The Adaptive Information Processing Model
One of the many contributions made by the late Francine Shapiro was the Adaptive Information Processing (AIP) model. From her 1995 publication of “Eye movement desensitization and reprocessing basic principles. protocols, and procedures”, Shapiro describes information processing as an intrinsic system that evolved to allow human beings to reorganize their responses to disturbing life experiences from an initial dysfunctional state of disequilibrium to a state of adaptive resolution. The work of EMDR reprocessing, therefore, is to activate a trauma memory and allow the client’s own adaptive information processing mechanisms to resolve the disturbance, gain insights, and allow the past to be truly in the past.
Bearing this in mind, when teaching EMDR Therapy, I am frequently encouraging clinicians to ‘stay out of the way’ as much as possible during reprocessing to allow the client’s own intrinsic healing processes to play out. In most cases, ‘staying out of the way’ renders the most efficient and effective results. However, as with most things in life, EMDR reprocessing is not a one-size-fits-all protocol and, sometimes, EMDR clinicians need to take a more active role in the reprocessing session to aid the client toward adaptive resolution. One of the ways we do this is by shifting from EMDR to EMDr, or from EMDr to EMD.
Defining Terms: the ‘D’ and the ‘R’
Before we between, let’s first clarify a few terms. The ‘D’ in EMDR stands for ‘Desensitization’. Whether we are doing EMDR, EMDr, or EMD, we are working toward desensitizing a memory; meaning, the goal is to either lower or fully eliminate the felt disturbance associated with a target memory. The ‘R’ in EMDR stands for ‘Reprocessing’, which is an examination of the meaning we make and take from an experience. With reprocessing, the client is reconsidering beliefs that they hold about themself and/or the world when focusing on a past experience. As a result of reprocessing a memory, the client often gains insight and adaptive understanding.
Now back to the task at hand: when to use EMDR, EMDr, or EMDR. To begin, imagine a bowling alley where each lane is a memory, and the goal of the game is to knock down all of the pins (SUDs) and leave the target memory (lane you’ve been assigned for play) free of disturbance (pins). Moving forward we will use this metaphor to consider ‘how’, ‘when’, and ‘why’ the lanes are modified depending on which form of reprocessing we are employing.
EMDR — also know as “EMD-big-R”
With EMDR, the client has full, relatively unfettered access to the associated memory network. With EMDR, the work involves both desensitization and reprocessing.
With EMDR, after each set of bilateral stimulation (BLS), we ask the very open ended question, “What do you notice?”. This gives the client the freedom to not only make contact with all aspects and channels of association related to the target memory (thoughts, beliefs, emotions, somatic sensations, images, sounds, urges, etc), but to access relevant experiences, past or present, that belong to the same memory network. For example, a client working on a past memory of feeling that they are not safe might answer the question, “what do you notice?”, with more details or new insights about the target memory. They might also make an association to a recent experience related to safety. In this case, we know that the client is doing the work of reprocessing, and we do our best to ‘stay out of the way’ by simply prompting them to, “notice that”, as we resume BLS.
As a general rule, we use EMDR to reprocess a memory when the client is able to: 1) tolerate the elements they notice during sets of BLS; 2) maintain a balance of dual attention between the target memory and the present moment; and 3) remain focused on the target memory and not stray too far off topic or get flooded.
If the client is able withstand contact with all aspects of a memory during reprocessing, even if these aspects include intense emotions, urges, aversions, revelations, or somatic sensations, EMDR is often the most efficient and effective way to resolve past disturbing events. With EMDR, we are offering the client the necessary time and space to make full use of their own, intrinsic Adaptive Information Processing system, whereby previously maladaptively stored elements of a trauma memory make contact with present day adaptive knowledge, and resolution is achieved.
In the EMDR bowling alley, the client does not need lane bumpers and is able to throw a few balls down neighboring lanes, as appropriate.
EMDr — also know as “EMD-little-r”
With EMDr, the work involves both desensitization and reprocessing; however, the client’s focus for those tasks is kept narrowly on the selected memory and on the channels of association related only to the target.
With EMDr, after each set of BLS, we direct the client’s attention back to the target memory prior to asking what they notice. This allows the client to report what they observed about the experience without letting them associate to other memories, related or otherwise. To do this, after each set of BLS, we keep the focus narrow by returning the client to target, “When you focus on this original experience, as it appears to you now, what do you notice?”. If the client report is related to the target memory, we prompt them to, “notice that” and continue with BLS.
Similar to EMDR, we use EMDr to reprocess a memory when the client is able to: 1) tolerate the elements they notice during sets of BLS; and 2) maintain a balance of dual attention between the target memory and the present moment. The difference here (and the reason to use EMDr) is that the client is unable to stay focused on the target memory and, when related experiences surface during sets of BLS, they become overwhelmed with the new material.
One main reason for employing EMDr is to keep the client within the window of tolerance —that sweet spot where the client is able to both feel and think. In cases where a client becomes overwhelmed by other memories that surface during BLS, they can become flooded and move outside of the window of tolerance. When this happens, not only is the client, most likely, no longer reprocessing, but you run the risk of them suffering an abreaction or re-traumatization.
Another reason to consider EMDr is when the client has a habit of moving far away form the target memory and ‘stray’ to other material, related or otherwise, for more than a set or two of BLS. In this instance, returning them to target after each set will help maintain focus on the target memory and avoid an unproductive ‘drift’.
In the EMDr bowling alley, the client does not make use of the lane bumpers; however, the clinician helps them avoid straying to other lanes, and keeps them focused on the pins in their single alley.
With EMD, the work only involves desensitization of the target, and the client is not prompted to follow any channels of association related to this or other memories. With the dropping of the ‘R’, we are no longer looking toward ‘reprocessing’ of the memory; the goal with EMD is to simply lower or eliminate the level of disturbance.
With EMD, after each set of BLS, we direct the client’s attention back to the target memory and, rather than asking what they notice, we simple measure the level of disturbance (SUD). To do this, we ask, “When you bring your attention back to this original experience, as it appears to you now, how disturbing does it feel to you, on a scale of 0 to 10, where 0 is neutral or no disturbance, and 10 is the highest level of disturbance you can imagine feeling?” If the client reports a number of 1 or greater, we simply ask, “what’s the worst part of it now?”. After hearing their reply, we prompt, “focus on that, and notice what happens next”.
We use EMD for clients who tend to get flooded by associated material. This could mean that they get overwhelmed by elements connected directly to the target memory, or they become flooded by material associated with other related events.
EMD can be useful in keeping a client’s attention very narrowly focused on the selected target memory and only on how disturbing it feels to them after each set of BLS. Much like with EMDr, we use EMD to avoid a situation where the client moves outside the window of tolerance and, potential, experiences an abreaction.
In the EMD bowling alley, the clinician has engaged the lane bumpers to keep the client singularly focused on one goal — knocking down those pins which, in this metaphor, is code for desensitizing the target memory.
Stay in touch!
I hope this overview of EMDR – EMDr – EMD has been useful to you and enhances the work you do with clients. Please do get in touch if you’ve any questions or comments regarding this or any other EMDR-related item. We are always happy to engage.