Telehealth Skill Applications

These are teachings that Dr. Jamie Marich shared on the Mindful Ohio & The Institute for Creative Mindfulness page in the first week of major clinical transition to telehealth. Although the videos are not new and directly drawn from her Trauma Made Simple resources pages, the applications represent new ideas for clinicians in this era. Study them together or in any combination to create your own virtual learning experience. Feel free to use and to pass along!

Idea #1: Clench and Release

Clench and Release is a skill I’ve taught for years. It’s a modified version of Progressive Muscle relaxation and can easily be taught and verbally processed over telehealth platforms. I often teach this skill close to the beginning of therapy because it can assist with embodied grounding, and it can give people a practice that they can access at any time in between sessions. Even for folks who struggle with it, what they learn about themselves and the process can be fascinating! One time, when I asked a client to do the release part of the exercise, they wouldn’t… they just kept clenching tighter! I kept inviting them to release and at some point they blurted out, “Come on Jamie, you know how much I struggle with letting go!” From there a fascinating dialogue ensured where they then realized that this strategy would help them to practice letting go. It became a part of their daily practice of mindfulness and ultimately helped them to embrace reprocessing with more enthusiasm.

For EMDR practitioners and people interested in EMDR-related skills, I’ve also prepared video of a bilateral variation you can use on this for resourcing and, at times, I’ve used it as a movement-based interweave.

Idea #2: Painting Light

“Painting Light” is a classic Tai Chi form that is one of my favorite movement strategies to use as an adjunct to EMDR therapy. There is broad applicability to other approaches as well. Yesterday during a teletherapy session, a client and I talked about the importance of moving physically in this new reality. While there are many ways we can keep the physical body moving, even in isolation or quarantine, this is certainly one of my favorite strategies that has a direct link to EMDR therapy.

The “Light Stream” meditation is one that many EMDR therapists teach for preparation and closure. This exercise, and many visualizations, can be tricky for people who are not optimally visual. “Painting Light” is an outstanding somatic variation on this exercise and can be easily led through the video platform. Like with all exercises of this nature, it’s important that you try it out yourself first before guiding a client through it.

After a few rounds of the traditional “Painting Light” form, invite a person to be still and, in the spirit of both embodied mindfulness and EMDR therapy, have them notice what they notice. From this place of awareness, you can transition to discussion, or invite another set of “Painting Light,” this time encouraging more freedom in the movement in the spirit of “go with that” or “notice whatever you’re noticing and let the body respond.” After this next set, invite the stillness and check in. The body may reveal a great deal so be prepared to support your client in the context of your usual relationship and in the context of your treatment plan after doing this exercise.

Many times people ask me, even for in-person sessions, if they should do movement exercises along with their clients. My general response is to give your clients the choice; some will feel better turning away from you to try it. Others prefer to have you be still and witness. Yet most, in my experience, like it when you move along with them.

Idea #3: Loving Kindness Meditation

Loving kindness meditation is a well-known practice to Western practitioners of mindfulness thanks to the work and dedication of Sharon Salzberg. There are many versions of loving kindness meditation that you can study online. In this teaching video prepared several years ago, I lead you through this meditation similarly to how I would lead a client.

As Dr. Stephen Dansiger and I wrote in our 2018 book EMDR Therapy and Mindfulness for Trauma-Focused Care, omitting the phrases on sending loving kindness to those people who challenge you may be necessary when you’re first doing this practice with trauma survivors. Yet I inevitably find that eventually working these phrases in for sending loving kindness to those who challenge us in an excellent and gentle way to work with resentment.

On March 19, 2020, Dharl Chintan, my 12-step sponsor and spiritual teacher took our regular Thursday night meditation group that meets here in Warren, OH online. Dharl led us through loving kindness meditation and it was a wonderful way to feel connected to others on the other side of the screen. I’ve often shared this practice in various areas of my remote work. I encourage you to explore it yourself and do the same.

Idea #4: Monkey Tap (aka Butterfly Hug)

For years, I’ve given clients and students the choice on what to call this skill. Although EMDR practitioners are likely to refer to it as Butterfly Hug, I propose the alternative name of Monkey Tap. Because this is what monkey and other primates do in nature to self-soothe.

In this video, I go through the basic technique of using this as a resourcing strategy, both in and of itself and pairing it with other positive or adaptive associations. During this time when we can’t see clients face-to-face, especially if you are nervous or need to get confidence about doing full scale Phases 3-6 work, you can always help people bulk up on their resources. This is a classic EMDR and EMDR-related strategy that helps you to do that.

Idea #5: Noodling

“Noodling” has become a classic exercise at ICM EMDR Therapy trainings and in our Dancing Mindfulness community. Based on an idea from my former student Cornelius Hubbard (featured in the second video), noodling can be a great way to get people into the spirit of moving using the metaphor of softening an uncooked piece of spaghetti. As I explain in the teaching, when we’re rigid and tense, the body can lack fluidity.

The exercise is pretty self-explanatory so have some fun with the video. And as I joke, if al dente is all that you can manage, that’s okay. This exercise can be done virtually and can be another wonderful way to get some movement flowing. Enjoy!