EMDR FORUM ARCHIVE, 2000
Re:Maxfield & Hyer meta-analysis: A few questions
Sandra Paulsen Inobe, PhD · 11/01/02 at 8:04 PM ET
Not sure when Louise will get back to answer, but I'll put my two cents worth in and she can add her piece if she disagrees. 1. The negative cognition is only visited at the beginning of processing when activating the full cognitive, affective and sensory elements of the image being targeted. Once the boat is launched and asail, one only rates level of disturbance (using SUDs) and the validity of the POSITIVE cognition, because you are measuring progress towards the goal, the; farther shore. Measuring the validity of the NEGATIVE cognition keeps looking back towards the shore you left behind and for some people would run the risk of turning the boat around and retreating to the shore you should be leaving behind. 2. The problem with measuring SUDS frequently is that it interferes with the free association, for lack of a behavioral term, aspect of EMDR. Switching metaphors to a land-bound mode of transportation, once we start processing, we "stay off the track" and let the train just go unless it gets stuck. If its stuck we get the logs off the track so it can resume." Once the client gets to a neutral spot, then we go back to target and check and see what's up (a SUDS rating is typically done here) so we can see if the whole target is now neutral or if we just cleare out one channel. If the client says the original target is neutral, that's a SUDS 0 for the target, marks the end of the processing. If the client says SUDs 2 or 5 or something, we say what's that about, and its typically another angle, another channel of the target. If instead of allowing this natural process you take frequent SUDS, it can derail the train. It can foreshorten the natural presentation of one channel or the next one. That's part of the difference in my experience with exposure. The bilateral stim seems to provide a push that spontaneously pushes up material from this channel then the next. We only check for SUDS if we aren't sure what's going on. Frequent SUDS (and I'm presuming that it means SUDS for the original target, or did Devilly use SUDS at each set, which would be removed from the original target) would tend to truncate a channel and likely give the message that the client shouldn't be free associating or deviating. We don't say "free associate", but rather, something like, "whatever comes up is fine, there is no right or wrong in terms of what you are noticing." Then we keep our mouths shut unless they are looping (the processing gets stuck)in which case then and only then we open our mouths with a concise cognitive interweave. The way I learned to do exposure, the therapist had to get the narrative ahead of time and then present the material snapshot by snapshot, moving ahead when each piece came up neutral. EMDR flows like a videotape, we don't have to jumpstart each element. (Except for the recent event protocol, which is more like snapshots, because the brain hasn't had time to consolidate the memory into a "videotape' sequence). We'll see if Louise agrees.
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