EMDR applications for pain management

The focus of this 3-hour workshop will be on using EMDR to alleviate emotional distress attendant to coping with acute physical pain and living with chronic pain. Participants in this workshop will learn: (a) how to conduct a targeted assessment of the patient whose chief complaint is physical pain; (b) a guided pain healing meditation; (c) an EMDR protocol for installing pain relief imagery and self-care techniques; (d) an EMDR protocol for reprocessing covert pain talk, pain behaviors and pain-related memories; (e) how to apply A.J. Popky's EMDR protocol for reducing substance abuse (i.e., Overeating, drinking) and dependence on pain medication in this population. The presentation will first address how to conduct a structured assessment that identifies targets for EMDR treatment. The dysfunctional information package associated with chronic pain (termed the "biogram")and "seven keys" to understanding chronic pain will be discussed. Then, essential principles for designing an effective individual psychotherapy program for the pain sufferer will be presented. Next, use of the "seven keys for constructing a guided healing meditation (i.e., Self-care technique) for the pain patient that also incorporates Francine Shapiro's "light stream" and "spiral" guided meditations will be demonstrated. A script for this, termed the "C.O.M.P.I.S.S. Pain Healing Meditation," will be distributed. The workshop will then address how to introduce EMDR to the patient whose chief complaint is physical pain. What EMDR can do and probably cannot do for pain patients will then be discussed. Next, principles for choosing an initial tarqet for reprocessing will be discussed. The presentation will then cover (with clinical case examples): (1) Red flags and cautions to consider before proceeding with EMDR- (2) What to do and what not to do if the patient is dissociative; (3) How to "mirror" and install with EMDR empathic responses to underlying beliefs associated with "secondary gains" minus primary losses; (4) Teaching the distinction between pain sensations and suffering; (5) How to teach and install with EMDR self-care and pain coping techniques such as pain relief imagery, mental distraction techniques, safe place imagery, and positive motivation for healthy self-care behaviors; (6) How to directly address with the patient the application of "cognitive psychology" and imagery for pain reduction; (7) EMDR reprocessing of memories around the pain's origins; (8) EMDR reprocessing of pain-related conflicts, negative beliefs, negative past experiences, internalized self-identifications, self-punitive tendencies and self-defeating behaviors; (9) Eliciting core negative pain coping cognitions and suggesting preferable positive cognitions to the pain patient; (10) EMDR reprocessing of negative cognitions associated with depression and anxiety. (11) Use of EMDR to facilitate mental rehearsal of coping responses to pain triggers; (12) Material that often comes up in using EMDR with pain patients; (13) Strategically restructuring patient "resistance" with coanitive interweave; (14) Managing narcotic and pain medication seeking behavior and substance abuse; (15) Use of Popky's EMDR protocol for reducing medication dependence and substance abuse in this population; (16) Treating pain patients who also have PTSD. Videotaped case excerpts will be shown that illustrate important points covered. If time permits, participants may be able to briefly discuss EMDR applications to specific medical and pain patient populations.

Conference

English

Bruce N. Eimer

Eimer, B. N. (1995, June). EMDR applications for pain management. Presentation at the EMDR Network Conference, Santa Monica, CA