Most people that we train understand Standard Protocol well enough and they understand EMDR’s Adaptive Information Processing model well enough to generally understand what it is. I’m not sure that they understand well the implications of the AIP model for clients with complex trauma. Standard Protocol walks you through the mechanics of what EMDR therapy is, which in the reprocessing phases requires tolerable activation of a specific piece of memory content, deep present-based noticing, and doing this while the nervous system receives a left-right stimulation. That process facilitates what is happening beneath client awareness, which is that the difficult and stuck information starts to connect with existing adaptive information. And Shapiro was clear that you have to have enough of the needed adaptive information somewhere in you for EMDR therapy to work. Who has a lot of adaptive information? Healthy people. People with complex trauma, generally, have profound deficits in adaptive information because life didn’t bring them the opportunities to develop it. In other places I’ve suggested that we can think about adaptive information as learning that is different than the learning in the trauma. If you are not sure about their fund of adaptive information, think about what you know about this client’s timeline. When would they have had the opportunity to develop it?
EMDR therapy involves more than simply gathering traumas and running the client through an EMDR machine. Beneath the hood, the old stuck information has to have enough of the needed existing right now information to connect to and metabolize into. Much of our Phase One should be an assessment of the clients fund of adaptive information. Whatever the client’s trauma, I have a general sense of how that might get better using the Eight Phase Protocol. But what I don’t know when I first meet a client is what the difficult stuff has to connect to and if there’s enough of it. With clients with complex trauma, we should assume that the boat of adaptive information is small. That means things. If EMDR therapy isn’t a magic wand that simply metabolizes whatever you point it at, then maybe we should be careful with clients related to how big of a fish we try to land. We trained you to work with relatively healthy people. That’s probably not who your client’s actually are. It is lunacy to try to land a whale into a canoe and to try this the first time the client goes fishing. Horrible idea. Therapy is going to be a while. We’re not in a sprint to be done in 8-12 sessions with clients with severe trauma.
So, the boat and the fish metaphor comes from the implications of the AIP model. You can’t land a fish bigger than your boat. You can’t resolve a memory if you do not have enough of the needed existing adaptive information for it to connect to. You can’t. Fortunately, adaptive information isn’t one thing. In some target domains, clients may be reasonably well-resourced. In others they may have profound deficits. But if you work often with clients with severe and complex trauma, what you will find repeatedly is that things don’t go well when you start with huge targets first. That also might cause harm and it may eventually lead to therapist disengagement from this therapy. I’ve never regretted starting with a small target with a client with complex trauma. This allows us to test the gear and make sure that clients have a boat that actually floats and it’s solid enough to land something. If it turns out that clients are far more resourced than we anticipated, we can easily adjust our targets accordingly and work on bigger stuff sooner.
The boat and the fish metaphor reminds us about what is actually happening in this version of healing. It reminds us about the AIP model and can help explain why things go well sometimes in EMDR therapy and why they go very, very, bad sometimes. Nothing I’ve said here is particularly controversial when working with clients with severe trauma. And nearly everything I’ve said here, you can find Shapiro saying in her core text.
365 Questions About EMDR With Complex Trauma 