emdr in your treatment

I am certified by the EMDR International Association (EMDRIA) to practice, and I very frequently employ, Eye Movement Desensitization and Reprocessing (EMDR) to resolve or reduce emotional dysregulation and inflammation, in addition to other difficulties in functioning, more swiftly, efficiently, and permanently than traditional  ‘talk’ therapies often can on their own. EMDR is a treatment approach that has been widely validated by peer-reviewed research for use with Post-Traumatic Stress Disorder (PTSD). There is also significant anecdotal, practical, and small-sample study evidence of its effectiveness to treat a variety of other psychological and mental health difficulties.

EMDR is a very powerful treatment, and I use it precisely because of that. Whereas cognitive-behavioral therapy (CBT) may be likened to walking toward a destination, and body-oriented techniques the equivalent of canoeing there, EMDR is rather like taking a powerful speedboat—you get there a lot faster, but it doesn’t mean the ride isn’t going to be bumpy at times.

Because of how deeply (and quickly) EMDR can access disturbing emotional material, you should know the following facts about EMDR and my use of it:

(1) Distressing, unresolved, and sometimes dissociated/forgotten memory material such as visuals, body sensations, and emotions may surface during sessions when EMDR and/or EMDR techniques are employed. Some clients experience intense responses during the treatment sessions, and even during preparation phases, that neither they nor I may or could have anticipated.

(2) Following a session in which EMDR and/or EMDR techniques are employed, related material, dreams, emotions, body sensations, flashbacks, or seemingly unrelated memory material may surface.

(3) Because memory is a process of encoding, storing, and retrieving sensory material, as opposed to being a concrete, static ‘thing’, it can be subject to perceptual and interpretive error. It is therefore not advised to accept memory material that surfaces in the course of an EMDR treatment as objective reality or as definitive proof that “something happened”. That said, I will always honor your emotional experience of any material that has surfaced.

(4) EMDR treatment is contra-indicated in situations where a client is in the midst of or anticipating involvement as a witness in court proceedings of any kind, owing to the impact that EMDR can have upon the emotional intensity and the perceptual vividness of traumatic memory material. In such instances, I will not employ EMDR techniques of any kind without an explicit release from you stating that a) you fully understand that your testimony may no longer be admissible as evidence; b) you may lose important details of –and the strong emotion associated with–traumatic memories; and, c) you are willing to accept the consequences of your decision to move forward with EMDR treatment.

(5) Clients with histories of ocular (eye), cardiac (heart), medically explained seizures, and some other medical issues may not be good candidates for the use of EMDR and/or some EMDR techniques or forms of alternating bi-lateral stimulation. In some instances, approval from your primary care physician may be needed before I will use EMDR to address the issues at hand.

(6) Same-day use of substances will prevent me from employing any form of EMDR or EMDR techniques due to the dissociating effects of all mind-altering substances, including marijuana and alcohol. I will take a full history of your substance using behaviors prior to considering EMDR as an appropriate treatment modality.

(7) I will not employ EMDR or EMDR techniques to help resolve or reduce emotional dysregulation and difficulties until and unless I can be certain that you will be able to tolerate and manage any strong emotions or sensations that may surface. I am therefore very careful and deliberate about pacing the treatment according to my assessment of known (or potential) barriers to successful resolution of your difficulties using EMDR. A significant amount of resourcing and other preparations are sometimes necessary to ensure that EMDR treatment will be successful. In trauma work, it’s been noted that “the slower you go, the faster you get there”—sometimes, for some people, that can mean months or years of preparatory work before the work of resolving traumatic material can begin.

(8) If we establish resources and tools to help you manage disturbing emotions and emotional material between sessions and it becomes apparent that you are not using them—or, if I discover that you are experiencing significant distress even with their use–then we will pause EMDR treatment until/unless I can be certain that you either are effectively using emotion management tools or that the resources you do have are sufficient to allow EMDR treatment to continue safely and effectively.

(9) You always have the right to decline to engage in (or to pause) EMDR treatment. I certainly do practice other treatment modalities in addition to–and, at times, instead of–EMDR. However, I may in some instances offer to refer you to another clinician whose approach to treatment more closely aligns with your preferred ways of accessing (or not accessing) your emotional experience.