CONTENTS
Chapter 1. BACKGROUND = 1
A Day of Discovery = 2
The First Controlled Study = 3
EMD Becomes EMDR = 9
Further Clinical and Experimental Observations = 10
Paradigm Shift = 12
Accelerated Information Processing = 13
Theoretical Convergences = 17
Posttraumatic Stress Disorder = 18
Biochemical Approaches = 18
Psychodynamic Approaches = 19
Behavioral Approaches = 19
Cognitive-Behavioral Approaches = 21
Integrative Approach = 23
Eye Movements = 24
Method Complexity = 25
Summary and Conclusions = 26
Chapter 2. ACCELERATED INFORMATION PROCESSING : THE MODEL AS A WORKING HYPOTHESIS = 28
Information Processing = 29
Alternate Stimuli = 31
Memory Networks = 32
A Sample EMDR Session = 33
Partial Transcript of the Sample Session = 34
Evaluation of the Sample Session = 38
Dysfunctional to Functional = 39
Disparate Neuro Networks = 40
Applications of EMDR to Other Disorders = 41
Static Experience : Affect and Belief Statements = 42
Resolution = 44
Frozen in Childhood = 45
Time-Free Psychotherapy = 46
Targets = 48
Access Restricted to Negative Material = 49
Memory Lapses = 50
Dissociation = 50
Integrated Psychotherapy = 51
Summary and Conclusions = 53
Chapter 3. COMPONENTS OF EMDR TREATMENT AND BASIC TREATMENT EFFECTS = 55
Basic Components of the EMDR Procedure = 55
The Image = 56
The Negative Cognition = 56
The Positive Cognition = 58
The Emotions and Their Level of Disturbance = 62
The Physical Sensations = 62
Activating the Information-Processing System = 63
Eye Movements = 63
Alternative Forms of Stimulation = 67
The Eight Phases of EMDR Treatment = 67
Phase One : Client History and Treatment Planning = 68
Phase Two : Preparation = 68
Phase Three : Assessment = 70
Phase Four : Desensitization = 70
Phase Five : Installation = 71
Phase Six : Body Scan = 72
Phase Seven : Closure = 73
Phase Eight : Reevaluation = 73
Standard EMDR Protocol = 74
Choosing a Target = 74
Patterns of Response = 76
Multimemory Associative Processing = 78
The Belief Inherent in the Trauma = 78
The Major Participant or Perpetrator = 78
The Pronounced Stimuli = 79
The Specific Event = 79
The Dominant Physical Sensations = 79
The Dominant Emotions = 80
Single-Memory Processing Effects = 81
Changes in Image = 81
Changes in Sounds = 82
Changes in Cognitions = 83
Changes in Emotions = 84
Changes in Physical Sensation = 84
Differential Effects = 86
Supervised Practice = 86
Summary and Conclusions = 87
Chapter 4. PHASE ONE : CLIENT HISTORY = 89
Client Readiness = 89
Client Safety Factors = 91
Level of Rapport = 91
Emotional Disturbance = 92
Stability = 92
Life Supports = 93
General Physical Health = 93
Office Consultation versus Inpatient Treatment = 94
Neurological Impairment = 94
Epilepsy = 95
Eye Problems = 95
Drug and Alcohol Abuse = 96
Legal Requirements = 96
Systems Control = 97
Secondary Gains = 97
Timing = 98
Medication Needs = 100
Dissociative Disorders = 100
Treatment Planning = 102
History-Taking Transcript = 105
Supervised Practice = 116
Summary and Conclusions = 116
Chapter 5. PHASES TWO AND THREE : PREPARATION AND ASSESSMENT = 118
Phase Two : Preparation = 118
Adopting a Clinical Stance = 119
Forming a Bond with the Client = 119
Explaining the Theory = 120
Testing the Eye Movements = 121
Creating a Safe Place = 122
Describing the Model = 124
Setting Expectations = 126
Addressing Client Fears = 128
Phase Three : Assessment = 129
Selecting the Picture = 130
Identifying the Negative Cognition = 131
Developing a Positive Cognition = 133
Rating the Validity of Cognition = 134
Naming the Emotion = 135
Estimating the Subjective Units of Disturbance = 136
Identifying Body Sensations = 136
Importance of the Components = 137
Supervised Practice = 139
Summary and Conclusions = 139
Chapter 6. PHASES FOUR TO SEVEN : DESENSITIZATION, INSTALLATION, BODY SCAN, AND CLOSURE = 141
Accelerated Processing of the Memory = 141
Phase Four : Desensitization = 146
Associative Processing = 148
Imagery = 148
New Memory = 149
Image Changes = 149
Incident Unfolds = 150
Appearance Changes = 150
Sounds and Thoughts = 151
Negative Statements = 151
Mismatches = 152
Positive Thoughts = 152
Insights = 153
Sensation and Affect = 153
New Emotions = 154
Shifting Sensations = 155
Assessment = 155
Phase Five : Installation = 157
Phase Six : Body Scan = 159
Phase Seven : Closure = 160
Visualization = 161
Safety Assessment = 161
Debriefing and Log = 162
Supervised Practice = 165
Summary and Conclusions = 165
Chapter 7. WORKING WITH ABREACTION AND BLOCKS = 167
Abreaction = 168
Guidelines for Facilitating Abreaction = 170
If Abreaction Persists = 176
Strategies for Blocked Processing = 177
Primary Target = 177
Altering the Eye Movement = 178
Focusing on Body Sensation = 178
All Sensation = 178
The Primary Sensation = 178
Unspoken Words = 178
Using Movement = 180
Pressing the Location = 180
Scanning = 180
Visual Cues = 181
Sound Effects = 181
Dialogue = 181
Alterations = 182
Appearance of Image = 182
No Action = 182
Hierarchy = 183
Redirecting to Image = 183
Redirecting to Negative Cognition = 183
Adding a Positive Statement = 183
Checking the Positive Cognition = 184
Return to Target = 184
Ancillary Targets = 184
Feeder Memories = 185
Blocking Beliefs = 188
Fears = 189
Fear of Going Crazy = 190
Fear of Losing the Good Memories = 191
Fear of Change = 191
Wellsprings of Disturbance = 193
Supervised Practice = 194
Summary and Conclusions = 194
Chapter 8. PHASE EIGHT : REEVALUATION AND USE OF THE EMDR STANDARD PROTOCOL = 196
Phase Eight : Reevaluation = 197
The Standard EMDR Protocol = 198
Working on the Past = 198
Single-Target Outcome = 199
Recycling through Multiple Targets = 201
Primary Events = 201
Past Events = 202
Progressions = 202
Clusters = 202
Participants = 203
Working on the Present = 203
Using the Log to Report Systems Issues = 204
Working on the Future = 206
Significant People = 206
Significant Situations = 207
Incorporating a Positive Template = 207
Concluding Therapy = 210
Follow-Up = 210
Terminating Therapy = 212
Supervised Practice = 214
Summary and Conclusions = 214
Chapter 9. PROTOCOLS AND PROCEDURES FOR SPECIAL SITUATIONS = 216
The 11-Step Standard Procedure = 217
Protocol for a Single Traumatic Event = 218
Protocol for Current Anxiety and Behavior = 218
Protocol for Recent Traumatic Events = 219
Protocol for Phobias = 222
Simple Phobias = 222
Process Phobias = 223
Protocol for Excessive Grief = 226
Protocol for Illness and Somatic Disorders = 229
Self-Directed Use of Eye Movements Sets for Stress Reduction = 236
Caveats and Suggestions = 236
Technical Considerations = 237
Self-Control／Closure Procedures = 238
Safe-Place Imagery = 239
Taped Visualizations = 239
The Light-Stream Technique = 239
Vertical Eye Movements = 241
Debriefing and Safety Assessment = 241
Summary and Conclusions = 242
Chapter 10. THE COGNITIVE INTERWEAVE : A PROACTIVE STRATEGY FOR WORKING WITH CHALLENGING CLIENTS = 244
Foundation of the Interweave = 246
Responsibility, Safety, and Choices = 247
Fitting the Intervention to the Client = 256
Interweave Choices = 257
New Information = 258
"I'm Confused" = 258
"What If It Were Your Child?" = 259
Metaphor／Analogy = 260
"Let's Pretend" = 260
Socratic Method = 260
Assimilation = 261
Verbalizations = 262
Education = 268
Supervised Practice = 270
Summary and Conclusions = 270
Chapter 11. SELECTED POPULATIONS = 272
Issues of Noncompliance = 273
Children = 276
Concrete Definitions of Feelings = 278
Eye Tracking = 278
Holding the Child's Attention = 279
The Positive Cognition = 279
Using the Child's Cognitions = 279
Generalizing Treatment Effects = 280
Creative Therapy = 281
Couples = 281
Early Sexual Abuse in a Marital Partner = 282
Joint versus Individual Sessions = 282
Infidelity = 282
Sexual Abuse Victims = 285
Appropriate Goals = 285
Client Readiness = 286
Safety and Stability = 286
Structure = 287
Integration = 288
Information Plateaus = 289
Emotional Stages = 289
False Memory = 291
Cautions Regarding Memory Work = 292
Hypnosis = 292
The Fallibility of Memory = 293
Combat Veterans = 296
Dealing with Self-Denigration = 296
Dealing with Feelings of Lack of Control = 297
Secondary Gain Issues = 297
Affiliation and the Fear of Forgetting = 298
Dealing with Denial and Transition States = 299
Dealing with Anger = 300
Using the Cognitive Interweave = 301
Therapy with Older Veterans = 302
Therapy with Female Veterans = 302
Dissociative Disorders = 303
Overall Evaluations = 305
Summary and Conclusions = 307
Chapter 12. THEORY, RESEARCH, AND CLINICAL IMPLICATIONS = 309
Theoretical Explanations = 309
Procedural Elements = 310
Eye Movements (and Alternative Stimuli) = 313
Distortion of Response Stereotype = 314
Distraction = 314
Hypnosis = 315
Synaptic Changes = 315
Dream Sleep = 319
Relaxation Response = 320
Cortical Functions = 321
Integrative Effect = 323
Controlled Research = 324
General Scarcity of PTSD Treatment Studies = 324
Suggested EMDR Research Criteria = 324
Method Validity = 324
Selection of Psychometrics = 325
Subject Selection = 326
Comparative Research = 326
Diverse Protocols = 327
Component Analyses = 327
The Initial Study of EMDR = 328
Review of EMDR Research = 328
Broader Clinical and Professional Implications = 336
Clinical Responsibility = 338
Summary and Conclusions = 340
REFERENCES = 342
Appendix A. CLINICAL AIDS = 360
EMDR Screening and Data Checklist = 360
EMDR Treatment Planning Checklist = 361
List of Generic Negative and Positive Cognitions = 362
EMDR Procedural Outline = 363
Appendix B. CLIENT SAFETY = 365
Section Ⅰ. EMDR Dissociative Disorders Task Force Recommended Guidelines : A General Guide to EMDR's Use in the Dissociative Disorders = 365
Additional Training = 368
Suggested Reading = 368
Section Ⅱ. EMDR Professional Issues Committee Recommended Guidelines = 369
Client Welfare = 370
Training = 371
Reference = 372
Appendix C. EMDR RESOURCES = 373
The International EMDR Network = 373
Training Availability = 374
Appendix D. EMDR CLINICIAN SURVEY = 376
Method = 377
Subjects and Procedure = 377
Materials = 378
Results = 380
Extent of Use = 380
Effectiveness = 380
Need for Training = 385
General Discussion = 385
Acknowledgment = 386
References = 386
INDEX = 387
