WHICH IS BETTER, THE STANDARD EMDR PROTOCOL OR A-I EMDR PROTOCOL? (SEPTEMBER 2021)
Richard Worthing-Davies discusses the differences between Attachment-Focused and Attached-Informed EMDR.
A little history…
For years there has been a debate about whether the standard EMDR protocol and the application of its eight-phases should be followed rigidly, even to the marginalisation, if not exclusion, of the Attachment-Focused or Attached-Informed EMDR protocol (AI-EMDR) from mainstream thinking and training.
For those not familiar with AF- or AI-EMDR, compared to the standard EMDR protocol, there is some reordering of the elements of Phase 3 Assessment and the latter doesn’t insist on a PC (Positive cognition) at this point[1]. Case-conceptualisation can also be significantly different.
A vote of thanks
We owe much to Dr Laurel Parnell in the US, who first set out what she called her Modified EMDR Protocol in her 2007 Therapist’s Guide to EMDR. Here in the UK, her work has been taken forward by Mark Brayne who for several years now has been fighting valiantly, and increasingly successfully, it may be said, for recognition of this adaption of the standard protocol as consistent with the mainstream, Standard Protocol/Standard Procedural Steps for EMDR.
It has been a journey of no little controversy. At one point Dr Parnell’s trainings were denied official EMDR Association UK CPD points. This decision was, thankfully, reversed after a very strong high-level appeal to EMDR Europe. Now, with Mark’s continuing Unleash your EMDR workshops, building on and developing Dr Parnell’s approach, there continues to be some argument over which of the two (AI-EMDR vs EMDR as conveyed in basic, standard training) is better, i.e. most effective in the treatment of trauma, particularly of the complex variety. That’s why I’m writing this blog: to offer some thoughts on these questions, especially for those new to the subject or coming across AI-EMDR for the first time, and perhaps confused by the arguments they may encounter in their work as EMDR therapists.
So, where shall I start? With tennis!
Matthew Syed, a Sunday Times writer and one of my favourites. Recently, he wrote about the best way to develop a great tennis player and compared the upbringing and development of several remarkable players[2].
Every day, Venus and Serena Williams as children would go to a public court with their father Richard, who would fire a shopping trolley of tennis balls at them. Theirs is a story of early specialisation leading to greatness on the tennis court. There are many examples within tennis, including Andre Aggasi, which testify to the power of this method; and there are many examples from areas outside sports, for example, Mozart whose father had him playing the piano from age two.
On the other hand, Syed pointed out that in recent years a different approach can be discerned. Roger Federer and Novak Djokovic tried a range of sports before specialising in tennis. Other athletes also tried several sports before settling on their specialism. Most recently we have the astonishing Emma Raducanu, the 18-year-old tennis superstar who won the US Open championship in her first major tennis event. Her early life included, ballet, horse riding, swimming, tap dancing, skiing, golf, karting and motocross alongside tennis and getting an A* in Maths and an A in Economics in her A-level exams.
An obvious question is, which of these two approaches – early specialisation or experimentation and later specialisation - is the best way forward for developing future greatness in any realm?
It’s the wrong question, and the right question is…
Matthew Syed suggests this is the wrong question, because it assumes we are all basically the same, and avoids the fact that we are all different, with our own idiosyncrasies, i.e. our own mode of behaviour or way of thinking. Going back to the question of which EMDR protocol is best, (or at least, preferred), this also is the wrong question to ask, and for the same reasons.
The choice of approach should depend on the idiosyncrasies of the client, and in particular what has happened to them and when. For this writer, I would unhesitatingly choose to use AI-EMDR over the Standard Protocol for clients whose early life was characterised by significant attachment issues. For many other situations, I would tend towards the Standard Protocol. At the end of the day, it’s not ‘What protocol is best’, but, ‘What’s best for the client in front of us’.
“Matthew Syed suggests this is the wrong question, because it assumes we are all basically the same, and avoids the fact that we are all different, with our own idiosyncrasies, i.e. our own mode of behaviour or way of thinking. Going back to the question of which EMDR protocol is best, (or at least, preferred), this also is the wrong question to ask, and for the same reasons. ”
Personally, I find the argument about whether we should only accept and work with Standard Protocol is foolish, for as Matthew Syed pointed out in his article, it avoids considerations to what is best for the individual being taught, and in the world of therapy, what is the best treatment approach for the client.
Client’s needs must come first, not our preferences and certainly not our ideology.
Richard (Worthing-Davies)
[1] Not insisting on a PC at this point is not unique to AI-EMDR. Neither does David Blore’s Blind to therapist protocol – see emdrgateway.com Video 001; nor does Elan Shapiro’s EMD in R-Tep if the client finds this difficult.
2 Sunday Times September, September 19 2021
I have always loved the pastoral side of education, particularly the opportunities to see young people develop and flourish in whatever ways work for them. As a result of this interest, I completed a Masters in Guidance and Counselling in Education in 1998 followed by a PhD in 2002 that bridged the worlds of counselling and education.