One of the most common questions I receive from consultees is how to make EMDR therapy their main modality and transition into being an EMDR therapist. They see the ease and comfort I have in my own practice as an EMDR therapist as well as in the group practice I co-founded. They want to emulate this and are stuck, not knowing the steps to take. However, what they don’t see are the years of work, education, training, consultation, client sessions, blood, sweat, and tears that went into building my clinical practice into what it is today. Cultivating a culture of EMDR therapy in your individual work with clients as well as your clinical setting is possible by being mindful of the following considerations.
Jump right in. A challenge I hear from new EMDR therapists is how to get themselves on board with EMDR therapy. Especially after part 1 of the basic training, many clinicians are completely overwhelmed by all of the new information presented and have a difficult time shifting their clinical framework from the old way of doing things to this new, seemingly mystical clinical framework. My best advice is to not wait. Jump right into to it as soon as you leave the training. Come Monday morning, start phase 1 with your clients and look for targets you can process. Also, schedule consultation soon after part 1 to further discuss and consult on how to implement the 8 phase protocol with your current clients. Schedule part 2 within a few months of completing part 1 even if you haven’t completed many consultation hours or started really using EMDR therapy much within your practice. If you wait, you will lose momentum as well as get lost in the new information. Months may pass before you tiptoe into using any bilateral stimulation, even just for resourcing. It’s okay if you have to read from a script during the first 100 sessions or ask the steps out of order periodically. Your EMDR sessions will be messier than what was demonstrated in the trainings; just keep jumping into it over and over again. Practice makes perfect and your clients will forgive you or not even know the difference if you asked for the VOC before the SUDs.
Shift your focus from clinical tool to clinical modality. Since its conception, the view on EMDR therapy shifted from a tool to use within therapy to an all-encompassing treatment modality. By viewing it as such, the approach is altered from having specific EMDR sessions in which you wave your fingers in front of your clients to engaging in EMDR therapy from day one with a client even without bilateral stimulation. Working through the 8 phases of EMDR therapy and understanding the effects of traumas/adverse experiences, further integrates EMDR therapy as a clinical modality. There are many insights and breakthroughs that occur in identifying the origins of negative beliefs and their associated traumas/adverse experiences. Knowing the power of these insights takes the pressure off of rushing into phase 3-6 when a client is not fully prepared and resourced and further highlights the benefits that occur even outside of reprocessing sessions emphasizing a culture of EMDR therapy within your practice.
Have the motto “we can process that!” I constantly have my ears open to potential targets and am known to say, to a bit of chagrin of my clients, “we can process that!”. Not all traumas/adverse experiences are disclosed at the beginning of treatment. Sometimes they are slow to reveal themselves because a client isn’t ready or is just ignorant that these potential targets are affecting their current functioning. With all the advanced EMDR topic trainings targeting specific symptoms and issues, there is potential for an endless number of special protocols. However, you do not have to be specially trained if you have a strong understanding of the basic EMDR therapy protocol and are competent in working with the specific population. Though there may be special considerations with different populations, you can target and process anything that proves to be a trauma/adverse experience. Attend consultation sessions and EMDR networking groups to listen to other clinicians’ experiences in identifying shrouded targets. The more you practice your EMDR skills, the more you will hone your intuition about what constitutes a good target.
Identify yourself as an EMDR Therapist. It is a self-fulfilling prophecy; if you identify as one, you are one. Introduce yourself as an EMDR therapist, which will give you ample opportunity to discuss your treatment approach with potential clients and referral sources. As you become more established, clients will seek you out specifically for EMDR therapy further cultivating the culture of EMDR therapy within your practice. I regularly receive requests from potential clients looking specifically for EMDR therapy indicating a familiarity with this modality. Initially after being trained in EMDR therapy, however, I had to convince all my clients to try this new-fangled therapy. It was a shift from their conceptualization of traditional talk therapy to a culture of EMDR therapy in which we identified potential trauma targets and used bilateral stimulation to desensitize and reprocess these targets. Despite my immediate enthusiasm for EMDR therapy, not all of my clients were as convinced, and it took some time, effort, educating, and demonstrating to create a culture of EMDR therapy within my own practice.
Get the word out. The more publicity and discussions about EMDR therapy, the more mainstream it becomes as a treatment modality. We can cultivate a culture of EMDR therapy in our clinical settings by addressing the effects of traumas/adverse experiences on the brain and explaining the Adaptive Information Processing model. Share the EMDR love with your friends and family. Post information and articles about the effects of trauma/adverse experiences and EMDR therapy on your social media. Host informational sessions at your practice or place of employment and work EMDR therapy into any presentations you are giving as a mental health provider. Network with other EMDR therapists by joining EMDRIA and regional network groups. If you are at an agency, hosting an informational session as a brown bag lunch can help education your colleagues in EMDR therapy. Also, ask your clients to provide testimonials about their experiences with EMDR therapy to their other healthcare providers..
Cultivating a culture of EMDR therapy can be an arduous process. You will constantly have to explain, reinforce, and reframe people’s beliefs about EMDR as a whole therapy framework. By jumping right into the 8 phases and identifying yourself as an EMDR therapist though, you will quickly begin to shift your practice to an EMDR therapy framework. Looking for potential targets within the therapeutic setting and getting the word out about EMDR therapy whether it is within your personal circle or at your practice or agency further cultivates a culture of EMDR therapy within your individual clinical practice as well as within your practice or agency. It will be well worth the effort as you process your clients’ traumas/adverse experiences helping them to achieve a higher level of healing.
The study of subjectivity is broadly concerned with what it means to be an experiencing subject in the world. When I touch the book, “I” am the subject doing unto an object, namely “the book.” This subjective “I” touches the book, reads the book, has the book fall on her head, absorbs the ideas in the book, discusses them with another human being. So, when studying subjectivity, we ask questions about who I am, how I experience the world, and what gives me meaning as a being in the world. It invites us to think about the way in which we relate to the world around us and how we understand our place in it.
There is a long tradition of western philosophy that talks about how we can never really know the things external to us. Sure, I may touch the book, but my sense perception filtered through my brain is all I really have access to. I could be living in the Matrix and the book may not even be real. The outside world is of course experienced, but in some ways, it is always a bit of a mystery. This tradition presupposes that subjects and objects are fundamentally distinct – that I can never know the “truth” of the external world. They suggest that the subject, that I, am reducible to my brain’s processing power of figuring out the external world.
This has always struck me a very disconnected an unsatisfying way to look at my place in the world. The few memories I do have of my childhood are characterized by that feeling of disconnectedness and inability to make contact with the “external world.” Like many, my adolescence was characterized by a chronic striving to “fit in” with the popular kids, with the ever-present anxiety that accompanied a lack of knowing what they really thought about me. Even now, I have very few memories of my childhood before the age of fourteen, which incidentally coincides with the age at which I discovered the ability of alcohol and drugs to manufacture a sense of connectedness to the world – a pastime which would temporarily cure that sense of longing, but ultimately exacerbate the feelings of disconnect and loneliness. Even as an adult I have few belongings that suggest I even existed more than a few years ago. And so, with a lack of history in terms of geographic location, memory and material possessions, save for the ephemeral sense of disconnect from the world around me, I stumbled into this philosophical tradition that reified every negative cognition and somatic discomfort about my lack of fitting into this world.
But there’s another way to think about our place in the world. Maybe we aren’t just minds functioning as detached observers. Part of what it means to be human is to have experiences in the world. To both contribute to shaping the world and to be shaped by it. To bring an amalgamation of life experiences to bear in our interactions with it. Everything we know, we know from a place that has been informed by a geographic, historic, and cultural context that we bring to the table when making sense of a situation or experience. Such an approach to understanding the subject or self means that we are fundamentally evolving, unfolding and growing with each encounter in the world. We are part of the world, connected intimately to it, and it is part of us.
So, what does this mean for the kid with no memories and a chronic sense of isolation from the world? What has it meant for the girl from nowhere? It means the way I understood myself has shifted over time away from the desire to figure out what others think of me and how I can access the inaccessible. Treating the world like an object to be figured out or analyzed as means to manufacturing a sense of connection with it, somehow only puts greater distance there. But in embracing my own unfolding story and honoring oneself as an evolving, growing, and emerging creature responding to the world around her, rather than trying to figure it out, has paradoxically resulted in a deeper sense of connection and intimacy in relationships and with the world at large. The ironic twist here, is that in my experience when I let go of striving to figure it all out and instead am mindful of my own experiences and responses to the world, I actually somehow become part of it rather than a detached observer.
Moreover, if in every interaction with the world I bring with me a history of experiences that help me to make sense of those interactions, then I also bring those experiences with me as I look back at my past. This means I get to look back at a childhood and adolescence that I don’t fully comprehend, that is missing large pieces, and characterized by a sense of not belonging with the wisdom of experiences and memories acquired later in life. For the girl from nowhere, understanding myself in hindsight with the full weight of the experiences I do have, means I get to weave together a new story and claim that history for myself – to rewrite my own narrative.
There is one last important consequence that results from understanding subjectivity as evolving in response to a world with which we are intimately related and in communion. An intimate connection with and sense of belonging to requires responsibility. If we are connected with the world and therefore one another, we are responsible for both validating one another’s unique experiences and histories and challenging one another to continue to grow and evolve. It is not enough to simply honor from whence we’ve come. Comfort with self, community and other, means we must continue to submit to new experiences that challenge us to discard old ideas that are no longer productive and avoid becoming stagnant.
Understanding subjectivity as the embrace of one’s unfolding story in response to the world about her sounds lovely. yet even as I write this, I am keenly aware that I don’t always live in this space of communion with the world. I would be lying if I said I never gave a damn about what you thought about me, or how even this piece of writing might be received. I want you to like it. I hope you do. But it’s not something I can figure out how to make happen. Even with the full recognition that my striving only feeds my discomfort, I readily admit I still fall into these patterns, defaulting to my analytic brain. I have a choice today about how I want to engage the world, and it’s not always an easy one as I slip into old ways of thinking. So if you see me on the street, feel free to remind me that my own history, experiences, and insights are worth honoring or perhaps need challenged so that I might continue to grow and feel a little more comfortable in this world, and I’ll try to do the same for you.
I woke up this morning to the news that a mass shooting occurred in Dayton, Ohio, about 90 miles west of my home. This was the second mass shooting in 24 hours from which I am still reeling. Though these events did not affect me directly, it is still impactful because of the way it alters my thoughts, feelings, beliefs, and actions. I feel heavier, weighed down with worry, and just an overall sadness. Today, I was planning on taking my kids back-to-school shopping and can’t help but think “What if this happens there and should we even go?”
I hate this thought process and don’t want to live in fear of a tragedy happening to my family, but it’s something I can’t shake. These feelings reveal themselves in the conversations I have with my kids about what to do if a shooting occurs in a public setting. Not to terrify them, but to prepare them in a time of crisis. Unfortunately, this is a common dialogue I have with them to teach them how to keep themselves safe, and they have already gone through this narrative in their schools where they practice lockdown drills and have even been exposed to shootings within our own community. Again, though we weren’t personally affected by these tragedies by being there or having a friend or family member involved, these traumas do affect me personally as I move through the world and teach my kids how to move through the world. I have a heightened sense of worry and anxiety for my family and friends because you never know when it is going to happen.
As an EMDR therapist, I am acutely aware of how trauma can impact individuals in a variety of ways. It is important to understand how mass shootings and community traumas impact not just the direct victims but also impact the community as a whole. The obvious application of EMDR therapy is with any person who was directly involved in a shooting as a victim. There may be images, sounds, smells, somatic sensations, and other stimuli that are triggering and bring the experience flooding back into the present creating a fight, flight, or freeze response. All of these can be processed with EMDR therapy, releasing the emotional charge associated with these triggers and distancing the past from the present.
Survivor guilt is often talked about in conjunction with shootings. My friend was killed, and I survived. A stranger died saving me; if I was at that event that day, it would have been me that was killed. Our brain tricks us into believing that if I was there I could have stopped it, it’s my fault she died, it should have been me, or any number of negative beliefs that our brain uses to try to make sense of what happened. The problem is that these beliefs are just not true and most of the time our rational brain knows this (the neocortex). Our trauma brain (limbic and reptilian) just hasn’t caught up and is in fight, flight, or freeze mode. When you process the traumatic memories, the trauma brain links up with the rational brain, bringing an adaptability to these negative beliefs.
Hearing about these events on the news or through stories told by survivors can be traumatizing in and of themselves. This can instill the same trauma response as directly experiencing a traumatic event. These vicarious traumas can be reprocessed in the same manner using EMDR therapy by targeting the corresponding images you have about these events. Reprocessing these events with EMDR therapy can help desensitize the horrific pictures that go along with a mass tragedy. It allows you to bring these images and memories to an adaptable place letting go of the associated negative beliefs, putting the past in the past and building resiliency. By doing so, you can engage in everyday life and feel empowered.
As I take my kids shopping this afternoon for their first day of school outfits, I will still talk to them about what to do if some crisis occurs to prepare them to keep themselves safe. However, I will do this from a place of preparedness and not fear. I will also talk to them about the different tragedies in our community and how they can affect change just by treating others with kindness and respect and putting more positivity out into the world. I hope to instill in them a sense of safety, empowerment, hope, and love. I hope and pray nothing like this directly affects us, but with the frequency of these occurrences, I fear it is inevitable. My hope is that as we help people to heal and show loving kindness to others, the occurrences of these tragedies will diminish.
Institute for creative mindfulness
Our work and our mission is to redefine therapy and our conversations are about the art and practice of healing. Blog launched in May 2018 by Dr. Jamie Marich, affiliates, and friends.