About ONE80 Staff
One80Center Announces The January 14 Reception To Celebrate The Grand Opening Of The Step Up On Vine Facility
For 25 years, Step Up on Second has provided psychosocial rehabilitation and support, including permanent supportive housing, to people affected by severe and persistent mental illness in the Los Angeles area. In 2012, SUOS joined the Clinton Global Initiative with a commitment to add 200 permanent supportive housing units in Hollywood. Step Up On Vine is the result of a $12 million dollar renovation of an abandoned hotel at Santa Monica and Vine in Hollywood. Step Up On Vine will be a Platinum LEED certified, 34-room permanent supportive housing facility.
On January 14, 2013, Step Up on Vine will be hosting a private reception to celebrate its unveiling. In conjunction with the Kobe and Vanessa Bryant Family Foundation, the Clinton Global Initiative and Step Up On Second, ONE80CENTER has teamed with Future Growing to help turn a vision of sustainability into a positive reality. The goal of Step Up on Vine is to end homelessness in Los Angeles through sustainability by providing help, hope, and a permanent home to individuals suffering from mental illness and currently living on the street.
Step Up On Vine Grand Opening Celebration
At the facility unveiling and fundraiser, participants will hear remarks from President Clinton and Los Angeles Lakers basketball star Kobe Bryant. This will be followed by a live auction and a special musical performance. Tickets for the private reception may be purchased at the Kobe and Vanessa Bryant Family Foundation website at http://kvbff.org/tickets/. General tickets for the event are $1,000 and VIP tickets for $5,000 that include a meet-and-greet and photo opportunity with President Clinton and Kobe Bryant. The event supports the mission of both Step Up On Second and the Kobe and Vanessa Bryant Family Foundation to end the problem of chronic homelessness in Los Angeles.
To assist Step Up On Vine in realizing their goal of sustainability, ONE80CENTER has partnered with Future Growing to provide 25 hydroponic tower gardens. Built and maintained by ONE80CENTER community members as a way of giving back, the gardens will be used to grow fresh produce for daily meal preparation at Step Up On Vine.
One80Center has partnered with Hepatitis Connect, a health-oriented social networking site owned by Alliance Health Networks. The partnership encourages clients and community members with the Hepatitis C virus (HCV) to join the Hepatitis Connect social network and help raise awareness about the need for Hepatitis C testing and treatment.
Hepatitis Connect – One80Center Partnership
People with HCV at One80Center will greatly benefit from joining http://www.hepatitisconnect.com – a unique online resource that provides the latest treatment updates product reviews and relevant news articles. Hepatitis Connect is part of Alliance Health’s growing portfolio of more than 50 health condition-specific social networks currently serving more than 1.5 million registered users. Membership in HepatitisConnect.com is free and anonymous.
“By working in connection with quality institutions like One80Center, Hepatitis Connect hopes to raise awareness about the need for Hepatitis C testing and treatment,” said John Lavitt, Hepatitis Connect site administrator and patient advocate. “With incredibly effective new treatments available, there is no point for this silent plague to continue. At Hepatitis Connect, our ultimate goal is to help save lives.”
The Center for Disease Control and Prevention estimates that more than two million people in the United States are unaware they are infected with Hepatitis C. The CDC recently issued a recommendation that anyone born between 1945 and 1965 – every baby boomer in the United States – be tested. People in drug & alcohol recovery often test positive.
“Our focus when a client enters treatment is to help them develop the tools that will lead to sustainable recovery,” said Alex Shohet, co-founder of One80Center and a former board member of the American Liver Foundation. “Before the Internet, I went through Hepatitis C treatment myself and wish I had access to a supportive community like Hepatitis Connect. To recommend such a resource helps us further empower our members infected with HCV to develop the skills necessary to live a healthy, happy and productive life.”
How is the “community-based” approach at ONE80CENTER conducive to the use of EMDR? – EMDR Discussion – Interview with Dr. Andrew M. Leeds Ph.D.
The community based program that you have at the ONE80CENTER is fantastic. I’ve been so impressed with everything I’ve learned through my conversations with you and Bernie and the other people on your staff. It’s not just the 28 day program. People often continue in residence in after care programs and sober living environments for months or weeks afterwards for as long as they need.
You have a number of innovative features that are a part of your entire treatment program here that I think make it possible to use EMDR, where other programs may not have the same facility as you do. For example, you have sober companions that are going to be monitoring people as often as needed.
You have an information management system where all members of your treatment team are in constant communication with each other. If someone is having family stress. If some has an adverse reaction to a group therapy session or a difficult response to an EMDR session everyone on the treatment team know immediately.
So you have intense containment strategies as a result of your entire treatment team being constantly aware of what everyone else is doing. This makes it possible for you to do intensive interventions like EMDR where I think other programs wouldn’t have the containment that would be needed to be able to do that as successfully as you are able to do it here.
I think that’s one of the factors is the structure of the program itself. You also have really experienced EMDR clinicians. The people who are offering EMDR here currently have years of experience and have consulted with other experts in the field of addiction treatment to help them learn how to approach these cases in the right way. I think those are the factors that make it possible for the ONE80CENTER to be successful in integrating EMDR into your comprehensive program in ways that other programs aren’t yet ready to do.
You’ve mentioned some of PTI and so I needed to say a couple of words about the Sonoma psychotherapy training institute that I founded three years ago, after my book came out in 2009. I think it’s a wonderful training model for a program like the ONE80CENTER. Sonoma PTI offers a four weekend training. Each weekend is two days long. And the consultation sessions are built into weekends two, three and four. This brings people from the local community together for a series of two day weekends. It builds cohesion.
You have a mixture of participants in the ONE80CENTER training who are active members of your treatment team as well as clinicians in the outlying community interested in referring cases to the ONE80CENTER and it’s building a community in the greater Los Angeles area of people aware of how EMDR can be used in complex cases and aware of how you’re using EMDR here in a very innovative way as part of the ONE80CENTER’s comprehensive program for addiction recovery.
So I think it’s a wonderful opportunity with the program that we’re offering here in southern California to bring a larger community together to make them aware of innovative ways that EMDR is being used and to give them a more comprehensive training than the traditional two weekend model. So it’s really wonderful to be associated with the ONE80CENTER and to be offering this program to your staff and other people in the community.
Can you define some guidelines for clinicians in recommending EMDR? – EMDR Discussion – Interview with Dr. Andrew M. Leeds Ph.D.
Well there are a lot of factors that go into that Steve. It’s actually a very sophisticated and complex issue and hard to discuss in a matter of minutes. In general terms I would say there is going to be a spectrum of cases. There are going to be some people where, for a variety of reasons that I’ll touch on briefly. You’ll probably need to wait a little while, at least for the standard protocol. With others you tend to begin and will need to begin sooner. So what are some of the factors? Well certainly first, if they’re in heavy detox.
That’s not the time to increase their level of distress even in the short term. So people have to be medically stable first of all and not going through intense cravings. Secondly you have a lot of general readiness criteria that are used when you consider using EMDR. Have you screened for a disassociative order. If you have some type of a disassociative you are going to need to modify the way you’re approaching with EMDR. There’s work that’s being done in Europe examining this question, some pilot studies have been done with some slightly modified EMDR protocols.
In early phase recovery from severe alcohol abuse showing that EMDR can be used in early phase residential treatment programs to decrease relapse rates. So again it’s going to depend how soon is the client ready for that and clinicians need a lot of experience to make that determination. So, clinicians early trained in EMDR will need to consult with approved consultants to help sort that out, but a lot of people will be ready early on. You have to have a standard protocol for treating PTSD and in some cases that’s going to be appropriate. Other people aren’t being troubled so much by their PTSD symptoms.
They are really being troubled more with severe urges to use and there are modified EMDR protocols to target the urge to use itself that are showing promise in early trials. Those modified approaches can be useful in early phase recovery where people are struggling with the urge to use. Maybe we’re not going. to be treating their trauma. We’ll be treating their compulsions, we’ll be treating their urges. That’s also true for other addictive compulsive behaviors like compulsive gambling, compulsive spending which are sometimes co-occurring with substance abuse disorders.
The same is also true with eating disorders where you often find eating disorders co-occurring with substance abuse disorders. So when EMDR becomes appropriate and which EMDR protocol becomes appropriate is a complex question. There are a number of protocols to be considered and a lot of research that’s going to need to be done to demonstrate which protocol is going to be used at which time.
Why is EMDR an important protocol in treating addicts? – EMDR Discussion – Interview with Dr. Andrew M. Leeds Ph.D.
Well I think this is a really important question and first I want to say that it’s really a privilege to be associated with the ONE80CENTER. I worked with you Steve and with Bernie even before you founded the ONE80CENTER and I’ve consulted on some of your other cases before. It isn’t just a feeling or a clinical observation that trauma is commonly involved with substance abuse problems. The SAMHSA, The Substance Abuse and Mental Health Services Administration research shows that the vast majority of people with alcohol and other substance abuse problems have co-occurring disorders.
Most commonly trauma related disorders. Trauma typically leads to symptoms of post traumatic stress disorder, but it can also cause other anxiety disorders and other depressive disorders. The vast majority of people with these co-occurring disorders don not receive treatment for both their substance abuse problem and their other co-occurring conditions which is why most treatment programs have high relapse rates. If you don’t treat the co-occurring condition then the person is going to continue to have a need to medicate.
If their prescription medications don’t meet their needs adequately they are going to begin to self medicate again. So, relapse rates are very high if you can’t resolve this. PTSD in particular has an episodic cycle. People alternate between phases of intrusion and phases of numbing. So people can have a quiescent phase where their intrusions are somewhat hidden and then as they get triggered their intrusions begin to get reactivated and then have urges to relapse again. It isn’t just a chemical process of detoxification.
It’s the condition association between a long established history of self medication in response to the cyclic turn of the trauma material. The trauma material as Bessel Van Der Kolk has pointed out is not that often in the form of disturbing images or nightmares in the kind of overt signs of PTSD that many clinicians may be looking for. The most common forms of the reoccurrence of trauma symptoms are body sensations and emotional states, that are the re experiencing of aspects of traumatic experiences.
So clinicians who don’t have a strong background in psychotraumatology won’t recognize that the cues that are triggering relapse are associated with traumatic experiences. They wouldn’t have gone looking for the trauma history. They would be thinking that’s too disruptive to the client who is in a recovery program to uncover that material and they won’t even think about treating it. As a result these co-occurring conditions largely go untreated and so what you are doing here at the ONE80CENTER, I think is really pioneering work.
I think you’re one of a handful of programs around the country that’s even thinking about attempting to use a comprehensive approach. And I know you do more than just conventional recovery work and EMDR here. You use lens neural feedback and other innovative approaches to try to get at the source of what’s going on behind the urge to use. EMDR is an essential part of a comprehensive treatment program for substance abuse programs. If you don’t treat the trauma people will relapse. That’s been demonstrated over and over again.
I think they’re kind of a common myth that you have to wait until people have been stable in recovery for years before you think about treating the co-occurring conditions. That was a model that was promoted in the 1980s. Researchers now have demonstrated that that doesn’t work. If you don’t begin to treat the co-occurring conditions immediately people will fail. They’ll go through a rehab program and then they’ll relapse again. So it’s essential. In EMDR compared with other approaches for treating the co-occurring PTSD or similar traumatic or depressive symptoms that patients may have, has a lot going for it.
As I think the first choice in ways of treating co-occurring disorders compared with prolonged exposure and cognitive processing therapy. The main thing it has going for it is it’s efficiency. The research studies show again and again that the modal response is faster to EMDR that prolonged exposure and cognitive processing. PE and cognitive processing do catch up with enough sessions but for people who respond well to EMDR, they respond faster and they get symptom relief faster.
So I think when you’re in a residential treatment or an aftercare program offering EMDR it’s a much more attractive modality to be considering because it’s going to produce faster symptom relief. When patients who have relapsed again and again start to experience substantial symptom relief of long existing symptoms in a few EMDR sessions they become believers. They go, I want more EMDR. Forget about that other stuff.
Well, we aren’t sure exactly how EMDR works and there are several leading models to explain the well established effectiveness of EMDR. So the first thing to make clear is that EMDR is a well established approach to psychotherapy and has shown to be effective for post traumatic stress disorder acute stress disorder and for specific phobias and there is quite a bit of emerging evidence for other conditions as well. The two primary models that are given the widest attention for how EMDR works, the first is the REM orienting response hypothesis and the second is the working memory hypothesis.
The REM, rapid eye movement or orienting response hypothesis, assumes that the system in the brain for orienting response is behind the effectiveness of EMDR. The REM hypothesis which explains how memory is reorganized during REM sleep. These two actually fit together. So as most mental health professionals are aware all mammals have REM sleep and deep sleep phases and in the REM phase of sleep memory is pruned. Parts of the memory are thrown away without this we would be left with a flood of images and feelings and physiological responses to mildly and severely distressing life experiences.
During REM sleep memory is digested and the unimportant aspects of memory are discarded taking away the emotional vividness, taking away the sensory vividness of memories and leaving us with a gist of these life experiences. The most important parts and the parts we can learn from. Something similar seems to happen during EMDR during the eye movements with EMDR. The unimportant parts of memory. The vividness of the feelings, the vividness of the sensory impressions become weakened and fade. In a way very similar to what happens during REM sleep.
Partially this may be caused by what’s called the orienting response developed by Sokolov a contemporary of Pavlov, who described a multi-phase process for how mammals respond to novel stimuli in the environment. When there’s a novel stimulus in the environment say a noise in the bush and there’s a deer out grazing. Acting under instinctual behavior it hears this noise and it orients towards it. It turns it’s head, it’s ears swivel, it’s eyes scan the environment, it’s nostrils sniff the air, trying to determine whether it’s a threat or not.
One of three things happen at that point. The first is that with orientation there is a spike of arousal and during this appraisal phase that comes right afterwards the animal checks a database stored in the amygdule the flight/fight site of the brain for all previous threat cues and it compares the incoming sensory inputs against what’s stored in the emotional part of the brain. If it’s a predator emerging from the bushes the deer sees it and in 1/25 of a second it’s fleeing. If it’s a big male deer with antlers and the doe was in rut she smells the air and goes prancing of toward the male, something good.
But, if it’s just the wind blowing the bushes it’s determined to be neutral, uninteresting and the arousal hoes down. Well this is what happens with eye movements with EMDR. You have an orienting response. There is a brief spike up as the eye movements begin and then as the amygdule looks out through the eyes it’s kind of in this paradoxical situation because the therapist has activated all the trauma cues active in the imaging in the brain and the same part of the brain where you see current imagery.
When you bring up old memories that are traumatic the same parts of the brain are active as during current sensory perception but the amygdule now is looking at the lights or the hand of the therapist going back and forth and sees something boring. It’s not a threat, it’s not exciting either. So arousal goes down. So the orienting response model says the dearousal is a compelled relaxation response. That’s what David Wilson called it. Part of the normal investigatory or orienting response process. That’s when the emotional parts of the brain perceive boring sensory stimuli.
So, what happens during REM is that emotionally intense material moves to the right hemisphere stored in vivid sensory to the left through a process organized primarily by dopamine. These things seem to go together. The orienting response the REM system in the brain being activated, information becomes decreasingly vivid decreasingly intense and moves from the right hemisphere into a narrative form in the left hemisphere. So that’s the first hypothesis. That’s the REM orienting response hypothesis. There’s not a lot of research behind that but there are some studies that support it. For example, The Quechan study Quechan bermyols and stern I believe did a study showing that with eye movements we become more creative.
We find more creative ideas and it had a very novel research protocol for demonstrating that. Showing that we make new associations more easily when we are making eye movements. The hypothesis with the most research support for it is the working memory hypothesis and this is actively being investigated by a group of researchers in the Netherlands and they’ve done a large number of studies that support this. Showing that both eye movements and auditory tones and the kinesthetic simulation that we use are capable of disturbing working memory. There are several parts of working memory but let stay with visual working memory for just a moment. If you see information written down, say a phone number you want to memorize. You temporarily hold that information in your short term working visual facial template of working memory.
If you then move your eyes it will disrupt the image. You wont be able to hold onto it. Working memory hypothesis researchers have demonstrated through their studies that for most disturbing memories the eye movements are dramatically more efficient at disrupting memory than the auditory tones or kinesthetic stimulation because they disrupt the visual spatial template of short term working memory. However, some clients suffering more from difficulties with sounds of disturbing memories and in some cases the auditory tones may be better for some people but certainly we could use them for people who cannot tolerate the eye movements.
So the working memory hypothesis has shown that different forms of distraction work almost as well as the bi-lateral eye movements that we use. Almost any visual distraction will work. The eye movements are just a little bit more efficient than some others so those are the two leading hypotheses. Now, there are others slightly more esoteric having to do with the role of the thalamus in the brain and a 40Hz binding frequency that’s put out by the thalamus under certain conditions and the eye movements seem to enhance the ability of the thalamus. To put out that 40Hz signal. One of the factors that allows consciousness to occur.
That is for a person to be aware of what’s going on in their brain. Different regions of the brain need to be simultaneously in communication with each other. As you know, during states of disassociation different parts of the brain are active but they’re not in communication with each other. So there is a fragmented experience. The 40Hz signal that’s put out by the thalamus helps to coordinate disparate regions of the brain so that they become into a relationship with each other to create a cohesive experience of consciousness. With all the different facets of sensory perception and memory and cognitive capability.
So, the eyes movements that we use in EMDR seem to enhance the ability of the thalamus to coordinate activity from disparate regions of the brain and allow consciousness to come into play. Another factor of what allows EMDR to work is the process of mindfulness. Some people who have studied meditation have joke that EMDR is like mindfulness meditation on steroids and certainly there is evidence from some of the brain studies that have been done that pre-funnel activation. This part of the brain. The pre-funnel orbital cortex where executive function resides is activated more strongly following EMDR sessions.
It brings the pre-funnel system back online. The pre-funnel system is one of the things that allows the brain to regulate the level of activation in the emotional brain. In the mammalian brain in the limbic system. So enhancing mindfulness is one of the factors that EMDR seems to do. Certainly, the metaphors we use when we do EMDR are intended to enhance mindfulness. We use the metaphor of being on a train and just noticing what’s happening. The need not to have to verbalize but to simply notice things silently, during brief intervals of eye movements.
Enhances the clients ability to mindfully attend to their experience without having to engage in narrative, without disrupting a continuous process of just noticing. The eye movements seem to enhance the brains ability to go into that state of mindful noticing without judging. Which is very different than what happens during prolonged exposure. Where people often go into prolonged intense emotional experiences and are sort of stuck there for an hour or longer. During EMDR the experience of intense emotional reprocessing is typically very brief because mindfulness comes to play, the arousal process comes to play, working memory comes into play and things change very quickly. So those are four of the leading hypotheses for how EMDR works. There are probably some others. I’ll just mention a fifth for fun.
The cerebellum is the part of the brain in the back that used to be thought of as predominately involved with sensory motor coordination. It does a lot of other things. One of the other things the cerebellum does is it helps to regulate our emotional life. A healthy cerebellum is able to down regulate activity in the amygdule. People who were raised with emotional neglect and abuse. You will often hear that they will report that when they become agitated they rock because they can’t quite do this internally in the cerebellum.
The two halves of the cerebellum are not properly connected the cerebellar vermis is incompletely developed. In EMDR when you do bi-lateral eye movements you get activity going on both sides of the cerebellum. It enhances activity in the cerebellum and helps the cerebellum to down regulate excessive activation in the amygdule. Left eye movements are therefore more effective because it’s an active muscular movement of the eyes. Where as passive listening to auditory tones in kinesthetic stimulation don’t activate left right cerebellum nearly as strongly.
So those are five of the possible hypothesis for what’s going on. None of them have been demonstrated conclusively , but there’s new research that’s being done where you can do simultaneous EEG and MEG studies during EMDR In the past we weren’t actually able to monitor the brain during eye movements because it produces a lot of artifacts on EEG. But there are new technologies that are going to allow us to monitor the brain in real time during EMDR sessions. Previously we’ve seen changes pre and post.
We’ve seen what could happen with a spect image before EMDR versus a spect image after. We can see how the over activation in the right hemisphere is moderated the under activation of the left hemisphere is brought up as the information moves from the left to the right side. Increase activation of the pre-funnel regions. Decreased excessive activation in the interior singlet, but we’ve never been able to watch the brain in real time during EMDR. That’s just starting to happen. So, I think these next few years we are going to see a lot more brain imaging studies and other types of brain studies that will demonstrate conclusively exactly what’s happening during EMDR. But you know, we don’t know how other therapies work yet either. So, we have some good hypothesis and the research is coming.
Can you discuss EMDR as an orientation as opposed to a technique? – EMDR Discussion – Interview with Dr. Andrew M. Leeds Ph.D.
There are several facets to that, but it’s a really good point Steve. I’m glad you bring that up because a lot of people do think of EMDR as a simple technique. They think you just think of this disturbing memory and that’s all there is and the rest of the time you’re doing regular therapy. Actually EMDR is not a simple technique it is an approach. What makes it an approach is the adaptive information processing model.
Imaginable exposure also sometimes talks about the need to do cognitive processing because of the limitations of pure exposure therapy. They don’t understand emotional information processing the way we do in the EMDR world, through the lens of adaptive information processing model. The AIP gives us an idea of how memories are organized. It gives us an idea of how people omit adaptive behaviors. It isn’t that people are bad. It isn’t that people want to do bad things. People process reality, they process their experience through the lens of what’s stored in their brain and it’s stored in maladaptive ways and the way that they perceive the world is going to be maladaptive. If you see someone smile at you, you might think that’s a friendly person.
Someone else looks at that person and thinks, what are they trying to get out of me? How are they trying to manipulate me? That suspiciousness, the paranoia, responding to innocuous cues in the environment as if there is a trauma that’s about to happen. Like combat veterans who hear a loud noise and think that they’re under attack. This is what’s stored in the brain. Understanding the way that dysfunctional stored material is organized in the brain is informed by the AIP model. So we need the model to be able to conceptualize what’s happening with our clients and how to develop treatment plans with the simplest cases. With a single incident trauma you don’t need a complicated plan, but those types of cases are relatively rare. Most of the cases that we see are either complex trauma cases or they are cases with co-occurring disorders.
With co-occurring disorders the way you’re going to organize the treatment plan , the sequence of targets you’re going to work with needs to be carefully selected to meet the needs of that person. Without the AIP model I don’t know how people would be able to figure that out. You need to understand the model. So in the beginning when clinicians are first trained in EMDR they often don’t understand the importance of the model and they are approaching EMDR as just a technique, but when they start having some successes and some treatment failures then they come back for more consultation and they begin to appreciate more and more the need to think within the model in order to be successful with a wider range of clients.
What led to your development of RDI and what made you believe it could work? – EMDR Discussion – Interview with Dr. Andrew M. Leeds Ph.D.
Resource Development Installation grew out of one of my treatment failures. I tell a story about this case in a book chapter in a book edited by Phil Manfield, The case book of EMDR. It’s called, Lifting the Burden of Shame, it’s a story about Meredith. I won’t belabor the case story here, but this young woman came to me with a complex set of co-occurring disorders including some medical conditions that made her not a good candidate for the standard EMDR protocol. And I deferred offering it to her but she saw the certificates appear on the wall in my office indicating my training and growing status in the EMDR world and demanded I treated her with EMDR and as I anticipated she did not respond well.
She had a problem with intense shame. She grew up in a family without supportive parents, with verbally abusive and neglectful parents. Her physical needs were being taken care of but her emotional needs were not being met.Whenever emotional material was activated she would go into what I call a shame melt down, hiding her face in her hands weeping silently for 20 30 40 minutes at a time and everything I would try to do to pull her out of those shame meltdowns failed. This had gone on for a couple of years. I didn’t really invent the thing that’s called RDI. I gave it a name and I came up with a standardized way of using it. Similar ideas have been proposed by other people. The idea of focusing on some other positive experience or some kind of positive symbol. Like Ron Martinez, talked about kids and having them think about superheroes and then installing the feeling about the superhero to help them feel stronger about themselves and being able to face their fears.
Other people had proposed this idea but they had done it in fragmentary ways or in very narrow populations. After several failed EMDR sessions that had melted down and we could not proceed. The next week Meredith came in and told me about a dream that she’d had. It was what I call a consolidation dream. It had some positive images in it, with some hopeful dream imagery I asked her if she was willing to focus on the dream images and strengthen them with some eye movements and so that’s what we did. She responded very positively to that. We then did a series of imagery exercises where she accessed internal images. A lion like figure for courage an old woman for self-acceptance and compassion for self. Just a whole series of very spontaneous images that were coming up through imagery.
I installed a series of these exercises with her over the space of about 45 minutes. When she came in the next week I almost didn’t recognize her. She suffered from a Lupus type condition that had left her with chronic physical pain. She often walked with a limp and sometimes needed a cane. She had chronic insomnia. She would wake up in the middle of the night and couldn’t get back to sleep. She couldn’t tolerate medications. She struggled with relationships with men. She had trouble with boundaries and assertiveness in social situations and when she came in the next week. The first thing that she reported was that she actually scheduled an early session a day or two earlier.
I was really afraid that I may had harmed her that she was asking for an early session but as it turned out she wanted to report some gains. She reported that she had no physical pain for the last five days. She said that she had slept through the night every night. She has reported a series of very positive things and I couldn’t quite make sense of how much change there had been from just doing eye movements on positive imagery. I’d never seen anything like it. I’d been practicing for about 17 years at that point and had been using EMDR for several years. We discussed the changes and at another scheduled appointment a few days later we did another series of installations. The next week she came in she made more life changes. She made some dramatic changes.
She managed to be assertive in a peer group in ways she hadn’t been able to stand up for herself in a confrontation. She confronted her boyfriend and demanded what she needed in the relationship and he responded positively. It was just a transformation. The following week she came in and we began doing the standard EMDR protocol on some disturbing memories where we had tried to address before and had failed and it went smoothly with no extra work needed on my part, it was spontaneous reprocessing. I was just completely blown away by the changes in her. Why I thought it work before it worked it was really desperation and it was kind of a light bulb moment. I thought well, we see many positive things during the standard installation phase, where things get stronger and stronger and sometimes in a way that’s very transformative for people. I thought why not just start with that. On something positive. Something that was already positive. I was so impressed with the changes Meredith made that I called Francine Shapiro and told her about it I was very excited. I said I wanted to teach this at some of the advanced trainings that I was teaching for the EMDR institute, the part 2 trainings.
At that time I had been teaching a specialty segment on how to select negative and positive cognitions. I had been doing that for several years. It was kind of stale. It was easy and this was much more exciting. She said maybe it’s just you maybe it’s just your skills with hypnosis or something. Teach it once then get feedback from the people who were there and write up some cases send that to me and if other people get similar results, then you can begin teaching this. So that’s what happened. The other members of the teaching faculty who were in that presentation went away and tried this and wrote to me and described similar successes. About a year or two after that Phil Manfield approached me and asked me to write a chapter on it and then people wanted me to teach a workshop and it became a runaway success. My name is now associated with this.
In 1999 I was given an award by Francine Shapiro for the development of RDI and some of my other contributions in other ways to EMDR. The truth of the matter is even though RDI is remarkable, I really don’t use it very much in my practice. I use it when it’s needed. I use the standard protocol most of the time. When clients need the resource information it’s incredible. I don’t usually do it for very long. One or two session of resource work is all they usually. Typically, it’s when the have failed to respond to the standard protocol. Or if they have persistently incomplete sessions and you can’t get to completion. Occasionally I’ll use it for clients who are unstable. Clients with problems with impulse control, with anger management problems or for clients who have problems with self injury. So I do use RDI in those situations. I might use it 5 times in a month and I use the standard protocol 4 times a day. So that’s what led to RDI.
Could you tell us about your history prior to your exposure to the practice of EMDR? – EMDR Discussion – Interview with Dr. Andrew M. Leeds Ph.D.
Well my interest in the field of psychology begins with my interest in the nature of consciousness. As an undergraduate at University of California Santa Cruz, I thought about going into the history of consciousness program and ultimately I decided not to go in that direction. My real interest is in the nature of consciousness and the relationship between consciousness and the physical universe. Does consciousness pre exist the development of the universe and does the universe develop from consciousness? Or is it the other way around and is consciousness an emergent property of matter.
Out of that philosophical and metaphysical interest there is a practical need to have a career. So, I began to study psychology and at that time mainstream psychology was not a big interest for me. I had become disenchanted with the psycho analysis. Because of Freud’s abandonment of the traumagenic theory of the origin of psycho neurosis in favor of the electra and edible complex and this complex theory he developed. I wasn’t very impressed with Skinnerian behavioral psychology which ignores the nature of consciousness. And basically acts like we aren’t conscious beings. So I was interested in the mind-body areas of psychology and I studied as many of the mind-body approaches as possible. I wrote my senior thesis on that and went on and got a masters degree in an integral approach to psycho therapy. Studying Upasana meditation, insight meditation. Studying Gestalt therapy and body focused psycho therapies. About a dozen different kinds of body focused psycho therapies.
Then I went on later and got my PhD in psychology and continue to figure out how to work with the mind and body together. I moved away from somatic psycho therapy in the mid 80s and became more interested when I went back to get my PhD in ericksonian hypnosis, self psychology and dynamic forms of therapy. Then in 1991 discovered EMDR. I’ve described it as the “Keystone” in my studies because my original training was in pure process work. Gestalt and boy work. It’s not based on psycho dynamics it’s not based on the DSM and differential diagnosis, it’s based on pure emotional process. We were trained on how to look at the body, how to see the history of the person in their body posture, in their facial expression, in the subtle expression in pupillary dilation and muscle movements in the body. In order to read the emotional history and the emotional experience of the person. Then when I went back to graduate school and studied differential diagnosis. I became fascinated by how do different conditions come about? And the need to treat different people with different kinds of histories and different kinds of conditions with different methods. Not one method for everybody. Not one way of using a method for anybody.
EMDR allowed me to bring these 2 very different streams of studies together. EMDR has this sort of paradoxical nature, that on the one hand the protocol is very structured. It’s very structured to the point that new trainees coming to EMDR struggle with the script. It’s very antithetical to people with humanistic backgrounds and other backgrounds. They have to kind of read the words off the page. Within the reprocessing work that we do with EMDR there is a tremendous scope for being very flexible in the way you interact with clients and the need to be able to read what’s happening in the moment. And a lot of what you’re reading is non-verbal. It’s in voice tones, it’s in facial expressions. It’s not just in the narrative of what people are saying. So that background in body mind psychology has been very helpful to me in being able to see things and understand things that sometimes mental health professional that don’t have that background ask, where are you seeing that? Or, where are you getting that information? So it’s been very helpful to me to bring together these two worlds. A world that’s very structured and uses differential diagnosis and differential treatment planning with a world that’s very pure process and works in a very client responsive way.
Well let me start just a little bit before my training in EMDR back in 1979 when my wife and I were in a motor vehicle crash and she had some physical injuries and I was not physically injured but I was not functioning very well afterwards. What I didn’t know until a few years later is that I had PTSD. Of course I couldn’t have PTSD back in 1979 because it didn’t come into existence until 1980 when the DCM3 came out.
It kind of became a mission of mine to look for ways of treating PTSD. I didn’t think that other people should have to suffer for months or years after developing PTSD. At that time I wasn’t very impressed with the available treatments which at that time were primarily prolonged imaginal exposure. It just didn’t appeal to my sensibilities. So, nothing really stood out on my radar until 1990 when I got a flyer in the mail about a EMDR training that was being held in Sonoma County where I was living at that time. And, I didn’t go. Because I associated the use of eye movements with another approach that I knew had no research behind it and then I thought Ok this can’t work for me either.
Then about 6 months later in the Spring of 1991 I got a postcard in the mail from a psychiatric hospital that I respected. Having a grand rounds presentation with Francine Shapiro. I though they’re sponsoring this person who is doing this wacky eye movement thing. The postcard mentioned that she had some publications. So I went to our local University Library and they had both of the publications there and I looked at her research and I immediately thought this was some kind of trick, some kind of deception or it’s the most important development in the field of psychology in 125 years because no one could resolve traumatic memories that fast. So, I went to the lecture and that was in early June of 1991.
I had the same perplexing problem during the lecture because as I listen and I watch her videos, I couldn’t believe it was real. It was too quick, but I couldn’t take the chance that it was as effective as it appeared to be. So, the next weekend there was a training in Berkeley and I went. I had some remarkable experiences in my practice exercises. So, I started using EMDR that next week in my practice. Almost all the sessions that I had were successful the very first week I began using it. I continue to use it on a weekly basis in my practice. In October of 1991 I attended the second of the basic training in EMDR. And at the second training one of the training supervisors came up to me and asked me if I was interested in joining the training staff. I was thrilled. I was convinced that this was a very exciting development in the field that would eventually be research validated.
I joined the training staff in November of 1991 and by February of the next year I was the chair of the training supervisors selection and training committee. I was helping to train other training supervisors. By the end of that year 1992 I was a trainer in training. In 1993 I was beginning to teach the basic training and by the end of 1993 I was authorized to conduct weekend one and weekend two trainings for Francine Shapiro. I continued to do that for 17 years. So, it’s been a very fast moving train. It’s completely transformed my professional life.
I continued to practice the whole time in Santa Rosa California. I’ve trained about 15,000 mental health professionals throughout the United States, in Europe and Japan. I’ve published articles and book chapters and a book on EMDR and I never thought I was going to go in that direction. I had pretty much given up on most of the treatment outcome research in the field of psychology. But I was forced back into looking at it as a result of my involvement with EMDR. I follow the research very closely now. A lot of the research is still not very good but we now have achieved a great deal international recognition for EMDR and it’s been a privilege to be with EMDR the whole time almost from the beginning. Originally with the EMDR institute and since 2010 with my own training institute.