SETTLING IN FOR THE RIDE
One of my clients, a mother of four, opened our recent weekly session with the following assessment of, what may well be, our collective pandemic experience:
This situation — the not knowing how long we will be held up in our homes — this ‘unknowing’ is exactly the thing that makes childbirth so difficult. It’s not so much the pain of labor that makes the experience so uncomfortable and scary, it’s the pain in the face of not knowing how long you’ll be stuck in it. If someone would have told me, “This will last 8 hours and be over”, I could have wrapped my mind around that information and settled in for the ride. But they can’t know, and they couldn’t say, so I always, all four times, opted early-on for the epidural.
So here we are, riding out varying degrees of pain and discomfort in the face of the unknown. And the fear of the unknown can be a powerful and ‘sticky’ emotion: powerful enough to shake us to our core, and sticky enough to not let go.
So the question becomes: given the unprecedented and seemingly unpredictable nature of the current global reality, how do we, as mental health professionals, support our clients through this moment in time? How do we, without a roadmap for what lies ahead, help our clients “settle in for the ride”?
LOOKING BACK TO FORGE AHEAD
I’ve often found comfort in the idea that past performance is the greatest predictor of future outcome. I like the concept, not because it is consistently true (it is not), but because it reminds us to draw on our former success in the face of a forthcoming challenge.
Far better than any daily affirmation found on a calendar and intended to inspire the masses, our own unique triumphs provide a personalized prescription for how we are to best proceed.
In EMDR Therapy, we use an ego-strengthening protocol known as Resource Development and Installation (RDI) to bridge the gap between our past and future. Developed by Andrew Leeds, PhD as a stabilization intervention to prepare clients for the future work of reprocessing traumatic memories, RDI is a powerful tool for decreasing disturbing emotions about a current or future experience by helping the client connect with and draw on their former victories and relevant strengths.
MEASURING THE DISTURBANCE
Before I share a modified version of Resource Development and Installation, I think it best to take a quick detour and explain an important element that we EMDR Therapists use in much of our work: measuring the disturbance.
The Subject Units of Disturbance, or SUD scale is a means to measure the overall level of emotional disturbance that a client is currently feeling in relation to a past, present, or future experience. The SUD scale runs 0-10, with a 0 score indicating ‘no disturbance or neutral feelings’, and a 10 score denoting the highest level of disturbance imagined. As a general rule, we ask the client for a SUD score at the beginning of the work to set a baseline, and we then recheck the SUD at the end to see what gains, if any, have been made. Just remember: a ‘gain’ is measured by a decrease in the SUD level.
RESOURCING THE GOOD STUFF
So, now that you’re up to speed on measuring the disturbance, let’s dive-in to the meat of the matter: resourcing.
STEP 1: Begin by asking the client to briefly describe the upsetting situation, then ask how disturbing is feels to them right now, from 0 to 10, where 0 is neutral and 10 is the highest level of disturbance imaginable.
example reply: being isolated alone during the pandemic feels like an 8 right now.
STEP 2: Have the client determine which resources (qualities, skills, or strengths) would help them better navigate the distressing situation. It’s okay if they just have one resource, but three would be ideal.
example reply: (1) patience, (2) creativity, (3) endurance
Now complete steps 3-5 for each resource individually. For example, go through steps 3-5 for resource #1, then circle back and do it again for resource #2, and then do a final pass of the three steps for resource #3.
STEP 3: Help the client connect with their personal experience of the resource by using the following three prompts:
“Briefly describe a symbolic image, mastery experience, or relational moment in your life when you have experienced this resource.”
example reply: When I had cancer, I demonstrated incredible endurance during the course of my treatment.
“What image best represents this situation?”
example reply: I see myself sitting with my doctor discussing my treatment options.
“Where do you feel this resource in your body?”
example reply: I feel endurance in my upper chest and shoulders.
STEP 4: Strengthen the resource by using the following prompt and check-in sequence:
“Focus on the image, notice where you feel it in your body, and take three slow and full breaths.” Have the client take three deep diaphragmatic ‘belly breaths’ at a slow pace.
“What do you notice in your body now?” If what the client reports is positive, repeat step 4 (prompt + check-in sequence) once more.
STEP 5: Name the resource and have the client engage with it one final time by using the following prompts:
“Tell me a word or phrase that best identifies this resource for you?”
example reply: I can do hard things.
“Focus on the phrase (word), notice where you feel it in your body, and take three slow and full breaths.”
Now go back and repeat steps 3-5 with the second resource, and then again with the third resource (if applicable). Once you’ve completed steps 3-5 for each resource, move on to the 6th step to bring this all together.
STEP 6: Combine and strengthen all of the resources together, then recheck the SUD level to see if the level of disturbance has diminished.
“Focus on all of the resources that you have found today. Notice where you feel them in your body and repeat the word or phrase for each one as you take three slow and full breaths.”
“What do you notice in your body now?”
“Notice these positive feelings as you think about the stressful situation you described a the beginning and take another three slow and full breaths.”
“What do you notice in your body now?”
“Focus on the stressful situation you identified at the beginning. How disturbing does it feel to you right now, from 0 to 10, where 0 is neutral or no disturbance, and 10 is the highest level of disturbance imaginable?”
CLOSURE AND A CAVEAT
Whenever I finish a resourcing exercise, I love to ask the client what they notice. This simple, open-ended query, “what do you notice?”, is a common troupe of EMDR therapists. Rather than limiting our client to a narrow scope of inquiry about feelings or thoughts, we expand the field of possible responses with this expansive question. Try it sometime and see what you get. Some clients, unfamiliar with the phrase, will give you a confused look at first. When this happens, I generally smile, shrug and remind them that there are absolutely no wrong answers; anything and everything is fair game.
Finally: a caveat. The goal and intention of this exercise is to resource positive elements: images, feelings, somatic sensations, beliefs, experiences, etc. If the client continues to provide positive reports between the sets of noticing and breathing, move through the steps. Conversely, if the client reports disturbing material, stop the process and check-in. If the disturbance is fleeting and the client is able to easily reconnect with the positive material, feel free to jump back in. If the disturbance persists, stop, set aside the exercise for another day, and use your best clinical judgement for addressing the needs of the client at that moment.
TAKING RESOURCING TO THE NEXT LEVEL
I hope that you give this simple and effective resourcing practice a try. In my own work with clients and in teaching the full protocol to clinicians, RDI has consistently proven to be a lovely gift we can give our clients — a reminder of their own strengths and success, and a reconnection with their own power and positive past experiences.
If you are interested in becoming an EMDR trained clinician with EMDR Education and Training Center, you will learn to use Resource Development and Installation in its complete form, and with the inclusion of bilateral stimulation, to treat complex cases.
To learn more about integrating EMDR therapy into your practice, check-out the Basic Training page on this website for information on virtual and in-person trainings. You are also welcome to contact me directly at kara@emdreducationandtrainingcenter.com.
In the meantime, I wish you peace as we collectively learn to settle in for the ride!