Overcoming Challenges in EMDR Therapy

Areas Not Covered in EMDR Basic Training

EMDR therapy is recognized as an effective trauma treatment. However, in some cases, additional support may be needed to realize further success. When a client cannot regulate their emotions to a clinically appropriate level, the EMDR therapist will need to take additional time to prepare the client. There are options to help in these challenging cases. The specific modality to help clients regulate their emotions is neuro auricular modulation. Clients will find this therapy very helpful in working through and treating their traumatic events without having to relive their traumatic experiences.

Common Challenges in EMDR Therapy

As a qualified EMDR specialist, I’ve dealt with many challenges and I have colleagues who’ve faced the same issues and questions I did when delivering effective EMDR therapy to clients. As a result, being able to support others to overcome these issues is meaningful to me, and I believe it aids humanity as a whole. The following are some of the significant obstacles therapists and clients face during EMDR treatment:

• Extreme anxiety about treatment planning and emotional distress
• A lack of willingness to undergo EMDR therapy
• Negative beliefs around being able to handle the process of reliving a distressing experience
• Wondering if it’s best to simply leave things be and not revisit traumatic experiences
• Unsure of where psychological parts work fits into the standard EMDR protocols

If a client is unwilling to receive eye movement desensitization and reprocessing to work through their traumatic memories, it can be frustrating for the therapist. However, a few things can be done to help get the client on board with the process. For example, one option is to use neuro auricular modulation to help regulate the client’s emotions and prepare them for EMDR therapy.

Neuro auricular modulation is the perfect tool to help regulate emotions and build a therapeutic relationship. For example, the client’s ear projects neural disturbances onto their ear, which can be identified by applying small amounts of pressure and getting the client to tell you how tender the point feels out of ten.

No Forcing

• Never push a client to participate in EMDR treatment they are not ready for, no matter the reason. Trying to coerce the client, shows the treatment is more about what you want to achieve rather than what the client actually needs. Explore your motivations and see what comes up for you. Once you recognize your own motivations, you will be able to see how you can support your client in making their own decisions about how to treat their traumatic memory.

Explore concern(s)

• Have a conversation with the client about their worries. What is it that they are concerned about when doing EMDR therapy or bilateral stimulation?
• Take your time and pay attention to what the client tells you.
• Help the client understand what they are concerned about and why others may feel that way.

Explore blocking beliefs

• If the client is willing, you can use short BLS sets or tap around blocking beliefs to explore deeper. If not, do not push them. Simply work where the client is at.

Have you spent enough time building the client/practitioner relationship?

This relationship is significant in building the client’s confidence in undertaking EMDR therapy and crucial to building the client’s treatment plan. The therapist needs to be supportive and understanding while also guiding the client through the process. If the client feels safe and comfortable with the therapist, they will be more likely to open up and work through their trauma as a partner in their mental health care.

Where do I even start?

1. Screen for the level of dissociation
2. Screen for safety and other risk factors
3. Strengthen existing skills & resources
4. Find developmental deficits
5. Build-in distress tolerance skills
6. Coach self-compassion skills

EMDR mechanics for dissociation

• Build a more significant window of tolerance
• Train metaphor. Stop signal
• Comfortable place/containment
• Catching a ball to orient
• ‘Tapping in’ positive felt sense
• Intense sensations
• Progressive muscle relaxation
• Self-compassion work
• Build a greater understanding of ‘Self Energy’

When processing does not work in EMDR

EMDR practitioners often get to a point in the preparation phases where clients cannot have dual attention to process distressing memories. When this happens, the client can become frustrated with the lack of progress. Neuro auricular modulation is a modality that is a great therapy to include because it bypasses the prefrontal cortex involvement and helps clients start processes without needing dual attention.

This gives therapists another tool to assist clients in preparing for EMDR processing and often can be done in the same session. EMDR therapy is a powerful therapeutic tool that can help people heal from traumatic memories, but it requires a certain level of dual attention to be effective.

For some people, this can be difficult or even impossible. In these cases, neuro auricular modulation can be a helpful way to get around this block and start the EMDR process, which makes treating the traumatic experience more likely to be successful.

EMDR Training Strategies to Get Your Client Back on Track

Neuro auricular modulation is a great way to help people regulate their emotions and prepare for EMDR therapy. It is a tool that can be used in addition to other standard treatments, such as skills training in emotional regulation and cognitive processing therapy. When clients cannot regulate their emotions to a clinically appropriate level, EMDR therapists will need to take additional time to prepare.

EMDR is a versatile technique that may aid clients in recovering from trauma and living with post-traumatic stress disorder symptoms, but it demands a high degree of dual attention to work. When clients cannot manage their emotions at a clinically acceptable level, EMDR practitioners will take longer to prepare active bilateral stimulation. 

EMDR therapists who use neuro auricular modulation to assist individuals in moving through the early phases to qualify for BLS safely and quickly, notice that clients engage well with information processing and stay more engaged and committed to therapy.

Neuro auricular modulation bypasses the need for dual attention by working with the limbic system instead of the prefrontal cortex. This makes EMDR more accessible to clients who may have difficulty accessing their emotions and distressing memories.

Written By Shannon Bowman