Updated: Sep 11, 2020
EMDR could be done right after the traumatic event using a specific protocol for those events.
Still, I’d like to add that it’s necessary to apply clinical judgment before doing so.
For example, I got a client that had been assaulted by a gang the previous month. She came to me with the purpose to do EMDR because she was not able to sleep and was really distressed due to the experience. It was a pro-bono work and I was supposed to give her just a few sessions to help her with the issue.
I took my time gathering the information not only of the event but of her history. I discovered that she had a lawsuit going on against the gang members and that she had to go to court and face her aggressors at some point. I also learned that she had been part of a lawsuit as a child when her parents had fought for her custody. She mentioned that the trail was pretty traumatizing because she was at risk of losing one parent, or both, Those 2 events made her not a candidate for either the Recent Traumatic Episode Protocol (EMDR R-TEP) or for Early EMDR Intervention (EEI).
First, the fact that she had to face her aggressors meant that the danger was not over and that her brain was not able to resolve the fear she felt; all the possibilities of the gang members to hurt her again were still possible, and therefore, she was still in danger. It was not over, and therefore, EMDR can’t help.
Second, the fact that she had a traumatic experience from the custody trial indicated that the possibility to activate those memories during the Recent Event Protocol was very high, and therefore, it was not going to resolve quickly. A larger number of sessions would have been necessary if the problem with her parents had been resolved.
All that to say that when doing EMDR it’s never a good idea to rush. Just because a protocol for recent events exist, doesn't mean it will work and it’ll help the person. EMDR should always be part of a treatment plan that considers the regulation capacity of the person, his/her resources, and the additional information that could interfere with the memory reconsolidation.
EMDR uses something called “bilateral stimulation” to activate both brain hemisphere. Bilateral stimulation (BLS) involves alternating bilateral visual (eye movement), auditory, or sensory stimulation (e.g. tactile stimulation).
Whit the BLS, the 2 brain hemispheres link emotions to images, sounds, or any other sensory information stored at the moment of the traumatic event. When they were unlinked, there was no emotion assigned to them in our conscious awareness.
When the right brain gets stimulated and activated, many of the emotions that were stored but unreachable become available, but they feel raw. Even after the BLS stops, and you find some resolution to your issue in session, your brain will continue linking memories to the newly available emotions.
That’s what makes you feel like a wreck. Just think that all those emotions were unavailable as a way to help you deal with life. Once the can of worms is open, the defenses are gone. Keep working on the memories until you replace the negative emotions with more actual, positive, objective ones.
Being emotionally activated is good news. It means that you started the process of healing, and with good support, you’ll finish processing and find resolution. When that happens, life changes.
I was retraumatized doing EMDR as I was given no grounding or way to cope after session and suffered panic attacks. Is this normal?
Of course, it’s not “normal.” It’s possible, very possible, and all the individuals trained in the modality are warned about this type of situation and are trained to avoid it or to fix it.
The problem with EMDR is that anyone with a mental health license (and pre-license) can train in the modality without requiring them to have previous training in trauma and trauma treatment. Many analysts or therapists trained in completely different approaches are training on EMDR to fill the void they had in their capacity to treat traumatized clients, but adding the modality without the foundation is ineffective, and could even be dangerous, as you are explaining. When I trained, the equipment was sold only to those that had completed training and 10 hours of supervision. Now anyone can buy it. Not that you really need equipment since you can use your fingers, but still, instead of having some control over who’s doing it, now laypeople think they can do it on their own. If you don’t know what the process is about, just remembering and using bilateral stimulation is not EMDR.
Trauma treatment follows very specific phases starting with stabilization and self-regulation exactly for the reason you are addressing: to avoid retraumatization. When you open the can of worms (traumatic memories) too soon, it creates a mess with no benefit. Trauma therapists know what to do before they use the modality. Sometimes it takes a year to stabilize a client before they can engage in EMDR. It has to do with affect tolerance, resilience building, and having regulation skills.
As I always say, EMDR is a great tool for a trauma therapist as a scalpel is for a surgeon, but a scalpel in the hands of a writer is either useless or it could become dangerous. EMDR in the hands of a therapist that doesn’t understand trauma, memory consolidation, resourcing, stabilization, and so on, could be a waste of time, or a retraumatizing method.
Even trauma therapists can confront this situation if the client goes way beyond their tolerance unexpectedly. That’s why, sometimes, in order to give space to that type of reaction, the clinician prolongs the session until the client is in a better place before they leave. Depending on the client, the first few sessions of EMDR, I allocate double slots. That way I have enough time to give my client the opportunity to end the processing and landing to the other side of the emotional reaction.
And independently of the time, I always make sure that the client is “present,” the emotions contained, and I offer the possibility to either contact me, or to schedule another session as soon as needed. EMDR requires close follow-up.