Video 024 Dealing With Abreactions

Use this solution

When a client shows intense abreactions usually associated with complex trauma.

Originator:

An amalgamation of Francine Shapiro (2005) EMDR The relational imperative.

See also Web resources

https://gowiththat.wordpress.com/2017/01/29/543/

Video production

Matthew Davies Media Ltd, Llanidloes, Powys. www.matthewmedia.com

Take-Away Section

What this covers

Intense affect often accompanies work with complex trauma.  It be can be truly shocking to witness.  The temptation for the therapist is to stop processing and to move into talking therapy or resource installation or an interweave to lower the intensity. 

 

Though these interventions are not wrong, it’s better if you can stay with the intense feelings and help the client continue to process while ‘staying out of the way’.  This video shows you different ways to do this with a client who was brought up with a violent and abusive father, witnessing extreme violence to her mother and sibling, as well experiencing it herself.

How long

13.10 minutes

Related videos

See Videos 001 and 002

Go to ‘Take-away’?

See Aide mémoire for step by step description for using different ways to deal with intense abreactions.

+ Wrap up

+ Aide-mémoire

Working with abreactions is much more about you as the therapist being able to use your own affect and your body to regulate your client than about technique. In this aide mémoire we present the keys to attuning to your client followed by some techniques you can try to aide client regulation.

Attending to the therapeutic relationship

  1. Remember the client lives with these intense feelings. They are not new to the client no matter how shocking they may be to you.
  2. Explain that intense emotions can be a normal part of EMDR work but that they don’t always occur. Whatever happens to the client is OK and you can deal with it together.
  3. Explain that the client always has choices. If it becomes too intense, there’s always the option of stopping.
  4. Agree a stop signal.
  5. Stay aware of your own body and the impact the client’s emotional response is having on you.
  6. Regulate your own physiology. You may need to do some work for yourself on self-regulation in the presence of intense emotion (see below).
  7. Stay curious and open to the client’s experience.
  8. Always listen to the client’s fears about certain targets and whether or not they have the energy to face this work today. It can always wait until next week! (Though we also have to be sure we aren’t colluding with avoidance.)

Techniques you can try while you keep the processing going

  1. Use a calm, deep and fairly quiet voice. Be careful not to allow any sense of panic or fear enter your voice.

  2. Keep your own body relaxed and untroubled:

    • keep your breathing regular and avoid short shallow breaths
    • if you are connecting with the strong emotions being evidenced by your client, just allow the emotions to flow through your body rather than fighting them.
  3. Use your own body to regulate the client’s body. Get them to breathe with you. It helps here if you start your breathing rate just below the client’s and then slowly bring it down to a slower rate. If you start too slow, a panicky client won’t be able to match you.
  4. Keep the client connected to the here and now with phrases like ‘you’re safe now’ ‘you are here with me in my office’ ‘this is old stuff’ ‘it’s not happening now’
  5. Try changing the speed, direction, and modality of bilateral stimulation.
  6. Remember that tapping, especially involving touch can stimulate the release of serotonin. Butterfly hugs can also be helpful to reduce pain stimulus.
  7. Put distance between the client and the trauma using an imagined glass screen or a TV screen or a video play-back with a remote control.
  8. Watch out for dissociation including a complete loss of sensation or emotion during processing. If this happens:
    • use grounding techniques such as noticing things in the room – visual, auditory, tactile and smell or the 4 elements exercise (Video 054)
    • stop the processing, talk about what happened
    • maybe switch to CIPOS (Video 001) to ground them.
Creating resources, Blocked processingRichard Worthing-DaviesComment