Episode 35: Understanding the Processing Continuum Framework in EMDR Therapy with Brittany Meredith

Welcome back to Your Clinical Supervisor’s Couch podcast, and I’m your host, Kayla Das.

In today’s episode, Brittany Meredith, Registered Psychologist and EMDR consultant will discuss the processing continuum framework in EMDR therapy.

Hi, Brittany. Welcome back to the show. I’m so glad to have you here again.

Hi Kayla. It’s nice to be back.

For listeners, if you haven’t had an opportunity to listen to Brittany’s previous episode, it was Episode 34: Strategies for History Taking Preparation in EMDR Therapy, which was just two weeks ago. So I recommend having a listen after you finish this episode

Brittany, just in case someone hasn’t had an opportunity to listen to the previous episode. Can you introduce yourself, tell us where you’re from, and tell us a little bit about your EMDR consulting journey.

For sure. Of course, my name is Brittany Meredith and I’m a registered psychologist in Alberta and an EMDR consultant and training coach. I work at Power Psychology and the training that we do is through Roy Kiessling’s EMDR consulting Group.

So my EMDR journey started in 2016 when I first got trained and then in 2018 I got trained with Roy Kiessling and pretty quickly became a consultant around that time.

Brittany, can you explain what the process continuum framework is and how it fits within the EMDR therapy model?

Yeah, so the processing continuum was developed by Roy Kiessling and it’s sometimes described in metaphorical terms as a three-speed blender or as an accordion kind of way that we can accordion in and accordion out during EMDR processing. So it helps us to choose how much we can process and how quickly.

Consists of restricted, contained, and unrestricted processing. Unrestricted processing is the gold standard or what most people know of EMDR and moves a client through the target sequence plan the most quickly by working through kind of anything that comes up from the identified negative belief network.

Contained processing is essentially working on one target at a time.

Restricted processing is more like desensitizing, where we use six to 10 classes of bilateral stimulation and focus on the subjective units of distress rating to help clients stabilize more quickly. So you can move between accordion in and out each of these speeds as needed.

So we might start with unrestricted and move to contained or restricted as needed. Or vice versa. So it makes EMDR a lot more flexible and responsive to client’s needs.

So how does the process continuum help clinicians make better clinical decisions during EMDR treatment?

It allows for a lot more choice. When there’s multiple speeds of processing, it allows us to switch gears, so to speak, and speed up or slow down as we see appropriate. So I believe this allows us to be more attuned to our clients, which helps us to make better clinical decisions.

So if we see that our client is becoming overwhelmed or flooded, or that they’re checking out or dissociated, we can adjust the speed of processing to help bring them back more into the process and be able to get through more processing, generally.

When I was first trained in EMDR, I only knew one speed, which was unrestricted. And that just doesn’t work as well, or with every client, especially for complex or dissociative client presentations. A lot of people just don’t have the capacity to do all of it all at once.

Oh, that makes a lot of sense. So how can therapists use a continuum to determine how to slow down, shift focus, or even return back to the preparation stage?

So if our clients are getting too far outside of their window of choice, getting into hyper arousal or hypo arousal, we can use a processing continuum to contain reduced distress, bring them back into the present and return to processing as needed.

In order to do EMDR processing, we need clients to be one foot in and one foot out, so to speak. And to take things one bit at a time to get through the processing. We call this titration and pendulation. And so if they’re two feet in or two feet out, processing can stall or be ineffective. So it gives us more control over the entire process of EMDR. And if we need to get back to preparation, we can say we’re doing unrestricted processing and they’re getting out of their window of choice or arousal.

Then we can narrow it down and switch into contained or restricted processing to help them reregulate and then go back into the preparation resources that we’ve developed.

In what ways is the process continuum helpful when working with complex trauma in particular?

I think that it makes EMDR a lot more effective when it comes to complex trauma. Oftentimes if people are only trained in unrestricted processing then they get afraid of going into complex trauma stuff, or I’ve heard some clinicians or clients say that, this person said that EMDR is not effective for me, or I’m not ready for it, or it’s going to be too much. So it makes EMDR a lot more accessible for a wider range of people.

So with complex trauma, sometimes we don’t ever get into unrestricted processing, so it’s important to have other options to be able to do any processing. It allows us to break experiences up into smaller pieces, processing them bit by bit so that clients can achieve more mastery and be more hopeful in the process. I think it also makes clinicians a lot more confident in being able to work through experiences with their clients.

You mentioned that some clients or therapists may say that specific clients are not, ready or EMDR is not a great fit for them. Can you give us a couple examples on when someone might not be ready to go into the processing continuum or who may not be a fit for EMDR specifically?

So if they don’t have the ability to identify a positive belief network, then that can be really hard to work with because EMDR is focused on, in some ways, integrating that negative belief work with the Positive Belief Network so that our brains learn to go to the positive beliefs associated with a particular event instead of the negative beliefs. So if they’re not able to identify that, then it becomes very difficult. It’s not impossible, but it just takes more work in the forefront to then help the client identify with particular positive beliefs.

If that comes up, it’s going to be more that they’re not ready for unrestricted processing. So the processing continuum makes it a lot more accessible for people. So like I said, even if they can’t do unrestricted processing, there’s still lots of ways that we can integrate EMDR or integrate EMDR principles without necessarily doing fully unrestricted processing.

I feel like there’s not a lot of cases that EMDR is strictly not a good fit because when we bring in the processing continuum, it can be so flexible.

I love that. And I think you said in our last episode that sometimes it could take weeks, months, and even years for some people to get to processing. So it sounds and please correct me if I’m wrong, that in some cases it’s not about who’s not a good fit for it, but when they might be ready for it.

Yeah. And I think it’s all about clinical judgment as well.

I love that. So how does this framework support, say flexibility in the process and then while also, continuing the phases that clients and therapists are expected to go through when it comes to the EMDR protocols?

So this framework allows us to get through the eight phases more effectively. While a gold standard is unrestricted processing, clients are not always able to achieve that if they can’t stay in the process. Or it becomes too overwhelming or causes clients to dissociate. Sometimes we pull in other approaches or move away from EMDR. We start to open up the client’s belief networks, I think it’s important that we can work through that material so the processing continuum makes that more likely.

So they don’t just have all this stuff opened up and we’re not able to contain it or help them get through it effectively. Where we can do these little bits and pieces and make it more effective or help clients and clinicians be more confident in their ability to work through it.

Fabulous. So what changes do you see in clinicians’ confidence once they have understood and able to apply the processing continuum in EMDR therapy.

So the processing continuum tends to be a huge game changer. We have lots of clinicians and consultations who come to light bulb moments when they understand the processing continuum and how to apply it. That helps them to be more confident in applying EMDR when they have more choice in the process.

And I think it makes clients more confident too and their ability to work through it because there’s so many options in how we can approach it and make it easier to work through.

I love that. Brittany, I know you offer EMDR consulting. Can you share with listeners how they can work with you?

Yeah, they can find me through Power Psychology website, www.emdrpower.com or through Roy Kiessling’s EMDR consulting list, which is emdrconsulting.com.

You can also find me on the EMDRIA website under their Find a Therapist Function.

So to access EMDR consulting with Brittany, head to emdrpower.com, or you could simply scroll down to the show notes and click on the link.

Brittany, thank you so much for joining us on the podcast today to discuss the processing continuum framework in EMDR therapy.

Thank you, Kayla. It’s been a pleasure.

I thank you everyone for tuning into today’s episode, and I hope you join me again soon on Your Clinical Supervisor’s Couch podcast.

Until next time, bye for now.