Video 033 Healing childhood trauma with storytelling and EMDR
Use this solution
With children who have difficulties with all or some parts of the standard protocol, and when family members are able and willing to be part of the process.
Originator:
See: Lovett, J. (1999). Small Wonders; Healing Childhood Trauma With EMDR. New York: Simon & Schuster.
Video production
Matthew Davies Media Ltd, Llanidloes, Powys. www.matthewmedia.com
What this covers
The case is about a nine year old girl, called Skye, who was dyslexic and attended a special class at school for children with learning difficulties. She had been bullied at school.
Like many children, Skye provided a real challenge to the therapist when using the standard protocol. Skye found it difficult to give details of the bullying and struggled to find negative and positive cognitions. She also had problems following eye-movement bilateral stimulation.
To overcome some of these difficulties the therapist involved the family in parts of the process including creating a safe environment, finding appropriate cognitions, giving an account of the bullying, and delivering bilateral stimulation.
How long
16.21 minutes
Related videos
Video 030 and 031
Go to ‘Take-away’?
Wrap up: How to write a story.
Aide mémoire: Step by step guide how to use the protocol - available to copy and paste.
Take-Away Section
+ Wrap up
Why stories are so important, how to write them, and the role of EMDR.
We tell stories - narratives - to make sense of our experience and telling stories about change is an essential step in living a story of change. Stories or narratives have been described as a: “primary scheme by means of which human existence is rendered meaningful” (Polkinghorne, citied in Cortazzi, 1993, p.1). Memory provides a way of looking back on experience and enables us to select those elements that fit together into some meaningful pattern or narrative, in other words into a story of one’s life.
Narratives can be thought of as existing in several forms. Labov’s (1982) structural approach, is cited or applied by most investigators. Riessman, (1993) not only argues that a “fully formed” narrative has certain fixed common elements, but that there is a one to one correspondence between the verbal sequence of clauses in the narrative and the sequence of events that actually occurred.
While this represents a particular model of the relation between language and reality, most researchers would agree with this definition/model. They would generally consider that narratives should include:
- An “abstract” (what this story is about - the beginning)
- An “orientation” (some sort of scene setting including an introduction to the characters and their actions. Be sure to put something positive about the child, to catch their interest)
- A “complicating action” (a narrative sequence specifying events and their relation over time and including a description of some significant conflict or problem. Details such as sights, sounds, smells, tastes, textures and feelings that may have been experienced at the time should be described).
- An “evaluation” (a ‘so what?’ – the significance and meaning of the action)
- A “resolution” (what finally happened – the ending. This should include the positive beliefs that the parents desire for the child to have about themself).
Several other factors need to be considered too:
- The language used should be age appropriate so it’s easy for the child to understand
- It should be like a familiar bedtime story in length
- Write in in third person style – about a boy or girl or child without using the names of individuals. This emphasises that traumatic events can happen to “any child”, and resolution can happen to ”any child”. Some children will immediately claim the story is about them – that’s fine – leave it to them to decide
- If the child has experienced a series of traumatic events, split the story into chapters – one for each event to be addressed in more than one session as required
- Note any current symptoms – e.g. fear of going to sleep – and include these in the story so they can be addressed too
- In the ending, include any rules for safety that will help the child feel competent and able to be safe.
Narrative therapy is based on the idea that if we “change the story” we change the future. EMDR, we know, is about changing the story at a neurological level of memory, beliefs, senses and emotions. It is thus an enormously powerful way of augmenting and accelerating the change in the story that Narrative therapy seeks simply through “talk”. The consequence is the creation of a new story that can be “lived” in the future.
Analysing the story used in the video
The story:
Once there was a family made up of mum, dad, a young girl and grandad. They all loved each other. Though dad was away quite a lot working in another country, he was coming back soon and always brought a present for the young girl. When he was home he always collected the young girl from school at the end of the day; and sometimes they would play football together.**
One day when the young girl was in school, she went out into the playground with some other children as usual. Then a girl called Sasha came up to her and called her a bad name and pushed her so that the young girl fell over….
Then, Sasha got hold of the young girl’s coat and began to drag her across the grass, shouting and saying bad things about her. The young girl felt very shocked, and as other children came across to see what was going on and laughed at her, she felt scared.
Then running across the play-ground came a teacher – Mr James, and he shouted at Sasha and sent her and the other children into the school. He helped the young girl to her feet.
Mr James took the young girl into first aid room and got another teacher, Mrs Philips, to help the young girl to clean herself up. Then they took her into Mr James’ study and he called her mother at home. Mr James told her mother what had happened and said she should fetch the young girl and take her home.**
*Soon the young girl’s mother comes in and gives her a big hug. Mr James and Mrs Philips leave so that the young girl and her mother can be alone together.
Soon mum and the young girl are on their way home. Mum cooked a special tea for the girl, grandpa and herself while the young girl watched her favourite programme on TV. Mum said she would go to school next day and talk to the headmistress about Sasha. The young girl was safe now.
Analysis:
- Paragraph 1 combines an “abstract” (this is about a family and a school) with “orientation” (scene setting and introducing the characters)
- Paragraphs 2-4 describe the “complicating action”
- Paragraph 5 give meaning to what had happened - this shouldn’t have happened, and the school authorities were concerned
- Paragraphs 6-7 provide the resolution.
+ Aide Mémoire
Guidelines for therapists – these are based on our own experience as accredited family therapists and EMDR Consultants, and also draws heavily on Joan Lovett’s ‘Small Wonders’.
First, work with the parents/family without the child in order that;
- They can give information or express worries that they might not wish to share in front of the child
- You as the therapist can make a preliminary assessment as to what extent the parents are able and willing to participate in the process, or in some cases should be actively encouraged to strengthen the relationship between family members
- You ask the parents to relate the story of the child’s traumatic experience in as much detail as possible, and then ask for:
- Any post-traumatic symptoms they have observed – fears, nightmares, etc.
- Any negative cognitions they imagine their child has in the light of the traumatic experience – ‘I’m not safe’, etc.
- Any ideas they might have connecting the post-traumatic symptoms and negative cognitions
- Any hypothesised positive cognitions the child might have had in the light of the traumatic experience which they want their child to have in the future e.g. ‘I’m safe now’, etc.
- What strengths the child has and how these may be displayed (Note: when the parents and child are together it may be helpful to have the parents relate what they identify as strengths again – children love praise – and these self-beliefs can be reinforced with bilateral simulation at an appropriate time)
- Get a history about pregnancy, labour, injuries, hospitalisations, family disputes or troubles, etc. that might have been traumatic for the child. They may need to be addressed in addition to the current issue brought to therapy
- Ask the parents for their beliefs about safety – how is the child kept safe, how he/she can protect themselves. Also in some cases parents need to come up with a developmentally appropriate explanation as to why ‘bad things’ sometimes happen to us
- Ask the parents to write the story of the child’s traumatic experience (See Wrap up for detailed guidelines). This should use language the child will understand, employ the third person narrative style, and make sure that:
- The story starts with everyone safe, leading up to the trauma
- Describe the details of what happened
- End with positive cognitions and everyone safe
- Check the story and agree any changes with the parents
- Explain EMDR and how working together you and they can help the child get over the trauma Ask the parents what sort of indoor activities their child enjoys, e.g. painting, drawing, etc. Plan to offer the child an activity when you see the family next time
- Ask the parents to explain to the child that they are all going to see a special person who helps families get over upsetting experiences.
Next, meet with parents and child
- Ask the parents to describe the strengths and qualities they like about the child and the child’s imaginative power
- Offer the child the chosen activity
- Lovett suggests that meanwhile the therapist asks the parents about the development challenges you know the child has already met. This will remind the child that problems can be resolved/overcome
- Ask the child whether they wish to sit with the parents or on a parent’s lap and explain you are going to do some work together
- Give the child choices about bilateral stimulation (BLS). There is much to be said for having one parent do this by tapping for example
- Ask the child to imagine a safe place and install with BLS; and/or to remember a time when they felt strong or successful or good about themselves and install with BLS
- Practice a “stop” signal.
Next meeting with parents and child
- Say we are going to do some work together today. Offer the child the option of doing their chosen activity first or later and abide by their choice
- Explain EMDR to the child – to desensitize the trauma and reprocess the memories associated with it so that you will feel better after it (here use the positive cognition(s) suggested by the parents). Say one parent will read a story.
- Implement agreed sitting and BLS choices
- Have one parent read the story during BLS
- Stop the reader from time to time to ask the child appropriate questions about their reactions to the story. Can you feel the love of your family? Can you hear the children shouting? How do you feel now? In response to the questions, do BLS until the child indicates desensitization has worked and/or a positive state has been installed.
- Read as much in the session as the child can tolerate.
- End the session, asking the child to put the story away until next session; ask parents to keep a log of symptoms shown by the child that may require treatment including situation, behaviour, trigger.
Future meetings
- Read the story again, focussing on parts that are still distressing
- Follow up on any issues logged by the parents End with installing the positive cognition(s)
- Praise the child for their bravery.