There are many things I wish I could tell younger versions of myself. "Don't date her", or "This apartment doesn't get heat in the winter". As a young therapist struggling with the impact of trauma on my own life, I wish I could go to her and show her all that EMDR has to offer. Personally and professionally.
Finding the right type of therapy for yourself as a client or a clinician isn't easy. There is so much out there - it can be hard to sort through all the noise. What is trendy right now may not be the thing that works for you. Many of us go to therapy without specific goals because it's just something we think we should do - something Mychal Denzel Smith wrote about for the NYT Opinion section and talked with me about. A lot of us therapists default to talk therapy only - which absolutely has its benefits and completely changed my life in my early 20's - even though we know our clients need more.
I wish I could show my young therapist self, my coming to terms with my own trauma self, EMDR. EMDR stands for Eye Movement Desensitization and Reprocessing. Don't let some of those big words fool you - it's actually quite simple. Our brain stores traumatic material in the here and now memories, which is why they feel so fresh and triggering. These memories haven't been fully digested by the brain's natural processing routine because in order to keep us safe, our brain thinks it needs to keep this memory right up front. This way, hopefully, it won't happen again. However, it means we don't get to move on, feel safe in the present, or create new beliefs about ourselves to replace the ones from trauma. The eye movements are clinically proven to help trigger that natural memory digestion process. The desensitization happens as the material becomes less disturbing through the reprocessing. Eventually we can say, "yeah that happened to me, and it sucked, but it's in the past". Eventually we can "I don't believe I'm worthless anymore, I truly believe I am worthy of love and respect". Eventually we can think of that time in our lives and not feel our mouth go dry or our hands start to shake.
EMDR has 8 clear and predictable phases. History taking, client preparation, assessment, desensitization, installation, body scan, closure and reevaluation of treatment effect. Rapport and relationship building happen during the history taking and client prep, as well as grounding skills. As a young therapist I was flooded with coping skills. Everyone wanted them, and there were simply too many to choose from. It often felt like I was throwing spaghetti at a wall trying to get something to work. Since myself and clients had so many choices, it felt like none of them were good enough. I often found myself saying in session: "Let's try this! No? What about this! Or this?" In EMDR, there are 3 or 4 clear resources to use for grounding and getting back into the window of tolerance. Container (literally a safe storage place in your mind to put unfinished work, triggers, overwhelming feelings), Safe Place (literally a safe place to go to in your mind and body that makes you feel calm and grounded) and whats called RDI (Resource Development and Installation) where you identify positive memories, relationships, and experiences and use those as grounding tools. All of the above is coupled with the eye movements, or any kind of back and forth of the body (tapping with small buzzers you hold in your hands, butterfly hug with tapping, tapping feet on the ground back and forth, all of this is called BLS aka bilateral stimulation).
The other phases focus on processing the traumatic material. What I wish I had known about EMDR - and what honestly kept me away from it for so long, was that this traumatic material is not just specific trauma memories! EMDR uses what is called a three-pronged protocol. Prong #1 is that classic past trauma memory. Prong #2 are triggers in the here and now. Prong #3 are future fears. EMDR addresses the past, present, and future of trauma. For clients who have a long history of trauma starting in childhood, it can feel way too overwhelming to start in the past. This was my main concern - I really didn't want to only work with specific trauma memories with clients! There is just so much more, we are so much more. Which EMDR addresses with this past, present, future protocol. So much of my work with clients is processing triggers that come up in the here and now, and fears for the future related to their trauma.
These processing phases have somatic, cognitive, and memory based components. You are not just processing traumatic memories and images of triggers or fears, but also where you feel that distress in your body, and the beliefs about self and the world that are attached to that image. I had no idea how holistic EMDR actually is, how it takes into account all aspects of our experience, not just one.
I also didn't realize how easily parts work, also known as ego state therapy or Internal Family Systems can be woven into EMDR, and with clients who have childhood trauma and/or dissociation, how parts should be included work! Parts can be invited to Safe Place for meetings with the whole internal system and to be heard from by the core self. Parts need to be checked in with before any deeper processing begins to make sure everyone is onboard and ready to dig into that memory, trigger, or fear. A huge part of my practice is weaving parts work and EMDR, something else I wish I had known was possible! That EMDR could be used to deepen the work I was already doing with parts.
An EMDR target is any specific memory, trigger, or fear that can be used to process. Targets however can expand to include so many other aspects of what clients come to therapy wanting to address. Grief, psychosomatic pain in the body, nightmares, obsessions, compulsions, phobias, attachment issues, addiction, and more. These can be worked with using specific protocols in EMDR.
As a client, I wish I had known the freedom EMDR had in store for me. How certain memories or beliefs about myself could be so directly targeted and processed. I didn't think the work was for me because my trauma didn't fit a specific narrative that at the time was associated with PTSD. As a therapist, I wish I had known how accessible EMDR is for clients and for me as a therapist in training. How EMDR addresses every aspect of the work I was already doing with clients, how it could've answered the question I asked myself everyday: "I know this client needs more than this, but what?"
I feel like I finally have that answer now.
To learn more about EMDR check out emdria.org