EMDR With Time on our Side

Bedford EMDR Regional Group15th October 2015

Nel Walkerwwwnelwalkercomnelnelwalkercom

Outline for the workshop

1 a) Trauma as a Time Disorder Look at NCs and PCs in a time

framework- simple PTSD- less obvious cases

b) Using time sequencing in EMDR 2 a) Two kinds of time disorder b) Relevance to the whole EMDR protocol

PTSD as a time disorder

Before the trauma

TIME

Now ndash symptoms blending in to self in the present

NightmaresFlashbacksJumpyIrritableCanrsquot concentrateStopped using the bike

The Mindrsquos normal processing system of everyday experience of slightly disturbing experience of very disturbing experience which

overwhelms the brainrsquos processing system and the memory becomes stuck

Time-taggingWhen experiences are processed or digested they are also automatically time-tagged (hippocampus) then archived in the felt sense of where they belong in our past

Memories that have not been processedhave not been time-tagged

Cannot be archived in the felt sense of the past

Continue to cause symptoms in the present

Traumatic event

PTSD as a time disorder

Before the trauma

Inadequate integrative capacity

Part fixed in time of trauma

A division occurs

After the traumaticexperience

TIME

Part getting on with normal lifeLess grounded in present now

TIME

Time of trauma Now

Memory time marker cues for times in between

Creating distance in time

Creating distance in time

TIME

Time of trauma Now

Strengthening the sense of time in between trauma and now

Spacing of cues

Time

Cues start after the trauma close together in time

Cues space out

Cues closer together into present

Present timeTime of trauma

Temporal Sequencing to create distance from traumatic event before processing

bull If client is anxious about accessing the trauma assure him that he will not need to until he is ready but we are just going to create some time distance from it Explain how

bull Ask him if can think of an image of a time just after the event but with some association to it

bull Then ask for a sequence of images through to the present as you write down the cue words

Temporal Sequencing to create distance from traumatic event before

processing(continued) bull The images used for the time cues should be

remembered events neutral or otherwise with or without an association to the trauma

bull They should be close together in time at the beginning close to the time of the trauma and then be spaced out depending how long ago the trauma happened

bull Then have closer together cues as you approach the present

bull Flag the present Could use slow BLS to reinforce the sense of the present

Using the distancing in time sequence

bull Note the present first then lead the client through the memory cues asking for him to nod when he has the image in mind

bull Always complete the timeline through to the presentbull Ask for feedbackbull Repeat through 3-5 times asking for feedback after

each repetition and noting how it changesbull Usually client will volunteer that the event feels more

distant not so intense and they feel more present

When to use temporal sequencing for distancing from traumatic event

Temporal sequencing to create distance from an event can be helpful

ndash When the client may be anxious and avoidant about accessing the traumatic memory directly

ndash When the processing my not be completed in one session of processing

ndash At the end of processing to reinforce the treatment effect

ndash As preparation for working with any target

Two main categories of time disorder

1 Simple - The present influenced by the past in ways that are inappropriate to the present (Eg Big T and little t traumas)

Two main categories of time disorder

Complex ndash Lack of a developed lsquofelt sensersquo of time and continuity

An insecure insufficiently developed sense of personal continuity through time leading to a diminished anchoring in the present and a diminished sense of self

Depersonalisation disorder

Writing about depersonalisation Simeon and Abugel (2006) describe one of the symptoms thus

lsquoTime often does not unfold in the normal

manner past present and future can seem

indistinguishable as if they were all happening at oncersquo

(De- lsquosense-of-selfrsquo ndashisation)

Felt Sense of Timebull What is the felt sense of timebull Is it a lsquohard-wiredrsquo human givenbull How does it develop normallybull What may block its development

Continuity of being

bullldquoWith the care that it receives from its mother each infant is able to have a personal existence and so begins to build up what might be called a continuity of being

bullIf maternal care is not good enough then the infant does not really come into existence since there is no continuity of being instead the personality becomes built on the basis of reactions to environmental impingementrdquo

bullWinnicott 1960

Felt Sense of Timebull What is the felt sense of timebull Is it a lsquohard-wiredrsquo human givenbull Does it vary from one person to anotherbull How does it develop normallybull What may block its developmentbull Is it vulnerable to damagebull What are the effects of a lack of thisbull How can we recognise a lack of this in clientsbull Is the felt sense of time repairable - can it be

developed or improved

Time

Felt sense of nearness in time

The Present

Recent past

Soon future

Distant past

Distant future

Adapted from Janet 1928a

Normal experience of the sense of time

Nearness in time

Present

FuturePast

Effect of unresolved trauma on presentness and the felt sense of time

Trauma memory active in present

Reduced level of groundedness in present

Nearness in time

Present

Past Future

High past either active in present or dissociated

Low reality in present

o

Multiple trauma - time is experienced as compacted into a dys-functional present Limited sense of past future or continuity of being

Limited ability to be grounded in the present (ANP)

Nearness in time

Present

Past Future

Or a sense of emptiness and detachment as the phobic barrierkeeps the memories out of awareness unless triggered

Low reality in present

o

Phobic barrier

What might alert us to this problem in an adult client

bull Very few memories of childhoodbull Resistance to talking about their historybull Feeling of fogginess or unrealitybull Feeling empty like empty shell or cardboard

cut-outbull Andor feeling of internal chaos bull Problems with emotion regulation andor

being out of touch with emotions

What might alert us to this problem in an adult client (continued)

bull Often dismissive of impact of childhood problems

bull May seem to function well up to particular time in their lives then collapse perhaps with ME-type symptoms or depression

bull Sense of vulnerability with lack of self-protective boundaries

bull Various somatic symptoms or feeling cut off from their body

What might alert us to this problem in an adult client (continued)

bull Hyperalert and highly reactivebull A feeling of not knowing who they arebull Relationship difficulties especially with regard

to intimacybull A sense of rootlessness and endless searching

for something but they donrsquot know whatbull Feelings of hopelessness and despair

Can we do EMDR processing with such clients

They are unlikely to be able to hold both the present and a memory at the same timeThey will be less resourced in the present so easily triggered into reliving a traumatic eventLikely to be out of touch with body sensations and emotions so limiting processing potentialProcessing would be incomplete as they would have no scaffolding for the felt sense of time and so no place for the hippocampus to archive the experienceOther traumatic material is likely to flood the process

What resource would be needed first

We work with two aspects of timeExplanation to client with reference to evolution of the felt sense of time in humans and how it can be developed quite simply

ndash Flagging the present as a unique representation

ndash Using the arc of the present cues

ndash And developing a sense of continuity of being

Continuity of being through time

bull One of the main lsquoguy ropesrsquo holding the sense of the present steady

bull A felt sense To add to the other recognised senses

bull A template for organising onersquos experience

Sequencing

bull One can use sequences in various ways that seem to teach the brain to join the dots of experience

bull These can all help to develop the sense of continuity of being and groundedness in the present when required

Examples of use of temporal sequences

bull To create a life narrative (See Pace 2007)bull To create a therapy narrativebull To bridge a vacation gap where the client may feel

the absence of the therapist as a frightening chasm

bull To create a sense of lsquostretched out timersquo ahead when the client may be highly fearful of coping with an upcoming event such as a family funeral and it seems that time is compacted and the event unmanageable

References

Cozolino L The Neuroscience of Psychotherapy Healing the social brainDamasio A (1999) The Feeling of What Happens Body emotion and the making of consciousness New York Harcourt Pace P (2003 - 4th Edition 2007) Lifespan Integration Connecting ego states through time Available from wwwLifespanIntegrationcom or wwwLi-UKcouk Metzinger T (2009) The Ego Tunnel The science of the mind and the myth of the self Basic Books New YorkSani F (Ed) (2008) Self-Continuity Psychology Press New York and Hove UK Siegel D (1999) The Developing Mind How relationships and the brain interact to shape who we are Guilford New York

PTSD as a time disorder

Before the trauma

TIME

Now ndash symptoms blending in to self in the present

NightmaresFlashbacksJumpyIrritableCanrsquot concentrateStopped using the bike

The Mindrsquos normal processing system of everyday experience of slightly disturbing experience of very disturbing experience which

overwhelms the brainrsquos processing system and the memory becomes stuck

Time-taggingWhen experiences are processed or digested they are also automatically time-tagged (hippocampus) then archived in the felt sense of where they belong in our past

Memories that have not been processedhave not been time-tagged

Cannot be archived in the felt sense of the past

Continue to cause symptoms in the present

Traumatic event

PTSD as a time disorder

Before the trauma

Inadequate integrative capacity

Part fixed in time of trauma

A division occurs

After the traumaticexperience

TIME

Part getting on with normal lifeLess grounded in present now

TIME

Time of trauma Now

Memory time marker cues for times in between

Creating distance in time

Creating distance in time

TIME

Time of trauma Now

Strengthening the sense of time in between trauma and now

Spacing of cues

Time

Cues start after the trauma close together in time

Cues space out

Cues closer together into present

Present timeTime of trauma

Temporal Sequencing to create distance from traumatic event before processing

bull If client is anxious about accessing the trauma assure him that he will not need to until he is ready but we are just going to create some time distance from it Explain how

bull Ask him if can think of an image of a time just after the event but with some association to it

bull Then ask for a sequence of images through to the present as you write down the cue words

Temporal Sequencing to create distance from traumatic event before

processing(continued) bull The images used for the time cues should be

remembered events neutral or otherwise with or without an association to the trauma

bull They should be close together in time at the beginning close to the time of the trauma and then be spaced out depending how long ago the trauma happened

bull Then have closer together cues as you approach the present

bull Flag the present Could use slow BLS to reinforce the sense of the present

Using the distancing in time sequence

bull Note the present first then lead the client through the memory cues asking for him to nod when he has the image in mind

bull Always complete the timeline through to the presentbull Ask for feedbackbull Repeat through 3-5 times asking for feedback after

each repetition and noting how it changesbull Usually client will volunteer that the event feels more

distant not so intense and they feel more present

When to use temporal sequencing for distancing from traumatic event

Temporal sequencing to create distance from an event can be helpful

ndash When the client may be anxious and avoidant about accessing the traumatic memory directly

ndash When the processing my not be completed in one session of processing

ndash At the end of processing to reinforce the treatment effect

ndash As preparation for working with any target

Two main categories of time disorder

1 Simple - The present influenced by the past in ways that are inappropriate to the present (Eg Big T and little t traumas)

Two main categories of time disorder

Complex ndash Lack of a developed lsquofelt sensersquo of time and continuity

An insecure insufficiently developed sense of personal continuity through time leading to a diminished anchoring in the present and a diminished sense of self

Depersonalisation disorder

Writing about depersonalisation Simeon and Abugel (2006) describe one of the symptoms thus

lsquoTime often does not unfold in the normal

manner past present and future can seem

indistinguishable as if they were all happening at oncersquo

(De- lsquosense-of-selfrsquo ndashisation)

Felt Sense of Timebull What is the felt sense of timebull Is it a lsquohard-wiredrsquo human givenbull How does it develop normallybull What may block its development

Continuity of being

bullldquoWith the care that it receives from its mother each infant is able to have a personal existence and so begins to build up what might be called a continuity of being

bullIf maternal care is not good enough then the infant does not really come into existence since there is no continuity of being instead the personality becomes built on the basis of reactions to environmental impingementrdquo

bullWinnicott 1960

Felt Sense of Timebull What is the felt sense of timebull Is it a lsquohard-wiredrsquo human givenbull Does it vary from one person to anotherbull How does it develop normallybull What may block its developmentbull Is it vulnerable to damagebull What are the effects of a lack of thisbull How can we recognise a lack of this in clientsbull Is the felt sense of time repairable - can it be

developed or improved

Time

Felt sense of nearness in time

The Present

Recent past

Soon future

Distant past

Distant future

Adapted from Janet 1928a

Normal experience of the sense of time

Nearness in time

Present

FuturePast

Effect of unresolved trauma on presentness and the felt sense of time

Trauma memory active in present

Reduced level of groundedness in present

Nearness in time

Present

Past Future

High past either active in present or dissociated

Low reality in present

o

Multiple trauma - time is experienced as compacted into a dys-functional present Limited sense of past future or continuity of being

Limited ability to be grounded in the present (ANP)

Nearness in time

Present

Past Future

Or a sense of emptiness and detachment as the phobic barrierkeeps the memories out of awareness unless triggered

Low reality in present

o

Phobic barrier

What might alert us to this problem in an adult client

bull Very few memories of childhoodbull Resistance to talking about their historybull Feeling of fogginess or unrealitybull Feeling empty like empty shell or cardboard

cut-outbull Andor feeling of internal chaos bull Problems with emotion regulation andor

being out of touch with emotions

What might alert us to this problem in an adult client (continued)

bull Often dismissive of impact of childhood problems

bull May seem to function well up to particular time in their lives then collapse perhaps with ME-type symptoms or depression

bull Sense of vulnerability with lack of self-protective boundaries

bull Various somatic symptoms or feeling cut off from their body

What might alert us to this problem in an adult client (continued)

bull Hyperalert and highly reactivebull A feeling of not knowing who they arebull Relationship difficulties especially with regard

to intimacybull A sense of rootlessness and endless searching

for something but they donrsquot know whatbull Feelings of hopelessness and despair

Can we do EMDR processing with such clients

They are unlikely to be able to hold both the present and a memory at the same timeThey will be less resourced in the present so easily triggered into reliving a traumatic eventLikely to be out of touch with body sensations and emotions so limiting processing potentialProcessing would be incomplete as they would have no scaffolding for the felt sense of time and so no place for the hippocampus to archive the experienceOther traumatic material is likely to flood the process

What resource would be needed first

We work with two aspects of timeExplanation to client with reference to evolution of the felt sense of time in humans and how it can be developed quite simply

ndash Flagging the present as a unique representation

ndash Using the arc of the present cues

ndash And developing a sense of continuity of being

Continuity of being through time

bull One of the main lsquoguy ropesrsquo holding the sense of the present steady

bull A felt sense To add to the other recognised senses

bull A template for organising onersquos experience

Sequencing

bull One can use sequences in various ways that seem to teach the brain to join the dots of experience

bull These can all help to develop the sense of continuity of being and groundedness in the present when required

Examples of use of temporal sequences

bull To create a life narrative (See Pace 2007)bull To create a therapy narrativebull To bridge a vacation gap where the client may feel

the absence of the therapist as a frightening chasm

bull To create a sense of lsquostretched out timersquo ahead when the client may be highly fearful of coping with an upcoming event such as a family funeral and it seems that time is compacted and the event unmanageable

References

Cozolino L The Neuroscience of Psychotherapy Healing the social brainDamasio A (1999) The Feeling of What Happens Body emotion and the making of consciousness New York Harcourt Pace P (2003 - 4th Edition 2007) Lifespan Integration Connecting ego states through time Available from wwwLifespanIntegrationcom or wwwLi-UKcouk Metzinger T (2009) The Ego Tunnel The science of the mind and the myth of the self Basic Books New YorkSani F (Ed) (2008) Self-Continuity Psychology Press New York and Hove UK Siegel D (1999) The Developing Mind How relationships and the brain interact to shape who we are Guilford New York

The Mindrsquos normal processing system of everyday experience of slightly disturbing experience of very disturbing experience which

overwhelms the brainrsquos processing system and the memory becomes stuck

Time-taggingWhen experiences are processed or digested they are also automatically time-tagged (hippocampus) then archived in the felt sense of where they belong in our past

Memories that have not been processedhave not been time-tagged

Cannot be archived in the felt sense of the past

Continue to cause symptoms in the present

Traumatic event

PTSD as a time disorder

Before the trauma

Inadequate integrative capacity

Part fixed in time of trauma

A division occurs

After the traumaticexperience

TIME

Part getting on with normal lifeLess grounded in present now

TIME

Time of trauma Now

Memory time marker cues for times in between

Creating distance in time

Creating distance in time

TIME

Time of trauma Now

Strengthening the sense of time in between trauma and now

Spacing of cues

Time

Cues start after the trauma close together in time

Cues space out

Cues closer together into present

Present timeTime of trauma

Temporal Sequencing to create distance from traumatic event before processing

bull If client is anxious about accessing the trauma assure him that he will not need to until he is ready but we are just going to create some time distance from it Explain how

bull Ask him if can think of an image of a time just after the event but with some association to it

bull Then ask for a sequence of images through to the present as you write down the cue words

Temporal Sequencing to create distance from traumatic event before

processing(continued) bull The images used for the time cues should be

remembered events neutral or otherwise with or without an association to the trauma

bull They should be close together in time at the beginning close to the time of the trauma and then be spaced out depending how long ago the trauma happened

bull Then have closer together cues as you approach the present

bull Flag the present Could use slow BLS to reinforce the sense of the present

Using the distancing in time sequence

bull Note the present first then lead the client through the memory cues asking for him to nod when he has the image in mind

bull Always complete the timeline through to the presentbull Ask for feedbackbull Repeat through 3-5 times asking for feedback after

each repetition and noting how it changesbull Usually client will volunteer that the event feels more

distant not so intense and they feel more present

When to use temporal sequencing for distancing from traumatic event

Temporal sequencing to create distance from an event can be helpful

ndash When the client may be anxious and avoidant about accessing the traumatic memory directly

ndash When the processing my not be completed in one session of processing

ndash At the end of processing to reinforce the treatment effect

ndash As preparation for working with any target

Two main categories of time disorder

1 Simple - The present influenced by the past in ways that are inappropriate to the present (Eg Big T and little t traumas)

Two main categories of time disorder

Complex ndash Lack of a developed lsquofelt sensersquo of time and continuity

An insecure insufficiently developed sense of personal continuity through time leading to a diminished anchoring in the present and a diminished sense of self

Depersonalisation disorder

Writing about depersonalisation Simeon and Abugel (2006) describe one of the symptoms thus

lsquoTime often does not unfold in the normal

manner past present and future can seem

indistinguishable as if they were all happening at oncersquo

(De- lsquosense-of-selfrsquo ndashisation)

Felt Sense of Timebull What is the felt sense of timebull Is it a lsquohard-wiredrsquo human givenbull How does it develop normallybull What may block its development

Continuity of being

bullldquoWith the care that it receives from its mother each infant is able to have a personal existence and so begins to build up what might be called a continuity of being

bullIf maternal care is not good enough then the infant does not really come into existence since there is no continuity of being instead the personality becomes built on the basis of reactions to environmental impingementrdquo

bullWinnicott 1960

Felt Sense of Timebull What is the felt sense of timebull Is it a lsquohard-wiredrsquo human givenbull Does it vary from one person to anotherbull How does it develop normallybull What may block its developmentbull Is it vulnerable to damagebull What are the effects of a lack of thisbull How can we recognise a lack of this in clientsbull Is the felt sense of time repairable - can it be

developed or improved

Time

Felt sense of nearness in time

The Present

Recent past

Soon future

Distant past

Distant future

Adapted from Janet 1928a

Normal experience of the sense of time

Nearness in time

Present

FuturePast

Effect of unresolved trauma on presentness and the felt sense of time

Trauma memory active in present

Reduced level of groundedness in present

Nearness in time

Present

Past Future

High past either active in present or dissociated

Low reality in present

o

Multiple trauma - time is experienced as compacted into a dys-functional present Limited sense of past future or continuity of being

Limited ability to be grounded in the present (ANP)

Nearness in time

Present

Past Future

Or a sense of emptiness and detachment as the phobic barrierkeeps the memories out of awareness unless triggered

Low reality in present

o

Phobic barrier

What might alert us to this problem in an adult client

bull Very few memories of childhoodbull Resistance to talking about their historybull Feeling of fogginess or unrealitybull Feeling empty like empty shell or cardboard

cut-outbull Andor feeling of internal chaos bull Problems with emotion regulation andor

being out of touch with emotions

What might alert us to this problem in an adult client (continued)

bull Often dismissive of impact of childhood problems

bull May seem to function well up to particular time in their lives then collapse perhaps with ME-type symptoms or depression

bull Sense of vulnerability with lack of self-protective boundaries

bull Various somatic symptoms or feeling cut off from their body

What might alert us to this problem in an adult client (continued)

bull Hyperalert and highly reactivebull A feeling of not knowing who they arebull Relationship difficulties especially with regard

to intimacybull A sense of rootlessness and endless searching

for something but they donrsquot know whatbull Feelings of hopelessness and despair

Can we do EMDR processing with such clients

They are unlikely to be able to hold both the present and a memory at the same timeThey will be less resourced in the present so easily triggered into reliving a traumatic eventLikely to be out of touch with body sensations and emotions so limiting processing potentialProcessing would be incomplete as they would have no scaffolding for the felt sense of time and so no place for the hippocampus to archive the experienceOther traumatic material is likely to flood the process

What resource would be needed first

We work with two aspects of timeExplanation to client with reference to evolution of the felt sense of time in humans and how it can be developed quite simply

ndash Flagging the present as a unique representation

ndash Using the arc of the present cues

ndash And developing a sense of continuity of being

Continuity of being through time

bull One of the main lsquoguy ropesrsquo holding the sense of the present steady

bull A felt sense To add to the other recognised senses

bull A template for organising onersquos experience

Sequencing

bull One can use sequences in various ways that seem to teach the brain to join the dots of experience

bull These can all help to develop the sense of continuity of being and groundedness in the present when required

Examples of use of temporal sequences

bull To create a life narrative (See Pace 2007)bull To create a therapy narrativebull To bridge a vacation gap where the client may feel

the absence of the therapist as a frightening chasm

bull To create a sense of lsquostretched out timersquo ahead when the client may be highly fearful of coping with an upcoming event such as a family funeral and it seems that time is compacted and the event unmanageable

References

Cozolino L The Neuroscience of Psychotherapy Healing the social brainDamasio A (1999) The Feeling of What Happens Body emotion and the making of consciousness New York Harcourt Pace P (2003 - 4th Edition 2007) Lifespan Integration Connecting ego states through time Available from wwwLifespanIntegrationcom or wwwLi-UKcouk Metzinger T (2009) The Ego Tunnel The science of the mind and the myth of the self Basic Books New YorkSani F (Ed) (2008) Self-Continuity Psychology Press New York and Hove UK Siegel D (1999) The Developing Mind How relationships and the brain interact to shape who we are Guilford New York

Memories that have not been processedhave not been time-tagged

Cannot be archived in the felt sense of the past

Continue to cause symptoms in the present

Traumatic event

PTSD as a time disorder

Before the trauma

Inadequate integrative capacity

Part fixed in time of trauma

A division occurs

After the traumaticexperience

TIME

Part getting on with normal lifeLess grounded in present now

TIME

Time of trauma Now

Memory time marker cues for times in between

Creating distance in time

Creating distance in time

TIME

Time of trauma Now

Strengthening the sense of time in between trauma and now

Spacing of cues

Time

Cues start after the trauma close together in time

Cues space out

Cues closer together into present

Present timeTime of trauma

Temporal Sequencing to create distance from traumatic event before processing

bull If client is anxious about accessing the trauma assure him that he will not need to until he is ready but we are just going to create some time distance from it Explain how

bull Ask him if can think of an image of a time just after the event but with some association to it

bull Then ask for a sequence of images through to the present as you write down the cue words

Temporal Sequencing to create distance from traumatic event before

processing(continued) bull The images used for the time cues should be

remembered events neutral or otherwise with or without an association to the trauma

bull They should be close together in time at the beginning close to the time of the trauma and then be spaced out depending how long ago the trauma happened

bull Then have closer together cues as you approach the present

bull Flag the present Could use slow BLS to reinforce the sense of the present

Using the distancing in time sequence

bull Note the present first then lead the client through the memory cues asking for him to nod when he has the image in mind

bull Always complete the timeline through to the presentbull Ask for feedbackbull Repeat through 3-5 times asking for feedback after

each repetition and noting how it changesbull Usually client will volunteer that the event feels more

distant not so intense and they feel more present

When to use temporal sequencing for distancing from traumatic event

Temporal sequencing to create distance from an event can be helpful

ndash When the client may be anxious and avoidant about accessing the traumatic memory directly

ndash When the processing my not be completed in one session of processing

ndash At the end of processing to reinforce the treatment effect

ndash As preparation for working with any target

Two main categories of time disorder

1 Simple - The present influenced by the past in ways that are inappropriate to the present (Eg Big T and little t traumas)

Two main categories of time disorder

Complex ndash Lack of a developed lsquofelt sensersquo of time and continuity

An insecure insufficiently developed sense of personal continuity through time leading to a diminished anchoring in the present and a diminished sense of self

Depersonalisation disorder

Writing about depersonalisation Simeon and Abugel (2006) describe one of the symptoms thus

lsquoTime often does not unfold in the normal

manner past present and future can seem

indistinguishable as if they were all happening at oncersquo

(De- lsquosense-of-selfrsquo ndashisation)

Felt Sense of Timebull What is the felt sense of timebull Is it a lsquohard-wiredrsquo human givenbull How does it develop normallybull What may block its development

Continuity of being

bullldquoWith the care that it receives from its mother each infant is able to have a personal existence and so begins to build up what might be called a continuity of being

bullIf maternal care is not good enough then the infant does not really come into existence since there is no continuity of being instead the personality becomes built on the basis of reactions to environmental impingementrdquo

bullWinnicott 1960

Felt Sense of Timebull What is the felt sense of timebull Is it a lsquohard-wiredrsquo human givenbull Does it vary from one person to anotherbull How does it develop normallybull What may block its developmentbull Is it vulnerable to damagebull What are the effects of a lack of thisbull How can we recognise a lack of this in clientsbull Is the felt sense of time repairable - can it be

developed or improved

Time

Felt sense of nearness in time

The Present

Recent past

Soon future

Distant past

Distant future

Adapted from Janet 1928a

Normal experience of the sense of time

Nearness in time

Present

FuturePast

Effect of unresolved trauma on presentness and the felt sense of time

Trauma memory active in present

Reduced level of groundedness in present

Nearness in time

Present

Past Future

High past either active in present or dissociated

Low reality in present

o

Multiple trauma - time is experienced as compacted into a dys-functional present Limited sense of past future or continuity of being

Limited ability to be grounded in the present (ANP)

Nearness in time

Present

Past Future

Or a sense of emptiness and detachment as the phobic barrierkeeps the memories out of awareness unless triggered

Low reality in present

o

Phobic barrier

What might alert us to this problem in an adult client

bull Very few memories of childhoodbull Resistance to talking about their historybull Feeling of fogginess or unrealitybull Feeling empty like empty shell or cardboard

cut-outbull Andor feeling of internal chaos bull Problems with emotion regulation andor

being out of touch with emotions

What might alert us to this problem in an adult client (continued)

bull Often dismissive of impact of childhood problems

bull May seem to function well up to particular time in their lives then collapse perhaps with ME-type symptoms or depression

bull Sense of vulnerability with lack of self-protective boundaries

bull Various somatic symptoms or feeling cut off from their body

What might alert us to this problem in an adult client (continued)

bull Hyperalert and highly reactivebull A feeling of not knowing who they arebull Relationship difficulties especially with regard

to intimacybull A sense of rootlessness and endless searching

for something but they donrsquot know whatbull Feelings of hopelessness and despair

Can we do EMDR processing with such clients

They are unlikely to be able to hold both the present and a memory at the same timeThey will be less resourced in the present so easily triggered into reliving a traumatic eventLikely to be out of touch with body sensations and emotions so limiting processing potentialProcessing would be incomplete as they would have no scaffolding for the felt sense of time and so no place for the hippocampus to archive the experienceOther traumatic material is likely to flood the process

What resource would be needed first

We work with two aspects of timeExplanation to client with reference to evolution of the felt sense of time in humans and how it can be developed quite simply

ndash Flagging the present as a unique representation

ndash Using the arc of the present cues

ndash And developing a sense of continuity of being

Continuity of being through time

bull One of the main lsquoguy ropesrsquo holding the sense of the present steady

bull A felt sense To add to the other recognised senses

bull A template for organising onersquos experience

Sequencing

bull One can use sequences in various ways that seem to teach the brain to join the dots of experience

bull These can all help to develop the sense of continuity of being and groundedness in the present when required

Examples of use of temporal sequences

bull To create a life narrative (See Pace 2007)bull To create a therapy narrativebull To bridge a vacation gap where the client may feel

the absence of the therapist as a frightening chasm

bull To create a sense of lsquostretched out timersquo ahead when the client may be highly fearful of coping with an upcoming event such as a family funeral and it seems that time is compacted and the event unmanageable

References

Cozolino L The Neuroscience of Psychotherapy Healing the social brainDamasio A (1999) The Feeling of What Happens Body emotion and the making of consciousness New York Harcourt Pace P (2003 - 4th Edition 2007) Lifespan Integration Connecting ego states through time Available from wwwLifespanIntegrationcom or wwwLi-UKcouk Metzinger T (2009) The Ego Tunnel The science of the mind and the myth of the self Basic Books New YorkSani F (Ed) (2008) Self-Continuity Psychology Press New York and Hove UK Siegel D (1999) The Developing Mind How relationships and the brain interact to shape who we are Guilford New York

Traumatic event

PTSD as a time disorder

Before the trauma

Inadequate integrative capacity

Part fixed in time of trauma

A division occurs

After the traumaticexperience

TIME

Part getting on with normal lifeLess grounded in present now

TIME

Time of trauma Now

Memory time marker cues for times in between

Creating distance in time

Creating distance in time

TIME

Time of trauma Now

Strengthening the sense of time in between trauma and now

Spacing of cues

Time

Cues start after the trauma close together in time

Cues space out

Cues closer together into present

Present timeTime of trauma

Temporal Sequencing to create distance from traumatic event before processing

bull If client is anxious about accessing the trauma assure him that he will not need to until he is ready but we are just going to create some time distance from it Explain how

bull Ask him if can think of an image of a time just after the event but with some association to it

bull Then ask for a sequence of images through to the present as you write down the cue words

Temporal Sequencing to create distance from traumatic event before

processing(continued) bull The images used for the time cues should be

remembered events neutral or otherwise with or without an association to the trauma

bull They should be close together in time at the beginning close to the time of the trauma and then be spaced out depending how long ago the trauma happened

bull Then have closer together cues as you approach the present

bull Flag the present Could use slow BLS to reinforce the sense of the present

Using the distancing in time sequence

bull Note the present first then lead the client through the memory cues asking for him to nod when he has the image in mind

bull Always complete the timeline through to the presentbull Ask for feedbackbull Repeat through 3-5 times asking for feedback after

each repetition and noting how it changesbull Usually client will volunteer that the event feels more

distant not so intense and they feel more present

When to use temporal sequencing for distancing from traumatic event

Temporal sequencing to create distance from an event can be helpful

ndash When the client may be anxious and avoidant about accessing the traumatic memory directly

ndash When the processing my not be completed in one session of processing

ndash At the end of processing to reinforce the treatment effect

ndash As preparation for working with any target

Two main categories of time disorder

1 Simple - The present influenced by the past in ways that are inappropriate to the present (Eg Big T and little t traumas)

Two main categories of time disorder

Complex ndash Lack of a developed lsquofelt sensersquo of time and continuity

An insecure insufficiently developed sense of personal continuity through time leading to a diminished anchoring in the present and a diminished sense of self

Depersonalisation disorder

Writing about depersonalisation Simeon and Abugel (2006) describe one of the symptoms thus

lsquoTime often does not unfold in the normal

manner past present and future can seem

indistinguishable as if they were all happening at oncersquo

(De- lsquosense-of-selfrsquo ndashisation)

Felt Sense of Timebull What is the felt sense of timebull Is it a lsquohard-wiredrsquo human givenbull How does it develop normallybull What may block its development

Continuity of being

bullldquoWith the care that it receives from its mother each infant is able to have a personal existence and so begins to build up what might be called a continuity of being

bullIf maternal care is not good enough then the infant does not really come into existence since there is no continuity of being instead the personality becomes built on the basis of reactions to environmental impingementrdquo

bullWinnicott 1960

Felt Sense of Timebull What is the felt sense of timebull Is it a lsquohard-wiredrsquo human givenbull Does it vary from one person to anotherbull How does it develop normallybull What may block its developmentbull Is it vulnerable to damagebull What are the effects of a lack of thisbull How can we recognise a lack of this in clientsbull Is the felt sense of time repairable - can it be

developed or improved

Time

Felt sense of nearness in time

The Present

Recent past

Soon future

Distant past

Distant future

Adapted from Janet 1928a

Normal experience of the sense of time

Nearness in time

Present

FuturePast

Effect of unresolved trauma on presentness and the felt sense of time

Trauma memory active in present

Reduced level of groundedness in present

Nearness in time

Present

Past Future

High past either active in present or dissociated

Low reality in present

o

Multiple trauma - time is experienced as compacted into a dys-functional present Limited sense of past future or continuity of being

Limited ability to be grounded in the present (ANP)

Nearness in time

Present

Past Future

Or a sense of emptiness and detachment as the phobic barrierkeeps the memories out of awareness unless triggered

Low reality in present

o

Phobic barrier

What might alert us to this problem in an adult client

bull Very few memories of childhoodbull Resistance to talking about their historybull Feeling of fogginess or unrealitybull Feeling empty like empty shell or cardboard

cut-outbull Andor feeling of internal chaos bull Problems with emotion regulation andor

being out of touch with emotions

What might alert us to this problem in an adult client (continued)

bull Often dismissive of impact of childhood problems

bull May seem to function well up to particular time in their lives then collapse perhaps with ME-type symptoms or depression

bull Sense of vulnerability with lack of self-protective boundaries

bull Various somatic symptoms or feeling cut off from their body

What might alert us to this problem in an adult client (continued)

bull Hyperalert and highly reactivebull A feeling of not knowing who they arebull Relationship difficulties especially with regard

to intimacybull A sense of rootlessness and endless searching

for something but they donrsquot know whatbull Feelings of hopelessness and despair

Can we do EMDR processing with such clients

They are unlikely to be able to hold both the present and a memory at the same timeThey will be less resourced in the present so easily triggered into reliving a traumatic eventLikely to be out of touch with body sensations and emotions so limiting processing potentialProcessing would be incomplete as they would have no scaffolding for the felt sense of time and so no place for the hippocampus to archive the experienceOther traumatic material is likely to flood the process

What resource would be needed first

We work with two aspects of timeExplanation to client with reference to evolution of the felt sense of time in humans and how it can be developed quite simply

ndash Flagging the present as a unique representation

ndash Using the arc of the present cues

ndash And developing a sense of continuity of being

Continuity of being through time

bull One of the main lsquoguy ropesrsquo holding the sense of the present steady

bull A felt sense To add to the other recognised senses

bull A template for organising onersquos experience

Sequencing

bull One can use sequences in various ways that seem to teach the brain to join the dots of experience

bull These can all help to develop the sense of continuity of being and groundedness in the present when required

Examples of use of temporal sequences

bull To create a life narrative (See Pace 2007)bull To create a therapy narrativebull To bridge a vacation gap where the client may feel

the absence of the therapist as a frightening chasm

bull To create a sense of lsquostretched out timersquo ahead when the client may be highly fearful of coping with an upcoming event such as a family funeral and it seems that time is compacted and the event unmanageable

References

Cozolino L The Neuroscience of Psychotherapy Healing the social brainDamasio A (1999) The Feeling of What Happens Body emotion and the making of consciousness New York Harcourt Pace P (2003 - 4th Edition 2007) Lifespan Integration Connecting ego states through time Available from wwwLifespanIntegrationcom or wwwLi-UKcouk Metzinger T (2009) The Ego Tunnel The science of the mind and the myth of the self Basic Books New YorkSani F (Ed) (2008) Self-Continuity Psychology Press New York and Hove UK Siegel D (1999) The Developing Mind How relationships and the brain interact to shape who we are Guilford New York

TIME

Time of trauma Now

Memory time marker cues for times in between

Creating distance in time

Creating distance in time

TIME

Time of trauma Now

Strengthening the sense of time in between trauma and now

Spacing of cues

Time

Cues start after the trauma close together in time

Cues space out

Cues closer together into present

Present timeTime of trauma

Temporal Sequencing to create distance from traumatic event before processing

bull If client is anxious about accessing the trauma assure him that he will not need to until he is ready but we are just going to create some time distance from it Explain how

bull Ask him if can think of an image of a time just after the event but with some association to it

bull Then ask for a sequence of images through to the present as you write down the cue words

Temporal Sequencing to create distance from traumatic event before

processing(continued) bull The images used for the time cues should be

remembered events neutral or otherwise with or without an association to the trauma

bull They should be close together in time at the beginning close to the time of the trauma and then be spaced out depending how long ago the trauma happened

bull Then have closer together cues as you approach the present

bull Flag the present Could use slow BLS to reinforce the sense of the present

Using the distancing in time sequence

bull Note the present first then lead the client through the memory cues asking for him to nod when he has the image in mind

bull Always complete the timeline through to the presentbull Ask for feedbackbull Repeat through 3-5 times asking for feedback after

each repetition and noting how it changesbull Usually client will volunteer that the event feels more

distant not so intense and they feel more present

When to use temporal sequencing for distancing from traumatic event

Temporal sequencing to create distance from an event can be helpful

ndash When the client may be anxious and avoidant about accessing the traumatic memory directly

ndash When the processing my not be completed in one session of processing

ndash At the end of processing to reinforce the treatment effect

ndash As preparation for working with any target

Two main categories of time disorder

1 Simple - The present influenced by the past in ways that are inappropriate to the present (Eg Big T and little t traumas)

Two main categories of time disorder

Complex ndash Lack of a developed lsquofelt sensersquo of time and continuity

An insecure insufficiently developed sense of personal continuity through time leading to a diminished anchoring in the present and a diminished sense of self

Depersonalisation disorder

Writing about depersonalisation Simeon and Abugel (2006) describe one of the symptoms thus

lsquoTime often does not unfold in the normal

manner past present and future can seem

indistinguishable as if they were all happening at oncersquo

(De- lsquosense-of-selfrsquo ndashisation)

Felt Sense of Timebull What is the felt sense of timebull Is it a lsquohard-wiredrsquo human givenbull How does it develop normallybull What may block its development

Continuity of being

bullldquoWith the care that it receives from its mother each infant is able to have a personal existence and so begins to build up what might be called a continuity of being

bullIf maternal care is not good enough then the infant does not really come into existence since there is no continuity of being instead the personality becomes built on the basis of reactions to environmental impingementrdquo

bullWinnicott 1960

Felt Sense of Timebull What is the felt sense of timebull Is it a lsquohard-wiredrsquo human givenbull Does it vary from one person to anotherbull How does it develop normallybull What may block its developmentbull Is it vulnerable to damagebull What are the effects of a lack of thisbull How can we recognise a lack of this in clientsbull Is the felt sense of time repairable - can it be

developed or improved

Time

Felt sense of nearness in time

The Present

Recent past

Soon future

Distant past

Distant future

Adapted from Janet 1928a

Normal experience of the sense of time

Nearness in time

Present

FuturePast

Effect of unresolved trauma on presentness and the felt sense of time

Trauma memory active in present

Reduced level of groundedness in present

Nearness in time

Present

Past Future

High past either active in present or dissociated

Low reality in present

o

Multiple trauma - time is experienced as compacted into a dys-functional present Limited sense of past future or continuity of being

Limited ability to be grounded in the present (ANP)

Nearness in time

Present

Past Future

Or a sense of emptiness and detachment as the phobic barrierkeeps the memories out of awareness unless triggered

Low reality in present

o

Phobic barrier

What might alert us to this problem in an adult client

bull Very few memories of childhoodbull Resistance to talking about their historybull Feeling of fogginess or unrealitybull Feeling empty like empty shell or cardboard

cut-outbull Andor feeling of internal chaos bull Problems with emotion regulation andor

being out of touch with emotions

What might alert us to this problem in an adult client (continued)

bull Often dismissive of impact of childhood problems

bull May seem to function well up to particular time in their lives then collapse perhaps with ME-type symptoms or depression

bull Sense of vulnerability with lack of self-protective boundaries

bull Various somatic symptoms or feeling cut off from their body

What might alert us to this problem in an adult client (continued)

bull Hyperalert and highly reactivebull A feeling of not knowing who they arebull Relationship difficulties especially with regard

to intimacybull A sense of rootlessness and endless searching

for something but they donrsquot know whatbull Feelings of hopelessness and despair

Can we do EMDR processing with such clients

They are unlikely to be able to hold both the present and a memory at the same timeThey will be less resourced in the present so easily triggered into reliving a traumatic eventLikely to be out of touch with body sensations and emotions so limiting processing potentialProcessing would be incomplete as they would have no scaffolding for the felt sense of time and so no place for the hippocampus to archive the experienceOther traumatic material is likely to flood the process

What resource would be needed first

We work with two aspects of timeExplanation to client with reference to evolution of the felt sense of time in humans and how it can be developed quite simply

ndash Flagging the present as a unique representation

ndash Using the arc of the present cues

ndash And developing a sense of continuity of being

Continuity of being through time

bull One of the main lsquoguy ropesrsquo holding the sense of the present steady

bull A felt sense To add to the other recognised senses

bull A template for organising onersquos experience

Sequencing

bull One can use sequences in various ways that seem to teach the brain to join the dots of experience

bull These can all help to develop the sense of continuity of being and groundedness in the present when required

Examples of use of temporal sequences

bull To create a life narrative (See Pace 2007)bull To create a therapy narrativebull To bridge a vacation gap where the client may feel

the absence of the therapist as a frightening chasm

bull To create a sense of lsquostretched out timersquo ahead when the client may be highly fearful of coping with an upcoming event such as a family funeral and it seems that time is compacted and the event unmanageable

References

Cozolino L The Neuroscience of Psychotherapy Healing the social brainDamasio A (1999) The Feeling of What Happens Body emotion and the making of consciousness New York Harcourt Pace P (2003 - 4th Edition 2007) Lifespan Integration Connecting ego states through time Available from wwwLifespanIntegrationcom or wwwLi-UKcouk Metzinger T (2009) The Ego Tunnel The science of the mind and the myth of the self Basic Books New YorkSani F (Ed) (2008) Self-Continuity Psychology Press New York and Hove UK Siegel D (1999) The Developing Mind How relationships and the brain interact to shape who we are Guilford New York

Creating distance in time

TIME

Time of trauma Now

Strengthening the sense of time in between trauma and now

Spacing of cues

Time

Cues start after the trauma close together in time

Cues space out

Cues closer together into present

Present timeTime of trauma

Temporal Sequencing to create distance from traumatic event before processing

bull If client is anxious about accessing the trauma assure him that he will not need to until he is ready but we are just going to create some time distance from it Explain how

bull Ask him if can think of an image of a time just after the event but with some association to it

bull Then ask for a sequence of images through to the present as you write down the cue words

Temporal Sequencing to create distance from traumatic event before

processing(continued) bull The images used for the time cues should be

remembered events neutral or otherwise with or without an association to the trauma

bull They should be close together in time at the beginning close to the time of the trauma and then be spaced out depending how long ago the trauma happened

bull Then have closer together cues as you approach the present

bull Flag the present Could use slow BLS to reinforce the sense of the present

Using the distancing in time sequence

bull Note the present first then lead the client through the memory cues asking for him to nod when he has the image in mind

bull Always complete the timeline through to the presentbull Ask for feedbackbull Repeat through 3-5 times asking for feedback after

each repetition and noting how it changesbull Usually client will volunteer that the event feels more

distant not so intense and they feel more present

When to use temporal sequencing for distancing from traumatic event

Temporal sequencing to create distance from an event can be helpful

ndash When the client may be anxious and avoidant about accessing the traumatic memory directly

ndash When the processing my not be completed in one session of processing

ndash At the end of processing to reinforce the treatment effect

ndash As preparation for working with any target

Two main categories of time disorder

1 Simple - The present influenced by the past in ways that are inappropriate to the present (Eg Big T and little t traumas)

Two main categories of time disorder

Complex ndash Lack of a developed lsquofelt sensersquo of time and continuity

An insecure insufficiently developed sense of personal continuity through time leading to a diminished anchoring in the present and a diminished sense of self

Depersonalisation disorder

Writing about depersonalisation Simeon and Abugel (2006) describe one of the symptoms thus

lsquoTime often does not unfold in the normal

manner past present and future can seem

indistinguishable as if they were all happening at oncersquo

(De- lsquosense-of-selfrsquo ndashisation)

Felt Sense of Timebull What is the felt sense of timebull Is it a lsquohard-wiredrsquo human givenbull How does it develop normallybull What may block its development

Continuity of being

bullldquoWith the care that it receives from its mother each infant is able to have a personal existence and so begins to build up what might be called a continuity of being

bullIf maternal care is not good enough then the infant does not really come into existence since there is no continuity of being instead the personality becomes built on the basis of reactions to environmental impingementrdquo

bullWinnicott 1960

Felt Sense of Timebull What is the felt sense of timebull Is it a lsquohard-wiredrsquo human givenbull Does it vary from one person to anotherbull How does it develop normallybull What may block its developmentbull Is it vulnerable to damagebull What are the effects of a lack of thisbull How can we recognise a lack of this in clientsbull Is the felt sense of time repairable - can it be

developed or improved

Time

Felt sense of nearness in time

The Present

Recent past

Soon future

Distant past

Distant future

Adapted from Janet 1928a

Normal experience of the sense of time

Nearness in time

Present

FuturePast

Effect of unresolved trauma on presentness and the felt sense of time

Trauma memory active in present

Reduced level of groundedness in present

Nearness in time

Present

Past Future

High past either active in present or dissociated

Low reality in present

o

Multiple trauma - time is experienced as compacted into a dys-functional present Limited sense of past future or continuity of being

Limited ability to be grounded in the present (ANP)

Nearness in time

Present

Past Future

Or a sense of emptiness and detachment as the phobic barrierkeeps the memories out of awareness unless triggered

Low reality in present

o

Phobic barrier

What might alert us to this problem in an adult client

bull Very few memories of childhoodbull Resistance to talking about their historybull Feeling of fogginess or unrealitybull Feeling empty like empty shell or cardboard

cut-outbull Andor feeling of internal chaos bull Problems with emotion regulation andor

being out of touch with emotions

What might alert us to this problem in an adult client (continued)

bull Often dismissive of impact of childhood problems

bull May seem to function well up to particular time in their lives then collapse perhaps with ME-type symptoms or depression

bull Sense of vulnerability with lack of self-protective boundaries

bull Various somatic symptoms or feeling cut off from their body

What might alert us to this problem in an adult client (continued)

bull Hyperalert and highly reactivebull A feeling of not knowing who they arebull Relationship difficulties especially with regard

to intimacybull A sense of rootlessness and endless searching

for something but they donrsquot know whatbull Feelings of hopelessness and despair

Can we do EMDR processing with such clients

They are unlikely to be able to hold both the present and a memory at the same timeThey will be less resourced in the present so easily triggered into reliving a traumatic eventLikely to be out of touch with body sensations and emotions so limiting processing potentialProcessing would be incomplete as they would have no scaffolding for the felt sense of time and so no place for the hippocampus to archive the experienceOther traumatic material is likely to flood the process

What resource would be needed first

We work with two aspects of timeExplanation to client with reference to evolution of the felt sense of time in humans and how it can be developed quite simply

ndash Flagging the present as a unique representation

ndash Using the arc of the present cues

ndash And developing a sense of continuity of being

Continuity of being through time

bull One of the main lsquoguy ropesrsquo holding the sense of the present steady

bull A felt sense To add to the other recognised senses

bull A template for organising onersquos experience

Sequencing

bull One can use sequences in various ways that seem to teach the brain to join the dots of experience

bull These can all help to develop the sense of continuity of being and groundedness in the present when required

Examples of use of temporal sequences

bull To create a life narrative (See Pace 2007)bull To create a therapy narrativebull To bridge a vacation gap where the client may feel

the absence of the therapist as a frightening chasm

bull To create a sense of lsquostretched out timersquo ahead when the client may be highly fearful of coping with an upcoming event such as a family funeral and it seems that time is compacted and the event unmanageable

References

Cozolino L The Neuroscience of Psychotherapy Healing the social brainDamasio A (1999) The Feeling of What Happens Body emotion and the making of consciousness New York Harcourt Pace P (2003 - 4th Edition 2007) Lifespan Integration Connecting ego states through time Available from wwwLifespanIntegrationcom or wwwLi-UKcouk Metzinger T (2009) The Ego Tunnel The science of the mind and the myth of the self Basic Books New YorkSani F (Ed) (2008) Self-Continuity Psychology Press New York and Hove UK Siegel D (1999) The Developing Mind How relationships and the brain interact to shape who we are Guilford New York

Spacing of cues

Time

Cues start after the trauma close together in time

Cues space out

Cues closer together into present

Present timeTime of trauma

Temporal Sequencing to create distance from traumatic event before processing

bull If client is anxious about accessing the trauma assure him that he will not need to until he is ready but we are just going to create some time distance from it Explain how

bull Ask him if can think of an image of a time just after the event but with some association to it

bull Then ask for a sequence of images through to the present as you write down the cue words

Temporal Sequencing to create distance from traumatic event before

processing(continued) bull The images used for the time cues should be

remembered events neutral or otherwise with or without an association to the trauma

bull They should be close together in time at the beginning close to the time of the trauma and then be spaced out depending how long ago the trauma happened

bull Then have closer together cues as you approach the present

bull Flag the present Could use slow BLS to reinforce the sense of the present

Using the distancing in time sequence

bull Note the present first then lead the client through the memory cues asking for him to nod when he has the image in mind

bull Always complete the timeline through to the presentbull Ask for feedbackbull Repeat through 3-5 times asking for feedback after

each repetition and noting how it changesbull Usually client will volunteer that the event feels more

distant not so intense and they feel more present

When to use temporal sequencing for distancing from traumatic event

Temporal sequencing to create distance from an event can be helpful

ndash When the client may be anxious and avoidant about accessing the traumatic memory directly

ndash When the processing my not be completed in one session of processing

ndash At the end of processing to reinforce the treatment effect

ndash As preparation for working with any target

Two main categories of time disorder

1 Simple - The present influenced by the past in ways that are inappropriate to the present (Eg Big T and little t traumas)

Two main categories of time disorder

Complex ndash Lack of a developed lsquofelt sensersquo of time and continuity

An insecure insufficiently developed sense of personal continuity through time leading to a diminished anchoring in the present and a diminished sense of self

Depersonalisation disorder

Writing about depersonalisation Simeon and Abugel (2006) describe one of the symptoms thus

lsquoTime often does not unfold in the normal

manner past present and future can seem

indistinguishable as if they were all happening at oncersquo

(De- lsquosense-of-selfrsquo ndashisation)

Felt Sense of Timebull What is the felt sense of timebull Is it a lsquohard-wiredrsquo human givenbull How does it develop normallybull What may block its development

Continuity of being

bullldquoWith the care that it receives from its mother each infant is able to have a personal existence and so begins to build up what might be called a continuity of being

bullIf maternal care is not good enough then the infant does not really come into existence since there is no continuity of being instead the personality becomes built on the basis of reactions to environmental impingementrdquo

bullWinnicott 1960

Felt Sense of Timebull What is the felt sense of timebull Is it a lsquohard-wiredrsquo human givenbull Does it vary from one person to anotherbull How does it develop normallybull What may block its developmentbull Is it vulnerable to damagebull What are the effects of a lack of thisbull How can we recognise a lack of this in clientsbull Is the felt sense of time repairable - can it be

developed or improved

Time

Felt sense of nearness in time

The Present

Recent past

Soon future

Distant past

Distant future

Adapted from Janet 1928a

Normal experience of the sense of time

Nearness in time

Present

FuturePast

Effect of unresolved trauma on presentness and the felt sense of time

Trauma memory active in present

Reduced level of groundedness in present

Nearness in time

Present

Past Future

High past either active in present or dissociated

Low reality in present

o

Multiple trauma - time is experienced as compacted into a dys-functional present Limited sense of past future or continuity of being

Limited ability to be grounded in the present (ANP)

Nearness in time

Present

Past Future

Or a sense of emptiness and detachment as the phobic barrierkeeps the memories out of awareness unless triggered

Low reality in present

o

Phobic barrier

What might alert us to this problem in an adult client

bull Very few memories of childhoodbull Resistance to talking about their historybull Feeling of fogginess or unrealitybull Feeling empty like empty shell or cardboard

cut-outbull Andor feeling of internal chaos bull Problems with emotion regulation andor

being out of touch with emotions

What might alert us to this problem in an adult client (continued)

bull Often dismissive of impact of childhood problems

bull May seem to function well up to particular time in their lives then collapse perhaps with ME-type symptoms or depression

bull Sense of vulnerability with lack of self-protective boundaries

bull Various somatic symptoms or feeling cut off from their body

What might alert us to this problem in an adult client (continued)

bull Hyperalert and highly reactivebull A feeling of not knowing who they arebull Relationship difficulties especially with regard

to intimacybull A sense of rootlessness and endless searching

for something but they donrsquot know whatbull Feelings of hopelessness and despair

Can we do EMDR processing with such clients

They are unlikely to be able to hold both the present and a memory at the same timeThey will be less resourced in the present so easily triggered into reliving a traumatic eventLikely to be out of touch with body sensations and emotions so limiting processing potentialProcessing would be incomplete as they would have no scaffolding for the felt sense of time and so no place for the hippocampus to archive the experienceOther traumatic material is likely to flood the process

What resource would be needed first

We work with two aspects of timeExplanation to client with reference to evolution of the felt sense of time in humans and how it can be developed quite simply

ndash Flagging the present as a unique representation

ndash Using the arc of the present cues

ndash And developing a sense of continuity of being

Continuity of being through time

bull One of the main lsquoguy ropesrsquo holding the sense of the present steady

bull A felt sense To add to the other recognised senses

bull A template for organising onersquos experience

Sequencing

bull One can use sequences in various ways that seem to teach the brain to join the dots of experience

bull These can all help to develop the sense of continuity of being and groundedness in the present when required

Examples of use of temporal sequences

bull To create a life narrative (See Pace 2007)bull To create a therapy narrativebull To bridge a vacation gap where the client may feel

the absence of the therapist as a frightening chasm

bull To create a sense of lsquostretched out timersquo ahead when the client may be highly fearful of coping with an upcoming event such as a family funeral and it seems that time is compacted and the event unmanageable

References

Cozolino L The Neuroscience of Psychotherapy Healing the social brainDamasio A (1999) The Feeling of What Happens Body emotion and the making of consciousness New York Harcourt Pace P (2003 - 4th Edition 2007) Lifespan Integration Connecting ego states through time Available from wwwLifespanIntegrationcom or wwwLi-UKcouk Metzinger T (2009) The Ego Tunnel The science of the mind and the myth of the self Basic Books New YorkSani F (Ed) (2008) Self-Continuity Psychology Press New York and Hove UK Siegel D (1999) The Developing Mind How relationships and the brain interact to shape who we are Guilford New York

Temporal Sequencing to create distance from traumatic event before processing

bull If client is anxious about accessing the trauma assure him that he will not need to until he is ready but we are just going to create some time distance from it Explain how

bull Ask him if can think of an image of a time just after the event but with some association to it

bull Then ask for a sequence of images through to the present as you write down the cue words

Temporal Sequencing to create distance from traumatic event before

processing(continued) bull The images used for the time cues should be

remembered events neutral or otherwise with or without an association to the trauma

bull They should be close together in time at the beginning close to the time of the trauma and then be spaced out depending how long ago the trauma happened

bull Then have closer together cues as you approach the present

bull Flag the present Could use slow BLS to reinforce the sense of the present

Using the distancing in time sequence

bull Note the present first then lead the client through the memory cues asking for him to nod when he has the image in mind

bull Always complete the timeline through to the presentbull Ask for feedbackbull Repeat through 3-5 times asking for feedback after

each repetition and noting how it changesbull Usually client will volunteer that the event feels more

distant not so intense and they feel more present

When to use temporal sequencing for distancing from traumatic event

Temporal sequencing to create distance from an event can be helpful

ndash When the client may be anxious and avoidant about accessing the traumatic memory directly

ndash When the processing my not be completed in one session of processing

ndash At the end of processing to reinforce the treatment effect

ndash As preparation for working with any target

Two main categories of time disorder

1 Simple - The present influenced by the past in ways that are inappropriate to the present (Eg Big T and little t traumas)

Two main categories of time disorder

Complex ndash Lack of a developed lsquofelt sensersquo of time and continuity

An insecure insufficiently developed sense of personal continuity through time leading to a diminished anchoring in the present and a diminished sense of self

Depersonalisation disorder

Writing about depersonalisation Simeon and Abugel (2006) describe one of the symptoms thus

lsquoTime often does not unfold in the normal

manner past present and future can seem

indistinguishable as if they were all happening at oncersquo

(De- lsquosense-of-selfrsquo ndashisation)

Felt Sense of Timebull What is the felt sense of timebull Is it a lsquohard-wiredrsquo human givenbull How does it develop normallybull What may block its development

Continuity of being

bullldquoWith the care that it receives from its mother each infant is able to have a personal existence and so begins to build up what might be called a continuity of being

bullIf maternal care is not good enough then the infant does not really come into existence since there is no continuity of being instead the personality becomes built on the basis of reactions to environmental impingementrdquo

bullWinnicott 1960

Felt Sense of Timebull What is the felt sense of timebull Is it a lsquohard-wiredrsquo human givenbull Does it vary from one person to anotherbull How does it develop normallybull What may block its developmentbull Is it vulnerable to damagebull What are the effects of a lack of thisbull How can we recognise a lack of this in clientsbull Is the felt sense of time repairable - can it be

developed or improved

Time

Felt sense of nearness in time

The Present

Recent past

Soon future

Distant past

Distant future

Adapted from Janet 1928a

Normal experience of the sense of time

Nearness in time

Present

FuturePast

Effect of unresolved trauma on presentness and the felt sense of time

Trauma memory active in present

Reduced level of groundedness in present

Nearness in time

Present

Past Future

High past either active in present or dissociated

Low reality in present

o

Multiple trauma - time is experienced as compacted into a dys-functional present Limited sense of past future or continuity of being

Limited ability to be grounded in the present (ANP)

Nearness in time

Present

Past Future

Or a sense of emptiness and detachment as the phobic barrierkeeps the memories out of awareness unless triggered

Low reality in present

o

Phobic barrier

What might alert us to this problem in an adult client

bull Very few memories of childhoodbull Resistance to talking about their historybull Feeling of fogginess or unrealitybull Feeling empty like empty shell or cardboard

cut-outbull Andor feeling of internal chaos bull Problems with emotion regulation andor

being out of touch with emotions

What might alert us to this problem in an adult client (continued)

bull Often dismissive of impact of childhood problems

bull May seem to function well up to particular time in their lives then collapse perhaps with ME-type symptoms or depression

bull Sense of vulnerability with lack of self-protective boundaries

bull Various somatic symptoms or feeling cut off from their body

What might alert us to this problem in an adult client (continued)

bull Hyperalert and highly reactivebull A feeling of not knowing who they arebull Relationship difficulties especially with regard

to intimacybull A sense of rootlessness and endless searching

for something but they donrsquot know whatbull Feelings of hopelessness and despair

Can we do EMDR processing with such clients

They are unlikely to be able to hold both the present and a memory at the same timeThey will be less resourced in the present so easily triggered into reliving a traumatic eventLikely to be out of touch with body sensations and emotions so limiting processing potentialProcessing would be incomplete as they would have no scaffolding for the felt sense of time and so no place for the hippocampus to archive the experienceOther traumatic material is likely to flood the process

What resource would be needed first

We work with two aspects of timeExplanation to client with reference to evolution of the felt sense of time in humans and how it can be developed quite simply

ndash Flagging the present as a unique representation

ndash Using the arc of the present cues

ndash And developing a sense of continuity of being

Continuity of being through time

bull One of the main lsquoguy ropesrsquo holding the sense of the present steady

bull A felt sense To add to the other recognised senses

bull A template for organising onersquos experience

Sequencing

bull One can use sequences in various ways that seem to teach the brain to join the dots of experience

bull These can all help to develop the sense of continuity of being and groundedness in the present when required

Examples of use of temporal sequences

bull To create a life narrative (See Pace 2007)bull To create a therapy narrativebull To bridge a vacation gap where the client may feel

the absence of the therapist as a frightening chasm

bull To create a sense of lsquostretched out timersquo ahead when the client may be highly fearful of coping with an upcoming event such as a family funeral and it seems that time is compacted and the event unmanageable

References

Cozolino L The Neuroscience of Psychotherapy Healing the social brainDamasio A (1999) The Feeling of What Happens Body emotion and the making of consciousness New York Harcourt Pace P (2003 - 4th Edition 2007) Lifespan Integration Connecting ego states through time Available from wwwLifespanIntegrationcom or wwwLi-UKcouk Metzinger T (2009) The Ego Tunnel The science of the mind and the myth of the self Basic Books New YorkSani F (Ed) (2008) Self-Continuity Psychology Press New York and Hove UK Siegel D (1999) The Developing Mind How relationships and the brain interact to shape who we are Guilford New York

Temporal Sequencing to create distance from traumatic event before

processing(continued) bull The images used for the time cues should be

remembered events neutral or otherwise with or without an association to the trauma

bull They should be close together in time at the beginning close to the time of the trauma and then be spaced out depending how long ago the trauma happened

bull Then have closer together cues as you approach the present

bull Flag the present Could use slow BLS to reinforce the sense of the present

Using the distancing in time sequence

bull Note the present first then lead the client through the memory cues asking for him to nod when he has the image in mind

bull Always complete the timeline through to the presentbull Ask for feedbackbull Repeat through 3-5 times asking for feedback after

each repetition and noting how it changesbull Usually client will volunteer that the event feels more

distant not so intense and they feel more present

When to use temporal sequencing for distancing from traumatic event

Temporal sequencing to create distance from an event can be helpful

ndash When the client may be anxious and avoidant about accessing the traumatic memory directly

ndash When the processing my not be completed in one session of processing

ndash At the end of processing to reinforce the treatment effect

ndash As preparation for working with any target

Two main categories of time disorder

1 Simple - The present influenced by the past in ways that are inappropriate to the present (Eg Big T and little t traumas)

Two main categories of time disorder

Complex ndash Lack of a developed lsquofelt sensersquo of time and continuity

An insecure insufficiently developed sense of personal continuity through time leading to a diminished anchoring in the present and a diminished sense of self

Depersonalisation disorder

Writing about depersonalisation Simeon and Abugel (2006) describe one of the symptoms thus

lsquoTime often does not unfold in the normal

manner past present and future can seem

indistinguishable as if they were all happening at oncersquo

(De- lsquosense-of-selfrsquo ndashisation)

Felt Sense of Timebull What is the felt sense of timebull Is it a lsquohard-wiredrsquo human givenbull How does it develop normallybull What may block its development

Continuity of being

bullldquoWith the care that it receives from its mother each infant is able to have a personal existence and so begins to build up what might be called a continuity of being

bullIf maternal care is not good enough then the infant does not really come into existence since there is no continuity of being instead the personality becomes built on the basis of reactions to environmental impingementrdquo

bullWinnicott 1960

Felt Sense of Timebull What is the felt sense of timebull Is it a lsquohard-wiredrsquo human givenbull Does it vary from one person to anotherbull How does it develop normallybull What may block its developmentbull Is it vulnerable to damagebull What are the effects of a lack of thisbull How can we recognise a lack of this in clientsbull Is the felt sense of time repairable - can it be

developed or improved

Time

Felt sense of nearness in time

The Present

Recent past

Soon future

Distant past

Distant future

Adapted from Janet 1928a

Normal experience of the sense of time

Nearness in time

Present

FuturePast

Effect of unresolved trauma on presentness and the felt sense of time

Trauma memory active in present

Reduced level of groundedness in present

Nearness in time

Present

Past Future

High past either active in present or dissociated

Low reality in present

o

Multiple trauma - time is experienced as compacted into a dys-functional present Limited sense of past future or continuity of being

Limited ability to be grounded in the present (ANP)

Nearness in time

Present

Past Future

Or a sense of emptiness and detachment as the phobic barrierkeeps the memories out of awareness unless triggered

Low reality in present

o

Phobic barrier

What might alert us to this problem in an adult client

bull Very few memories of childhoodbull Resistance to talking about their historybull Feeling of fogginess or unrealitybull Feeling empty like empty shell or cardboard

cut-outbull Andor feeling of internal chaos bull Problems with emotion regulation andor

being out of touch with emotions

What might alert us to this problem in an adult client (continued)

bull Often dismissive of impact of childhood problems

bull May seem to function well up to particular time in their lives then collapse perhaps with ME-type symptoms or depression

bull Sense of vulnerability with lack of self-protective boundaries

bull Various somatic symptoms or feeling cut off from their body

What might alert us to this problem in an adult client (continued)

bull Hyperalert and highly reactivebull A feeling of not knowing who they arebull Relationship difficulties especially with regard

to intimacybull A sense of rootlessness and endless searching

for something but they donrsquot know whatbull Feelings of hopelessness and despair

Can we do EMDR processing with such clients

They are unlikely to be able to hold both the present and a memory at the same timeThey will be less resourced in the present so easily triggered into reliving a traumatic eventLikely to be out of touch with body sensations and emotions so limiting processing potentialProcessing would be incomplete as they would have no scaffolding for the felt sense of time and so no place for the hippocampus to archive the experienceOther traumatic material is likely to flood the process

What resource would be needed first

We work with two aspects of timeExplanation to client with reference to evolution of the felt sense of time in humans and how it can be developed quite simply

ndash Flagging the present as a unique representation

ndash Using the arc of the present cues

ndash And developing a sense of continuity of being

Continuity of being through time

bull One of the main lsquoguy ropesrsquo holding the sense of the present steady

bull A felt sense To add to the other recognised senses

bull A template for organising onersquos experience

Sequencing

bull One can use sequences in various ways that seem to teach the brain to join the dots of experience

bull These can all help to develop the sense of continuity of being and groundedness in the present when required

Examples of use of temporal sequences

bull To create a life narrative (See Pace 2007)bull To create a therapy narrativebull To bridge a vacation gap where the client may feel

the absence of the therapist as a frightening chasm

bull To create a sense of lsquostretched out timersquo ahead when the client may be highly fearful of coping with an upcoming event such as a family funeral and it seems that time is compacted and the event unmanageable

References

Cozolino L The Neuroscience of Psychotherapy Healing the social brainDamasio A (1999) The Feeling of What Happens Body emotion and the making of consciousness New York Harcourt Pace P (2003 - 4th Edition 2007) Lifespan Integration Connecting ego states through time Available from wwwLifespanIntegrationcom or wwwLi-UKcouk Metzinger T (2009) The Ego Tunnel The science of the mind and the myth of the self Basic Books New YorkSani F (Ed) (2008) Self-Continuity Psychology Press New York and Hove UK Siegel D (1999) The Developing Mind How relationships and the brain interact to shape who we are Guilford New York

Using the distancing in time sequence

bull Note the present first then lead the client through the memory cues asking for him to nod when he has the image in mind

bull Always complete the timeline through to the presentbull Ask for feedbackbull Repeat through 3-5 times asking for feedback after

each repetition and noting how it changesbull Usually client will volunteer that the event feels more

distant not so intense and they feel more present

When to use temporal sequencing for distancing from traumatic event

Temporal sequencing to create distance from an event can be helpful

ndash When the client may be anxious and avoidant about accessing the traumatic memory directly

ndash When the processing my not be completed in one session of processing

ndash At the end of processing to reinforce the treatment effect

ndash As preparation for working with any target

Two main categories of time disorder

1 Simple - The present influenced by the past in ways that are inappropriate to the present (Eg Big T and little t traumas)

Two main categories of time disorder

Complex ndash Lack of a developed lsquofelt sensersquo of time and continuity

An insecure insufficiently developed sense of personal continuity through time leading to a diminished anchoring in the present and a diminished sense of self

Depersonalisation disorder

Writing about depersonalisation Simeon and Abugel (2006) describe one of the symptoms thus

lsquoTime often does not unfold in the normal

manner past present and future can seem

indistinguishable as if they were all happening at oncersquo

(De- lsquosense-of-selfrsquo ndashisation)

Felt Sense of Timebull What is the felt sense of timebull Is it a lsquohard-wiredrsquo human givenbull How does it develop normallybull What may block its development

Continuity of being

bullldquoWith the care that it receives from its mother each infant is able to have a personal existence and so begins to build up what might be called a continuity of being

bullIf maternal care is not good enough then the infant does not really come into existence since there is no continuity of being instead the personality becomes built on the basis of reactions to environmental impingementrdquo

bullWinnicott 1960

Felt Sense of Timebull What is the felt sense of timebull Is it a lsquohard-wiredrsquo human givenbull Does it vary from one person to anotherbull How does it develop normallybull What may block its developmentbull Is it vulnerable to damagebull What are the effects of a lack of thisbull How can we recognise a lack of this in clientsbull Is the felt sense of time repairable - can it be

developed or improved

Time

Felt sense of nearness in time

The Present

Recent past

Soon future

Distant past

Distant future

Adapted from Janet 1928a

Normal experience of the sense of time

Nearness in time

Present

FuturePast

Effect of unresolved trauma on presentness and the felt sense of time

Trauma memory active in present

Reduced level of groundedness in present

Nearness in time

Present

Past Future

High past either active in present or dissociated

Low reality in present

o

Multiple trauma - time is experienced as compacted into a dys-functional present Limited sense of past future or continuity of being

Limited ability to be grounded in the present (ANP)

Nearness in time

Present

Past Future

Or a sense of emptiness and detachment as the phobic barrierkeeps the memories out of awareness unless triggered

Low reality in present

o

Phobic barrier

What might alert us to this problem in an adult client

bull Very few memories of childhoodbull Resistance to talking about their historybull Feeling of fogginess or unrealitybull Feeling empty like empty shell or cardboard

cut-outbull Andor feeling of internal chaos bull Problems with emotion regulation andor

being out of touch with emotions

What might alert us to this problem in an adult client (continued)

bull Often dismissive of impact of childhood problems

bull May seem to function well up to particular time in their lives then collapse perhaps with ME-type symptoms or depression

bull Sense of vulnerability with lack of self-protective boundaries

bull Various somatic symptoms or feeling cut off from their body

What might alert us to this problem in an adult client (continued)

bull Hyperalert and highly reactivebull A feeling of not knowing who they arebull Relationship difficulties especially with regard

to intimacybull A sense of rootlessness and endless searching

for something but they donrsquot know whatbull Feelings of hopelessness and despair

Can we do EMDR processing with such clients

They are unlikely to be able to hold both the present and a memory at the same timeThey will be less resourced in the present so easily triggered into reliving a traumatic eventLikely to be out of touch with body sensations and emotions so limiting processing potentialProcessing would be incomplete as they would have no scaffolding for the felt sense of time and so no place for the hippocampus to archive the experienceOther traumatic material is likely to flood the process

What resource would be needed first

We work with two aspects of timeExplanation to client with reference to evolution of the felt sense of time in humans and how it can be developed quite simply

ndash Flagging the present as a unique representation

ndash Using the arc of the present cues

ndash And developing a sense of continuity of being

Continuity of being through time

bull One of the main lsquoguy ropesrsquo holding the sense of the present steady

bull A felt sense To add to the other recognised senses

bull A template for organising onersquos experience

Sequencing

bull One can use sequences in various ways that seem to teach the brain to join the dots of experience

bull These can all help to develop the sense of continuity of being and groundedness in the present when required

Examples of use of temporal sequences

bull To create a life narrative (See Pace 2007)bull To create a therapy narrativebull To bridge a vacation gap where the client may feel

the absence of the therapist as a frightening chasm

bull To create a sense of lsquostretched out timersquo ahead when the client may be highly fearful of coping with an upcoming event such as a family funeral and it seems that time is compacted and the event unmanageable

References

Cozolino L The Neuroscience of Psychotherapy Healing the social brainDamasio A (1999) The Feeling of What Happens Body emotion and the making of consciousness New York Harcourt Pace P (2003 - 4th Edition 2007) Lifespan Integration Connecting ego states through time Available from wwwLifespanIntegrationcom or wwwLi-UKcouk Metzinger T (2009) The Ego Tunnel The science of the mind and the myth of the self Basic Books New YorkSani F (Ed) (2008) Self-Continuity Psychology Press New York and Hove UK Siegel D (1999) The Developing Mind How relationships and the brain interact to shape who we are Guilford New York

When to use temporal sequencing for distancing from traumatic event

Temporal sequencing to create distance from an event can be helpful

ndash When the client may be anxious and avoidant about accessing the traumatic memory directly

ndash When the processing my not be completed in one session of processing

ndash At the end of processing to reinforce the treatment effect

ndash As preparation for working with any target

Two main categories of time disorder

1 Simple - The present influenced by the past in ways that are inappropriate to the present (Eg Big T and little t traumas)

Two main categories of time disorder

Complex ndash Lack of a developed lsquofelt sensersquo of time and continuity

An insecure insufficiently developed sense of personal continuity through time leading to a diminished anchoring in the present and a diminished sense of self

Depersonalisation disorder

Writing about depersonalisation Simeon and Abugel (2006) describe one of the symptoms thus

lsquoTime often does not unfold in the normal

manner past present and future can seem

indistinguishable as if they were all happening at oncersquo

(De- lsquosense-of-selfrsquo ndashisation)

Felt Sense of Timebull What is the felt sense of timebull Is it a lsquohard-wiredrsquo human givenbull How does it develop normallybull What may block its development

Continuity of being

bullldquoWith the care that it receives from its mother each infant is able to have a personal existence and so begins to build up what might be called a continuity of being

bullIf maternal care is not good enough then the infant does not really come into existence since there is no continuity of being instead the personality becomes built on the basis of reactions to environmental impingementrdquo

bullWinnicott 1960

Felt Sense of Timebull What is the felt sense of timebull Is it a lsquohard-wiredrsquo human givenbull Does it vary from one person to anotherbull How does it develop normallybull What may block its developmentbull Is it vulnerable to damagebull What are the effects of a lack of thisbull How can we recognise a lack of this in clientsbull Is the felt sense of time repairable - can it be

developed or improved

Time

Felt sense of nearness in time

The Present

Recent past

Soon future

Distant past

Distant future

Adapted from Janet 1928a

Normal experience of the sense of time

Nearness in time

Present

FuturePast

Effect of unresolved trauma on presentness and the felt sense of time

Trauma memory active in present

Reduced level of groundedness in present

Nearness in time

Present

Past Future

High past either active in present or dissociated

Low reality in present

o

Multiple trauma - time is experienced as compacted into a dys-functional present Limited sense of past future or continuity of being

Limited ability to be grounded in the present (ANP)

Nearness in time

Present

Past Future

Or a sense of emptiness and detachment as the phobic barrierkeeps the memories out of awareness unless triggered

Low reality in present

o

Phobic barrier

What might alert us to this problem in an adult client

bull Very few memories of childhoodbull Resistance to talking about their historybull Feeling of fogginess or unrealitybull Feeling empty like empty shell or cardboard

cut-outbull Andor feeling of internal chaos bull Problems with emotion regulation andor

being out of touch with emotions

What might alert us to this problem in an adult client (continued)

bull Often dismissive of impact of childhood problems

bull May seem to function well up to particular time in their lives then collapse perhaps with ME-type symptoms or depression

bull Sense of vulnerability with lack of self-protective boundaries

bull Various somatic symptoms or feeling cut off from their body

What might alert us to this problem in an adult client (continued)

bull Hyperalert and highly reactivebull A feeling of not knowing who they arebull Relationship difficulties especially with regard

to intimacybull A sense of rootlessness and endless searching

for something but they donrsquot know whatbull Feelings of hopelessness and despair

Can we do EMDR processing with such clients

They are unlikely to be able to hold both the present and a memory at the same timeThey will be less resourced in the present so easily triggered into reliving a traumatic eventLikely to be out of touch with body sensations and emotions so limiting processing potentialProcessing would be incomplete as they would have no scaffolding for the felt sense of time and so no place for the hippocampus to archive the experienceOther traumatic material is likely to flood the process

What resource would be needed first

We work with two aspects of timeExplanation to client with reference to evolution of the felt sense of time in humans and how it can be developed quite simply

ndash Flagging the present as a unique representation

ndash Using the arc of the present cues

ndash And developing a sense of continuity of being

Continuity of being through time

bull One of the main lsquoguy ropesrsquo holding the sense of the present steady

bull A felt sense To add to the other recognised senses

bull A template for organising onersquos experience

Sequencing

bull One can use sequences in various ways that seem to teach the brain to join the dots of experience

bull These can all help to develop the sense of continuity of being and groundedness in the present when required

Examples of use of temporal sequences

bull To create a life narrative (See Pace 2007)bull To create a therapy narrativebull To bridge a vacation gap where the client may feel

the absence of the therapist as a frightening chasm

bull To create a sense of lsquostretched out timersquo ahead when the client may be highly fearful of coping with an upcoming event such as a family funeral and it seems that time is compacted and the event unmanageable

References

Cozolino L The Neuroscience of Psychotherapy Healing the social brainDamasio A (1999) The Feeling of What Happens Body emotion and the making of consciousness New York Harcourt Pace P (2003 - 4th Edition 2007) Lifespan Integration Connecting ego states through time Available from wwwLifespanIntegrationcom or wwwLi-UKcouk Metzinger T (2009) The Ego Tunnel The science of the mind and the myth of the self Basic Books New YorkSani F (Ed) (2008) Self-Continuity Psychology Press New York and Hove UK Siegel D (1999) The Developing Mind How relationships and the brain interact to shape who we are Guilford New York

Two main categories of time disorder

1 Simple - The present influenced by the past in ways that are inappropriate to the present (Eg Big T and little t traumas)

Two main categories of time disorder

Complex ndash Lack of a developed lsquofelt sensersquo of time and continuity

An insecure insufficiently developed sense of personal continuity through time leading to a diminished anchoring in the present and a diminished sense of self

Depersonalisation disorder

Writing about depersonalisation Simeon and Abugel (2006) describe one of the symptoms thus

lsquoTime often does not unfold in the normal

manner past present and future can seem

indistinguishable as if they were all happening at oncersquo

(De- lsquosense-of-selfrsquo ndashisation)

Felt Sense of Timebull What is the felt sense of timebull Is it a lsquohard-wiredrsquo human givenbull How does it develop normallybull What may block its development

Continuity of being

bullldquoWith the care that it receives from its mother each infant is able to have a personal existence and so begins to build up what might be called a continuity of being

bullIf maternal care is not good enough then the infant does not really come into existence since there is no continuity of being instead the personality becomes built on the basis of reactions to environmental impingementrdquo

bullWinnicott 1960

Felt Sense of Timebull What is the felt sense of timebull Is it a lsquohard-wiredrsquo human givenbull Does it vary from one person to anotherbull How does it develop normallybull What may block its developmentbull Is it vulnerable to damagebull What are the effects of a lack of thisbull How can we recognise a lack of this in clientsbull Is the felt sense of time repairable - can it be

developed or improved

Time

Felt sense of nearness in time

The Present

Recent past

Soon future

Distant past

Distant future

Adapted from Janet 1928a

Normal experience of the sense of time

Nearness in time

Present

FuturePast

Effect of unresolved trauma on presentness and the felt sense of time

Trauma memory active in present

Reduced level of groundedness in present

Nearness in time

Present

Past Future

High past either active in present or dissociated

Low reality in present

o

Multiple trauma - time is experienced as compacted into a dys-functional present Limited sense of past future or continuity of being

Limited ability to be grounded in the present (ANP)

Nearness in time

Present

Past Future

Or a sense of emptiness and detachment as the phobic barrierkeeps the memories out of awareness unless triggered

Low reality in present

o

Phobic barrier

What might alert us to this problem in an adult client

bull Very few memories of childhoodbull Resistance to talking about their historybull Feeling of fogginess or unrealitybull Feeling empty like empty shell or cardboard

cut-outbull Andor feeling of internal chaos bull Problems with emotion regulation andor

being out of touch with emotions

What might alert us to this problem in an adult client (continued)

bull Often dismissive of impact of childhood problems

bull May seem to function well up to particular time in their lives then collapse perhaps with ME-type symptoms or depression

bull Sense of vulnerability with lack of self-protective boundaries

bull Various somatic symptoms or feeling cut off from their body

What might alert us to this problem in an adult client (continued)

bull Hyperalert and highly reactivebull A feeling of not knowing who they arebull Relationship difficulties especially with regard

to intimacybull A sense of rootlessness and endless searching

for something but they donrsquot know whatbull Feelings of hopelessness and despair

Can we do EMDR processing with such clients

They are unlikely to be able to hold both the present and a memory at the same timeThey will be less resourced in the present so easily triggered into reliving a traumatic eventLikely to be out of touch with body sensations and emotions so limiting processing potentialProcessing would be incomplete as they would have no scaffolding for the felt sense of time and so no place for the hippocampus to archive the experienceOther traumatic material is likely to flood the process

What resource would be needed first

We work with two aspects of timeExplanation to client with reference to evolution of the felt sense of time in humans and how it can be developed quite simply

ndash Flagging the present as a unique representation

ndash Using the arc of the present cues

ndash And developing a sense of continuity of being

Continuity of being through time

bull One of the main lsquoguy ropesrsquo holding the sense of the present steady

bull A felt sense To add to the other recognised senses

bull A template for organising onersquos experience

Sequencing

bull One can use sequences in various ways that seem to teach the brain to join the dots of experience

bull These can all help to develop the sense of continuity of being and groundedness in the present when required

Examples of use of temporal sequences

bull To create a life narrative (See Pace 2007)bull To create a therapy narrativebull To bridge a vacation gap where the client may feel

the absence of the therapist as a frightening chasm

bull To create a sense of lsquostretched out timersquo ahead when the client may be highly fearful of coping with an upcoming event such as a family funeral and it seems that time is compacted and the event unmanageable

References

Cozolino L The Neuroscience of Psychotherapy Healing the social brainDamasio A (1999) The Feeling of What Happens Body emotion and the making of consciousness New York Harcourt Pace P (2003 - 4th Edition 2007) Lifespan Integration Connecting ego states through time Available from wwwLifespanIntegrationcom or wwwLi-UKcouk Metzinger T (2009) The Ego Tunnel The science of the mind and the myth of the self Basic Books New YorkSani F (Ed) (2008) Self-Continuity Psychology Press New York and Hove UK Siegel D (1999) The Developing Mind How relationships and the brain interact to shape who we are Guilford New York

Two main categories of time disorder

Complex ndash Lack of a developed lsquofelt sensersquo of time and continuity

An insecure insufficiently developed sense of personal continuity through time leading to a diminished anchoring in the present and a diminished sense of self

Depersonalisation disorder

Writing about depersonalisation Simeon and Abugel (2006) describe one of the symptoms thus

lsquoTime often does not unfold in the normal

manner past present and future can seem

indistinguishable as if they were all happening at oncersquo

(De- lsquosense-of-selfrsquo ndashisation)

Felt Sense of Timebull What is the felt sense of timebull Is it a lsquohard-wiredrsquo human givenbull How does it develop normallybull What may block its development

Continuity of being

bullldquoWith the care that it receives from its mother each infant is able to have a personal existence and so begins to build up what might be called a continuity of being

bullIf maternal care is not good enough then the infant does not really come into existence since there is no continuity of being instead the personality becomes built on the basis of reactions to environmental impingementrdquo

bullWinnicott 1960

Felt Sense of Timebull What is the felt sense of timebull Is it a lsquohard-wiredrsquo human givenbull Does it vary from one person to anotherbull How does it develop normallybull What may block its developmentbull Is it vulnerable to damagebull What are the effects of a lack of thisbull How can we recognise a lack of this in clientsbull Is the felt sense of time repairable - can it be

developed or improved

Time

Felt sense of nearness in time

The Present

Recent past

Soon future

Distant past

Distant future

Adapted from Janet 1928a

Normal experience of the sense of time

Nearness in time

Present

FuturePast

Effect of unresolved trauma on presentness and the felt sense of time

Trauma memory active in present

Reduced level of groundedness in present

Nearness in time

Present

Past Future

High past either active in present or dissociated

Low reality in present

o

Multiple trauma - time is experienced as compacted into a dys-functional present Limited sense of past future or continuity of being

Limited ability to be grounded in the present (ANP)

Nearness in time

Present

Past Future

Or a sense of emptiness and detachment as the phobic barrierkeeps the memories out of awareness unless triggered

Low reality in present

o

Phobic barrier

What might alert us to this problem in an adult client

bull Very few memories of childhoodbull Resistance to talking about their historybull Feeling of fogginess or unrealitybull Feeling empty like empty shell or cardboard

cut-outbull Andor feeling of internal chaos bull Problems with emotion regulation andor

being out of touch with emotions

What might alert us to this problem in an adult client (continued)

bull Often dismissive of impact of childhood problems

bull May seem to function well up to particular time in their lives then collapse perhaps with ME-type symptoms or depression

bull Sense of vulnerability with lack of self-protective boundaries

bull Various somatic symptoms or feeling cut off from their body

What might alert us to this problem in an adult client (continued)

bull Hyperalert and highly reactivebull A feeling of not knowing who they arebull Relationship difficulties especially with regard

to intimacybull A sense of rootlessness and endless searching

for something but they donrsquot know whatbull Feelings of hopelessness and despair

Can we do EMDR processing with such clients

They are unlikely to be able to hold both the present and a memory at the same timeThey will be less resourced in the present so easily triggered into reliving a traumatic eventLikely to be out of touch with body sensations and emotions so limiting processing potentialProcessing would be incomplete as they would have no scaffolding for the felt sense of time and so no place for the hippocampus to archive the experienceOther traumatic material is likely to flood the process

What resource would be needed first

We work with two aspects of timeExplanation to client with reference to evolution of the felt sense of time in humans and how it can be developed quite simply

ndash Flagging the present as a unique representation

ndash Using the arc of the present cues

ndash And developing a sense of continuity of being

Continuity of being through time

bull One of the main lsquoguy ropesrsquo holding the sense of the present steady

bull A felt sense To add to the other recognised senses

bull A template for organising onersquos experience

Sequencing

bull One can use sequences in various ways that seem to teach the brain to join the dots of experience

bull These can all help to develop the sense of continuity of being and groundedness in the present when required

Examples of use of temporal sequences

bull To create a life narrative (See Pace 2007)bull To create a therapy narrativebull To bridge a vacation gap where the client may feel

the absence of the therapist as a frightening chasm

bull To create a sense of lsquostretched out timersquo ahead when the client may be highly fearful of coping with an upcoming event such as a family funeral and it seems that time is compacted and the event unmanageable

References

Cozolino L The Neuroscience of Psychotherapy Healing the social brainDamasio A (1999) The Feeling of What Happens Body emotion and the making of consciousness New York Harcourt Pace P (2003 - 4th Edition 2007) Lifespan Integration Connecting ego states through time Available from wwwLifespanIntegrationcom or wwwLi-UKcouk Metzinger T (2009) The Ego Tunnel The science of the mind and the myth of the self Basic Books New YorkSani F (Ed) (2008) Self-Continuity Psychology Press New York and Hove UK Siegel D (1999) The Developing Mind How relationships and the brain interact to shape who we are Guilford New York

Depersonalisation disorder

Writing about depersonalisation Simeon and Abugel (2006) describe one of the symptoms thus

lsquoTime often does not unfold in the normal

manner past present and future can seem

indistinguishable as if they were all happening at oncersquo

(De- lsquosense-of-selfrsquo ndashisation)

Felt Sense of Timebull What is the felt sense of timebull Is it a lsquohard-wiredrsquo human givenbull How does it develop normallybull What may block its development

Continuity of being

bullldquoWith the care that it receives from its mother each infant is able to have a personal existence and so begins to build up what might be called a continuity of being

bullIf maternal care is not good enough then the infant does not really come into existence since there is no continuity of being instead the personality becomes built on the basis of reactions to environmental impingementrdquo

bullWinnicott 1960

Felt Sense of Timebull What is the felt sense of timebull Is it a lsquohard-wiredrsquo human givenbull Does it vary from one person to anotherbull How does it develop normallybull What may block its developmentbull Is it vulnerable to damagebull What are the effects of a lack of thisbull How can we recognise a lack of this in clientsbull Is the felt sense of time repairable - can it be

developed or improved

Time

Felt sense of nearness in time

The Present

Recent past

Soon future

Distant past

Distant future

Adapted from Janet 1928a

Normal experience of the sense of time

Nearness in time

Present

FuturePast

Effect of unresolved trauma on presentness and the felt sense of time

Trauma memory active in present

Reduced level of groundedness in present

Nearness in time

Present

Past Future

High past either active in present or dissociated

Low reality in present

o

Multiple trauma - time is experienced as compacted into a dys-functional present Limited sense of past future or continuity of being

Limited ability to be grounded in the present (ANP)

Nearness in time

Present

Past Future

Or a sense of emptiness and detachment as the phobic barrierkeeps the memories out of awareness unless triggered

Low reality in present

o

Phobic barrier

What might alert us to this problem in an adult client

bull Very few memories of childhoodbull Resistance to talking about their historybull Feeling of fogginess or unrealitybull Feeling empty like empty shell or cardboard

cut-outbull Andor feeling of internal chaos bull Problems with emotion regulation andor

being out of touch with emotions

What might alert us to this problem in an adult client (continued)

bull Often dismissive of impact of childhood problems

bull May seem to function well up to particular time in their lives then collapse perhaps with ME-type symptoms or depression

bull Sense of vulnerability with lack of self-protective boundaries

bull Various somatic symptoms or feeling cut off from their body

What might alert us to this problem in an adult client (continued)

bull Hyperalert and highly reactivebull A feeling of not knowing who they arebull Relationship difficulties especially with regard

to intimacybull A sense of rootlessness and endless searching

for something but they donrsquot know whatbull Feelings of hopelessness and despair

Can we do EMDR processing with such clients

They are unlikely to be able to hold both the present and a memory at the same timeThey will be less resourced in the present so easily triggered into reliving a traumatic eventLikely to be out of touch with body sensations and emotions so limiting processing potentialProcessing would be incomplete as they would have no scaffolding for the felt sense of time and so no place for the hippocampus to archive the experienceOther traumatic material is likely to flood the process

What resource would be needed first

We work with two aspects of timeExplanation to client with reference to evolution of the felt sense of time in humans and how it can be developed quite simply

ndash Flagging the present as a unique representation

ndash Using the arc of the present cues

ndash And developing a sense of continuity of being

Continuity of being through time

bull One of the main lsquoguy ropesrsquo holding the sense of the present steady

bull A felt sense To add to the other recognised senses

bull A template for organising onersquos experience

Sequencing

bull One can use sequences in various ways that seem to teach the brain to join the dots of experience

bull These can all help to develop the sense of continuity of being and groundedness in the present when required

Examples of use of temporal sequences

bull To create a life narrative (See Pace 2007)bull To create a therapy narrativebull To bridge a vacation gap where the client may feel

the absence of the therapist as a frightening chasm

bull To create a sense of lsquostretched out timersquo ahead when the client may be highly fearful of coping with an upcoming event such as a family funeral and it seems that time is compacted and the event unmanageable

References

Cozolino L The Neuroscience of Psychotherapy Healing the social brainDamasio A (1999) The Feeling of What Happens Body emotion and the making of consciousness New York Harcourt Pace P (2003 - 4th Edition 2007) Lifespan Integration Connecting ego states through time Available from wwwLifespanIntegrationcom or wwwLi-UKcouk Metzinger T (2009) The Ego Tunnel The science of the mind and the myth of the self Basic Books New YorkSani F (Ed) (2008) Self-Continuity Psychology Press New York and Hove UK Siegel D (1999) The Developing Mind How relationships and the brain interact to shape who we are Guilford New York

Felt Sense of Timebull What is the felt sense of timebull Is it a lsquohard-wiredrsquo human givenbull How does it develop normallybull What may block its development

Continuity of being

bullldquoWith the care that it receives from its mother each infant is able to have a personal existence and so begins to build up what might be called a continuity of being

bullIf maternal care is not good enough then the infant does not really come into existence since there is no continuity of being instead the personality becomes built on the basis of reactions to environmental impingementrdquo

bullWinnicott 1960

Felt Sense of Timebull What is the felt sense of timebull Is it a lsquohard-wiredrsquo human givenbull Does it vary from one person to anotherbull How does it develop normallybull What may block its developmentbull Is it vulnerable to damagebull What are the effects of a lack of thisbull How can we recognise a lack of this in clientsbull Is the felt sense of time repairable - can it be

developed or improved

Time

Felt sense of nearness in time

The Present

Recent past

Soon future

Distant past

Distant future

Adapted from Janet 1928a

Normal experience of the sense of time

Nearness in time

Present

FuturePast

Effect of unresolved trauma on presentness and the felt sense of time

Trauma memory active in present

Reduced level of groundedness in present

Nearness in time

Present

Past Future

High past either active in present or dissociated

Low reality in present

o

Multiple trauma - time is experienced as compacted into a dys-functional present Limited sense of past future or continuity of being

Limited ability to be grounded in the present (ANP)

Nearness in time

Present

Past Future

Or a sense of emptiness and detachment as the phobic barrierkeeps the memories out of awareness unless triggered

Low reality in present

o

Phobic barrier

What might alert us to this problem in an adult client

bull Very few memories of childhoodbull Resistance to talking about their historybull Feeling of fogginess or unrealitybull Feeling empty like empty shell or cardboard

cut-outbull Andor feeling of internal chaos bull Problems with emotion regulation andor

being out of touch with emotions

What might alert us to this problem in an adult client (continued)

bull Often dismissive of impact of childhood problems

bull May seem to function well up to particular time in their lives then collapse perhaps with ME-type symptoms or depression

bull Sense of vulnerability with lack of self-protective boundaries

bull Various somatic symptoms or feeling cut off from their body

What might alert us to this problem in an adult client (continued)

bull Hyperalert and highly reactivebull A feeling of not knowing who they arebull Relationship difficulties especially with regard

to intimacybull A sense of rootlessness and endless searching

for something but they donrsquot know whatbull Feelings of hopelessness and despair

Can we do EMDR processing with such clients

They are unlikely to be able to hold both the present and a memory at the same timeThey will be less resourced in the present so easily triggered into reliving a traumatic eventLikely to be out of touch with body sensations and emotions so limiting processing potentialProcessing would be incomplete as they would have no scaffolding for the felt sense of time and so no place for the hippocampus to archive the experienceOther traumatic material is likely to flood the process

What resource would be needed first

We work with two aspects of timeExplanation to client with reference to evolution of the felt sense of time in humans and how it can be developed quite simply

ndash Flagging the present as a unique representation

ndash Using the arc of the present cues

ndash And developing a sense of continuity of being

Continuity of being through time

bull One of the main lsquoguy ropesrsquo holding the sense of the present steady

bull A felt sense To add to the other recognised senses

bull A template for organising onersquos experience

Sequencing

bull One can use sequences in various ways that seem to teach the brain to join the dots of experience

bull These can all help to develop the sense of continuity of being and groundedness in the present when required

Examples of use of temporal sequences

bull To create a life narrative (See Pace 2007)bull To create a therapy narrativebull To bridge a vacation gap where the client may feel

the absence of the therapist as a frightening chasm

bull To create a sense of lsquostretched out timersquo ahead when the client may be highly fearful of coping with an upcoming event such as a family funeral and it seems that time is compacted and the event unmanageable

References

Cozolino L The Neuroscience of Psychotherapy Healing the social brainDamasio A (1999) The Feeling of What Happens Body emotion and the making of consciousness New York Harcourt Pace P (2003 - 4th Edition 2007) Lifespan Integration Connecting ego states through time Available from wwwLifespanIntegrationcom or wwwLi-UKcouk Metzinger T (2009) The Ego Tunnel The science of the mind and the myth of the self Basic Books New YorkSani F (Ed) (2008) Self-Continuity Psychology Press New York and Hove UK Siegel D (1999) The Developing Mind How relationships and the brain interact to shape who we are Guilford New York

Continuity of being

bullldquoWith the care that it receives from its mother each infant is able to have a personal existence and so begins to build up what might be called a continuity of being

bullIf maternal care is not good enough then the infant does not really come into existence since there is no continuity of being instead the personality becomes built on the basis of reactions to environmental impingementrdquo

bullWinnicott 1960

Felt Sense of Timebull What is the felt sense of timebull Is it a lsquohard-wiredrsquo human givenbull Does it vary from one person to anotherbull How does it develop normallybull What may block its developmentbull Is it vulnerable to damagebull What are the effects of a lack of thisbull How can we recognise a lack of this in clientsbull Is the felt sense of time repairable - can it be

developed or improved

Time

Felt sense of nearness in time

The Present

Recent past

Soon future

Distant past

Distant future

Adapted from Janet 1928a

Normal experience of the sense of time

Nearness in time

Present

FuturePast

Effect of unresolved trauma on presentness and the felt sense of time

Trauma memory active in present

Reduced level of groundedness in present

Nearness in time

Present

Past Future

High past either active in present or dissociated

Low reality in present

o

Multiple trauma - time is experienced as compacted into a dys-functional present Limited sense of past future or continuity of being

Limited ability to be grounded in the present (ANP)

Nearness in time

Present

Past Future

Or a sense of emptiness and detachment as the phobic barrierkeeps the memories out of awareness unless triggered

Low reality in present

o

Phobic barrier

What might alert us to this problem in an adult client

bull Very few memories of childhoodbull Resistance to talking about their historybull Feeling of fogginess or unrealitybull Feeling empty like empty shell or cardboard

cut-outbull Andor feeling of internal chaos bull Problems with emotion regulation andor

being out of touch with emotions

What might alert us to this problem in an adult client (continued)

bull Often dismissive of impact of childhood problems

bull May seem to function well up to particular time in their lives then collapse perhaps with ME-type symptoms or depression

bull Sense of vulnerability with lack of self-protective boundaries

bull Various somatic symptoms or feeling cut off from their body

What might alert us to this problem in an adult client (continued)

bull Hyperalert and highly reactivebull A feeling of not knowing who they arebull Relationship difficulties especially with regard

to intimacybull A sense of rootlessness and endless searching

for something but they donrsquot know whatbull Feelings of hopelessness and despair

Can we do EMDR processing with such clients

They are unlikely to be able to hold both the present and a memory at the same timeThey will be less resourced in the present so easily triggered into reliving a traumatic eventLikely to be out of touch with body sensations and emotions so limiting processing potentialProcessing would be incomplete as they would have no scaffolding for the felt sense of time and so no place for the hippocampus to archive the experienceOther traumatic material is likely to flood the process

What resource would be needed first

We work with two aspects of timeExplanation to client with reference to evolution of the felt sense of time in humans and how it can be developed quite simply

ndash Flagging the present as a unique representation

ndash Using the arc of the present cues

ndash And developing a sense of continuity of being

Continuity of being through time

bull One of the main lsquoguy ropesrsquo holding the sense of the present steady

bull A felt sense To add to the other recognised senses

bull A template for organising onersquos experience

Sequencing

bull One can use sequences in various ways that seem to teach the brain to join the dots of experience

bull These can all help to develop the sense of continuity of being and groundedness in the present when required

Examples of use of temporal sequences

bull To create a life narrative (See Pace 2007)bull To create a therapy narrativebull To bridge a vacation gap where the client may feel

the absence of the therapist as a frightening chasm

bull To create a sense of lsquostretched out timersquo ahead when the client may be highly fearful of coping with an upcoming event such as a family funeral and it seems that time is compacted and the event unmanageable

References

Cozolino L The Neuroscience of Psychotherapy Healing the social brainDamasio A (1999) The Feeling of What Happens Body emotion and the making of consciousness New York Harcourt Pace P (2003 - 4th Edition 2007) Lifespan Integration Connecting ego states through time Available from wwwLifespanIntegrationcom or wwwLi-UKcouk Metzinger T (2009) The Ego Tunnel The science of the mind and the myth of the self Basic Books New YorkSani F (Ed) (2008) Self-Continuity Psychology Press New York and Hove UK Siegel D (1999) The Developing Mind How relationships and the brain interact to shape who we are Guilford New York

Felt Sense of Timebull What is the felt sense of timebull Is it a lsquohard-wiredrsquo human givenbull Does it vary from one person to anotherbull How does it develop normallybull What may block its developmentbull Is it vulnerable to damagebull What are the effects of a lack of thisbull How can we recognise a lack of this in clientsbull Is the felt sense of time repairable - can it be

developed or improved

Time

Felt sense of nearness in time

The Present

Recent past

Soon future

Distant past

Distant future

Adapted from Janet 1928a

Normal experience of the sense of time

Nearness in time

Present

FuturePast

Effect of unresolved trauma on presentness and the felt sense of time

Trauma memory active in present

Reduced level of groundedness in present

Nearness in time

Present

Past Future

High past either active in present or dissociated

Low reality in present

o

Multiple trauma - time is experienced as compacted into a dys-functional present Limited sense of past future or continuity of being

Limited ability to be grounded in the present (ANP)

Nearness in time

Present

Past Future

Or a sense of emptiness and detachment as the phobic barrierkeeps the memories out of awareness unless triggered

Low reality in present

o

Phobic barrier

What might alert us to this problem in an adult client

bull Very few memories of childhoodbull Resistance to talking about their historybull Feeling of fogginess or unrealitybull Feeling empty like empty shell or cardboard

cut-outbull Andor feeling of internal chaos bull Problems with emotion regulation andor

being out of touch with emotions

What might alert us to this problem in an adult client (continued)

bull Often dismissive of impact of childhood problems

bull May seem to function well up to particular time in their lives then collapse perhaps with ME-type symptoms or depression

bull Sense of vulnerability with lack of self-protective boundaries

bull Various somatic symptoms or feeling cut off from their body

What might alert us to this problem in an adult client (continued)

bull Hyperalert and highly reactivebull A feeling of not knowing who they arebull Relationship difficulties especially with regard

to intimacybull A sense of rootlessness and endless searching

for something but they donrsquot know whatbull Feelings of hopelessness and despair

Can we do EMDR processing with such clients

They are unlikely to be able to hold both the present and a memory at the same timeThey will be less resourced in the present so easily triggered into reliving a traumatic eventLikely to be out of touch with body sensations and emotions so limiting processing potentialProcessing would be incomplete as they would have no scaffolding for the felt sense of time and so no place for the hippocampus to archive the experienceOther traumatic material is likely to flood the process

What resource would be needed first

We work with two aspects of timeExplanation to client with reference to evolution of the felt sense of time in humans and how it can be developed quite simply

ndash Flagging the present as a unique representation

ndash Using the arc of the present cues

ndash And developing a sense of continuity of being

Continuity of being through time

bull One of the main lsquoguy ropesrsquo holding the sense of the present steady

bull A felt sense To add to the other recognised senses

bull A template for organising onersquos experience

Sequencing

bull One can use sequences in various ways that seem to teach the brain to join the dots of experience

bull These can all help to develop the sense of continuity of being and groundedness in the present when required

Examples of use of temporal sequences

bull To create a life narrative (See Pace 2007)bull To create a therapy narrativebull To bridge a vacation gap where the client may feel

the absence of the therapist as a frightening chasm

bull To create a sense of lsquostretched out timersquo ahead when the client may be highly fearful of coping with an upcoming event such as a family funeral and it seems that time is compacted and the event unmanageable

References

Cozolino L The Neuroscience of Psychotherapy Healing the social brainDamasio A (1999) The Feeling of What Happens Body emotion and the making of consciousness New York Harcourt Pace P (2003 - 4th Edition 2007) Lifespan Integration Connecting ego states through time Available from wwwLifespanIntegrationcom or wwwLi-UKcouk Metzinger T (2009) The Ego Tunnel The science of the mind and the myth of the self Basic Books New YorkSani F (Ed) (2008) Self-Continuity Psychology Press New York and Hove UK Siegel D (1999) The Developing Mind How relationships and the brain interact to shape who we are Guilford New York

Time

Felt sense of nearness in time

The Present

Recent past

Soon future

Distant past

Distant future

Adapted from Janet 1928a

Normal experience of the sense of time

Nearness in time

Present

FuturePast

Effect of unresolved trauma on presentness and the felt sense of time

Trauma memory active in present

Reduced level of groundedness in present

Nearness in time

Present

Past Future

High past either active in present or dissociated

Low reality in present

o

Multiple trauma - time is experienced as compacted into a dys-functional present Limited sense of past future or continuity of being

Limited ability to be grounded in the present (ANP)

Nearness in time

Present

Past Future

Or a sense of emptiness and detachment as the phobic barrierkeeps the memories out of awareness unless triggered

Low reality in present

o

Phobic barrier

What might alert us to this problem in an adult client

bull Very few memories of childhoodbull Resistance to talking about their historybull Feeling of fogginess or unrealitybull Feeling empty like empty shell or cardboard

cut-outbull Andor feeling of internal chaos bull Problems with emotion regulation andor

being out of touch with emotions

What might alert us to this problem in an adult client (continued)

bull Often dismissive of impact of childhood problems

bull May seem to function well up to particular time in their lives then collapse perhaps with ME-type symptoms or depression

bull Sense of vulnerability with lack of self-protective boundaries

bull Various somatic symptoms or feeling cut off from their body

What might alert us to this problem in an adult client (continued)

bull Hyperalert and highly reactivebull A feeling of not knowing who they arebull Relationship difficulties especially with regard

to intimacybull A sense of rootlessness and endless searching

for something but they donrsquot know whatbull Feelings of hopelessness and despair

Can we do EMDR processing with such clients

They are unlikely to be able to hold both the present and a memory at the same timeThey will be less resourced in the present so easily triggered into reliving a traumatic eventLikely to be out of touch with body sensations and emotions so limiting processing potentialProcessing would be incomplete as they would have no scaffolding for the felt sense of time and so no place for the hippocampus to archive the experienceOther traumatic material is likely to flood the process

What resource would be needed first

We work with two aspects of timeExplanation to client with reference to evolution of the felt sense of time in humans and how it can be developed quite simply

ndash Flagging the present as a unique representation

ndash Using the arc of the present cues

ndash And developing a sense of continuity of being

Continuity of being through time

bull One of the main lsquoguy ropesrsquo holding the sense of the present steady

bull A felt sense To add to the other recognised senses

bull A template for organising onersquos experience

Sequencing

bull One can use sequences in various ways that seem to teach the brain to join the dots of experience

bull These can all help to develop the sense of continuity of being and groundedness in the present when required

Examples of use of temporal sequences

bull To create a life narrative (See Pace 2007)bull To create a therapy narrativebull To bridge a vacation gap where the client may feel

the absence of the therapist as a frightening chasm

bull To create a sense of lsquostretched out timersquo ahead when the client may be highly fearful of coping with an upcoming event such as a family funeral and it seems that time is compacted and the event unmanageable

References

Cozolino L The Neuroscience of Psychotherapy Healing the social brainDamasio A (1999) The Feeling of What Happens Body emotion and the making of consciousness New York Harcourt Pace P (2003 - 4th Edition 2007) Lifespan Integration Connecting ego states through time Available from wwwLifespanIntegrationcom or wwwLi-UKcouk Metzinger T (2009) The Ego Tunnel The science of the mind and the myth of the self Basic Books New YorkSani F (Ed) (2008) Self-Continuity Psychology Press New York and Hove UK Siegel D (1999) The Developing Mind How relationships and the brain interact to shape who we are Guilford New York

Nearness in time

Present

FuturePast

Effect of unresolved trauma on presentness and the felt sense of time

Trauma memory active in present

Reduced level of groundedness in present

Nearness in time

Present

Past Future

High past either active in present or dissociated

Low reality in present

o

Multiple trauma - time is experienced as compacted into a dys-functional present Limited sense of past future or continuity of being

Limited ability to be grounded in the present (ANP)

Nearness in time

Present

Past Future

Or a sense of emptiness and detachment as the phobic barrierkeeps the memories out of awareness unless triggered

Low reality in present

o

Phobic barrier

What might alert us to this problem in an adult client

bull Very few memories of childhoodbull Resistance to talking about their historybull Feeling of fogginess or unrealitybull Feeling empty like empty shell or cardboard

cut-outbull Andor feeling of internal chaos bull Problems with emotion regulation andor

being out of touch with emotions

What might alert us to this problem in an adult client (continued)

bull Often dismissive of impact of childhood problems

bull May seem to function well up to particular time in their lives then collapse perhaps with ME-type symptoms or depression

bull Sense of vulnerability with lack of self-protective boundaries

bull Various somatic symptoms or feeling cut off from their body

What might alert us to this problem in an adult client (continued)

bull Hyperalert and highly reactivebull A feeling of not knowing who they arebull Relationship difficulties especially with regard

to intimacybull A sense of rootlessness and endless searching

for something but they donrsquot know whatbull Feelings of hopelessness and despair

Can we do EMDR processing with such clients

They are unlikely to be able to hold both the present and a memory at the same timeThey will be less resourced in the present so easily triggered into reliving a traumatic eventLikely to be out of touch with body sensations and emotions so limiting processing potentialProcessing would be incomplete as they would have no scaffolding for the felt sense of time and so no place for the hippocampus to archive the experienceOther traumatic material is likely to flood the process

What resource would be needed first

We work with two aspects of timeExplanation to client with reference to evolution of the felt sense of time in humans and how it can be developed quite simply

ndash Flagging the present as a unique representation

ndash Using the arc of the present cues

ndash And developing a sense of continuity of being

Continuity of being through time

bull One of the main lsquoguy ropesrsquo holding the sense of the present steady

bull A felt sense To add to the other recognised senses

bull A template for organising onersquos experience

Sequencing

bull One can use sequences in various ways that seem to teach the brain to join the dots of experience

bull These can all help to develop the sense of continuity of being and groundedness in the present when required

Examples of use of temporal sequences

bull To create a life narrative (See Pace 2007)bull To create a therapy narrativebull To bridge a vacation gap where the client may feel

the absence of the therapist as a frightening chasm

bull To create a sense of lsquostretched out timersquo ahead when the client may be highly fearful of coping with an upcoming event such as a family funeral and it seems that time is compacted and the event unmanageable

References

Cozolino L The Neuroscience of Psychotherapy Healing the social brainDamasio A (1999) The Feeling of What Happens Body emotion and the making of consciousness New York Harcourt Pace P (2003 - 4th Edition 2007) Lifespan Integration Connecting ego states through time Available from wwwLifespanIntegrationcom or wwwLi-UKcouk Metzinger T (2009) The Ego Tunnel The science of the mind and the myth of the self Basic Books New YorkSani F (Ed) (2008) Self-Continuity Psychology Press New York and Hove UK Siegel D (1999) The Developing Mind How relationships and the brain interact to shape who we are Guilford New York

Nearness in time

Present

Past Future

High past either active in present or dissociated

Low reality in present

o

Multiple trauma - time is experienced as compacted into a dys-functional present Limited sense of past future or continuity of being

Limited ability to be grounded in the present (ANP)

Nearness in time

Present

Past Future

Or a sense of emptiness and detachment as the phobic barrierkeeps the memories out of awareness unless triggered

Low reality in present

o

Phobic barrier

What might alert us to this problem in an adult client

bull Very few memories of childhoodbull Resistance to talking about their historybull Feeling of fogginess or unrealitybull Feeling empty like empty shell or cardboard

cut-outbull Andor feeling of internal chaos bull Problems with emotion regulation andor

being out of touch with emotions

What might alert us to this problem in an adult client (continued)

bull Often dismissive of impact of childhood problems

bull May seem to function well up to particular time in their lives then collapse perhaps with ME-type symptoms or depression

bull Sense of vulnerability with lack of self-protective boundaries

bull Various somatic symptoms or feeling cut off from their body

What might alert us to this problem in an adult client (continued)

bull Hyperalert and highly reactivebull A feeling of not knowing who they arebull Relationship difficulties especially with regard

to intimacybull A sense of rootlessness and endless searching

for something but they donrsquot know whatbull Feelings of hopelessness and despair

Can we do EMDR processing with such clients

They are unlikely to be able to hold both the present and a memory at the same timeThey will be less resourced in the present so easily triggered into reliving a traumatic eventLikely to be out of touch with body sensations and emotions so limiting processing potentialProcessing would be incomplete as they would have no scaffolding for the felt sense of time and so no place for the hippocampus to archive the experienceOther traumatic material is likely to flood the process

What resource would be needed first

We work with two aspects of timeExplanation to client with reference to evolution of the felt sense of time in humans and how it can be developed quite simply

ndash Flagging the present as a unique representation

ndash Using the arc of the present cues

ndash And developing a sense of continuity of being

Continuity of being through time

bull One of the main lsquoguy ropesrsquo holding the sense of the present steady

bull A felt sense To add to the other recognised senses

bull A template for organising onersquos experience

Sequencing

bull One can use sequences in various ways that seem to teach the brain to join the dots of experience

bull These can all help to develop the sense of continuity of being and groundedness in the present when required

Examples of use of temporal sequences

bull To create a life narrative (See Pace 2007)bull To create a therapy narrativebull To bridge a vacation gap where the client may feel

the absence of the therapist as a frightening chasm

bull To create a sense of lsquostretched out timersquo ahead when the client may be highly fearful of coping with an upcoming event such as a family funeral and it seems that time is compacted and the event unmanageable

References

Cozolino L The Neuroscience of Psychotherapy Healing the social brainDamasio A (1999) The Feeling of What Happens Body emotion and the making of consciousness New York Harcourt Pace P (2003 - 4th Edition 2007) Lifespan Integration Connecting ego states through time Available from wwwLifespanIntegrationcom or wwwLi-UKcouk Metzinger T (2009) The Ego Tunnel The science of the mind and the myth of the self Basic Books New YorkSani F (Ed) (2008) Self-Continuity Psychology Press New York and Hove UK Siegel D (1999) The Developing Mind How relationships and the brain interact to shape who we are Guilford New York

Nearness in time

Present

Past Future

Or a sense of emptiness and detachment as the phobic barrierkeeps the memories out of awareness unless triggered

Low reality in present

o

Phobic barrier

What might alert us to this problem in an adult client

bull Very few memories of childhoodbull Resistance to talking about their historybull Feeling of fogginess or unrealitybull Feeling empty like empty shell or cardboard

cut-outbull Andor feeling of internal chaos bull Problems with emotion regulation andor

being out of touch with emotions

What might alert us to this problem in an adult client (continued)

bull Often dismissive of impact of childhood problems

bull May seem to function well up to particular time in their lives then collapse perhaps with ME-type symptoms or depression

bull Sense of vulnerability with lack of self-protective boundaries

bull Various somatic symptoms or feeling cut off from their body

What might alert us to this problem in an adult client (continued)

bull Hyperalert and highly reactivebull A feeling of not knowing who they arebull Relationship difficulties especially with regard

to intimacybull A sense of rootlessness and endless searching

for something but they donrsquot know whatbull Feelings of hopelessness and despair

Can we do EMDR processing with such clients

They are unlikely to be able to hold both the present and a memory at the same timeThey will be less resourced in the present so easily triggered into reliving a traumatic eventLikely to be out of touch with body sensations and emotions so limiting processing potentialProcessing would be incomplete as they would have no scaffolding for the felt sense of time and so no place for the hippocampus to archive the experienceOther traumatic material is likely to flood the process

What resource would be needed first

We work with two aspects of timeExplanation to client with reference to evolution of the felt sense of time in humans and how it can be developed quite simply

ndash Flagging the present as a unique representation

ndash Using the arc of the present cues

ndash And developing a sense of continuity of being

Continuity of being through time

bull One of the main lsquoguy ropesrsquo holding the sense of the present steady

bull A felt sense To add to the other recognised senses

bull A template for organising onersquos experience

Sequencing

bull One can use sequences in various ways that seem to teach the brain to join the dots of experience

bull These can all help to develop the sense of continuity of being and groundedness in the present when required

Examples of use of temporal sequences

bull To create a life narrative (See Pace 2007)bull To create a therapy narrativebull To bridge a vacation gap where the client may feel

the absence of the therapist as a frightening chasm

bull To create a sense of lsquostretched out timersquo ahead when the client may be highly fearful of coping with an upcoming event such as a family funeral and it seems that time is compacted and the event unmanageable

References

Cozolino L The Neuroscience of Psychotherapy Healing the social brainDamasio A (1999) The Feeling of What Happens Body emotion and the making of consciousness New York Harcourt Pace P (2003 - 4th Edition 2007) Lifespan Integration Connecting ego states through time Available from wwwLifespanIntegrationcom or wwwLi-UKcouk Metzinger T (2009) The Ego Tunnel The science of the mind and the myth of the self Basic Books New YorkSani F (Ed) (2008) Self-Continuity Psychology Press New York and Hove UK Siegel D (1999) The Developing Mind How relationships and the brain interact to shape who we are Guilford New York

What might alert us to this problem in an adult client

bull Very few memories of childhoodbull Resistance to talking about their historybull Feeling of fogginess or unrealitybull Feeling empty like empty shell or cardboard

cut-outbull Andor feeling of internal chaos bull Problems with emotion regulation andor

being out of touch with emotions

What might alert us to this problem in an adult client (continued)

bull Often dismissive of impact of childhood problems

bull May seem to function well up to particular time in their lives then collapse perhaps with ME-type symptoms or depression

bull Sense of vulnerability with lack of self-protective boundaries

bull Various somatic symptoms or feeling cut off from their body

What might alert us to this problem in an adult client (continued)

bull Hyperalert and highly reactivebull A feeling of not knowing who they arebull Relationship difficulties especially with regard

to intimacybull A sense of rootlessness and endless searching

for something but they donrsquot know whatbull Feelings of hopelessness and despair

Can we do EMDR processing with such clients

They are unlikely to be able to hold both the present and a memory at the same timeThey will be less resourced in the present so easily triggered into reliving a traumatic eventLikely to be out of touch with body sensations and emotions so limiting processing potentialProcessing would be incomplete as they would have no scaffolding for the felt sense of time and so no place for the hippocampus to archive the experienceOther traumatic material is likely to flood the process

What resource would be needed first

We work with two aspects of timeExplanation to client with reference to evolution of the felt sense of time in humans and how it can be developed quite simply

ndash Flagging the present as a unique representation

ndash Using the arc of the present cues

ndash And developing a sense of continuity of being

Continuity of being through time

bull One of the main lsquoguy ropesrsquo holding the sense of the present steady

bull A felt sense To add to the other recognised senses

bull A template for organising onersquos experience

Sequencing

bull One can use sequences in various ways that seem to teach the brain to join the dots of experience

bull These can all help to develop the sense of continuity of being and groundedness in the present when required

Examples of use of temporal sequences

bull To create a life narrative (See Pace 2007)bull To create a therapy narrativebull To bridge a vacation gap where the client may feel

the absence of the therapist as a frightening chasm

bull To create a sense of lsquostretched out timersquo ahead when the client may be highly fearful of coping with an upcoming event such as a family funeral and it seems that time is compacted and the event unmanageable

References

Cozolino L The Neuroscience of Psychotherapy Healing the social brainDamasio A (1999) The Feeling of What Happens Body emotion and the making of consciousness New York Harcourt Pace P (2003 - 4th Edition 2007) Lifespan Integration Connecting ego states through time Available from wwwLifespanIntegrationcom or wwwLi-UKcouk Metzinger T (2009) The Ego Tunnel The science of the mind and the myth of the self Basic Books New YorkSani F (Ed) (2008) Self-Continuity Psychology Press New York and Hove UK Siegel D (1999) The Developing Mind How relationships and the brain interact to shape who we are Guilford New York

What might alert us to this problem in an adult client (continued)

bull Often dismissive of impact of childhood problems

bull May seem to function well up to particular time in their lives then collapse perhaps with ME-type symptoms or depression

bull Sense of vulnerability with lack of self-protective boundaries

bull Various somatic symptoms or feeling cut off from their body

What might alert us to this problem in an adult client (continued)

bull Hyperalert and highly reactivebull A feeling of not knowing who they arebull Relationship difficulties especially with regard

to intimacybull A sense of rootlessness and endless searching

for something but they donrsquot know whatbull Feelings of hopelessness and despair

Can we do EMDR processing with such clients

They are unlikely to be able to hold both the present and a memory at the same timeThey will be less resourced in the present so easily triggered into reliving a traumatic eventLikely to be out of touch with body sensations and emotions so limiting processing potentialProcessing would be incomplete as they would have no scaffolding for the felt sense of time and so no place for the hippocampus to archive the experienceOther traumatic material is likely to flood the process

What resource would be needed first

We work with two aspects of timeExplanation to client with reference to evolution of the felt sense of time in humans and how it can be developed quite simply

ndash Flagging the present as a unique representation

ndash Using the arc of the present cues

ndash And developing a sense of continuity of being

Continuity of being through time

bull One of the main lsquoguy ropesrsquo holding the sense of the present steady

bull A felt sense To add to the other recognised senses

bull A template for organising onersquos experience

Sequencing

bull One can use sequences in various ways that seem to teach the brain to join the dots of experience

bull These can all help to develop the sense of continuity of being and groundedness in the present when required

Examples of use of temporal sequences

bull To create a life narrative (See Pace 2007)bull To create a therapy narrativebull To bridge a vacation gap where the client may feel

the absence of the therapist as a frightening chasm

bull To create a sense of lsquostretched out timersquo ahead when the client may be highly fearful of coping with an upcoming event such as a family funeral and it seems that time is compacted and the event unmanageable

References

Cozolino L The Neuroscience of Psychotherapy Healing the social brainDamasio A (1999) The Feeling of What Happens Body emotion and the making of consciousness New York Harcourt Pace P (2003 - 4th Edition 2007) Lifespan Integration Connecting ego states through time Available from wwwLifespanIntegrationcom or wwwLi-UKcouk Metzinger T (2009) The Ego Tunnel The science of the mind and the myth of the self Basic Books New YorkSani F (Ed) (2008) Self-Continuity Psychology Press New York and Hove UK Siegel D (1999) The Developing Mind How relationships and the brain interact to shape who we are Guilford New York

What might alert us to this problem in an adult client (continued)

bull Hyperalert and highly reactivebull A feeling of not knowing who they arebull Relationship difficulties especially with regard

to intimacybull A sense of rootlessness and endless searching

for something but they donrsquot know whatbull Feelings of hopelessness and despair

Can we do EMDR processing with such clients

They are unlikely to be able to hold both the present and a memory at the same timeThey will be less resourced in the present so easily triggered into reliving a traumatic eventLikely to be out of touch with body sensations and emotions so limiting processing potentialProcessing would be incomplete as they would have no scaffolding for the felt sense of time and so no place for the hippocampus to archive the experienceOther traumatic material is likely to flood the process

What resource would be needed first

We work with two aspects of timeExplanation to client with reference to evolution of the felt sense of time in humans and how it can be developed quite simply

ndash Flagging the present as a unique representation

ndash Using the arc of the present cues

ndash And developing a sense of continuity of being

Continuity of being through time

bull One of the main lsquoguy ropesrsquo holding the sense of the present steady

bull A felt sense To add to the other recognised senses

bull A template for organising onersquos experience

Sequencing

bull One can use sequences in various ways that seem to teach the brain to join the dots of experience

bull These can all help to develop the sense of continuity of being and groundedness in the present when required

Examples of use of temporal sequences

bull To create a life narrative (See Pace 2007)bull To create a therapy narrativebull To bridge a vacation gap where the client may feel

the absence of the therapist as a frightening chasm

bull To create a sense of lsquostretched out timersquo ahead when the client may be highly fearful of coping with an upcoming event such as a family funeral and it seems that time is compacted and the event unmanageable

References

Cozolino L The Neuroscience of Psychotherapy Healing the social brainDamasio A (1999) The Feeling of What Happens Body emotion and the making of consciousness New York Harcourt Pace P (2003 - 4th Edition 2007) Lifespan Integration Connecting ego states through time Available from wwwLifespanIntegrationcom or wwwLi-UKcouk Metzinger T (2009) The Ego Tunnel The science of the mind and the myth of the self Basic Books New YorkSani F (Ed) (2008) Self-Continuity Psychology Press New York and Hove UK Siegel D (1999) The Developing Mind How relationships and the brain interact to shape who we are Guilford New York

Can we do EMDR processing with such clients

They are unlikely to be able to hold both the present and a memory at the same timeThey will be less resourced in the present so easily triggered into reliving a traumatic eventLikely to be out of touch with body sensations and emotions so limiting processing potentialProcessing would be incomplete as they would have no scaffolding for the felt sense of time and so no place for the hippocampus to archive the experienceOther traumatic material is likely to flood the process

What resource would be needed first

We work with two aspects of timeExplanation to client with reference to evolution of the felt sense of time in humans and how it can be developed quite simply

ndash Flagging the present as a unique representation

ndash Using the arc of the present cues

ndash And developing a sense of continuity of being

Continuity of being through time

bull One of the main lsquoguy ropesrsquo holding the sense of the present steady

bull A felt sense To add to the other recognised senses

bull A template for organising onersquos experience

Sequencing

bull One can use sequences in various ways that seem to teach the brain to join the dots of experience

bull These can all help to develop the sense of continuity of being and groundedness in the present when required

Examples of use of temporal sequences

bull To create a life narrative (See Pace 2007)bull To create a therapy narrativebull To bridge a vacation gap where the client may feel

the absence of the therapist as a frightening chasm

bull To create a sense of lsquostretched out timersquo ahead when the client may be highly fearful of coping with an upcoming event such as a family funeral and it seems that time is compacted and the event unmanageable

References

Cozolino L The Neuroscience of Psychotherapy Healing the social brainDamasio A (1999) The Feeling of What Happens Body emotion and the making of consciousness New York Harcourt Pace P (2003 - 4th Edition 2007) Lifespan Integration Connecting ego states through time Available from wwwLifespanIntegrationcom or wwwLi-UKcouk Metzinger T (2009) The Ego Tunnel The science of the mind and the myth of the self Basic Books New YorkSani F (Ed) (2008) Self-Continuity Psychology Press New York and Hove UK Siegel D (1999) The Developing Mind How relationships and the brain interact to shape who we are Guilford New York

What resource would be needed first

We work with two aspects of timeExplanation to client with reference to evolution of the felt sense of time in humans and how it can be developed quite simply

ndash Flagging the present as a unique representation

ndash Using the arc of the present cues

ndash And developing a sense of continuity of being

Continuity of being through time

bull One of the main lsquoguy ropesrsquo holding the sense of the present steady

bull A felt sense To add to the other recognised senses

bull A template for organising onersquos experience

Sequencing

bull One can use sequences in various ways that seem to teach the brain to join the dots of experience

bull These can all help to develop the sense of continuity of being and groundedness in the present when required

Examples of use of temporal sequences

bull To create a life narrative (See Pace 2007)bull To create a therapy narrativebull To bridge a vacation gap where the client may feel

the absence of the therapist as a frightening chasm

bull To create a sense of lsquostretched out timersquo ahead when the client may be highly fearful of coping with an upcoming event such as a family funeral and it seems that time is compacted and the event unmanageable

References

Cozolino L The Neuroscience of Psychotherapy Healing the social brainDamasio A (1999) The Feeling of What Happens Body emotion and the making of consciousness New York Harcourt Pace P (2003 - 4th Edition 2007) Lifespan Integration Connecting ego states through time Available from wwwLifespanIntegrationcom or wwwLi-UKcouk Metzinger T (2009) The Ego Tunnel The science of the mind and the myth of the self Basic Books New YorkSani F (Ed) (2008) Self-Continuity Psychology Press New York and Hove UK Siegel D (1999) The Developing Mind How relationships and the brain interact to shape who we are Guilford New York

Continuity of being through time

bull One of the main lsquoguy ropesrsquo holding the sense of the present steady

bull A felt sense To add to the other recognised senses

bull A template for organising onersquos experience

Sequencing

bull One can use sequences in various ways that seem to teach the brain to join the dots of experience

bull These can all help to develop the sense of continuity of being and groundedness in the present when required

Examples of use of temporal sequences

bull To create a life narrative (See Pace 2007)bull To create a therapy narrativebull To bridge a vacation gap where the client may feel

the absence of the therapist as a frightening chasm

bull To create a sense of lsquostretched out timersquo ahead when the client may be highly fearful of coping with an upcoming event such as a family funeral and it seems that time is compacted and the event unmanageable

References

Cozolino L The Neuroscience of Psychotherapy Healing the social brainDamasio A (1999) The Feeling of What Happens Body emotion and the making of consciousness New York Harcourt Pace P (2003 - 4th Edition 2007) Lifespan Integration Connecting ego states through time Available from wwwLifespanIntegrationcom or wwwLi-UKcouk Metzinger T (2009) The Ego Tunnel The science of the mind and the myth of the self Basic Books New YorkSani F (Ed) (2008) Self-Continuity Psychology Press New York and Hove UK Siegel D (1999) The Developing Mind How relationships and the brain interact to shape who we are Guilford New York

Sequencing

bull One can use sequences in various ways that seem to teach the brain to join the dots of experience

bull These can all help to develop the sense of continuity of being and groundedness in the present when required

Examples of use of temporal sequences

bull To create a life narrative (See Pace 2007)bull To create a therapy narrativebull To bridge a vacation gap where the client may feel

the absence of the therapist as a frightening chasm

bull To create a sense of lsquostretched out timersquo ahead when the client may be highly fearful of coping with an upcoming event such as a family funeral and it seems that time is compacted and the event unmanageable

References

Cozolino L The Neuroscience of Psychotherapy Healing the social brainDamasio A (1999) The Feeling of What Happens Body emotion and the making of consciousness New York Harcourt Pace P (2003 - 4th Edition 2007) Lifespan Integration Connecting ego states through time Available from wwwLifespanIntegrationcom or wwwLi-UKcouk Metzinger T (2009) The Ego Tunnel The science of the mind and the myth of the self Basic Books New YorkSani F (Ed) (2008) Self-Continuity Psychology Press New York and Hove UK Siegel D (1999) The Developing Mind How relationships and the brain interact to shape who we are Guilford New York

Examples of use of temporal sequences

bull To create a life narrative (See Pace 2007)bull To create a therapy narrativebull To bridge a vacation gap where the client may feel

the absence of the therapist as a frightening chasm

bull To create a sense of lsquostretched out timersquo ahead when the client may be highly fearful of coping with an upcoming event such as a family funeral and it seems that time is compacted and the event unmanageable

References

Cozolino L The Neuroscience of Psychotherapy Healing the social brainDamasio A (1999) The Feeling of What Happens Body emotion and the making of consciousness New York Harcourt Pace P (2003 - 4th Edition 2007) Lifespan Integration Connecting ego states through time Available from wwwLifespanIntegrationcom or wwwLi-UKcouk Metzinger T (2009) The Ego Tunnel The science of the mind and the myth of the self Basic Books New YorkSani F (Ed) (2008) Self-Continuity Psychology Press New York and Hove UK Siegel D (1999) The Developing Mind How relationships and the brain interact to shape who we are Guilford New York

References

Cozolino L The Neuroscience of Psychotherapy Healing the social brainDamasio A (1999) The Feeling of What Happens Body emotion and the making of consciousness New York Harcourt Pace P (2003 - 4th Edition 2007) Lifespan Integration Connecting ego states through time Available from wwwLifespanIntegrationcom or wwwLi-UKcouk Metzinger T (2009) The Ego Tunnel The science of the mind and the myth of the self Basic Books New YorkSani F (Ed) (2008) Self-Continuity Psychology Press New York and Hove UK Siegel D (1999) The Developing Mind How relationships and the brain interact to shape who we are Guilford New York

Shapiro F (2001) EMDR Basic Principles Protocols and procedures GuilfordNew YorkSiegel D (2010) The Mindful Therapist a clinicianrsquos guide to mindsight and neural integration Norton New York Simeon D and Abugel J Feeling Unreal Depersonalisation disorder and the loss of the self (2006I Oxford New YorkStern D (2004) The Present Moment in Psychotherapy and Everyday Life Norton New YorkVan der Hart O Nijenhuis E and Steele K (2006) The Haunted Self Structural dissociation and the treatment of chronic traumatisation Norton New YorkWinnicott DW (1962) Ego Integration in child development in Maturational Development (pp 56-63) International Universities Press New York

nelnelwalkercom

References (continued)

• EMDR With Time on our Side
• Outline for the workshop
• Slide 3
• Slide 4
• Slide 5
• Slide 6
• Slide 7
• Slide 8
• Spacing of cues
• Temporal Sequencing to create distance from traumatic event bef
• Temporal Sequencing to create distance from traumatic event bef (2)
• Using the distancing in time sequence
• When to use temporal sequencing for distancing from traumatic e
• Two main categories of time disorder
• Two main categories of time disorder (2)
• Depersonalisation disorder
• Felt Sense of Time
• Continuity of being
• Felt Sense of Time (2)
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• Slide 24
• Slide 25
• What might alert us to this problem in an adult client
• What might alert us to this problem in an adult client (contin
• What might alert us to this problem in an adult client
• Can we do EMDR processing with such clients
• What resource would be needed first
• Continuity of being through time
• Sequencing
• Examples of use of temporal sequences
• Slide 34
• Slide 35