Video 030 Four Field Technique
Use this solution
With children/young people who might not have the verbal and self-awareness skills required to work with the standard protocol or who would be unable to tolerate the standard EMDR procedure; also if, for example, two siblings have experienced an identical traumatic event. The technique helps to capture a child’s attention and establish support while slowly introducing them to the memories to be re-processed.
The Shapiro Library’s reference to Four Field technique also suggests the application of this technique for adults with complex trauma, drug addiction, etc. who would not be able to tolerate the exhausting confrontation with the standard procedure.
Originator
The Four-Field-Technique and its use with individuals is an application of a group protocol originally developed by Jarero et al. This mirrors the 8 phases of the standard EMDR protocol. See Wrap up.
Video production
Matthew Davies Media Ltd, Llanidloes, Powys.
www.matthewmedia.com
What this covers
Case of a child – Grace/Seren - injured in a horse riding accident. Shows the use of the Four Field Technique that asks the client to make use of drawings - a safe place, initial target and what subsequently arises during the Bilateral Stimulation phase. Aide mémoire describes option for installing a positive cognition for children who are mature enough to handle this phase.
How long
12.47 minutes.
Related Videos
See Video 031.
Go to ‘Take-away’?
For Aide-mémoire for use in a client session and for references to protocols.
Take-Away Section
+ Wrap up
See original paper: The EMDR Integrative Group Treatment Protocol (IGTP) for Early Intervention with Children. https://emdrresearchfoundation.org/toolkit/igtp-children.pdf
See: Morris-Smith, J & Silvestre M. EMDR for the Next Generation - healing children and families. Published by: Academic Publishing International Limited, Reading.
Visual scales for SUDs and VOC can be obtained from Traum Aid UK: https://www.traumaaiduk.org
+ Aide-mémoire
You can copy and paste this text into a Word document, and can edit it, adding any additional text you might find helpful.
- Make sure you have a variety of drawing instruments – pens, pencils, etc. available, and prepare an appropriate piece of paper divided into four quarters by folding it twice, once vertically and once horizontally.
- Introduce the idea of butterfly taps and explain what it does. Demonstrate how to do this with the hands linked by the thumbs, and with the middle fingers touching the chest just below the collarbone.
- Encourage the child to draw a picture of a safe place on a new separate piece of paper.
- Have the child look at the drawing and do butterfly taps to install their safe place and enhance the feeling of safety. Set the drawing aside.
- Check the child is grounded/calm in the therapy room before moving to processing. If not, do more tapping and check again.
- Go back to the folded paper and ask the child to make a drawing of the worst part of the incident in the top left hand box. Have the child rate the level of distress on a SUDs scale of one to ten. Use a visual scale if you have one. Then instruct the child to do twenty four or so fast butterfly taps until he/she comes up with a new/changed image.
- Ask the child to move to the second box (top right hand side) and draw a new picture to represent the new/changed image. Have the child rate the level of distress again. Then repeat the instruction to do butterfly hugs until a new or changed image comes up.
- Repeat the process moving to the third box (bottom left hand side). Check the SUDs level. If it is still raised, repeat the process using the fourth box.
- If more reprocessing is needed repeat the steps above with a fresh piece of paper until SUDs go to zero.
- If the SUDs level is at a zero, the process could be ended at this point after having the child repeat the safe place exercise, as in the video (see reference above to - ‘Next Generation - healing children and families.’). Often, children do not have a positive cognition to install. At this point, it can be helpful to install whatever comes up as positive until it ceases to get stronger or improve.
- Depending on the ability of the child, when SUDs fall to zero, continue with the normal eight phase protocol by asking the child to draw how they see themselves in the future. Have them write a word, phrase or sentence that explains what they drew. Then instruct them to look at the drawing and what they wrote and do the butterfly hug. You may be able to assess the VOC using a visual scale from one to seven, though it is asking quite a lot of a child to hold the target image in mind plus the PC and evaluate ‘how they feel now in the present’.
- Do a body scan, if possible, but recognise that many children will not be able to hold an image, a PC, and scan their body for tension. One approach is to ask, ‘How does your body feel now?’ and install any nice sensation. If there is a disturbing feeling go back to having the child notice the feeling and do butterfly hugs until it resolves.
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.