Are you ready for EMDR?

Patients suffering from Post-Traumatic Stress Disorder (and other trauma-induced disorders of structural dissociation) can benefit from the EMDR (Eye Movement Desensitization and Reprocessing) procedure.

EMDR appears to work by increasing the number of connections in the brain between the Apparently Normal Part that attends therapy and takes care of normal socialization, and the Emotional Part that is trapped in recalling a traumatic event. There are success stories and horror stories related to EMDR; the procedure is not without risk — critical to success is the therapist’s ability to assist the patient to handle the material presented by the Emotional Part.

This questionnaire may be helpful to patients who feel anxious about EMDR, helping them to convert ‘nervous feelings’ into specific questions. Professional therapists who perform EMDR are welcome to use it at their own risk — please let me know how it goes in your practice.

 In terms of your relationship with your therapist:
 Do you feel safe if your therapist learns that you feel upset? 
 Do you feel safe disagreeing with them, and saying things that risk disapproval? 
 When distressed, is your therapist’s voice something that you consider comforting?
 If your therapist asked you to do something that was uncomfortable to imagine, would you be willing to try it and see if it works?
 
 If your answer to those is a comfortable ‘yes’, then you have the relationship with the therapist that you need. If your answer is a strong ‘no’, then you’re definitely not ready. If in between, it might be useful to explore the question with your therapist.
 
 In terms of trigger coping:
 While triggered, are you able to receive good advice from a trusted source?
 While triggered, are you able to refrain from acting on dangerous impulses?
 
 If you are in a position to get value out of breaking down barriers (if your ‘good days’ are good), then it’s OK if your trigger-coping is imperfect. If, on the other hand, you are afraid that you’ll immediately get physically violent if triggered, then that fear needs to be addressed. If you experience frightening suicidal ideation or impulses to self-harm (if you don’t feel able to restrain those things), then you need to have safety mechanisms in place to prevent those outcomes from taking place.
 
 In terms of getting value out of breaking down barriers:
 At your best, are you able to receive kindness?
 At your best, are you able to offer kindness to others?
 At your best, are you able to acknowledge other perspectives without feeling threatened?
 
 EMDR breaks down the barriers between the ‘apparently normal part(s)’ (ANP) and the ‘emotional part(s)’ (EP). If your best ANP doesn’t have a reservoir of kindness that it can access, and an ability to acknowledge other perspectives, then you may be better off building it up in isolation before connecting it to the bits that are really suffering.
 
You’ll have some idea of what you’re going to find, what you’re going to connect to. It’s OK to be frightened of it. Your therapist will be there and will try to help you get through it. The question is whether you think that the two of you will be able to work together to endure making the connection, and to get something positive out of it. The questions above are hopefully helpful in making that assessment.