Video 014 Feeling State Addiction Protocol
Use this video
With clients who have a behavioural or substance addiction. This protocol is based on the feeling-state theory of behavioural and substance addiction, proposes that just as single-event traumas can become fixated with negative feelings, intensely positive events can become fixated with positive feelings.
Any activity/experience that generates an intensely positive experience can become addictive. While some/many of these may be quite harmless, others can cause financial, emotional and physical difficulties for the addictive individual and those close to them. These can include gambling, pornography, extreme sexual practices, and use of addictive substances such as alcohol, ketamine, cocaine, etc.
Anecdotal evidence suggests FSAP outcomes may be boosted if the client alongside this protocol takes part in a Twelve step or other similar support programme.
Originator
R. Miller (2012). Feeling-state theory of behavioral and substance addictions and the feeling-state addiction protocol.
Video production
Matthew Davies Media Ltd, Llanidloes, Powys.
www.matthewmedia.com
What this covers
Stacey was a 45 year old woman with three teenage children. She had a history of difficult relationships. She’d used many different drugs during her adult life and had, in recent years, become addicted to crack cocaine.
This resulted in Social Services becoming involved in her life again, because her addiction had raised child-protection concerns. Her children had been taken into temporary foster care while she worked on getting free from her addiction. This wasn’t the first time she’d tried to get free. She’d been in and out of rehab at least twice, but this was her final chance to regain custody of her children. She was very motivated to succeed in overcoming the addiction and had already been clean for three weeks when she came to see the therapist.
How long
17.20 minutes
Go to ‘Take-away’?
For further information in Wrap up and for the Aide mémoire to use in a client session.
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Take-Away Section
+ Wrap up
- Understanding the history of how the addiction began is very important in setting up the protocol. In this video, we use the Power Threat Meaning framework to understand the root of Stacey’s addiction as a response to a lifetime of emotional impoverishment. This framework also helped to ask questions that generated clues as to her abilities and strengths that enabled the therapist to trust that Stacey would be able to manage the EMDR based process.
Read more
+ Aide Mémoire
You can copy and paste this text into a Word document, and can edit it, adding any additional text you might find helpful.
Aide Memoire Feeling State Addiction Protocol
The Feeling State Addiction Protocol is in three parts
- Feeling State reduction
- Addressing the underlying trauma that made the person vulnerable to addiction
- Addressing the negative consequences of the addiction
General preparation
1. Obtain history, frequency, and context of addictive behaviour.
2. Evaluate the person for having the coping skills to manage feelings if he or she is no longer using the addictive behaviours to cope. If not, do resource development before continuing. Install a future template if necessary.
Feeling-State Reduction
3. Identify the specific aspect of the addictive behaviour that has the most intensity associated with it. If the addiction is to a stimulant drug, then the rush/euphoria sensations are usually the first to be processed. However, if some other feeling is more intense, process that first. The starting memory may be the first time or the most recent—whatever is most potent.
4. Identify the specific positive feeling [sensation + emotion + cognition] linked with the addictive behaviour and its Positive Feeling Scale (PFS) level (0–10).
5. Locate and identify any physical sensations created by the positive feelings.
6. The client visualizes performing the addictive behaviour, feeling the positive feeling, combined with the physical sensations.
7. Eye movement sets are performed until the PFS level drops to 0 or 1.
8. Install future templates of how the person will live without having that feeling.
9. Between sessions, homework is given to evaluate the progress of therapy and to elicit any other feelings related to the addictive behaviour.
10. In the next session, the addictive behaviour is re-evaluated for both the feeling identified in the last session as well as identifying other positive feelings associated with the behaviour.
11. Steps 3–9 are performed again as necessary.
12. Once the FSs associated with the addictive behaviour have been processed, the negative beliefs underlying the FSs are determined, and the desired positive beliefs are chosen.
Addressing the underlying trauma that made the person vulnerable to addiction
13. The negative beliefs are processed and the positive beliefs are installed with the standard EMDR protocol steps.
Addressing the negative consequences of the addiction
14. The negative belief that was created as a result of the addictive behaviour is determined and a positive belief is chosen.
15. The negative beliefs are processed and the positive beliefs are installed.
16. Install future templates.
Miller, R. (2012) Treatment of Behavioural Addictions Utilizing the Feeling-State Addiction Protocol: A Multiple Baseline. Study Journal of EMDR Practice and Research Vol 6 (4), DOI:10.1891/1933-3196.6.4.159
This is about Tom, a young man brought up in a dysfunctional family: an alcoholic mother and a controlling, sometimes violent, father who would belittle him for showing a desire to learn and do well in school. Tom grew up with a sense of being rejected by his family and carried thoughts of being ’bad’ and ‘shameful’. These became particularly troublesome after Tom developed a serious interest in a fellow student at university. He found himself holding back from the relationship, scared that she might reject him when she found out what a ‘bad’ person he was.
What you will learn:
The video demonstrates how Tom’s damaging and pervasive attachment experiences with his mother and father can be repaired and reversed through rewiring his thought patterns. The video shows how the therapist and Tom co-construct and install an alternative reality - a hypothetical ‘ideal’ mother as a resource. In turn, this led to new neural pathways that changed the way he felt about himself and how he related to others.
This video is about Sally, a young woman who has been in a car accident, the target memory, and has started treatment with the standard EMDR protocol. Unexpectedly during processing, she is flooded with memories of a previous event from her childhood.
What you will learn
The use of EMDr to successfully desensitize and reprocess the new intrusive memory through this narrow focussed adaption of the standard EMDR process, before going back to the original target memory.
The video of the case shows Carla, who is experiencing chronic pain with no evident cause in the here and now.
What you will learn
The latest thinking about how and why pain is made, and the basic mechanism behind how EMDR works to reduce pain. Step by step protocol for working with chronic pain – includes use of drawing/art.
The case is about Jane, who came for help about her relationship with her wife, Mary. This video is the third of a three part video series showing several important aspects of working with difficult partner relationships. The three videos focus on the relationship in the past, in the present and in the future. This final video demonstrates the use of Future template protocol to install new skills designed to prevent/manage conflict in future.
What you will learn:
Enable clients develop and deploy new skills to reduce risk of conflict and help resolve conflict should it arise in future. In particular it shows:
Case of a woman, Jane, whose marriage to Mary was in trouble. Video 035 describes how to identify and desensitize/reprocess past trauma affecting the relationship. This video deals with current difficulties
What you will learn:
What you will learn: Use of an adaption of the standard EMDR protocol to undo concurrent negative beliefs held by the client about herself and her partner in one process.
Case of a woman, Jane, whose marriage to Mary was in trouble. Differences between them, including experiences of trauma and educational achievements, were leading to serious discord.
What you will learn:
What you will learn: Use of EMDR to work with couples. Key questions for use in history taking to uncover causes of discord, and to identify EMDR targets. Consideration of whether to have both partners ‘in the room’ when using EMDR on one of them.
This video demonstrates the use of storytelling along with the standard EMDR process with a child who found it difficult to tell what happened to her, struggled to find cognitions and had problems following eye-movement bilateral stimulation.
What you will learn:
How to create a story describing a child’s traumatic experience, involve family members in the process, and carry out the adapted standard EMDR process.
The video demonstrates the application of the EMD protocol, generally thought of as an early EMDR intervention protocol (EEI).
What you will learn:
How to use this protocol with dysregulated clients who may want therapy soon after experiencing a very distressing event.
Intense affect often accompanies work with complex trauma. These can be a re-enactment of emotions experienced during the trauma and can be shocking to witness. The temptation is to stop processing and move into talking therapy or other mode of operation. Usually, a better way is to enable the client to safely continue to process while you ‘stay out of the way’.
What you will learn:
How to manage yourself as therapist and the client when there is a strong emotional response during an EMDR processing session and several different ways of working with abreactions.
This video demonstrates the development and installation of three types of resources that can be very useful for some clients who might benefit from access to sources of nurturing, protection or wisdom during treatment with EMDR. They can be installed prior to or during processing.
What you will learn:
To learn how to stabilise clients prior to using EMDR or during actual processing to overcome blockages or stuck situations.
Case of a singer who suffered an unexpected panic attack during a performance, seriously threatening his future ability to continue as a soloist.
What you will learn:
How to use the standard EMDR protocol along with the three prong approach to overcome performance anxiety. Can be used in many other situations, e.g. fear of a future medical procedure after a bad experience.
The sudden, accidental death of a grandson. While Video 019 dealt with the pain and loss associated with a past event and Video 020 with the present, this video deals with the future.
What you will learn:
How to use EMDR to help the client readjust to life without the loved one.
The sudden, accidental death of a grandson. While Video 019 dealt with the pain and loss associated with a past event, this video deals with the present: triggers and secondary losses associated with the death.
What you will learn:
How to use EMDR to help the client re-experience the absent loved one, relinquish memories of old (now unsuitable) attachments, while identifying memories he/she wants to hold on to.
When a client’s grief has become complex i.e. deviating from the norm in either the time or intensity of specific or general symptoms of grief and/or the level of impairment in social, occupational, or other areas of life.
What you will learn:
How to use EMDR to release the complex nature of stuck or distorted grief – the first phase in a three-phase process to address Complex grief. Also, how Narrative therapy provides a ‘bird’s eye’ picture of how the three phases work together.
Case of woman with history of childhood physical and emotional abuse. Video shows how to work safely when there is a high risk of dissociation, which can lead a client to lose contact with the present moment and be caught up in the past when asked to describe or focus on a traumatic event.
What you will learn
How to use CIPOS (Constant installation of present orientation and safety) and BHS (Back of the head scale) when risk of dissociation is high.
Many clients come to therapy with a problem that includes both positive and negative affect components. In terms of Shapiro’s Adaptive Information Processing Model, it’s as if there are two entry points to stored memory networks.
What you will learn:
What to target when clients come to therapy with a problem that includes both positive and negative affect components
Case of woman with history of childhood physical and emotional abuse. Video shows a Phase 3 Assessment with a dissociative client, stabilised with CIPOS and BHS, when the trauma is held by a part of the personality.
What you will learn
How to do a Phase 3 Assessment with a dissociative client when the trauma is held by a part of the personality. Phase 4, Desensitisation, follows.
This video covers the use of Socratic Questioning as a form of cognitive interweave.
What you will learn
Learn how to use this technique to overcome blocking and looping with the standard EMDR protocol.
This is about a company executive living in fear of his boss. His family history was one of negative interactions with powerful people over several generations. This was the source of his class inferiority - the introject or psychic object that he had unconsciously absorbed, and now blighted his relationship with his boss.
What you will learn
How to free clients from damaging generational and cultural practices using the standard protocol in conjunction with a process based on Narrative therapy in which the introject is ‘externalized, disowned by the client and removed with a two handed and imagination interweaves.
Procrastination is a recurring pattern of avoidance behavior. It can be thought of as a sort of addiction to the short term gratification of a delay. It involves avoiding action.
What you will learn
Step by step protocol borrowed from Popky’s use of EMDR with addictive disorders and Jim Knipe’s “Level of urge to avoid (LOUA).”
NAW stands for Notice, Acknowledge and Welcome. It’s a technique borrowed from sensorimotor psychotherapy to address psychological and physically experienced pain and in this application is incorporated into the standard EMDR protocol. This video shows two case examples. In the first, a 40 year old woman experienced lots of pain during the stabilization phase of the work with her therapist.
What you will learn
How to use this technique with a step by step protocol, and understand the basic mechanism that leads to pain relief.
In this video you will see a therapist work with a child part or ego state and an adult part or ego state using a two-handed interweave. This new child ego state has emerged following ego state work demonstrated in Videos 001, 002 and 003.
What you will learn
How to facilitate communication between two ego states.
This video demonstrates the use of Constant Installation of Present Orientation and safety (CIPOS) with Olivia, a child who had been in a car accident. She has had flashbacks about the accident and is reluctant to process the memories
What you will learn
How to use CIPOS (Constant installation of present orientation and safety) with children
This video is about a man who had had a serious car accident. Many years later he still could not remember what had happened to him. He came for therapy wondering if he could recover the memory.
What you will learn
How to access and process memories stored in close-to-original form (i.e. in non- linguistic somatosensory form).
Lucy, was a young woman in her twenties. She was suffering from Obsessive compulsive disorder (OCD) and presented with anxiety and a constant need to check things over and over. This behaviour significantly interfered with her life.
What you will learn
How to use John Marr’s “Adapted EMDR Phobia Protocol with Video Playback”.
Samantha is in her forties. She came to therapy after returning from holiday in a foreign country. There, she was hospitalised following an accident.
What you will learn
What you can do when client is terrified to revisit the trauma events.
John was a retired civil servant, who’d come to therapy because of anxiety. He had always been an anxious person, but it had become worse since retiring. Now his worries seemed to increase in number and intensity.
What you will learn
How to help clients manage stress.
This video demonstrates the use of three different types of questions designed to overcome blocking and looping in EMDR processing.
What you will learn
Learn how to use these question to overcome blocking and looping with the standard EMDR protocol.
Client was a young female executive caught in a dilemma over whether to focus on her career or on having a baby. This dilemma came to light after having EMDR to deal with stress related to some difficulties she was having with one of her staff.
What you will learn
How to help clients resolve dilemmas.
What this is about: The case is about a man in his forties who has lost his family and career. He experiences extreme dysregulation, suicidal thoughts and an inability to make sustained relationships. He has a childhood of extreme neglect and abuse. The defining condition is a lack of any hope of change or relief in the future. He is unable to contemplate dealing with past and current traumas.
What you will learn: How to work, first with the future loss of hope using the standard EMDR protocol. You will also learn how to use aspects of Brief Solution Focused Therapy to create a hopeful future, if the client is unable to do so himself. This hopeful future will become the target in this first phase of the three-part therapeutic journey.