EMDR Therapy Quarterly

Introduction

I want to share with you how, over the last five years, I have been on a personal growth journey. I used to always think that the personal me was separate from the professional/therapist me, but I now appreciate how these dimensions are rarely separate. The core of me continues to grow, and this shapes me personally and professionally as I work on developing my own practice with the science and art of EMDR.

I qualified as a clinical psychologist in 2002 and began my EMDR journey in 2006. My start in EMDR was slow. I was working in secondary care services in the NHS and found it difficult to find appropriate clients because I was encouraged to start with one-off trauma memories and discouraged from working with complexity. Over the years, my client numbers increased. With this came an improvement in both my knowledge and skill, and I started working toward accreditation and consultancy. In 2019, I qualified as an EMDR facilitator. I loved being part of a training team supporting other clinicians to train in EMDR, and I was inspired to develop further to co-found Mindsync EMDR Training. I am currently working towards becoming an EMDR trainer.

In 2017, my world was shattered when my sister was diagnosed with breast cancer. Sadly her diagnosis was later to become terminal and she died in 2019. This was an emotionally challenging time and a personal struggle. I lost my passion and joy for many aspects of my work, and eventually, this led to me leaving the NHS and transitioning full-time into private practice. A move that I would never have anticipated.

I knew I needed to recover from burnout and work through my grief, and to this day I feel this work continues. I received some additional support from psychologists, which included coaching. To me, this was new and exciting, and I loved learning more. The coaching was about helping me to develop my clinical practice outside the NHS. This approach started to ignite something in me; I began to connect again with the joy and enthusiasm of the work I once loved. At first, I held coaching and my EMDR work as something separate, but then I became more curious about how the two could be blended.

What is coaching?

The International Federation of Coaching (2024) defines coaching as “partnering with clients in a thought-provoking and creative process that inspires them to maximise their personal and professional potential. The process of coaching often unlocks previously untapped sources of imagination, productivity and leadership.”

I’m sure that many people would say similar things about the therapy work that we do and the outcomes for many of the clients we see within our clinics.

EMDR and coaching

At first, I viewed the coaching as something different from my EMDR. However, a few years into this coaching journey I started to see how I could begin to blend the two together, and I began to try it. Indeed, it was during one of my business coaching sessions when my business coach (the fabulous Wendy Kendall) said to me something along the lines of “You are looking at how to move EMDR outside of the therapy room.” I began to combine the work I was doing on myself and with my clients. This included:

• My personal coaching sessions and a wonderful coaching course I did with Tara Mohr in the US
• Working with RDIs (resource development and installation) (Korn & Leeds, 2002) and future templates
• More future-focused work with my clients.

Through this, I have developed a six-step programme in EMDR-informed coaching. It’s a flexible framework that I use to hold and contain the coaching work with my clients.

In therapy and especially in the NHS, the focus is generally on mental health symptoms because that is usually what brings our clients into contact with services and us as therapists. Generally, people must meet a ‘caseness’ or severity threshold to be accepted into mental health services.

There are a significant number of people who don’t necessarily meet the threshold for mental health symptoms but who are nonetheless being held back in life because of their blocking beliefs. Perhaps arising because of past trauma, adverse experiences or just unhelpful beliefs they have developed about themselves.

For me, coaching is about performance and helping people to live the life they would love to live, but their blocking beliefs get in the way. As Grand (2009) stated, “EMDR is highly effective with all types of performance issues. By widening the definition of EMDR performance work, we can include all clinical issues that impact behaviour.” He sees things like public speaking, writer’s block and an inability to do necessary work tasks as having their roots in earlier trauma. Using EMDR for performance includes identifying the blocking beliefs, targeting and reprocessing them, and then bringing the new adaptive behaviour into the future.

Adaptive information processing and coaching

The adaptive information processing (AIP) model (Solomon & Shapiro, 2008) hypothesises that the brain has a natural tendency to process experiences and integrate them into existing adaptive memory networks.

However, when we experience things that are challenging and overwhelming, our AIP system goes offline, and we do not adaptively file the experience away so that it can be used in new situations. Instead, the adverse experience is stored maladaptively, along with any thoughts, feelings, sensations and beliefs linked to it.

When EMDR is used within a coaching framework, it is always within the AIP framework because we look to where our clients’ challenges have their roots.

For example, the person who is fearful of speaking in public, because she believes she is stupid and will get things wrong, may have many shame-based memories of arguments with her dad when he shouted her down for her different opinions. These memories are stored maladaptively and are activated when she tries to do any public speaking. This could stop her from speaking publicly and therefore hold her back in her career. This person may not be someone who presents to her GP with an anxiety disorder or a phobia, or even thinks to call up a therapist about this. They are likely to just accommodate their discomfort and avoid progressing in their career.

O’Malley (2018) discussed peak performance in his book Sensorimotor-Focused EMDR: A New Paradigm for Psychotherapy and Peak Performance. He talked about how EMDR can be used with key memories that are connected to lack of success. He also discussed identifying the accompanying blocking beliefs. The coaching aim therefore is to identify the key memories that are connected to our clients’ challenges with performance and work directly with these to help them respond more adaptively and positively in the here and now.

A six-step EMDR framework for coaching

McKelvey (2009) wrote a chapter about EMDR and coaching in Robin Shapiro’s EMDR Solutions II, in which she explores “combining EMDR and coaching to continue our own transformational growth as clinicians while helping our clients live their dreams.”

There are often blocking beliefs that hold people back. I thought I couldn’t speak at my sister’s funeral because that’s just not something I do. I had the belief that I was not capable of speaking in front of so many people, especially when experiencing such strong emotions. But I wanted to do it; it felt important to me. So, I worked on it. I did some future template work. I wrote what I wanted to say. I installed some positive beliefs: ‘I am strong’ ‘I am capable’ ‘I can do hard things’. I did a future template where I practised the reading and worked through the blocks that came up for me. I was able to stand up and read at my sister’s funeral, and I am so grateful that I was able to do that.

Step 1: Identify the big picture

This is similar to phase 1 history taking. I ask my clients what they want to achieve, what they enjoy about their lives, and what gives them energy and inspires them. Some examples are speaking more in public, performing in front of a live audience, writing a paper for publication, appearing on a TV show, or competing in a rowing competition without being completely overwhelmed with anxiety.

Step 2: Identify the blocks

This is phase 1 history taking too. I aim to identify what the performance blocks are and the associated beliefs. It can be helpful to do a timeline and think about what has happened in a person’s life that may have led to these blocks. For example, being told off frequently as a child may have led to someone holding themselves back when it comes to job promotion because they don’t believe they can do it.

I always develop a 3-prong (past, present, future) case conceptualisation. As always with EMDR, this case conceptualisation is used to guide our sessions and is a flexible document that we revisit and amend as necessary.

Also in this step, any preparation work that our clients might need or that will help them stay within their window of tolerance is completed. This might include the safe place exercise, emotional regulation techniques or RDIs.

Step 3: Process any relevant past experiences

This is where I go through the standard EMDR protocol phases 3-7 and process any relevant memories that have been identified in steps 1 and 2. As well as the distant past, processing memories in the past prong might also involve more recent experiences; for example, the athlete who was overwhelmed with fear during a recent race or the client who wanted to speak publicly and had recent bad experiences of forgetting her words during the presentation.

For many of the clients I work with, the SUD (subjective units of distress) are relatively low about these experiences and don’t warrant being processed. Often, understanding the case conceptualisation and making sense of why the client struggles can be enough to help clients move on. This is all about the clinical judgements that we are constantly making.

Step 4: Build on resources

Now this is where the real fun can begin. Now that some of the memories that were keeping my clients blocked have been processed, I start to fan the flames of their goals, hopes and dreams. I often find that I focus on psychoeducation in this step. I work to widen my clients’ window of tolerance even more, and I may well do a lot of work that activates the parasympathetic nervous system. I almost always find myself talking about the peak performance curve and how the right conditions for peak performance can be achieved and maintained. The Yerkes-Dodson Law (1908) is an inverted U-shaped curve. It looks at the balance of levels of arousal (stress) and the levels of performance. This suggests the middle of the curve is the optimal point for performance. This is where the stress is just enough, but not too much! Many people believe that working harder and for longer will lead to better performance, but what often happens is that doing this creates a tipping point and people move away from peak performance and into anxiety, overwhelm and burnout.

Similar to phase 2 in standard protocol work, I will use anything that I have in my toolbox, regardless of whether I have learnt it from EMDR, from training in ACT, the coaching course I completed with Tara Mohr, or from my experience receiving coaching. I will use whatever helps my clients.

Step 4 can often be a perfect time to complete some more RDIs. I often think the more, the merrier. For example, a client wanted to lead group sessions at work, so we installed a resource where they had been able to lead a group session and cope with any conflict that arose. I often feel that trying to do these types of RDIs before any memories have been processed can be quite a challenge, so it can be nice to revisit them at this stage.

My clients generally enjoy doing this work. Often, they have forgotten many of their positive experiences and what they have achieved in the past because they are so focused on their blocks and what they are struggling to achieve. So, it can be really good to fan the flames that were only partially ignited.

Step 5: Growth and forward-focused change

In this step, the focus is on growth and change in the future. What better way to do this than to integrate the future template? Even though I know Shapiro (2018) talks about the future template in her book, and it was covered in our standard training, I often found that with my traditional therapy clients, I would rarely complete future templates. In the EMDR-informed coaching, I find I spend a lot of time doing this.

These are never about toxic positivity and the “let’s imagine you doing that thing you are fearful of and everything going swimmingly!” school of coaching. Because the universe often throws us a curveball and nothing is ever perfect, so I need to prepare my clients for that. I don’t want to set them up for failure.

I often find flashforwards can be helpful in this step too. For example, the cyclist fearful of crashing might focus on the worst-case scenario of being unable to compete in their sport. Again, it would all be in the case conceptualisation about whether we would do a future template, a flashforward or often even both.

There is much debate within the EMDR community about whether it is appropriate to work on the future prong if all the past and present triggers have not yet been worked through. But we are seeing more people who will work in this way. Adler-Tapia (2013) developed the EMDR reverse protocol and found this to be effective, especially when working with children and adult clients who would struggle to work on the past prong first. She would often work with clients to look at their anxiety about the future and negative cognitions about this before focusing on past experiences.

Step 6: Lean in to the future

This step often involves mindset work. Mindset includes a set of beliefs or attitudes that people hold about themselves, their abilities, their intelligence and their potential for growth (Dweck, 2007). In this step, I want my clients to step into a growth mindset. A space where they believe that they can grow and develop. This may be through the individuals’ efforts and support from others too. I always consider what skills my clients need to continue to flourish and how they will develop them.

Here I may develop the AIP further. Focusing on resources and installing those that will help the client. In this step, the aim is to build upon what has been achieved so far and help them to imagine what they are truly capable of and to develop the skills that they will need. Let me give a personal example of this. Months after delivering the eulogy at my sister’s funeral (something I had not thought possible), I reflected on what I had been able to achieve, and I started to think about what else could be possible. I was already facilitating at EMDR training workshops but I had always believed that I was not capable of actually being a trainer myself. Well, here I am in 2024 on my journey to be an EMDR trainer. I have been observed countless times now delivering the teaching, something that I would never have thought was possible.

Conclusion

My journey has taught me that as well as being an effective treatment for mental health challenges, EMDR can also help within the coaching field – a specialty in the UK that is constantly growing and developing. As EMDR therapists, I believe we are well trained and experienced to offer clients EMDR within a coaching framework that will help them live the life they choose to live and be the person they choose to be. And who knows, maybe this is proactively working to protect the person from experiencing mental health challenges in the future.

Dr Hannah Bryan is a Chartered Clinical Psychologist and a Europe Accredited EMDR Facilitator and Consultant. If you are interested in working in this way you might consider joining the EMDR-Informed Coaching Forum. Email Hannah@drhannahbryan.com for details of further meetings.