Welcome one four posts from the presenters for the Iowa Regional Network’s recent workshop on EMDR with Children and Adolescents in 2013.  Each of four Des Moines area EMDR therapists with expertise in child and adolescent treatment were asked to respond to the question of what they would have liked to know when first trained in EMDR.  Each discussed techniques and resources utilized in order to implement the 8 Phases of the standard protocol in working with children and adolescents.  I am delighted that they all agreed to post a summary of their presentation on this blog to benefit EMDR IOWA and the broader EMDR community.

Kellie Patterson LMSW is an experienced EMDR children’s therapist at Des Moines Child Guidance Center, Her compassion and creativity adds to her expertise in healing for children.  Here is a summary of what she shared with the group about working with the smallest of our trauma survivors:

Working with Infants and Toddlers

“Trauma affects people of all ages.  It is interesting how many adults assume that infants and toddlers are not affected by adverse events in their lives because they cannot explain in words what happened to them.  To further complicate this matter some adults project adult manipulative intentions onto these very little people’s behavior, not understanding that their children’s behavior contains the “words” of their experience. Adults tend to treat themselves in much the same way and expect themselves to, “suck it up” or “just get over it” or “just talking about it” will make it better.  If they could, if their children could, “just get over it” they would.

When we work with infants and toddlers we are working with the caregivers in their lives, the trauma’s these adults have experienced and how these experiences have impacted and continue to impact their relationships with their children (this includes foster parents as well). In order to be effective in therapy, gathering background information about the caregivers’ lives, experiences, traumas, beliefs, parenting skills is extremely important.

The first thing I wish I would have known when I started working with children and their caregivers is how important it is for them to be able to look at their children and themselves with “very soft eyes”.  Ultimately this is the ability to extend compassion, patience, and calm–to themselves as well as their children. A more behavioral way to say this is positively utilizing caregivers’ mirror neurons by exhibiting a calm, regulated, neutral, demeanor so that children can mirror that behavior back.

Interestingly, parents often comment that when they engage in exercises meant to keep themselves calm, their children’s behavior is more manageable.  In addition, regulating exercises that are meant for their children wind up helping caregivers to maintain their own sense of calm and well-being. When caregivers are calmer and more in control, the child’s anxiety is reduced and their behavior is positively affected.  In terms of successfully resolving trauma in therapy the relationship between the caregiver and the child must be calm, nurturing, reciprocal and supportive so that the relationship becomes the “container” for the child. Since I believe that resolving young children’s trauma is integrally connected to the relationships they have, I nearly always have the caregivers in sessions unless I am looking to gather or give adult information.

Exercises that encourage calm and regulated affect include those activities that are rhythmic, repetitive, and patterned: rocking in a rocking chair, singing nursery rhymes, playing pat-a-cake, marching, drumming, patting.  Exercises such as Children’s Yoga and Brain Gym encourage body awareness and bi-lateral processing.  Blowing bubbles, putting a book on a child’s tummy and “breathing” it to the ceiling encourages the ability to calm oneself.

Engaging in play strengthens the relationship between the caregiver and the child.  During therapy, playing games that allow the parent to be in control in fun ways is helpful.  Bilateral stimulation can be applied to strengthen the positive feelings between the parent and child that are occurring during the session.  These activities are part of “resourcing” and helping the parent to become the “container” the infant or toddler uses when feelings become intense and frightening.

When the parent/child relationship has become secure and regulated, resolving the trauma becomes possible. Discussing with the caregiver as well as observing symptoms and behaviors informs the items I choose to put out during a reprocessing session. The child can be trusted to use the items in such a way that the trauma is reprocessed.  My job is to attune to and support the child in their activity during the session of reprocessing.

I use bi-lateral stimulation while the child is engaged in playing with the items provided and allow their behavior to inform me about when it is being helpful. I provide verbal reflection about what I see occurring and what feeling(s) I observe and encourage the caregiver to do the same. Ultimately, although bi-lateral stimulation helps children to process through the trauma more quickly, it is the relationship between the caregiver and the child that makes the reprocessing possible.”  Kellie Patterson, LMSW

Thanks Kellie for the passion and heart for your work with children that comes through in your information for us.  You can put comments or questions here or contact Kellie at kpatterson@orchardplace.org.

Bonnie the Blogger