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Core Questions
Restoring Dignity:
Healing Culturally-Based Wounds
2014 EMDRIA Conference
Denver, CO
Mark Nickerson, LICSW
markinickerson.com
[email protected]
1. How can we build and maintain culturally
competent EMDR?
2. How can EMDRIA promote cultural
competence?
3. How can we as clinicians use EMDR to
effectively treat the effects of cultural-based
trauma?
EMDRIA Goal D
EMDRIA will be recognized for achieving and maintaining the
relevance of EMDR in a culturally diverse and evolving world.
Some strategies:
1.
Recruit, train, and retain as EMDRIA members clinicians that meet
diversity goals.
2.
Establish and maintain standards for cultural competence.
3.
Promote trainings that are accessible to diverse and underserved
populations and the practice settings that work with these
populations.
4.
Support the development of effective treatment strategies to
address the impact of social discrimination and culturally-based
adverse life experiences.
HAP training (2013): Charlotte, NC
Cultural Competence:
1. Cultural sensitivity
2. Cultural Humility
3. Responsiveness
4. Effectiveness
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What is Cultural Humility?
An attitude that includes:
• An awareness of the importance of culture
• Pride for one's own culture
• Yet the knowledge that the clinician's world
view is not universal
• An attitude that acknowledges that another’s
culture can best be appreciated by learning
from that person
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Psychotherapy
Individual
Si
Family,
Friends
Society.
Cultural Context
Social Work
Social
Psychology/
Sociology
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Multiculturalism
“Social forces define you before you can define
yourself”
Culturally based social identity is a profound
dimension of how people know themselves
and find meaning in the world.
“Stigma is the white noise of everyone's life”
Successful multiculturalism experiences for a
person includes the adaptive integration of
multiple social identities within the self and in
relationship to others
(client voices)
Clinical Relevance
Clinical Relevance
Social identities are often ascribed by others to
people with sometimes positive and too often
negative consequences.
Real external threats and unprocessed
disturbing memories impede successful
adaptive integration
Many clients have experienced culturally connected
adverse and traumatic events, often linked to and
reinforced by broader patterns of social
discrimination, and retain trauma templates in
the form of internalized oppression introjects.
Blocked successful adaptive integration can take
forms ranging from abandoning social
identities to “fit in” to isolating from
interactions with those perceived to be
unwelcoming
Parts of the self
• Social Identities can be understood clinically with familiar
concepts such as “aspects of the self”
• These “aspects” of the self have varying degrees of
meaning to any one individual
• These “aspects” carry state-based learning including
positive affirming dimensions and negative or disturbing
dimensions
• State-linked associations are activated when the social
identity “aspect” of self is accessed
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Oppression
The Psychological Effects of
Oppression
Research Supported Social
Effects of Oppression
Research Supported Psychological
Effects of Oppression- Intercultural
Being Oppressed
• Less employment, economic, political, medical
and educational opportunities.
• Cultural values of minority groups are
threatened by dominant cultures.
The Psychological Effects of
Oppression (Body, Mind and Spirit)
Being Oppressed
• Marginalized
• Isolation
• Defined as other than the norm
• Counter- stereotyping
• Dismissed/Disrespected
• Discriminated against both openly and subtly
The Psychological Effects of
Oppression
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Research Supported Psychological
Effects of Oppression- Internalized
The Impact
• Lower life satisfaction (research supported)
• Lose the ability to self-define
• Low Self-Esteem (often contextual)
• Self-hate
• Depression
Clinical Stance
“Traumatized people live the trauma not their lives”
Van der Kolk
Despite the fact that most psychotherapists have
egalitarian value structures, support diversity and
are aware of the importance of cultural forces on
a macro level, psychotherapy practice too often
ignores the additional "elephant in the living
room" of social-identity and tends to understand
and address disturbing life experiences within a
"culture blind" analysis of interpersonal trauma.
Michael Ventura
Clinical Stance
Clinical Stance
1. See the impact of social stigma and
prejudice
2. Understand it through the AIP model
3. Weigh it amidst other clinical goals or
obstacles
4. Integrate it into treatment as
appropriate
Types of
Social-Identity Based Oppression
•
•
•
•
•
•
•
•
•
•
Sexism
Racism
Ethnocentrism
Ethnic discrimination
anti-Semitism
Classism
Elitism
Heterosexism
Ageism
Adultism
• Physical appearance
discrimination
• Intellectual style or ability
discrimination
• Physical ability discrimination
(able-bodyism)
• Mental health discrimination
• Cool kids vs. “Geeks and
Nerds”
• Family different (never
married, single parents,….)
• Etc., etc.
The AIP guided EMDR approach can sensitively
and effectively reduce the impact of socially
reinforced stigma/oppression.
Internalized stigma/oppression and prejudice is
a manifestation of lack of information,
misinformation and dysfuntionally stored
information and can be treated.
Social stigma both creates and sits on top of core negative cognitions. While
stigma often hides cloaked in shame, its force is highly clinically relevant.
In two days EMDR work:
• a woman whose recent suicidal ideation was fed by
unaddressed trauma linked to being taunted as a child
about her weight. NC- "I'm worthless"
• a woman who grew up thinking of herself as "the kid
without a father". NC- "I'm damaged"
• a man who had to address masculine socialization before
he could fully grieve his mother's death. NC- "I'm weak"
• an alcoholic who only felt accepted in AA. NC- "I'm bad"
• a man who couldn't speak up because he had less formal
education than others. NC- "I'm powerless"
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EMDR can ....
• “...root out destructive cultural or generational
introjects”
• “...target the cultural transmission of racism, sexism, class
expectations, and the increasingly narrow parameters of
acceptable appearance, interests and personality. “
• “...transform the effects of the generational transmission
of destructive beliefs, identities and emotional states….”
Definition of terms:
• Social Identification- Identification of oneself through an
association to a social group (chosen or assigned).
• Entitativity- the degree to which members of a group are
bonded together in a coherent social unit (Campbell,
1958) (Relevant factors: group size, degree of spatial
proximity, amount of interaction, importance of
social identity, perceived common goals, outcomes
of group, interdependence, interpersonal bonds,
organization, behavior included among group
members)
• “...help people accept themselves even when they are
bombarded with external messages that they are
unacceptable.”
Robin Shapiro EMDR Solutions II (2009)
Definition of terms:
• Prejudice is a negative attitude or response pattern toward a group
or toward members of the group. It is the learned affective
component of intergroup attitudes. Prejudice can be implicit or
explicit.
Definition of terms:
•
Stigma- An ancient Greek term that referred to a sign, or mark burned into the
body, that designated the bearer as a person who was morally defective and
to be avoided. Stigma is a powerful social force which serves to control.
•
Social Oppression- The use of a powerful social “position” to exert power over
another. Oppression is typically backed by laws, institutional policies or other
strong means of enforcing ongoing power over the oppressed group.
Oppression is typically longstanding and deeply embedded in a culture.
•
Internalized Oppression Introject: A specific “frozen” psychic structure or
template that retains the characteristics of the traumatic oppression. This
structure becomes the template of a response system when stimuli related to
the content of this frozen structure is triggered. Though commonly noticed
for internalized impact, it can be projected in the form of externalized
discrimination.
• Stereotypes are the traits viewed as characteristic of a social group
of member of that group including the presumed knowledge,
beliefs, and expectancies about that social group (Hamilton and
Trolier 1986). It is the cognitive component of prejudice.
• Discrimination- Discrimination is the response linked to prejudice.
It can be thought of as the behavioral component of prejudice
though it includes any actions (explicit or implicit) including
avoidance.
Stigma and the fear of Stigma
“She has cooties!”
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Attachment: Developmental Stages
Most significant relationships
Infancy: Birth to 18 Mos.
Early Childhood: 18 Mos. to 3
Play Age: 3 to 5 Years:
School Age: 6 to 12 :
Adolescence: 12 to 18 :
a constant caregiver
parents
the basic family
the school/neighborhood
peer groups and larger world
Childhood and Society by Erik Erikson
Evolutionary and Developmental Role of Social Identity:
Understanding the acquisition of patterns of prejudice
(AIP consistent)
• Action Systems- Defense and Attachment systems are designed
for survival. Sociability/Affiliation system emerges later in
development.
• Evolutionary benefit- those seen as similar or having valuable
attributes can be helpful, trusted, sought after. Others to be
avoided.
• Essential for all age groups including infants to be able to sort
people quickly.
• Developmentally, kids show a particularly strong interest in
social categories and how they fit in at ages 7-11.
Two Primary Dimensions of Social Grouping
Ingroup
Outgroup
High-status
group
Nelson, Todd (ed.). Handbook of Prejudice,
Stereotyping, and Discrimination, (2009),
New York: Psychology Press.
Low-status
group
Information processing:
People tend to encode in memory their
observations of the behaviors of ingroup and
outgroup members differently.
Information processing:
People tend to encode in memory observed behaviors of ingroup and
outgroup members at different levels of abstraction
Toward those perceived as ingroup members,
people tend to:
• Retain more detailed information
• Biased toward retaining positive information
• Remember ways ingroup members are similar
and outgroup members are dissimilar
• Be more forgiving
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Behavior- Toward those perceived as ingroup
members, people tend to:
Information processing:
• Show preference with reward allocations and
esteem.
• Display more prosocial and cooperative behavior
• When there are limited resources, show greater
generosity and more personal restraint.
• Create a decreased sense of psychological
distance which facilitates the arousal of empathy.
People tend to:
• Encode undesirable actions of outgroup
members at a more abstract level (e.g. she is
hostile vs. she slapped the girl)
• Encode desirable actions of outgroup members
at more concrete levels (e.g. she walked across
the street holding the old man's hand vs. she is
helpful)
• Attribute positive behaviors and successful
outcomes to internal stable characteristics (the
personality) of ingroup than outgroup members.
Impact
Impact
• Individuals have difficulties due to seeing others
through the outgroup lens and/or by being seen
though the outgroup lens
• These cognitive biases help perpetuate social biases
and stereotypes even in the face of countervailing
evidence.
• Because positive behaviors of outgroup members are
encoded on the concrete level, they tend not to
generalize to reduce stereotypes. People don’t
remember that an outgroup member was helpful,
only that they did a helpful thing.
• Outgroup stereotypes containing information
pertaining to traits, dispositions or intentions are not
likely to be influenced by casual observing of counter
stereotypic outgroup behaviors.
• The use of pronouns like “we” and “they” alone can
influence reactions to the associated matters.
Impact
• fMRI studies indicate that prejudiced reactions
are linked to amygdala reactivity, as is trauma.
• EMDR is perfectly suited to reprocess the
foundations of learned prejudice and
internalized stigma/oppression
“Perspectives, affects and sensations are not
ephemeral ‘learned’ reactions, they are
manifestations of the stored memory and the
reactions to them.”
“Dysfunction persists because the negative
networks are unable to link up with the more
adaptive information. “
Francine Shapiro (2001)
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Eight Phases of EMDR
I.
II.
III.
IV.
V.
VI.
VII.
VIII.
Phase 1- Culturally Aware Psycho-social Assessment:
Affirming social identity, uncovering internalized social
stigma/oppression and prejudice
Social Identity:
Client History and Treatment Planning
Preparation
Assessment
Desensitization
Installation of Positive Cognition
Body Scan
Closure
Reevaluation
1. Are there aspects of your social or cultural life that you
are most connected to or proud of?
2. Are there any cultural or social groups that you identify
with (chosen social identities) that are important to you or
that seem closely linked to your values and who you are?
3. Are there any cultural or social groups that others identify
you with (ascribed social identities) and how has that
been for you?
4. Are there ways you have better understood yourself or
your difficulties by seeing yourself in a social/ cultural
context?
Phase 1- Assessment Questions Continued
Phase 1- Assessment Questions Continued
Stigma/ Oppression
1. Are there ways in which you have been affected
by social oppression or stigma during your life?
2. Do you have early memories of being avoided,
shunned, ostracized, devalued related to social
dynamics?
3. What were your earliest experiences related to
observing or being the victim of social stigma,
prejudice or stereotyping?
4. How did it impact you?
Phase 1- Assessment Questions Continued
Stigma/Oppression
9. What beliefs did you form about yourself as you
were growing up that might be linked to your
social experiences and/or socially based
trauma?
10. What caused you to come to these beliefs?
11. Can you see ways you may have internalized the
impact of social stigma/oppression?
12. (Create a Timeline of positive or negative
associations with issues)
Stigma/ Oppression
5 When did you first become aware of differences
between types of people (wealthy people and
poor people, different races)?
6 When did these differences take on negative
meaning?
7 How did members of your family handle
apparent differences between people?
8 What was it like experiencing these dynamics?
Phase 1- Assessment Questions Continued
Prejudice
1. Have you noticed that you carry any negative
belief/attitude/ prejudices toward others?
2. What caused you to come to these beliefs?
3. Do you see problems associated with
carrying these beliefs?
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EMDRIA workshop on Cultural Sensitivity 2010
Target selection-
RDI related:
• Build pride with social identity including pride on behalf of a social
group.
• Support external resourcing such as their connection to others who
share their social identity.
• Where ever possible, use standard
Three- Prong Protocol
Target identification related:
• Target personal experiences of cultural of trauma/insensitivity.
• Target fear of being cast out of the pack, rejection is the fear
• Target the secrecy associated with a cultural identity.
• Target the impact of larger issues traumatic to the social group (e.g.
AIDS)
• Identify specific current manifestations of
difficulties then case formulate for PastPresent-Future desensitization
Targeting considerations:
• Look for small “t” trauma (e.g. being excluded
at school).
• Look for a feeder socially dismissive
memories: Many people can access a memory
as a child of being dismissed because they
were “just a kid”.
• Target fear/trauma that keeps internalized
oppression in place. (e.g. breaking with the
ingroup's stereotype)
Potential Gateway Target
“What does stigma(or oppression) look like?”
Oppression is like smog, sometimes invisible
yet poisonous.
Anonymous client
As clinicians, we are the experts on toxic fumes.
We must be willing to name them when we
see them.
Uncovering the issue:
Internalized culturally reinforced negative
introjects:
Don’t wait for the client to see it.
Look for clinically relevant difficulties
Target that image knowing it may associate to
memories or past experience.
1. Woman’s lack of confidence in an all male workplace
2. Teenagers feeling of alienation to social issues
3. Hispanic man feeling his view point will not be
respected amongst Anglos
4. Heavy person being afraid to work out at a gym
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Uncovering the issue:
A direct approach:
Formulas
1. I am _____________________(social identity) and
that means I am ____________________________
2. As a _____________________(social identity), I feel
like I am ___________________________________
3. As a _____________________(social identity), I
should be_________________________________
Use of Two- Hand Interweave (Summary) full description in
Robin Shapiro- Solutions (2005)
Phase II- Resource Development
Increase mindfulness to issues, psycho-education
Identify and enhance:
• positive qualities that will support this exploration (e.g.
open-mindedness, courage, curiosity)
• pride and meaning found with social identities
• positive associations of standing up against discrimination
• moments of feeling free of the internalized stigma/
oppression
• memories of meaningful connection with someone of an
“other” group being there for client or the issue
Negative and Positive Meta-Beliefs
Purpose: To differentiate the “true self” from the negative or
positive cultural projection
Intervention:
• Put the “true self” and the “negative or positive cultural
projection” in different hands (e.g. “I should be thin like a
model” vs. “I’m fine as I am”) (administer sets of BLS)
• If client can see the distinction, then install the
spontaneously derived version of “I’m acceptable the way I
am.” and move on
• This may also lead to a spontaneous float back to the heart
of the distress
• If distress does not clear, target the disturbance
Develop more acuity to identify NC’s that are
linked to internalized oppression introjects
•
•
•
•
•
I’m a reject/ I don’t fit in
I’m out of it/ I don’t get it
I’m a weirdo
I’m a loser
I’m unimportant
• Expand the range of meaningful NC’s and PC’s
• Target link NC’s and PC’s to the social
identities
• Watch for an externalized negative cognition
when targeting a prejudice
Develop more acuity to identify NC’s that are
linked to internalized oppression introjects
• I cannot trust _______ (certain “type” of
people)
• I am less than ________(member of group of
people)
• I am different than _____(certain others) and
that makes me _________ (NC)
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Socially linked NC’s
• As a ________(e.g. woman, person raised
poor), I am __________ (NC)
• I am not good enough
• I don’t matter
• I am powerless
• I unsafe
High status group members can identify NC’s that are
linked to internalized cultural message
For a high status/dominant group member
• If I lose my status (power over)_________(low
status group), I will be _______________(NC)
• If I truly understand the experience
of________________(low status group member),
I will be _______________(NC)
Socially linked PC’s
• As a ________(e.g. woman, person raised
poor), I am __________ (PC)
• I am good enough
• I matter
• I can assume power
• I can protect myself
Effective PC’s
For people in dominant majority, identify any positive
response to the following beliefs and enhance with
BLS:
• My well-being is linked to the well-being of others
• I am connected to all people
• All people deserve respect
• I can become aware of my conditioned prejudiced
reactions and be OK
• Everyone deserves opportunity
• I can let go of social privilege and be okay
Phase 4 - Interweaves
Be prepared to offer culturally sensitive interweaves
• Are there ways in which being a ______ (e.g. black
man) impacted this situation?
• Do you think another woman/man in your position
may have felt that way?
• Do you see that large social forces came into play in
this situation?
• Do you feel this was socially just?
Anger and intolerance are the enemies of
correct understanding
Mahatma Gandhi
It is never too late to give up our prejudices
Henry David Thoreau
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Impact of prejudice on wellbeing and
mental health:
• Situational cues trigger prejudiced reactions increase
prejudicial/ internalized response
• Prejudiced behaviors include withdrawal, avoidance,
discounting, threatening, submission and can be
reflected in ways as subtle as facial expressions
• Internalized prejudice can fuel and "justify" aggressive
and passive aggressive behaviors including lying,
cheating, stealing and other behaviors thought of as
"sociopathic“
“…wanting to be non-prejudiced is
not the same as being nonprejudiced.”
Siri Carpenter “Buried Prejudice”
Scientific American Mind
• Self-fulfilling prophecies
Desensitization (impacting automatic/implicit response-amygdala)
Research supported
Early theory developed around prejudice by Gordon Allport
(1954) defines prejudice as having the following four
characteristics:
1. Negativity
2. Overgeneralization
3. Inaccuracy
4. Directed at others (or at an aspect of the self)
These components link to the four primary criteria for a negative
cognition about the self as used in Phase 3 Assessment .
Prejudice is effectively an externalized Negative Cognition
Mindful Attention
Research supported
Mindful attention to good information reduces prejudice
Divine’s model (1989) for breaking the bad habit of
prejudice requires:
• Sustained effort
• Motivation to respond without bias
• Awareness that the stereotype has seen activated
• Cognitive resources (attention and working memory) to
inhibit biased response tendencies with an intentional
non-prejudiced response
• Awareness, motivation and ability are necessary to
change responses
• Trying to overcome bias can lead to
overcompensation and hence discrimination
• People motivated to be non-biased tend to
avoid situations that might trigger bias
response- reverse by rehearsal and behavioral
goals
• Address fears of being seen as prejudiced
Resource and Perspective Building and Strengthening:
(addressing control/explicit response- PFC)
Research supported
Strengthening PFC awareness will decrease
stereotyping and increase regulating control
over amygdala based reactivity.
Research shows that low –prejudice people
must consciously “choose” to say "no" to
prejudice to bring significant change. We can
help people not apply prejudiced beliefs.
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Resource Development
Resource Development
Impacting automatic/implicit response-amygdala)
Research Supported
Impacting automatic/implicit response-amygdala)
Research Supported
BLS can be used to install the following research
supported strategies that reduce prejudice:
• Making Outgroups become Ingroups by finding
common ground
• Endorsing multiculturalism over color-blind
(“Exposure to a statement endorsing a
multicultural perspective on race relations led to
less in-group favoritism among White participants
on a stereotyping task, compared with exposure
to a statement endorsing a color-blind
perspective. Wolsko et al (2000))
BLS can be used to install the following research
supported strategies that reduce prejudice:
• Achieved identities can help overcome
ascribed prejudice (important for emerging
teenagers)
• Affirmations- link self-esteem with social
identity affirmations (positive cognitions)
• Positive Role models
Resource and Perspective Building and Strengthening:
Resource and Perspective Building and Strengthening:
(addressing control/explicit response- PFC)
Research supported
(addressing control/explicit response- PFC)
Research supported
Slow BLS can be used to enhance the following
research supported strategies that reduce
prejudice:
• Positive, meaningful intergroup contact
experiences that defy group boundaries
• Increased intergroup knowledge
• Realization of shared identities and other
commonalities
Slow BLS can be used to enhance the following
research supported strategies that reduce
prejudice:
• Overt rejection of the stereotypes related to
specific category reduce activation
• Thinking about counter stereotypic examples
• Motor reinforcement – (e.g. simple smiles while
viewing Black faces diminished implicit bias)
Desensitization
Desensitization
(impacting automatic/implicit response-amygdala)
Research Supported
(impacting automatic/implicit response-amygdala)
Research Supported
Desensitizing amygdala responsiveness will
reduce prejudice
• Those with high self-esteem view out-groups
more positively- link to personal strengths
• Low-prejudice people learn from mistakes
To manage autonomic responses:
• Consistently pair the goal of being egalitarian
with the presence of the stereotyped person
(goal-triggering stimulus) Bargh and Gollwitzer,
1994) EMDR possibilities.
• Pairing control goals (non-biased responding)
with goal-relevant stimuli (bias eliciting group
members)
• “Primes” can be used- pictures-
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Prejudices generally contain a negative
cognition about the target
• Clients were asked to identify initial NC’s about
the group/person targeted by the prejudice
before identifying an NC about the self
Positive Cognitions about the “other”
• Upon completion of the session, clients were
asked to identify a PC about the group/person
targeted at the close of the session
• Rationale: The NC’s about others are a key
component of the prejudice. “Naming” them can
assist with more full reprocessing. It is often an
illuminating step to identifying resonant NC’s
about the self
• Rationale: Complete reprocessing should go
beyond a restored PC about the self in regards to
the issue. A refreshed and resonant PC about the
originally targeted group/other creates a deeper
shift in awareness. When installed and combined
with a future template, change is likely to be
more profound
Targeting Prejudice
Program Objectives:
Mark Nickerson
• Identify Prejudice or subject of prejudice
• Identify E NC (externalized NC about the
targeted other)
• Identify NC (about self)
• Complete Assessment and Desensitize
• Install PC (about the self)
• Identify and install a E PC (about other)
• Future Template related to the target issue
Participants at this workshop will be able to:
1. Describe the importance of cultural awareness in
assessment and intervention
2. List clinical examples of difficulties related to internalized
stigmatization, oppression and prejudice
3. Describe the common link between internalized
oppression/prejudiced beliefs and traumatic/disturbing
life events
4. List Phase 1 and 2 considerations in the treatment of
internalized stigmatization, oppression and prejudice
5. Select appropriate targets for topic-related EMDR
desensitization
Report of the Practicum Experiences of EMDR
clinicians from the training entitled:
EMDR Protocol for Targeting Prejudice and
Hostile Externalized Beliefs
See handout
Mark Nickerson
Undoing Stigma: EMDR Applications in the
Dismantling of Socially Based Internalized
Oppression and Prejudice
Theory, Examples and Practicum
Mark Nickerson, LICSW
markinickerson.com
[email protected]
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Workshop Format
• A total of 60 EMDR clinicians participated in four
workshops.
• Each seven-hour workshop consisted of a
morning session which included a two-hour
didactic overview and discussion of the topic of
social identity and the impact of traumatic and
disturbing life events associated with
stigmatization and oppression.
• This was followed by an hour and a half long
practicum, in which participants were asked to
identify and reprocess a personal issue related to
stigmatization/oppression.
Practicum 1
Practicum 1 clients were given the following instructions for targeting
internalized stigma/oppression:
• Identify a current example of a current problematic issue related to
internalized stigma/oppression or simply identify a past related
trauma. Identify a disturbing memory related to that issue. or
Identify a past disturbing incident associated with stigma/oppression
• Guide questions to identify target issue:
• Are there ways in which you are being/ have been affected by social
stigma/ oppression during your life?
• Do you have early memories of being avoided, shunned, ostracized,
devalued related to social dynamics?
• What were your earliest experiences related to observing or being
the victim of social stigma, prejudice or stereotyping?
Most common target issues:
•
•
•
•
•
•
Socioeconomic status, social class
Racial discrimination
Gender- sexism and male conditioning
Sexual orientation, gender identity
Age
Other experiences of exclusions
• The afternoon session of the training included an
hour and a half didactic overview and discussion
on the topic of prejudice including a protocol and
videotapes of clients identifying and reprocessing
memories associated with a prejudiced belief.
• In practicums, participants were asked to identify
a personal prejudice. The followed a
recommended protocol to further identify the
externally focused negative beliefs associated
with the prejudice and to identify and reprocess
personal memories that appeared to be
associated with the learned prejudice.
Social Identities identified in the initial
Phase 2 exercise included:
•
•
•
•
•
•
Therapist
Younger wife
Divorced person
African-American
"Social outcast"
Asian
•
•
•
•
•
•
Mother
Musician
Hispanic/ Latina
Being poor
Working women
Portuguese
Target Issues/ Memories
• Boys don't cry
• No ethnic identity
• Father telling me as a woman I couldn't go to
medical school
• Being a Colombian woman
• "Girls are not allowed to try things“
• Not being recognized as Latina by other
Latinos
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Target Issues/ Memories
• Ageism with colleagues – dismissed,
marginalized, demeaned
• I never felt smart enough or good enough
• Women earn less than men
• Being the only woman in the department as a
young woman
• Being assigned a life role
Negative and Positive Cognitions
NC: I don’t belong
PC: I'm accepted, I'm acceptable
NC: I am different and that's bad
PC: It's okay to be different
Negative and Positive Cognitions
NC: My value is based on how much I have.
PC: My value is not related to money
NC: It doesn't matter how smart I am, I can't realize my
potential. I can't succeed.
PC: There aren't any impediments to my succeeding or
completing things. I don't need to keep myself back
NC: I'm not good enough, something's wrong with me
PC: I'm competent, and comfortable with myself
Emotion:
• When it came to accessing the related, the
primary emotions identified were fear, shame,
sadness and hurt. Also mentioned were
panic, embarrassment, anger, alone, and
anxious.
NC: I am not like other boys, I am not lovable
PC: I am who I am and whatever that is, it's okay
Body Sensations
• 25% indicated that they felt disturbance in
their throat a region.
• Speculation: Might this be related to the
trauma linked inability to express oneself?
Pre and Post session SUDS
• 75% of participants identified an initial SUDs of
five or above
• At the end of the session, 85% of participants
reported a final SUDs under two
• 67% reported that they completely cleared the
disturbance associated with the target memory
altogether.
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8/3/2014
Practicum 2
Experimental Protocol for targeting the issue of Prejudice: A few steps
are added to the standard protocol to increase activation during the
assessment phase so as to best address the identified problem of
hostile attitudes and prejudice.
“I have worked a fair number of people of color
and never thought ought to target
stigmatization so directly. I’m eager to do so.“
Participant
Issue Themes Included:
•
•
•
•
•
•
•
Age
Wealthy people
Nationalism
Race/Ethnicity
Appearance
Political views
Other ways people seem “different”
What did you find interesting about
the session? Client Summary
• Prejudice in one's life goes back to themes early
in life
• So many connections between a prejudice and
current behavior
• Connection to being bullied and carrying racial
prejudice
• Profound shift as a targeted prejudice of
severely handicapped people. Instant
(connected) float back to age 7 (memory)
• Fading of the image
Prejudice: Identify a current manifestation of a prejudice directed
toward another or a group of others linked to a negative learned
social belief (a prejudice).
Guide questions:
• Have you noticed that you carry any negative belief/attitude/
prejudices toward others?
• Do you see problems associated with carrying these beliefs?
• Alternative: Target attitudes/ prejudice toward aging/the elderly,
etc.
Pre and Post session SUDS
• 80% of participants identified an initial SUDs
of five or above
• At the end of the session, 85% of participants
reported a final SUDs under three
• 67% reported that they completely cleared
the disturbance associated with the target
memory altogether.
What did you find interesting about
the session? Client Summary
• The added sections of saying out what one
believes about "the other" was great
• Helped me to get underlying feelings
• The connection between the floating back
experience and the cultural prejudice
• The "double layering" of NCs and PCs
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8/3/2014
Did you notice shifts in understanding as a result of
the session? Client Summary
• Consistent “Yeses”
• I may be able to think more about individual wealthy people
and their behavior rather than making a blanket judgment
• Feeling more curious about members of group I have been
avoiding.
• Realizing I am making more connections then I realized in my
life.
• Clarity about seeing essence of person beneath physical
attributes, easing of fear regarding self becoming fat
• Profound
Did you notice shifts in understanding as a result of
the session? Client Summary
• Everyone's different
• Yes, shifts in clients understanding of her own
empathy capacities
• Brand-new, very different PC came up after
original one was installed.
• I can comfortably explore this issue (topic) and
my own life and with others
• Yes, I didn't realize how much I had aligned with
the oppressor
• (Link to) feelings about myself
Did you notice shifts in understanding as a
result of the session? Therapist Summary
• Consistent “Yeses”
• She became better able to feel compassion for overweight
people. To see beyond the physical to who the person is
• He saw things about his bigoted family, (himself as a)
scared kid (led to) more understanding, compassion
• More confidence regarding self being able to positively
navigate aging process
• Initial tension led from insight to empathy and
understanding of target selection
• She recognized that her prejudice is minor and
manageable.
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