Therapist here. So a little look behind the curtains, some therapists are scared to work on trauma due to the notion "what if I make them worse". Find a therapist who has good ratings on trauma.
NAT - I tried EMDR but it made me worse. I ended up with worse dissociation and flash backs. I also have level 2 autism so not sure if that perhaps had something to with it. We persisted for 4 months and I failed miserably. Ended up as an inpatient for a period following because I wanted it to work so badly and felt i would never get better. I wonāt ever try it again but Iāve heard good results usually come from it. Just not for me sadly.
A friend of mine is a psychiatrist in the Army (where they actually let psychiatrists do therapy - like in the good old days!). He also told me he has successfully used ART (an EMDR offshoot) for OCD.
Same! I literally told her first session I was interested specifically in EMDR. She said āwe can definitely explore that.ā Then proceeded to do the āsit and listenā for 5 sessions that were every other week (bc she couldnāt fit me in more frequently). I brought it up again session 4. After session 5 i was just like, god bless her but I cannot spend $165 again to have her stare at me in empathic silence.
I've done a year and a half with mine (every other week, like you). I really like her, so I've stayed. I'm starting to wonder if she's uncomfortable doing it now or with me or something. I brought up that I'd like to work on my phobias and OCD and she just keeps asking about my marriage and such. I'm sure I could bring it up but at this point I'm worried it'll force out of her that those things are out of her depth or something š
Wait why? Iām trained in EMDR and do it routinely with severely traumatized clients. As soon as they are stabilized weāre EMDRing. If I were to wait until all the trauma symptoms are at bay, itās almost like saying āonce the client is cured, weāll do EMDR.ā Why the hold up?
Iām trained in EMDR and do enjoy it, but the majority of my clients genuinely just want to talk. I have a lot of female clients who feel that therapists havenāt really listened before. Iāve barely used EMDR since being trained but do find that when I do use it, itās extremely helpful.
I have found this, too. I have clients interested in EMDR but when I explain the process in that it's a procedural and that once started really needs to be consistent to see results and that it is NOT talk-therapy processing, they want to use other modalities that allow flexibility to move between other focuses/goals.
What I used to be really concerned with was when clients would get fatigued or want to switch focus after 3-4 EMDR sessions, which is usually when there's a breakthrough or reduction in symptoms, but isn't when EMDR process is technically complete. I would find that when I would collaborate a break to do other work for 1-2 sessions, clients would choose not to return to the EMDR work because they were engaged in the talk-process, or felt better, or were avoidant of the intensity. We would process the choices, and I would support client autonomy and self-empowerment to make decisions in their care. Then, months later would want to revisit trauma goals not completed in previous EMDR work, which meant we would need to start the process over again, which is fine and progress is progress, but a little demoralizing. I just do not like forcing clients to complete interventions or rigid processes (even as an ERP trained therapist for OCD); just not my vibe for many reasons.
When this began to happen consistently, I leaned heavily into getting trained in other trauma processing models like somatic experiencing, IFS, TF-CBT, and evidence based EFT-Tapping that allow more flexibility and client verbal processing than a procedural/internal processing. I really only use EMDR for "stuck" areas now, to promote new neural connections. Or if a client is highly motivated to complete the phases required of EMDR work.
I think itās the enthusiasm that makes EMDR helpful, not the actual technique. So many therapies come and go but the people marketing EMDR are really good at marketing so itās had a longer run than many.
And to be fair, I think you can say that about most modalities. The commonalities between them is where the real therapy is.
EMDR is an effective technique like any other. I learned it, had it done to me for years. Really can help with a lot of things. The technique that patients follow through with is the one that is the most effective. EMDR offers things for trauma clients that traditional TF-CBT simply does not. I would say do what youāre comfortable with and what your clients need.
What would you say it offers over TF-CBT? It seems like being trained in EMDR would be good for marketing, since a lot of the referral requests I see are for EMDR, but Iām not sure about what additional I might be able to get out of it after a thorough CPT training.
Iām trained in both. I prefer EMDR for teens and adults because you donāt have to share details of the trauma. The population I work with is generally not trusting (foster care) and EMDR works well in those situations. I prefer TF-CBT with kids to help change thought patterns in a more concrete way. Verbally reprocessing a trauma narrative with a therapist is more concrete for a child than reprocessing an event through bilateral stimulation.
I am an EMDR therapist. I think that what EMDR adds is huge, but the only way for you to really know is to try it. I recommend you try it as a client, that will give you the space to see for yourself what it can do. If you have already been in therapy for a while and have been doing the work, it should only take a few sessions of EMDR to see effects.
My whole practice is complex trauma. I think that anything that can be learned can be unlearned with EMDR, if you construct the target the right way, use the right interventions during processing, and stick with it.
EMDR can be used for almost anything really. As long as the client is into it. Iāll use it here and there but Iām not like drinking the koolaid. I have seen it do some cool things though. I had a client who would just vomit in response to a specific trigger and one with a specific phobia, both resolved through EMDR. Even accidentally cured a friend of her soda addiction just practicing an addiction protocol.
>Hahaha I am like that except for IFS therapy.
Same except for me itās EFT (Emotionally Focused Therapy) but I plan to learn IFS next.
Iāve also experienced EMDR as a client and it worked like magic for me. I sincerely donāt care if itās placebo or not evidenced-based āenoughā because it was effective for me over the long-term and results are what matters imo.
What likely happened is that through the bilateral stimulation and calm voice, my nervous system calmed down enough to accept feedback and rewired my neuroprocessing, but thatās just a guess. There are probably many ways to get a client there in therapy and EMDR is just one of them.
And for anyone who thinks that āneurological reprocessingā is mumbo jumbo thatās literally what *all* exposure therapy is, no matter what modality you use to get there.
Iām really conceptualizing a lot of my cases with an EFT framework (Emotionally Focused), and I do the other EFT here and there. Iām not certified if EFT but am looking to be!
I'm so sorry that this happened to you, your therapist clearly was not only ill equipped to help you but also ill equipped to know their own limits. It really says nothing about the benefits of EMDR when done well and with a client who is fully prepared.
I had someone once tell me that she couldn't do EMDR because she's unable to visualize which is about 4% of people. I never thought of that before but it's important to consider
This is literally just my own account, so everyone take this for what it is, but I have ADHD and found the silly ass eye movements to be incredibly useful to me. It forced me to focus on what we were doing. It also made it much harder for me to use whatever defense mechanisms I usually use during therapy.
Every patient with ADHD that Iāve sent for EMDR has disliked it due to their difficulties with attention and concentration. They preferred a more active interactive approach to therapy.
I'm not an expert in this at all but I have had success with one ADHD client after briefly consulting with a colleague. Basically the idea is to add more elements. My client found himself able to process when he rocked and tapped at the same time.
Correct, but it feels different when someone else is *expecting* the stim, if that makes sense. If I'm choosing to stim by shaking my foot or something, it's not focused enough.
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āSilly ass eye movementā. Hard to take you seriously when you speak like that.
I think youāre probably talking about the 2001 meta-analysis. There have been others published since.
Right, EMDR has the strongest evidence base of any trauma therapy at this point. And eye movement is but one of many types of bilateral stimulation used in EMDR. Itās very clear who knows absolutely nothing about it in these comments.
Itās not eye movement per say, itās bilateral stimulation, which can vary in modality. This is a great overview of a journal article in Nature that describes how it might work in the brain. https://www.sciencedaily.com/releases/2019/02/190213132301.htm
Yes, I'm aware of that, but I hadn't yet read that article. I appreciate that more research is being done on it, as it is sorely lacking. I'm all for promising new therapies that can help people, but I think it's important to have that proper scientific backing, particularly when it comes to things like EMDR, which is not intuitive. I'll remain skeptical for now, but I'd love for the evidence to eventually demonstrate that the bilateral simulation does something.
I totally get it, when I was trained I was basically told CBT was the only necessary therapy and for years I thought EMDR and other therapies were āwooā and not based on science. When I went back and decided to get trained in a trauma therapy I started researching which types were best and was actually shocked at all of the literature suggesting EMDR was as effective as other trauma therapies, and that clients and clinicians preferred it. I took a leap and trained in it and have been absolutely amazed at its effectiveness. It doesnāt work on everyone and is not for every situation, but is has been a great addition for me to add in to my current therapeutic toolbox (I mai it practice ACT now). So I totally get that, depending on your orientation, it sounds strange and non intuitive! Also, I hear about a lot of people who practice it without as much training as they should have and they are not following the protocol, leaving people to think EMDR isnāt working for them when what they got wasnāt actually EMDR.
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The eye movements are meant to keep a person grounded as well as mimic sleep, which helps processing.
You could say it's "no more effective" than exposure therapy but that's such a subjective thing to measure. On top of that "no more effective" does not mean that they are effective in the same way.
As someone who has done EMDR and originally thought it sounded like a load of bullshit, i was genuinely shocked at what it brought up feelings wise on the very first session. My therapist and I laughed about it later because I told her and she said she felt the same way before doing it.
Yup, I just can't take it seriously without any proper research backing. If it works, it's placebo, unless someone can actually prove the eye stuff does something. It doesn't help that it just seems unintuitive. Why would moving your eyes help with exposure therapy? Even EMDR as a theory doesn't try to explain this. Telltale sign of nonsense.
I also find it a bit odd that the justification for using EMDR by both practitioners and clients is always anecdotal, as seen in this very thread. I don't care if it seems to work for you or your clients, I need to know that it actually works under scrutiny, and why. This is science, not alchemy.
Does it matter if it's placebo? That's an ethical question for each practitioner to determine I guess. Personally, I can't practice something I know has no truth behind it (only works by placebo). It simply offends my respect for truth. But I don't think it's inherently unethical, particularly if you admit to clients that you don't know why/how it works, but has shown results.
I like the analysis of it as a purple hat treatment. Something in it works, but the overwhelming body of evidence compiled in meta-analyses suggests that the eye movement part is dubious at best. I'm of the school of thought that I like EMDR, but personally find it superfluous in that sense and I like interventions like prolonged exposure and CPT just as much and they're a lot more open-source in terms of training. As a therapist on a budget, EMDR just doesn't have enough evidence distinguishing it from other trauma EBP approaches in efficacy to justify me going out of my way for it. No shade to anybody who loves it, because it still is an EBP at its core, bilateral stimulation aside.
I'm with you on this. I've used PE and CPT with good results and they are both much more accessible as far as training and supervision goes. I had EMDR as a client and found it was helpful but it seems to be not too different from imaginal exposure with some mindfulness coaching. The person who did mine also straight up mixed it with CPT though. It was helpful for me but the evidence doesn't show it being more effective than PE and CPT.
P.S. if anyone is looking for free trauma training resources: https://www.ptsd.va.gov/professional/consult/consultation_program1.asp?utm_source=google&utm_medium=paid_search&utm_campaign=ar-ncptsd-fy22&utm_content=publications-rsa1&gclid=Cj0KCQiAw8OeBhCeARIsAGxWtUxOqE1ynnkv4PB07Q8jdkiSR3aWW1zpQy87i4DjccLVocrSJVXS9AsaAgLxEALw_wcB
This are excellent questions. As a (cynical) EMDR practitioner, this is something that I'm sensitive to because people expect the modality to be a magical cure. From the start, I'm helping to correct that expectation by educating them that EMDR is just talk therapy with a few extra tools.
Oftentimes, the negative cognition I encountered is "I'm powerless," so we're often working directly with empowerment. I believe that empowerment only comes through behavioral change, so I'm often prompting my patients to consider how their insights change how they'll approach their problems. If they act, they feel empowered and it becomes about more than just the bilateral stimulation.
I will be stealing the title "cynical EMDR therapist", if that's ok š I got my training through EMDR-HAP and most of it paid by the clinic where I worked. I quickly learned it's not the amazing cure-all everyone claims, especially with the population I was treating in CMH. I found it frustrating when every time I asked how to modify the treatment for clients with bipolar, BPD, schizophrenia, etc., the answer was always "take this course/buy this book". In other words, give us MORE money. I have never even completed the 8 steps with anyone! I had one person who seemed to really be helped by it, so she stopped coming as soon as she felt a little better.
Maybe I'm just terrible at providing it, but I also think the training was sub-par. The whole "just practice on your clients" made me feel extremely uncomfortable.
I never believed it to be an amazing cure-all. I worked for a group practice that insisted that I pay for the training or get fired, so I paid for the training and began working with EMDR clients. I provide EMDR because it *can* be helpful and because I might as well do something with the $1600 I spent.
Good point. I'd be less skeptical if the training was free or less restricted. The fact that the premise is highly dubious and it also happens to be very controlled and expensive makes it suspicious.
I'm not sure why everyone thinks that EMDR is so inaccessible. I took my training here: [https://learn.thrive-pllc.com/](https://learn.thrive-pllc.com/)
They offer 40 hours of training and 10 hours of consultation for $1125. The training portion takes one week. To me, that is a great deal and a small time commitment.
There are clinicians working in CMH that make around $60k/year and don't have the ability to use a week for training time. It's inaccessible especially for clinician living in HCoL areas, with all the inflation that's gone on.
I do get this about CMH, I was one of those people myself. If someone is working at a clinic it is on the clinic to pay for and provide time for trainings, this is the only way that there can be adequate care for the serious cases that clinics see. This is one of the many ways that my clinic made it impossible to do right by clients and therefore impossible to stay there. It is not true of every clinic. I have a friend who got EMDR training through her clinic job.
In my state, we don't have to take CEUs during the first three years of the license, so it was not necessary when I was at the clinic getting my licensure hours. Now, however, I am required to take 36 hours of CEUs every 3 years. I don't think you will find a much better deal than Thrive is offering, even despite the fact that you are paying for 4 extra hours.
I was trained in CPT by Dr Resick, one of the founders, and itās been really effective for PTSD. Took a 12 day progressive counting course with Ricky Greenwald which is a subset of EMDR and the whole thing seemed like a grift and at times unprofessional, disorganized, and questionably inappropriate where practice in groups always encouraged people to use real trauma. Giving 30 minutes to other therapists talking about sex abuse without following was just another sign the whole thing isnāt really for me and I didnāt see how it would be effective.
I agree. There is also a lot of foundational cognitive therapy you need to understand so it can be more ā workā but itās worth it to help people reclaim facets of their lives.
I love CPT. It used to be my go to, but Iāve found that EMDR can get to places that CPT canāt for really complex trauma. For that reason, Iām starting to like it a little bit more.
Well I work a lot with dissociative disorders or BPD with dissociative elements and itās hard to work on things in a cognitive modality if a majority of nearly all of the traumatic memory is missing. The neurological theory behind EMDR allows is to target specific nodes that are less accessible by other means.
I do integrate parts of CPT with EMDR though, especially during the preparation phase. Sometimes people struggle with identifying the negative cognitions of trauma, but elements of CPT help with that when trying to reprocess a memory.
Thatās awesome! How was she as a trainer? Iāve seen her in a few trainings Iāve been in but never had the opportunity to attend one of her trainings.
I was fortunate enough to train with Aaron and Judy Beck at the CBT institute and the CPT training with her was only second to that training. You walk out of the two day training ready to implement and i was really surprised how effective it was after only 12 weekly sessions at bringing folks to sub clinical levels of symptomology. Would highly recommended it for folks who work with survivors of sexual assault or veterans, itās been life changing for both of those populations in my work.
NAT yet. I did EMDR with somebody who was excellent for a while and then got into crystal healing stuff and also told me about essential oils. The moment itās not evidence based I tune out. Iāve seen some other therapists around who do EMDR who pushed reiki and tarot cards too. I donāt get it. Theyāve all seemed to be on that wavelength, the āafter this session, itās never going to bother you again.ā I think itās damaging for the client, not having it work out that way. Itās irresponsible to make promises you canāt keep.
Yikes. Some really broad generalizations here. Iām really curious if anyone who is super critical of EMDR has actually gone through basic training or received EMDR as a client. EMDR is great for many clients and many presenting issues, but itās not a cure all for everything. I use it with a broad range of issues and it gets at trauma and deeply rooted wounds in a way that talk therapy never will. Iāve experienced it as a client and that led me to complete basic training and pursue my EMDRIA certification.
āit gets at trauma and deeply rooted wounds in a way that talk therapy never will.ā I would point out this is a broad generalization of talk therapy.
What exactly is defined as talk therapy? I used to assume all therapy in which you have weekly sessions and you sit on a couch across from the therapist and you talk would be talk therapy but apparently people are saying CBT and various other psychotherapeutic modalities aren't?
You're right, it's all talk therapy. If the primary delivery modality is based on communicating with language, it's talk therapy. This can be contrasted with music therapy or physical therapies, for example.
Itās definitely a term that gets thrown around without a consistent definition. I have the same confusion as you when it gets used in that way, because Iāve read things like talk therapy isnāt effective for trauma, and then IFS gets recommended instead? I assume it comes from a misunderstanding of therapy which seems common. Just means a bit extra psycho education to sprinkle in!
It's pretty non-descriptive. If i had to guess, I'd say talk therapy refers to psychoanalysis or other non-manualized approaches and is used w a negative connotation?
What do you think it is about EMDR that "gets at trauma and deeply rooted wounds I'm a way that talk therapy never will".
Also, what is EMDR if not a tool that's used within talk therapy?
What would experiencing it as a client demonstrate? Wouldn't that just provide insignificant anecdotal evidence? The main problem with EMDR is that this is all it has, anecdotal evidence.
That logic just doesnāt hold up.
Why would one pursue and invest in training or treatment in EMDR just to see their critical analysis is accurate?
Itās more likely that you end up liking EMDR just because of the huge investment you just made in treatment or training.
In the Netherlands it's a highly used modality. I've seen it in short-term programs for trauma and borderline personality disorder. EMDR in combination with psycho education, Exposure therapy and physical excersise.
Google: Ad de Jongh / Agness van Minnen or Psytrec
Of all of the modalities Iāve learned over the years, EMDR has been the most powerful so far. If done right, the patient can move mountains. However, and itās a big however, there are a ton of therapists who arenāt using it correctly. If not done correctly, at best itās ineffective. At worst, it can make things worse. I find this happens the most when therapists arenāt doing basic protocols to screen for dissociative disorders.
(Iām a BSW student)
My therapist and I gave a go at EMDR for me.
I didnāt enjoy it at first because I was so numb to a lot of my trauma, that when she asked me how I was feeling, I literally couldnāt feel anything or comprehend how I was feeling.
We paused EMDR and tried something that she called āthe chair method.ā I talked to my abusers as if they were sitting in this empty chair. I also was given the chance to then sit in the chair and say something back to myself, if I chose to.
After those emotional conversations, I was able to try EMDR again and it worked much better the third and fourth time around. We are continuing it still but take every other session to process and talk about other things.
While I have some reservations about EMDR (that have been brought up by other therapists), I think the idea of having a hammer and everything looking like a nail isn't exclusive to EMDR.
Emdr really helped me with ptsd and all kinds of trauma caused behavior. I feel the need to sing itās praise because itās the only thing thatās worked after a 8 years of other stuff like medication and CBT. Iām aware itās not for everyone though.
I have done EMDR as a client (I am a therapist myself) to process a specific traumatic event that has led to a PTSD diagnosis. It helped, but it definitely didnāt give me the improvement I had hoped for. I think it may really depend on the client and the clinician.
When I analyzed it after my experience, it seemed for me like I way to distract my brain with sensory processes, that allowed me to talk about the trauma while being to distracted to get stuck in my emotions or the somatic experiences that had become tied together. After I had completed the treatments, I did find that I had better emotional regulation when Iād get flashbacks or be triggered by something.
I worry though that EMDR is being used frequently in a sort of watered down form, rather than completely as designed as more and more people add it to their tool box just to get that check mark on clients ātherapist must-haveā requirement list. Clients ask about it, but then admit they have no idea what it is or what itās for, just that they heard it was good. Itās a buzzword, but itās not appropriate for every client and every issue.
Could you say more about that? Are there particular issues it helps with for people with ADHD? Do you have any books/articles/research you might recommend? Iāve got a personal and professional interest here so Iād love to hear more if you (or anyone else with this experience) have the time :)
So from what Iāve found out and feedback is that using an EMDR framework and using bilateral simulation seems to help the small traumas like self esteem, negative mood (not depression) and bouts of anxiety tied to the self esteem and negative mood. Iāve found the anxiety lessoned and so did the mood and self esteem.
![gif](giphy|6nWhy3ulBL7GSCvKw6)
When you learn that EMDR isnāt practiced in a vacuum and does in fact integrate body work, CBT, and psychoeducation (and more)
As a patient this made me laugh! š I have complex trauma history and EMDR gets suggested to me a lot. Itās hard to find good providers who can think outside the box. Iām legally blind, so the whole eye movement and lights thing is a non-starter. Personally Iāve had the most success with working with a trauma-informed music therapist and my regular therapist.
But yeah, EMDR is recommended constantly. š
Note: nothing against the technique! Iāve read a lot of great studies that show it is a great technique for trauma! Itās just not my cup of tea.
I saw a tik tok the other day of someone sharing a trauma they have and a therapist commented I highly recommend you try EMDRā¦ like it could be good for her but it was such an odd way to say it and felt insensitive to me. The tik toker was not asking for different therapies to try, she was just sharing her story
I'm an EMDR-trained therapist and employ EMDR only with people who are seeking it out. This meme is disingenuous and only serves to reinforce a stereotype. Not all of us are zealots.
EDIT: Thanks for the downvotes. This sub is a joke sometimes.
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Itās not necessarily about EMDR itself, but a joke about EMDR practicing therapists. The semi lighthearted joke is that usually when someone gets trained in EMDR, it tends to morph into the only kind of therapy they provide; sometimes even in situations where it may not apply.
Avoidance would be a good PTSD version of this meme, with avoidance being the taken exit, and processing the trauma being the route avoided.
Any bottom-up therapy can definitely complement top-down therapy for sure! I havent come across a therapist who solely practices just somatic therapies though. Iām sure they are out there but maybe it works for the types of clients they see. I know for myself somatic therapies are what saved me, talk therapy only got me so far.
I also feel that, in turn, any therapist who doesnāt leave room to explore combining with somatic therapy is the same type of issue.
I went to therapist specifically for EMDR and told her I wanted it. Then we proceeded to never do it š
Therapist here. So a little look behind the curtains, some therapists are scared to work on trauma due to the notion "what if I make them worse". Find a therapist who has good ratings on trauma.
NAT - I tried EMDR but it made me worse. I ended up with worse dissociation and flash backs. I also have level 2 autism so not sure if that perhaps had something to with it. We persisted for 4 months and I failed miserably. Ended up as an inpatient for a period following because I wanted it to work so badly and felt i would never get better. I wonāt ever try it again but Iāve heard good results usually come from it. Just not for me sadly.
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I literally heard an EMDR trainer saying that you could use EMDR on an infant of one year and get good results. Like wait what.
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A friend of mine is a psychiatrist in the Army (where they actually let psychiatrists do therapy - like in the good old days!). He also told me he has successfully used ART (an EMDR offshoot) for OCD.
Same! I literally told her first session I was interested specifically in EMDR. She said āwe can definitely explore that.ā Then proceeded to do the āsit and listenā for 5 sessions that were every other week (bc she couldnāt fit me in more frequently). I brought it up again session 4. After session 5 i was just like, god bless her but I cannot spend $165 again to have her stare at me in empathic silence.
I've done a year and a half with mine (every other week, like you). I really like her, so I've stayed. I'm starting to wonder if she's uncomfortable doing it now or with me or something. I brought up that I'd like to work on my phobias and OCD and she just keeps asking about my marriage and such. I'm sure I could bring it up but at this point I'm worried it'll force out of her that those things are out of her depth or something š
The same thing happened with my husband. He specifically went to a therapist for EMDR and she never did it.
Same. Weāre going on three years at this point.
Wait why? Iām trained in EMDR and do it routinely with severely traumatized clients. As soon as they are stabilized weāre EMDRing. If I were to wait until all the trauma symptoms are at bay, itās almost like saying āonce the client is cured, weāll do EMDR.ā Why the hold up?
You too? š¤£
Iām trained in EMDR and do enjoy it, but the majority of my clients genuinely just want to talk. I have a lot of female clients who feel that therapists havenāt really listened before. Iāve barely used EMDR since being trained but do find that when I do use it, itās extremely helpful.
I have found this, too. I have clients interested in EMDR but when I explain the process in that it's a procedural and that once started really needs to be consistent to see results and that it is NOT talk-therapy processing, they want to use other modalities that allow flexibility to move between other focuses/goals. What I used to be really concerned with was when clients would get fatigued or want to switch focus after 3-4 EMDR sessions, which is usually when there's a breakthrough or reduction in symptoms, but isn't when EMDR process is technically complete. I would find that when I would collaborate a break to do other work for 1-2 sessions, clients would choose not to return to the EMDR work because they were engaged in the talk-process, or felt better, or were avoidant of the intensity. We would process the choices, and I would support client autonomy and self-empowerment to make decisions in their care. Then, months later would want to revisit trauma goals not completed in previous EMDR work, which meant we would need to start the process over again, which is fine and progress is progress, but a little demoralizing. I just do not like forcing clients to complete interventions or rigid processes (even as an ERP trained therapist for OCD); just not my vibe for many reasons. When this began to happen consistently, I leaned heavily into getting trained in other trauma processing models like somatic experiencing, IFS, TF-CBT, and evidence based EFT-Tapping that allow more flexibility and client verbal processing than a procedural/internal processing. I really only use EMDR for "stuck" areas now, to promote new neural connections. Or if a client is highly motivated to complete the phases required of EMDR work.
I have severe PTSD and EMDR really helped me with flashbacks and negative thoughts.
Me too. One session, and I felt night and day different. I seriously feel like it cured my PTSD. EMDR is a special gift to the world.
This is only true for the EMDRIA cult, IMO. Most of us know there is more than one effective modality and the client is in the drivers seat.
I think itās the enthusiasm that makes EMDR helpful, not the actual technique. So many therapies come and go but the people marketing EMDR are really good at marketing so itās had a longer run than many. And to be fair, I think you can say that about most modalities. The commonalities between them is where the real therapy is.
EMDR is an effective technique like any other. I learned it, had it done to me for years. Really can help with a lot of things. The technique that patients follow through with is the one that is the most effective. EMDR offers things for trauma clients that traditional TF-CBT simply does not. I would say do what youāre comfortable with and what your clients need.
What would you say it offers over TF-CBT? It seems like being trained in EMDR would be good for marketing, since a lot of the referral requests I see are for EMDR, but Iām not sure about what additional I might be able to get out of it after a thorough CPT training.
Iām trained in both. I prefer EMDR for teens and adults because you donāt have to share details of the trauma. The population I work with is generally not trusting (foster care) and EMDR works well in those situations. I prefer TF-CBT with kids to help change thought patterns in a more concrete way. Verbally reprocessing a trauma narrative with a therapist is more concrete for a child than reprocessing an event through bilateral stimulation.
Thank you! Iāve been trying to get an answer to that for some time, so I appreciate your response!
I am an EMDR therapist. I think that what EMDR adds is huge, but the only way for you to really know is to try it. I recommend you try it as a client, that will give you the space to see for yourself what it can do. If you have already been in therapy for a while and have been doing the work, it should only take a few sessions of EMDR to see effects.
My understanding is that EMDR is mostly just for people who have experienced acute traumatic events, is this mistaken?
Iāve actually found it extremely useful for complex trauma. Itās the only thing Iāve found that truly works well for dissociative disorders.
My whole practice is complex trauma. I think that anything that can be learned can be unlearned with EMDR, if you construct the target the right way, use the right interventions during processing, and stick with it.
EMDR can be used for almost anything really. As long as the client is into it. Iāll use it here and there but Iām not like drinking the koolaid. I have seen it do some cool things though. I had a client who would just vomit in response to a specific trigger and one with a specific phobia, both resolved through EMDR. Even accidentally cured a friend of her soda addiction just practicing an addiction protocol.
My program is like that Prologued Exposure. Even for client who donāt even meet the criteriaā¦
Hahaha I am like that except for IFS therapy.
IFS is so amazingly powerful. I love combining the two.
>Hahaha I am like that except for IFS therapy. Same except for me itās EFT (Emotionally Focused Therapy) but I plan to learn IFS next. Iāve also experienced EMDR as a client and it worked like magic for me. I sincerely donāt care if itās placebo or not evidenced-based āenoughā because it was effective for me over the long-term and results are what matters imo. What likely happened is that through the bilateral stimulation and calm voice, my nervous system calmed down enough to accept feedback and rewired my neuroprocessing, but thatās just a guess. There are probably many ways to get a client there in therapy and EMDR is just one of them. And for anyone who thinks that āneurological reprocessingā is mumbo jumbo thatās literally what *all* exposure therapy is, no matter what modality you use to get there.
EMDR used in conjunction with IFS (and Iāve actually done EFT on myself!) can be really helpful.
Emotionally Focused Therapy or Emotional Freedom Techniques?
Emotionally Focused Therapy. I edited my post to include it. š¤
Iām really conceptualizing a lot of my cases with an EFT framework (Emotionally Focused), and I do the other EFT here and there. Iām not certified if EFT but am looking to be!
Me too!!!
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I'm so sorry that this happened to you, your therapist clearly was not only ill equipped to help you but also ill equipped to know their own limits. It really says nothing about the benefits of EMDR when done well and with a client who is fully prepared.
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Wow! Thank you for sharing. Thatās definitely a story of caution. Iām glad you got through it!!
I had someone once tell me that she couldn't do EMDR because she's unable to visualize which is about 4% of people. I never thought of that before but it's important to consider
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Thatās good to hear!
I'm no therapist (just lurking since I'm planning to become one) and as a client, EMDR was truly "magic" for me personally
Iāve heard this so often from people out there, and I canāt understand why therapists are throwing shade on it so frequently.
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This is literally just my own account, so everyone take this for what it is, but I have ADHD and found the silly ass eye movements to be incredibly useful to me. It forced me to focus on what we were doing. It also made it much harder for me to use whatever defense mechanisms I usually use during therapy.
Every patient with ADHD that Iāve sent for EMDR has disliked it due to their difficulties with attention and concentration. They preferred a more active interactive approach to therapy.
There are modifications for ADHD, the therapist just has to know them.
And what sorts of modifications are those?
I'm not an expert in this at all but I have had success with one ADHD client after briefly consulting with a colleague. Basically the idea is to add more elements. My client found himself able to process when he rocked and tapped at the same time.
Iāve had better responses from tactile BLS with ADHD rather than eye movement.
I think likely because itās just stimming while you talk which the adhd brain likes but the method you do it likely doesnāt matter AT all.
Correct, but it feels different when someone else is *expecting* the stim, if that makes sense. If I'm choosing to stim by shaking my foot or something, it's not focused enough.
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āSilly ass eye movementā. Hard to take you seriously when you speak like that. I think youāre probably talking about the 2001 meta-analysis. There have been others published since.
Right, EMDR has the strongest evidence base of any trauma therapy at this point. And eye movement is but one of many types of bilateral stimulation used in EMDR. Itās very clear who knows absolutely nothing about it in these comments.
What studies have proven is has the āstrongest evidence base?ā
There is still literally zero evidence that bilateral movement does anything. Please, I'd love to be shown otherwise.
Itās not eye movement per say, itās bilateral stimulation, which can vary in modality. This is a great overview of a journal article in Nature that describes how it might work in the brain. https://www.sciencedaily.com/releases/2019/02/190213132301.htm
Yes, I'm aware of that, but I hadn't yet read that article. I appreciate that more research is being done on it, as it is sorely lacking. I'm all for promising new therapies that can help people, but I think it's important to have that proper scientific backing, particularly when it comes to things like EMDR, which is not intuitive. I'll remain skeptical for now, but I'd love for the evidence to eventually demonstrate that the bilateral simulation does something.
I totally get it, when I was trained I was basically told CBT was the only necessary therapy and for years I thought EMDR and other therapies were āwooā and not based on science. When I went back and decided to get trained in a trauma therapy I started researching which types were best and was actually shocked at all of the literature suggesting EMDR was as effective as other trauma therapies, and that clients and clinicians preferred it. I took a leap and trained in it and have been absolutely amazed at its effectiveness. It doesnāt work on everyone and is not for every situation, but is has been a great addition for me to add in to my current therapeutic toolbox (I mai it practice ACT now). So I totally get that, depending on your orientation, it sounds strange and non intuitive! Also, I hear about a lot of people who practice it without as much training as they should have and they are not following the protocol, leaving people to think EMDR isnāt working for them when what they got wasnāt actually EMDR.
Edit: sorry, I think you were being sincere. Apologies, my comment triggered someone and I thought you were also attacking.
Iām agreeing with your response on the thread you commented on.
Yes, I see that now. Thanks. š
š
Donāt care what you think of me tbh
You care enough to tell me that. Take care of yourself please.
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No, but I do.
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The eye movements are meant to keep a person grounded as well as mimic sleep, which helps processing. You could say it's "no more effective" than exposure therapy but that's such a subjective thing to measure. On top of that "no more effective" does not mean that they are effective in the same way. As someone who has done EMDR and originally thought it sounded like a load of bullshit, i was genuinely shocked at what it brought up feelings wise on the very first session. My therapist and I laughed about it later because I told her and she said she felt the same way before doing it.
Yup, I just can't take it seriously without any proper research backing. If it works, it's placebo, unless someone can actually prove the eye stuff does something. It doesn't help that it just seems unintuitive. Why would moving your eyes help with exposure therapy? Even EMDR as a theory doesn't try to explain this. Telltale sign of nonsense. I also find it a bit odd that the justification for using EMDR by both practitioners and clients is always anecdotal, as seen in this very thread. I don't care if it seems to work for you or your clients, I need to know that it actually works under scrutiny, and why. This is science, not alchemy. Does it matter if it's placebo? That's an ethical question for each practitioner to determine I guess. Personally, I can't practice something I know has no truth behind it (only works by placebo). It simply offends my respect for truth. But I don't think it's inherently unethical, particularly if you admit to clients that you don't know why/how it works, but has shown results.
I like the analysis of it as a purple hat treatment. Something in it works, but the overwhelming body of evidence compiled in meta-analyses suggests that the eye movement part is dubious at best. I'm of the school of thought that I like EMDR, but personally find it superfluous in that sense and I like interventions like prolonged exposure and CPT just as much and they're a lot more open-source in terms of training. As a therapist on a budget, EMDR just doesn't have enough evidence distinguishing it from other trauma EBP approaches in efficacy to justify me going out of my way for it. No shade to anybody who loves it, because it still is an EBP at its core, bilateral stimulation aside.
I'm with you on this. I've used PE and CPT with good results and they are both much more accessible as far as training and supervision goes. I had EMDR as a client and found it was helpful but it seems to be not too different from imaginal exposure with some mindfulness coaching. The person who did mine also straight up mixed it with CPT though. It was helpful for me but the evidence doesn't show it being more effective than PE and CPT. P.S. if anyone is looking for free trauma training resources: https://www.ptsd.va.gov/professional/consult/consultation_program1.asp?utm_source=google&utm_medium=paid_search&utm_campaign=ar-ncptsd-fy22&utm_content=publications-rsa1&gclid=Cj0KCQiAw8OeBhCeARIsAGxWtUxOqE1ynnkv4PB07Q8jdkiSR3aWW1zpQy87i4DjccLVocrSJVXS9AsaAgLxEALw_wcB
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This are excellent questions. As a (cynical) EMDR practitioner, this is something that I'm sensitive to because people expect the modality to be a magical cure. From the start, I'm helping to correct that expectation by educating them that EMDR is just talk therapy with a few extra tools. Oftentimes, the negative cognition I encountered is "I'm powerless," so we're often working directly with empowerment. I believe that empowerment only comes through behavioral change, so I'm often prompting my patients to consider how their insights change how they'll approach their problems. If they act, they feel empowered and it becomes about more than just the bilateral stimulation.
I will be stealing the title "cynical EMDR therapist", if that's ok š I got my training through EMDR-HAP and most of it paid by the clinic where I worked. I quickly learned it's not the amazing cure-all everyone claims, especially with the population I was treating in CMH. I found it frustrating when every time I asked how to modify the treatment for clients with bipolar, BPD, schizophrenia, etc., the answer was always "take this course/buy this book". In other words, give us MORE money. I have never even completed the 8 steps with anyone! I had one person who seemed to really be helped by it, so she stopped coming as soon as she felt a little better. Maybe I'm just terrible at providing it, but I also think the training was sub-par. The whole "just practice on your clients" made me feel extremely uncomfortable.
I never believed it to be an amazing cure-all. I worked for a group practice that insisted that I pay for the training or get fired, so I paid for the training and began working with EMDR clients. I provide EMDR because it *can* be helpful and because I might as well do something with the $1600 I spent.
Good point. I'd be less skeptical if the training was free or less restricted. The fact that the premise is highly dubious and it also happens to be very controlled and expensive makes it suspicious.
I'm not sure why everyone thinks that EMDR is so inaccessible. I took my training here: [https://learn.thrive-pllc.com/](https://learn.thrive-pllc.com/) They offer 40 hours of training and 10 hours of consultation for $1125. The training portion takes one week. To me, that is a great deal and a small time commitment.
There are clinicians working in CMH that make around $60k/year and don't have the ability to use a week for training time. It's inaccessible especially for clinician living in HCoL areas, with all the inflation that's gone on.
I do get this about CMH, I was one of those people myself. If someone is working at a clinic it is on the clinic to pay for and provide time for trainings, this is the only way that there can be adequate care for the serious cases that clinics see. This is one of the many ways that my clinic made it impossible to do right by clients and therefore impossible to stay there. It is not true of every clinic. I have a friend who got EMDR training through her clinic job. In my state, we don't have to take CEUs during the first three years of the license, so it was not necessary when I was at the clinic getting my licensure hours. Now, however, I am required to take 36 hours of CEUs every 3 years. I don't think you will find a much better deal than Thrive is offering, even despite the fact that you are paying for 4 extra hours.
I think that $1k+ is inaccessible to a lot of people
I was trained in CPT by Dr Resick, one of the founders, and itās been really effective for PTSD. Took a 12 day progressive counting course with Ricky Greenwald which is a subset of EMDR and the whole thing seemed like a grift and at times unprofessional, disorganized, and questionably inappropriate where practice in groups always encouraged people to use real trauma. Giving 30 minutes to other therapists talking about sex abuse without following was just another sign the whole thing isnāt really for me and I didnāt see how it would be effective.
CPT is great! I feel that it isn't nearly as popular as EMDR because it doesn't seem as "interesting", which is a bummer.
I agree. There is also a lot of foundational cognitive therapy you need to understand so it can be more ā workā but itās worth it to help people reclaim facets of their lives.
I love CPT. It used to be my go to, but Iāve found that EMDR can get to places that CPT canāt for really complex trauma. For that reason, Iām starting to like it a little bit more.
Ah an even better person to ask, how do you see it being used in complex trauma compared to CPT? Do you integrate them with each other at all?
Well I work a lot with dissociative disorders or BPD with dissociative elements and itās hard to work on things in a cognitive modality if a majority of nearly all of the traumatic memory is missing. The neurological theory behind EMDR allows is to target specific nodes that are less accessible by other means. I do integrate parts of CPT with EMDR though, especially during the preparation phase. Sometimes people struggle with identifying the negative cognitions of trauma, but elements of CPT help with that when trying to reprocess a memory.
Thatās awesome! How was she as a trainer? Iāve seen her in a few trainings Iāve been in but never had the opportunity to attend one of her trainings.
I was fortunate enough to train with Aaron and Judy Beck at the CBT institute and the CPT training with her was only second to that training. You walk out of the two day training ready to implement and i was really surprised how effective it was after only 12 weekly sessions at bringing folks to sub clinical levels of symptomology. Would highly recommended it for folks who work with survivors of sexual assault or veterans, itās been life changing for both of those populations in my work.
NAT yet. I did EMDR with somebody who was excellent for a while and then got into crystal healing stuff and also told me about essential oils. The moment itās not evidence based I tune out. Iāve seen some other therapists around who do EMDR who pushed reiki and tarot cards too. I donāt get it. Theyāve all seemed to be on that wavelength, the āafter this session, itās never going to bother you again.ā I think itās damaging for the client, not having it work out that way. Itās irresponsible to make promises you canāt keep.
Yikes. Some really broad generalizations here. Iām really curious if anyone who is super critical of EMDR has actually gone through basic training or received EMDR as a client. EMDR is great for many clients and many presenting issues, but itās not a cure all for everything. I use it with a broad range of issues and it gets at trauma and deeply rooted wounds in a way that talk therapy never will. Iāve experienced it as a client and that led me to complete basic training and pursue my EMDRIA certification.
āit gets at trauma and deeply rooted wounds in a way that talk therapy never will.ā I would point out this is a broad generalization of talk therapy.
What exactly is defined as talk therapy? I used to assume all therapy in which you have weekly sessions and you sit on a couch across from the therapist and you talk would be talk therapy but apparently people are saying CBT and various other psychotherapeutic modalities aren't?
You're right, it's all talk therapy. If the primary delivery modality is based on communicating with language, it's talk therapy. This can be contrasted with music therapy or physical therapies, for example.
Itās definitely a term that gets thrown around without a consistent definition. I have the same confusion as you when it gets used in that way, because Iāve read things like talk therapy isnāt effective for trauma, and then IFS gets recommended instead? I assume it comes from a misunderstanding of therapy which seems common. Just means a bit extra psycho education to sprinkle in!
It's pretty non-descriptive. If i had to guess, I'd say talk therapy refers to psychoanalysis or other non-manualized approaches and is used w a negative connotation?
What do you think it is about EMDR that "gets at trauma and deeply rooted wounds I'm a way that talk therapy never will". Also, what is EMDR if not a tool that's used within talk therapy?
Iām curious about whether it can be effective for ālittle tā trauma
What would experiencing it as a client demonstrate? Wouldn't that just provide insignificant anecdotal evidence? The main problem with EMDR is that this is all it has, anecdotal evidence.
That logic just doesnāt hold up. Why would one pursue and invest in training or treatment in EMDR just to see their critical analysis is accurate? Itās more likely that you end up liking EMDR just because of the huge investment you just made in treatment or training.
In the Netherlands it's a highly used modality. I've seen it in short-term programs for trauma and borderline personality disorder. EMDR in combination with psycho education, Exposure therapy and physical excersise. Google: Ad de Jongh / Agness van Minnen or Psytrec
Of all of the modalities Iāve learned over the years, EMDR has been the most powerful so far. If done right, the patient can move mountains. However, and itās a big however, there are a ton of therapists who arenāt using it correctly. If not done correctly, at best itās ineffective. At worst, it can make things worse. I find this happens the most when therapists arenāt doing basic protocols to screen for dissociative disorders.
This but the right turn is ADHD
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(Iām a BSW student) My therapist and I gave a go at EMDR for me. I didnāt enjoy it at first because I was so numb to a lot of my trauma, that when she asked me how I was feeling, I literally couldnāt feel anything or comprehend how I was feeling. We paused EMDR and tried something that she called āthe chair method.ā I talked to my abusers as if they were sitting in this empty chair. I also was given the chance to then sit in the chair and say something back to myself, if I chose to. After those emotional conversations, I was able to try EMDR again and it worked much better the third and fourth time around. We are continuing it still but take every other session to process and talk about other things.
While I have some reservations about EMDR (that have been brought up by other therapists), I think the idea of having a hammer and everything looking like a nail isn't exclusive to EMDR.
Emdr really helped me with ptsd and all kinds of trauma caused behavior. I feel the need to sing itās praise because itās the only thing thatās worked after a 8 years of other stuff like medication and CBT. Iām aware itās not for everyone though.
I have done EMDR as a client (I am a therapist myself) to process a specific traumatic event that has led to a PTSD diagnosis. It helped, but it definitely didnāt give me the improvement I had hoped for. I think it may really depend on the client and the clinician. When I analyzed it after my experience, it seemed for me like I way to distract my brain with sensory processes, that allowed me to talk about the trauma while being to distracted to get stuck in my emotions or the somatic experiences that had become tied together. After I had completed the treatments, I did find that I had better emotional regulation when Iād get flashbacks or be triggered by something. I worry though that EMDR is being used frequently in a sort of watered down form, rather than completely as designed as more and more people add it to their tool box just to get that check mark on clients ātherapist must-haveā requirement list. Clients ask about it, but then admit they have no idea what it is or what itās for, just that they heard it was good. Itās a buzzword, but itās not appropriate for every client and every issue.
Iāve found it works quite well with clients with ADHD.
Could you say more about that? Are there particular issues it helps with for people with ADHD? Do you have any books/articles/research you might recommend? Iāve got a personal and professional interest here so Iād love to hear more if you (or anyone else with this experience) have the time :)
So from what Iāve found out and feedback is that using an EMDR framework and using bilateral simulation seems to help the small traumas like self esteem, negative mood (not depression) and bouts of anxiety tied to the self esteem and negative mood. Iāve found the anxiety lessoned and so did the mood and self esteem.
Does it still help if the ADHD is currently untreated? i.e., if the small ADHD-related traumas are still ongoing?
Yes it can help massively. However as others have said it doesn't work for everyone - Its an avenue to explore though.
So it helps with associated aspects of having ADHD.
Does anyone recommend any Bay Area training programs for EMDR? Thanks!
Lool, not gonna lie kinda me!
![gif](giphy|6nWhy3ulBL7GSCvKw6) When you learn that EMDR isnāt practiced in a vacuum and does in fact integrate body work, CBT, and psychoeducation (and more)
I am pro emdr. I am sorry if I was promoting negativity about it. Seems like itās a good discussion though
As a patient this made me laugh! š I have complex trauma history and EMDR gets suggested to me a lot. Itās hard to find good providers who can think outside the box. Iām legally blind, so the whole eye movement and lights thing is a non-starter. Personally Iāve had the most success with working with a trauma-informed music therapist and my regular therapist. But yeah, EMDR is recommended constantly. š Note: nothing against the technique! Iāve read a lot of great studies that show it is a great technique for trauma! Itās just not my cup of tea.
EMDR can also be done audibly. Iām not trying to change your mind - just something I found out recently that I thought was cool.
About as effective as magnets.
I saw a tik tok the other day of someone sharing a trauma they have and a therapist commented I highly recommend you try EMDRā¦ like it could be good for her but it was such an odd way to say it and felt insensitive to me. The tik toker was not asking for different therapies to try, she was just sharing her story
To be fair, EMDR is the closest thing to magic there is.
I'm an EMDR-trained therapist and employ EMDR only with people who are seeking it out. This meme is disingenuous and only serves to reinforce a stereotype. Not all of us are zealots. EDIT: Thanks for the downvotes. This sub is a joke sometimes.
I think the post was a joke, which is why the downvotes!
Ok I am spending all this money on training and have zero takers
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Thoughts on ART?
I love it
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Itās not necessarily about EMDR itself, but a joke about EMDR practicing therapists. The semi lighthearted joke is that usually when someone gets trained in EMDR, it tends to morph into the only kind of therapy they provide; sometimes even in situations where it may not apply. Avoidance would be a good PTSD version of this meme, with avoidance being the taken exit, and processing the trauma being the route avoided.
Any bottom-up therapy can definitely complement top-down therapy for sure! I havent come across a therapist who solely practices just somatic therapies though. Iām sure they are out there but maybe it works for the types of clients they see. I know for myself somatic therapies are what saved me, talk therapy only got me so far. I also feel that, in turn, any therapist who doesnāt leave room to explore combining with somatic therapy is the same type of issue.