Emdr - Question About Best Time To Start It

[Hashi]

I should just clarify that I'm not considering EMDR for myself - it's not my path, and I'm already doing trauma therapy in a different way. I want to try to understand EMDR a bit better, though, because I see how many people here find it helpful.

Many people seem to have spent some time in general talk therapy or other therapy before beginning EMDR. I realise that may simply be how things happened, but I'm wondering if you feel it's an advantage, or even feel it might be necessary. Or the opposite.

If you've found EMDR helpful, do you think it would be good to do it as the first step in trauma therapy, or do you think it's good to have done an amount of general talking about the trauma/s first - either with the EMDR therapist or with someone else?

In other words, if I was starting therapy for the first time and chose an EMDR therapist, would you recommend starting the EMDR treatments quite quickly (after talking about safety), say within a few weeks of starting therapy, or do you think it's better to have a few months of just talking first?

 

[LizardViolet]

I'm a supporter for the most part, but I've been experiencing ptsd symptoms lately.

I've been working with a hypnotherapist for a couple of years. She also does some body work (I mean somatic stuff) and she has a lot of experience with trauma survivors, so her insights have been important as I cope with my boyfriend, who has untreated complex ptsd.

But the moment I realized that I was experiencing ptsd symptoms myself, I found an EMDR therapist. Based on what I've read, here and in various books, EMDR strikes me as being the treatment with the best track record, in the shortest time, with the least mucking around in the swamp of my mental misery. My EMDR therapist also uses somatic techniques and over the past couple of weeks, we've been identifying and installing postive resources and coping and grounding strategies. We're going to start processing next time we meet.

I'm a very goal-oriented person. I have a life that depends on me being able to work in my profession and take care of my family and myself, and I'm not interested in talking about stuff for a year before I can get back to being my usual strong self. I am already feeling myself healing and I'm hoping that EMDR will enable me to get all the way back to being the captain of my ship again.

When I first learned about EMDR, particularly (a) the speed with which it works and (b) the fact that the person under treatment does not have to go into long explanations of what has happened to them, my assumption was that it would be the treatment of choice as soon as a trauma survivor learned of its existence. Of course I know that life and being a survivor and choosing to heal are way more complicated than that, but my focused and goal oriented self is taking that road directly.

 

[LizardViolet]

A postscript to my earlier post. I have completed my sessions with the EMDR therapist and I was impressed with how effective it was.

I'd like to note that EMDR therapy has a multi-step protocol. Hashi, you ask whether a person might want to talk through things before they go to EMDR -- but there IS a certain amount of talking before what one may think of as EMDR, the eye movements or bilateral stimulation, actually starts. All those earlier steps hopefully establish a level of trust between the sufferer and the therapist.

The therapist wants to know the broad outlines of your history. The two of you spend a good amount of time coming up with and installing positive resources and coping strategies. Together, you determine the past memories to target for reprocessing. After you address the difficult past memories, there are a couple of concluding steps where you evaluate the effectiveness of the reprocessing and then install additional positive resources for the future.

In short, you don't walk in and instantly start addressing traumatic memories.

 

[Hashi]

Hi LizardViolet,

Thank you so much for sharing this. I've only just seen your posts, I seem to be getting muddled with alerts these days.

What you wrote is very helpful in understanding. It sounds like you have a very good therapist, I'm glad for you that you do. I read posts where it's obvious the therapist isn't following the best approach (eg is doing EMDR at the first session together), but I haven't had such a clear picture of how it should be done, which your posts give me. Thank you.

One reason that EMDR isn't for me is because my brain won't tolerate that kind of reprocessing - I get a strong reaction against anything that tries to "rewire" it. I've tried things like emotional freedom technique/tapping with a somatic therapist, which was a bit pointless because my brain just rejected it. I've tried one EMDR session on something non-traumatic, and found the process really intrusive and disturbing. I've heard that EMDR isn't recommended where there's a history of traumatic amnesia, and the jury still seems to be out on multiple traumas/splitting and fragmenting of the self, so maybe that's why. For me, what feels right is somatic therapy, talk therapy and working with imagery. I think different things suit different people.

I'm sorry you've been experiencing symptoms but it sounds like you have a clear direction and it's working for you. I hope you soon achieve your goals.

 

[Abstract]

Hashi,

I am far from being in the know but thought I would drop off some support anyway. I know there are people on here who have had a lot of therapy before so they can possibly give you their opinion.

My therapist mentioned it at the beginning (after my first session) but it soon became obvious I was not nearly at the level of trust needed to make it safe and she never mentioned it again. At the time others (online) who had a lot of experience said it is not something that should be done without a good level of stability and trust. That it can almost be isolating in that there is limited communication whilst you are doing the actual treatment. But from what I know there is discussion after when it is done properly. It seems some people go in, the treatment is done and there is not much follow through after. And from what I know that is very risky. Maybe a good therapist will decide the timing according to the clients needs.

So just taking a wild a guess I would think the more therapy one has had before the easier it would be. But as I said I don't have the experience or the knowledge.

I agree different things suit different people. You are addressing your trauma and in a way that feels doable for you and that has to be right.

 

[samson]

I have been in therapy for a year now. I had never had any therapy before. My T specializes in EMDR. He mentioned it to me on my 3rd session and gave me some websites to research and see if it sounded like something I would be willing to do. Always giving me to option to do traditional talk therapy.

We spent a couple of months discussing history and making a list of target traumatic memories to try and process. It took a while to get into a grove and took me a while to get used to it. But now it seems we are on a roll.

We do the eye movements where I follow his fingers back and forth. I prefer this because it makes me feel connected to him. He does talk to me during the eye movements - especially if I seem scared - he will gently remind me that it's all over now and this stuff happened a long time ago. He makes me feel safe and it really builds trust even when we are going through some really hard things.

It's not easy. But I believe it is effective.

Hope I've helped and not rambled.

 

[therapybankrupt]

My Therapist explained that EMDR is the fastest and most effective way to reprocess and desensitize trauma. It takes from one visit to a few years of weekly visits depending on the amount of trauma and how deeply buried it is.

I would explain it as if the trauma is not in my face and its far in the distance after a successful treatment. Then I go home and it continues processing moving further away. I know this hard to believe but the rumination stops and when I think of that trauma. Its just like oh that happened pshhhh! It does not hurt me cause of fear, guilt or shame. It just is what it is and was part of my past.

Talk therapy and trauma talk therapy take some people 10- 20 years re-inflicting and re-living the pain until you hopefully get desensitized to it. I did talk therapy for 8 years and only got worse.

I have Been doing EMDR for over a year and can see progress. Its worth all the stuff and hard work that comes with doing EMDR if I can remember without the pain. Putting distance between me and what happened! It no longer feels like I am re-living the trauma and horrible body memories. As a plus some of the good memories at the age of trauma returned! I now have some healthy childhood memories!

Always remember to get a registered EMDR therapist. Check the EDMIRA site for their name. You should also be aware that if you have disassociation or fragmentation of the therapist needs additional education to front load you with the coping skills and possible inner child work to make it easier on you! It is my experience you have to fully invest in the process to have it work.

Tb

 

[Hashi]

Thank you Abstract, samson and TB.

I think I'm starting to understand something a bit more. I think the way I do talk therapy, or maybe I should say the way things happen for me when I do talk therapy, has the same reprocessing effect that other people find with EMDR. I'm aware that my brain is rewiring itself around talking in therapy, it's actually the same type of feeling I would get from trying tapping, EMDR or other brain reprocessing approaches, except that it feels more gentle, natural and controlled by my own system entirely. So my brain accepts it, even if it's uncomfortable. And there are other healing aspects for me, in addition to the rewiring.

I would explain it as if the trauma is not in my face and its far in the distance after a successful treatment.... It does not hurt me cause of fear, guilt or shame. It just is what it is and was part of my past.

This is how talk therapy (plus visualisation and imagery) feels for me, but sort of in layers. I can feel things moving to the past, and I can feel my negative emotions changing to calm acceptance. I think it has to happen in layers for me, because there's so much re-integration that I need to do around it. But it sounds like a similar thing, so I can understand when you say you have this effect from EMDR.

My Therapist explained that EMDR is the fastest and most effective way to reprocess and desensitize trauma. It takes from one visit to a few years of weekly visits depending on the amount of trauma and how deeply buried it is... Talk therapy and trauma talk therapy take some people 10- 20 years re-inflicting and re-living the pain until you hopefully get desensitized to it. I did talk therapy for 8 years and only got worse.

I think this illustrates for me why people would prefer EMDR over talk therapy, if only EMDR will give that result and they feel OK with the process.

I would probably fall into the several years of EMDR category, and I think I'm spending the equivalent time in talk therapy, but I know it isn't going to have to be ten or twenty years. If it did, though, I don't think there's anything wrong with that. I think what's important is moving forward rather than being stuck, especially not being stuck in distress which I don't think is inevitable with talk therapy, but I see that it's possible.

I think as long as it's not an unhelpful prolonging (or worsening) of the misery, then the process for moving forward and the time it takes doesn't matter as long as it's right for the individual. If it's not taking the client anywhere though, or it's more painful than helpful, I think it's essential to try a different route.

For me, talk therapy has a fairly quick and powerful effect, similar to the way other people talk about EMDR. Clearly, my experience of talk therapy isn't the same as everyone else's. I'm sorry that it made things worse for you.

We spent a couple of months discussing history and making a list of target traumatic memories to try and process.

This is something I've wondered about - that it seems you need to be able to talk at least a little before starting. It would take me more than a couple of months to be able to discuss history and make a list of memories to work on, but again I suppose that must be very different from person to person. I'm not saying that's necessarily anything to do with the nature of the trauma, but is probably individual approach as much as anything.

We do the eye movements where I follow his fingers back and forth. I prefer this because it makes me feel connected to him.

it can almost be isolating in that there is limited communication whilst you are doing the actual treatment. But from what I know there is discussion after when it is done properly.

I think the low level of communication/connection during the process would be an issue for me. I understand about having discussion afterwards, but I feel that there's so much about my traumas that's around secrecy and having to deal with everything alone, this would be a tough one for me personally.

samson, you didn't ramble at all and what you said is very helpful.

I agree different things suit different people. You are addressing your trauma and in a way that feels doable for you and that has to be right.

I hope you won't mind if I allow myself an ironic smile at how "doable" it feels right now... :eek: Actually, that's getting better, and you're right - it is doable and it does feel right for me. Thank you for saying that.


I think I'm the one who's rambling here, but this has been really useful. It helps me understand things about EMDR which I couldn't before, and clarifies some things about my own process. Thank you all for taking time to share your experiences and thoughts.

 

[Abstract]

allow myself an ironic smile at how "doable" it feels right now... A

:oops:;) I did actually give that phrase a moments thought as I realise you are struggling a lot at present. I am glad you feel it is doable despite its "revoltingness".

Maybe that it is slower and more controlled is what appeals to you.

The way I have understood it (disclaimer - very limited understanding and no experience) is that exposure therapy (which is essentially what you are doing in talk therapy) and EDMR do absolutely do the same thing. The way I have understood it is as if the EMDR has a bit more direct access to the brain (very rough description) in a sense. Maybe thats why it can go so horribly wrong with the wrong therapist and administration. And maybe that is why it can go wrong when there are memory gaps.

I think I need a lot of reassurance and connection and I don't really look like I do so I don't know how that would affect EMDR for me. I am so far away from even having to contemplate that as a decision at present that it isnt something I spend time on.

But I think what I am saying is that I can understand if your present approach feels more calming and comfortable (what a word!) for you. Its wonderful that so many are helped by EMDR though.

clarifies some things about my own process

Always good! :tup:

 

[samson]

One additional note. Even though we made a "list" of memories to process. We have covered many, many more than are on the list. One thing will lead to something else. If I'm frustrated with one aspect of emdr it is this. I love lists. When I have a project at work or home - I make a list and I check off each task as I complete it. Emdr does not work like that.

Every few weeks I look at my T and say "Where are we and when will I feel better?" I used to quit every couple of weeks (in my head) when I left his office. But then I started noticing a difference and I've been working harder at it ever since.

 

[therapybankrupt]

Hashi

You are doing what is right for you and that is great. You have evaluated all the options and made an informed and personal decision! You are very right when you say certain treatments are not always the answer for everyone! Personally I have never worked with imagery so I have no comparison to how that is. Best of luck in your journey for healing!

Tb

 

[maddog]

This thread has offered me some really insightful perspectives into how others are working with EMDR, and some of the reasons for and against it.

The more I read and hear, the more I am convinced that the effectiveness or otherwise of EMDR is every bit as much about the therapist as it is about the client. Though I don't truly believe that *anyone* fully understands how EMDR works, the fact is that it does facilitate a pathway into the wiring of the brain that is startling for its directness and intensity and therefore has the potential for really drastic impact. Not surprisingly, therefore, it can either go really well, or really badly, depending on how it is managed, and as the informed expert and the one in control of guiding the process, most of the onus for this is on the therapist.

Yes, the client needs to be relatively stable (very important I believe, due to the potential for extended and often turbulent processing during and after the EMDR), open-minded to the process (being a skeptic such as I used to be is no good and dooms you to failure before you begin), have a significant level of trust in the therapist and an ability and willingness to explore and process the trauma, and, preferably, a reasonable ability to recount and articulate what is going on in your brain during and after the EMDR.

This last one is critical and is one of the reasons, along with trust, that it was easily 2 years working with my therapist before either of us believed I was ready. While it is true that on face value there isn't a lot of talking and sharing verbally during the process, I actually believe that something which separates ineffective or damaging EMDR from successful EMDR is the ability of the client to be able to verbally explore and "process" the session with the therapist, and the therapist's skill in guiding and facilitating that process.

My therapist actually talks to me quite a lot throughout the process. We do the hand tapping, partly because it has a very grounding and stabilising effect for me, without which I would probably not be able to manage the intensity of it. He speaks to me frequently during and between tapping sequences, reminding me that the events are in the past, I'm safe now etc, much as Samson described, and also encouraging and reminding me to maintain my dual focus on the tapping and on the memory itself. It took me a while to master this dual process component, which is critical, and as I tire it helps to have him "cheer me on"... so to speak towards the end of a session.

He also encourages me at regular intervals to tell him what I'm experiencing/noticing now, whilst also prompting me to observe my body sensations, rate my emotional disturbance, and various other things that are all part of the EMDR model, but which can be used very effectively to facilitate safe communication between client and therapist, assist the therapist to monitor and control pace and intensity, and allow the client to seek and achieve the verbalising of memories and associated cognitions.

He always always always follows up with me shortly afterwards, usually by way of a phone call or text later in the day to make sure I'm ok and to deal with any intense immediate post-session reaction, and then by way of followup session within a couple of days, at which we discuss and verbally process the entire EMDR experience and its outcomes as fully as possible. The process would not be complete or effective for me without this followup session, which really does add the critical language component to the processing experience.

I am very very lucky to have an extremely skilled and attentive therapist who was not daunted by the complexity and extent of my trauma or by my DDNOS diagnosis. I trust him deeply, have a well established relationship and communication dynamic with him, have educated myself as fully as possible about the theory and practice of EMDR and am at a point in therapy where talking about my trauma actually "feels right" - in spite of how difficult and distressing it is. I think EMDR works because I have all of these factors - I suspect that without even one of them, the process would not be nearly so effective.

Like everything, it's not for everyone. We've also done imaginal exposure quite effectively in the past, but I actually find EMDR to be more versatile, more able to help explore and make sense of fragmented memories, less potentially retraumatising and more immediately effective as others have said.

I guess I like it....

Maddog