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manual [2024/04/25 08:17] – [Story Examples] andrewtaustinmanual [2024/10/16 16:16] (current) – [Application of IEMT Techniques to Pain Management] andrewtaustin
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 ===== Organisation of Training and Delivery ===== ===== Organisation of Training and Delivery =====
  
-{{ :diagram.png?800|}}**Advisory Board**+{{ :diagram.png?600 |}}**Advisory Board**
  
   * **Role**: Guides and advises the Trainer and Director for the Project.   * **Role**: Guides and advises the Trainer and Director for the Project.
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 This introductory exercise is designed to lay a practical foundation for managing basic eye movement techniques in therapeutic settings. It also helps participants become sensitive to the emotional aspects of therapy. The session prepares them for more advanced topics in the training, including a deeper exploration of trauma and its kinesthetic manifestations. This introductory exercise is designed to lay a practical foundation for managing basic eye movement techniques in therapeutic settings. It also helps participants become sensitive to the emotional aspects of therapy. The session prepares them for more advanced topics in the training, including a deeper exploration of trauma and its kinesthetic manifestations.
  
-  ==== Module 2: IEMT Kinaesthetic Pattern ==== +==== Module 2: IEMT Kinaesthetic Pattern ==== 
-    * Understanding Kinaesthetic Pattern Questions + 
-    * Techniques for Professional Delivery+=== Understanding Kinaesthetic Pattern Questions === 
 + 
 +The Kinaesthetic Pattern (hereafter, "The K-Pattern") 
 + 
 +Elicit the undesired state (whole being) or kinaesthetic expression (part body feeling) 
 + 
 +  * Ask the client to assign an amplitude scale (1 – 10). “…and out of ten, how strong is this feeling, with ten being as strong as it can be?” 
 +  * Ask: “…//and how familiar is this feeling//?” 
 +  * Ask: “...//and when was the first time that you can remember feeling this feeling… now… it may not be the first time it ever happened, but rather the first time that you can remember now//…” 
 + 
 +Allow the client 20-40 seconds to access the imprinting event. Do not offer guidance or advice and allow the client to perform his or her own kinaesthetic transderivational search. 
 + 
 +  * When the client has accessed their earliest recollection, ask, “...//and how vivid is this memory now//?” 
 + 
 +Instruct the client to hold that memory vividly in their mind for as long as possible… 
 + 
 +Guide the client in performing eye movements through the different access points. 
 +Periodically reminding the client that “…//and if this memory fades, try very hard to bring it back…try as hard as you can to retain that experience//…” 
 + 
 +Continue until the client protests that they cannot retain or recall visual memory, or for a maximum of 40 seconds, which occurs soonest. 
 + 
 +  * Test 1. Ask, “...//and how does that memory feel now//…?” 
 +  * Test 2. Ask, “…//and what happens when you try to access that feeling now//?” If the imprint event still triggers negative kinaesthetic, repeat the process. 
 + 
 +Test 3 (optional). Ask: “...//and when you think about event now, what feeling comes up for you now//?” 
 + 
 +If a negative kinaesthetic emerges, then repeat the basic process and locate the next imprint. 
 + 
 +---- 
 + 
 +=== Techniques for Professional Delivery === 
 + 
 +Using as few words as possible and keeping strictly to the script is essential, and it is important not to get sidetracked by side issues, chit-chat, and rapport-building, as this can be counterproductive to the overall approach. 
 + 
 +Some general guidelines in delivery: 
 + 
 +  * Sit opposite but slightly off-centre from the client. When guiding the eye movements, your finger should be around 18 inches from the patient's face. 
 +  * An upward-pointed finger, or pen, is better than using a "pointing finger" that points directly at the client. 
 +  * The movement speed will be around 1 second per left-right-left sweep ("double sweep"). This can be slowed a little for a client who demonstrates slower processing, as revealed in their communication style, kinetic movements, etc, i.e. slower speech and overall bodily movement. 
 +  * It is important that the finger sweeps are broad enough to move the eyes to their peripheries. 
 + 
 + 
  
 ==== Module 3: Addressing PTSD ==== ==== Module 3: Addressing PTSD ====
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 <blockquote>**The lynchpin**, a central tenet in IEMT, refers to a pre-trauma personality characteristic that was previously inconspicuous but has become a key causative factor in the individual's PTSD following a traumatic event. This once innocuous trait now serves as a catalyst, triggering intense and distressing flashback experiences when the individual encounters similar contexts or experiences that involve this trait.</blockquote> <blockquote>**The lynchpin**, a central tenet in IEMT, refers to a pre-trauma personality characteristic that was previously inconspicuous but has become a key causative factor in the individual's PTSD following a traumatic event. This once innocuous trait now serves as a catalyst, triggering intense and distressing flashback experiences when the individual encounters similar contexts or experiences that involve this trait.</blockquote>
 +
 +=== Addressing the Lynchpin ===
 +The common thread in PTSD is the attempt to retroactively alter the past or revert to their pre-trauma selves, hoping to change the outcome and seeking understanding from others. Unfortunately, while the focus is often on the aftermath, the internal struggle to amend a perceived fault goes unnoticed. This pattern is crucial to identify as it forms the basis of the therapeutic intervention.
  
 //It is essential to discern true PTSD, which aligns with the DSM-5 criteria, from conditions that may superficially resemble it but do not fulfil the formal diagnostic requirements. This distinction underscores the need for precise clinical evaluation and avoids conflating self-diagnosed PTSD with that which is clinically established.// //It is essential to discern true PTSD, which aligns with the DSM-5 criteria, from conditions that may superficially resemble it but do not fulfil the formal diagnostic requirements. This distinction underscores the need for precise clinical evaluation and avoids conflating self-diagnosed PTSD with that which is clinically established.//
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 Pain is a complex sensory and emotional experience that plays a critical role in protecting the body from harm. Understanding the pathways through which pain signals are transmitted to the brain is essential for clinicians managing trauma and combat injuries. Pain is a complex sensory and emotional experience that plays a critical role in protecting the body from harm. Understanding the pathways through which pain signals are transmitted to the brain is essential for clinicians managing trauma and combat injuries.
  
-===== Types of Pain Signals =====+==== Types of Pain Signals ====
  
 Pain signals are initiated by nociceptors, specialized sensory receptors that detect damage or potential damage to tissues. These signals are primarily of two types: Pain signals are initiated by nociceptors, specialized sensory receptors that detect damage or potential damage to tissues. These signals are primarily of two types:
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   * **Neuropathic Pain**: This type of pain is a result of damage to the nervous system itself, which can alter pain perception. It might be experienced as a burning, shooting, or stabbing sensation.   * **Neuropathic Pain**: This type of pain is a result of damage to the nervous system itself, which can alter pain perception. It might be experienced as a burning, shooting, or stabbing sensation.
  
 +{{ :pain-classification.png?900 |}}
 ===== Transmission of Pain Signals ===== ===== Transmission of Pain Signals =====
  
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   * **Modulation**: At the spinal cord, neurotransmitters can either amplify or dampen the pain signal.   * **Modulation**: At the spinal cord, neurotransmitters can either amplify or dampen the pain signal.
   * **Perception**: The brain interprets these signals as pain, influenced by both physical and psychological factors.   * **Perception**: The brain interprets these signals as pain, influenced by both physical and psychological factors.
 +{{ :napkin-selection_1_.png |}}
 ==== Types of Pain ==== ==== Types of Pain ====
  
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   * **Acute Pain**: Immediate pain resulting from injury, lasting less than six months. It serves as a warning mechanism.   * **Acute Pain**: Immediate pain resulting from injury, lasting less than six months. It serves as a warning mechanism.
   * **Chronic Pain**: Persistent pain that lasts longer than six months and can continue even after the injury has healed.   * **Chronic Pain**: Persistent pain that lasts longer than six months and can continue even after the injury has healed.
-  * **Burn Pain**: Typically acute and intensely painful due to nerve damage. Requires immediate pain relief and long-term management.+  * **Burn Pain**: Burn pain is typically acute and intensely painful due to nerve damage. It requires immediate pain relief and long-term management.
   * **Crush Injuries**: Can result in both nociceptive and neuropathic pain. Initial severe pain may transition to chronic pain syndromes if nerves are damaged.   * **Crush Injuries**: Can result in both nociceptive and neuropathic pain. Initial severe pain may transition to chronic pain syndromes if nerves are damaged.
   * **Visceral Pain**: Originates from internal organs; often difficult to localize. Typical in blunt force trauma to the abdomen.   * **Visceral Pain**: Originates from internal organs; often difficult to localize. Typical in blunt force trauma to the abdomen.
-  * **Somatic Pain**: Arises from skin, muscles, bones, and joints. More localized; caused by direct trauma. +  * **Somatic Pain**: It arises from skin, muscles, bones, and joints. It is more localized and caused by direct trauma. 
-  * **Referred Pain**: Pain felt in a part of the body other than its actual source, important for diagnosis. +  * **Referred Pain**: Pain felt in a part of the body other than its source, which is important for diagnosis. 
-  * **Phantom Limb Pain**: Occurs after amputation where pain is felt as though it comes from the amputated limb.+  * **Phantom Limb Pain**: This occurs after amputation, and the pain is felt as though it comes from the amputated limb.
   * **Psychological Pain**: Emotional distress that exacerbates physical pain symptoms, requiring holistic care.   * **Psychological Pain**: Emotional distress that exacerbates physical pain symptoms, requiring holistic care.
-  * **Inflammatory Pain**: Signifies tissue damage and inflammation, sustained by biochemical substances.+  * **Inflammatory Pain**: Signifies tissue damage and inflammation sustained by biochemical substances. 
 + 
 +===== Gate Control Theory of Pain ===== 
 +The gate control theory of pain, proposed by Ronald Melzack and Patrick Wall in 1965, is a revolutionary theory that provides a new framework for understanding the mechanisms of pain perception and modulation. This theory challenges the traditional view of pain as a simple sensory experience. It introduces the concept of a "gate control system" that regulates the flow of pain signals to the brain. 
 + 
 +===== Overview of the Theory ===== 
 +The gate control theory proposes that pain signals from the periphery (e.g., skin, muscles, organs) are modulated by a "gate" mechanism in the dorsal horn of the spinal cord. This gate can either facilitate or inhibit the transmission of pain signals to higher brain centres, depending on the interplay of various factors. 
 +The key components of the gate control theory are: 
 + 
 +The gate control system: A functional unit located in the spinal cord's dorsal horn that regulates pain signals' flow. 
 +Afferent fibres: Sensory nerve fibres carry pain signals from the periphery to the spinal cord. 
 + 
 +Small-diameter, slowly conducting fibres (C-fibers) transmit dull, burning, and chronic pain signals. 
 +Large-diameter, rapidly conducting fibres (A-beta fibres) transmit sharp, localized pain signals and non-noxious stimuli like touch and pressure. 
 + 
 + 
 +Descending fibres are nerve fibers that originate in the brain and descend to the spinal cord, modulating the gate control system. 
 + 
 +===== Mechanism of Gate Control ===== 
 + 
 +According to the theory, the gate control system functions as follows: 
 + 
 +Pain signals from the periphery travel through the afferent fibres (both C-fibers and A-beta fibres) to the dorsal horn of the spinal cord. 
 +The gate control system in the dorsal horn can either allow or block these pain signals from reaching the brain. 
 +The activity of the gate is modulated by the relative activity of the afferent fibres: 
 + 
 +Increased activity in the small-diameter C-fibers tends to open the gate, facilitating the transmission of pain signals to the brain. 
 +Increased activity in the large-diameter A-beta fibres tends to close the gate, inhibiting the transmission of pain signals to the brain. 
 + 
 + 
 +The descending fibres from the brain can also influence the gate control system, either facilitating or inhibiting the transmission of pain signals. 
 + 
 +===== Implications and Applications ===== 
 + 
 +The gate control theory provided a new understanding of pain modulation and had several important implications: 
 + 
 +It explained how psychological factors, such as attention, emotion, and past experiences, can influence pain perception by modulating the descending fibres that control the gate. 
 +It provided a theoretical basis for non-pharmacological pain management techniques, such as transcutaneous electrical nerve stimulation (TENS), which activates the large-diameter A-beta fibres and can close the gate, reducing pain perception. 
 +It highlighted the importance of considering both the sensory and emotional components of pain, leading to the development of multidisciplinary pain management approaches. 
 + 
 +While the gate control theory has been refined and expanded upon over the years, it remains a fundamental theory in pain research. It has contributed significantly to understanding pain mechanisms and developing effective pain management strategies.
  
 ==== Management Implications ==== ==== Management Implications ====
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   - The pain that is current   - The pain that is current
   - The pain that is anticipated   - The pain that is anticipated
 +
 +{{ :napkin-selection_2_.png |}}
  
 In addition, the practitioner needs to consider the response to the pain, which may be adaptive or maladaptive. Pain leads to suffering, and in some instances, alleviating the pain does not necessarily change the experience of suffering, depending on how the person has adapted to it. Alcohol and drug use, self-harm, social withdrawal, self-pity, etc, may continue long after pain has been alleviated. In addition, the practitioner needs to consider the response to the pain, which may be adaptive or maladaptive. Pain leads to suffering, and in some instances, alleviating the pain does not necessarily change the experience of suffering, depending on how the person has adapted to it. Alcohol and drug use, self-harm, social withdrawal, self-pity, etc, may continue long after pain has been alleviated.
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 ===== 3. Application of Mirror Visual Feedback (MVF) ===== ===== 3. Application of Mirror Visual Feedback (MVF) =====
-  ==== Part 1: Pre-Assessment ==== 
-    * Comprehensive Assessment Protocols 
  
-  ==== Part 2: Assessing the Phantom ==== +==== Part 1: Pre-Assessment ====
-    * Techniques for Effective Assessment +
-    * Distinguishing Between Pain Sources+
  
-  ==== Part 3: Stages of the Treatment Session ==== +The pre-assessment process is not a substitute or alternative to any prior medical assessment but rather assesses the likelihood that the MVF process will be the best choice for the patient with phantom limb pain. The principles outlined here are not exact nor universal, as there will be counterexamples to the generalisations offered here. Experience has shown that prior failure with MVF does not necessarily mean that MVF won't work for that individual, but may well just indicate the delivery of MVF was carried out erroneously. 
-    * Detailed Steps from Patient Expectation through to Reunion with Limb Image+ 
 +Mirror Visual Feedback will be most likely to be effective when the following criteria are met: 
 + 
 +  * The phantom limb image is distorted from a healthy limb image. This may be a gross injury retained in the limb image, phantom contractures, or abnormal positioning. 
 +  * The limb is mobile. This mobility may be willed or involuntary. 
 +  * The limb image changes when pain occurs. 
 +  * Sensorial "remapping" has occurred - hands to face/neck, lower limb to genital area. 
 + 
 +Mirror Visual Feedback will be less likely to be effective when: 
 + 
 +  * The limb image is normal. 
 +  * The phantom has no movement. 
 +  * No sensorial remapping has occurred. 
 +  * The limb image is fixed and unchanging, even when pain occurs. 
 + 
 +The length of time that the person has suffered phantom limb pain appears to have no relationship to the outcome. 
 + 
 + 
 +==== Part 2: Assessing the Phantom ==== 
 + 
 +==== Initial Patient Assessment ==== 
 + 
 +In the context of phantom limb pain, a comprehensive initial medical assessment is crucial. Typically, patients will have undergone detailed evaluations to establish an accurate diagnosis. However, clinicians must know that some individuals might be "poor historians" for various reasons. They may agree with the examiner's suggestions without critical reflection due to a desire to please, may lack insight into their symptoms, or find it challenging to articulate their physical sensations. These factors can complicate the diagnostic process. 
 + 
 +Phantom limb pain is pain that feels like it's coming from a body part that's no longer there. Clinicians should recognize that this condition is not monolithic but potentially multifactorial with overlapping pain types: 
 + 
 +  * **Neuromas**: Nerve endings at the amputation site may form neuromas, which can become painfully sensitive. 
 +  * **Stump Pain**: Pain at the amputation site can arise from various sources, including skin irritation, muscle spasms, and bone pain. 
 +  * **Bone Pain**: Can be due to bone spurs or other irregularities at the amputation site. 
 +  * **Psychogenic Pain**: Sometimes, the pain may also have psychological contributors, reflecting the complex interplay between mind and body post-amputation. 
 + 
 +These various pain experiences might coexist, making it critical not to view the patient's condition through a binary lens of "either/or" but rather consider a "both/and" scenario in which multiple factors may contribute to the pain. 
 + 
 +<blockquote>//**So, the scenario may arise that a person has a phantom limb that is otherwise pain-free, but the neuroma pain projects into it. In this instance, the MVF treatment is unlikely to be productive.**// 
 +</blockquote> 
 +==== Part 3: Stages of the Treatment Session ====
  
 The patient progresses through eight observable stages when using the mirror box.   The patient progresses through eight observable stages when using the mirror box.  
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 **Stage 1. Patient expectations and anticipation** **Stage 1. Patient expectations and anticipation**
  
-The patient unfamiliar with MVF use will likely have their preconceptions of what will follow in terms of the experience and the clinical outcome. It should be noted that patients with the most amount of distress and the most to gain may be apprehensive and fearful that the method will be ineffective, and clinicians should note that the greater the distress, then the greater the level of disappointment and added distress will be in the event of MVF proving to be ineffective.+The patient unfamiliar with MVF use will likely have their preconceptions of what will follow in terms of the experience and the clinical outcome. It should be noted that patients with the most amount of distress and the most to gain may be apprehensive and fearful that the method will be ineffective, and clinicians should note that the greater the distress, the greater the level of disappointment and added distress will be in the event of MVF proving to be ineffective.
  
 Clinicians should seek to ascertain and neutralise the patient's expectations, regardless of their beliefs and expectations. The attitude to foster is that of, "//We are finding out what is possible with this process//" rather than, "//This is a treatment for your condition//." Discussion of outcomes should also be avoided other than to offer that "outcomes are largely irrelevant at this stage, as we are simply exploring what is possible." Clinicians should seek to ascertain and neutralise the patient's expectations, regardless of their beliefs and expectations. The attitude to foster is that of, "//We are finding out what is possible with this process//" rather than, "//This is a treatment for your condition//." Discussion of outcomes should also be avoided other than to offer that "outcomes are largely irrelevant at this stage, as we are simply exploring what is possible."
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 Patients whose phantom pain is primarily caused by phantom contractures who only use the mirror box occasionally in order to "release" the contracture may not experience any telescoping phenomena. Patients whose phantom pain is primarily caused by phantom contractures who only use the mirror box occasionally in order to "release" the contracture may not experience any telescoping phenomena.
 +
 +==== Part 4: Managing Complex Issues ====
 +
 +=== The Interrelationship Between Pain, Depression, and Dysmorphic Distress ===
 +
 +**Pain and Depression Dynamics**
 +
 +Pain, particularly chronic pain as seen in phantom limb syndrome, is a potent stressor on mental health and can significantly increase the likelihood of depression. Chronic pain can be both physically and emotionally draining, diminishing patients' ability to enjoy life and cope with stress, which in turn elevates their risk for depression.
 +
 +Conversely, depression itself can alter the body's perception mechanisms, lowering the threshold for pain. This means that those suffering from depression may experience pain more intensely and more frequently than those not affected by mental health issues. This lowered pain threshold can create a vicious cycle where pain heightens the symptoms of depression, which then exacerbates the perception of pain.
 +
 +<blockquote>**People do not get used to chronic pain and desensitise to it. Over time, the pain perception threshold lowers and sensitivity to pain increases.**</blockquote> 
 +
 +**Dysmorphic Distress and Its Role**
 +
 +Dysmorphic distress arises from a profound disruption in body image and identity following major physical changes, such as the amputation of a limb. This type of distress can significantly alter how individuals perceive themselves and how they believe they are perceived by others. The dramatic change in body image can lead to a persistent sense of identity loss and self-consciousness, which feeds into both depressive symptoms and the experience of pain.
 +
 +In this context, dysmorphic distress acts as a bridge that intensifies the reciprocal relationship between pain and depression. Individuals struggling with their altered appearance may experience increased pain sensitivity as their mental distress heightens their physical sensations. Similarly, the ongoing struggle with pain can deepen feelings of depression due to changes in body image and functionality.
 +
 +==== Catharsis Through Abreaction in Mirror Box Therapy ====
 +
 +One therapeutic approach that has shown promise in disrupting this cycle is the use of mirror box therapy. This method provides a form of catharsis through abreaction, a psychological process where patients relive and express emotional turmoil. In the context of mirror box therapy, patients can confront and reprocess the emotional distress associated with the visual and physical absence of their limb.
 +
 +The mirror creates a visual illusion of the missing limb, which can help reconcile the brain's internal map of the body with its physical reality. This reconciliation can significantly reduce phantom limb pain and, by extension, the depressive symptoms and dysmorphic distress associated with it. The cathartic release obtained through this visual and emotional re-experience allows patients to interrupt the cycle of pain and depression, potentially stabilizing their emotional and physical well-being.
  
  
-  ==== Part 4: Managing Complex Issues ==== 
-    * Addressing the Pain-Depression-Dysmorphic Distress Complex 
  
 ===== 4. Appendices ===== ===== 4. Appendices =====
-  ==== A: Recommended Resources ==== +==== A: Recommended Resources ==== 
-    * Books and Articles for Further Reading+    - "Phantom Limb Pain: A Case Study and Review" by K. L. Jensen - Discusses the mechanisms and management of phantom limb pain post-amputation. 
 +    - "The Challenge of Pain" by Ronald Melzack and Patrick Wall - Explores the complex nature of pain, including neuropathic and chronic pain.  
 +    - "The Sensory Homunculus: Anatomy of a Neurological Concept" by Penfield and Rasmussen - This foundational work explores the sensory and motor representations of the body in the brain. 
 +    - "Neuroscience: Exploring the Brain" by Mark Bear, Barry Connors, and Michael Paradiso - Offers detailed insights into the homunculus and its relation to sensory processing and phantom limb pain. 
 +    - "Phantom Limbs and the Neuroplasticity of the Brain" by V.S. Ramachandran - Discusses the role of the homunculus in the perception of phantom limb sensations. 
 +    - "Pain and Brain: Chronic Pain, Phantom Limb Syndrome, and Neural Plasticity" by Vilayanur S. Ramachandran - Covers neural mechanisms behind phantom limb pain. 
 +    - "Coping with Limb Loss" by Ellen MacKenzie - Focuses on psychological adaptation and coping mechanisms post-amputation. 
 +    - "Phantom Limb: From Medical Knowledge to Folk Understanding" by Robert G. Frank - Explores the psychological impact of phantom limb syndrome. 
 +    - "Psychological Aspects of Amputation and the Stump" by Hugh Watts - Discusses the mental health challenges faced by amputees, including depression, anxiety, and body image issues. 
 +    - "Amputation and Prosthetics: A Case Study Approach" by Bella J. May - Includes sections on the psychological adjustment to amputation. 
 +    - American Chronic Pain Association - Website - Provides resources on managing chronic pain, including phantom limb pain. 
 +    - Amputee Coalition - Website - Offers comprehensive resources on coping with limb loss, including mental health support. 
 +    - National Institutes of Health (NIH) - Article on Phantom Limb Pain - Provides detailed information on the neurological aspects of phantom limb pain. 
 +    - Mind.org.uk - Mental Health and Amputation - Offers resources for mental health issues specific to amputees. 
 +==== B: References ==== 
 + 
 +Austin, Andrew, T. (2015). Integral Eye Movement Therapy. In Neukrug, Edward S. (Ed.), //The SAGE Encyclopedia of Theory in Counseling and Psychotherapy// (pp. 539–541, 718). Los Angeles: Sage Publications. [[https://en.wikipedia.org/wiki/Special:BookSources/978-1452274126|ISBN 978-1452274126]] 
 + 
 + 
 +Richards, S. (2021) Integral Eye Movement Techniques - The Definitive Guide. //Integraleyemovement.com//. [[https://en.wikipedia.org/wiki/Special:BookSources/1838496408|ISBN 1838496408]] 
 + 
 + 
 +Ramachandran, V. S. (1998) Phantoms in the Brain: Probing the Mysteries of the Human Mind, coauthor Sandra Blakeslee [[https://en.wikipedia.org/wiki/Special:BookSources/0688172172|ISBN 0688172172]] [[https://archive.org/details/phantomsinbrainh0000rama|archive.org]] 
 + 
 + 
 +Ramachandran, V. S. (2010) The Tell-Tale Brain: A Neuroscientist's Quest for What Makes Us Human [[https://en.wikipedia.org/wiki/Special:BookSources/9780393077827|ISBN 9780393077827]] [[https://archive.org/details/telltalebrainunl0000rama|archive.org]] 
 +==== C: Glossary of Terms ==== 
 +**Abreaction**:  Psychological process involving the reliving and expression of emotional distress, particularly effective in mirror box therapy for reprocessing emotional trauma associated with limb loss. 
 + 
 + 
 +**Amplitude Scale**:  A scale used to measure the intensity of a sensation or feeling, typically ranging from 1 to 10, with 10 representing the highest intensity. 
 + 
 + 
 +**Body Image Disruption**:  Profound alteration in self-perception following physical changes like limb amputation, leading to persistent identity loss and self-consciousness. 
 + 
 + 
 +**Bridge Effect**:  Dysmorphic distress acts as a link intensifying the bidirectional relationship between pain and depression by increasing pain sensitivity and exacerbating depressive symptoms. 
 + 
 + 
 +**Catharsis**:  Emotional release and relief achieved through expressing and reliving emotional turmoil, allowing patients to interrupt the cycle of pain and depression. 
 + 
 + 
 +**Chronic Pain**:  Long-lasting pain, such as in phantom limb syndrome, causing significant stress on mental health and increasing the risk of depression. 
 + 
 + 
 +**Clinical Evaluation**:  A comprehensive assessment conducted by healthcare professionals to diagnose and evaluate the severity of mental health conditions, ensuring accurate diagnosis and appropriate treatment. 
 + 
 + 
 +**Core Training Group**:  A group composed of both clinical and non-clinical members tasked with receiving training and disseminating knowledge to relevant stakeholders. 
 + 
 +**Dysmorphic Distress**: Dysmorphic distress refers to a profound psychological disturbance characterized by intense dissatisfaction or discomfort with one's physical appearance. It often involves a distorted perception of body image, leading to significant emotional distress and impaired functioning in daily life. 
 + 
 +**DSM-5**:  The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, published by the American Psychiatric Association, provides criteria for the diagnosis of various mental disorders, including PTSD. 
 + 
 + 
 +**Edit Points**:  In the context of IEMT, edit points refer to specific moments within traumatic memories that can be targeted and adjusted through therapeutic techniques to disrupt their recurrent and debilitating nature. 
 + 
 + 
 +**Identity Disturbance**:  A disruption or alteration in an individual's sense of self-identity, often observed in PTSD patients due to the impact of traumatic experiences on their core beliefs and perceptions of themselves. 
 + 
 + 
 +**Imprinting Event**:  The initial experience or memory associated with a particular emotional response or sensation. 
 + 
 + 
 +**Integral Eye Movement Therapy (IEMT)**:  A psychotherapeutic approach aimed at alleviating emotional distress and identity-based issues through specific eye movement techniques, particularly effective in addressing PTSD symptoms. 
 + 
 + 
 +**Kinesthetic Pattern (K-Pattern)**:  A technique within IEMT aimed at eliciting and addressing undesired physical sensations or feelings associated with trauma or emotional distress. 
 + 
 + 
 +**Living Dead Metaphor**:  A metaphorical concept describing the feeling of emotional detachment or numbness experienced by individuals with PTSD, reflecting a sense of existing rather than truly living. 
 + 
 + 
 +**Lynchpin Concept**:  In the context of PTSD and IEMT, the lynchpin refers to a pre-trauma personality trait that becomes a central causative factor in an individual's PTSD following a traumatic event. It triggers distressing flashback experiences when encountered in similar contexts, representing a key focus for therapeutic intervention. 
 + 
 + 
 +**Mirror Box Therapy**:  Therapeutic approach utilizing a mirror to create a visual illusion of the missing limb, facilitating emotional processing and reducing phantom limb pain. 
 + 
 + 
 +**Mirror Visual Feedback (MVF)**:  A therapeutic technique used in treating phantom limb pain, where patients use a mirror to create the illusion of the presence of their amputated limb. This visual feedback helps reconcile the discrepancy between perceived and actual physical body, reducing pain and discomfort associated with phantom sensations. 
 + 
 + 
 +**NGOs (Non-Governmental Organizations)**:  Organizations independent of government involvement, typically focused on humanitarian, environmental, or social causes. 
 + 
 +**Pain Perception Threshold**:  The level of pain intensity required to evoke a response, which can be lowered by chronic pain or depression, leading to heightened pain experiences. 
 + 
 + 
 +**Phantom Limb Pain**:  Pain or discomfort experienced in a limb that is no longer present, often occurring after amputation or loss of a body part. 
 + 
 + 
 +**PTSD (Post-Traumatic Stress Disorder)**:  A mental health condition triggered by experiencing or witnessing a traumatic event. Symptoms may include flashbacks, nightmares, severe anxiety, and uncontrollable thoughts about the event. 
 + 
 + 
 +**Rapport-building**:  The process of establishing a positive and trusting relationship between therapist and client, often through empathetic communication and mutual understanding. 
 + 
 + 
 +**Retroactive Alteration**:  The attempt to change or amend past events, often observed in individuals with PTSD who seek to revert to their pre-trauma selves or alter the outcome of the traumatic event. 
 + 
 + 
 +**Therapeutic Modalities**:  Various approaches or methods used in therapy to address mental health conditions, including PTSD, such as cognitive-behavioral therapy (CBT), exposure therapy, and eye movement desensitization and reprocessing (EMDR). 
 + 
 + 
 +**Transderivational Search**:  A process in which an individual accesses memories or experiences related to a specific feeling or sensation. 
 + 
 + 
 +**Trauma**:  Psychological distress resulting from a disturbing experience that overwhelms an individual's ability to cope, often leading to long-lasting emotional and psychological effects. 
 + 
 + 
 +**Vicious Cycle**:  A detrimental loop where pain exacerbates depressive symptoms, which in turn intensifies pain perception, perpetuating the cycle.
  
-  ==== B: Glossary of Terms ==== 
-    * Definitions of Key Terms Used in the Manual 
  
 ===== 5. Quality Assurance ===== ===== 5. Quality Assurance =====
   * Standards for Training Delivery   * Standards for Training Delivery
   * Feedback and Continuous Improvement Processes   * Feedback and Continuous Improvement Processes
 +  * Preparation of material ahead of training delivery
 +  * Compliance with ethical guidelines
 +  * Collaboration with the core group to ensure challenges are dealt with promptly
  
  • Last modified: 2024/04/25 08:17
  • by andrewtaustin