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 ====== Integral Eye Movement Technique ======
-Integral Eye Movement Technique (IEMT) is a psychotherapeutic modality designed to address intense negative emotional states, facilitate reconnection with the self, and effectively alleviate complex emotional challenges. Developed with the aims of reducing emotional intensity, diminishing self-sabotaging patterns (Patterns of Chronicity), releasing Emotional Imprints (EmIs), and addressing Identity Imprints (IdIs), IEMT offers a comprehensive approach to mental and emotional well-being.
+Integral Eye Movement Technique (IEMT), also referred to in this wiki as Integral Eye Movement Therapy, uses directed eye movements and structured enquiry to work with reported emotional responses and aspects of self-experience. Its practice model includes Emotional Imprints (EmIs), Identity Imprints (IdIs) and Patterns of Chronicity. These terms describe concepts used within IEMT; they should not be read as established neurological entities or diagnoses.
+Practitioners use observation and the client's account to agree a focus for the work. Claims about benefit, explanations of how a procedure works and a framework for choosing that procedure require different kinds of evidence.
+The wiki's proposed [[governing_principles|Roy-informed governing principles]] place this work within the person's wider life. The [[treatment_plans|planning workflow]] and [[adaptive_formulation|formulation and outcome-review sheet]] connect a chosen life outcome with assessment, an intervention rationale and follow-up.
-Central to IEMT practice are the skills of observation, identification, and focused attention on specific behavioural and linguistic patterns. By leveraging these skills, practitioners administer tailored treatment protocols to support clients in navigating their emotional landscapes.
 ===== Background and Development =====
 The roots of this model can be traced to Steve Andreas and Connirae Andreas's [[models|eye-movement integration therapy]] and Francine Shapiro's [[models#eye_movement_desensitization_and_reprocessing_emdr|eye movement desensitization and reprocessing (EMDR) therapy]], and it was also influenced by David Grove's ideas about exploring identity through the use of pronouns. The model was developed by therapist [[https://23nlpeople.com/|Andrew T. Austin]], in the United Kingdom.
-This development followed the observation of a number of neurological phenomena that occur during the therapeutic eye movements, specifically at the moment that the problematic imagery changed its emotional coding.
+IEMT's development account links its procedures to observations of changes in imagery, feeling and self-experience during eye movements. Such observations can inform a practice model, but do not themselves identify the neural processes responsible. References to emotional "coding" or "imprints" should be understood as the model's explanatory language unless supported by specific evidence.
-From this followed the development of a set of applications of these phenomena that enabled Integral Eye Movement Technique to be applied specifically to neurological imprints, including imprints of emotion and some imprints of identity.
 ===== Emotional Imprints =====
-Negative emotional imprinting occurs when a person experiences an event of high emotional distress. During such events, the hippocampus registers a memory that becomes strongly linked with the amygdala’s Fight-or-Flight response. The result is a painful memory that may serve as an emotional template or map for all subsequent related experiences. Over time, this template forms the individual’s emotional set, shaping how they feel and respond in similar contexts.
+Within IEMT, an emotional imprint describes a familiar emotional response associated with remembered experience and subsequent situations. This is a way of organising the client's reported experience. It does not establish that a particular memory caused the present problem or that an imprint has been directly identified in the brain.
-The K-Protocol in IEMT (also known as the IEMT Kinaesthetic Pattern, and formerly referred to as the Basic Pattern) is designed to resolve such negative imprints. The process begins by eliciting the client’s present experience of the undesired state—whether this is a whole-body emotional state or a specific kinaesthetic sensation.
+The K-Protocol, also known as the [[kinaesthetic_pattern|IEMT Kinaesthetic Pattern]] and formerly the Basic Pattern, begins with the client's present experience of an unwanted emotional state or bodily sensation. Its set-up enquiry concerns the intensity and familiarity of the feeling and an early memory the client can access in connection with it.
-Structured set-up questions are then used to establish:
+An accessible early memory is material recalled now, not proof of the earliest causal event. Enquiry should allow uncertainty and should not require the client to discover a hidden cause or endorse the practitioner's explanation.
-  * The amplitude of the feeling (//its strength and intensity//).
+IEMT descriptions also refer to "axis deviations", subtle eye movements used to inform the direction of the procedure. Claims that this makes treatment more efficient, changes a particular neural pathway or clears an emotional imprint require direct investigation. A reported change in emotional intensity does not by itself establish those mechanisms.
-  * The familiarity of the feeling (//its recurring nature across experiences//).
-  * The imprinting experience (//the earliest memory of this feeling that the client can access//).
-These preparatory questions, while simple, are crucial in orienting the client towards the emotional template at the root of their distress.
-Once identified, the imprint is addressed through carefully calibrated eye movements. In IEMT, these eye movements are aligned with subtle, unconscious micromovements of the eyes—referred to as axis deviations. By working with the individual’s natural axis deviations, the number of eye movements required for therapeutic change is significantly reduced, making the process both efficient and precise.
-Through this method, the emotional loading attached to the original imprint can be cleared, allowing the individual to update their emotional template and reduce the intensity of their unwanted emotional responses in the present.
+The practical task is to record the agreed target and what changes, then review whether the result is useful in the client's life. See [[treatment_plans|IEMT Treatment Plans]] for the proposed assessment and evaluation process.
 ===== Identity Imprints =====
-An "Identity Imprint" consists of deeply ingrained self-perceptions and beliefs about one's identity that are formed through past experiences. These imprints significantly influence an individual's behaviour and emotional responses across different situations.
+IEMT uses "Identity Imprint" for self-perceptions and descriptions that appear to organise a person's experience across situations. The term belongs to the IEMT [[imprinting|imprinting model]]. It does not identify a distinct neurological structure or provide a diagnosis.
-Identity [[imprinting|imprinting]] occurs throughout life and is constantly evolving and changing. Some aspects of identity are attributed neurologically but mostly occur as a feedback response to the environment. An example of this is the production worker who yesterday was "one of the boys" and today, following promotion to lower management, is now officially an enemy to his former friends and colleagues. Some people will be able to adapt with the appropriate emotional and behavioural adjustments better than others who may find themselves in conflict with themselves.
+The model distinguishes a description of a feeling, such as "I feel unhappy", from a description of oneself, such as "I am an unhappy person". Practitioners may explore [[pronouns|pronouns and self-reference]] to understand how the client experiences these descriptions. The question "How did this person learn to be this way?" is a prompt within the model, not proof that a single learning event explains an identity.
-Other deeper aspects of identity are more permanent and "feed-forward" into the environment. These are the aspects of identity that tend to occur in all contexts, with some being more stable than others. Examples of this are gender identity, identity as a father/mother, brother/sister and so forth. However, [[pronouns|some aspects of identity]] are much more flexible or unstable and may change according to context.
+Changes in circumstances can make a role or self-description difficult to sustain. For example, a promotion can alter a person's responsibilities and relationships with former peers. A Roy-informed formulation asks about these actual demands and available support as well as the person's understanding of themselves.
-Thus, IEMT also addresses the issue of, "How did this person learn to //be// this way?"
+Identity work should follow the client's own priorities and values. It is not a licence to bypass consent, dismiss a diagnosis or impose a preferred identity. Sexual orientation and gender identity are not themselves treatment targets. Whether work on a chosen self-description produces useful and sustained change needs to be evaluated.
-In some cases, the person can adopt aspects of identity that can be problematic. For example, an emotional imprint might be, "I feel unhappy" whilst an identity imprint might be, "I am an unhappy person" or even, "I am a depressive."
+===== Patterns of Chronicity =====
-By specifically addressing the [[imprinting|identity imprint]], this enables the therapist to bypass the beliefs that often support the undesired identity such as, "I cannot do that because I am a depressive" and so forth.
+IEMT uses "Patterns of Chronicity" to describe recurring processes that may contribute to a difficulty continuing or complicate work towards an agreed change. They are interpretive concepts within the model, not diagnoses. The practitioner needs to establish what actually happens, in which circumstances and with what consequences, rather than infer a motive from a phrase or gesture.
+A response may reflect uncertainty, a protective strategy, exhaustion, an unsuitable intervention, a problem in the therapeutic relationship or a real constraint in the person's environment. Its function should be explored with the client and the explanation revised when it does not fit.
-===== Patterns of Chronicity =====
+**A client may disagree, report no benefit, decline a topic or stop a procedure. None of these actions alone establishes a Pattern of Chronicity.** Respecting these choices is consistent with the [[governing_principles|proposed governing principles]] and with shared decision making. [[https://www.nice.org.uk/guidance/ng197/chapter/Recommendations|NICE NG197: shared decision making]].
-A pattern of chronicity is a behavioural pattern that serves to defend the problem from therapeutic change. These patterns can be readily discovered through simple linguistic analysis of the ways in which the client expresses themselves.
-Whilst a therapeutic process aims at helping the client solve the problem, the client may experience it as a threat to the elements of their identity structure. As a result, the patterns of chronicity allow the client to avoid involvement in the change process or even to sabotage it.
+The five patterns discussed in IEMT are:
-IEMT offers the model of recognition of those patterns and helps the therapist to cross the barriers that would otherwise prevent the client from improving their condition.
+  - The Three-Stage Overreaction, formerly called the Three-Stage Abreaction.
+  - The Maybe Man.
+  - The Great Big "What If" Question.
+  - Testing for the Existence of the Problem Rather Than Testing for Change.
+  - "Being at Effect" rather than "Being at Cause".
-IEMT identifies five key patterns of chronicity:
+The names are retained here to connect with IEMT teaching. Descriptive, collaborative language is preferable when discussing an individual client's experience.
-  - The Three-Stage Overreaction (//formerly known as "The 3 Stage Abreaction")//.
-  - The Maybe Man.
-  - The Great Big "What if" Question.
-  - Testing for the Existence of the Problem Rather Than Testing for Change
-  - "Being at Effect" rather than "Being at Cause"
 ==== The Three-Stage Overreaction Pattern (3SAR) ====
-This is a pattern resulting from the conviction of some clients that the therapist (and others) should act according to their expectations. When a client experiences an undesirable emotion, they may try to transfer the responsibility for that undesirable emotion onto the therapist and expect them to make changes to the process. This attitude of the client often results in three distinct stages leading to “punishing” the therapist (or others) who do not respond to the signal (see below).
+This model describes a proposed sequence in which an interpersonal signal escalates when the other person does not respond as expected. Its traditional labels are warning, threat and punishment. Those labels imply an interpretation of the interaction; they cannot be established simply from increasing distress or a request to change the session.
-<WRAP center round box 90%>
 ==== Stage 1. Signal (Warning) ====
-This is the first stage of the pattern leading to punishment—it manifests itself as an expression of dissatisfaction with the process and usually consists of an indirect warning about an emotional reaction.
+The person expresses discomfort, dissatisfaction or a preference. For example, "I do not want to talk about this." First clarify what they mean and what they want to happen. A stated boundary or concern about the practitioner's conduct is information to act on, not evidence of a problem-maintaining strategy.
-For example, "//I don't like the fact that we're talking about this issue, I think you should address another topic//."
-Also commonly expressed is responsibility for negative emotion, such as:
-"Your tone of voice is annoying to me."
-"You are making me very uncomfortable."
-"I don't like the way you are looking at me."
 ==== Stage 2. Signal Amplification (Threat) ====
-The second stage often involves a direct threat and takes the form of firm opposition, usually through emotional blackmail. A visible increase in negative emotion can often be seen.
+The message becomes more emphatic. If the client says they will stop if a topic continues, respect that limit and agree the next step. The practitioner should consider whether the earlier signal was missed, whether the work is appropriate and whether consent remains in place. The word "threat" is a model label, not a reason to continue against the person's wishes.
-For example, “If we continue to talk about this, I’m done with this session.”
 ==== Stage 3. Overreaction (Punishment) ====
-This is the client's extortion of will, manifesting itself in a strong emotional response (overreaction) and making it difficult or impossible to continue to work in a constructive manner.
+The traditional model interprets the final stage as an attempt to impose a consequence on the other person. Crying, silence, leaving or ending a session do not establish that intention. Attend to the person's needs and review the interaction. Only discuss a recurring interpersonal sequence as a working hypothesis when there is supporting information and the client has an opportunity to correct the account.
-For example, it may involve taking offence, remaining silent, leaving, or crying hysterically.
+==== The Maybe Man ====
-</WRAP>
-===== The Maybe Man =====
-A pattern called the maybe-man is an expression of uncertainty of the client's own feelings and/or beliefs.
-Often it results from insufficient engagement of the client with their feelings, beliefs, and inner experiences. It is expressed in a language characterised by terms that lack precision and clarity. It is based on descriptions and statements rich in generalisations and lacking specific content. In some cases, it may also constitute a subconscious resistance of the client's psyche against realising a solution that they are not ready for and therefore prevents the client from having a clear view of the problem.
-The simplest example is the inaccurate determination of one's emotions on a numerical scale: “I feel stressed out at a level of… something like five or six out of ten.”
-Linguistic modifiers are commonly employed, such as, "I kind of, sort of, maybe feel X," "Well, I might say that I get angry", "I don't know, maybe it is just I get angry, or something" etc.
+This label refers to recurrent qualifying language such as "kind of", "sort of" or "maybe". Such language can make a proposed target difficult to specify, but it can also accurately express uncertainty, a changing experience or the limits of a rating scale.
+"About five or six out of ten" is a usable approximate report, not evidence of insufficient engagement. Ask for a concrete situation, allow time and offer a different way of describing the experience. If the meaning remains unclear, record that uncertainty rather than presuming unconscious resistance.
 ==== The Great Big "What If" Question ====
+Within IEMT, this describes a proposed pattern in which a hypothetical exception is used to invalidate an entire course of action. It is more specific than ordinary worry about the future. A question about risk or whether an intervention will help may be entirely reasonable.
-This pattern is based on the question “What if…?”, by means of which the client tries to find a gap in a given approach, solution or generalisation. The question is a trap.
+For example, "What if my partner does not appreciate it?" could express either a practical concern or an assumption that a disappointing response would make every effort worthless. Explore the implied conclusion without calling the question a trap. Agree what would be within the client's control and how a genuine difficulty could be handled.
-Usually, the person asking this type of question has a ready answer, which they do not verbalise. Often the question 'what if X?' is intended to imply an answer of "then Y", where X is a single example of a potential difficulty that is intended to overturn the legitimacy of the planned actions, and Y is a negative consequence of that overturn.
-So, "What if X is true, then B will also be true." However, this is actually a //complex equivalency// where the speaker holds the value that condition X is actually //equal// to condition Y.
-For example, a man who concludes that he should express his feelings to his partner more consistently with her expectations may ask: “What if she doesn't appreciate it anyway?” Such a question implies a belief that the answer would be: “Then my efforts will be in vain”
 ==== Testing for Existence of the Problem Rather Than Testing for Change ====
+This describes attention to what remains difficult while overlooking a relevant improvement. Review the original baseline and agreed goal so that both progress and continuing difficulty can be considered.
-The fourth pattern of chronicity is characteristic of those who tend to verify the progress of therapy by measuring the remainder of the problem rather than noticing the change being introduced.
+A remaining problem may still matter greatly to the client. Do not demand a positive account or imply that reporting it cancels earlier gains. Record improvement, no change and deterioration with the same care. If the outcome is insufficient, revise the plan.
-These are individuals who in their observations will overlook a 99% improvement and focus on the remaining 1% of the problem.
+==== "Being at effect" rather than "being at cause" ====
-This pattern can undermine effective change work and suppress any benefits achieved.
+This distinction is used in IEMT to explore perceived agency: what the person believes they can influence and where they feel powerless. The useful question is which options are actually available, with what resources and at what cost.
+Responsibility for abuse, discrimination or another person's harmful conduct does not belong to the person affected. Illness, poverty and limited support can also impose real constraints. Adaptation may involve seeking protection, practical assistance or changes in the environment.
+Where a person has overlooked a possible action, explore it collaboratively. Where there is little individual control, acknowledge that reality and consider support or collective action. Receiving help or needing the practitioner to take an active role is not, by itself, evidence of passivity or an inability to benefit.
-==== “Being at effect” rather than “being at cause” ====
+===== Post-Traumatic Stress Disorder (PTSD) =====
-A pattern in which people see themselves as subjects of problems can thus limit their ability to influence the situations in which they find themselves.
-For coaches and therapists, this is a pattern that requires particular attention, sensitivity, and insight in order to avoid unintentionally suggesting to someone who is genuinely a victim of other people or external factors that they are responsible for what has happened to them.
-Inexperienced personal development practitioners, but also professional psychologists, sometimes promote the idea that “all the problems are in our heads”, which is harmful and counterproductive.
-However, in many cases, many people find relief from feeling responsible for their very own decisions, ill-considered actions, or inaction, in the belief that they are subject only to external factors and no change is in their power. If objective facts contradict such a view, it indicates a typical pattern of “being at effect instead of being at cause”.
-People who manifest this pattern expect that the help will consist of the work of the therapist and that they will only be passive recipients. Such an approach excludes the possibility of change and effective help and requires a skilful guide for the client to find their agency (which of course will also entail an element of responsibility).
-===== Post-Traumatic Stress Disorder (PTSD) =====
+The "lynchpin" is an IEMT concept proposing that a particular shame-related experience may be relevant to a person's intrusive imagery. It should not be presented as a universal cause, a diagnostic feature of PTSD or an established mechanism of recovery. Claims that addressing it resolves flashbacks require appropriate clinical evidence.
-IEMT posits that central to the PTSD experience is a shame-based micro-experience that exists below the diagnostic threshold and as a result is usually overlooked by both patient and clinician. Referred to as "the lynchpin" in IEMT, it is claimed that by addressing this micro-experience, or experiences, flashback phenomena and intrusive imagery that are common to PTSD are frequently resolved.
+The exploratory eye-movement study described below does not establish IEMT as an effective PTSD treatment. PTSD assessment and treatment decisions should follow appropriate clinical guidance and competence. NICE recommendations include trauma-focused CBT and, under specified circumstances, EMDR; evidence for EMDR cannot simply be transferred to IEMT. [[https://www.nice.org.uk/guidance/ng116/chapter/recommendations|NICE NG116: PTSD recommendations]].
 {{ :lynchpin.jpg?800 |}}
@@ Line 170: / Line 116: @@
 ===== Physiological State Accessing Cues (PSACs) =====
-Physiological State Accessing Cues is known in IEMT as PSACs for short.
+Within IEMT, Physiological State Accessing Cues (PSACs) refers to observed changes in posture, movement or other bodily presentation that accompany access to a reported emotional state. The observation is a starting point for enquiry, not a reading of the person's nervous system or proof of a trauma history.
-It has been seen that when a person experiences trauma one of the physiological responses that can occur is a frozen state for the body, i.e. the "freeze" part of the fight, flight, or freeze response. This is a stress response and a survival response in terms of the autonomic nervous system, which is beyond the control of the neocortex/conscious functioning of the brain.
+The practitioner can describe what they noticed and ask whether the client notices a relationship with their experience. Where appropriate and agreed, a comfortable change in posture or movement can be explored and the client asked what, if anything, changes. Pain, physical limitations and a wish to stop need to be respected.
-Not everybody locking into a particular physiological state will have experienced what is traditionally known as ‘trauma’; however, as seen when working with PTSD what is trauma to one person can be shrugged off by another. So a person develops a coping strategy that is physiologically based and the stance or position reinforces the strength of the emotions and feelings.
+A change in reported distress is an observation to record. It does not demonstrate a particular vagal pathway, lasting neurological change or a general ability to control unwanted states. Statements about these mechanisms require evidence beyond body-language observation.
-In trauma and PTSD situations, there is a down-regulation social engagement system that can keep people in a state of hyperarousal via the sympathetic part of the autonomic nervous system (myelinated fibres), disconnection via the reptilian un-myelinated vagus or in a coping mode i.e., avoidance. Each of these responses is a way to survive in optimal safety. A person's nervous system can become primed to react to cues based on past traumatic experiences that may not fit with a current situation.
-The IEMT Practitioner is ever-observant of body language. When somebody is talking about an issue and accessing their associated state, shifts in physiology can be detected. This may be very obvious or very subtle.
-The IEMT Practitioner can make use of the [[https://en.wikipedia.org/wiki/Subjective_units_of_distress_scale|Subjective Unit of Distress (SUD) scale]] to ascertain what level of discomfort that person is currently at as they enter into a physiological response. By making the person consciously aware of the way that they are holding their body, the IEMT practitioner can elicit small shifts in that physiology and ask the person very simply how this changes the subjective distress.
-Through these processes, the practitioner is able to demonstrate to a person the relationship between their physiology and emotional state, and then with the subtle change in that physiology, there can be a tangible shift. This can often be a significant moment of insight for some people to understand that if they want to stop or downgrade the strength of a particular feeling or state, all they have to do at that moment is a subtle physiological shift.
-Such changes using the PSACs model do not necessarily create long-term neurological change in the here and now. However, over time, if a person becomes more aware of how their body can affect their mind, they can start to exercise such changes more regularly and thus begin to repattern their emotional perception.
-These principles can be utilised to incapacitate unconscious access into negative states. One method for doing this is to use humorous shock and provocation to anchor a conscious taboo to the first physiological access cues by which the person accesses the negative state.
+The [[governing_principles|Roy-informed approach]] also asks whether rest, physical support, assessment or a change in demands is needed. Provocation or shock should not be used to override a boundary or treat a request to stop as something to overcome. Evaluate the client's experience and any unwanted effects, rather than assuming that an observable shift is beneficial.
 ===== Psoriasis =====
-One of the more unusual applications of IEMT has been in the [[iemt_treatment_for_psoriasis|treatment of psoriasis]].
+The wiki discusses an exploratory application of IEMT in [[iemt_treatment_for_psoriasis|work with psoriasis]]. Moore and Manea's 2018 case report describes work conducted in 2016 with one person, followed by reported improvement in skin eruptions and no further reported seizures at follow-up. The authors acknowledge other possible influences, including changes in alcohol and marijuana use. [[https://jep.ro/images/pdf/cuprins_reviste/83_art_7.pdf|Moore and Manea, 2018: full case report]].
-Psoriasis is a non-contagious dermatological disease affecting around 2% of the population. Studies reveal that psoriasis is mostly related to stressful life events, body mass index growth, smoking, alcohol use, skin infection, and the use of beta-blockers and other anti-hypertensive drugs.
-Although psoriasis is primarily treated with prescription medication, psychotherapeutic approaches have also become more frequent as a secondary or complementary approach, especially in reducing the emotionally stressful effects associated with psoriasis. A case study in 2016 published in //Journal of Experiential Psychotherapy, vol. 21, no. 3 (83), September 2018// shows promising results in treating psoriasis. Another surprising positive side-effect was the lack of the client’s additional epileptic seizures which had not recurred since the IEMT-based treatment session.
-The full case study is published here: https://jep.ro/images/pdf/cuprins_reviste/83_art_7.pdf
+These observations do not establish that IEMT treats psoriasis or prevents epileptic seizures, and should not be used to justify changing medical care. The report is preliminary material, not proof of a treatment effect.
 ===== Controversies =====
@@ Line 229: / Line 158: @@
+===== Evidence and interpretation =====
+A 2026 exploratory study compared IEMT-directed eye movements, EMDR-directed eye movements and a control condition in 33 adults recruited from the general population, with conditions presented in randomised order. Both eye-movement conditions had lower reported distress than control after the intervention and at one week; the active conditions did not significantly differ. [[https://cris.maastrichtuniversity.nl/en/publications/an-exploratory-comparison-of-iemt-versus-emdr-directed-eye-moveme/|van Heugten-van der Kloet and colleagues, 2026]].
+This finding concerns the studied procedures and outcomes. It does not establish equivalence of the complete therapies, effectiveness for particular diagnoses, the proposed imprint or chronicity mechanisms, or the validity of the Roy-informed planning framework. Claims about durable benefit and mechanism need evidence matched to those claims.
+See [[iemt_research_evidence|Research Evidence for IEMT]] for a source-based overview, and [[iemt_emdr_2026_study|IEMT and EMDR: The 2026 Comparative Study]] for the experiment's design, outcomes and limitations. [[iemt_emi_emdr_compared|IEMT, EMI and EMDR Compared]] distinguishes the three approaches and their evidence bases.
 ===== See also =====
   * [[adapt|The IEMT Adaptive Model]]
+  * [[governing_principles|Roy-informed Governing Principles]]
+  * [[treatment_plans|IEMT Treatment Plans]]
+  * [[adaptive_formulation|Adaptive Formulation and Outcome Review Sheet]]
   * [[models|Alternative Eye Movement Therapy Models]]
   * [[pain|Gate Theory of Pain]]