EMDR handbook promises to increase therapists’ competence and confidence

The Art and Science of EMDR: Helping clinicians bridge the path from protocol to practice

Rotem Brayer

PESI Publishing, Inc. 2023

ISBN 9781683736318 Cost £20.99

Any EMDR therapist who wishes to become, or support others in becoming, ‘more competent and confident’, will appreciate this slim book which addresses common therapist doubts about EMDR. The author, Rotem Brayer, is a practitioner, consultant and trainer with a mission to make EMDR work. Based on his experience that many therapists find EMDR too regimented or get stuck, the majority of the book challenges practitioners to make EMDR work, explaining the rationale for doing so, and offering a vast array of solutions to common issues. This is extremely timely, coming just as it has been estimated that 75-80 per cent of those who train do not continue to practise (Leeds, A.2023) 

This is not an in-depth textbook, assuming that readers are familiar with the standard protocol and looking for ways to make it work more reliably. Brayer does not think of EMDR as a binary model, but as a starting point for creativity. Seeing EMDR therapists as ‘applied neuroscientists’(Cozolino, L.2017), ‘psychobiological regulators’ (Schore, A. 2012) and ‘healers’, Brayer advocates an inventive and holistic approach to the EMDR Standard Protocol, addressing ways to manage each stage more effectively. Aware that insistence on fidelity to the phased approach can lead to practitioners quietly abandoning elements when it feels uncomfortable or a poor fit for a particular client, he is nonetheless a huge fan of the standard protocol. Discouraging new EMDR practitioners from hurrying to acquire more advanced skills and training, he urges them to first become confident with the basics before gradually incorporating more through ‘deliberate practice’ (Ericsson, A. & Pool, R. 2016) and the support of a good consultant. Unlike the majority of EMDR authors, he advocates adapting the standard protocol to meet the needs of individual clients rather than trying to make a client fit any of the many speciality protocols. In practice, this means identifying issues in the therapy and ways to address them, which this book does extremely well, making it a great resource.  

Indeed, Brayer’s ability to thoroughly explain complex concepts simply is exciting and enabling. By normalising our struggles and anxiety, he makes this book empowering from the outset. This is reassuring for practitioners dealing with their millionth attack of imposter syndrome or just having a rotten day. Brayer knows how we feel and has remedies, urging therapists to keep seeking solutions creatively and carrying on with EMDR rather than quitting before they have gathered enough experience to make a judgement. 

This seems good sense. Practitioners’ familiarity with the phases can only lead to improved confidence in the standard protocol and more ability to make it work aesthetically while maintaining fidelity. We also need to be able to notice our personal journey as EMDR practitioners. Experience inevitably changes our relationship with the process and thereby our practice, and we should be able to recognise what is different. Making the process our own renders this far more likely. It also supports safety. Humanising practitioners’ experience as well as that of clients makes it more possible to authentically review our practice and, crucially, to seek help rather than give up because it all seems too hard. Paying attention in the book to therapists’ self-care, and addressing vicarious trauma, Breyer helps equip us to offer a three-dimensional, nurtured approach to practice and to each client’s experience. 

The colloquial, succinct and straightforward style makes this a particularly accessible read. Early chapters straightforwardly discussing relevant neuroscience and how EMDR works are followed by one about the importance of the therapeutic relationship in EMDR. As Brayer points out, there is little advice on establishing and maintaining a therapeutic relationship in basic EMDR training, which may contribute to therapists abandoning EMDR or adapting it to suit themselves. Certainly, once processing begins in earnest, there is much less space for the therapist’s personality or for talking. How this is managed is likely to vary between clients, but it’s likely to be harder if insufficient attention has been paid to the relationship in earlier phases.  

Though there is considerable advice on practical interventions throughout the book, there are three chapters devoted to practice as well as chapters on mindfulness and preparation for EMDR. Not an admirer of long/medical words and descriptions, especially in psychoeducation, Breyer advocates we video ourselves rehearsing explanations of EMDR and recording over and over again until we are satisfied. The book supports this as it is such a helpful resource in developing an explanatory narrative and creating handouts for consolidation. There is also a large section suggesting further reading, relevant podcasts and useful apps. 

For students and the newly qualified, this well-referenced book is a valuable adjunct to basic training. For the most knowledgeable and experienced consultants and practitioners, it is a reminder of how it felt to practise at earlier points, highlighting what trainees and supervisees most need to know. 

Cate Campbell is a psychotherapist, supervisor and EMDR consultant in training.

References

Cozolino, L. (2017) The neuroscience of psychotherapy: Healing the social brain, (2nd ed.). W.W. Norton.   

Ericsson, A. & Pool, R. (2016) Peak: secrets from the new science of expertise. Mariner Books. 

Leeds, A. M. (2023) Keynote Presentation: An Update on the progress and future of EMDR therapy. EMDRAA 2023 Hybrid Conference, May 5. 

Schore, A. (2012) The science of the art of psychotherapy. W.W. Norton.