"Loose" EMDR

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I've been working with a likable, empathetic therapist for over a year now. I like them very much. I began seeing them because they were trained in EMDR and also accepted my insurance. They practice 'Attachment-Focused EMDR', a variation that spends a lot of time on early life trauma and relational attachments. Good emphasis for at least part of the trauma I'm dealing with. It's been helpful, over the long run, though definitely not easy or always pleasant.

I've read a bit of Francine Shapiro, and in my sessions there seems to be a deficit of emphasis on fully bookending the bilateral stimulation with sufficient grounding, resourcing and, at the end, effective containers. T tends to just dive right into the BLS (we use hand buzzers) during the course of us discussing triggers etc. The times in between sessions, since I began, have often been tumultuous for me, and I've gone into some sessions feeling good and come out with depression that leaves me unable to get out of bed for weeks at a time-- esp as weekly sessions to install and further process keep it going. I've addressed this repeatedly with T, hoping to establish some clear structure and barriers about not diving into the BLS without the resources that're hopefully going to keep me sane. (We're dealing with C-PTSD from sustained trauma, as well as multiple single-incident violent traumas, so there's a lot of interconnected stuff that bubbles up once we start digging).

For other EMDR recipients, does this seem like standard operating procedure to you-- that therapist just wants to dive into the processing, and seems to be impatient about laying the groundwork for in-session and between-session safety?

There's a huge difference for me during, immediately after, and between sessions when we've spent real time on the resourcing and containers: I feel well more in control, and not like I've walked into that room in "Poltergeist" where all the objects are spinning and flying around. I've emphasized this repeatedly, and T definitely means well-- but it's like they've been trained in a more loose, off-the-cuff EMDR that I'd expected to be the standard.
So, in order, the things that helped me most in dealing with EMDR were: (in the order we worked on them in therapy)

1 . Building a robust and nearly unbreakable box (or containers). Being able to collect some of the "fall out" and stick it in the box until next session or to put stuff in the box between sessions for the next appointment is difficult to master to some degree but invaluable as you move along.

2. The ptsd cup explanation That one was my own homework but its essential........you need to be able to manage the cup as much as possible.

3. Grounding. Can't do EMDR without it. Learn it and work on using it. When it gets so automatic you realize your stress is rising and you find yourself in the middle of your grounding routine, you are starting to learn how.

4. Recognizing how "loaded" (how much room is available in the cup) you are and communicating it with your T - IS MASSIVELY IMPORTANT. They can't see whats going on in your head, you need to tell them. You need to know when your stress cup is close to overflowing constantly and say "it has to wait."

5. You can't prepare for everything. Memories long buried and covered by PTSD amnesia will come back. Stuff you thought was nothing turn out to be the thin end of the wedge. In short - you never know what is going to fall out between sessions. It's why the box is so hugely important to work on and why you should have your T's phone number handy at all times. Because stuff will come along that won't stay in any box or container.........
This does sound a bit odd. I used to have a therapist that was like this. We spent one or two sessions talking about EMDR and then just went for it. We did practice going to a safe space to calm down if I got too overwhelmed. Once. We didn't have a system to calm down after every session or to prepare for every session. Unsurprisingly, I wasn't able to handle this way of doing EMDR for very long. It would always turn all of my symptoms up to 100% for weeks. She didn't really help me make a plan to deal with that either.

My new therapist spent many weeks laying the groundwork for EMDR. She determined if I was stable enough for EMDR, practiced the safe space exercise with me (and when that didn't work for me we practiced the container ritual), talked to me about some of my memories without bilateral stimulation, and built a trusting relationship with me. It has been an EXTREMELY slow and careful process. We technically have only done EMDR once and are still laying this groundwork. My therapist didn't think it would be safe for us to try EMDR without doing this.

I don't have any tips other than what @Freddyt has already said, but I do agree that it is odd. Especially since you've already mentioned that this bothers you to your T and they haven't changed anything. It is a reasonable request

I’m sorry that sounds awful! I do feel I signed up for more than I bargained for in my EMDR experience but I’ve given suggestions and I keep my T well-informed. He’s started ending with safe space exercises to keep the aftermath to a doable level. I will say that was at my suggestion. However we also started EMDR at my suggestion and T was not entirely convinced I was ready, he did however give me his number and encourage me to call, text or email if I needed to. I haven’t but it did help to know he was available.

When you’ve told him/her how much it affects your life afterwards is there no attempt to prepare you better the next time? If there isn’t and they aren’t explaining why when you tell them your distress level it might be time to find someone better equipped to deal with your level of trauma as to not traumatize you in the name of helping you.

I would say that your experience is not standard operating procedure but then in T we are humans so I can’t imagine a one size fits all approach can be applied. I read a presentation for therapists about dealing with people who have more complex histories and/or dissociate that has the therapist close off channels, maybe that would help?
I have multiple trauma's as well and there are things that are common to more than one. One of the things that happens with that is when you shake tree A something you didn't expect falls out of tree B........or vice versa....or something falls out of tree A and B at the same time....

Learning to live with an very small window of tolerance is the hardest part. We already live with a small window but with EMDR it gets really really tight sometimes - the mail slot of tolerance if you will. Learning how to survive there is hard as hell...especially when you don't know whats going on at times.

That's where this site and all the awesome people and mods helped so so much. Getting through the tough parts is way easier when you have the right tools. You can find those tools here. You can find how to use those tools here too....
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