Affect theory & EMDR

• somatisation by Michael Owen, 11/16/97
  • What part of the soma? by Don Nathanson, 11/16/97
    
    

I was delighted to read Don Nathanson’s comments on Michael Owen’s case as I have for several years been encouraging clinicians to consider how affect theory and EMDR theory and application converge and can inform each other.

For example, affect theory describes emotional responses as having an intrinsic physiological component as well as associational aspects based on a lifetime of associated memories and interpretations of situations in which a similar pattern of affects was triggered together with associated behavioral response sets.

EMDR theory (Accelerated Information Processing) also proposes that there are intrinsic physiologically based memory networks and affective elements that are altered by unresolved traumatic life experiences and that these can be addressed directly via the procedural elements of the EMDR method.

In addition, patterns of affective shifts observed in EMDR treatment sessions tend to typically follow a stimulus density curve which corresponds to Tomkins model.

Startle-surprise is an innate affect that is triggered by the most rapidly rising stimulus gradient. A slightly less steep and yet rapidly increasing stimulus gradient (such as a sudden noise or unexpected movement) can trigger fear-terror.

Distress-anguish is triggered by a higher than optimum level of stimulus density that remains relatively steady over time. When the density of a steady state stimulus increases beyond that sufficient to produce distress-anguish, anger-rage is triggered.

David Wilson et al (1996) have written of a “compelled relaxation” response in effective EMDR treatment sessions in which physiological measures of distress are consistently reduced in parallel with self-report measures of change on affective distress and cognitive restructuring.

While Wilson et al reported these decreases in physiological indices of distress, EMDR clinicians treating clients with PTSD commonly see corresponding within session shifts from intense fear states to anger. Then as the anger subsides, distress-anguish can be triggered which may take the form of regret that the tragedy occurred or that the client held onto the fear for so long. Before the residual distress (which may been a familiar element of the client’s life for months or years) dissolves, there can be a phase of grief or sadness which may take a form of compassion for self or even for a perpetrator.

While I do not mean to imply in anyway that such patterns of affective resolution occur rigidly or mechanistically, I believe that the rapidity of treatment effects in many EMDR treatment sessions compress such shifts, which might otherwise take place over a period of weeks, months or years, into a time frame that sometimes permits the observation of such patterns of resolution within minutes.

An thorough understanding of affect and script theory would appear to facilitate EMDR case formulation by assisting clinicians to notice even brief affective displays during history taking, treatment planning and reprocessing sessions and to link these affects to the scripts (core beliefs and defensive scripts) employed by clients to attempt to manage the affects associated with unsatisfactory response sets. These affect and behavioral response sets together with their associated beliefs can then be used to assist clients to target and reprocess pivotal unresolved earlier life experiences.

EMDR treatment research involving process physiological measures and videotaped recording of changes in affect as displayed in facial expression could help advance our understanding of the affect system as well as enhance the skill of clinicians seeking to extend the effectiveness of EMDR to previously treatment resistant client populations.

Andrew M. Leeds, Ph.D.

Private practice, Santa Rosa, CA, USA and Senior Trainer EMDR Institute, Pacific Grove, CA, USA.

Wilson, D., Silver, S.M, Covi, W., & Foster, S. (1996). Eye movement desensitization and reprocessing: Effectiveness and autonomic correlates. Journal of Behavior Therapy and Experimental Psychiatry, 27 , 219-229.

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