Video 076 (pt1) Three useful inquiry interweaves
Use this solution
When the client is blocking or looping. Try non-interweave interventions and if these fail use interweaves such as the inquiry interweaves shown here.
Originator:
Shapiro, F. (2001). Eye Movement Desensitization and Reprocessing: Basic Principles, Protocols, and Procedures (2nd edition). New York: Guilford Press.
Video production
Matthew Davies Media Ltd, Llanidloes, Powys. www.matthewmedia.com
What this covers
This video demonstrates the use of three different types of questions designed to overcome blocking and looping in EMDR processing. They are designed to uncover material already held in the client’s memory likely to ‘jump start’ the process. The questions deliberately link to the cognitive domains of responsibility, safety, choice and shame – these four domains are relevant to clients’ stuckness. The fourth domain was added to Shapiro’s original domains by Laurel Parnell
How long
7.21 minutes
Related videos
See Video 070 for a comprehensive overview of both non-interweave and interweave interventions.
Go to ‘Take-away’?
For the Aide mémoire to use in a client session
Take-Away Section
+ Aide Mémoire
You can copy and paste this material into a Word document, edit it, and add further information that you think may be of help to you.
- Notice when the client becomes stuck or when the processing is looping back through the same material and not becoming more adaptive.
- Try changing the methods of process interweaves such as changing the type or speed of bilateral stimulation or dual attention stimulation before introducing cognitive information
- Notice when the processing hasn’t changed with two consecutive sets of bilateral or dual attention stimulation or the SUDS are failing to drop or when the SUDs drop then return to the original high levels
- Consider which cognitive domain the client is working in
- The inquiry interweave introduces new perspectives or a new direction by asking a question
- Think of a question related to that domain that will help the client’s processing to become more adaptive or help the client to overcome the block in their processing
- At the end of a set of bilateral stimulation, introduce the question and ‘go with that’
- It is usual for one interweave to ‘kick start’ processing
- If one interweave doesn’t work, consider the domain and check to see that the negative cognition hasn’t changed
- If there has been a shift in the processing domain, then try with an inquiry interweave in the newly emerging domain.
More Inquiry interweave suggestions:
Safety domain Is the danger happening right now? Are you in danger right now? Were you able to keep yourself safe as a very young child? I’m curious, was it reasonable for your mum to expect you to keep yourself safe as a baby? Are you safe now?
Choice domain I’m confused, did the 6 year old have choice? Did you, as a young child have more power than your dad? As an adult, can you choose now? If this was your child, would you expect them to make that choice?
Responsibility domain What makes you think it’s your fault? I’m curious about that, how could a 5 year old have done more? I’m confused, how does that make you a bad person? What skills would you have needed to be able to do that? Whose responsibility is that? If this was your friend …………….? How much responsibility is yours and how much is his / hers?
Shame domain How much guilt do you need to hold on to and how much can you let go of? Was it the child’s fault or the adults’? If this was your child, what would you expect?
+ Wrap Up
- Inquiry interweaves can be useful when the processing has become stuck. Stuckness is identified when the information emerging in processing hasn’t changed for two consecutive sets of bilateral stimulation (Shapiro, 2001)
- The inquiry interweave can also be used when processing does not generalise to other targets despite processing to calmness in the current target or if there is extreme emotional distress
- Questions can also be used when there is time pressure and the client has a strong abreaction with no time to process it.
- Inquiry interweaves are usually introduced during the desensitisation phase of the EMDR protocol when the processing is stuck or is looping back to the same series of thoughts or responses.
- Inquiry interweaves are not random questions however. They are carefully crafted to fit with the cognitive domain relevant to the client’s processing. They usually fit into one of four different domains: responsibility, safety, choice or shame. In the aide memoire we give a selection of different inquiry interweaves that can be used in the different domains as a springboard to you finding your own, wider and more creative selection.
- It is helpful to remember that you can think of inquiry interweaves before a session as well as coming up with them during the session. Sometimes a client is prone to blocking or becoming stuck so we can think of possible questions ahead of time or use supervision to discuss interweaves that might help the processing to become more adaptive.
This is about Tom, a young man brought up in a dysfunctional family: an alcoholic mother and a controlling, sometimes violent, father who would belittle him for showing a desire to learn and do well in school. Tom grew up with a sense of being rejected by his family and carried thoughts of being ’bad’ and ‘shameful’. These became particularly troublesome after Tom developed a serious interest in a fellow student at university. He found himself holding back from the relationship, scared that she might reject him when she found out what a ‘bad’ person he was.
What you will learn:
The video demonstrates how Tom’s damaging and pervasive attachment experiences with his mother and father can be repaired and reversed through rewiring his thought patterns. The video shows how the therapist and Tom co-construct and install an alternative reality - a hypothetical ‘ideal’ mother as a resource. In turn, this led to new neural pathways that changed the way he felt about himself and how he related to others.
This video is about Sally, a young woman who has been in a car accident, the target memory, and has started treatment with the standard EMDR protocol. Unexpectedly during processing, she is flooded with memories of a previous event from her childhood.
What you will learn
The use of EMDr to successfully desensitize and reprocess the new intrusive memory through this narrow focussed adaption of the standard EMDR process, before going back to the original target memory.
The video of the case shows Carla, who is experiencing chronic pain with no evident cause in the here and now.
What you will learn
The latest thinking about how and why pain is made, and the basic mechanism behind how EMDR works to reduce pain. Step by step protocol for working with chronic pain – includes use of drawing/art.
The case is about Jane, who came for help about her relationship with her wife, Mary. This video is the third of a three part video series showing several important aspects of working with difficult partner relationships. The three videos focus on the relationship in the past, in the present and in the future. This final video demonstrates the use of Future template protocol to install new skills designed to prevent/manage conflict in future.
What you will learn:
Enable clients develop and deploy new skills to reduce risk of conflict and help resolve conflict should it arise in future. In particular it shows:
Case of a woman, Jane, whose marriage to Mary was in trouble. Video 035 describes how to identify and desensitize/reprocess past trauma affecting the relationship. This video deals with current difficulties
What you will learn:
What you will learn: Use of an adaption of the standard EMDR protocol to undo concurrent negative beliefs held by the client about herself and her partner in one process.
Case of a woman, Jane, whose marriage to Mary was in trouble. Differences between them, including experiences of trauma and educational achievements, were leading to serious discord.
What you will learn:
What you will learn: Use of EMDR to work with couples. Key questions for use in history taking to uncover causes of discord, and to identify EMDR targets. Consideration of whether to have both partners ‘in the room’ when using EMDR on one of them.
This video demonstrates the use of storytelling along with the standard EMDR process with a child who found it difficult to tell what happened to her, struggled to find cognitions and had problems following eye-movement bilateral stimulation.
What you will learn:
How to create a story describing a child’s traumatic experience, involve family members in the process, and carry out the adapted standard EMDR process.
The video demonstrates the application of the EMD protocol, generally thought of as an early EMDR intervention protocol (EEI).
What you will learn:
How to use this protocol with dysregulated clients who may want therapy soon after experiencing a very distressing event.
Intense affect often accompanies work with complex trauma. These can be a re-enactment of emotions experienced during the trauma and can be shocking to witness. The temptation is to stop processing and move into talking therapy or other mode of operation. Usually, a better way is to enable the client to safely continue to process while you ‘stay out of the way’.
What you will learn:
How to manage yourself as therapist and the client when there is a strong emotional response during an EMDR processing session and several different ways of working with abreactions.
This video demonstrates the development and installation of three types of resources that can be very useful for some clients who might benefit from access to sources of nurturing, protection or wisdom during treatment with EMDR. They can be installed prior to or during processing.
What you will learn:
To learn how to stabilise clients prior to using EMDR or during actual processing to overcome blockages or stuck situations.
Case of a singer who suffered an unexpected panic attack during a performance, seriously threatening his future ability to continue as a soloist.
What you will learn:
How to use the standard EMDR protocol along with the three prong approach to overcome performance anxiety. Can be used in many other situations, e.g. fear of a future medical procedure after a bad experience.
The sudden, accidental death of a grandson. While Video 019 dealt with the pain and loss associated with a past event and Video 020 with the present, this video deals with the future.
What you will learn:
How to use EMDR to help the client readjust to life without the loved one.
The sudden, accidental death of a grandson. While Video 019 dealt with the pain and loss associated with a past event, this video deals with the present: triggers and secondary losses associated with the death.
What you will learn:
How to use EMDR to help the client re-experience the absent loved one, relinquish memories of old (now unsuitable) attachments, while identifying memories he/she wants to hold on to.
When a client’s grief has become complex i.e. deviating from the norm in either the time or intensity of specific or general symptoms of grief and/or the level of impairment in social, occupational, or other areas of life.
What you will learn:
How to use EMDR to release the complex nature of stuck or distorted grief – the first phase in a three-phase process to address Complex grief. Also, how Narrative therapy provides a ‘bird’s eye’ picture of how the three phases work together.
Case of woman with history of childhood physical and emotional abuse. Video shows how to work safely when there is a high risk of dissociation, which can lead a client to lose contact with the present moment and be caught up in the past when asked to describe or focus on a traumatic event.
What you will learn
How to use CIPOS (Constant installation of present orientation and safety) and BHS (Back of the head scale) when risk of dissociation is high.
Many clients come to therapy with a problem that includes both positive and negative affect components. In terms of Shapiro’s Adaptive Information Processing Model, it’s as if there are two entry points to stored memory networks.
What you will learn:
What to target when clients come to therapy with a problem that includes both positive and negative affect components
Case of woman with history of childhood physical and emotional abuse. Video shows a Phase 3 Assessment with a dissociative client, stabilised with CIPOS and BHS, when the trauma is held by a part of the personality.
What you will learn
How to do a Phase 3 Assessment with a dissociative client when the trauma is held by a part of the personality. Phase 4, Desensitisation, follows.
This video covers the use of Socratic Questioning as a form of cognitive interweave.
What you will learn
Learn how to use this technique to overcome blocking and looping with the standard EMDR protocol.
This is about a company executive living in fear of his boss. His family history was one of negative interactions with powerful people over several generations. This was the source of his class inferiority - the introject or psychic object that he had unconsciously absorbed, and now blighted his relationship with his boss.
What you will learn
How to free clients from damaging generational and cultural practices using the standard protocol in conjunction with a process based on Narrative therapy in which the introject is ‘externalized, disowned by the client and removed with a two handed and imagination interweaves.
Procrastination is a recurring pattern of avoidance behavior. It can be thought of as a sort of addiction to the short term gratification of a delay. It involves avoiding action.
What you will learn
Step by step protocol borrowed from Popky’s use of EMDR with addictive disorders and Jim Knipe’s “Level of urge to avoid (LOUA).”
NAW stands for Notice, Acknowledge and Welcome. It’s a technique borrowed from sensorimotor psychotherapy to address psychological and physically experienced pain and in this application is incorporated into the standard EMDR protocol. This video shows two case examples. In the first, a 40 year old woman experienced lots of pain during the stabilization phase of the work with her therapist.
What you will learn
How to use this technique with a step by step protocol, and understand the basic mechanism that leads to pain relief.
In this video you will see a therapist work with a child part or ego state and an adult part or ego state using a two-handed interweave. This new child ego state has emerged following ego state work demonstrated in Videos 001, 002 and 003.
What you will learn
How to facilitate communication between two ego states.
This video demonstrates the use of Constant Installation of Present Orientation and safety (CIPOS) with Olivia, a child who had been in a car accident. She has had flashbacks about the accident and is reluctant to process the memories
What you will learn
How to use CIPOS (Constant installation of present orientation and safety) with children
This video is about a man who had had a serious car accident. Many years later he still could not remember what had happened to him. He came for therapy wondering if he could recover the memory.
What you will learn
How to access and process memories stored in close-to-original form (i.e. in non- linguistic somatosensory form).
Lucy, was a young woman in her twenties. She was suffering from Obsessive compulsive disorder (OCD) and presented with anxiety and a constant need to check things over and over. This behaviour significantly interfered with her life.
What you will learn
How to use John Marr’s “Adapted EMDR Phobia Protocol with Video Playback”.
Samantha is in her forties. She came to therapy after returning from holiday in a foreign country. There, she was hospitalised following an accident.
What you will learn
What you can do when client is terrified to revisit the trauma events.
John was a retired civil servant, who’d come to therapy because of anxiety. He had always been an anxious person, but it had become worse since retiring. Now his worries seemed to increase in number and intensity.
What you will learn
How to help clients manage stress.
This video demonstrates the use of three different types of questions designed to overcome blocking and looping in EMDR processing.
What you will learn
Learn how to use these question to overcome blocking and looping with the standard EMDR protocol.
Client was a young female executive caught in a dilemma over whether to focus on her career or on having a baby. This dilemma came to light after having EMDR to deal with stress related to some difficulties she was having with one of her staff.
What you will learn
How to help clients resolve dilemmas.
What this is about: The case is about a man in his forties who has lost his family and career. He experiences extreme dysregulation, suicidal thoughts and an inability to make sustained relationships. He has a childhood of extreme neglect and abuse. The defining condition is a lack of any hope of change or relief in the future. He is unable to contemplate dealing with past and current traumas.
What you will learn: How to work, first with the future loss of hope using the standard EMDR protocol. You will also learn how to use aspects of Brief Solution Focused Therapy to create a hopeful future, if the client is unable to do so himself. This hopeful future will become the target in this first phase of the three-part therapeutic journey.