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Integral Eye Movement Therapy (IEMT) - An Adaptive Model

Based on Sr. Callista Roy’s (1970) Adaptation Model

Nursing theories frame, explain or define the practice and delivery of nursing care. There are a number of prominent models in common use, and different models may be used according to the organisational needs and the provisional requirements of the patient group served.

Sister Callista Roy developed the Adaptation Model of Nursing which quickly became regarded as a major nursing theory worldwide, especially in rehabilitation environments. Roy's model sees the individual as a set of interrelated biological, psychological and social systems. Whilst the individual strives to maintain a balance between these systems and the pressures of the outside world, an ideal level of balance is rarely found, thus the need for continual adaptation.

Overview of the theory

The Adaptation model has four domain concepts of: (i) person, (ii) health, (iii) environment, and (iv) nursing;

The model views the person as “a biopsychosocial being in constant interaction with a changing environment”.

As in systems theory, a person is an open and adaptive system that uses internal coping skills to deal with environmental stressors. The environment is defined as “all conditions, circumstances and influences that surround and affect the development and behaviour of the person”.

Stressors are defined as stimuli and the model uses the term residual stimuli to describe those stressors whose influence on the person is not immediately clear. Many life experiences and events that are long over may continue to exert residual stress upon the individual.

Health is defined as the process of “being and becoming an integrated and whole person” and Callista Roy's goal for the delivery of nursing care is “the promotion of adaptation in each of the four modes*, thereby contributing to the person's health, quality of life and dying with dignity”.

*The four modes referred to are: (i) physiological, (ii) self-concept, (iii) role function and (iv) interdependence.

Adaptive Model and IEMT

Embedded within the operating mechanism of IEMT is a fundamental assumption that holds a person as a dynamic being who is in constant interaction with the ever-changing environment. Human beings are an intricate design of biological, social and psychological factors, both internal and external.

Every environment offers the individual resources, challenges, struggles and stressors of different forms and variable degrees thereby resulting in all consequential effects being subjective and occurring on a spectrum.

An important aspect of IEMT is an increase in resilience in order to get the client more effective to face, handle and adapt to the current environment. IEMT attempts to increase adaptability and maturity on part of the individual in order to manage life and its' ongoing complexities.

Being an “adaptive system”, a person has input from the environment, which is subject to internal processing, eventually leading to an output. Our model presumes that the individual uses both innate and acquired (learned) mechanisms to adapt. Some of these adaptations may bring about unintended negative consequences and may be termed maladaptive.

The environmental stimuli that present as a resource, challenge, stressor or any combination of these may have its’ origin in the historical biography of an individual. This, in turn, can exert an effect in the present through its psychological, physiological, emotional, social and/or environmental nature.

The Adaptive IEMT Model states that well-being is an integral and central feature of a person’s life, and can be represented on a well-being/distress spectrum. Along with health, well-being can be described as a state and process of being and becoming integrated and whole as a person, freed from the negative historical stresses and maladaptive responses.

Environmental stressors have four components:

  1. Focal - current and specific stresses (extraneous pressures, intrinsic health issues) applied to the individual present in many or all contexts;
  2. Contextual - all context-dependent stimuli, that is, those present in the background, and frame the situations that exacerbate the consequences of the focal stresses;
  3. Residual - historical stresses whose after-effects continue into the current situation and affect the individual’s well-being. This may include attitudes, beliefs and strong influences in the form of either people or experiences.
  4. Prospective Stresses - can reasonably be known, anticipated and expected prior to their occurrence.

With the IEMT model, well-being is affected when an individual’s adaptation fails to de-potentiate residual negative states resulting from historical environmental interactions and pressures. This in turn leads to specific maladaptive patterns, The Patterns of Chronicity, which inadvertently serve to maintain the residual negative state.

  1. Focal - the presenting problem
  2. Contextual - via reactive patterns of chronicity
  3. Residual - past events and traumas that leave a residual kinaesthetic that affects well-being and behaviour in the present moment
  4. Prospective - habitual responses to “routine” triggers



The IEMT Adaptive Model makes fifteen operating assumptions.

  1. The person is a dynamic system that operates within the web of biological, psychological and social influences.
  2. The person is a product of his/her interaction with an ever-changing environment.
  3. Well-being, eustress and distressing stressors are an in-built part of human life.
  4. The environment is embedded with stressors and changes. Adaptation is not a choice, but a necessity for life.
  5. The adaptation of an individual is a function of the relationship between the flexibility and skills of adaptation and the familiarity and degree of the stimuli.
  6. All behaviours are learned within a socio-cultural context.
  7. No symptom of distress exists in isolation from this context.
  8. Maladaptive emotional responses can give rise to patterns of chronicity that inadvertently serve to maintain a distressed state and prevent natural healing across time.
  9. There is a dynamic objective for existence with the ultimate goal of achieving dignity and integrity.
  10. Movement of the eyes while thinking of an unhelpful memory changes the contents of the memory and the feelings/reactions attached to the memory.
  11. A person can be reduced to parts for therapeutic change work and then needs to be looked at as part of the whole.
  12. IEMT is based on the principle of causality. Feelings, emotions, roles, identities and events have a cause. Each experience sets up an effect in motion.
  13. A patient’s behavioural, emotional and cognitive patterns can be challenged effectively by the IEMT model.
  14. A positive and effective state of adaptation leads toward greater integration in an individual and also frees a person’s energy to respond to other stimuli.
  15. A limitation of IEMT is to only be able to make changes to the body's conditioned reflex responses, IEMT cannot, for example, change the genetics of a body, although it is hypothesised that further research could well find epigenetic adaptations occurring as a result from working with PTSD clients.

Goal and Intention of IEMT

The goal of IEMT is to free the client from the effect of negative memories, feelings of distress and constricted identities that restrict the fundamental idea of life which is to experience it fully. It is to know and imbibe that stressors are integral to living and our adaptability to them defines well-being. Therefore, IEMT gives an empowering choice to stay on the spectrum towards robust health, in all domains, physical, mental, social and spiritual.

The intention of IEMT is the integration of experience and maturing of identity thereby leading to increased well-being within the dynamic system called the human being.

An integrated individual with greater well-being is more contributive to self and their social environment invariably leading to a better quality of life.

Steps of IEMT

  1. Addressing a troublesome memory and mitigating the impact of unpleasant feelings
  2. De-linking the cognate emotion-physiologic-memory web (separating stimuli and response) by identifying patterns of distress and specific stimuli
  3. Increasing awareness of the maladaptive behaviours (“Patterns of Chronicity”) that hinder healing and evolution
  4. Identifying triggers within the body-mind loop
  5. Introducing choice towards any frame/ state of mind
  6. Evaluation of the intervention in the real world

Discussion

, 2021/03/26 07:34

The first 2 points using the word person. A 'person', in the case of clients seeking help to change is static/stuck in place by their beliefs, rituals, self identity.

(A persona is the image or personality that a person presents in public or in a specific setting—as opposed to their true self.) A suggestion is to use 'body' in this context?

The BODY is a dynamic system that operates within the web of biological, psychological and social influences. The BODY is a product of his/her interaction with an ever-changing environment.

, 2021/04/01 08:24

I like this thinking. I wonder whether we could define 'person instead? Does the body need 'mind' as well?

, 2021/04/01 21:56

I like this thinking. I wonder whether we could define 'person' instead? Does the body need 'mind' as well?

, 2021/03/26 07:45

15. A limitation of IEMT is to only be able to make changes to the body's conditioned reflex responses, IEMT cannot for example change the genetics of a body, although further research could well find epigenetic adaptations happen as a result from working with PTSD clients.

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/home/integral/public_html/data/pages/adapt.txt · Last modified: 2021/10/18 12:32 by andrewtaustin