1. Integrating Mindfulness into EMDR Therapy & Trauma-Focused Care
“Notice That”
Integrating Mindfulness into EMDR Therapy & Trauma-Focused Care
Ohio Counseling Association
Spring Conference 2019
Suzi Rutti, MSW, LISW-S
&
Rachel Weaver, MSW, LISW-S, LICDC-CS, DBTC, CEAT

2. “Mindfulness is awareness that arises through paying attention, on purpose, in the present moment, non-judgmentally”
-Jon Kabat Zinn

3. Objectives
1. Define mindfulness and its application to trauma-focused care
2. Discuss EMDR therapy as a mindfulness-informed practice
3. Demonstrate 3 mindfulness strategies for integration into trauma treatment and/or EMDR therapy

4. Practicing Awareness Exercise

5. What is Mindfulness?
Mindfulness: a mental state achieved by focusing one's awareness on the present moment, while calmly acknowledging and accepting one's feelings, thoughts, and bodily sensations without judgment. “Be here now.”
Step one is to notice whatever you are doing. This can be eating, walking, listening to music, breathing, almost anything can be “mindful”.
How to do it:
Inevitably, your attention will leave and wander to other places.
When you get around to noticing this—in a few seconds, a minute, five minutes—return your attention to the moment/activity.
Don’t bother judging yourself or obsessing over the content of the thoughts. Come back.
You go away, you come back.
That’s the practice. It’s often been said that it’s very simple, but it’s not necessarily easy.
The work is to just keep doing it. Results will come.
(Germer, 2004)
Rachel

6. Meditation vs Mindfulness?
Meditation: thinking deeply or focus one's mind for a period of time, in silence or with the aid of chanting, for religious or spiritual purposes or as a method of relaxation
Differences between Mindfulness and Meditation?
Meditation is dedicated time, set aside to specifically engage in focusing one’s mind fully. This is usually done sitting or lying down quietly with stillness.
Mindfulness, however, can pretty much be done…Any Time, Any Place/Environment, During any variety of activities (eating, walking, music, *dancing): Dancing Mindfulness
(Germer, 2004)
Rachel

7. Trauma-Informed Care vs Trauma-Focused Care
Recognizes the role that unhealed trauma plays in human behavior
Provides a template for minimizing harm in the delivery of human services
Offers an educational framework for human services systems
Trauma-Focused Care
Assumes that unhealed trauma plays a major role in presenting issues
Denotes greater action in the delivery of treatment services
Promotes proactive treatment planning to heal the legacy of trauma
(Marich & Dansigner, 2018)
Suzi

8. Neurobiology of Trauma/Triune Brain
(English, 2016)
Suzi

9. EMDR Therapy What is EMDR Therapy?
A structured therapy that encourages the patient to briefly focus on the trauma memory while simultaneously experiencing bilateral stimulation which is associated with a reduction in the vividness and emotion associated with the trauma memories. (APA; Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder, July 31, 2017).
EMDR Therapy as a Mindfulness-Based Practice
There is considerable overlap between neurobiological models of PTSD and neurobiological findings in the mindfulness literature. Recent research shows that mindfulness-based treatments have the potential to target emotional undermodulation (associated with hyperarousal and intrusion symptoms) and emotional overmodulation (associated with dissociative symptoms). Specifically, evidence suggests that mindfulness-based therapies may be effective in increasing activity in prefrontal regions and reducing activity in limbic regions (e.g., amygdala), and thus may effectively target intrusion and hyperarousal symptoms. (Boyd, et al., 2017)
Rachel

10. Why Mindfulness? Awareness Grounding Connection Integration
“A human mind is a wandering mind, and a wandering mind is an unhappy mind” (Killingsworth & Gilbert, 2010)
Suzi
How are you feeling right now; what are you doing right now; are you thinking about something other than what you’re doing
46.9% of the time we are thinking about something other than what we are doing
Less happy when minds wandering

11. Where does Mindfulness fit?
Phase 1 History Taking: Awareness of past impacting present
Phase 2 Preparation: Resourcing (previously known as Stabilization)
Phase 3 Assessment: Emotional/Body Awareness
Phase 4 Desensitization: “Notice that;” “Go with that”
Phase 5 Installation: Connecting Positive Belief & Body
Phase 6 Body Scan: Body awareness
Phase 7 Closure: Strategies for use between sessions
Phase 8 Reevaluation: Checking back in/future planning

12. Mindfulness Strategies for use with EMDR Therapy
Awareness/grounding
Breathing
Muscle tense/release
Guided visualization
Movement; Dancing Mindfulness
Expressive Arts
Identification of other recovery capital
(Marich, 2019)
Suzi

13. Evaluation of the Process
Pleasant?
Unpleasant?
Neutral?
Buddha: all sensations, emotions and thoughts can fall within one of these categories- simplify our mind’s constant opinions about experiences. Increased awareness can help us neutralize the effects of craving positive experiences, avoiding negative experiences, and dulling (mindlessness) from neutral experiences

14. Let’s practice...

15. Breath exercise
Rachel; lion’s breath

16. Container Visualization
Suzi

17. Movement
Rachel; tree pose

18. Discussion
How could these strategies (or others like them) be useful in your trauma-focused practice?
Suzi

19. Best Practices/Final Notes about Mindfulness
Self-practice
Building a “toolbox”
Rachel

20. Questions/Comments

21. Resources Trauma Made Simple: www.traumamadesimple.com
Institute for Creative Mindfulness:
EMDR Therapy & Mindfulness for Trauma Informed Care
(Marich & Dansigner)

22. References
APA; Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder (July 31, 2017)
Boyd, et al. (2017). Psychiatry Neurosci Jan; 43(1): 7–25. Published online 2017 Oct 3. doi: /jpn Mindfulness-based treatments for posttraumatic stress disorder: a review of the treatment literature and neurobiological evidence.
Germer, C. (2004). What Is Mindfulness… And Why Is It Important to Therapists? Article, Fall
Killingsworth, M.A. & Gilbert, D.T. (2010). A wandering mind is an unhappy mind. Science 330 (6006) November 11,
Marich, J. (2019). Eye Movement Desensitization and Reprocessing (EMDR) Therapy: Training Course Part 1. Warren, OH: The Institute for Creative Mindfulness.
Marich, J. & Dansiger, S. (2018). EMDR Therapy and Mindfulness for Trauma-Focused Care. New York: Springer Publishing Company.
English, I. (2016). Part 1: Understanding heuristics and biases in homeland security: The triune brain. Retrieved February, 2019 from:
Stachelski, M. (retrieved March, 2019). Module 1 - Mindfulness. Colorado Cancer Counseling. Colorado Cancer Clinic.