I have questions about EMDR

January 31, 2019 10:03 PM

I talked with a therapist today about doing EMDR therapy to try to work out some rather egregious physical symptoms I'm suffering which might be traced back to an incident in which I was smashed against the side of my delivery van by a semi rig sliding sideways on an icy road. She said some things today which have confused me a bit, and I'm hoping people can help provide some broader information.

She doesn't use actual eye movements. She has headphones and hand vibrators. She gave me a 30 second demo of her system.

Things I don't understand:

She said "if I gave you more time in the demo, you might start feeling things". Does this process do things to people without volition? Like, I wasn't expecting any effect because I wasn't doing any mental work toward any process or effect. Would it have done something regardless?

She said "in order for EMDR to work you have to not be in your thoughts but in your feelings. you have to really feel the thing you're working on". I'm not a person who really lives in their feelings of past events much unless they are very recent (this incident is over 2 years old). Is there something I can be told or something I can learn to help me get to this state of feeling which will make this therapy helpful for me?

It's like, I'm really interested in trying this therapy but I understand basically nothing about it. Her descriptions were all rather metaphorical "take the moment and take the feeling out of it and put the feeling away" and I don't have any clue what this means. I mean, on a metaphorical level I do.

I would appreciate any insight into exactly what this therapy entails and what to expect during a session. Will I need to take a ride share home afterward, or can I drive the 30 minutes to my house? Practical stuff, as well as insights.

I'm not wanting to be convinced. I'm wanting to be prepared.

posted by hippybear to Health & Fitness (8 answers total)

I can try to answer a bit since my therapist does EMDR. Went into it thinking it sounded like the strangest stuff but for particular almost-traumatic things it's helped remarkably.

Wouldn't say it does things to people without volition but it CAN be fairly passive-seeming in that you are watching movement/feeling a buzzer and not necessarily attempting to DO anything mentally while this is happening. The first thing is usually to attempt to get in touch with all sensations I can feel - scan through the body from head to toe, I guess in order to center and focus on feelings and sensations.

Then the usual order of operations for me is to recall something that happened in the past, usually something that was distressing, and then basically feeling it - both as in whatever thoughts/feelings come up mentally, as well as any physical sensations, such as sensation of overheatedness, tightness in the chest, nausea, what have you. Sensations is mostly what I get, and it is apparently enough.

At that point the eye movements begin - how long the set is can vary, but 30 seconds would be sorta long for unpleasant-memory work for me - and after each set feedback is asked of if/how the feelings/sensations are changing, what new is coming up, and so forth. Periodically I will re-focus/specifically recall the incident in question, but usually concentrate more on feelings/sensations and how they are changing. It's my understanding that both are important. If you can't get any sensations or feelings from attempting to vividly recall a particular incident, yeah, may not be of as much use, and I'm not sure how you could change that.

As far as being able to drive afterwards, I don't have anything I would call serious trauma or anything that intense, but even exploring the most unpleasant memories which definitely have me feeling too anxious to drive at the moment I am recalling them, I have always been able to make a 40-minute drive on the freeway almost immediately after each session ends without issue or feeling I am being unsafe. If what comes up for you is more intense, can't guarantee it will be the same.

Apparently the processing can continue over time even when not in a session, so there may be things that come up for you later. So far I have not really had this happen, so I don't know exactly what it would be like, but I've been warned about it and my therapist is always open for me to get in touch if things somehow got to be too much to handle.

I've heard some explanations on how it works but nothing that really convinced me, other than memories of past serious unpleasantness so treated now being something I can recall and *not* instantly tense up with panic and anxiety, despite being 100% skeptical this was anything but snake oil.

Hope some of this helps. For all I know different therapists also do the process slightly or considerably differently so your mileage may vary.
posted by Wotron at 11:05 PM on January 31, 2019 [1 favorite]

I've done maybe 2 or 3 EMDR sessions. I'm more of a thinking person (don't feel much in my body, or maybe don't pay attention to it!). For me it was:

1. Think of the strongest/most recent memory while eyes are closed
2. Beep, boop, buzz, buzz of the paddles & headphones happen for 30 seconds
3. As that happens, I just try to let my mind wander to whatever it wants to go to next
4. After ~30 seconds, the beeping and buzzing stops, the therapist asks, "What came up for you?"
5. Holding the new thought in your head, you start over with the 30-second beeping/buzzing and let your mind wander again.

I cry at the drop of a hat so I always took a taxi home, but YMMV.
posted by tinydancer at 11:33 PM on January 31, 2019

I have had between 4 and 6 sessions about really old stuff. I just kind of hung out, followed the process, and waiting to see what popped up in my brain. My therapist would ask leading questions; if we got to a dead end I would tell her nothing was coming up, then she would gently nudge me in a different direction. YMMV. I found it surprisingly (to me) helpful. Good luck!
posted by Bella Donna at 7:39 AM on February 1, 2019

Some googling suggests that there are a couple of certifying organizations. Check out the training and certification the therapist has.

You don't sound very confident in your therapist, and I am generally skeptical. I would insist on certification and lots of training and supervised experience.
posted by theora55 at 7:42 AM on February 1, 2019 [1 favorite]

I've talked before on here about why I generally do not recommend EMDR, as someone with expertise in PTSD and its treatment. The tl;dr is that the eye movements/buzzing should not make a difference- in the PTSD research community, they are nearly universally considered to be an inert add-on to a therapy that already works (i.e., exposure to thoughts AND emotions related to a trauma). So it will work if your therapist helps you focus on thoughts and emotions, but it will not work any better than doing that without eye movements or buzzing, and it will not have any effect that will make it hard to drive home. The fact that she is discouraging emotional engagement is concerning, because that is considered essential to effective PTSD treatment. This suggests to me that she does not understand the active ingredient of the treatment she is offering, which is my precise concern about EMDR.
posted by quiet coyote at 12:23 PM on February 1, 2019 [9 favorites]

I came to say essentially what quiet coyote said. I had EMDR therapy about 6 years ago and found it to be immensely helpful for my PTSD, but I went into it after reading the scientific literature and knowing that the active ingredient was not the eye movement (my therapist used hand buzzers, but same difference). My usual therapist was pushing it at the time, and I figured why not. This turned out to be a good decision for me, because it worked, but I think standard trauma therapy would also have worked as well. The real key for me was that I liked and trusted the therapist doing the EMDR.
posted by sockermom at 1:07 PM on February 1, 2019

Response by poster: While I appreciate the views of naysayers, this is a treatment I have chosen with a therapist I have chosen, and I'm looking for information other than what you are providing here.
posted by hippybear at 6:05 PM on February 1, 2019 [6 favorites]

I did it recently.I too have trouble getting out of my head, especially if the alternative is feeling unpleasant things. But some things my therapist did helped a lot.

I pictured myself on a train with a supportive friend, and I looked out the window and would see the images related to my trauma go by. She began sessions by reminding me how sturdy the train window was. I would start the processing by thinking about an image while buzzing, and then she'd stop and ask what I got, then start again by telling me to go back to the original image. It helped keep me on task pretty well. She also introduced a container (to hold any thoughts or feelings or memories) and a safe place to visualize. (At the end of a session she'd slow down the tappers and I'd think about the safe space, which was one special place I'd chosen to come back to over and over. )

After my first session I was okay to get home, do chores, etc. But the next day I was wiped out. That did lesson as we went on.

We worked on the first target for a couple months and it helped a lot. Later we tried to repeat with a different target, but that one didn't move as much.

EMDR keeps working long after the session, so you'll experience good, bad, and neutral things later at home. Like I was suddenly able to remember all these small things from my past. Nothing major . Just they were suddenly back in my head.

It's powerful stuff. I'm glad I did it. But I'm also glad that I stopped it when I did.
posted by mermaidcafe at 6:32 PM on February 1, 2019