EMDR and Trauma: A Powerful Brain-Based Therapy with the Opportunity To Coach

EMDR is a wonderful and powerful brain-based therapy that I feel lucky to have at my disposal. Before starting with a new client, I search newspaper articles and videotapes of individuals talking about how difficult the process of EMDR was, but how rewarding it was in the end and how those individuals would never want to go back to how it was before EMDR.  This usually gives my new client a sense of comfort and confidence in the process.  In a way, it’s the same approach that a coach has to take with his/her players on his team—-he/she has to get them to buy into his/her philosophy before they start firing on all cylinders.  After a client becomes comfortable with EMDR,  I like to add that if it wasn’t a memory that was painful,  the client would have worked through it already.  Because it’s so painful, it’s stuck in a disorganized file of the brain.  In order to heal, I emphasize the memory must be confronted and reprocessed.  This is opposed to “leaving it on shelf” unattended where triggers can creep up and reactivate it.

EMDR incorporates a lot of coaching skills, which resonates with me because I have a background as a coach.  A lot of times there are positive moments which need to be strengthened and low points which need to be desensitized.  Both are equally important, so it’s important to be observant and to act appropriately.  If there are some traumatic memories that need to be reprocessed (with a subjective unit distress of 4 or higher) it’s also important to lay the groundwork by strengthening the memories of the people that assisted the client when the trauma occurred, for example.  This could also involve strengthening any characteristic of the client that is particularly helpful to grasp onto in confronting the negative memory, such as resiliency, strength etc.  Beyond the actual process of EMDR, there is a lot of prep work that involves teaching regulation of the lower brain through RSA breathing and state shifts, among other coping skills, such as “resourcing” and “safe place.”  These skills are of utmost importance so that when the client is confronting the negative memory, they can utilize these skills if necessary.  These are kind of like the fundamental building blocks of EMDR—-the basics you need to have in your toolkit.  A coach always emphasizes the importance of fundamentals.

During the actual process of EMDR, the dual attention state is key.  The therapist needs to coach the client through the negative memories by saying “get through the worst of it, so you can get to the other side,” or “use my voice to keep grounded in the present,” or “whatever you want to come out, just let it.”  A lot of times the client didn’t have control then, but they do NOW.  It’s important for the therapist to relay to the client that they are doing fine with it and can handle it now.  If a client gets stuck, it’s important for the therapist to change the stimulation, whether this be the length or speed of the stimulation ie. Diagonal, eyes closed with tactile stimulation.  If that doesn’t get the client back on track, scanning the experience for another scenario or component (body, thought, emotion) is key to finding out what bothers the client the most.   And finally, if that doesn’t solve things, it’s important to look for a feeder memory, blocking belief or floatback.  It’s necessary to have a game plan in place, just like a coach has for his team.  A coach would never let his team go out on the field unaware unprepared against the opponent, and a therapist can’t lead his client through his/her negative past without being adaptable to the client’s varied responses.

One of the key things for EMDR to explain is that emotions are like “little thunderstorms” and that sometimes you will get wet, but then you will be able to dry off.  This is a much better process than learning suppression and just putting it on a shelf.  In order to better have the ability to feel in the moment, it’s important to coach the client to notice other people’s emotions more in between sessions.  Also, throughout the process of EMDR, there are times that clients may notice a change that is positive during the process. These micro-changes, no matter how small they are, should never be neglected.  It is important for the client to thank the part of him or herself that made some progress, so the client knows that they can accomplish good things.

When coaching a client on generally how to approach a memory, it is important to describe to not “hold it,” but instead “go with it.”  This is the opposite of exposure in which you concentrate on the incident. In EMDR, we want the client to go where the brain wants to go.  In other words the train is already going down the track, so don’t hold it, but go with it!  This allows things to happen much more naturally, which I think is great.

It’s amazing to see negative memories become desensitized, but even more amazing to see full blown cognitive shifts regarding how a client feels about themselves when thinking of the target memory.  With that positive cognitive shift also comes a drastic change in their emotions and how it feels in their body.  There is no better feeling than creating a helping relationship with a client and properly coaching them through these “little thunderstorms,” knowing that you have the backing of a powerful and effective brain-based therapy that will deliver.  As a EMDR therapist or coach, you are helping people move forward in their lives, making it more meaningful and happy.

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Ryan Long, MSW, LICSW

ryan@ryanlonglicsw.com

202-875-1495

verified by Psychology Today

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