I have a strong memory of sitting in my initial training in EMDR and feeling it was very evangelical (I even wrote that down in my workbook and still have it to remind myself now!). By this I felt that everybody was super enthusiastic about it and it was presented almost in a similar way to how I had viewed religion. “Follow me, I am the light, I am the way” was a phrase that sprung to mind! There does just feel a vibe in EMDR that the enthusiasm and passion spreads and subsequently the expectation is that it will work with everybody. It is lovely to see the enthusiasm that trainees experience when they first attend training but it does have it’s downside.
So the problem can lie with the perceived expectation that EMDR should work with everybody. Did anybody else have this feeling when coming out of training? I do wonder if this is why some therapists don’t carry on with EMDR when the first clients they work with don’t run as smoothly as the video sessions they saw on the training.
So, I feel I must emphasise EMDR is not a miracle cure, it’s not that we have a magic wand to wave and everything goes away (although for those of us that do use the wands to do the bilateral stimulation at times it can feel like there is some magic happening!!) IT IS BLOODY HARD WORK Hard work for the client and hard work for the therapist.
There are so many things that we can try when therapy doesn’t seem to be going smoothly and in EMDR supervision you can take a deep dive into thinking about these things – who are we doing EMDR with? (https://theemdrsupervisor.com/the-most-frequently-asked-emdr-supervision-questions-part-1/) what’s the case conceptualisation, choosing different memories to work on, working with blocks (https://theemdrsupervisor.com/what-to-do-when-emdr-processing-appears-stuck/) are the clients within the window of tolerance? The list does go on and on. Remember EMDR is an 8 phased, 3 pronged treatment approach and we have to consider all of these phases. For more guidance on Getting Unstuck with EMDR you can purchase my PDF here
One of the things I often say is push it where it moves so if your intervention is not working try something a little different. And there are many many things that you can try. So my advice is always don’t dismiss the little things that you can change and remember my blog post last week and the importance of trying the easy strategies before you start thinking about the more complex interventions.
I often find that the question ‘what do we do when EMDR doesn’t work? not only a popular one with supervisees but also one with from colleagues. I sometimes think it’s a bit of unfair question. To me it feels quite blaming of the model. There often seems to be some rivalry (shall we say) between the different psychological approaches and how they are viewed by clinicians and clients. For example, therapists (often those not trained in EMDR) might ask how exactly does EMDR work? There are many hypotheses, I’ll save my thoughts around that for another day. But I don’t think I have ever experienced CBT or even Psychodynamic psychotherapy being asked the same kind of questions, and I find that really odd, anyone else think similar or is this just due to my love of EMDR? It might be because the mechanism of the bilateral stimulation can just a bit weird in comparison to other models.
In my experience EMDR works really well but it’s not easy for the client or the therapist, there are many things we can change when things get stuck and supervision helps to create a space where we can reflect on this. I rarely see people where there has not been some positive change but yes I will see people that don’t reach all their goals and we end therapy somewhat disappointed about that. But do you know what some research suggests that from those in therapy only 50% show significant improvement. I’m shocked by these findings. But when you compare those in therapy to those people that receive no therapy 80% have reliable change or improvement. So whatever the treatment model, the presenting problem etc therapy does not work all of the time. As long as we seek supervision and keep moving forward as Clinicians that’s a good way forward.