The Myth of the ‘Good Enough’ EMDR Session

One of the cornerstones of EMDR is the importance of staying out of the way and “letting whatever happens, happen.” Our job is to allow the client’s own brain to do the processing. Clinical interventions are only indicated when the client’s process is stuck. That makes sense when you consider that EMDR was originally developed as a desensitization technique. You brought a past experience to mind that is disturbing, because it is still disturbing long after that time has passed, and you kept focusing on it until it was no longer disturbing.

But most of us are working with clients that struggle with relationship problems, self-esteem issues, and self-regulation difficulties over the course of a lifetime. These problems are not due to discrete, single-event traumas. These are symptoms based in formative and often pervasive attachment experiences where people were hurt and wounded. Their developmental milestones didn’t get met and they didn’t get the kind of guidance and support they needed. Those things are missing. For these clients, staying out of the way is still important, but it’s not sufficient.  These are clients we refer to in our profession as suffering from complex trauma.

When things get stuck

Here’s an example of how staying out of the way is not sufficient: Imagine you grew up with a mother who was depressed and spent a lot of time in bed. When it was time to get up in the morning and go to school, you had to find your own clothes, get your own books, and make your own lunch. You missed out on the important experience of identifying and asking for what you needed. You incorrectly assumed there was something wrong with you that your mother wasn’t helping you.  So, you didn’t learn how to negotiate getting what you needed, never mind having the experience of someone anticipating your needs because you are important. Instead, that little boy or girl learned not to ask. Not to want. Not to feel. It was what they learned to do in order to adapt to their situation.

When this is your client’s childhood memory network, often they’re not feeling their distress because they learned not to. So, how do you get this client to begin to approach the unapproachable territory of their inner life when it’s been treated like a forbidden territory? Or, how do you help the client put words to their feelings with their own voice, rather than the voices of the past prohibiting them from doing so?

You ask not because the client necessarily needs you to ask, but because it helps them know now what they couldn’t know before: how to approach their inner life safely and in the context of another. Their habit has been to avoid their inner life because it was too painful and overwhelming.  As their therapist, I would like to help them have a little curiosity about their inner experience, to help them approach, to help them discover their capacities and how they’re different now as an adult than they were as a kid.  And finally, of course, be in touch with their experience in real time, not in retrospect; to find their words, gestures and impulses, and to have the experience of sharing it with me without my judging them or being overwhelmed, but by meeting them in the moment.

Fill in what’s needed

Good therapy is restorative—it helps people come into the fullness of who they can become now. The absence of the negative doesn’t automatically translate into the positive. That’s the difference between standard EMDR and EMDR therapy. EMDR therapy harnesses an integrative psychotherapy approach to fill in what’s needed to help the person come into their capacities and be fully present to themselves and others. Ultimately, the goal is to help them step into their own authentic sense of self, unencumbered by their histories, but defined and informed by who they are becoming now and going forward into their future.

In order to really optimize what EMDR therapy can offer clinically, we need to bring in all that we didn’t really know 25 years ago when EMDR was first developed. We have huge advances in the field of attachment theory, interpersonal neurobiology, affective neurosciences and body psychotherapies. Those four areas alone make a huge difference. How do you not integrate that body of knowledge into your work? If you only adhere to the EMDR protocol, you relegate yourself to essentially being a technician. Most of the therapists I know want so much more for their clients and from themselves. They want mastery, not technique.

Find out about upcoming programs with Deany Laliotis at Kripalu.

This post was originally published on Deany's website, deanylaliotis.com.

Deany Laliotis, LICSW, an international trainer, clinical consultant, and practitioner of EMDR therapy, specializes in treating traumatic stress disorders and attachment issues.

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