Emdr

[Fraser46]

Hello,


I have being seeing a NHS psychologist for the past year for sessions focussing on coping skills and exposure therapy. I didnt respond well to exposure therapy and had to be signed off work multiple times. I was able to talk about the trauma but as I got anxiety the memory would disappear from my head. The psychologist has gone on maternity leave and I have seen a new therapist for two sessions. She wants to start EMDR next week. I had EMDR about 2 1/2 years ago when I was working abroad, after being attacked but still living in the unsafe environment. I found it very difficult to focus on the memory for more than a split second. The new therapist has said that it probably didn't work because I felt unsafe. My concern is the new therapist wants to start the therapy really quickly and I don't know her or trust her yet. She is aiming for two sessions per week until December (she leaves her post in December) and I will then be transferred over to another psychologist. I feel that this is all quite rushed. Does it matter if I cant keep the main memory in my head. The PTSD is a combination of 1 main event and then smaller events spanning a four month period.

 

[Lucycat]

I suspect that the therapist is 'rushing' because her colleague has done all the ground work. I have had EMDR and found it very effective. Like you I could only tolerate a few seconds of the memory at first. Over a period of time I built it up to a few minutes.

I would say, go with it and take this opportunity. However stay in control and if you don't like what is happening or feel uncomfortable tell the therapist at all times.

2 sessions of EMDR a week is a lot. Are you sure she is not planning to use EMDR on alternate sessions? My therapist said I needed 7 days between EMDR to process it all, but I still saw him I between to talk things through.

 

[Fraser46]

I just presumed it would be EMDR twice a week, maybe it is just a session to discuss things. I will need to check next week. It all just seems a bit of a rush although I have had lots of sessions with another therapist. I just really struggle with strangers but hopefully over time I will learn to trust. I am just worried that we will get to December and another change in person wont help me.

 

[digger]

I think you should discuss this with her in more detail. Talk to her about not feeling that you know or trust her well enough in just two weeks to do trauma work with her yet. Talk to her about your concerns about knowing that you're going to have to change therapists again in December and are worried about starting something with her that you won't be able to finish? It's all well and good having learned coping skills with one therapist, but the trust is not instantly transferable from one person to another I don't think and personally I would need and want to work on that some more first.

 

[Andreea]

Hi Suzanne, it must be difficult for you to change the therapist so many times because the "therapeutic alliance" is also a very important factor in the healing process... Nevertheless, EMDR works even if your therapist didn't speak the same language as you. We always say that in EMDR is your brain that does the work, the therapist only assists and sometimes guides the process. But, there are some conditions that must be fulfilled in order EMDR to work, and one of them is the patient to stay in his/her window of tolerance. And also the dual attention: "a foot in the past and one in the present". These are conditions the therapist must watch to be fulfilled, and a EMDR trained one will assure this is done. We also want the patient to stay in control and before you started the session he/she will tell you that you may rise your hand whenever you want to stop. EMDR is an eight phases process and a trauma desensitization isn't started (phase 4) until the others haven't be given. Like phase 2 which means teaching the patients resources in order to handle the intense emotions, affects dysregulations etc.

 

[Hashi]

EMDR is another type of exposure therapy.

If you're going to do it, you really need to make sure you have good enough coping and grounding skills - like @Andreea says.

The NHS isn't necessarily goihg to do things the way they ought to be done (sorry). You need to advocate for yourself, which I know is really unfair because you ought to be able to trust that the therapist will do things right and in your best interests. Unfortunately, the only person who'll make sure of that is you.

I would sugget talking to the new therapist about your past problems with exposure therapy and asking her how she sees EMDR in that context. For example Is there more work you need to do first on stability? And ask her about the initial preparation stages for EMDR work, which Andreea referred to.

 

[Fraser46]

It is difficult with changing therapists, as I really got to trust the therapist that I was seeing. I had a therapist in Moscow, I have seen two private therapists (the first said that she wanted me to see a colleague who had more experience with trauma) and I am now onto my 2nd one through the NHS. I do think it takes time to build up this trust and I am just worried that I will not be confident enough to open up with someone if they are trying to rush me. I am hoping the EMDR will help me as I am now in a safer environment. Just a bit worried that I didnt respond well to the Exposure therapy and was signed off work a few times. I am just hoping that I am now a bit stronger and will cope with the treatment.

 

[Lucycat]

I could not have done full exposure therapy. EMDR is like exposure by proxy. It is still difficult, but there is a much greater sense of control on the part of the client. I think you can achieve an awful lot between now and December with EMDR, and then possibly continue with your old therapist if she is returning then, for what my T calls 'mopping up' sessions.

 

[Fraser46]

I think the Exposure was difficult as I had no option but to keep talking about the events. The therapist was lovely and we did stop the Exposure as soon as she could see that I was getting really upset or too anxious. The sessions from December would be with another psychologist again. I did ask if it would be possible to then go back to the previous psychologist but was informed that she wont be back until nearer May/June.

 

[Fraser46]

I spoke to the psychologist today about my concerns and she said that over the next couple of weeks we would focus on grounding techniques and safe space. She said that hopefully then we would be ready to start the EMDR as lots of work recently has been completed on this.The EMDR will be completed on most sessions as long as I am coping and sessions will be twice a week, but it could be short bursts of the EMDR rather than EMDR for the whole session.

 

[digger]

And are you happy with that? Has she addressed the concerns you had do you feel?

 

[Fraser46]

I am happy that she will take a few weeks to revisit grounding techniques etc. Still a little worried about two sessions a week as it seems quite intensive. More worried about how this will effect my emotionally at work, as I struggled so much with the Exposure Therapy. Although hopefully by not pushing myself too much I will cope.