What is Resolution, Actually?
In EMDR therapy, the resolution of a Target Memory is defined as a SUD of 0, VOC of 7 and a clear Body Scan. That means the client experiences no actual distress when bringing up what remains of the memory. The client also resonates with their positive belief to be “absolutely true,” about themselves, and their body is in agreement with all of the above. Okay, we can even concede that having some emotions about what happened is ecological as long as the body is quiet. But is that all that we mean by “resolution?”
When the Target Memory is a childhood experience, such as dropping the baseball in the outfield in a championship game and you are not only devastated by that you did, but are screamed at by your coach, ostracized by your team members and criticized by your parents, what is the self-talk from all these experiences, even when they’re ‘over and in the past?’ “I did the best I could,” or, “I’m a good person?”. That’s all well and good, but what happens to the years of that kind of harsh criticism? It acts like a cancer in our system that promotes the growth of negative self-talk and self-defeating behaviors that forge a neural pathway of their own after years of use beyond the memory networks that contain these hurtful and confusing memories. If you consider that the average human talks to themselves using 300 to 1000 words per hour, that’s a lot of practice! Not so fast on the positive self-talk?
Most of us who treat complex developmental trauma find that these voices or parts of self are pesky and persistent about their point of view that the child who endured them are the source of the badness, or they’ll never be safe, or that they’ll always be powerless. That’s because they operate independently of the memories where these learnings first took place. Whether you think of them as separate selves, ego states, or states of consciousness that are activated by similar events in the present, (the AIP explanation), the clinical challenge is the same: How do we get this negative chatter to stop? And how do we replace it with a kind and self-compassionate voice that is more accurate and adaptive to the client?
The Absence of the Negative Doesn’t Translate into the Positive
The competition for center stage between these negative neural networks and the adaptive memory networks for many of our clients who had a steady diet of these messages is not in their favor. They don’t stand a chance at being able to override the strength of these convictions as they are so deeply rooted, often from their earliest moments. So, we begin by establishing with our clients this harsh but helpful truth: they got a bad deal as a kid. It’s not that they are bad; the parenting they got was bad, and even if they don’t believe that that they are good enough, lovable and deserving, they need to be willing to consider that they are. And, in time, they will come to feel more that way about themselves, but it may take a while before it becomes the default setting in their memory banks.
Dual Awareness
In EMDR therapy, we talk about dual attention as the client’s ability to focus on their disturbing experiences in the past while at the same time, tracking that they’re not happening now. This “one foot in the past and one foot in the present” is the cornerstone of reprocessing in EMDR therapy. With dual awareness, the client can stay emotionally resourced enough to stay present to their experience, however painful it is, and get through it in a way they couldn’t at the time it happened.
Similarly, when we ask our clients to observe their reactivity, we are also in a matter of speaking, asking them to have dual awareness and observe their reaction rather than believe it to be true. So, when we ask our client to consider that, even though they feel ashamed that they dropped the ball in the outfield, or that they’re not good enough, they also know that it’s not true and understand it as a distorted reaction. Further, we can propose to our clients that part of the work can be around rectifying that disparity so that what they know and how they feel can be in alignment, and that they have an adult perspective about themselves, others, and their role in these experiences.
Sounds pretty straightforward, right? But then what? Session after session, memory after memory you’re getting a SUD of 0, a VOC of 7 and a clear Body Scan, but it’s not generalizing. With clients who have complex developmental trauma, it’s not just about what happened to them. The cancer is experienced as part of “who they are.”
What Happens Next?
As a trainer, consultant and EMDR therapist, I can tell you unequivocally that we too often forget about the future. EMDR therapy is a three-pronged approach of past, present, and future, and our brain, when it’s working the way it’s supposed to, is always oriented towards the future. As trauma therapists, we can be like a moth to a flame, over-focused on offering our clients symptom relief, and less concerned about what they’re going to be thinking, feeling, and doing when they’re not hurting.
So, what happens next is you target present-day situations and triggers more regularly because there is frequently less of a generalization effect, and when you bring them to resolution, you make it a rule to proceed to the future. Always.
The Contract
Over the thirty years I’ve been part of this community, there have been innumerable discussions about how and when we target the past, the present and the future. Instead of trying to arrive at a consensus as if one size fits all, let’s keep going back to the agreed upon goals for treatment, as every client is different and the same client is different over time. What is the problem the client is coming to you for help with? Why are they struggling in the ways that they are (the AIP question)? What are the memories that need to be targeted to get to the root causes of the client’s current difficulties?
Whether those memories are foundational or happened later in life, it is important that we routinely check in with the client about their progress and ensure in the Reevaluation phase that we’re reinforcing their progress by asking them to record and report their positive experiences and reinforce them by sharing our excitement. We then want to strengthen these positive moments with BLS adding a corresponding positive belief that reflects how the client feels about themselves based on this positive experience they’re sharing with you.
The Future
Good work, but we can’t stop here. It’s about the future, remember? We need to check our work by exploring how they might respond to similar situations they’ve experienced in their present-day life sometime in the future. Do they know how they would be thinking, feeling, and responding? Or, do they not feel any distress but don’t really know how to respond? Or, do they get triggered at the thought of having to deal with a similar situation in the future? The answers to these questions are diagnostic and help us map out what our next steps will be.
So, it’s not just about resolving the memory networks of experiences that are inadequately processed and maladaptively encoded. It’s also about clearing a path for new neural networks to develop. That doesn’t always happen spontaneously, as clients come with varying degrees of adaptive memory networks, but we can always make sure that our clients can develop new, more adaptive ways of being and relating, which accentuates the positive.