The methods of the back-of-the-head scale (BHS) and constant installation of present orientation and safety (CIPOS)
It is important for therapist and client alike to know when a client is drifting into derealization, that is, losing a felt sense of the reality and safety of the present situation. For clients who are potentially dissociative, the degree of orientation to the present situation can be assessed through the use of the Back of the Head Scale (Knipe, 2002). This procedure is introduced to the client during the preparation phase, before any desensitization of trauma is begun. The therapist says, “Think of a line that goes all the way from here [the therapist holds up one index finger about fifteen inches in front of the person’s face], running right from my finger, through your face to the back of your head. Let this point on the line [therapist wiggles index finger] mean that you are completely aware of being present here with me in this room, that you can easily listen to what I’m saying, and that you are not at all distracted by any other thoughts. Let the other point on the line, at the back of your head [therapist points] mean that you are so distracted by disturbing thoughts, feelings, or memory pictures that you feel like you are somewhere else. Your eyes may be open, but your thoughts and your awareness are completely focused on another time, place, or experience. At this very moment, show with your finger where you are on this line.” [Excerpt]
Original Work Citation
Knipe, J. (2013). The methods of the back-of-the-head scale (BHS) and constant installation of present orientation and safety (CIPOS). EMDR in Action.com. Retrieved from http://www.emdrinaction.com/article/methods-back-head-scale-bhs-and-constant-installation-present-orientation-and-safety-cipos-j on 8/4/2013.
“The methods of the back-of-the-head scale (BHS) and constant installation of present orientation and safety (CIPOS),” Francine Shapiro Library, accessed June 16, 2021, https://emdria.omeka.net/items/show/22146.