Video 050 Reliable way to install a safe place
Use this solution
During the preparation phase as a first choice option for installing a safe place that remains ‘safe’ for the client during the assessment and desensitisation phases. Reduces the risk of re-traumatisation.
At the end of an incomplete processing session to reconnect the person to PNS activity. Reduces risk of re-traumatisation
As a coping strategy in challenging external situations e.g. a public performance, to bring calm before entering into the situation. Reduces the risk of suppression or arrest of higher brain functions during stressful situations.
Can work with clients who cannot recall ever having felt safe in their lives
To minimise the risk of failure in the installation phase. Failure during installation can undermine a client’s confidence in the treatment and in the therapist – this is best avoided!
Originator
Dr Claudia Herbert, Director of the Oxford Development Centre Ltd
Video production
Matthew Davies Media Ltd, Llanidloes, Powys.
www.matthewmedia.com
What this covers
This is about a man called Tony who in his younger days, was a gang member. Now older, and less able to look after himself, he’s recently received a very bad beating from members of a different gang. He’d heard about EMDR and wanted to know if this could help. He was hyper vigilant, always looking out for enemies (and, of course, the police), showing overactive Sympathetic Nervous System (SNS) activity.
The video demonstrates a very reliable protocol for installing a safe place. It uses an imaginary place rather than a real one familiar to the client. The latter can be problematic if the chosen place has some forgotten negative connotations. With Tony, given his history, it was decided that an imaginary place would be more likely to work for him.
The aim of this protocol is to install an internal resource that enables a client to connect to their Parasympathetic Nervous System (PNS) activity to counteract overactive Sympathetic Nervous System (SNS) activity.
How long
14.48 minutes
Related Videos
See Video 051
Go to ‘Take-away’?
For Aide mémoire to use in client session and other useful information
Take-Away Section
+ Wrap up
- The protocol presented in the aide mémoire was first published in 2000. Some alterations have been made for clarity.
- You may want to install key aspects of the Safe Place e.g. what is seen, heard, smelt, felt, etc. with slow tapping, buzzers or other bilateral stimulation.
+ 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.
- Explain how the human nervous system works – two systems directly opposed in functioning – SNS and PNS. Safe place protocol is a way to enable client to activate PNS in order to work towards balance.
- Explain you will talk them through a script that will ask them to create an imaginary Safe Place. Encourage them not to choose a real place; encourage them not to try too hard and think about a place, but to let it emerge as they follow your instructions; let them know there is no ‘right’ or ‘wrong’ and that they can change their safe place if they want to later.
Installation process:
- Obtain a SUD’s (Subjective Units of Distress) rating in terms of level of tension experienced at this point in time by the client (0-10). Note this.
- Explain that you will give them a series of instructions to follow. Arrange for them to give you a signal whenever they have accessed a particular image or completed a particular instruction (e.g. lifting a finger).
- Encourage the client to be as comfortable as possible in their chair. Say they can close their eyes o focus on the floor beneath them, whichever is most comfortable.
Begin by establishing a relaxed breathing sequence. Have our client focus on the:
- Temperature of their out-breath (say, just notice it and let me know when you have done that)
- Pace of their breathing; and then encourage them to slow it down to as slow a level as is comfortable without straining
- Time it takes to breathe in and the time to breathe out; and the amount of air they breathe in and the amount they breathe out. Then encourage them to gently balance their in and out breaths
- Depth of their breathing whether ‘shallow’, stopping somewhere in the chest cavity, or ‘deeper’ in their abdomen. Then encourage them to take a few deep and slow breaths. Have your client pay attention to their feet and the way their body is supported by their chair. Encourage them to feel grounded and supported.
Now have the client imagine an artist’s palette of colours (in any medium that they like, e.g. oils, water colours, etc.). Remind them to signal you when they have accessed the image.
Ask the client to choose 3 or 4 colours that have an especially calming and safe effect on them.
- Now encourage the client to imagine what the colours would look like in a place that was a ‘Safe Place’ for them. Remind them that they may choose to use any or all of the colours they chose originally or go back to the palette and choose different ones.
- After the client has signalled this task has been accomplished, ask your client to imagine what it would sound like in this Safe Place?
- Next, ask your client what smells or scents would be in their Safe Place?
- Ask, what would the temperature be like?
- Ask, would there be any other thing that they would feel or sense in their Safe Place, such as a specific aspect of weather? What would those sensations be like?
- Have the client look around their Safe Place and to consider whether there are any objects (no people) they would like to add to the Safe Place that would make it even more safe and calm for them.
- Invite the client to explore the place and notice if there is anything else they would like to change or be different to make their Safe Place even safer and more containing for them.
- When the client feels the Safe Place is just how they like it, invite them to focus on what it feels like in their body while they are in the Safe Place. Invite them to enjoy those feelings.
- Invite them to notice the thoughts that go with the Safe Place.
- Let the client know that they can access the feelings and thoughts through connecting with the Safe Place whenever they like – at home, at work, etc. Encourage them to keep control of this place – only sharing it with others if they wish to and then only with those who will respect it.
- Now, encourage the client to build an imaginary pathway between the Safe Place image and the ‘here-and-now’. Have them practice going back and forth to make sure it works. If not, discuss what would allow it to work and allow them to make changes.
- When the pathway is established, ask the client to stay in their Safe Place for a time that is convenient for you both. Keep time for them if necessary. Then ask them to connect with the pathway and to come back into the here-and-now.
- Obtain a SUD’s rating (0-10) immediately after and compare with the initial SUD. Debrief with the client, noting any difficulties they had and discuss how these might be overcome.
- Ask the client to practice the protocol and to note any difficulties that might arise, planning to discuss these in the next session.
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.