More Ideas on Integrating EMDR with Object Relations (Separate Selves)

• Accelerated Learning and Positive Templates by Francine Shapiro, 8/4/97
  • Integrating Psychodynamic Object Relations by David Grand, LCSW, 8/13/97
    
    

This posting addresses a new EMDR twist on some ideas that have existed in other clinical fields of thought. It is innovative primarily in the integrative aspect of it. The EMDR treatment approach can be used to build up strength and stability in our clients as well as reducing their painful and disabling inner conflict. Andrew Leeds has done much ground breaking work in this area. It is often assumed that the concept of separate selves pertains primarily to the defensive personality fracturing found in clients with dissociative identity disorder. However, dissociation can be conceptualized as a developmental and adaptive process found in all people. This can be illustrated by thinking of the situations where we say to ourselves, "why did you do that?" or "how could you be so stupid?" This voice emanates from the mildly dissociated voice of the critical self that we all possess. Drawing from the theory base of object relations (Edith Jacobson, et. al.) we all unconsciously internalize representations of the significant people in our early developmental years which come to exist as introjects or part objects within ourselves. We also form self representations from early in life. The interaction between these introjects is what the generally term object relations refer to. As we develop, more mature objects develop as the old ones tend to remain frozen in time. By adulthood, there exists a full panoply of internalized objects, which I will hereto for refer to as separate selves. My belief is that most of what we experience is internal and as a result of the conflicts, alliances and resolutions of these separate selves. Accordingly, our belief that how we feel is based on the events in our lives is self-deception (necessary to a certain extent). Shakespeare was diagnostically correct when he wrote, "The fault is not in our stars but in ourselves." That is not an issue of blame but simply an accurate assessment of our true locus of emotional control. The outside world, the events we face and the people we encounter serve more as triggers of our internal experience than causal factors. The concept of transference is basically the projection of an inner self on to another or as induced in treatment, on to the therapist. Working directly with these inner selves precludes the need for the use of transference to draw out, somewhat inexactly, these selves. While receiving the bilateral stimulation of EMDR, the elucidation and manipulation (in a constructive manner) of the inner selves is greatly facilitated. We can see how inner selves are metamorphized and integrated through basic protocol processing. However, with are most difficult, slow moving, prone to blocking clients more direct access to the inner selves is needed. The technique I will now illustrate was developed by myself and a few other EMDR therapist/theorists working synthetically. It is referred to as "Calling Out the Selves." You explain to your client that all people have different sides that we will refer to as separate selves. Educate and reassure if necessary that this does not mean you think they are a multiple personality. To illustrate, ask the client if she/he ever hears herself say, "why did you do that?" or "how could you be so stupid?" Use this as an illustration of the voice of the critical or shaming self. (Parenthetically, the negative cognition is simply the voice of these negative selves). The technique then entails setting up mental imagery which fosters the emergence of these selves. Ask whether she/he would like to work with the image of being in front of a clearing in a forest or in a safe room with a number of doors [business people often choose a board room]. This approach can either be applied projectively, with some direction or a combination of the two. In the former, the client is instructed that she/he hears rustling in the woods or footsteps outside the office and suspects it is one of her selves. Ask her to call in and observe the self. How old is she? What does she look like? What is she wearing? What is the look on her face and her posture? What is her name? This is followed by calling out other selves. The more directive approach is to instruct the client to call out her self-critical or self-attacking self. This is followed by calling out her victim or attacked self. Child selves, self-doubting selves, angry or frightened selves, competent adult selves, parental selves, healer selves, etc. are often fruitful images to access. The selves can then be directed to interact in a directive or non-directive fashion aimed at communication, negotiation, mutual cooperation and healing. I like to start with the caveat that each self is equally valuable [just like one's arm or leg] as a part of the valued overall self and the goal is not to expel or surgically remove even an abusive self. I stress that self attacking or denigrating selves are suffering, and often feel unrecognized, voiceless and impotent. The first order of business is to address the needs of these selves as one would a disruptive child who is not bad but in obvious need of help. Guide either the host self or one of the other selves to ask the attacking self what her/his suffering is and give her a voice that will be heard. Healing the aggressive selves, or introjects, will oftentimes lead to a reduction in self abuse and lessen inner conflict. It is then more possible to proceed with healing the victim or child self. At times a verbal give and take reciprocal negotiation between the attacking and attacked selves where each one states what they need and what they are willing to offer to the other in response to having these needs met. If a mediator is necessary, use one of the other selves or call in a mediator self. Often times the attacker will end up using her/his power to protect the victim self if she agrees to stand up for herself more. The victim self often provides the sensitivity or empathy the attacker self craves. In this case of this stuck client, one can call out the selves that are blocking the processing and ask them why they need to do this. Negotiate and work with healing them and possibly the processing can continue on. Closing this exercise can be done by guiding the client to the imagery of the selves holding hands and saying her/his favorite prayer, poem, healing meditation. If they are ready, the selves can be guided to slowly blend into each other. This exercise is also best done within the structure of an EMDR protocol where the original self is draw from the image of the client from the target incident. When one returns to the protocol after this method, you will often find substantial movement has occurred in the image and the overall experience as indicated by a significantly lowered SUDS rating. My colleagues and I have found this technique, which lends itself to both client and therapist creativity and experimentation, to be profoundly helpful to even the most stuck and difficult clients. Humans seem to be naturally able to work with this imagery and it is powerfully enhanced by applying EMDR stimulation. It also lends itself to tactile and auditory stimulation as sets can be longer and the clients can close their eyes when they choose.

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