Energy Psychology and EMDR: Combining forces to optimize treatment

John Hartung and Michael Galvin

Overview – Excerpt – Table of Contents

Preface

As clinical and consulting psychologists, we have continually searched for ever better ways to help people. At this point after almost 60 years of combined practice, we have come to rely on energy psychology (EP) and eye movement desensitization and reprocessing (EMDR) as our preferred methods. In this book we present the clinical findings that have led us to believe that these methods excel-especially in combination-in helping clients achieve profound change and growth, usually quickly and with stable results. While clinical impressions eventually must be verified by scientific evidence, advances in practice almost always precede scientific validation. We expect to modify these methods as what we learn from research catches up with or surpasses what we learn from clinical practice.

Some 60,000 individuals have been trained in EMDR (Robbie Dunton, personal communication, 2001). We have found no estimate of the number of those trained in all of the EP methods, or even in those based on meridian theory. Sandmeier & Cooper (2000) write that over 30,000 have been trained in TFT alone.

We hope to persuade energy therapists to look at the richness that EMDR has to offer, keeping in mind that the interests of some clients sometimes might be better served by treatment with EMDR than EP. We also hope to convince EMDR clinicians to consider using energy techniques as additional resources for those times when EMDR stalls. For readers yet untrained in either, we offer an overview of the two brief therapies that have transformed our professional lives.

We have collaborated on various projects since we first worked together in a community mental health agency in 1974, and we have continued to share ideas, often on long bicycle trips, on how to broaden our traditional graduate school training. For over a dozen years we have worked together as executive coaches. We became so impressed with the healing power of EP and EMDR that we began to train others in both approaches. Either together or separately we have conducted therapy sessions and training courses for both professional and nonprofessional participants in 13 countries, in Europe, Asia, and the Americas.

The case studies in this book are true stories about our trainees, supervisees, or clients (we use the terms client and patient interchangeably). Many of the examples are disguised to protect the identities of the individuals mentioned. In some cases we pieced together data from more than one individual to protect confidentiality further. To limit confusion, we use the pronoun I, followed by J. H. or M. G., when we are describing particular clients or a project of special interest to only one of us. When discussing our collaborative projects, we use the pronoun we.

About John

In my early professional years, I looked for more effective treatment strategies among the traditional psychotherapies. I spent long hours observing and listening to many of the "masters." I learned about optimism while listening to Abe Maslow and Victor Frankl and about intuition while watching Virginia Satir and Arnold Lazarus. I reflected on my thinking errors in the presence of Albert Ellis, then Aaron Beck, Christine Padesky, and Don Meichenbaum. It was moving to watch Alexander Lowen perform his bioenergetic magic on his 80th birthday, and unsettling to have my questions challenged by Joseph Wolpe and Thomas Szasz. I experienced the warm power of Mary Goulding and Carl Rogers, put up with the provocative Sal Minuchin, and endured many analytic interpretations. I meditated, punched pillows, ran long distances, fasted, and dissected dreams on my pilgrimage in search of ways to be of use to my clients.

Each time I found something useful from one of my teachers and experiences, and I shared my discoveries: I told friends, taught what I was learning in university courses, conducted off-campus trainings, and offered what seemed to be useful strategies to my patients.

But it was not enough. Too many of my clients did not seem to benefit much for very long. Growing increasingly doubtful of the promises of psychotherapy as I knew it, I took a sabbatical in 1989 from my private practice and traveled around Europe on my bicycle. I then taught for a semester with the Fulbright program in Peru, telling my students about the latest in psychotherapy and about the frustrations that caused me to question its efficacy.

In 1992 I heard about the unusual approach to psychotherapy called EMDR. This preposterous-sounding method seemed too good to be true, but I always have that glimmer of naïve hope that psychology might yet prove useful in helping people to change within a reasonable period of time. I signed up for EMDR training and was hooked after my first hour with the inspirational Francine Shapiro. I began to use EMDR in my practice the day after that training ended, and since then my clients have consistently reported more benefit from psychotherapy than I had ever heard before.

EMDR has also been a blessing in my personal life. About six years ago I had been mountain biking with my buddy Michael Merrifield, who writes books about "gonzo rides in Colorado." Just trying to follow him down a particularly gnarly ravine got me in over my head-quite literally-as I flipped twice that day and landed upside down each time. My helmet protected my skull, but the rest of my body suffered. The next morning I could not lift my head from the pillow because of a muscle spasm in my neck and shoulder. Consulting with my primary care physician, a chiropractor, and a physical therapist did little to relieve the pain. Three months later I still felt significant muscle pain, and on awakening in the morning, I still had to use a hand to lift my head off the pillow.

At about that time I volunteered to supervise someone who was completing her training to become an EMDR facilitator. Since there was no client available, I agreed to be the treatment subject. I felt emotionally fine that day, I said, and could recall no unfinished business in my life. However, I did remember that a week earlier I had butterflies in my stomach as I introduced myself to a group of corporate leaders. At the moment it had been unpleasant; now, however, it was but a vague memory.

The trainee did a nice job having me imagine back to the previous week. I was able to get a picture and negative belief about myself, but not much emotion. She then asked me to notice the picture, repeat the negative belief, and then simply to "notice what comes up" as she moved her hands back and forth in front of me and I followed her fingers with my eyes. At one point I noted that my neck and shoulder hurt. "I fell off my bike," I explained. There was no traumatic memory maintaining it, I assured her. It had a purely mechanical explanation, I insisted. She asked me for a bit of detail, then suggested that I simply pay attention to what I had just reported, and move my eyes again as she waved her hands in front of me. Much to my surprise I drifted back to a memory of presenting myself at another time in my life, a time I was reciting a poem to a group of peers in high school. I recalled being very nervous. Apparently I had been reciting too fast because the face of the teacher then flashed into my memory as he shouted, "SLOW DOWN," startling everyone in the room and giving me a pretty good scare. The tears that then welled up in me, and the shame and anger that I had not fully admitted to before, further surprised me. And with the apparent randomness that so characterizes EMDR, I began processing memories that connected the butterflies from the previous week, with the recitation from decades before, with the physical back pain that I would not have tied to either of these memories prior to this EMDR experience.

Within 45 minutes I was able to recall both memories without feeling any upset. I then put my hand to my neck and shoulder. No pain. I bent and twisted. Still no pain. Six years later I remain pain free and grateful to my colleague who more than reciprocated for the help I had offered her.

Then Michael Galvin told me about another odd-sounding psychotherapy called thought field therapy (TFT), and I took a course taught by psychologist Fred Gallo. As I applied TFT, I noticed it seemed to work as well as EMDR and had additional virtues.

After a few months, however, I was using TFT infrequently. I was finding it had minimal impact on the clients I treated. I had also become rather skeptical about the claims being made about its efficacy.

To humor my old friend Michael, I signed up for advanced TFT training, again with Fred Gallo. Fred opened his Level 2 training by asking those of us in attendance to report our success rates with TFT. I confessed that my clients did not respond very favorably, certainly not as positively to energy therapy as they did to EMDR. The other trainees in attendance that day, to the contrary, reported both high rates of success and much enthusiasm. Fred then invited me to the front of the training room to be checked out energetically.

Fred offered to muscle test me for the possibility of an energy interference, called a psychological reversal or energy reversal, that might account for the trouble I had been having using the basic energy techniques effectively (see Chapters 1 and 3). These reversals will sometimes show up in the middle of treatment and interfere with therapy, much as a negative belief (e.g., "I really don't deserve to be feeling this good") might appear and disrupt treatment that is based on positive thinking. To check on his hypothesis, Fred asked me to make certain statements as he tested my muscles by pressing down on my extended arm. He and I then went through every possible energy reversal statement in the training manual, for example: "I deserve to use energy methods effectively," "It's possible for me to be effective," "I will do the work necessary ?," "I will allow myself to?," and so forth. Alas, nothing turned up that looked like an energy reversal. Being the sensible educator he is, Fred then turned to me:

Fred: I'm confused, John. What do you think is going on?

John: I don't know if this makes sense, but I have this odd idea that I can't get too good at using TFT. Somehow being highly effective using energy therapy might make me disloyal to the people in the EMDR community, and I feel such commitment to them. Does that sound crazy?

Fred: Energy reversals take strange forms at times. Let's test for what you said.

Fred muscle tested me for this hunch and finally found something that looked like it could account for the trouble I had been having using TFT effectively. On an energy level and quite unconsciously, I had come to associate success using TFT with disloyalty to EMDR. Fred then corrected me for that particular psychological reversal and the subsequent muscle test suggested that I was "cured" of that particular interference.

The end of this short story is that later in that training I worked with another participant who had been trying for several months to resolve a gruesome memory of having been tortured as a child. For several months prior to the TFT workshop, the participant had been using EMDR and other therapies with a very experienced and well-trained private practitioner but would dissociate every time he began to work on the memory. Because of earlier feedback from his regular therapist and his ease at dissociating from his truly horrible memory of abuse, he was beginning to think he might have multiple personalities. I began to use some energy techniques I learned the same day that Fred corrected my disloyalty psychological reversal, and the participant finally was able to resolve the traumatic emotions associated with this particularly difficult memory, without dissociating.

After this and similar experiences, I was finally able to make use of TFT. Not only did the techniques begin to work consistently, but also I was able to appreciate the ways that reversals can occur, and be corrected, on the energy level. I was reminded again of how we sometimes learn more under conditions of failure, and how we invent when the basic tools we already have no longer suffice.

About Michael

My graduate training involved an interesting range of schools of thought, as some professors in the department, including H. S. Pennypacker, were very active in investigating and teaching basic behavioral psychology while Sidney Jourard and others pioneered humanistic psychology. Vernon Van De Riet returned from a strange-sounding place in California-Esalen-with a new method, Gestalt therapy, which he taught to a group of students, including me. I settled on Gestalt therapy as my principal modality. During my internship, I was introduced to a method that was fast becoming popular among psychotherapists, but of which I had heard not a word in graduate school, transactional analysis. Though a brilliant intellectual therapy, it lacked in emotional content, and so I, along with many others, combined it with Gestalt therapy (James & Jongeward, 1971). On beginning practice, I founded and directed the Pikes Peak Area Transactional Analysis Seminar. This Gestalt-enhanced transactional analysis and its advances, such as redecision therapy (Goulding & Goulding, 1997), was my main modality for years. An important concept in transactional analysis is that under parental influence, each of us makes decisions in early childhood that form a life "script" (Berne, 1972). I have found understanding the nature of these decisions to be helpful in planning and carrying out treatment, and I still use life script analysis to help choose targets for therapeutic intervention.

I learned much from many of the same teachers as John and have also incorporated elements from many sources including Harold Greenwald's Direct Decision Therapy (1989), Frank Farrelly's Provocative Therapy (1989), and the varieties of solution-focused therapy (O'Hanlon & Weiner-Davis, 1989). For years I have been using the framework in Lazarus's Practice of Multimodal Therapy (1989) to conceptualize and guide my work.

Soon after he became involved with EMDR, John told me about it. At first I was quite skeptical: "This woman in California is curing serious disorders in people by moving her fingers in front of their faces and having them follow with their eyes?" John admitted that skepticism was also his first reaction, and it is similar to the one we now often get when we introduce the method to others. Nevertheless, I was persuaded by John's continuing enthusiasm and that of other trusted colleagues, including Jim Knipe and Bob Tinker. After a few months, I took Level I training in EMDR.

At about the same time I saw an ad for a "five-minute phobia cure" in a publication from a division of the American Psychological Association. Immediately skeptical, I turned the page, but then turned back, considering that if it really would help, I owed it to my clients to investigate. The tape and documents I received began my introduction to Roger Callahan's thought field therapy (TFT). This form of psychotherapy was even more peculiar than EMDR, but I got good results from simply studying and applying the techniques described. Interested in more training, I was referred by Dr. Callahan to Fred Gallo, who agreed to come to Colorado to conduct an early TFT Level 1 training. I told John, who was open enough to take the first training presented by Fred in the region. As we applied it, TFT seemed to work as well as EMDR, and both had complementary virtues.

I readily took to the energy concepts and soon was practicing them with the bulk of my clients.

Case example:

Early on, I described the case of a client who was fearful about an upcoming computed axial tomography scan (Galvin, 1995). In fact, she had called off a previous scan halfway through, in spite of having been given Vicodin intravenously. In the office, we lowered her anxiety to negligible levels with some tapping therapy and she left confident of being able to undergo the procedure, which had been rescheduled for that Friday. Her anxiety returned in the days before the appointment, however, and she asked me to go to the hospital to work with her there if need be. We met before the procedure and did some tapping therapy to lower her fear again. In the examination room, I sat with her as she went into the scanner. A couple of times she asked to be pulled out, we did a little more tapping, and she continued the examination. About halfway through the procedure, my schedule required me to leave. The client said she thought she would be all right. When I returned to the office the following Monday, I found a message the client had left on my answering machine: "Thank you for helping me; it was about the most relaxing time I have ever had." She later reported that over the following weeks other symptoms of a long-standing claustrophobia had disappeared, though we had not specifically addressed them.

Combining the methods

The final step for us was to begin blending energy approaches with EMDR. The first impetus for this arose when we independently discovered that using an energy exercise during an EMDR session could help a client to process trauma more efficiently. With time we experimented more and more with using energy techniques with EMDR to contain an emotionally upsetting experience, help to finish a session where the subjective units of disturbance (SUD) score was still too high, or slow down the dissociative process. We also began to notice that clients who were reworking the same issue over and over without much resolution were often helped after we corrected for a psychological reversal-much as Fred did with John in his advanced energy training course. We found we could introduce these strange energy procedures in the midst of EMDR processing with very little resistance from patients, and the techniques worked wonderfully.

Case example:

In an EMDR session, a client with a history of being verbally abused determined that her target issue had a SUD of 9. (SUD is determined by a 1 to 10 scale, where 0 means "no distrurbance" and 10 means "highest disturbance.") After different "channels," or aspects, of the issue had been processed, the SUD level was down to 6. After a few more minutes of work it was at 5. The next couple of sets of bilateral stimulation had very little effect. When I asked, "What do you get now?" the client repeatedly responded, "It's the same thing. He's still standing there yelling how stupid I am."

This treatment block could be targeted with EMDR techniques that Shapiro (2001a) calls interweaves. I instead decided to conceptualize the problem as a psychological reversal (see Chapter 3), so I asked the client to tap the side hand point while saying three times, "I deeply accept myself even though I still have some of this problem." No changes were immediately apparent in the client, but when bilateral stimulation was reinitiate-still targeting "the same thing"-treatment progressed rapidly and the SUD rating was soon at 0.

A second impetus for combining the methods came from administrators of forensic treatment programs. Early efforts using EMDR with criminals produced two distinct problems. One was that many offender-clients refused to use EMDR, or to continue to do so when they realized it would likely require them to relive traumatic memories, a particularly discouraging proposition for a person who has survived by suppressing or diverting certain emotions. Another problem was created by a group of newly trained and very enthusiastic EMDR clinicians who had been using EMDR rather inappropriately with offenders. In some cases a client left what appeared to be a successful EMDR session, only to return to his community corrections halfway house talking about wanting to commit suicide. After several threats of this sort (no deaths, we are happy to report), program administrators began to believe that EMDR, far from being the treatment of choice for this population, was too dangerous to be considered at all. As detailed in Chapter 9, we were able to continue by blending energy therapy into EMDR for the sake of both clients and administrators. Eventually we worked as therapists in a research program with an offender population.

A third motive arose from discussions with student-trainees. The first trainings we conducted were in EMDR. We then began to offer training in energy methods, either to our EMDR students who wanted to learn more about the innovative therapies or to paraprofessionals who would not have been eligible for EMDR training. In both our EMDR and energy therapy seminars we began to hear from students who were frustrated in their work with certain clients who responded to neither of these methods alone. Since our trainees' experiences paralleled our own, we began to tell them how we were combining EMDR with energy therapies with positive results. Eventually we organized a training format that included blending strategies.

Our experiences in discovering EMDR and energy therapies, then blending them, are not particularly unique. Many of our colleagues have been on their own pilgrimages in search of better solutions to psychological problems. Some, like Michael, learned the two methods and took to them immediately. Others, as in John's experience with TFT, began or became skeptical of the new paradigm, and needed to revisit them before they felt legitimate. Still others, however, began using the methods enthusiastically but eventually slipped back to old habits. One of our colleagues, for example, referred a client for a consult:

Colleague: I just don't seem to be very good at using EMDR.

Question: What has been your experience so far?

Colleague: Well, I get the usual miracles, quick responses, problems resolved, client is happy with the therapy, that sort of thing. But it just does not seem to fit my style.

What does "not fit my style" mean? we wonder. Could this be a case of a psychological reversal, accessible to muscle testing and correctable with energy treatment? Could the client's problem be triggering something similar in the therapist, perhaps an unresolved traumatic memory? Part of our purpose in this book is to suggest ways for healing distress. And part is to encourage therapists to apply the techniques from EMDR and the energy therapies to themselves. Sometimes by resolving their own personal issues (traumas, energy blocks, blocking beliefs), therapists can eliminate what has been interfering with their ability to use the treatment strategies effectively with others. We know that many of our colleagues have had experiences similar to the one John described earlier, and that by attending to them, they find the problem is not so much a "matter of style" but rather unfinished personal business that limits them and their work. From time to time in the book, we will visit the issue of therapist variables and will mention ideas for how therapists can use both EMDR and energy techniques on themselves. The old adage "Physician heal thyself" has become more meaningful to us since learning these new methods and raising our standards for treatment efficacy.

About the Authors

John Hartung, Psy.D. and Michael Galvin, Ph.D., are clinical psychologists in private practice and are affiliated with the Colorado School of Professional Psychology. Their collaboration as clinicians and authors has spans a quarter century. During this period they have taught EMDR in more than a dozen countries in the Americas, Asia, and Europe and has coauthored various manuals in EMDR.

ISBN: 0-393-70378-9
November, 2002
Hardback, 320 pages