AF-EMDR
Attachment Focused Eye Movement Desensitization and Reprocessing
What is AF-EMDR?
Attachment Focused Eye Movement Desensitization and Reprocessing (AF-EMDR) is a modified version of the standard protocol of EMDR, developed by psychologist Dr. Francine Shapiro in the mid 1980’s. Laurel Parnell modified the standard EMDR to be more client centered, and to support people with early attachment traumas, CPTSD, as well as people who struggle with PTSD, anxiety, OCD, and other presentations. AF-EMDR utilizes Resource Tapping, EMDR, and talk therapy. It is a somatic, and free associative process to therapy that focuses on physical sensations in the body, emotions, and core beliefs. It is cross-cultural, and the desensitization can be mostly non-verbal.
What is the Difference Between AF-EMDR and EMDR?
There are slight differences between the two approaches. AF-EMDR always begins with Resource Tapping and installing resources for the client. To promote ‘going inward,’ we move away from eye movements, and focus on bilateral stimulation (BLS) such as the butterfly hug and tapping or tapping on the legs, with closed eyes (if appropriate). Since AF-EMDR is client centered, the BLS just needs to be bilateral and alternating, there is no standard of what the tapping needs to look like. AF-EMDR can also use hand devices that vibrate and alternate, or headsets with alternating sounds.
How Does EMDR and AF-EMDR Work?
The concept behind EMDR is that trauma effects people’s ability to store memories, and thus the incorrect storage of the trauma memory impacts people in present day. Stimuli, situations, or events keep people in a reactive state to the original trauma material. EMDR allows for a free associative processing of memories, with bilateral stimulation (BLS), to both desensitize, and reprocess the traumatic memories. Theories behind the BLS and eye movements, is that it mimics REM sleep, where one rapidly processes on an unconscious level.
Why Should I Try AF-EMDR?
If you have previously tried regular talk therapy and felt like you didn’t progress, you may want to try AF-EMDR. You may also want to attempt this somatic modality if you don’t feel comfortable verbalizing your traumas, if you can’t ‘remember’ what happened, if trauma memories are preverbal, and if there are language, or language processing barriers to your therapeutic journey. Here are some examples of presentations or concerns that EMDR and AF-EMDR can be help treat.
- Sexual Trauma, Molestation, Rape
- Early Childhood Trauma and Neglect
- Negative Beliefs About Self/World
- Motor Vehicle Accidents
- Medical Trauma
- Infidelity and Betrayal Trauma
- War, Immigration, Displacement, Homelessness
- Culturally Based Historical Trauma (ie. Residential School Survivors)
- Grief and Loss
- First Responders, Veterans
- Acute Stress Disorder (ie. very recent trauma within 30 days)
Can I do AF-EMDR Virtually?
Yes! The only requirement for virtual AF-EMDR therapy will be that your camera needs to be on, and placed in a stable location where the therapist can see the bilateral stimulation (ie. if you are tapping your shoulders, we need to be able to see that clearly to track the process).
What is Trauma and PTSD?
Trauma is not just the event. It is more nuanced than that and includes trauma imprints on the body (somatic and nervous system), core beliefs about self, negative beliefs about self, others, and the world. Cross-culturally, PTSD can also look like intrusive thoughts, diminished participation in activities, irritability, aggression, hypervigilance, distressing dreams, flashbacks, and sleep paralysis. PTSD is diagnosed with looking at clinical presentations from one or more traumatic events which leads to fear-based reexperiencing, emotional and behavioural symptoms. People with PTSD can have different presentations of hyper or hypo arousal, for example, panic and anxiety versus dissociation. PTSD is a result of events where people are exposed to real or perceived threats such as sexual assault, war, physical attack, torture, POW, kidnapping, mugging, motor vehicle accidents, and natural and human-made disasters. Witnessing, or indirect exposure to traumatic events such as unnatural death, physical or sexual abuse, violent assault, accident, war or disaster, and prolonged medical catastrophe, can also lead to PTSD. First responders, military, and therapists are obvious examples of people who are regularly exposed to vicarious trauma, or secondary trauma.
What is CPTSD?
Complex Post Traumatic Stress Disorder (CPTSD) involves cumulative exposure to traumatic events. This may look like childhood neglect, emotional, physical, and psychological abuse. CPTSD has symptoms of dysregulation, negative self-concept, and disturbances in relationships (ongoing). CPTSD can also look similar to borderline personality disorder (BPD). Judith Herman, Harvard psychiatry professor wrote and published the seminal Trauma and Recovery in the early 1990’s, which compared survivors of rape with combat veterans. Her work outlines the dismissal of women’s trauma, which was once diagnosed and dismissed as ‘hysteria.’ Herman introduced the triphasic model of treatment for trauma, which emphasizes the element of safety and choice. It has only been in the last few years that CPTSD has been recognized in the International Classification of Diseases 11 (ICD-11).