Empathy and Flexibility: Adapting the HMDR Protocol for Children and Adolescents

Therapeutic work with children and adolescents using the HMDR protocol (Hypnosis combined with Bilateral Stimulation) requires translating clinical concepts into developmental, experiential, and playful language. In children, the connection to the subconscious and the world of imagination is much more available and accessible than in adults, but simultaneously, self-regulation capacity and attention spans are shorter.

Below are the key considerations, practical adaptations, and a demonstration of the 12 stages in an age-appropriate version.

Key Considerations When Working with Children and Adolescents

1. Experiential Anchoring and Gamification: Abstract concepts like "negative belief" or "safety barrier" take the form of superheroes, force fields, or characters from computer games (like Minecraft or Fortnite).
2. Short and Dynamic Pace: Bilateral stimulation sets are shorter. Closely monitor physical signs (movements, restlessness, changes in breathing) and do not reach prolonged emotional flooding.
3. Recommended Types of Bilateral Stimulation:

• Butterfly Hug ("Butterfly Taps"): Light taps on the shoulders or knees (in an X shape).
• Foot Taps / Drums: Light right-left tapping on the knees or on dedicated pads.
• Auditory Sounds with Headphones: Playful sounds or light melodies moving from ear to ear, while closing and moving the eyes.

Adapting the 12 Stages of HMDR for Children and Youth

Stage 1: Resource Installation ("Recruiting the Superhero Team")

• Adaptation: The child chooses a favorite character, a magical place, or a special power (such as: "Superman", "Faithful Guard Dog", "Invisible Bubble").
• Bilateral Stimulation: Slow "butterfly taps" while the child imagines the resource's power and responds to the "super-power" feeling in the body.

Stage 2: Control Tools ("The Remote Control" / "The Volume Slider")

• Adaptation: Instead of an abstract gauge, use the image of a TV remote control, a joystick, or a volume button. The child practices "turning up and down" the intensity intentionally.

Stage 3: Hypnotic Induction ("Journey in Imagination / Floating on a Cloud")

• Adaptation: Use of storytelling techniques, guidance for floating on a magical cloud, or passing through a magic gate to a quiet inner world.

Stage 4: Deepening the Trance ("Descending in the Magic Elevator")

• Adaptation: Descending in a transparent elevator or sliding down a slider, combined with sounds or taps at a slow and rhythmic pace.

Stage 5: The Safety Barrier ("The Hero's Force Field")

• Critical Adaptation: Building a powerful material or energetic barrier (like "spaceship bulletproof glass", "multi-galactic force field").
• Bilateral Stimulation: Strengthening the barrier with slow taps until the child reports with full confidence: "Nothing bothersome can pass this wall."

Stage 6: Accessing the Block / Memory ("Screening the Movie on the Small Screen")

• Adaptation: The child looks at the event or fear through the force field, on a small TV screen or through inverted binoculars that shrink the situation.

Stage 7: Opening the Emotion in a Controlled Manner ("Letting the Dragon Shout")

• Adaptation: The child allows the emotional expression (anger, fear, sadness) to rise through the barrier. With children, keep flooding time much shorter to prevent overload.

Stage 8: Desensitization via Bilateral Stimulation ("Dismantling the Energy")

• Adaptation: Activate fast sets of butterfly taps or sounds. Explain to the child that the taps "crumble" the fear or block into tiny particles that disappear.

Stage 9: Regulation via the Remote Control ("Turning Down the Volume")

• Adaptation: The child presses the remote control in their imagination and lowers the level of pain/fear from 10 to 2 or to 0.
• Bilateral Stimulation: Slow, calming taps to reinforce the lower intensity.

Stage 10: Reframing ("Changing the End of the Story")

• Adaptation: The child adds empowering elements to the story or the block (for example: "The fear turned into a tiny ant", "Now I have the hero's sword").

Stage 11: Positive Belief ("The Strength Badge")

• Adaptation: Instilling an empowering statement (such as: "I am brave", "I am protected", "I can succeed").
• Bilateral Stimulation: Brief butterfly tapping to reinforce the positive feeling in the body.

Stage 12: Exit, Returning to the Room, and Grounding ("Soft Landing")

• Adaptation: Gradual return (counting from 1 to 3), touching the floor, opening eyes, and ending with a short game or drawing for full grounding.