Anxiety in the Corona virus pandemic

The Fells & Dales network of counsellors met on 17th April, of necessity using an online meeting platform.  We all agreed it was ‘second best’ to meeting in person, but we still managed to offer one another support and share our thoughts.  Even before the coronavirus pandemic it had been suggested that we might spend a session on the theme of anxiety, so we had no trouble finding a context for our discussion.  As a change from more academic papers, the pre-read comprised three recent press articles:  ‘Advice on how to cope with coronavirus anxiety’ by Bill Merrington (York Press 17/3/20), ‘The secret excitement that lurks beneath our distress’ by Matthew Parris (The Spectator 20/3/20), and ‘I was born anxious, so why am I not panicking about coronavirus’ by Adrian Chiles (The Guardian, 25/3/20).

We noted that anxiety and fear have spread as rapidly as the virus, and commented on clients’ differing responses, from feeling even more alone and isolated than usual, having their pre-existing underlying anxiety heightened, to feeling less ‘different’ because everyone else is anxious too.  We agreed on the importance of being containers of our clients’ (and supervisees’) anxiety, whilst also trying to cope with our own.  Whereas with most issues clients present, we may not share their experience but we are still able to empathise by imagining how they might be feeling, sometimes based on a commonality of experience.  However, with anxiety around the coronavirus, we all, without exception, have our own anxieties which we have to contain.  We are with our own ‘story’ at the same time as trying to attend fully to our clients’.

We identified some of the key principles of working with anxiety, including mindfulness/calming/breathing exercises, normalising and contextualising, managing rather than ‘solving’, and exploring the triggers.  The remarkable stoicism exhibited by many was observed, but we also wondered what would follow in the aftermath of the ‘lockdown’, and what the presenting issues might then be.

The differences between face-to-face and online working were discussed in some detail  –  practical, technical and relational.  We acknowledged the need to be grounded, prepared and confident, in order to be true to ourselves and own way of working, and to remember that we are interacting with a real person and not a computer screen.  As with in-person therapy, it is hopefully our intentionality that communicates our care and compassion.

Anxiety in the Corona virus pandemic

OVERVIEW of EMDR

6 March 2020
One of our members, a retired trauma therapist, was invited to give an overview of Eye Movement Desensitisation Reprocessing (EMDR). He was an accredited practitioner for over ten years.
The group was asked to respond to and ask questions about the following proposed and recent definition of EMDR:
The group was asked to respond to and ask questions about the following proposed and recent definition of EMDR:

Definition – EMDR is an evidence-based, clinician led, psychotherapy for Posttraumatic Stress Disorder (PTSD). In addition, successful outcomes are well-documented in the literature for EMDR treatment of other psychiatric disorders, mental health problems, and somatic symptoms. The model on which EMDR is based, Adaptive Information Processing (AIP), posits that much of psychopathology is due to the maladaptive encoding of and/or incomplete processing of traumatic or disturbing adverse life experiences. This impairs the client’s ability to integrate these experiences in an adaptive manner. The eight-phase, three-pronged process of EMDR facilitates the resumption of normal information processing and integration. This treatment approach, which targets past experience, current triggers, and future potential challenges, results in the alleviation of presenting symptoms, a decrease or elimination of distress from the disturbing memory, improved view of the self, relief from bodily disturbance, and resolution of present and future anticipated triggers. EMDR therapy is a therapeutic intervention that must be administered by an EMDR trained clinician or those who are currently participating in an EMDRIA Approved training.

Wisely the group noted the absence of ‘bi-lateral stimulation’ in this definition.

Reference was made to the insistence within theEMDR profession that the 8 stage protocol was adhered to rigorously. The fundamental reason was assumed to be to ensure that there was a consistent base upon which to base efficacy research. Evidently many many different adaptations of the basic protocol were available. The EMDR UK and Ireland has a jiscmail interaction and frequent requests are made for information about how to use the protocol for numerous different presentations.

A copy of the 8 stage protocol was shared with the members. As seasoned professional therapists this mapping of normal good therapeutic process was noted. The need to be thorough about history taking becomes clear when it is acknowledged that trauma builds on trauma. Often a current trauma effect does not get ‘cleared’ until earlier traumas have been dealt with. Just as likely is the scenario in which the client is unaware of earlier and unprocessed memories until processing begins. Processing refers to the use of bi-lateral stimulation when focused on the physical bodily awareness of a memory.

It is is of paramount importance to spend as much time as is necessary in the early phases of the protocol to ensure that a client is able to say where in the body the feeling that tells them there is an unprocessed memory upon which they may then focus using bi-lateral stimulation. And it is essential that as much time as is necessary is taken to ensure the client has learnt how to self-soothe. It would of course, be irresponsible to encourage the client to engage with a trauma memory without the practised confidence of being able to self-soothe.

A member of the group volunteered to experience bi-lateral stimulation being used whilst focused on a ‘safe place’ memory and the stored memories of each of the sensed about that memory. A client would be invited to practice accessing this now reinforced ‘safe place’ until they were confident that they could manage more anxiety than previously realised perhaps. This was acknowledged to be a real experience which made the safe place memory more vivid. The value of this for a client was noted.

Reference via a UTube video drew out the specific nature of PTSD as a particular form of trauma memory defined by DSM 5. The life long history of potential unhealthy experiences leading to trauma, beginning in the womb ‘where there are no words’ (with reference to the workshops led by Sandra Paulson), and moving on to the whole of the attachment process and the manner in which those experiences are recorded in the limbic system, was noted.

The group also had a transcript of an interview with Peter Levine whose book Waking the Tiger and In an Unspoken Voice were highly recommended reading. The interview can be accessed at: https://www.psychotherapynetworker.org/magazine/article/2347/an-interview-with-peter-levine

Reference was made in conclusion to the training available. in particular training  from EMDR Workshops and David Blore and that offered by Sandi Richman (the presenter’s trainers) was recommended.

Definition – EMDR is an evidence-based, clinician led, psychotherapy for Posttraumatic Stress Disorder (PTSD). In addition, successful outcomes are well-documented in the literature for EMDR treatment of other psychiatric disorders, mental health problems, and somatic symptoms. The model on which EMDR is based, Adaptive Information Processing (AIP), posits that much of psychopathology is due to the maladaptive encoding of and/or incomplete processing of traumatic or disturbing adverse life experiences. This impairs the client’s ability to integrate these experiences in an adaptive manner. The eight-phase, three-pronged process of EMDR facilitates the resumption of normal information processing and integration. This treatment approach, which targets past experience, current triggers, and future potential challenges, results in the alleviation of presenting symptoms, a decrease or elimination of distress from the disturbing memory, improved view of the self, relief from bodily disturbance, and resolution of present and future anticipated triggers. EMDR therapy is a therapeutic intervention that must be administered by an EMDR trained clinician or those who are currently participating in an EMDRIA Approved training.

Wisely the group noted the absence of ‘bi-lateral stimulation’ in this definition.

Reference was made to the insistence within theEMDR profession that the 8 stage protocol was adhered to rigorously. The fundamental reason was assumed to be to ensure that there was a consistent base upon which to base efficacy research. Evidently many many different adaptations of the basic protocol were available. The EMDR UK and Ireland has a jiscmail interaction and frequent requests are made for information about how to use the protocol for numerous different presentations.

A copy of the 8 stage protocol was shared with the members. As seasoned professional therapists this mapping of normal good therapeutic process was noted. The need to be thorough about history taking becomes clear when it is acknowledged that trauma builds on trauma. Often a current trauma effect does not get ‘cleared’ until earlier traumas have been dealt with. Just as likely is the scenario in which the client is unaware of earlier and unprocessed memories until processing begins. Processing refers to the use of bi-lateral stimulation when focused on the physical bodily awareness of a memory.

It is is of paramount importance to spend as much time as is necessary in the early phases of the protocol to ensure that a client is able to say where in the body the feeling that tells them there is an unprocessed memory upon which they may then focus using bi-lateral stimulation. And it is essential that as much time as is necessary is taken to ensure the client has learnt how to self-soothe. It would of course, be irresponsible to encourage the client to engage with a trauma memory without the practised confidence of being able to self-soothe.

A member of the group volunteered to experience bi-lateral stimulation being used whilst focused on a ‘safe place’ memory and the stored memories of each of the sensed about that memory. A client would be invited to practice accessing this now reinforced ‘safe place’ until they were confident that they could manage more anxiety than previously realised perhaps. This was acknowledged to be a real experience which made the safe place memory more vivid. The value of this for a client was noted.

Reference via a UTube video drew out the specific nature of PTSD as a particular form of trauma memory defined by DSM 5. The life long history of potential unhealthy experiences leading to trauma, beginning in the womb ‘where there are no words’ (with reference to the workshops led by Sandra Paulson), and moving on to the whole of the attachment process and the manner in which those experiences are recorded in the limbic system, was noted.

The group also had a transcript of an interview with Peter Levine whose book Waking the Tiger and In an Unspoken Voice were highly recommended reading. The interview can be accessed at: https://www.psychotherapynetworker.org/magazine/article/2347/an-interview-with-peter-levine

Reference was made in conclusion to the training available. in particular training  from EMDR Workshops and David Blore and that offered by Sandi Richman (the presenter’s trainers) was recommended.

OVERVIEW of EMDR