Paperback, 2003

Description

Put Your Best Foot Forward: An EMDR-related protocol for empowerment using visual and somatosensory priming of resource experiences

The theory and how-to of the protocol are contained in a 153 page manual, 8.5" x 11". The second edition updates the database and includes a new chapter with case reports from other therapists. The manual`s contents include:

• the full text protocol
  
• enough practical information so you can knowledgeably use it if you wish
  
• a simplified record form for the client`s file
  
• two new ratings scales: Subjective Units of Body Safety( SUBS) and Rating of Confidence (RoC)
  
• theoretical discussion of midbrain areas that I think are activated by the process
  
• 13 tables of descriptive statistics, n= 40, 67 administrations of the protocol
  
• stills taken from video of therapy sessions (with client permission, faces obscured)
  
• colored illustrations of client imagery, key midbrain areas, and body diagrams summarizing different results
  
• a 3 page table summarizing each of the protocol`s eight stages from four operational factors - therapist mode of activity, information processing, somatosensory processing, and conjectured neural activation
  
• more than 15 cases are described in whole or in part, 8 from other therapists

Please note that this is not controlled research but a reasonably systematic study of a single, specified procedure repeated with many clients. The protocol is in the early stages of wider use by other EMDR therapists. Its clinical decision points continue to be clarified with ongoing analysis of its outcomes, limits, and validity. A casebook is planned because there is now a rich accumulation of clinical material. I am very grateful for any outcome data you may care to send me and all such feedback will be appropriately credited

Table of Contents

• C H A P T E R 1 : I N T R O D U C T I O N
  
  • Overview 1
    
  • Clinical Impetus 2
    
  • The Eight Sections of the Protocol 5
    
  • A Somatosensory View of Resource Work 7
    
  • Explanatory Conundrums 9
    
  • Client Database 10
    
  • A Happy Accident 11
    
  • Finding things easily in this Manual 12
    
• C H A P T E R 2: U N D E R L Y I N G P R O C E S S E S
  • Associative Retrieval 13
    
  • Memory Systems and Neural Dynamics 14
    
  • Projection 18
    
  • Priming 19
    
  • Present-time Experiencing 20
    
  • Eidetic Imagery 21
    
  • Constructing the Body Landscape 22
    
• C H A P T E R 3 : T H E C L I N I C A L F R A M E
  
  • When to Use this Protocol 23
    
  • Contraindications 25
    
  • Practical Considerations 25
    
  • Therapy Tone and Flow 28
    
  • Working with the Body 31
    
• C H A P T E R 4: G E T T I N G S T A R T E D
  
  • Section A: Recurrent Difficulty 34
    
  • SUDS, SUBS, and RoC 36
    
  • Procedural Memory 39
    
• C H A P T E R 5: E N G A G I N G T H E B O D Y
  
  • Section B: Body Position 41
    
  • The Body as a Projective Cue 45
    
  • Section C: Body Scan 46
    
• C H A P T E R 6: E N G A G I N G T H E B R A I N
  
  • Section D: Three Images 50
    
  • Image Content 52
    
  • Image Analysis 58
    
  • A Depiction of Human Needs 59
    
  • Information Processing Dynamics 60
    
  • Images as Memory 63
    
  • The Role of the Hippocampus 65
    
• C H A P T E R 7: P R O C E S S I N G A F F E C T I N T H E B O D Y
  
  • Sequential Awareness 68
    
  • Body Sensation 70
    
  • Affect Theory Revisited 71
    
  • The Body-Brain Dialogue 73
    
• C H A P T E R 8: B O O K M A R K I N G T H E S E L F
  
  • Section E: Journeys through Internal Space 79
    
  • Section F: Paired Titrated Exposures 82
    
  • Working without a Context 89
    
  • Section G: Future Rehearsal 91
    
  • Section H: End Ratings 91
    
• C H A P T E R 9: C L I N I C A L P R A C T I C E I S S U E S
  
  • First-time Use 93
    
  • Depressed Clients 95
    
  • Risk Assessment 96
    
  • Variations on a Theme 97
    
  • A Case of PTSD 100
    
  • Other Possible Applications 102
    
  • Comparison with Standard EMDR Protocol 103
    
  • Clinical Utility Summary 104
    
• C H A P T E R 1 0: P O S T - S E S S I O N O U T C O M E S
  
  • Changes in Body Sense and Energy 105
    
  • A Tool for Self-support 106
    
  • Self-coherence and Assurance 107
    
  • Symptom Reduction 108
    
  • Cognitive Clarity 108
    
  • Unexpected Generalizations 109
    
  • The Images kept Speaking 110
    
  • Stabilization for Trauma Therapy 111
    
  • Counterconditioning in Trauma Therapy 111
    
  • Deeper Integrations 114
    
• C H A P T E R 1 1: R E P O R T E D C A S E S
  
  • Case 1. Long-term functional problems 115
    
  • Case 2. A helpful hint from Abe 117
    
  • Case 3. Adjustment Disorder with prominent depression 117
    
  • Case 4. A depressed teenager 118
    
  • Case 5. Protocol difficulty 119
    
  • Case 6. Airborne therapy 120
    
  • Case 7. A chronic sense of personal inadequacy 122
    
  • Case 8. An EMDR smorgasbord 122
    
  • Further Analysis 124
    
• C H A P T E R 1 2: S U M M A R Y A N D S Y N T H E S I S
  
  • Operational Summary 125
    
  • A Potpourri of Observations and Conclusions 127
    
  • Midbrain Therapy 129
    
• A P P E N D I X 1: F U L L - T E X T P R O T O C O L
  
• A P P E N D I X 2: C L I N I C A L R E C O R D F O R M 135
  
• A P P E N D I X 3: S U B J E C T I V E U N I T S O F B O D Y S A F E T Y
  
• A P P E N D I X 4: C L I E N T F E E D B A C K Q U E S T I O N S
• A P P E N D I X 5 D A T A C O L L E C T I O N P R O J E C T 138
  
• R E F E R E N C E S
  
• G L O S S A R Y
  
• L IST OF TABLES
  
• TABLE 1. Client Characteristics in Database 10
  
• TABLE 2. Memory Systems 15
  
• TABLE 3. Percentage of Types of DAS/ABS 34
  
• TABLE 4. Percentage of Client Positions 45
  
• TABLE 5. The Language of Physical Sensation 48
  
• TABLE 6. Image Content Percentages 53
  
• TABLE 7. Imagery as Human Resource Needs 60
  
• TABLE 8. Degree of Synthesis in Imagery 61
  
• TABLE 9. Human Content as % of all Imagery 61
  
• TABLE 10. Images from Memory Systems 64
  
• TABLE 11. Frequency of Reported Changes in Sensation 71
  
• TABLE 12. Procedural Comparison with Standard EMDR Protocol 103
  
• TABLE 13. Operational Summary of the Protocol 125

Reviews

Lilian Palachi, LMHC
Miami, Florida.

Five years ago, learning EMDR transformed and revitalized my already busy thirty-one year private practice of psychotherapy. As if that was not enough, in February 2003, I had the good fortune to attend Krystyna Kinowski`s "Put Your Best Foot Forward" workshop. I found her material to be so exciting, so original, and so user-friendly that I immediately put it to use with my clients. The results have been dramatic in a positive way, with little discomfort for either therapist or client. BFF enables clients to clearly identify and resolve difficulties that have previously seemed intractable. In addition, the process is often enjoyable, full of spontaneity and surprises.

Krys has developed a psychotherapeutic method that links up the inherent wisdom of the body with unconscious right brain imagery. Both of these powerful, non-rational tools combine to liberate clients from repetitive, undesired reactivity. They experience a shift in the geological plates under the psyche; things reconfigure inside and the person is liberated to achieve preferred behaviors that had been unattainable before. This protocol facilitates the capacity of body and soul to heal themselves in ways that are natural to the particular individual. As a therapist, I have felt honored and privileged to be able to offer my clients the gift of BFF.

Susan Hubbard, LSCW
EMDRIA certified in EMDR

I took Dr. Kinowski`s training this summer at the suggestion of Phil Manfield and found that he was right in his assessment that this is a wonderful protocol to use with clients who have difficulty in affect regulation. I have used several other resourcing protocols and find that this one flows very organically with clients, even fairly disorganized ones, and the clients display less confusion moving through it. They like it, it flows from their own processes and it stays with them. I think it would benefit other practitioners to have knowledge of Dr. Kinowski`s protocol and website.

Barbara Maynard, MA, LMFT

I want to ? recommend strongly that others acquaint themselves with her protocol. The thirty-five clinicians who attended the presentation were lavish in their praise for the presentation, especially the several hours of edited DVD video she used to illustrate the practical application of the procedure.
(Posted to the EMDR Institute electronic discussion list, Feb 5, 2003)

Philip Manfield, Ph.D.
Northern California Regional Coordinator
EMDRIA Institute Facilitator `91
EMDRIA Certified Consultant, Approved University Instructor
Editor, Extending EMDR: A casebook of innovative applications.

Warm thanks for your outstanding presentation at yesterday`s workshop! The material was useful, clear, powerful, and empowering. I appreciated the depth of your background and the thoroughness of your clinical presentation as well as your personal warmth. Your clients are blessed to have you as their therapist and your colleagues to have you share your knowledge.
Thanks again!
All best to you,

Susan Borkin, M.A., Licensed Marriage & Family Therapist
EMDRIA Certified in EMDR
Chair, EMDR & Writing SIG

I am using your protocol to deepen the effectiveness of deep breathing, relaxation and meditation techniques. Last week a severely depressed 32 year old man visualized being in a dark room and gradually added icy-clad walls, a white lattice fence, gate and gazebo, a place he could retreat to when feeling anxious or stressed. A 10-year-old boy saw himself in a room surrounded by panels of mirrors, but one panel had all the things he likes being near (dad, stepmom, bike...) and these things were reflected beside him all around the room. I`ve never had this kind of success with visualization prior to learning your technique. Best wishes as you continue to expand upon and promote this wonderful tool.

Nancy Battilega, LPC. EMDR L2

This mail is just to tell you that I downloaded your manual last week and spent my week-end reading it, and I used it with 5 clients with great results. I felt happy to find a protocol with such a clear focus in body processing because of my background in body psychotherapy (Reich) before EMDR. I also appreciate the resources being built from body experience through eidetic images, which is much