Eight Step Model
Tamie Pushlar has developed an eight step model to guide the therapeutic process.
1. Step One: Relationship-Building & Importance of Breath
This step is very important for the therapeutic process. In addition to good communication, an individual or couple and Tamie need to feel physical and emotional safety. Relationship-building is the step that Tamie will always return to if at any time the therapeutic relationship does not feel safe for any party. Relationship-building can take many forms but often will look like general conversation, boundary establishment and discussions regarding roles and responsibilities.
Early on, Tamie will also teach you the importance of using breath as a way to regulate and feel grounded.
2. Step Two: History
Tamie will take a full social, physical and developmental history. It is important to understand all aspects of your present and past to understand what skills and resources will benefit you and to understand "what happened". You may also expect a genogram, relationship map, dissociation scales, and attachment interviews, along with general questions. Every detail is important, and it can provide another piece to the puzzle.
3. Step Three: Goals and Treatment Path
Once a relationship is established and your history is discussed, the next step is to develop your goals. Your established goals will help decide which treatment path you will take. Some individuals just want to learn new skills and resources and do not feel the need to process any past memories. Some individuals want a deep dive and want a full assessment to have increased self-awareness and self-actualization. The path will be chosen based on what goals you establish. Your length of treatment will often be determined once you develop your goals.
4. Step Four: Skills and Resource Development
It is essential to have skills and resources to manage life’s stressors and emotions. Tamie is well-versed in EMDR, Progressive Counting, DBT (Dialectical Behavioral Therapy), CBT (Cognitive Behavior Therapy), Parts Work, Polyvagal Exercises, and Mindfulness. You may be referred to other community resources if needed. It is also possible that you will be enouraged to use apps, read books, read articles, or watch videos. The purpose is to provide skills and resources to meet your stated goals.
5. Step Five: Processing
If you experience an emotional, body sensation or thought disturbance when you think about or are reminded of an old memory, it would be helpful to process that memory. Processing the memory decreases the disturbance and will allow the memory to be part of the past. At this phase, you will decide with Tamie if you will choose to process past memories and trauma. Tamie primarily uses EMDR to process the memories.
6. Step Six: Check In/Evaluation
After a period of time, it is important to check in and evaluate progress. At this time, you will decide if therapy will continue with the same goals or different goals, if you need to be referred to someone else, or you are ready to stop therapy. Check In/Evaluation can happen at any time; it is important to check in after processing a cluster of memories.
7. Step Seven: Future Concerns
Before you end therapy it is important to address any future concerns you may have. Tamie will use EMDR Future Protocol for any future concerns or make sure you have the needed skills and resources.
8. Step Eight: Culmination
“There is no greater agony than bearing an untold story inside of you” -Maya Angelou
You have told your story out loud and shared it with Tamie. It can be difficult to end a relationship after you have released the agony. You and Tamie will decide how your relationship will culminate. This is a shared process, and it is an important part of therapy.
“Some people come into our lives and quickly go. Some stay for a while and leave footprints on our hearts and we are never the same.” -Flavia Weedn
*Disclaimer: Sometimes the steps are not progressive, and you may need to return to an early step.