There could be a variety of reasons why EMDR didn’t work such as lack of training from your therapist, lack of preparation prior to reprocessing, or blocking emotions and body sensations that need to be felt during the reprocessing. In my experience, most issues with EMDR stem from either a lack of training or lack of preparation.
Your therapist wasn’t adequately trained or updated on their training.
EMDR is not an easy therapy to learn or apply. Therapists can be trained in EMDR protocol, yet not have the knowledge on how to apply the protocol to real life client situations. Further consultation is important and necessary once the therapist runs into real world issues that occur after training. This is especially true for clients who have complex PTSD presentations or have a co-occuring diagnosis.
Some therapists were trained in EMDR several years ago when there was something called Level 1 and Level 2 training in EMDR. If a therapist is currently referring to themselves as Level 1 of Level 2 Trained in EMDR, they are not connected to the EMDR community enough to know that these labels have been dropped and are no longer being used. Technically, a Level 1 therapist is not fully trained in EMDR because they have only had one weekend of training instead of the full two weekends of training.
Some therapists were trained early in the development of EMDR when clients were asked to list their 10 best and 10 worst life events. When I was early in my training, a consultant recommended that I do this with my client. Let’s just say it didn’t go so well. Listing someone’s 10 worst life events can be rather overwhelming. Another therapist told me that she did not use the assessment form in the process of having the person access the memory. When asked why, she told me, “They did it differently back when I was trained.”
To find a therapist who is keeping up with EMDR trends and training, you can find a therapist through the EMDR International Association (EMDRIA) website. While there are likely quality EMDR therapists who chose not to be a member of EMDRIA, finding a member will give you a greater likelihood of finding someone who is using EMDR on a regular basis and as one of their primary modalities. EMDR practitioners can continue their training in EMDR and become Certified. With additional hours and training, they can become a Consultant.
To complicate matters, some individuals were trained by organizations that are not accredited by EMDRIA. Since these trainings are not regulated by the governing body for EMDR, these therapists are less likely to be utilizing the EMDR standard protocol. Since they are unable to become members of EMDRIA or become consultants, they often do not pursue continuing education or consultation in EMDR (both of which are necessary to be a good EMDR therapist).
As much as I enjoy EMDR, I understand all too well that the processing of a memory can get blocked to the point where intervention by the therapist is necessary. After years of consultation, additional training, and experience with clients, my practice of EMDR is much different than when I started out. By incorporating ego state therapy (parts or inner child work), I found a missing link that has helped many clients get unstuck. Other therapists incorporate Internal Family Systems (IFS), play therapy, or other modalities into EMDR.
You were given treatment labeled as EMDR that wasn’t EMDR standard protocol.
When people come to me saying they’ve received EMDR in the past, I’ve learned to ask more details regarding the process. One client told me she was handed tappers (a tool that provides alternating vibrations to the right and left hand) while she was talking in her first session. This is not EMDR! EMDR is more than receiving some type of Bilateral Stimulation (BLS) also referred to as Dual Attention Stimulation (DAS). This client was neither prepared properly (see next point) or given enough information to even consent to EMDR. Unfortunately, this negative experience with something the client was told was EMDR, turned her off to true EMDR therapy.
You were not adequately prepared to start reprocessing trauma.
EMDR has eight phases. The first two phases are history taking and preparation. Clients who are excited to start EMDR may become frustrated during the initial two phases if they have been told that EMDR is going to do amazing things for them. However, if surgeons have to determine that you are healthy enough for surgery, it only makes sense that a therapy involving your brain has a preparation process.
The biggest mistake I’ve made as an EMDR therapist is moving too fast. When clients are not prepared adequately, they will either underacess or overaccess traumatic material. When clients underacess traumatic material, they are not experiencing the pictures, emotions, and body sensations that were occurring at the time of the traumatic event. Clients cannot heal from something they are not accessing. On the other hand, when clients overacess traumatic material, they are overwhelmed by the pictures, emotions, and body sensations that come up for them during reprocessing. I have seen clients who no longer want to reprocess trauma again because they had a negative experience.
Preparation activities may include mindfulness, feelings identification, developing a safe container to hold trauma, identifying a calm/safe place, or identifying nurturing or protective figures. These are just a few examples. It’s the therapist’s job to assess and identify what preparation materials a client might need prior to engaging in trauma reprocessing.
You didn’t let go and trust the process
Proper preparation typically prevents this from being an issue. Some clients have difficulty allowing themselves to feel emotions due to invalidation or criticism they received as a child. Other clients may stay in thier head and not connect to their emotions or body sensations. Some clients are afraid on looking internally because they are afraid of what they will find or are afraid of being overwhelmed by it. Being fully imbodied and feeling comfortable enough to share your internal experiences with your therapist are key elements to effective EMDR therapy.
Letting go and trusting the process is an important aspect of EMDR. There is no need to try hard or try to specifically remember something. I encourage my clients to let their brain do all the work. Having a mindful awareness of what is coming up in the mind, body, and emotions and being able to relay this information is paramount. The brain knows how to move towards healing, but it is also important for the therapist to know strategies for getting it unstuck.
What if EMDR didn’t work for me?
If EMDR was not helpful for you, you may want to pursue a therapist who is certified in EMDR therapy or who incorporates other modalities with EMDR. You can also look into other modalities of counseling for trauma such as somatic experiencing, the flash technique, or brainspotting. There is no one size fits all when it comes to therapy. The important thing to understand is that the effects of trauma are highly treatable and not to give up in your healing journey.
Carrie Bock, LPC-MHSP of By The Well Counseling is a Licensed Professional Counselor who specializes in helping clients with trauma, anxiety and OCD get to a deeper level of healing through EMDR via online counseling across Tennessee and in person intensive therapy sessions. Carrie is the host of the Hope for Anxiety and OCD podcast, which is a welcome place for struggling Christians to reduce shame, increase hope, and develop healthier connections with God and others.