EMDR Therapy Quarterly

I undertook EMDR training to address a specific problem that arose with my trauma clients, namely that they (and particularly those with complex trauma) did not consistently respond well to trauma-focused CBT (TF-CBT). I found this approach was not really ‘cutting the mustard’ and although trauma symptoms often decreased, clients still lived their lives flavoured by their trauma. Undertaking my EMDR training and beginning to use it with clients has fulfilled my expectations and more.

Background

As an experienced counselling psychologist, grateful for integrative training, I am experienced and comfortable working with clients who are traumatised. I am not afraid of exposure work or strong trauma symptoms that may manifest in sessions, and although many of my clients improved with a combination of TF-CBT and compassion-focused therapy (CFT), I noticed that it was more of a ‘head’ resolution rather than a ‘whole body’ resolution. The NICE recommended approach of TF-CBT seems to work well with some personalities and presentations but not with others. I wanted something that addressed the trauma directly so that people could work through it without being re-traumatised. I wanted people to be able to put their traumatic experience(s) firmly in the past, where they belonged, so that the impact on their lives in the present was minimal. Of course, I knew about EMDR, had read a lot about it, and had discussed it with practitioners, so it felt that EMDR would fit the bill of being a tangible, focused and evidence-based intervention that would shift the traumatic memories and free people up sufficiently to live their lives fully without the trauma hanging over them.

Personal experience of EMDR

I decided to give EMDR a try myself, and my supervisor recommended a practitioner. I brought various issues to those sessions, including my own imposter syndrome, which I have grappled with throughout my professional life. My therapist floated me back to the moment I first appreciated that I felt not good enough (arriving at university as the first member of my family ever to attend), and I processed that target and many subsequent ones. I was bowled over by how effective it was and the relief and freedom that came with it.  This issue was something I had taken to supervision many, many times and struggled with, almost to the point of giving up the work I loved. I had tried behavioural approaches: distancing myself from the thoughts, reading papers like “Love Yourself as a Person, Doubt Yourself as a Therapist?” (Nissen-Lie, H. A., et al., 2015), doing loads of additional training, seeking reassurance, but none of it worked to dispel that sense that I simply was not good enough. Following the processing of the targets, the knowledge that I was good enough and that I could continue to learn and improve emerged with a sense of feeling lighter in my body. It is sitting alongside me and not causing any effect. It’s just over there; it’s shrunk.

EMDR training

I was convinced by how effective EMDR was, so I took the plunge and self-funded my training. I completed part 4 in the autumn of last year, and I have completed work with five clients since, with hugely positive outcomes for them. I am now working towards accreditation.

My experience with the training was overwhelmingly positive. The trainers were brilliant, and the content and resources provided were relevant, comprehensive and well-presented. A feature of the training that I found most helpful was the numerous experiential exercises. Some of these were challenging, but we were able to learn from our mistakes, so I felt equipped when it came to working with my own clients.

For me, the only downside of the training was the long, online days, which I found intense and tiring. The trainers advised us all to get cracking at applying our learning and practising our new skills. We were given a manual, which was so useful. Without a doubt, I sat in the first few sessions with clients reading the manual. I had to overcome the fear of appearing unskilled, and I am still using the manual a lot, but I am becoming less reliant on it as I become more familiar with the protocol.

I am aware that some new trainees come away from their training searching for a client with a single-incident trauma, particularly those working in the NHS, where the culture seems to be that EMDR is only applicable in those cases. I have never been one to shy away from multiple layers of trauma; in fact, I don’t think I’ve ever worked with anyone with a single-incident trauma. Perhaps for me, being well versed in the area meant that the fear of working with more complex clients and managing abreactions was not so much in the fore. I know from conversations with other trainees that they felt the need to be more fluent when dealing with abreactions, but that was not an overriding issue for me. I have lots of tools for stabilising and containing clients and feel skilled enough to apply them. I wonder if perhaps a pre-requisite for EMDR training might be some demonstration of knowledge and experience in trauma-informed work, rather than the assumption that trainees know this.

One of the things I found harder than I imagined was learning about and explaining the adaptive information processing (AIP) model to clients. I think, if I am honest, I need to keep reading the information in the training manual, and I printed off some blurb from the resources section of the training so that I could keep it to hand in sessions. I am still winging it because I understand the science behind it (but then I don’t really understand it), and I am not afraid to tell clients that. I think it is right that they know that the mechanism of action has not yet been proven, even though the evidence base for the intervention is so convincing.

Finding a supervisor

Finding a supervisor was not easy. I sent loads of emails asking for supervision and trying to get into supervision groups. By chance, I met with someone through work who mentioned that the local trust’s lead EMDR trainer had space for supervision, and fortunately, they took me on. Perhaps the apparent scarcity of supervisors is the reason that some of the consultants charge astronomical amounts for supervision!

Progressing my training

Having joined the EMDR UK Association I have now become aware of the many add-ons or supplemental EMDR techniques that are out there. It is tempting, given my history, to sign up for courses in all of them. However, I have decided to take things slowly and thoroughly consolidate my basic training and learning. At the moment, the standard protocol is sufficient for me and my clients. I will investigate G-TEP because that could be helpful to staff and parents in my current work in the neonatal unit.

In summary, I am so pleased I have begun my EMDR practitioner journey. I have experienced the benefits personally and with my clients, and I would encourage new trainees to maximise their investment in the training, take the plunge, and start using it with clients.

Charlotte Warburton is a counselling psychologist, currently working in the Neonatal Intensive Care Unit at the Queen Alexandra Hospital in Portsmouth.