Peak performance EMDR: Adapting trauma treatment to positive psychology 
outcomes and self-actualization
Sandra Foster, Ph.D., Success at Work, San Francisco, California
Jennifer Lendl, Ph.D., Performance Enhancement Unlimited, San Jose, California

An expansion of the basic EMDR protocol (Lendl & Foster, 1997) has been developed for enhancing performance in the workplace, to aid in the reduction of performance anxiety experienced by creative and performing artists, and for competition preparation and psychological recovery from injury in athletes. The authors, in their Silicon Valley practices, often witnessed the upsetting, even traumatic effect that layoffs and competitive pressures could have on employees in corporate workplaces. They likewise observed the adverse impact that ‘stage fright’ and audition anxiety could have on actors, dancers, and musicians, as well as the emotionally bruising experience for an athlete who loses a crucial competition. Reasoning that a trauma method such as EMDR could be applied to procrastination, fear of failure, and the reprocessing of actual setbacks, the EMDR Peak Performance protocol was created (Lendl & Foster, 1997).
This application of EMDR was originally designed to assist high functioning clients in business, performing and creative arts, and sports. It soon became clear that another population could benefit--those clients with recent traumas which had disrupted their employment, and adults traumatized as children who had made good progress in conventional psychotherapy or ‘clinical’ EMDR. Additionally, one particular aspect of the Peak Performance protocol, the Expanded Future Template (Lendl & Foster, 1997), may be a helpful adjunct to almost any client’s therapeutic process because the full sensory experience of successful future responding is rehearsed and integrated using bilateral stimulation. Thus, Peak Performance EMDR can assist a broad range of clients in expanding their capacities for a more creative and productive future.
Philosophically, Peak Performance EMDR emphasizes what is positive in the client’s existing repertoire, what is possible for the future, and how self-actualization could manifest in the client’s life.  This approach draws upon the writings of Abraham Maslow (1971) and the Human Potential Movement and is informed by the findings of those investigating positive psychology, for example, Seligman (Seligman, Shulman, DeRubeis, & Hollon, 1999), Taylor and her colleagues (Taylor, Kemeny, Reed, Bower, & Gruenewald, 2000), Buss (2000), and Csikszentmihalyi (1990). This philosophical orientation naturally leads the practitioner to adopt a view that is nonpathologizing but discerning in appraising a client’s current situation and potential. 
Procedural steps for the Peak Performance protocol may be found at the end of this discussion. To help illustrate the process, examples are offered of two clients (in a composite form to ensure anonymity). One is a 27 year-old male engineer struggling to meet the demands of a promotion to management. The other is a 45-year old female who, after three years of successful therapy to work through the incest by her uncle, wishes to pursue a long-held dream to sing professionally and secure the lead singer’s spot with a well-known jazz ensemble. A case example also appears in a recent publication on coaching (Foster, 2001).
The text that follows describes how the Peak Performance protocol elaborates upon the standard EMDR methodology. 

Comparison of the standard EMDR protocol and the Peak Performance protocol

As explained in Shapiro’s second edition of her practitioners’ manual (2001), the standard protocol for most complaints is carried out in three stages, known as the three-pronged approach: targeting the past material; targeting the present-day stimuli that trigger the client’s current dysfunctional responses; and establishing a positive template for acquiring new adaptive responses for appropriate future action. The Peak Performance EMDR protocol adheres faithfully to the standard EMDR model with its eight phases of treatment but with three modifications (Lendl & Foster, 1997). 
One, the future is the stage emphasized in the intervention. Two, the process of Resource Development and Installation (RDI) is oriented toward the peak performance strategies used in sport psychology in order to promote a client’s sense of possibility rather than safety (as in the standard protocol) before initiating desensitization. Three, the client is educated in the skills of peak performance to increase the probability of reaching and sustaining high-stakes goals and promoting the conditions for enjoying a fully satisfying life.  This approach is therefore helpful not only with high functioning clients at work, but also with trauma survivors who have made good progress in their ‘clinical’ EMDR and wish to seek employment or develop interpersonal skills.
In her description of the standard EMDR protocol, Shapiro (2001) elaborates upon the creation of the positive template, an expansion of the Installation Phase in which the practitioner guides the client in learning healthy new responses for a safer, more productive future. In Peak Performance EMDR this positive template becomes the Expanded Future Template, repeatedly facilitating the client’s cognitive rehearsal of successful performance and installing these hoped-for outcomes. 
The practitioner remains focused on the future, exploring personal and career development in near-term while addressing the client’s present-day performance. In looking toward the more distant future, the practitioner guides the client in a strategic visioning process, asking for pictures of who it is the client wishes to become. Working backward from that goal of the Self the client wishes to become, the practitioner helps the client identify what learning must occur and what circumstances must be created to reach that state of being. The client is urged to take advantage of training opportunities offered by the employer as well as locating classes and workshops in the community. Role models are sought who demonstrate sophisticated skills such as executive presence and leadership behaviors. The client may observe these models directly in the workplace or view their presentations on cable channels such as C-Span or on commercially available training videos. 

Client History-taking

Each prospective recipient of Peak Performance EMDR should be carefully evaluated in terms of the appropriateness of this approach. Those with dissociative disorders, previously undiagnosed or insufficiently treated trauma histories, active substance use, neurological symptoms, Axis I disorders resulting in impairment at work or interpersonally, or significant Axis II symptomology should be treated with the standard EMDR protocol or other intervention (for example, an inpatient detox program). Following a thorough clinical interview, those appropriate for Peak Performance EMDR are further queried about issues related to authority, control, health, experiences of success and failure in school, perceived ‘success’ in the family dynamic, friendships, love relationships, and history of performance in the area targeted for intervention.

Client Preparation and Resource Development and Installation

The standard EMDR protocol incorporates Resource Development and Installation (RDI) to promote  stabilization in clients with deficient capacity for affect regulation and limited access to positive self-referents. In Peak Performance EMDR, RDI is used to remind the client of the potential for growth and to create a sense of possibility for the future. During the Preparation Phase of Peak Performance EMDR, variations on the standard EMDR protocol (“safe place” as a place of relaxation and peace of mind; “inner advisor” as inner coach) as well as concepts from sport psychology are integrated as resources. For example, a ‘success review’ of the client’s past achievements shifts attention away from failure to what has been done well. 
Other positive resources specific to this EMDR application are the internalizing of real or imagined support people as the client’s ‘team,’ and the creation of the “mental room” (Unestahl, 1982). This latter technique guides the client in creating a personalized internal space featuring a projection screen onto which desired future performances are imaginally viewed.

Assessment Phase: Selecting the target of intervention

From the history, the practitioner carefully notes and discusses events and issues related to past difficulties that are important targets for processing. While in the standard EMDR protocol the initial target is a recent trauma or disturbance originating in childhood, Peak Performance EMDR begins with a 
present-day issue related to health, work, sport, or the performing arts. The reason for this is twofold. First, many clients appropriate for Peak Performance EMDR are highly motivated, results-oriented people. They are not given to analyzing their personal pasts nor are they seeking therapy. For them, the face validity of beginning in the present provides the rationale necessary to engage in EMDR. Secondly, past concerns and childhood issues (explored in the history-taking) frequently emerge spontaneously in the processing. If they do not, they will be addressed as subsequent targets.

Education in the skills of peak performance

When the desensitization and reprocessing of the initial and subsequent targets are complete, the practitioner begins to incorporate the education of the client in the skills of peak performance using sport psychology and leadership training techniques. The client learns how to: better focus and concentrate; find an optimal level of arousal for peak performance; how to sustain persistence; how to relax and energize at will; how to redirect negative thoughts to those more motivating; and how to manage negative emotional states.

Research testing the efficacy of the Peak Performance protocol

The first published single subject series (Foster & Lendl, 1996) reported promising findings with four diverse work-related situations. Results of a second case study series being submitted for publication also indicate that a Peak Performance EMDR protocol was helpful for coaching business leaders back from failures to regain or even exceed their optimal functioning at work.  Similarly, outcomes for mature performing artists were reduced anxiety and increased self-confidence as each launched an existing repertoire into a new arena (Foster, 2000). Peak Performance EMDR thus offers promise as a tool in breaking through barriers of the past to achieve optimal performance in the present and to reach future ‘dream goals.’ To address the limited generalizability of case studies, large sample investigations comparing Peak Performance EMDR with credible alternatives are being implemented.	

Applications to sport psychology

	This protocol has been tested with college and elite athletes in carefully selected circumstances with coaches’ and parental consent (Foster & Lendl, 1995; Ogelsby, 1999). Results are encouraging but controlled studies are needed. Given the pressures athletes face, clinicians using this protocol with competitive athletes are encouraged to become well-versed in sport psychology and the sociology of professional sport including the imperative to win, financial expectations, and the use of banned substances to produce results at any cost. 

Procedural Steps

Note: The scripted words in italics are taken from EMDR Peak Performance specialty training materials (Foster, 2001). Practitioners using the Peak Performance protocol are encouraged to adapt specific phraseology to meet the needs of their individual clients.
Phase One: Client History
The presenting Problem is a current concern or problem at work or in the client’s pursuit of competitive sport or creative or performing art. For the engineer, the focus of treatment is his present-day uncertainty about being able to perform adequately his duties as a team leader with no prior management experience. For the incest survivor, the focus of treatment is her current trepidation about initiating her singing career  and the residual sense of vulnerability she feels in the presence of men.
 “What concerns you now at work/in your music/art/sport?”
As noted earlier, attending to trauma and debilitating psychological disorders take precedence in treatment. For a client appropriate for Peak Performance EMDR, the first target is a present-day issue. However, the practitioner explores past experiences that become subsequent targets. Areas relevant to performance are discussed in detail: ideas about authority and control, experiences of success and failure in school, perceived ‘success’ in family and other significant relationships; and history of the performance that is the focus of treatment.
“When you are told what to do by someone in authority such as a boss, what is that experience like for you?”
“How much control do you feel you have over what happens in your team at work/ in your relationship with your spouse (or partner)?”
“How well did you perform in school in terms of grades and meeting your own as well as your parents’ and teachers’ expectations?”
“Who was the successful one (or star) in your family? What was your sense of how much attention and affection you received from your parents? Did you pursue the career that your parents wanted you to follow?”
 “Tell me about how your career began and how you have progressed. Please describe those functions in which you feel  most successful and those in which you feel less competent. Please describe the times when you felt you have experienced  failure.”

Phase Two: Client Preparation and Resource Development and Installation

This series of positive resources is suggested for EMDR Peak Performance work, using material generated by the client. One or two short sets of eye movements is used, from six to twelve saccades (Korn & Leeds, in press; Leeds & Shapiro, 2000), to install each resource separately. 
Creating a Safe Place
“Imagine a place, real or virtual, in which you feel a sense of refuge, well-being, and peace of mind. Notice the emotion and physical sensations that you feel when you imagine being in this place. Think now how you might take one or two minutes from a busy work day to recreate this place and sense of well-being. Imagine yourself right now going to that place as you sit quietly somewhere in your workplace. ”
Creating the Inner Advisor
“Imagine an actual person or virtual being who can be an inner resource for you, like an inner coach. This may be some part of yourself, like your Higher or Wiser Self. Imagine this person’s or being’s voice, calming you when you are upset or frustrated and reminding you of your strengths, talents, and positive qualities.”
Creating an Inner Team of Support People
“Imagine this inner coach and others who give you support and encouragement as your inner team, like your own personal cheering section. Hear and see them now as they rally around you, calling out words of encouragement, smiling at you, and offering advice when you need it.”
Success Review
“Think back to the times when you felt more powerful, or more in control, or more pleased with the results you reached at the end of the day. Notice the emotions and physical sensations that come up when you think of these successful experiences. Imagine deliberately bringing these successful times to mind when you are feeling discouraged, in order  to change your state of mind  to one more powerful and positive.”
Mental Room
“In your mind’s eye, imagine an internal space like a comfortable room or a beautiful space outdoors, in which you can sit in a favorite chair or on the grass under the trees. Imagine a large projection screen in front of you on which you can see the images of yourself doing the things well that you wish to do in the future.”

Phase Three: Assessment

The first target is a present-day issue. 
“What picture represents the challenge you face right now at work (or the prospect of beginning to perform)?”
“What words go best with that picture and express the negative belief (worry/concern/self-doubt) that you are thinking about yourself now?”
“When you bring up that picture (or issue related to work, performing art or sport), what would you like to believe about yourself right  now?”

Examples of Cognitions

Negative Cognitions			Positive Cognitions

I was a failure before.			I’m better prepared this time and can succeed.
I get a raw deal compared to others.          I can perform to the best of my ability and ask assertively for
						recognition and fair compensation.
I can’t perform perfectly and that	I can strive for excellence and learn to manage setbacks
	makes me a failure.			with grace and a willingness to learn.
	
(for the engineer)
I can’t deal with people effectively	I can learn, as other technical people have, how to be
	so I’m just a geek.			an effective manager.

(for the incest survivor)
I am not safe with men.     		I can remember that I am an adult, in the Present Moment,
	 					who can keep herself safe as she expresses her
						talents for an audience of men and women.

Phase Four: Desensitization

Desensitize the present-day upset to SUDS=0. A goal of this phase is for the client to access the insights that help make the connection between the present-day performance concerns and past upsets or disappointments. These connections most often have been observed to emerge spontaneously, as do memories of past upsetting events which become subsequent targets. If the client begins looping and does not see the connection between present and past, the following use of an affect bridge may prove helpful:
“Think of that (key) person in the (performance) situation. Do you notice anything when you think of (person’s name) and what went on in your family (at school/at the music academy/sport competition)?”

Phase Five: Installation	
			
The Extended Future Template may be used by itself with almost any client involved in a therapeutic process with ‘clinical’ EMDR. First install the positive cognition following the steps in the standard EMDR protocol, as explained in Shapiro (2001). Then expand upon the creation and integration of future action with the following instruction:
“Now imagine the posture, voice quality, gestures, and positive feeling in your upper body as you think about successfully conducting the meeting (giving your sales presentation, speaking with that difficult coworker, auditioning for that part, making the free throw with ten seconds left on the clock).”  
When the client signals that the future successful action is clearly imagined, the practitioner installs it with short sets of eye movement or other form of bilateral stimulation. 
For maximum effect, the practitioner can then ask the client to stand and face an imaginary audience or team at work and then move about and speak in a successful manner. The practitioner can then install this imagined successful experience while both practitioner and client are standing.

Phases Six and Seven: Body Scan and Closure

The Peak Performance protocol follows the standard EMDR protocol during these phases.

Phase Eight: Reevaluation

When future goals (for example, the Self the client wishes to become) are addressed in the reevaluation phase, the client’s use of the “mental room” may be helpful. 
“Imagine being in that space in which you can picture and mentally rehearse your goals and plans. See that projection screen in front of you. Now imagine that you can see projected onto that screen the images of yourself delivering that speech to the executives (performing your part on opening night/offering your painting to the gallery for consignment/playing in the tournament).”
As the client experiences these images of a desired future from beginning to end, the practitioner processes any blocking beliefs that surface, any fear of failure that arises, or worries about sustaining success once it has been achieved. The processing continues until the client experiences no disturbance when thinking once again about the entire desired future performance.

A Final Note

	Aspects of the EMDR Peak Performance protocol may be appropriate for most clients who are completing their ‘clinical’ EMDR. The Expanded Future Template and the Resource Development for possibility, not just safety, could be considered to allow all clients the option of progressing beyond basic functioning into areas of personal growth, creativity, and optimal performance.

References

Buss, D. (2000). The evolution of happiness. American Psychologist, 55, 15-23.
Csikszentmihalyi, M. (1990). Flow: The psychology of optimal experience. New York: Harper & Row.
Foster, S. (2001). A case of EMDR-integrated performance enhancement coaching. In J. E. Auerbach. Personal and executive coaching. Ventura, CA: Executive College Press. 
Foster, S. (2000, August).  Peak performance EMDR: Adapting trauma treatment to positive psychology outcomes. Poster presented at the 108th Annual Convention of the American Psychological Association, Washington, DC.
Foster, S. (2001). From trauma to triumph: EMDR and advanced performance enhancement strategies. 
Self-published training materials. San Francisco, CA: Success at Work.
Foster, S., & Lendl, J. (1995). Eye movement desensitization and reprocessing: Initial applications for enhancing performance in athletes. Journal of Applied Sport Psychology, 7 (Supplement), 63.
Foster, S., & Lendl, J. (1996). Eye movement desensitization and reprocessing: Four cases of a new tool for executive coaching and restoring employee performance after setbacks. Consulting Psychology Journal: Practice and Research, 48, 155-161.
Korn, D.L., & Leeds, A.M. (in press). Preliminary evidence of efficacy for EMDR resource development and installation in the stabilization phase of treatment of complex posttraumatic stress disorder. Journal of Clinical Psychology.
Leeds, A.M., & Shapiro, F. (2000). EMDR and resource installation: Principles and procedures for enhancing current functioning and resolving traumatic experiences. In J. Carlson & L. Sperry (Eds.). Brief therapy strategies with individuals and couples. Phoenix, AZ: Zeig/Tucker.
Lendl, J., & Foster, S. (1997). EMDR performance enhancement for the workplace: A practitioners’ manual. San Jose, CA: Performance Enhancement Unlimited.
Maslow, A. (1971). The farthest reaches of human nature. New York: Viking.
Ogelsby, C. (1999, September). Report of a study of EMDR with college athletes. Symposium presented at the Annual Conference of the Association for the Advancement of Applied Sport Psychology, Banff, Canada.
Shapiro, F. (2001). Eye movement desensitization and reprocessing: Basic principles, protocols, and procedures. (2nd ed.) New York: Guilford Press.
Seligman, M., Shulman, P.,  DeRubeis, R., & Hollon, S. (1999). The prevention of depression and anxiety. Prevention and Treatment, Article 8. Available on the World Wide Web:  http://journals.apa.org/prevention/
volume2/pre0020008a.html.
Taylor, S.E., Kemeny, M.E., Reed, G.M., Bower, J.E., & Gruenewald, T.L. (2000). Psychological resources, positive illusions, and  health. American Psychologist, 55, 99-109.
Unestahl, L.E. (1982). Better sport by IMT—inner mental training. Orebro, Sweden: Veje.

Authors’ Note. This article was originally written for Francine’s revised practitioners’ manual (Shapiro, 2001) but space limitations did not permit its inclusion.

Please address correspondence to:
Sandra Foster, PhD samrolf@aol.com
Jennifer Lendl, PhD 1142 McKendrie Street   San Jose, Ca 95126       tel  408-244-6186