When you start therapy, your therapist needs to do a Biopsychosocial history to identify:
What have you come to therapy to resolve?
What your life experience has been like. Your life experiences create how you perceive and experience the world.
Developmentally, starting from in utero, there are many very important activities and experiences that form a core stable foundation. If you do not have them or they have been breached the core foundation is not stable. You are missing resources not available to you for negotiating even simple things in life: focus, attention, impulse control, skills in math & reading, sensory integration, emotional regulation. This is like building a house. If you build the house on a swamp, it will eventually collapse under pressure. If you build it on a strong, stable foundation it will support you.
What has your ability to be and feel connected to others been like.
Do you have a sense of safety and security?
Can you identify what you need, and can you get your needs met?
Have you experienced losses? How many and how far back in life?
Have you experienced physical, emotional or sexual abuse. How often and how far back in life?
Have you experienced medical trauma? When, what kind and how often?
What medications and supplements are you on? Do you use substances? What, how often and is there a dependency and/or addiction? If you do have a hx of dependency/addiction, for how long and is it current?
Some medications block your ability to reprocess.
Some drugs and medicinal plants specifically work to block emotions and sensations. This means when you attempt to reprocess a memory the emotions and sensation related to that memory cannot be accessed for reprocessing.
There are ways to work with all of this in Phase 2 so reprocessing can be successful.
How do you take care of yourself (diet, exercise, sleep, etc.)
How do you handle stress? What tools to you have, do you use them and do they work for you?
What does your support system look like?
Can you dual focus? Stay in present time will recalling memories. Observe your internal experience while moving your eyes.
Can you observe old memories without reliving them.
Can you allow yourself to move from upset to positive emotional experiences?
What internal resources you have and what is missing.
What you will need to be successful in EMDR therapy.
This helps identify what you will need in Phase 2 to prepare you for reprocessing memory targets, and make sure you have the internal stabilization needed to handle what may come up when reprocessing memories.
Once the history has been gathered and reviewed. It is helpful to create what I call a Master Plan. A Master Plan is where you identify Presenting Issues (what you want to resolve). These could be:
Negative beliefs: I’m not good enough. I never do anything right. I don’t have a right to exist. I’m a burden
Patterns of behavior: overreacting when someone gives you feedback, lashing out in anger if someone disagrees with you, wanting to isolate and avoid people.
Emotional Patterns: Feeling something is wrong with you, powerless, unsafe, like you don’t belong
Having been abused (physically, sexually and/or emotionally)
This Master Plan is a working document that you can add to as you progress in your EMDR therapy. It is helpful to list symptoms you experience at the beginning of therapy and the Presenting Issues. This way as you work your way through your therapy process you will be able to see things resolve. My clients find this helpful because they can track and see their progress.
People usually have more than one Presenting Issue when they start therapy, so this is a good way to keep track of things and make sure everything is resolved.
Then you move to Phase 2.
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