Emdr: Questions/comments From An Emdr Therapist Who Also Has Ptsd

[orangeweezel]

OW,
Actually, I have a question for you.
I have read in a few places, and actually had some one tell me th...

Hi katz. It's understandable that you would be hesitant based on what you've heard. Since I don't know your specific experiences, I can't say whether it would be likely helpful for you or not, but the tendency to avoid EMDR is usually when there is extreme dissociation. It doesn't necessarily make it impossible, but definitely more risky. Also, if there is a pending court case or pregnancy, EMDR should also be avoided. One other factor that would make this an improper modality would be if current life circumstances are very similar to the type of trauma originally present, because there would not be enough safety to heal from the protective purpose of traumatic reactions, when the environment is still painful. This could be living with an abuse person (partner or family member; and any kind of abuse). This is a general idea of how the T would decide whether to use EMDR, although there may be more if there were more details. One option would be to find an EMDR therapist in your area, briefly describe your concern, and they can likely give you an idea if it would be a good fit, with no commitment to actually do it. I hope this helps, and please feel free to ask additional questions :)

 

[orangeweezel]

I am impressed by this thread. While I don't have a lot to contribute to it since I haven't done EM...

Thank you for your feedback! I truly appreciate the encouragement and suggestions of setting safety in the therapy relationship. I will keep those things in mind with the precious people I work with. Thank you for taking the time to write!

 

[katz]

Hi katz. It's understandable that you would be hesitant based on what you've heard. Since I don't...

OW
What would be a "determining factor" for a T to consider a patient as having "extreme" dissociation? In other words, what makes it extreme?

I'm still looking for a new T in my area. I'm trying to find one that has some experience with PTSD. I never imagined that it would be this difficult.

FYI *no pregnancy-no physical safety issues-no court cases involved.

 

[loui50]

Hello everyone,

I have my master's degree in Marriage and Family Therapy (and work in a group pra...

Orangeweezel, when do you consider it acceptable for a client to contact you outside of sessions? Only an emergency? Under significant distress before an emergency? I am battling with this issue personally and this seems like a safe place to ask someone.

 

[orangeweezel]

OW
What would be a "determining factor" for a T to consider a patient as having "extreme" dissociation? In other words, what makes it extreme?

Katz, good question. The word extreme was my own, and not really a clinical definition. What I mean by it is when dissociation is the go-to coping strategy and puts too many barriers in front of healing the trauma. We have an assessment we use called the DES-II, it's not "diagnostic" but more a "screen," and asks questions about different types of dissociation to determine how frequently it happens, etc. As therapists we need to know what happens, how difficult it is to "come back," and whether you know it's happening and can pull yourself back. All of those things are important because for EMDR to be effective, it requires being able to be aware and connected to the trauma. If someone dissociates (like they did originally with the trauma) during reprocessing of the trauma, it won't be accessed to be healed, essentially. I'm a little hesitant to recommend this, but if you google search "DES-II" you can read through the questions and see if your dissociation might be on the higher end. Disclaimer for you though, please don't use it to try to diagnose yourself, or immediately disqualify yourself from being acceptable for EMDR. I hope it might simply be a way to notice things about yourself. Everyone dissociates sometimes, so please keep that in mind if you do check out the scale.

 

[orangeweezel]

Orangeweezel, when do you consider it acceptable for a client to contact you outside of sessions? Only an emergency? Under significant distress before an emergency? I am battling with this issue personally and this seems like a safe place to ask someone.

Hi loui50. Something I personally do with clients is give the option to leave a "venting voicemail" at any time. This might mean having a very upsetting day, feeling overwhelmed, or significant distress, and needing to have a safe place to share it and know the T will listen and bring it up at the next session. A lot of my clients find this containing enough, knowing it got to me and that I care. I encourage them to let me know whether or not they need a call-back. (If they do want a call back, I always ask that they leave a time window or two, so I know a good time to reach them.)

Many therapists have a phone call policy - my agency has a 15-minute policy, where after that amount of time there will be a charge for time on the phone with the T (basically like a phone session). I've found that even just a 10 minute phone call can be incredibly helpful to get to before an emergency happens. In my opinion, it's better to stop an emergency from happening than it is to do clean-up (meaning to heal the damage and suffering that happens). I appreciate that you feel the safety here, and I would greatly encourage you to ask your own T their policy, which might be easier when you're not in that pre-emergency state.

Another great thing about the therapeutic relationship is that if the boundaries are not clear, and they start to get crossed, it's the best possible place to push up against possible boundaries and have the T communicate gently what the boundaries are. At times I have found a client to be getting to a place that is close to my boundaries and realizing I never clearly identified them, which is a great opportunity to do so. Again, I understand how difficult that can be to directly ask your T. If you can muster up the courage I would greatly encourage it, giving both of you the opportunity to put it on the table, and hopefully make you not feel so alone in the uncertainty.

-OW

 

[loui50]

Hi loui50. Something I personally do with clients is give the option to leave a "venting voicemail...

Thank you OW for your thoughtful reply. My T is going out of town for a week, so with 2 weeks between appointments, I was forced to ask about contact. She was very nice and reiterated that I can contact her anytime by email and she will respond. She will check in by phone if needed. I feel much better.

 

[Rumors]

I am wondering about doing emdr when things seem so raw. Lately I have been having such vivid flashbacks that I can actually hear, see, smell, taste..feel...what went on and the thought of doing emdr frightens me quite a bit. It is like it just happened. I'm not a crying type person but I get so anxious and afraid when those spells come that I feel like I could curl up and cry... Does emdr help get rid of that? I have done it before but didn't get too far...

 

[orangeweezel]

Does emdr help get rid of that? I have done it before but didn't get too far...

Hi Rumors. Your hesitance is understandable with how scary that is. Many people with PTSD who receive EMDR therapy experience remission or lack of flashbacks. By reprocessing the trauma in a safe environment with a person who can bring you dual-awareness (meaning being present here and now, while still experiencing the past) can help clear out the symptoms.

It's one of those things where it can feel worse before it feels better, but then it feels much better. It takes away some of the power of the memory, and redefines what that experience means about us. I hope this answers your question, and please feel free to ask follow-up questions.

 

[Freedomfighter]

Hello everyone,

I have my master's degree in Marriage and Family Therapy (and work in a group pra...

EMDR has been very beneficial for me and in the beginning I used this technique a lot. But even despite this therapy I feel extremely vulnerable and so far have not really found aid that concerns my personal vulnerability.

 

[ShodokanJenn]

My experience with EMDR was horrible. I was referred to a therapist who had been the developer of a sexual assault recovery plan for the national guard, to have EMDR for the sexual trauma in my childhood. I didn't tell her much at all before we started the EMDR. In the course of several weeks, my flashbacks spiraled out of control, which led to the dissociation spiraling out of control, which led to severe self harm. The spiral went so far that I ended up in the psychiatric unit three times, for a total of 11 weeks. It is clear now that the therapist did not do the necessary prep work, and I did not share with the necessary honesty. I like reading here about how EMDR is SUPPOSED to work.

The T I see now doesn't do EMDR, but he does have me tap bilaterally while we go through my trauma narrative. My trauma was severe and extended from age 3 to age 12. I used to think I would have to go over every single memory I have, but with my therapist's help I'm finding that I can focus on key memories, and many similar memories get less intense at the same time.

 

[Panda Bear]

My T is always absolve via text or email, especially following EMDR sessions. He will answer my questions or reaffirm me when needed. I'm usually okay, but sometimes get scared of how I'm feeling and need to be reminded that I'll be okay.

I'm glad others have available Ts after EMDR.