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The blind to therapist (B2T) protocol (Blore & Holmshaw, 2009a, 2009b) was devised to circumvent client unwillingness to describe traumatic memory content during eye movement desensitization and reprocessing (EMDR). It has been used with at least six clinical presentations:
* Reassertion of control among "executive decision makers"
* Shame and embarrassment
* Minimizing potential for vicarious traumatization
* Cultural issues: avoiding distress being witnessed by a fellow countryman
* Need for the presence of a translator versus prevention of information "leakage"
* Reducing potential stalling in processing: client with severe stammer
This article details the history, development, and current status of the protocol, and provides case vignettes to illustrate each use. Clinical issues encountered when using the protocol and "dovetailing" the B2T protocol back into the standard protocol are also addressed.
Keywords: eye movement desensitization and reprocessing (EMDR); blind to therapist protocol; client-centered approach; shame and guilt; aphasia
Francine Shapiro (2001) has advised that divulging information is not crucial to the success of EMDR:
Sometimes a client is unwilling to concentrate on a particular memory because of shame or guilt. The clinician should reassure the client that because the processing is happening internally, she need not divulge the details of the memory; merely reporting the fact she is withholding something is sufficient. (p. 132)
In the current authors' experiences, there is a fine line to tread between respecting clients' wishes and knowing sufficient to engage the client in EMDR. Indeed, it can be argued that this theme runs throughout several eye movement desensitization and reprocessing (EMDR) protocols and forms the foundation for the basic EMDR protocols set out by F. Shapiro (1995, 2001) that have subsequently been supplemented by an array of modifications to accommodate the individual needs of the client undergoing EMDR (see, e.g., Luber, 2009; R. Shapiro, 2005, 2009). This evolution supports EMDR's credentials as a client-centered therapy (e.g., F. Shapiro, 2007; see also Dworkin, 2005, pp. 8-10), which implies that the onus is on the therapist to devise methods to circumvent difficulties encountered by clients when undergoing EMDR rather than adopting an a priori expectation that the client should adhere to preexisting requirements of the EMDR protocol.
The blind to therapist (B2T) protocol represents one of these attempts to accommodate...