Alligning with Sr. Callista Roy’s (1970) Adaptation Model

While IEMT is not derived from Roy’s model, it aligns with its goal of promoting adaptation by recalibrating emotional responses to past experiences. This page explores how IEMT supports adaptation, drawing parallels with Roy’s Adaptation Model, and offers insights for practitioners and learners.

Sister Callista Roy¹⁾ is an influential figure in the modern nursing profession. After graduating from Mount St. Mary’s College with a Bachelor of Science in Nursing and Sociology, she went on to pursue her Master's and Doctorate degrees at the University of California, Los Angeles. She contributed greatly to the field of nursing science with her research into Adaptation Model(C. Riehl, 1980) (H. Andrews, C. Roy, 1991) of Nursing, which includes assessing patient health issues through understanding their adaptation patterns for better, more informed care.

Her concept has been cited by various scholars and forms the basis for many current approaches to health evaluation and assistance. Moreover, her Adaptive Model has been expanded overseas, providing the opportunity for research collaboration between nurses around the world. Sister Callista Roy’s exceptional scientific contributions have set new precedents in holistic nursing assessment, making her an esteemed professional in both American and international healthcare communities.

Nursing theories frame, explain or define the practice and delivery of nursing care. There are a number of prominent models in common use, and different models may be used according to the organisational needs and the provisional requirements of the patient group served.

Sister Callista Roy developed the Adaptation Model of Nursing²⁾ which quickly became regarded as a major nursing theory worldwide, especially in rehabilitation environments. Roy's model sees the individual as a set of interrelated biological, psychological and social systems. Whilst the individual strives to maintain a balance between these systems and the pressures of the outside world, an ideal level of balance is rarely found, thus the need for continual adaptation.

The Adaptation Model has been used in neurological rehabilitation units in a number of ways. Some examples³⁾ include:

• Assessing the impact of neurological injuries or conditions on an individual's physical, psychological, and social functioning.

• Developing treatment plans that address the unique needs and strengths of each individual, taking into account their personal goals and priorities.

• Evaluating the effectiveness of rehabilitation interventions by tracking changes in an individual's adaptation level over time.

• Providing a framework for collaborative care, where multiple healthcare professionals can work together to support the individual's adaptation and recovery.

• Educating individuals and their families about the impact of neurological injuries or conditions on their lives, and helping them develop coping strategies to manage any challenges they may face.

Health is not freedom from the inevitability of death, disease, unhappiness or stress, but rather is the ability to cope with them in a competent way.

Ivan Illich

We now act as if we really believe that disease, aging, and death are unnatural acts and all things are remediable. All we have to do, we think, is know enough (or spend enough), and disease and death can be prevented or fixed.

Faith T. Fitzgerald

The Adaptation model has four domain concepts of: (i) person, (ii) health, (iii) environment, and (iv) nursing;

The model views the person as “a biopsychosocial being in constant interaction with a changing environment”.

As in systems theory, a person is an open and adaptive system that uses internal coping skills to deal with environmental stressors. The environment is defined as “all conditions, circumstances and influences that surround and affect the development and behaviour of the person”.

Stressors are defined as stimuli and the model uses the term residual stimuli to describe those stressors whose influence on the person is not immediately clear. Many life experiences and events that are long over may continue to exert residual stress upon the individual.

Health is defined as the process of “being and becoming an integrated and whole person” and Callista Roy's goal for the delivery of nursing care is “the promotion of adaptation in each of the four modes*, thereby contributing to the person's health, quality of life and dying with dignity”.

*The four modes referred to are: (i) physiological, (ii) self-concept, (iii) role function and (iv) interdependence.

The physiological mode addresses the basic physical needs such as oxygenation, nutrition, elimination, activity, and rest. In IEMT, therapists can explore how changes in these physiological areas might correlate with emotional experiences, like how anxiety can disrupt sleep (rest) or increase heart rate (oxygenation).

IEMT can reduce physical stress symptoms like heart palpitations or muscle tension by altering the way memories are stored and recalled, improving health outcomes. For instance, a client with anxiety-induced insomnia might find relief as IEMT helps regulate physiological responses.

This mode focuses on the beliefs and feelings one holds about oneself, encompassing both the physical and personal self. In an IEMT setting, a therapist might help a client who views themselves as 'weak' to see their strengths, impacting their self-esteem and self-image.

IEMT assists in changing negative self-perceptions tied to traumatic memories, boosting self-esteem. For example, a client viewing themselves as “weak” due to past bullying could, through IEMT, reframe this to recognize their resilience, enhancing self-image.

Role function pertains to the social and familial roles an individual plays. For example, a person transitioning from being a student to a professional might struggle with their new identity. IEMT can facilitate this transition by addressing the emotional upheavals that accompany role changes.

By alleviating the emotional burden of past experiences, IEMT can improve performance in personal and professional roles. A parent struggling with past trauma affecting parenting could use IEMT to adapt, leading to better family dynamics.

Interdependence involves the balance and effectiveness of one's relationships. IEMT can be used to improve how individuals relate to others, manage dependencies, and promote healthier social interactions, such as enhancing communication skills in a marriage or between coworkers.

Enhanced emotional regulation and self-understanding can lead to healthier relationships and communication. A client with strained family ties due to unresolved grief might, through IEMT, develop stronger, more supportive networks, improving interdependence.

Embedded within the operating mechanism of IEMT is a fundamental assumption that holds a person as a dynamic being who is in constant interaction with the ever-changing environment. Human beings are an intricate design of biological, social and psychological factors, both internal and external.

While Integral Eye Movement Therapy (IEMT) is not directly based on Sr. Callista Roy’s Adaptation Model, it shares the common goal of promoting adaptation in individuals facing emotional challenges. IEMT, through its eye movement techniques, aims to help clients adapt their emotional responses to past experiences, thereby facilitating better mental and emotional well-being. This aligns with the broader concept of adaptation as described in various psychological and nursing models.

Every environment offers the individual resources, challenges, struggles and stressors of different forms and variable degrees thereby resulting in all consequential effects being subjective and occurring on a spectrum.

An important aspect of IEMT is an increase in resilience in order to get the client more effective to face, handle and adapt to the current environment. IEMT attempts to increase adaptability and maturity on part of the individual in order to manage life and its' ongoing complexities.

Being an “adaptive system”, a person has input from the environment, which is subject to internal processing, eventually leading to an output. Our model presumes that the individual uses both innate and acquired (learned) mechanisms to adapt. Some of these adaptations may bring about unintended negative consequences and may be termed maladaptive.

The environmental stimuli that present as a resource, challenge, stressor or any combination of these may have its’ origin in the historical biography of an individual. This, in turn, can exert an effect in the present through its psychological, physiological, emotional, social and/or environmental nature.

The Adaptive IEMT Model states that well-being is an integral and central feature of a person’s life, and can be represented on a well-being/distress spectrum. Along with health, well-being can be described as a state and process of being and becoming integrated and whole as a person, freed from the negative historical stresses and maladaptive responses.

Unlike EMDR, which focuses on processing trauma over multiple sessions, IEMT emphasises rapid emotional shifts, making it particularly suited for immediate adaptive challenges.”

1. Focal - current and specific stresses (extraneous pressures, intrinsic health issues) applied to the individual present in many or all contexts. The focal stimuli are those which attract the most attention from individuals (injury, divorce, debt, etc) or communities (such as a bombing, kidnap, environmental disaster, etc);
2. Contextual - all context-dependent stimuli, that is, those present in the background, and frame the situations that exacerbate the consequences of the focal stresses;
3. Residual - historical stresses whose after-effects continue into the current situation and affect the individual’s well-being. This may include attitudes, beliefs, and strong influences in the form of either people or experiences.
4. Prospective Stresses - can reasonably be known, anticipated, and expected prior to their occurrence.

With the IEMT model, well-being is affected when an individual’s adaptation fails to de-potentiate residual negative states resulting from historical environmental interactions and pressures. This in turn leads to specific maladaptive patterns, The Patterns of Chronicity, which inadvertently serve to maintain the residual negative state.

1. Focal - the presenting problem
2. Contextual - via reactive patterns of chronicity
3. Residual - past events and traumas that leave a residual kinaesthetic that affects well-being and behaviour in the present moment
4. Prospective - habitual responses to “routine” triggers

While the Adaptation Model provides the framework for what needs to adapt, Hans Selye's General Adaptation Syndrome (GAS) provides the biological mechanism for how the body responds to stressors over time. In IEMT, understanding GAS is crucial for identifying where a client is stuck in their trauma response.

Roy's Physiological Mode can be mapped directly onto Selye's three stages of stress response. IEMT interventions are often most critical when a client has moved from “Alarm” into “Resistance” or “Exhaustion.”

• Physiological State: The immediate “fight or flight” response. The body mobilizes resources (cortisol, adrenaline) to deal with a Focal Stimulus.
• IEMT Context: This corresponds to the formation of an Emotional Imprint. In a healthy adaptive system, this is a temporary state; the danger passes, and the system returns to homeostasis.
• Relevance: IEMT does not seek to prevent this stage, as it is a survival mechanism. However, if the emotion is not processed, the “alarm” remains active as a Residual Stimulus.

• Physiological State: The body attempts to adapt to the continued presence of the stressor. Physiological arousal remains higher than normal, but the individual appears to be “coping.”
• IEMT Context: This is the domain of Patterns of Chronicity. The client is expending massive amounts of energy to maintain a facade of normalcy while suppressing the emotional imprint.
• The Cost: This stage creates a high load of Contextual Stress. The individual may develop psychosomatic symptoms (headaches, tension) as the body diverts energy from long-term maintenance (digestion, immune system) to immediate stress management.

• Physiological State: The body's adaptive energy is depleted. The system can no longer maintain the resistance. Signs of burnout, depression, and chronic illness appear.
• IEMT Context: This is typically when a client seeks therapy. The “coping mechanisms” (Patterns of Chronicity) have failed or become too costly to maintain.
• Therapeutic Goal: IEMT intervenes here by accessing the original Imprint (from the Alarm stage). By neutralising the emotional charge of the memory, the demand on the system drops, allowing the body to exit the “Exhaustion” phase and return to a state of rest and repair.

In the context of the Adaptation Model, IEMT acts as a catalyst for Systemic Reorganisation. By removing the emotional “glitch” (the active memory trace) that keeps the system in the Resistance/Exhaustion phase, the therapist allows the physiological mode to naturally self-regulate back to a healthy baseline.

The Adaptation model proposes 3 levels of adaptation

1. Adaptive (systemic reorganisation) 2. Compensatory (part-system reorganisiton) 3. Maladaptive (failure to reorganise)

In the context of the Adaptation Model, the 5 Patterns of Chronicity identified in IEMT can be understood as specific maladaptive responses. While the individual’s system intends to adapt to environmental stressors (focal, contextual, or residual), these patterns represent a failure to achieve systemic reorganization. Instead of resolving the stressor, the system adopts a rigid, cyclical coping mechanism that maintains the problem rather than solving it.

Each pattern correlates with disruptions in the four adaptive modes (Physiological, Self-Concept, Role Function, and Interdependence).

• Maladaptation Type: Failure of the Interdependence Mode.
• Mechanism: The individual reacts to a stimulus (input) with a disproportionate emotional output intended to force the environment to change, rather than adapting the self to the environment.
• Adaptive Failure: The system bypasses internal processing and regulation, relying entirely on external validation or submission to regain stability. This prevents the development of internal coping skills.

• Maladaptation Type: Instability in the Self-Concept Mode.
• Mechanism: The individual utilizes linguistic uncertainty (“maybe,” “it might be,” “I'm not sure”) to prevent the nervous system from locking onto a specific identity or reality.
• Adaptive Failure: By refusing to acknowledge the current state of the system (the “is” state), the individual prevents the physiological mode from processing the reality of the stressor. Adaptation cannot occur because the system refuses to define what it is adapting to.

• Maladaptation Type: Hyper-arousal of the Physiological Mode.
• Mechanism: The individual projects a prospective stressor (a future negative event) that has not occurred. This generates immediate physiological anxiety (focal stimuli) in the present moment.
• Adaptive Failure: The system expends energy preparing for a threat that does not exist in the immediate environment. This creates a high Contextual stress load, leaving no energy available for adapting to actual, present-moment challenges.

• Maladaptation Type: Disruption of the Physiological Mode and Self-Concept.
• Mechanism: Even when the system has successfully adapted or the stressor is removed, the individual actively seeks out the “feeling” of the problem to confirm their identity or safety.
• Adaptive Failure: This is a failure to recognize the New Equilibrium. The system rejects the adaptive state (calm/neutrality) because it feels unfamiliar, interpreting the absence of the stressor as a threat in itself. It artificially re-introduces the Residual stressor to return to a familiar (albeit distressed) homeostatic baseline.

• Maladaptation Type: Collapse of the Role Function Mode.
• Mechanism: The individual perceives themselves solely as a passive recipient of environmental stimuli (“It makes me feel,” “He made me angry”).
• Adaptive Failure: This pattern denies the adaptive capacity of the individual entirely. By locating the cause of the state outside the system boundaries, the individual relinquishes the agency required to initiate biological or psychological reorganization. Adaptation is rendered impossible because the “control panel” is perceived to be in the hands of the environment.

1. The person is a dynamic system that operates within the web of biological, psychological and social influences.
2. The person is a product of his/her interaction with an ever-changing environment.
3. Well-being, eustress and distressing stressors are an in-built part of human life.
4. The environment is embedded with stressors and changes. Adaptation is not a choice, but a necessity for life.
5. The adaptation of an individual is a function of the relationship between the flexibility and skills of adaptation and the familiarity and degree of the stimuli.
6. All behaviours are learned within a socio-cultural context.
7. No symptom of distress exists in isolation from this context.
8. Maladaptive emotional responses can give rise to patterns of chronicity that inadvertently serve to maintain a distressed state and prevent natural healing across time.
9. There is a dynamic objective for existence with the ultimate goal of achieving dignity and integrity.
10. Movement of the eyes while thinking of an unhelpful memory changes the contents of the memory and the feelings/reactions attached to the memory.
11. A person can be reduced to parts for therapeutic change work and then needs to be looked at as part of the whole.
12. IEMT is based on the principle of causality. Feelings, emotions, roles, identities and events have a cause. Each experience sets up an effect in motion.
13. A patient’s behavioural, emotional and cognitive patterns can be challenged effectively by the IEMT model.
14. A positive and effective state of adaptation leads toward greater integration in an individual and also frees a person’s energy to respond to other stimuli.
15. A limitation of IEMT is to only be able to make changes to the body's conditioned reflex responses, IEMT cannot, for example, change the genetics of a body, although it is hypothesised that further research could well find epigenetic adaptations occurring as a result from working with PTSD clients.

The goal of IEMT is to free the client from the effect of negative memories, feelings of distress and constricted identities that restrict the fundamental idea of life which is to experience it fully. It is to know and imbibe that stressors are integral to living and our adaptability to them defines well-being. Therefore, IEMT gives an empowering choice to stay on the spectrum towards robust health, in all domains, physical, mental, social and spiritual.

The intention of IEMT is the integration of experience and maturing of identity thereby leading to increased well-being within the dynamic system called the human being.

An integrated individual with greater well-being is more contributive to self and their social environment invariably leading to a better quality of life.

1. Addressing a troublesome memory and mitigating the impact of unpleasant feelings
2. De-linking the cognate emotion-physiologic-memory web (separating stimuli and response) by identifying patterns of distress and specific stimuli
3. Increasing awareness of the maladaptive behaviours (“Patterns of Chronicity”) that hinder healing and evolution
4. Identifying triggers within the body-mind loop
5. Introducing choice towards any frame/ state of mind
6. Evaluation of the intervention in the real world

• Additional nursing models
• Orders of Adaptation
• Orders of Change