Attachment-Informed EMDR with Ego States and Parts
Annabel McGoldrick set a helpful context for this course by imparting a raft of clear and fascinating information about Internal Family Systems (IFS) therapy as based on the work of Richard C Schwartz and his newly published book No Bad Parts: Healing Trauma and Restoring Wholeness with the Internal Family Systems Model (2021). She produced four helpful handouts to accompany the course and there was a comprehensive and clear PowerPoint presentation throughout, illustrating each concept and skill in a paced and effective way. This is perhaps not surprising, given her background as a radio and TV journalist prior to working as a Family Therapist and University Lecturer in Sydney, Australia. She is also an EMDR Consultant in the UK and Australia a former Board member of EMDR Australia. Most recently, she has been working as a Facilitator and Trainer with EMDR Focus. Our learning was also peppered with filmed or live demonstrations throughout which made it much easier to relate the new material to existing skills and practice. I immediately felt excited at this new understanding and was really keen to integrate it into my client work after the course was over.
Internal Family Systems
For those unfamiliar with IFS, its premise is that trauma, often in childhood, distorts our authentic Self leading to the development of ‘Protector Parts’ to safeguard our wounded and damaged younger selves (Exiles) from becoming dysregulated or overwhelmed. The Protector Parts can either take the form of Managers or Firefighters and their role is to prevent these traumatised Exiles from being triggered in the present and thus destabilising our day-to-day functioning. McGoldrick gave a useful metaphor of a mobile over a baby’s cot. When the wind blows, the whole mobile moves as each of its component parts is delicately connected to the others. Thus, when the internal system (mobile) is challenged by external triggers (the wind) all of it is affected and the internal system has the task of trying to come back to some kind of equilibrium to minimise damage.
McGoldrick explained that, with heavily defended clients, there is a risk that standard EMDR works too fast, overriding Manager and Protector Parts and pushing vulnerable Exiles into chaos. This can lead to clients, for example, self- harming following a session as the client feels a need to punish (parts of) themselves or to try to express the inner conflict that has been activated. Instead, she invited us to learn to create a dialogue with the Protector Parts and even to ask permission from them in order to do the necessary processing.
She made reference to the excellent work of Ana Gomez who helps her clients to identify conflicting parts and imagine holding one in their right hand and another in their left hand. In this way, the client is invited to move their hands out in front of them and observe them (along with the Part the hand represents). This effective form of ‘un-blending’ helps us see more clearly the parts that were previously inside us. We returned to this concept in more depth later in the training.
We were then invited to participate in a guided meditation, the purpose of which was to help us identify any Parts we may have in our own internal systems. We were invited to map these Parts and to draw and describe them. We were then divided into triads (which we returned to many times over the duration of the three days). We were able to share our drawings and descriptions and hold space for one another. It really helped me to understand how I was made up of different Parts and how these Parts related to one another. We identified how we felt towards each of them and we were able to thank the Parts for showing up and letting us get to know them.
A prerequisite to attending this course was having previously attended at least one recognised course in the Attachment-informed way of working within the Standard Protocol. For those of you not familiar with this approach, time is devoted at the beginning of therapy to tap in with slow Bilateral Stimulation (BLS) and establish not only a “Place that feels safe” but also a number of Resource Figures that can be utilised later when in the processing phase of EMDR. These figures might include a Nurture figure, a Wise Figure and a Protector Figure. An assumption was made on this training therefore, that participants were familiar with these helpful resources and we were also encouraged to tap in a dwelling place in our imagination where these figures could reside as a team. This was important to establish as we used these resources later in the course.
The Repair/Rescue protocol
The first handout we received explained and described the Repair/Rescue Protocol that can be carried out during the preparation Phase of EMDR. McGoldrick said some clients present with such intense, multiple traumas that it can be difficult for therapists to know where to start. In her Repair/Rescue Protocol, preparation centres on a list of traumatic memories e.g. the memories of a 2-year old, a 5-year old, a 10-year old and an adult memory. The memories need not be linked so long as they all happened to one person, and this combined trauma led to the system being a bit overwhelmed. Rather than set each one up and process one at a time as in the Standard Protocol, some repair work and interweaves can be carried out in each of the scenes where the upsetting event happened, before each of them is invited to the dwelling place to be safely greeted and looked after by the Resource Figures and the client’s Self.
Once there, these younger selves have the opportunity to unburden any uncomfortable thoughts or feelings and to cleanse them whilst experiencing BLS. The younger selves are reassured that they need never go back to the original scenes if they don’t want to. Mark Brayne, who hosted and helped with the training, likened this to the gathering of forensic evidence in the Court system where a child never needs to go back to the scene of an abusive crime; witness statements, photos and videos are used instead. Once this rescue/repair work is complete, it is then possible to install an interim more positive image/cognition. The advantage of doing this is that if a client does get triggered between sessions, they can place their hand(s) on the place where they installed the repaired interim image/cognition and receive immediate soothing and stabilisation. The idea is for the therapist to then return to each scene in subsequent sessions to process each memory individually using the Standard protocol.
Negotiating with parts
The second handout described tips for working with Protector Parts who may be blocking trauma processing. We learned how to talk to these Parts and elicit permission from them. We also learned how to work with Parts that may be in opposition to each other. For example, a client with an eating disorder may have a Part that wants to binge and another Part that is extremely critical of the bingeing behaviour. We learned to use a two-handed interweave to facilitate an interaction between these two opposing Parts and to also raise awareness of the Self in the middle who is observing these two Parts. We learned to mediate between the Parts who were at war and where possible, find the Exiled Part that might be shielding underneath them.
We then had time to practise these new skills in triads. I liked the fact that we were returning to the same triad each time as we were building up trust and rapport and it felt like an extremely safe place in which to learn, make mistakes, take risks and ultimately grow.
Self to Part connection
The third handout focussed on bringing together all the skills we had learned thus far on the course by putting on one page, a comprehensive EMDR – Parts Protocol. This involved preparation: tapping in a clear calm place, a robust resource team and a dwelling place for that team and the Self to reside in. In Phase 3, the protocol focussed on identifying a trauma target in the present and identifying a clear emotion, location in the body and belief that was associated with the trauma as per Standard Protocol EMDR. We then bridged back to find a touchstone memory and checked to see if the System would give us permission to help and get to know this younger Exile. At this juncture, McGoldrick reinforced the dual awareness by helping us facilitate a dynamic between the child Part and the Self where we oscillated between seeing things through the child’s eyes and the adult Self’s eyes. We could identify the level of compassion each felt towards the other and then pendulated between the level of compassion offered and how much compassion the other could receive using BLS. We then learned how to carry out any necessary repair work to enhance the growing compassion and enabled any remaining rescue or unburdening work to be activated in the dwelling place. Once this was complete, we were able to install a new Positive Cognition (PC) with EMDR and also check that the Protector Parts were satisfied. The part I found the most helpful was checking if any of the Protector Parts were now in a place where they could contemplate changing their role or even being ready to take on a new job. If the answer was “yes” we were able to tap this in with BLS.
Self – like Protector Parts
In the final part of the course, McGoldrick identified ways to build Self energy. We learned about the qualities of Self such as compassion, courage, calm etc. and then identified times in the past when we had felt and expressed that quality. We were able to install each of these qualities using BLS thus strengthening the experience of Self energy already there. The reason this is important is that sometimes a Part may pose as Self energy when it is in fact just a Part trying to rescue or please others. For example, if we feel tired because we are conscientiously overworking, we may think that it is our Self energy doing good work, but in fact this may be a Part trying to get stroked. Real Self is compassionate and able to rest when needed. We identified how to recognise when this may be happening and how to remedy it. Usually, there is a vulnerable Exile that the Self-like part is protecting so our job is to allow the Self to step up and lead the system rather than this Self-like Part. Once again, we learned to use our Self energy to take care of the vulnerable Exile and also to help the Self-like part unburden their role when they felt able to.
The final afternoon of the course saw McGoldrick showing an in-depth video session of a colleague who was being triggered by a client. She expertly demonstrated many of the skills we had learned on the course. It was a privilege to watch this poignant and beautifully crafted interaction as it unfolded before us. I imagine no one was left unmoved by the depth of healing facilitated. We then had the opportunity to go into our triads for the final time to practise the skills for ourselves.
I came away from the training full of new ideas about how to work with clients when in the past a session may have got stuck or when there was a lack of growth. Due to the way the course was designed and the material presented, I felt confident to begin utilising the new skills the very next day when I went back into my clinic. Since then, I have used the skills so often that now I barely recognise they are new. I would recommend this course unreservedly.
References
Gomez A. M. & Grause P.K. (2013). EMDR Therapy and the Use of Internal Family Systems Strategies with Children, in A.M. Gomez (Ed.), EMDR Therapy and Adjunct Approaches with Children (pp. 299-345). New York, NY: Springer publishing.
Schwartz, R. (2021). No Bad Parts: Healing Trauma and Restoring Wholeness with the Internal Family Systems: Sounds True.