Chapter 3 - The 6 Borrelli Pointers
Dr Scott Borrelli
2002
As advertised previously, this is my authoratitive chapter, helped along by my
own techno-jargon which I shall call The Borrelli Pointers. It sounds good, and
who knows, maybe one day my 'BPs' just might form a volume of my memoires. You
will note, to avoid any confusion, I use a small 's' so as not to incur any wrath
from any official body of psychologists in the UK. I nominate six BPs as my personal
route toward the goal of quality EMDR client preparation.
The first Pointer is 'initial preparation' in which, if time permits, I reserve
one entire session for introducing and discussing EMDR. As in the protocol, I
briefly explain the concepts and theories behind EMDR, basing the extent of this
explanation on client interest and capacity to use the information productively.
I have found that some clients in the UK would rather not realise that there remain
some important unknowns about EMDR, or that it is not a cure-all. On the other
hand, clients have the right to know the limitations, and we are ethically responsible
for informing the client about the pros and cons of the techniques. That positive
treatment results often occur quickly is an encouraging point. Additionally I
find the process of preparation and negotiation, whether treatment were to take
place in Copenhagen or Tel Aviv, has its own therapeutic benefits, well before
the eye movements ever begin.
My second BP involves the 'theoretical base' of EMDR. Although some clients may
be wary of the procedure at first (after all, let's face it, it IS a bit unusual),
I emphasise the REM sleep and accelerated information processing rationale. This
'neuropsychological' base is comforting in its logic. Its inclusion of physical
components, often neglected by other approaches, increases credibility and confidence
in therapist and procedure. It is 'scientific' and measurable in the form of SUDS
and VoC. This is especially attractive to our more cognitive clients, and the
emphasis on sophisticated consumerism. These points become especially convincing
when combined with the principle of one's innate potential for self-healing. The
latter generates a sense of personal power and control, essential building blocks
for more positive self-cognitions.
The third BP I call 'the experiment'. I am both forthright and communicate my
enthusiasm about the 'freshness' and 'originality' of EMDR (i.e., it's new!).
Stimulating hope in clients by encouraging them to gather more information about
EMDR, through the Internet for example, leads to their bringing questions to the
next session. When they do explore it between sessions, they are even more impressed
by the volume of documented successes, professional research, and number of prestigious
supporters. Many enjoy the feeling of being 'on the cutting edge' of psychotherapy.
Or am I really encouraging a change of role in my clients, from the tortured soul
of the 'problem sufferer', to the dynamic research-based ethos of the 'social
scientist' - who just so happens to be studying themself and their intriguing
pathology?
BP number four I consider to be 'sharing control'. I seek a reasonable balance
of empowerment by communicating an appropriate degree of mastery and confidence
in the process, while inviting the client to make vital decisions about various
aspects of the procedures, including the selection of the target memories, the
speed and length of eye movements and, especially, about stopping when desired.
Our traumatised fellow Europeans are most sensitive to issues of control and authority,
some wanting more than others. Their stance on these issues depends on the age
of the client, the type and degree of trauma experienced, personal resources,
and the level of trust in themselves and in the therapist. These are sensitive
areas, indeed, and marvellous bonding opportunities. I am reminded of the ambivalence
these clients often have regarding their ability to recapture a more flexible
and secure sense of control. Importantly, my invitation to take more control is
matched with the assurance that they can change their minds at any time.
A 'dynamic process' is my fifth BP. I emphasise the dynamic nature of human behaviour,
the uniqueness of individuals, and so, the importance of tailoring the EMDR process
to the person. Targets, timing, strategies, direction are all flexible aspects
of the procedure. There is no mislukking, no failure, but only a focused attempt
to get the best out of the treatment. The best attitude, then, is to modify the
strategies within reason and according to individual needs. This requires the
sensitive judgement of a seasoned therapist.
Finally, but crucially, the sixth BP is 'pushing through'. I remind clients that
I intend to 'push' them, with their informed consent, just a bit beyond where
they might prefer to linger. After all, it is my responsibility to invite the
client to reach for new territory in order to revise previous, mostly negative,
conclusions about the self and the world. I have noticed that the anticipatory
fear of entering into new, or for that matter old, places is often worse than
getting there. If I can encourage them to persevere even a bit more, both the
insights and positive cognitions are more likely to break through. My clients
seem to appreciate hearing this once they are convinced they reside in a safe
pair of hands.
Until next time, Good Practice!
Dr. Scott E. Borrelli
©2002 The EMDR Practitioner - All
Rights Reserved Worldwide