                        emphasis is more on reducing disturbance related to
                                                            developmental trauma and attachment issues often                                                                                                                                                                                                            present-daysituationsandpreparationforlikelyfuture
                                                            experience daily life tasks and relationship demands                                                                                                                                                                                                        scenarios, which are the primary goals when dealing
                                                            as stressful, exacerbated by their maladaptive reac-                                                                                                                                                                                                        with an acute crisis situation or ongoing life stress.
                                                            tions linked to memory networks containing unre-
                                                            solvedpainfulmemories.Theprotocolwasdeveloped
                                                                                                                                                                                                                                                                                                                        Procedural Steps
                                                            to directly target these patterns of response as they
                                                            manifest in the client’s daily life, as one part of a com-
                                                                                                                                                                                                                                                                                                                        The procedural steps for the EMDR Life Stress Pro-
                                                            prehensive treatment plan in EMDR psychotherapy.
                                                                                                                                                                                                                                                                                                                        tocol are the same as those used in Phases 3–7 of
                                                            The expected outcome is a decrease in problematic
                                                                                                                                                                                                                                                                                                                        Shapiro’sstandardprotocol(Shapiro,2018),withthree
                                                            behaviors, without comprehensive processing of the
                                                                                                                                                                                                                                                                                                                        exceptions:
                                                            completememorynetwork.
                                                                                                                                                                                                                                                                                                                                    • TheTargetMemoryisarecentexperienceorsce-
                                                                        TheEMDRLifeStressProtocolcanalsobeapplied
                                                                                                                                                                                                                                                                                                                                              nario (defined here as any situation that is unre-
                                                            as a stand-alone intervention for clients requesting
                                                                                                                                                                                                                                                                                                                                              markable as a stand-alone event, but trigger the
                                                            brief treatment. Such clients may be having difficul-
                                                                                                                                                                                                                                                                                                                                              person).
                                                            ties coping with ongoing life stress in ways that are
                                                                                                                                                                                                                                                                                                                                    • The Desensitization Phase includes more active
                                                            a departure from their usual responses, due to the
                                                                                                                                                                                                                                                                                                                                              interventionsonthepartofthetherapisttoaccess
                                                            unique demands of the situation. For example, care-
                                                                                                                                                                                                                                                                                                                                              and limit channels of associations to include
                                                            taking an elderly parent during the pandemic can
                                                                                                                                                                                                                                                                                                                                              the Floatback technique. The therapist redirects
                                                            trigger a maladaptive pattern of response, such as
                                                                                                                                                                                                                                                                                                                                              the client back to the Target Memory more
                                                            getting overwhelmed, unable to make an appropri-
                                                                                                                                                                                                                                                                                                                                              frequently, keeping the focus on resolving the
                                                            ate decision about their care. The client’s inability to
                                                                                                                                                                                                                                                                                                                                              client’s reaction to their current situation.
                                                            respond more adaptively exacerbates their life stress,
                                                                                                                                                                                                                                                                                                                                    • InstallationofaFutureTemplateofthesamesce-
                                                            making it even more unmanageable. It is clinically
                                                                                                                                                                                                                                                                                                                                              narioorsimilarsituationimmediatelyfollowsthe
                                                            moreexpedient,therefore, to target the current situa-
                                                                                                                                                                                                                                                                                                                                              resolutionoftheTargetMemory(SUDof0;VOC
                                                            tion where these maladaptive reactions present with-
                                                                                                                                                                                                                                                                                                                                              of 7; clear body scan). While this is not a depar-
                                                            out fully activating the earlier memory networks.
                                                                                                                                                                                                                                                                                                                                              turefromthestandardprotocol,thereisanadded
                                                            The EMDR Life Stress Protocol was exported from
                                                                                                                                                                                                                                                                                                                                              emphasis on immediately generating an alterna-
                                                            its initial attachment-based application in EMDR psy-
                                                                                                                                                                                                                                                                                                                                              tive pattern of response to optimize treatment
                                                            chotherapy as a response to the emergent clinical
                                                                                                                                                                                                                                                                                                                                              effects by offsetting the strength of the patterned
                                                            demandsstemmingfromtheCOVIDcrisis.
                                                                                                                                                                                                                                                                                                                                              reaction.
                                                            Treatment Conceptualization
                                                                                                                                                                                                                                                                                                                        Case Illustrations
                                                            Shapiro’s (2018) AIP model views inadequately pro-
                                                            cessed and maladaptively stored memories as the                                                                                                                                                                                                             In this section, the use of this EMDR Life Stress
                                                            root cause of most pathology. In addition to recog-                                                                                                                                                                                                         Protocol for an ongoing crisis is illustrated by describ-
                                                            nized mental health disorders, symptoms can include                                                                                                                                                                                                         ing its application to three different case presenta-
                                                            unremitting emotional distress, dysfunctional pat-                                                                                                                                                                                                          tions. Non-essential details in the cases are changed
                                                            terns of behavior, or medically unexplained somatic                                                                                                                                                                                                         toprotecttheclients’anonymityandpseudonymsare
                                                            symptoms. When current events or conditions share                                                                                                                                                                                                           used. Two cases highlight the use of the protocol as a
                                                            similarities with past experiences, the individual may                                                                                                                                                                                                      brief intervention, while the third case shows how it
                                                            react in ways that exacerbate their current difficul-                                                                                                                                                                                                       can be incorporated into a comprehensive treatment
                                                            ties, makingitevenmorechallengingforthem.These                                                                                                                                                                                                              plan. The first case is a client who initiated treatment
                                                            Pdf_Folio:153
                                                            Journal of EMDR Practice and Research, Volume 14, Number 3, 2020                                                                                                                                                                                                                                                                                                                                                                                                                   153
                                                            Laliotis
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...Letting steam out of the pressure cooker emdr life stress protocol deanylaliotis emdrinstitute inc washington dc standard eye movement desensitization and reprocessing therapy has been well established as an efficacious brief treatment for posttraumatic disorder ptsd addressing past present future aspects a traumatizing event this article provides instruction in administration which targets significant recent experience or scenario that is not necessarily remarkable stand alone getting up every morning with dread feeling anxious about leaving house causes distress impaired function such commonly reported during covid crisis involves minor but modifications within s procedures it uses day target memory while accessing briefly network historical experiences inform client reactions to their circumstances successful processing immediately followed by template generate alternative pattern response optimizing capacity respond adaptively continued demands differs from various events protocols...

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