I'm a KKiC by Dr. Robbie

I'm working on a new project to help children with cancer and the families who care for them. I have a workbook written collaboratively with my daughter. The new workbook is called, "I'm a KKiC" on kids kicking cancer. I also have a second workbook to help children and families with resources during the medical journey that includes creating resources to help with what can be intrusive and traumatic medical procedures. Stay tuned for the workbooks to be available to the public.

Pay it Forward

I find great wisdom and joy in reading quotes.
I am sharing these two quotes because I have had many reminders
over the last several days of the incredible people in my life and
the challenges I have over come because I have so many loving people to support me.

As I can never repay the debt I owe to the people who have loved me,
supported me, challenged me and demanded that I be true to myself
while striving to be who I have the potential to be,
I can only try to repay my debt to the amazing people in my life
by sending out to others this kindness and love.

So today on "Youth Day" in South Africae where the we celebrate
the activities of school students who contributed to the end of Apartheid,
I thought that writing about joy and paying it forward seemed apropos.



Live.
Breathe.
It is not fear that we need to live by, but joy, hope.
Inside you, in your ocean, maybe it seems barren;
maybe it feels as if there is no hope, no kindness,
no reason for happiness.
But deep within you, undeniably, something rumbles,
cries out, wants to be born.
Allow the joy to come forward.
Allow the hope to exist.

Maharaji



Hope is a state of mind, not of the world.
Hope, in this deep and powerful sense,
is not the same as joy that things are going well,
or willingness to invest in enterprises
that are obviously heading for success,
but rather an ability to work for something
because it is good.

Vaclav Havel

A Proposal for an EMDR Reverse Protocol

Introduction

As a psychologist for the child welfare system working with severely and chronically traumatized children and families, and as a psychologist for law enforcement, I returned to my office following my EMDR Basic Training I struggled to implement the protocol with my clients. In my 25 year career, I cannot recall ever encountering one client with a single incident trauma. So how then could I use EMDR? Because literature has discussed that EMDR trauma reprocessing (Phases 3-7) must be delayed due to the client’s need for extended resource development and skills to manage intense affect, I initially abandoned case conceptualization with EMDR because time and external resources did not afford my clients the opportunity to complete the entire targeting sequence plan. My clients were consistently presenting with intense and complex trauma histories.

I continued to provide psychotherapy as I had practiced all along, while I also explored opportunities with clients to develop resources to prepare for trauma reprocessing with EMDR. Yet I noticed that many clients still struggled because they had no hope for the future. Many clients had been in therapy and believed that therapy was to help them learn to cope with symptoms. EMDR offered the opportunity for the client to reprocess symptoms so those symptoms no longer would be present in the future; however, most clients could not imagine a future at all, let alone a future with no mental health symptoms.

The children referred from the child welfare system adamantly avoided the past because they were young and their pasts were horrendous. In addition, the future was not something these children could imagine nor was the present a pleasant existence for many of them either. Many clients struggled to exist in the moment and to cope with each day. I struggled to integrate EMDR into my practice even though I was working with severely and chronically traumatized clients who needed EMDR.

So how could I think conceptually through Shapiro’s Adaptive Information Processing (AIP) theory in my treatment approach and yet not focus on reprocessing past events first? Could I help clients with those horrendous past events that were maladaptively stored in the client’s memory thereby preventing the client from seeing any kind of future at all? It was evident to me that many of my clients came to psychotherapy for symptom relief without the expectation of a healthier, happier future. Was it possible for me to assist my clients to reprocess the client’s foreshortened sense of future that was driven by the past events they had experienced?

What is the EMDR Reverse Protocol?

The Reverse Protocol is the EMDR 3-Pronged Approach targeting in reverse order - Future-Present-Past. This protocol uses all 8 phases of the standard protocol. It is not beginning therapy with a future template or resource development (Korn & Leeds, 2002; Leeds, 2001). Some who are familiar with Solution Focused Brief Therapy (SFBT) (de Shazer, Berg, Lipchik, Nunnally, Molnar, Gingerich, & Weiner-Davis, 1982) will recognize a flavor of focusing on the solution rather than the problem in that this EMDR reverse protocol focuses on addressing the client’s negative beliefs about the future before reprocessing past traumas. This reverse protocol reprocesses the anxiety and negative cognitions about the future before reprocessing present triggers followed by reprocessing past events. Many clients with trauma, dissociation and depression exist in survival mode and cannot participate in past trauma reprocessing because they experience life through the lens of trauma with a foreshortened sense of future. These clients need extended psychotherapy focused on skill building, affect regulation, and developing emotional intelligence in which the client can identify and tolerate intense emotions. Past trauma cannot be reprocessed without significant time in the Preparation Phase of EMDR. Another potential for case conceptualization is to reverse the temporal order of the targeting sequence plan. This idea still considered that maladaptively stored information from the client’s history were driving current symptoms; however, the client was not developmentally capable of focusing on trauma reprocessing about the past until the client could imagine a future.

This is the essential proposal for a Reverse EMDR Protocol

1. The Reverse Protocol is about a beginning therapy by reprocessing future targets before present triggers and past events. Treatment begins with identifying a positive future and the negative cognitions about why the client cannot consider the future and/or does not entertain a future free of symptoms. Future reprocessing is also a resource focused on the client anticipating using replacement behaviors integrated with plans for what to do in the future when you have these symptoms. The therapist might ask the client, “How do you see the future without these symptoms that brought you into treatment? What prevents you from accomplishing this future goal (NC)?”.

2. Present symptoms: While reprocessing the future targets, therapy simultaneously monitors triggers, stressors and the use of self-soothing/self-calming skill. After the client has reprocessed negative cognitions, emotions, and body sensations about the future, then present triggers are reprocessed.

3. Past events: Past events/targets are reprocessed using the standard protocol. This still includes reprocessing the past target, present triggers and completing the target by installing a positive future template consistent with the standard EMDR protocol. Essentially the temporal order of therapy is future-present-past (reverse protocol) and then past-present-future (standard protocol.) Why use the reverse protocol and the standard protocol? The therapist may consider the Reverse Protocol because the client cannot initially manage the standard protocol.

If you are interested in learning more about the Reverse Protocol, please listen to one of my trainings, attend a new one, or look for this complete article to be published.

Why not?

"Why not?" has been my life mantra! Why not get a Ph.D. when I was told "Girls don't go to college!" Why not have children? When I was told, "You will never carry a baby to full term!" Why not write a book? When I was told that, "You will need to hire a professional writer, if you want to publish a book." I have said "why not?" so many times, that a dear friend gave me note pads that are inscribed with "Why not?"

In my half a century of life, I have encountered many obstacles that at first appeared insurmountable. Maybe I'm just stubborn!?! Yes, I am absolutely stubborn! There are so many things in life worth fighting for and supporting because it's the right thing to do! My career is about fighting for children and families and helping people pursue happy healthy lives. So today when my teen daughter was watching a new MTV show called, "The Buried Life," I was intrigued and delighted! After all the shows about what young people do wrong, here is a group of four young men committed to helping the world. I'm so pleased that MTV is airing something I would encourage everyone to watch! These young men show vitality for life and commitment to improving the lives of others - one person at a time! Congratulations to them for doing something that doesn't usually get noticed or make the news - people doing good in the world. Everywhere you look - the news, media, environment, it is easy to get saddened by the horrors in the world! It is much harder to find the good in the world! Hoorah for MTV in showing young people with great hearts!

I have been blessed with a wonderful family and three children of whom I am very proud! I continue to be challenged by my list of, "Why nots?"

So if you're reading this, I hope that you will check out "The Buried Life" at http://theburiedlife.com/about/ especially if you need something to brighten your day and maybe even make you chuckle! Yes there a few bleeps from the mouths of young men, but these are young men who are shining examples of the good in people!!

What's on your list of "Why nots?"

February is National Teen Dating Violence Awareness and Prevention Month

National Teen Dating Violence Awareness and Prevention Month
http://www.ncjrs.gov/teendatingviolence/index.html


http://www.ncjrs.gov/pdffiles1/ojjdp/227744.pdf
“Peer and sibling victimization. Six types of victimization, including being attacked by a group of children; being hit or beaten by another child, including a brother or sister; being hit or kicked in the private parts; being chased, grabbed, or forced to do some¬thing; being teased or emotionally bullied; and being a victim of dating violence.”

Not Safe In My Own Backyard

Am I Safe in My Own Backyard?
The need to teach children personal safety.
Robbie Adler-Tapia, Ph.D.

In one day I took referrals from three different frantic parents who had learned that their young child had been sexually assaulted by a classmate, a cousin and even an older sibling. The devastation that these and many families experience is often accentuated with, “I didn’t know!” These are often well-educated and healthy families who didn’t know to teach their child about the risk the child had in their own backyard. I decided that I could no longer stay in my office providing mental health services to children after they had been traumatized, when perhaps a call or an article might help parents learn about this risk to children and most importantly, prevent another child victim. As a psychologist who specializes in working with young children, the frustration that parents and children are not being educated about the risk that children pose to other children compelled me to write this article.
How often do we consider how safe our children are in their own homes, schools, and backyards? We install pool fences, use car seats, and cover electrical outlets. Parents and schools often teach children about stranger danger, drugs and alcohol, and even AIDS. In our schools we even teach children about bullying and give children strategies to get along with other children, but when do we teach children to protect themselves from people and children they know? When do we help children learn about their personal safety from other people and especially from other children? How do we give children skills to protect themselves?
The statistics support my concern that we are missing some of the greatest risks to our children. For example, statistically the likelihood of a child between the ages of birth to twelve years being harmed by someone they don’t know is less than 14%. It is significantly more likely that a child will be molested by a family member or someone known to the child than by a stranger.

Except for victims under age 6, most sexual assault offenders were not family members but were otherwise known to the victim.
Sixty percent of all sexual assault offenders were classified by law enforcement as acquaintances of the victim. Just 14% of offenders
were strangers to their victims. Strangers were a greater proportion of the offenders of adult victims (27%) than juvenile victims (7%).
The youngest juveniles were least likely to have an offender who was a stranger. Just 3% of the offenders in the sexual assaults of
children under age 6 were strangers, compared with 5% of the offenders of youth ages 6 through 12, and 10% of offenders of juveniles
ages 12 through 17. (pp 13) “That is, 40% of the offenders of victims under age 6 were themselves juveniles. A similar proportion (39%)
of offenders of victims ages 6 through 11 were also juveniles. “ (pp. 8)
http://www.ojp.usdoj.gov/bjs/pub/pdf/saycrle.pdf

We don’t want children to become anxious or fearful all the time, but rather empowered to act if it ever becomes necessary. So what can you do as a parent or someone who cares about children? Most kids say to me, "I didn't know." Many children don't have the words or the conceptualization to tell about yucky feelings from other kids. But, how many parents or schools teach children how to protect themselves from other children? What can you as a parent do to teach your child how to be aware in order to protect themselves even from people with whom they feel safe?
EDUCATION AND PREVENTION!!!!!!!!
1. Talk to your child about personal safety.
a. BOOKS: Those Are My Private Parts by Diane Hansen. One of my favorite books that I think every child should read over and over.
b. LINKS: http://darkness2light.org/docs/Final7steps.pdf
2. Take classes for you and your child.
a. www.radkids.org radKids Personal Empowerment Safety Education. Have your child take classes on personal safety.
b. www.thejoyfulchild.org/ This is an organization to teach personal safety.
3. Make a plan with your child! AND, practice, practice, practice.
4. Contact local authorities. Many incidents are not reported to local authorities so juvenile perpetrators go undetected. People don’t want to tell because of shame or fear of retribution from the juvenile perpetrator and/or his/her family. If you don’t notify the local authorities, this juvenile perpetrator will not get the help he/she needs and will continue to offend. These juvenile perpetrators need help and need to be prevented from hurting others. Treatment is our best option while also protecting any future victims.
These are just a few recommendations to help you get started in teaching your child personal safety. I’m not suggesting that this is the only way to give your child additional tools or that this will prevent every child from being hurt, but we do need to start somewhere. As a parent it is important to be cautious, but not overprotective.

Upcoming Workshop

TREATMENT OF ATTACHMENT TRAUMA AND
THE DISSOCIATIVE
SEQUELAE THROUGH THE LIFE SPAN:
EMDR AND CASE CONCEPTUALIZATION
Presented by
Robbie Adler-Tapia, Ph.D.
Psychologist,

EMDR Institute Facilitator,

EMDRIA Approved Consultant
EMDR-HAP Trainer
Co-Author: EMDR and the Art of Psychotherapy With Children
Co-Sponsored by
The EMDR Institute and Windermere Counseling
March 12 & 13 2010
4851 S. Apopka Vineland Rd
Orlando, Fl 32819

To Register Contact: Reg Morrow reg@cfl.rr.com

WORKSHOP
When earliest relationships are traumatic, attachment injuries can significantly change the trajectory of one’s life. Bonding and attachment are neurobiologically driven survival mechanisms; but when irreconcilable conflict exists within the innate mechanisms of survival and attachment, individuals can experience extreme distress leading to mental health disorders and physical disease. Although these conditions may begin in infancy, if untreated they can endure for a lifetime. It is so essential that attachment disruptions be addressed in both children and adults experiencing complex trauma reactions, including Axis II conditions and dissociation. EMDR provides a comprehensive, integrative, and effective approach to the treatment of attachment and the dissociative sequelae.