And Start Referring to a Consultation with a Specialist
By Adrienne Loker, LCSW, EMDR, SE
What is EMDR?
Eye Movement Desensitization and Reprocessing (EMDR) is a specialized treatment modality for addressing trauma disorders resulting from a shock trauma. EMDR can be modified to treat relational trauma, attachment trauma, complex trauma, and dissociative disorders. In order to use EMDR to address these intricate forms of trauma, advanced training beyond EMDR standard protocol is required, including adequate consultation and oversight from a qualified and competent EMDR and trauma therapist.
Why do so many professionals refer to EMDR?
EMDR works quickly. In fact, one 60-minute session of EMDR can achieve one year’s worth of CBT. But these numbers reflect the use of EMDR with trauma therapists who have more tools in their trauma therapy toolbox than just EMDR that they integrate into their EMDR practice. Without the proper cross training, EMDR therapists run a high risk of re-traumatizing their clients.
How can EMDR be re-traumatizing?
1) If a clinician doesn’t fully assess for developmental trauma.
Borrowing from Peter Levine, developmental trauma refers to anything the is too much, too fast, too soon, with too little support during the formative periods of neurological development. Developmental trauma requires treatment that is facilitated through the therapeutic relationship – meaning that the relationship between client and therapist is the vessel for change. Whereas EMDR standard protocol heavily focuses on the use of a technique as the main change agent. By its very nature, developmental trauma will take a lot more time to treat than a shock trauma, due to the way it metastasizes into every subsequent relationship.
2) If a clinician doesn’t properly assess for dissociation.
Dissociation is an unconscious neurological fragmenting of our emotional experiences. Using standard EMDR protocol with individuals who are highly dissociative can result in a penetration of fragmented memories that can emotionally flood an individual beyond their ability to cope. Another possible outcome of the use of standard EMDR protocol with dissociative individuals is that no reprocessing actually takes place. This is because dissociation organizes the psyche so that consciousness is highly fragmented – meaning that parts of the brain that need to be online for effective reprocessing are unavailable. EMDR with dissociation should including training in ego-state therapies, primarily Structural Dissociation Theory.
3) If a clinician is not capable of containment.
Effective EMDR clinicians will possess training in somatic therapies – allowing them to properly assess activation and deactivation in the autonomic nervous system. Standard EMDR protocol can easily breach an individual’s capacity to contain their emotional experience. A somatically-informed EMDR protocol will support individuals in learning how to safely use the gas and brake pedals in their brain and remain in an emotionally contained state.
The issue with EMDR recommendations.
Without knowing the intricacies associated with trauma treatment, it’s easy to recommend to what’s becoming pop psychology and buzz words. The reality is, if you needed treatment for cancer, your primary care physician wouldn’t recommend a course of treatment for you. Instead, they’d refer you to a specialist in the field of cancer treatment.
Similarly, a primary care physician, psychiatrist, or talk therapist is practicing outside of their scope of practice when they recommend a specific course of treatment for trauma therapy, such as EMDR. Instead, these individuals should refer to a trauma specialist who can conduct an assessment and make an appropriate recommendation for trauma treatment.
About Seeking Depth to Recovery
Our mission is to provide the highest quality trauma treatment so that we can increase the emotional safety of our community. Our providers are cross trained in a variety of experiential therapies to provide the most comprehensive treatment in the entire Richmond area.
We are trained to use EMDR with dissociation, Internal Family Systems (IFS), childhood trauma, preverbal trauma, and compulsive disorders. We provide 90-minute therapy intensives that allow adequate time to warm up, reprocess, and re-center.
If you’re ready to invest in your trauma recovery, schedule an intensive with us: info@SeekingDepthToRecovery.com
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