Draft discussion paper
Similarities and differences between AIT and EMDR
by Michelle Shapiro and Jill Martin
Introduction
Two experienced practitioners who are both trained in EMDR and AIT were considering the similarities and differences in their working with both modalities.
We found that what we were achieving in terms of releasing disturbing trauma memories, sensations and trauma charge with both modalities was similar. We consider that it is possible and probable that all the trauma therapies or energy psychology methods are achieving this too.
The purpose of this paper is to explore the similarities and differences between EMDR and AIT as a base for further discussion with colleagues. Please note this paper does express our own personal experiences and observations.
Principles underpinning Trauma work
The core underpinning principles of these modalities are:
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The body holds the score – and it this holding of trauma which produces the autonomic nervous systems response of fight, flight or freeze (sometimes the only viable option).
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Memories are stored in associative memory networks, and are the basis of perception, attitude and behaviour. Experiences are translated into physically stored memories and stored memory experiences are contributors to pathology and to health of the individual.
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Mind-body divide does not exist as such.
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The neurobiological system is intrinsic, physical and adaptive.
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We are self-healing, self-regulating systems if it is at all possible, and that it is the presence of trauma in its ‘frozen’ state that impedes this natural self-healing process.
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Talking alone, whilst aiding insight, is not sufficient to shift the core frozen hub of trauma.
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The unfreezing or releasing of this trauma allows the natural healing process to resume.
Similarities
Theory
EMDR talks explicitly about the neuro-biology and using memory networks within the brain, and AIT does too. Both approaches work with the stored images and full range of sensations associated with the target trauma, along with the resulting negative core beliefs elicited.
Both hypothesise and ‘trust’ that the system has its own coordinating and healing intelligence. This includes that the associative memory networks ‘know’ what to do, during the treatment, and that it ‘knows’ how to continue with the healing once the trauma is released. We get out the way to let the system do its own ‘intelligent’ healing.
The basic concepts for this adaptive information processing are set out in appendix 1. (see below)
Set up and Process
Both EMDR and AIT focus on working with the mind and body, where AIT also considers the transpersonal.
Clinical Outcomes
Both EMDR and AIT focus on releasing trauma and allowing the system to heal itself following trauma release.
Differences
Theory
EMDR talks about trauma being experienced all over the mind and body, as does AIT, however AIT also looks at the transpersonal or spiritual aspects.
A critical component of the information processing in EMDR is that the target trauma being treated shifts between consciousness of the left and right hemisphere through bilateral stimulation. The early EMDR hypothesis was that the brain needed eye movement to start reprocessing, replicating REM sleep. It was subsequently discovered as long as there was bilateral movement the processing occurred, this included processing by tapping, buzzing etc. AIT does not focus on bilateral stimulation as the method or means to release the trauma charge. AIT proposes that the target trauma is held and released from the major memory centres located all the way down the centre of the body from the crown to the root. Contact is made by the client focussing on, or even touching, each of their own memory centres, for example, placing the hand over the heart centre in the centre of the chest.
With EMDR considerable preparation work is done in stabilising and resourcing the client to be strong enough to do the trauma work. With AIT there is an understanding that a strong ego is critical to doing significant trauma work. AIT works to strengthen the ego through controlled, focussed ‘minor’ trauma work and building positive core beliefs and qualities eg courage, self compassion, or trust.
In working through a trauma EMDR trusts the associative memory networks to go wherever the associative chains take them (‘go with the flow’), so neither the client nor therapist takes conscious or active control of the process, and both trust the flow. EMDR accepts the appraisal of the person they are working to assess if the subjective units of disturbance or distress (SUDS) are coming down. AIT uses muscle testing to inform and confirm the treatment process and results, and this offers an additional measure of efficacy.
EMDR implicitly trusts the coordinating intelligence and associative chains to achieve the desired outcome. AIT is explicit in its conceptualisation of this intelligence, and in collaborative working with this intelligence. With AIT this collaborative relationship is central to the work and begins as early in the process as possible. In AIT this coordinating intelligence is named ‘The Centre’.
EMDR recognises that the past impacts on the present, and by treating past traumas there is an improvement and resolution of the after effects, and manifestations of that past trauma in the present. AIT is explicit in the aftereffects and manifestation of past trauma in the present, and addresses this directly within the therapy formulation through the protocol known as the 3 step transformation. Within this protocol the past trauma is treated, the present manifestation is treated, and the associative link between the two is treated independently. AIT proposes it is only with the resolution of this connection between the past and the present that a trauma driven compulsive pattern is released or dissolved. For example a child who was ignored in childhood finds themselves ignored in their adult relationship(s) and with the recognition that ‘I am ignored in the present’ at least in part, is because that pattern was set up in childhood and they do not now have the skills or confidence to change this.
Set up and Process
Here the main differences are in the set up and processing of the trauma, and not the outcome, which are still similar.
EMDR uses the bilateral stimulation to establish safety and then work with trauma memories, following the flow of what is offered, ‘go with that’. AIT offers attention to multiple trauma foci, by using memory held in major memory centres all the way down the centre of the body. One such memory centre is the heart, the heart seems to have its own mini brain, which was discovered when the recipient of a heart transplant started having confirmed memory flashbacks of the donor. If the heart has its own little brain, so does the gut, which seems to have a vast and complex neural network, comparable to the brain. These memory centres are also described in Indian healing tradition as chakras.
AIT uses muscle testing developed in Applied Kinesiology, as an integral form of working with the body, the unconscious mind and connecting with ‘the internal healing intelligence’, (named the Centre in AIT). Muscle testing is a naturally occurring bio-feedback mechanism; we naturally weaken to ‘No’, or ‘False’, (a person being told ‘No they cannot’, is weakened or depleted), whereas it is naturally strengthening if something is ‘True’, or ‘Yes’ (a person being told ‘Yes you can’ is energised and enlivened). This is currently largely experiential but there is a growing evidence base of the accuracy of muscle testing.
As with EMDR, and many other approaches, AIT is working on the assumption that we are naturally self healing, self regulating systems if at all possible. Trauma interferes with this regulation, and trauma methods release the trauma charge ‘held’, ‘trapped’ or ‘frozen’ within the person, allowing self regulation to resume.
AIT uses and relies upon muscle testing as an integral form of working with the body and the internal intelligence, ‘the Centre’. The Centre, is consulted and encouraged to guide the treatment, by means of the muscle testing, alongside established psychotherapeutic clinical judgement and formulation. By doing so AIT allows exquisite control of the process and pacing in the treatment of traumas, and brings attention to safety in every engagement.
EMDR does not use the process of muscle testing, however it could readily be integrated into the practice.
Clinical Outcomes
EMDR has established a solid empirical evidence base, ensuring well deserved confidence in this method. AIT has a strong anecdotal evidence base, however has not been as efficient at conducting empirical research. This is a current failing on the part of AIT and is being addressed.
EMDR is assessed to be effective for a wide range of presentations including major trauma. There is however a caution within EMDR to work with people with complex early attachment trauma, which may be diagnosed as a personality disorder. AIT also works with a wide range of presentations and does not exclude working with people who have experienced complex early attachment trauma. This allows, with time and care, a resolution of the rigidity of the defences of a person with a personality disorder, reducing the suffering of all involved.
Discussion
AIT offers more direct client and clinician control over the material accessed, where EMDR trust the associative chains to take the treatment where it needs to go. This is a key strength but also a potential weakness in the EMDR process. It is a strength in that what needs to be reached, is reached. The weakness lies in that neither the clinician nor client knows exactly where this process will take during the ‘journey’. This is viewed as a potential weakness in that the ego may not be strong enough or ready to confront or address this material. The experience can lead to surprising and powerful emotional abreactions, which they may not have anticipated and were not mindfully prepared for.
It is to avoid this distress that EMDR responsibly spends considerable time strengthening client internal resources. (memories may be surprising shocking for the client who may feel re-traumatised at the valuable material they find themselves unexpectedly facing).
AIT encourages small manageable trauma treatments as the very means of resourcing the client and strengthening the ego functioning.
There seems to be less emotional abreaction; and again more control in the speed of discharge and of the focus of the material being treated.
EMDR works on distant past trauma as well as more recent trauma – but advises against working with current trauma. AIT would offer trauma treatment around current trauma, but in discreet and manageable ‘bite size’ chunks allowing the person to at least not have the ‘load’ of the past trauma in every moment in the current ongoing experience. For example a woman who has experienced, and is still experiencing, domestic violence is strengthened by any manageable trauma treatment so that the ongoing challenges have less and less of the past load. Perhaps it is only with this continuing reduction of the traumatic load that she will ever be in a place to be able to consider change.
AIT relies upon muscle testing to determine what the client and ego are strong enough to work with at each session.
AIT has a structure formulation of past trauma impacting on current functioning and difficulties with a clear connection between the past and the present. This is the AIT three step transformation which is the heart of AIT formulation and treatment. A woman who is fearful of authority figures is likely to have been fearful of a parent authority figure and we hypothesise and treat that she is fearful of current figures because of her fear of the past authority figure.
EMDR remains solidly neuro-biologically driven, where AIT has become all inclusive of every aspect of a person, including emotions, thoughts, core beliefs, body sensations and embraces the transpersonal as an important aspect of our experience.
Conclusion
Trauma is prevalent everywhere in our current stressed world. All trauma treatments and all trauma treating modalities are therefore invaluable. At present two major modalities are both achieving comparable outcomes in terms of healing and recovery each having unique strengths as well as weaknesses in what they offer. EMDR has achieved a solid evidence base making it the most readily recognised treatment of choice, with AIT still in the process of establishing an empirical research base.
Appendix 1
Adaptive Information Processing Model - basic concepts
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The neuro biological information processing system is intrinsic, physical, and adaptive.
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The system is geared to integrate internal and external experiences.
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Memories are stored in associative memory networks and are the basis of perception, attitude and behaviour.
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Experiences are translated into physically stored memories.
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Stored memories are contributors to pathology and health.
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Trauma causes a disruption of normal adaptive information processing which results in unprocessed information being dysfunctionally held in memory networks.
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Trauma can include DSM IV Criterion A events and/or the experience of neglect of abuse that undermines an individuals sense of self worth, safety, ability to assume appropriate responsibility for self or others, or limits ones sense of control or choices.
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New experiences link into previously stored memories which are the basis of interpretations, feelings and behaviours.
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If experiences are accompanied by high levels of disturbance, they may be stored in the implicit/non-declarative memory system. These memory networks contain the perspectives, affects and sensations of the disturbing event and are stored in a way that does not allow them to connect with adaptive information networks.
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When similar experiences occur (internally or externally) they link into the unprocessed memory networks and the negative perspective, affect and/or sensations arise.
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This expanding network reinforces the previous experiences.
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Adaptive (positive) information, resources, and memories are also stored in memory networks.
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Direct processing of the unprocessed information facilitates linkage to the adaptive memory networks and a transformation of all aspects of the memory.
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Non-adaptive perceptions, affects and sensations are discarded.
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As processing occurs, there is a shift from implicit/non-declarative memory to explicit/declarative memory.
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Processing of the memory causes an adaptive shift in all componentsof the memory, including sense of time and age, symptoms, reactive behaviours and sense of self.
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The Adaptive Information Processing model explicit within EMDR, and implicit in other trauma therapies such as AIT, distinguish them from other forms of psychotherapy by viewing the present situation producing distress as a trigger for a past unprocessed incident. The current event appears to stimulate the memory network, causing stored negative emotions, physical sensations and perspective to emerge, typically without conscious control.
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EMDR’s procedures have been developed to access the dysfunctionally stored experiences and stimulate the innate processing system, allowing it to change the information to an adaptive resolution, shifting the information to the appropriate memory systems.
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This processing is at the heart of every EMDR treatment.