Why I Am Not in an Exclusive Relationship with EMDR

Why I Am Not in an Exclusive Relationship with EMDR

I find that often people are looking for EMDR therapy because they've heard how it's really helped someone they know. I LOVE this! I am a huge fan of EMDR and have experienced its power for myself firsthand in my own therapy. This is also why I invested a lot of time and energy to get EMDR certified.

However, even though I believe in the power of EMDR wholeheartedly, I don't ONLY use EMDR. I know many theories and modalities of therapy. Your therapist needs to have experience in more than one modality of therapy.

Understanding Modalities and Theories

A therapy modality is the tool or the specific type of therapy that is being used. Examples include Cognitive Behavioral Therapy (CBT), Dialectical Behaviour Therapy (DBT), Internal Family Systems (IFS), Emotionally Focused Therapy (EFT), Somatic Experiencing (SE), and Sensorimotor Psychotherapy (SP).

Theory provides therapists with a foundational understanding of how people heal and change. This is crucial because each client brings unique experiences, trauma responses, and ways of processing the world. Without theoretical grounding, a therapist might apply a one-size-fits-all approach that could miss important nuances.

Why Each Person Needs Something Different

EMDR is incredibly effective for PTSD because it helps the brain reprocess traumatic memories through bilateral stimulation. However, sometimes clients hit blocks with EMDR - maybe they can't access the memory, feel too overwhelmed, or their nervous system becomes too activated. This is where other approaches become essential.

Think of therapy theories like different tools in a toolbox. When EMDR gets stuck, I can draw from other modalities. In addition, EMDR might not be appropriate to start with, sometimes we need a secure relational base first. Here are some of the modalities I use in conjunction with EMDR:

SomatoSymbolic Processing: recognizes that trauma lives in the body, not just the mind. When someone can't process through EMDR, working with body sensations, breathing, or movement can help release what's stored in the nervous system. The body has wisdom to share with us. 

Internal Family Systems (IFS): understands that we all have different "parts" of ourselves. Sometimes EMDR gets blocked because a protective part doesn't feel safe letting the person access painful memories. IFS helps identify and work with these parts. IFS is the most currently popular version of this but an older version is called “Ego State Therapy.” 

Emotionally Focused Therapy (EFT) focuses on attachment and emotional connection. EFT helps with understanding attachment patterns that can actively playing out between the client and therapist in the therapy room. When a client feels securely connected to their therapist, their nervous system feels safer to access traumatic material during EMDR processing. EFT therapists are especially skilled at recognizing patterns of insecure attachment and helping to facilitate secure attachment. 

The Therapeutic Relationship as an Important Healing Component

Psychodynamic Theory and the Intersubjective Space allows a therapist to recognize how a client's particular wounds and way of being in the world affect the work of “together-ness” with the therapist. Someone with anxious attachment might worry about being "too much," while someone with avoidant attachment might intellectualize their trauma. By understanding these dynamics, as well as the therapist’s own natural response, the therapist can use the therapeutic relationship to provide a corrective emotional experience.

This relational attunement creates the safety necessary for deeper trauma processing. The therapeutic relationship becomes the container that holds the trauma work. Without that secure foundation, techniques like EMDR might feel too threatening, but with it, clients can move through processing with an internalized sense of safety.

More Than Just Throwing Tools

Therapy is much more than just throwing tools at something. In my work with clients I weave these approaches together based on what each person needs in the moment. I might start with somatic work to help someone feel grounded, use IFS to understand what parts are activated, then move into EMDR when the system feels ready, while incorporating EFT principles to address the relational aspects of healing. There is a dance that is always happening with these different levels of perspective interplaying together all the time. 

This integration allows for a more complete and personalized healing process rather than forcing someone into a single therapeutic approach. More than one theory and more than one treatment is helpful because healing happens differently for each person.

Source: Babette Rothschild "The Body Remembers"

What to Expect from Your First (and future) EMDR Therapy Session(s)

If you've been considering Eye Movement Desensitization and Reprocessing (EMDR) therapy, you may have a mix of anticipation and apprehension about your first session. EMDR is a powerful therapeutic approach designed to help people process and heal from traumatic experiences, but stepping into something new can naturally stir up some nerves. Here’s a glimpse into what you can expect from your first EMDR session to help you feel more prepared and at ease.

First, our initial session will typically begin with an introduction to therapy in general, including the practice policies and procedures, as well as introductions for us as the therapist and client, and then the assessment phase begins. I will start by getting to know you, your history, and your current concerns. This is an opportunity for you to share your background and any specific issues or traumas you want to address. It’s also a chance for you to ask me any questions, and we can begin to establish what safety feels like for you in the therapeutic process. 

I will also explain the EMDR process in as much detail as you’d like. You are always welcome to ask questions and clarify any doubts you may have about the process.

Then, once your history and concerns are understood, I will work with you to identify your therapeutic goals. These goals will guide our EMDR process and help tailor the sessions to your specific needs. The treatment plan will outline the steps involved. It can be as simple or as detailed of a treatment plan as we want to create together. 

Here’s an overview of the 8 phases of EMDR therapy. 

1. History Taking and Treatment Planning

This is what I described above.

2. Preparation –

This involves building trust together and explaining the EMDR techniques, including the bilateral stimulation (typically involving guided eye movements), as well as tons of other exercises. This stage can sometimes be the longest, and we often return to this phase between other phases. 

3. Assessment –

Identifying specific memories to target and the sensations, emotions, and negative beliefs that come with them.

4. Desensitization –

Using bilateral stimulation to process the traumatic memories. This is the part that most people understand as EMDR. It is the part where you brain is very active in healing itself and updating the system. 

5. Installation –

This phase is what we do when we install the true positive beliefs about yourself or the world. We are replacing the old programs with new chosen ones. 

6. Body Scan –

This is what I often refer to as “double-checking our work.” Here, we bring up the target and check for any residual tension or distress related to the memory. Sometimes it brings up a new layer of the onion that allows us to heal even more deeply. 

7. Closure –

This gives you a moment to let the learning settle in, before the session ends.

8. Re-evaluation –

We re-evaluate where we are as we re-engage each session. 

Some of the time, the therapy follows the 8 phases in order, but there are times when we will do things “out of order” for good reasons. You can ALWAYS ask if you’re curious about something we’re doing in therapy. I like making decisions together with my clients, so that they have voice and choice and vote about what gets prioritized. You’re the expert on your own life after all!

As you can see, EMDR is a very thorough therapeutic approach. Even with an intensive session (2 hours or more) we may not get through very many stages, depending on the level of complication of the traumas. 

It’s important to know that each and every stage IS EMDR therapy. A lot of time the 4th phase “Desensitization” gets all the hype. However, the bi-lateral stimulation won’t magically cure you of your panic attacks or other symptoms if we just start there. Every phase that we work in is making progress towards that healing.

In a traditional 50-minute therapy session, often we will only get to phases 1 and SOMETIMES 2 and 3. (This is partially why I offer longer sessions, it allows us to do less of phase 8, and more of the other phases which seems to move us along the therapeutic journey more effectively.)

Side Note:

If you decide to start therapy with me, please reach out and ask about access to my For Clients Only page. There I have journal prompts and videos that you can use to prepare in order to get the most out of our time together. This allows you to start on phase 2 before we’ve even met in person.

I hope this is helpful as you get a feel for what EMDR therapy can look like. A big part of my therapeutic approach is permission. I want you to feel comfortable giving and NOT giving me permission for different things that arise in therapy. (For example, if a certain exercise doesn’t work well for you, I want you to feel like you can say “I don’t want to do that exercise anymore, it doesn’t work for me.”) A big part of our first several sessions together is working to create that space for us to learn how to communicate with each other. 

I hope that you have the chance to experience EMDR therapy and decide if it is a good fit for you. As always, if you want to schedule a consultation, be sure to reach out. 

Take Care, 

~Molly

Dissociation vs. DisAssociation

The concept of dissociation is beginning to make its way into popular culture. This is great! Let’s talk about mental health and de-stigmatize it! The concept of dissociation is even brought up in the new Inside Out movie- I can’t wait to see it! 

I’m not on social media (I found that my mental health is correlated with less time on social media. The more time I spent there, the less content and more anxious I became, but I digress), but I hear from people who are on these platforms that this idea is discussed on Tik Tok and Instagram. 

Unfortunately, often the word that is being (mis)used on these platforms is “disassociation.” There’s an extra syllable in there, and there’s a big difference between these two words. 

To dissociate is to leave your body somehow.

It can be anything from going on autopilot while driving, to repressing memories. Often we compartmentalize in big or small ways, and we can leave certain things in a file deep in our subconscious. This is a normal part of life for all humans, even though there are extreme uses of this as deemed necessary by trauma. 

To disassociate is to separate the connection between two things or ideas that are blended together. 

In fact, right now, I’m trying to disassociate the word disassociate from dissociate. Make sense? 

For example, my friend’s dog learned that when the word “cheese” was said, they would receive a treat from the fridge. This dog lost its mind when a photo was being snapped and everyone said “cheese” but they didn’t get the snack! They needed to disassociate the word “cheese” from the dog receiving a snack if they ever wanted to meal plan or take a picture while the dog was around. In this case, they might have wanted to re-train the dog to associate the word “treat” with the cheese treat. Disassociating is a hard task! 

You can see how easy it is to mix these ideas together. 

Sometimes associations happen when a traumatic event occurs. For example, a woman who is sexually assaulted associates the smell of the cologne of her attacker with the attack itself. In this case, as she works through her trauma, eventually the smell of the cologne may be disassociated with the trauma.
She might even have this association, even if she dissociated during the attack and doesn’t remember other details. Her body may remember the smell deep in her subconscious.

In this case, both disassociation and dissociation are important aspects of the conversation, and the meanings of these words are significant.

Why I Don't Use The Phrase "Graduating From Therapy" Anymore

When I was first practicing therapy, I used to use the term “Graduating from therapy” - as if a client could walk across the stage, receive their diploma, and be done, never to look back again (as some people feel about their high school or college graduation.)

But that image doesn’t seem to fit the kind of work that I find myself doing with clients these days. Graduating from therapy feels like a one way ramp- you can only get off, you can’t get back on. That doesn’t sit well with the type of work I do.

I am in therapy myself, and I don’t think there will ever come a day when I “graduate.” Life continues to have transitions, even up until we die. Having a trusted therapist along the journey with me is something I value. Sometimes I need to just plop down on the couch and receive, hear a different perspective, do some EMDR to get through some traumatic things, sometimes I need someone else’s mind along with mine to work through and process something. I don’t want to graduate from having needs or being a human.

I’ve come to change my thoughts about the ending of therapy- now it feels more like a pause. Some of my clients will pause, and they know that they can come back at any time and we will pick back up wherever most needed. I take pauses from my own therapy from time to time, and then I return, because it is good to not be alone on this journey of life. It is good to continue learning. It is great to keep unlearning some of the unhelpful-to-me-now habits and strategies that I needed in the past, but I don’t need anymore. Sometimes I pause with one therapist, only to pick back up with another who feels like a better fit for this season of life.

Can we work through our traumas and “come to completion” on some of our EMDR targets- the answer is both yes and no. Yes, the memory can no longer disturb you. Yes, you can live without having nightmares all the time. Yes, you can have loving and fulfilling relationships.

And No, we’re never done with the work. You might not need to process it in therapy, but you are growing and learning and metabolizing the life events that have happened to you. You may not need therapy weekly, bi-weekly, or even monthly, but knowing that you have a safe place to process anything that might come up feels important, even if it is years later. The only time we are static is when we are dead.

I hope that my clients know that they can always come back to therapy with me.

Whether it is working through a new level of healing from the same story we were working on before, or a new transition, I want to be the therapist that you can come back to whenever you feel a need. I am grateful to the therapists I have had who have been that for me. I also believe that different therapists can help in different seasons. So I hope that my clients feel free to explore what it is like to sit in someone else’s therapy office and learn from that relationship new and different things.

I love celebrating growth, and I believe it is a lifelong process.

I hope that you are finding yourself with some good companions along the way whether that be a therapist, your friends, your given or chosen family.