Course Roadmap - s3.amazonaws.com€¦ · Course Overview What the Approach Is AIP Foundation 8-Phase, 3-Prong, Standard Protocol How This Course Came to Be Mark Odland’s Background

Course Roadmap

The Artistic Flow Approach to EMDR Therapy

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by Mark Odland - MA, LMFT, MDIV

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Contents

Course Outline 3-4 Key Concepts 5-7 Case Examples Utilizing the Artistic Flow Approach 8-9 Study Guide 10-12 Resources and References 13 Artistic Flow Client Selection Criteria Checklist 14 Script for Introducing Client to Multiple Forms of Eye Movements 15 Script for Introducing Artwork 16 Script for Introducing Artistic Flow Approach for Safe/Calm Place 17 Script for Creating A Safe/Calm Place Using Artistic Flow Approach 17 Interventions When Reprocessing Appears to be Stuck 18 Script to Begin Processing on a Memory Target (Spontaneous Flow) 19 Script to Begin Processing on a Memory Target (Self-Directed Flow) 20 Troubleshooting Technical Difficulties 21

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Course Outline

Welcome and Introduction Course Overview What the Approach Is AIP Foundation 8-Phase, 3-Prong, Standard Protocol How This Course Came to Be

Mark Odland’s Background as an Artist Mark’s Initial Hypothesis Artistic Principles Developed During the Renaissance

Linear Perspective Chiaroscuro

How it Works: Using the Approach as Part of the 8-Phase, Standard Protocol Phase 1: History Taking and Treatment Planning

Introduction to Multiple Forms of Eye Movements Client Selection Criteria Checklist Objectification and Power Dynamics Triggers - Potential Triggers

Health Professional Triggers Medical Equipment Triggers Power Dynamics Triggers

Therapist Appearance and Physical Proximity - Potential Triggers Therapist Appearance and Presentation Physical Proximity

Standard EMDR Mechanics Are Not Available or Desirable Therapist Physical Limitations EMDR Devices Are Not Available Use of Therapist Hand or Arm for BLS is a Trigger Pursuit Eye Movements Are Difficult to Follow

Phase 2: Preparation EMDR Therapy Education and Expectations Script for Introducing Artwork Script for Introducing Artistic Flow Approach for Safe/Calm Place Script for Using Artistic Flow Approach to Install Safe/Calm Place

Phase 3: Assessment Phase 4: Desensitization

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Interventions When Reprocessing Appears to be Stuck Option 1: Spontaneous Flow

Script to Begin Reprocessing on a Memory Target Option 2: Self-Directed Flow

Script to Begin Reprocessing on a Memory Target Benefits of Using the Artistic Flow Approach for Desensitization

Benefit 1: It Retains the Unique Benefit of Eye Movements Benefit 2: It Provides Natural Speed and Variation in Eye

Movements Benefit 3: It Provides Another Valid Alternative for Bilateral

Stimulation Phases 5-8: Installation, Body Scan, Closure, and Reevaluation Additional Benefits of the Approach

It Can Be Cost Effective How the Artwork Was Selected

Strength of Composition Neutrality of Color Neutrality of Content Impact on Speed and Direction of Eye Movements

Conclusion Course Summary Additional Questions and Answers Course Evaluation Post-Course Wrap-Up Post-Test

* (Instructions for obtaining credits will be emailed to attendees approximately 1-2 business days after finishing course and completing a survey at http://bilateralinnovations.com/artistic-flow-wrap-up/

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Artistic Flow Key Concepts Summary on Using the Approach

The Artistic Flow Approach introduces a new method of stimulating eye movements, which involves the use of visual art. Compatible with the AIP model and the EMDR therapy Standard Protocol, the approach has proven successful in a number of case studies for both resourcing and reprocessing. While still being refined, it appears to provide a promising alternative to other forms of bilateral stimulation, and introduces a beautiful and elegant approach into a therapy process that can sometimes feel overly cold and clinical.

AIP Foundation

The AIP model is the theoretical foundation for why the Artistic Flow Approach works, and the explanation for why it fits so well within EMDR Standard Protocol. It is therefore referenced throughout the course. Just as a cut will naturally heal unless it becomes infected, our memories are able to do the same. However, sometimes an experience is so pervasive or intense that it overwhelms the nervous system and becomes dysfunctionally stored. It becomes frozen, cut off from truth, time, and a more objective, adult perspective. The EMDR 8-Phase Standard Protocol activates the brain’s natural capacity to heal and helps it to reprocess these dysfunctionally stored memories. Like standard methods such as the use of arm movements and light bars, the Artistic Flow Approach also generates eye movements. By doing so, it operates within the Standard Protocol and like these other methods, activates the clients adaptive information processing system.

8-Phase, 3-Prong Protocol

The Artistic Flow is an “approach” rather than a “Protocol,” because it doesn’t significantly deviate from the standard, 8-phase Standard Protocol. Just as there is no “Light Bar Protocol” or “Buzzers Protocol,” there is no

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“Artistic Flow Protocol.” Light bars, buzzers, and now visual art, are all simply tools, instruments that assist the EMDR therapy process. However, because it introduces visual art into the EMDR process in an unorthodox way, the course specifically details how the approach fits within each of the 8-Phases. This includes concrete guidance on how to implement this new “technology” for stimulating eye movements, and includes video demonstrations and scripts.

Possible Pros and Cons of the Approach

Because there is variation between clients and between different pieces of visual art, when using the approach eye movements do not always follow a left-right pattern “on beat,” as they would with traditional eye movements. The concern is that it might slow down reprocessing. However, the course addresses this directly, suggesting multiple interventions to increase the speed, consistency, and direction of eye movements if necessary. On the flip side, the sometimes slower eye movements of the approach and the tactile nature of holding artwork in the client’s hands can also be a benefit. The approach tends to be grounding, allowing clients to stay within their window of tolerance.

As demonstrated in Dr. Philip Manfield’s groundbreaking “Flash Technique,” reprocessing can occur “behind the scenes” at a subconscious level. Time will tell, but it appears that the artwork itself may serve as a kind of, as Dr. Manfield calls in his training, “engaging focus.” Upon examination, each method of stimulating eye movements for EMDR therapy (traditional eye movements, tones, taps, and buzzers, etc.) has its own unique strengths and weaknesses that must be catered to each client. The course examines these nuanced considerations, and makes a persuasive case that any perceived shortcomings of the approach are far outweighed by the many benefits. it is Mark Odland’s hope that as therapist and client feedback accumulate over time, the course will continue to be refined and improved.

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How This Course Came to Be

Mark Odland’s undergraduate education as an art-major and experience as a visual artist and EMDR therapist helped inspire the Artistic Flow Approach. He noticed that when looking at visual art, an individual’s eyes move spontaneously. He then applied this knowledge to use carefully selected works of art in order to stimulate eye movements during the EMDR therapy process. He hypothesized that principles from the Renaissance, such as linear perspective and chiaroscuro, increased the likelihood of certain works of art being more conducive to producing the spontaneous eye movements necessary for resourcing and reprocessing. This hypothesis was reinforced by successful case studies, and existing research utilizing eye-tracking software. Acknowledging the “don’t fix what isn’t broken” mentality, he continues to acknowledge that in most cases traditional arm movements, etc. would still be used. However, given how frequently therapists resort to using tactile and auditory stimulation, he emphasizes the Artistic Flow Approach as a valid alternative to retain the unique benefit of eye movements. To help EMDR therapists determine when to use the approach, he developed an expanded client selection criteria to help them identify situations where it could be used as either a first-line method for producing eye-movements, or as a backup to be used before tactile or auditory stimulation.

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Case Study Examples Utilizing The Artistic Flow Approach

In the following three case examples, each client was able to reach resolution or near-resolution of their target memories using the Artistic Flow Approach to EMDR Therapy. In Cases #1 and

#2 reprocessing appeared to go smoothly, as memories were reprocessed to completion. Results in these cases seemed comparable to sessions utilizing BLS generated from therapist

arm movements. In Case #3 the client’s complex trauma posed challenges, yet the artwork used in the approach appeared to be grounding, and supportive of the client remaining within

her window of tolerance.

Case Study #1 Description: Male, approximately 30 years old Diagnosis: Posttraumatic Stress Disorder Memory: Childhood memory involving medical emergency Session #1 Assessment: VOC: 5; SUD: 8 Conclusion: VOC: 7; SUD: 10, Body Scan Clear (memory was completed) Session #2 Reevaluation: Resolution of memory confirmed.

Case Study #2 Description: Male, approximately 35 years old Diagnosis: Adjustment Disorder, Unspecified Memory: Childhood memory involving bullying Session #1 Assessment: VOC: 4-5; SUD: 3-4 Conclusion: SUD: 2 (incomplete session) Session #2 Reevaluation: SUD had reduced to 0 (client reported that the memory was now resolved. Moved on to assess new memory on EMDR Treatment Plan) Assessment: VOC: 4; SUD: 4 Conclusion: SUD: 1 (incomplete session) Session #3 Reevaluation: SUD had reduced to 0 (client reported that the memory was now resolved)

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Case Study Examples Continued...

Case Study #3: Description: Female, approximately 45 years old. Diagnosis: Posttraumatic Stress Disorder. Memory: Childhood memory involving witnessing near death of friend. Session #1 Assessment: VOC: 1; SUD: 3 Conclusion: (memory was not completed - updated SUD was not assessed, although client’s body language indicated an increase in distress during reprocessing). Session #2 Reevaluation: SUD had increased to 7-8. Reprocessing: Given complexity of trauma history, utilized pendulation and titration strategies to keep client within her window of tolerance. Conclusion: (SUD decreased to 0; PC increased to 7; body scan was clear. Session #3 Reevaluation: SUD had increased to 7-8. Reprocessing: Identified feeder memory at age 2, which became new target memory for session. Continued using pendulation and titration strategies. Conclusion: (SUD: 0 (incomplete session).

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STUDY GUIDE The following study guide questions have been made available as

one option for helping you better retain the course material and prepare for the Post Test. The questions below are categorized by each course section, so that you can follow along as the training unfolds. If you are able to answer these questions, the Post Test should be a breeze! Simply read each question, and circle the best answer... Phase 1: History Taking and Treatment Planning Using the Artistic Flow Approach may be helpful if a client:…

a. has experienced trauma with other health professionals b. is triggered by the appearance of EMDR equipment c. is triggered by the power dynamic inherent to therapy d. all of the above

Using the Artistic Flow Approach may be helpful is triggered by close, physical proximity to the therapist.

a. True b. False

Using the Artistic Flow Approach may be helpful when:

a. the therapist has physical limitations b. EMDR devices are not available c. the therapist’s use of hand or arm is triggering d. all of the above

Phase 2: Preparation Developing a Safe/Calm Place using the Artistic Flow Approach involves the client includes:

a. painting something beautiful b. using the Standard Protocol, with a subtle change in scripting c. first introducing them to the idea of using artwork as a possible

method for producing bilateral stimulation

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d. B and C Clients are given the opportunity to choose their own artwork

a. True b. False

Phase 3: Assessment The Assessment Phase of EMDR Therapy is significantly different when using the Artistic Flow Approach.

a. True b. False

Phase 4: Desensitization The “Spontaneous Flow Option” involves spontaneous eye-movements

a. True b. False

If the client’s eyes stop moving across the artwork or appears to be stuck, it might be helpful to:

a. ask them to turn the artwork upside down b. ask them to close their eyes c. ask them to share their most embarrassing memory d. A and B

Phases 5-8: Installation, Body Scan, Closure, and Reevaluation Phases 5-8 of EMDR Therapy are significantly different when using the Artistic Flow Approach.

a. True b. False

Additional Benefits of the Approach An additional benefit of the approach is that it can be cost-effective

a. True b. False

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How the Artwork Was Selected Artwork used for the approach was selected according to the following foundational principle/s:

a. strength of composition b. neutrality of content and color c. impact on speed and direction of eye movements d. all of the above

Artistic principles like “chiaroscuro” and “linear perspective” help explain why a work of art might be appealing and stimulate eye movements.

a. True b. False

---------------------------------------------------------------------------------------------------- * Remember to refer back to this study guide when taking your Post Test. It should help! (the actual Post Test MUST be completed online at CE-Classes.com. Remember, after completing the course and taking an exit survey at http://bilateralinnovations.com/artistic-flow-wrap-up/ you will receive a letter from Mark detailing how to take the post test and obtain your credits.)

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Resources and References The following resources and references were mentioned either directly or indirectly, and have

been listed below for further study: Books EMDR Institute Basic Training Course Manual for Weekend 1 of the Two Part EMDR Therapy Basic Training - by Francine Shapiro (2017) EMDR Institute Basic Training Course Manual for Weekend 2 of the Two Part EMDR Therapy Basic Training - by Francine Shapiro (2017) The World of Durer - by Francis Russell (1967) The World of Rembrandt - by Robert Wallace (1968) The World of Leonardo - by Robert Wallace (1975) The Complete Poetry of Michelangelo - by Michelangelo and Sidney Alexander (1993) Websites emdria.org emdr.com Articles Accessing traumatic memory through art making: An art therapy trauma protocol (ATTP) - by Savneet Talwar (2007) Bilateral art: facilitating systemic integration and balance - by Carole M. McNamee (2003) How Do We See Art - An Eye Tracker Study - by Quiroga and Pedreira (2011) How Emotions Influence Color Preference - by Lee, Andrade, and Palmer (2011).

Relationship Between Color and Emotion: A Study of College Students - by Kaya and Epps (2004) Smooth pursuit eye movements in normal and dyslexic children - by Black, Collins, De Roach, and Zubrick (1984) Smooth pursuit eye movements in schizophrenia and attentional dysfunction: adults with schizophrenia, ADHD, and a normal comparison group - by Ross, Olincy, Harris, Sullivan, and Radant (2000)

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ARTISTIC FLOW SELECTION CRITERIA CHECKLIST Administering BLS with the Artistic Flow Approach retains the benefit of eye movements, while

potentially reducing anxiety related to issues of personal space, potential objectification, and perception

of power dynamics inherent to the therapy process itself.

If the client is a good candidate for EMDR Therapy (according to Client Selection Criteria Checklist from the EMDR Basic Training Manual), the following additional checklist can be used to identify barriers to

traditional eye movements (therapist arm, light bar, etc.). If issues are identified, the Artistic Flow Approach may be used to administer eye movements as appropriate. If no issues are identified, the

approach may still be used as a backup for cases when traditional methods prove unsuccessful.

OBJECTIFICATION AND POWER DYNAMICS - POTENTIAL TRIGGERS ___ OK ___ PROBLEM ___ CONSULTATION

❏ Health Professional Triggers (Possible triggers around previous negative experiences of abuse, neglect, incompetence, objectification, or invalidation with health professionals like physicians or therapists)

❏ Medical Equipment Triggers (Possible triggers around appearance and delivery of commonly used EMDR equipment, or by things that appear clinical, mechanical, or sterile, etc.)

❏ Power Dynamics Triggers (Possible triggers around past abuse or neglect at the hands of someone in a position of power, such as a parent, older sibling, teacher, coach, or religious leader. Examples include physical abuse, emotional abuse, sexual abuse, spiritual abuse, bullying, harassment, invalidation, and objectification)

THERAPIST APPEARANCE AND PHYSICAL PROXIMITY - POTENTIAL TRIGGERS ___ OK ___ PROBLEM ___ CONSULTATION

❏ Therapist Appearance (Possible triggers related to the therapist’s physical appearance and presentation, including factors like the therapist’s gender, physical characteristics, dress, or biography)

❏ Therapist Physical Proximity (Possible triggers related to the therapist’s physical proximity to the client, including the close seating position necessary for traditional eye movements using one’s arm)

STANDARD EMDR MECHANICS ARE NOT AVAILABLE OR DESIRABLE ___ OK ___ PROBLEM ___ CONSULTATION

❏ Therapist Physical Limitations - (Therapist arm fatigue or injury prevents use of traditional arm movements to administer BLS)

❏ EMDR Devices Are Not Available - (EMDR devices like buzzers and/or lightbar are not available due to insufficient funds or the devices being in disrepair)

❏ Use of Therapist Hand or Arm for BLS is a Trigger - (Possible triggers related to past experience of arm or hand being used as an instrument of criticism or abuse)

❏ Pursuit Eye Movements are Difficult to Follow - (A client’s eyes can’t seem to stay in synch with the therapist’s arm or light bar).

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Script for Introducing Multiple Forms of Eye Movements

“When it’s time to strengthen resources or heal painful memories, we can use

eye movements or buzzers, because they both work. I like to start with eye movements… but we can always move to the buzzers later if we need to. For the eye movements, you can either look at my hand going back and forth, or

you can look at a piece of artwork that you hold your hands. From what you’re describing, I think EMDR therapy could be really helpful. Is that something

you’d be open to?”

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Script for Introducing Artwork

“As we work together to strengthen resources and reprocess past hurts,

we’ll use artwork to create the eye movements. It will be as simple as listening

to my voice and holding a piece of artwork in your hands. You’ll just look at the

artwork, … allowing your eyes to move naturally across the page. But first, you

get to choose which work of art you’d like to use (hand client artwork choices).

Take a moment to look at the different options, and select the piece of artwork

that feels right to you. There’s no right or wrong to the image you choose. I’d

just encourage you to pick one that has a neutral or positive feeling to it. Let me

know when you’ve chosen, or if you’d like any help” (pause while client selects

their preferred piece of artwork).

(After the client has chosen their image, record this in your notes for

future reference, and then continue the instructions by saying the following:)

“Now that you’ve chosen your image, take a moment to find a

comfortable way to hold it. Some like to hold it in front of them, and some like to

rest it on their lap. If during our work together things ever feel stuck, I might ask

you to turn the artwork upside down, ask you to squint your eyes, try a new

piece of artwork, or look at the art in a different way. And we always have the

buzzers and headphones as a backup as well. There are lots of things we can

try, so there’s no pressure. With EMDR, you can’t mess it up… you don’t have

to perform. It’s just about letting go, and noticing what happens.”

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Script for Introducing Artistic Flow Approach for Safe/Calm Place

“Earlier I mentioned the idea of using eye movements to strengthen a

Safe or Calm Place in your mind. Is that something you’re still open to?...

Great. The hope is that when we’re done, you’ll have another calming resource

we can use at the end of our sessions together, and a strategy you can practice

between sessions. To help you develop your calm place, I’ll ask you to notice

certain things, and with the artwork you’ve chosen, we’ll use eye movements to

help strengthen any positive sensations…”

Script for Creating A Safe/Calm Place Using Artistic Flow Approach

(All scripting for creating a Safe/Calm Place is the same as with the

Standard Protocol. However, whenever the script would normally prompt you to

say “Concentrate on those sensations and follow my fingers,” instead say:)

“Concentrate on those sensations, and as you hold the artwork in your

hands, allow your eyes to move naturally across the page.”

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Interventions when Reprocessing Appears Stuck

Ideas include asking client to do one of the following:

● Turn artwork upside down ● Slightly squint eyes in order to blur vision when looking at artwork ● Switch to a new piece of artwork ● Intentionally move their eyes between 2 fixed points on the artwork (if

fixed points don’t naturally exist within artwork, fixed points can be added to artwork by drawing them or by using stickers)

● Hold a second piece of artwork, and move eyes back and forth between the two

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Script to Begin Reprocessing on a Memory Target (Spontaneous Flow)

(All scripting for the Artistic Flow Approach in the Desensitization Phase

is identical to the Standard Protocol, with the exception of a slight modification

to the opening script. After finishing the Assessment Phase, you’ll still say “I’d

like you to bring up that picture, with those negative words (repeat the Negative

Cognition), notice where you are feeling it in your body...” However, instead of

then saying, “and follow my fingers,” you’ll instead say, “and allow your eyes to

move naturally across the page.” In summary, to begin processing a memory

target with the Artistic Flow Approach, use the following alternative script:)

“I’d like you to bring up that picture, those negative words (repeat

Negative Cognition), notice where you are feeling it in your body, and allow

your eyes to move naturally across the page.”

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Script to Begin Processing on a Memory Target (Self-Directed Flow)

(All scripting for the Artistic Flow Approach in the Desensitization Phase

is identical to the Standard Protocol, with the exception of a slight modification

to the opening script. After finishing the Assessment Phase, you’ll still say “I’d

like you to bring up that picture, with those negative words (repeat the Negative

Cognition), notice where you are feeling it in your body...” However, instead of

then saying, “and follow my fingers,” you’ll instead say, “and allow your eyes to

go back and forth across the page between the two objects.” In summary, to

begin processing a memory target with the Artistic Flow Approach, use the

following alternative script:)

“I’d like you to bring up that picture, those negative words (repeat

Negative Cognition), notice where you are feeling it in your body, and allow

your eyes to go back and forth across the page between the two objects.”

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Troubleshooting Technical Difficulties Trouble Downloading Course

Unlike a live streamed event, this on-demand distance learning course should all but eliminate technical difficulties. The only foreseeable issue is that for some downloading the course may take longer than others. This will largely depend on the quality of your viewing device and the speed of your internet. In particular, the full, 3-hour course can take some time to download. To help remedy this, you’ll see that we’ve also broken up the course into smaller sections. Downloading these smaller sections should take much less time and eliminate the need for one big download.

Having technical problems taking the Post-Test

1-2 business days after finishing the course and completing the survey at http://www.bilateralinnovations.com/artistic-flow-wrap-up/ , you should receive an email attachment with detailed information on how to take the Post-Test and get your credits. If you’re having technical problems with taking your Post-Test or getting your credits, please contact CE-Classes.com directly at: [email protected]

If anything else comes up, please don’t hesitate to contact us, and

we’ll do our best to make things right. Thank you, - Bilateral Innovations Tech Support

Tech Support Bilateral Innovations P.O. Box 643 Willernie, MN 55090 [email protected]