Starting EMDR therapy reprocessing can be scary. After all, you are typically facing some difficult past experiences in a new way. We’ve heard both EMDR therapists and the public ask how clients can stay hopeful about continuing the work of reprocessing (EMDR phases 4-6) even when it might feel really hard. We reached out to our EMDR Consultants to ask how they might answer this question. EMDR Consultants have been through EMDR training, EMDR Certification, and a Consultant-in-Training process, and offer experience and wisdom valuable to the EMDR community.

 

“What strategies do you recommend for keeping clients hopeful during the reprocessing phases of EMDR therapy?”

 

 

*** Alison Acton, LMFT – “In describing the EMDR reprocessing phase, I let clients know that when we reprocess a traumatic memory—often the strong emotions will intensify because to move the memory over in the brain, the emotions need to come up and come out, that this is normal and temporary.  I also let them know that usually, by the end of the session, the emotional intensity is greatly reduced; if it is not, we will use already established resourcing to achieve this. When resourcing with clients during the initial phases of EMDR therapy, I explain the context of the resourcing. Earlier in my career, I would have said, “This will help you to calm things down and cope with stress.” Now I will explain how resourcing helps create the ability to contain traumatic material and change the state of your body. This helps the client manage their anxiety and other intense emotions. Ideally, the client will have been practicing the resourcing strategies we have worked on in sessions in between sessions to strengthen them and set themselves up for the best reprocessing experience possible. I invite them to do so. Another strategy I use is telling clients my experience: in my 30-year career as a therapist, EMDR is what I have seen clients obtain the most healing and relief from. That is why I have chosen to use this approach in my private practice.”

 

*** Marlee Bardenett, LCPC, LPC – “This memory is a 10, and the intense feelings will come up, but you are already carrying a 10 around every day. You are already doing the hardest thing!” I also ensure my clients have installed resources to support and soothe them through those intense emotions.”

 

*** Stella Bhagwat Ph.D. – I introduce strategies like those below at relevant places and with sensitivity to whatever is going on during reprocessing. These strategies are apart from the usual “ it’s all in the past,” “you are safe now,” “step on the gas,” train metaphor, and other distancing tips:

  • Remind clients of my presence with soft, empathetic monosyllables to help them keep dual attention.
  • If they report anything positive or neutral at any point, I’ll pause and ask them to dwell on the reporting a little more. This strengthens that neural network for later adaptation and helps regulate intense emotions.
  • I may try to draw out a quality in them. For example, you endured a lot and are here today, what might that quality be in you? (they might say – resilience, endurance, grit, etc.) “go with that”. If they are unable to see, I’ll gently bring it to their attention. Usually, they tend to agree and are pleasantly surprised, then I anchor it towards the end of the session. It also provides closure to an incomplete target.

 

*** Herb Cohen, LCAT – “I engage EMDR as an energy therapy since emotions are experienced as energy in the body, and I use techniques that can move energy instantly, thus taking away distress immediately, and that gives them hope. My approach is to help people connect to their Souls and learn to converse. Their Soul is a resource; it is comforting, never abandons, and never lies. It has access to all memory, no matter how dissociated. My first few sessions are always focused on stabilization, not assessing history as most are not ready.

 

*** Tiffany Crawshaw, PsyD – I tell clients: “It is like a light at the end of the tunnel. But you have to walk through the darkness first. However, once you get a glimpse of the light, you will feel tremendous relief.” Then I talk to them about the importance of utilizing their resources during this time and invite them to call me if the resources aren’t working.”

 

*** Andrew Dobo, PsyD – “I remind the client that EMDR does not create anything; it reprocesses events they have already experienced and survived. I encourage them to allow whatever wants to happen to let it happen because whatever they allow themselves to experience during EMDR stays here with me. Whatever they avoid processing, they get to take that material home with them. I also ask if they are ever troubled by the memory during the week. They almost always say yes. I then tell them that all I am asking them to do is let what happens to them during the week happen with me in my office during EMDR, and that will be the last time it will ever trouble them. I am not asking them to do anything that does not already happen to them. These explanations comfort clients enough to surrender to the process.”

 

*** Jessica Downs, LCSW – “It’s easy to overemphasize outcomes in therapy, whether in goal-setting, treatment plans, or the classic “magic wand” question from graduate school. We often talk about “having done the work” as if it has a clear endpoint, driven by our desire to alleviate suffering. While having direction is crucial, the journey itself—the process—is just as important. Micro-moments of clarity, internal reorganization, and learning to feel and reorient to what is true now are invaluable. Healing occurs as we tune into and care for our wounded parts, finding glimpses of our worth and experiencing the nurturing presence of a trusted person. If I could offer one piece of advice to clinicians, it would be to loosen their attachment to outcomes and, instead, find value in the process. This shift enriches the therapeutic experience and infuses it with hope, making it more meaningful for both therapist and client.”

 

*** Holly Forman-Patel, LMFT, LPCC – “Reminding our clients that there are no rights or wrongs during reprocessing and preparing them for what may or may not happen is the best way to support hope.”

 

*** Celia Grand, LCSW – Phase 4 Interweaves for clients with strong emotions:

  • Cognitive Interweave for clients crying: “Everything needs water to grow; imagine yourself growing.”
  • Somatic Interweaves: “Stay with your body and stay with your breath.” or “Gently press your spine against the back of your chair, feel yourself supported.”
  • Sensory Interweave: “Sense and feel the ground below; feel the earth’s gravitational field grounding and supporting you.”

 

*** H. Mari Grande, LCSW-R, LCAT – “Establish a Container to use as an Interweave if the client’s emotions become too intense or for the end of the session to contain leftover or unprocessed material, which helps to close the session. Combining EMDR therapy and the AIP model with complementary embodied practices is a powerful tool for instilling hope during EMDR reprocessing. For instance, HeartMath is a simple tool that can organically elevate mood, trust, and faith in themselves and their healing process. Creating or finding images of their Positive Cognition before or after processing can be a tangible reminder of their goals and progress, strengthening hope and supporting neuroplasticity. During reprocessing, remind clients of your presence and remain fully engaged. This practice helps to reassure them and maintain a sense of safety. Grounding techniques, such as the four elements, can help clients reorient and transition from therapy to their lives.”

 

*** Sandra Gutierrez, LCSW–“It is important to educate patients on the potential reactions, the positive and not-so-pleasant. And for this to happen way before reprocessing. It is also important for the patient to be reassured that they will be assisted in coming back to their baseline.”

 

*** Barbara Horne, RP, RMFT: “Therapists can project a calm, compassionate witnessing of our clients’ intensity. That’s how they can be reassured that the work is worth doing (and a good investment in their mental health). Therapists should maintain the same hopeful attitude for the client.”

 

*** Stephanie Johnson, LCSW – “During reprocessing, when the clients begin to have heightened emotion that may contribute to the client not being hopeful and is becoming overwhelming for them, I often stick with cornerstones of EMDR. When it arises during active dual attention stimulation (DAS), I start with supportive statements such as “turn towards,” “let it flow through,” etc. I may take an obvious breath/yawn if the client’s breath is becoming quick and shallow to see if their mirroring neurons kick in to aid in downshifting the level of emotion. At the end of DAS, have a client shake it out when they take their breath to release the energy that has sat in the body before reprocessing. These steps aid clients in being able to work through the intense emotion and recognize their ability to move through what they have lived through, reinforcing hope for the future.”

 

*** JoAnn Koester, LCPC – “I give people permission to have choice in the EMDR process by saying ‘if it is too intense for you or you cannot do it on any day let me know.’ Abuse is feeling forced to do something. Choice whether to do something or not is very empowering.”

 

*** Wendy Krauss, LMHC – “Safety is always the bottom line. Safety with me, safety in their living situation, and most importantly, internal safety of being able to handle processing. In preparation, I like to front-end load. I work on the self-regulation skills of calming, grounding, distancing, and distracting so clients can build confidence and handle what comes at them. I remind them that if they were able to survive the experience they can survive the memory of it and discuss dual awareness and avoiding over accessing. I remind them that they are the ones in control and that they will discover their solutions. I may use a metaphor such as hiking over rough terrain for a distance before getting to a beautiful waterfall or vista. Finally, I remind them that if I did not know that the destination was going to be positive,  I would never ask them to take the journey.”

 

***Julie Kyle, LCSW – “Before Reprocessing: Prepare clients that they may feel more uncomfortable before the relief comes. We’re inviting them to approach potentially distressing material in reprocessing, and they may experience big feelings. We’re going to let whatever happens happen. This sets the expectation that intense emotions may be part of this journey, but we’re doing this ultimately to bring relief, healing, and freedom. Connect to the “why” of the work.

During Reprocessing: Keep going. Both clinician and client are brave enough to engage in reprocessing. Only slow down or stop if clinically indicated and/or the client gives a stop sign. Get curious about any parts of the client, or you want to slow down or stop.

After Reprocessing: It is important to remember to ask clients specific questions at the start of the next session (Phase 8: Revaluation) about their symptoms and how they are changing. Clients can surprisingly minimize or forget how bad the symptoms are as they improve. Clients recognizing and acknowledging those shifts can be motivating through challenging work.”

 

*** Elizabeth Legg, Ph.D., LPC – “I find it helpful to protect time at the end of reprocessing sessions to reflect what new shifts I’m witnessing as they follow their own wise Adaptive Information Processing system through the EMDR process. For example, perhaps they are moving from holding shame to bravely feeling and expressing grief, longing, self-compassion, or anger on their behalf. I also might highlight how the intensity of the process reflects how scary, painful, and traumatic that experience they are reprocessing was at the time, as well as how brave they are now in allowing themselves the possibility of something new. I also find it helpful to remind them that we have the flexibility to pace the process so they can integrate those changes rather than pushing through overwhelm. I also allow time to check in with clients about how my reflections are landing for them and to collaborate around what they might need.”

 

*** Claudia Lewis, LMFT – “A therapist who has a well-regulated nervous system and feels confident of resolution promotes co-regulation and groundedness in the client. Ahead of reprocessing, I also sometimes offer the metaphor of a car driving through a long dark tunnel—you don’t take your foot off the gas if it feels scary or intense; you continue with the foot on the gas to reach the light at the end of the tunnel.”

 

*** Bradley Mallett – “What I have found most helpful for keeping people hopeful during reprocessing is helping them to identify the truths that they have identified for themselves throughout reprocessing. Even as hard/dark things may come up, I help them to see where they can view it differently and how, just like in exercising where our bodies will be sore, even painful when we finish the process, we are stronger and the true self.”

 

*** Marci Martel, Ph.D., LCMHC – “After years of engaging my clients with EMDR Therapy, I emphasize the importance of EMDR as a complete 8 Phase modality. There are times when flexibility is necessary to keep the client engaged and regulated, especially during reprocessing. Embracing the freedom to move back into Phase 2 – Preparation, I assess the current moment when positive emotional states are verbalized and resource these positive emotional states with slow bilateral stimulation (BLS). I recorded the skills with my voice and provided clients access to my website. I actively use containment and Calm Place at the end of each session, reminding clients that the skills are available to them at any time so that they can return to the sense of a calm, regulated state that they can access. Hope is a feeling based on trust and a realistic expectation of progress. Emphasizing the hopeful progress by measuring it in small steps provides a clear pathway toward healing.”

 

*** Amanda Martin, PhD, LMFT-S, LPC – In EMDR therapy, maintaining motivation and hope during the reprocessing phases is crucial. I focus on four main areas to support my clients that empower clients and promote a successful EMDR therapy journey:

  • Psychoeducation: By providing clear information about EMDR, I help clients understand and normalize their experiences throughout therapy. This knowledge fosters trust and reduces anxiety.
  • Assessments: Regular pre-assessments, follow-ups, and post-assessments enable clients to track their progress and gain insights into their symptom changes. This measurable feedback reinforces their awareness and commitment.
  • Robust Preparation: I ensure clients are well-prepared with a self-care plan. This preparation helps them manage their emotional states and use their coping tools effectively.
  • Empathic Attunement and Rapport: Building a solid therapeutic relationship is vital. By being attuned to my client’s needs and allowing them to set the pace, I create a safe and supportive environment for reprocessing.

 

*** Kara Niccum, LMFT – “During active reprocessing, I use soothing interweaves that I hope clients find encouraging, similar to Shapiro’s “it’s old stuff.” For example, “Of course emotion is there, I encourage you to allow it, just feel your way through, notice, you’ve got this, let your body lead, I’m right here with you.” Pre- and post-active reprocessing, I remind clients that this tough stuff is brewing under the surface and wreaking havoc, regardless of whether we are doing this work or not. We aren’t just stirring it up during active reprocessing, we are releasing it and healing. We’re allowing your body to digest what it couldn’t at the time of the trauma because it was focused on survival. Also, anytime there are positive treatment gains, I highlight those by asking for an accompanying image and body sensation and pair it with slow DA/BLS (a brief return to phase 2 to utilize treatment growth as a resource). Also, I often use AJ Popky’s positive treatment goal in Phase 2 to instill hope and build a vision for the future.”

 

*** Eileen Ormond, RP – “This is a good question, as the deep layers of trauma are being peeled away throughout the process of trauma therapy, wherein the client may experience feelings of helplessness and hopelessness as one aspect of their traumatic experience. I first normalize these feelings with clients by messaging them about the fact that compassion and patience are required as they are honoring and unpacking their painful experiences. I use some IFS techniques to assist the client in connecting with the presence of the Self by observing those qualities that the client has exhibited, i.e., compassion, calm, clarity, and creativity… I also always spend time at the beginning of a new session reviewing their observations of how the themes that arose in their EMDR work manifested in their thoughts, feelings, or somatic experiences. Then, I will reinforce any insights they share. Suppose the insights are related to their current target work. In that case, I will suggest an RDI or future template to consolidate the gains further and explore the ramifications further they they can implement in their current functioning. Clients also often need a talk session between EMDR target work, and I also emphasize that discussion is essential to the whole process.

 

*** Dr. Gillian O’Shea Brown, LCSW – “I like to quote EMDR’s founder. The late Francine Shapiro, Ph.D., famously said that there are about 10-20 memories responsible for all of the pain in our lives, and each memory, when processed, is like taking one log out of the fire. Now that you have identified your so-called ‘logs in the fire,’ you know that these are the specific memories creating pain and suffering in your life. I like to remind clients that each log we take out of the fire will create lightness and clarity, which will help them strengthen the internal guiding wisdom that has been waiting there all along to be uncovered and reconnected to.”

 

*** Sandra Paulsen, Ph.D. – I show a fossil that sits on my desk and say, “What is this?” They say, “It’s a fish.” I say, “Is it a fish or a memory of a fish?” I sniff it and say, “It’s not a fish. If the pain feels intense, it’s a memory of a fish, not happening now.” I say sometimes, “Have you ever avoided the dentist, and then when you finally go, you say why didn’t I go sooner?” Yes, it’s uncomfortable briefly, but then you have relief! I sometimes say, “Back then you were alone, this time you’re not alone, I’m right here with you.” I sometimes say, “Never again will you be a helpless child with one to protect you. You’ll always have adult you to be with little you.”

 

*** Sharon Rollins, LPC-S – “I find that validation is critical. I watch for the slightest sign of progress and point that out. I validate their pain and acknowledge they’ve been carrying it for a long time … it’s okay to let it move through now. I also encourage them by explaining that the first step into the work is often the most challenging, but now that they’ve faced the worst part, they know they can move through the rest together with me. ”

 

*** Ann Rosoff, PhD – “Trust in the therapist is critical, and establishing a good working alliance is crucial. Over time, we then introduce and explain EMDR, trauma, and its impact on the brain and body, the AIP model, and provide a general roadmap for treatment.  This psychoeducation can help people understand and tolerate what can often be an arduous process.

Then, preparing clients for processing by letting them know what to expect and how you will help them manage intense emotion is also critical: “You may feel a lot of emotions as we get into this, especially at the beginning. But you will not be alone: We are doing this together, and I am here with you every step of the way. I will help you re-center yourself if you get overwhelmed.” 

 

*** Laura Russell, LPC – “I lay down the expectation that things will be uncomfortable while processing. I ask them permission each time a wave of emotions occurs during a session. I tell them ‘I know this is difficult, but can you sit with this for a couple of minutes? If it is too much, we can stop.’  By getting their permission and acknowledgment, they proceed and get past the emotion.  When I am done with an EMDR session, I always end with some deep breathing and meridian tapping work or simple energy work by rubbing their hands together and creating some heat, then taking a deep breath in and then moving their hands from the top of their bodies to their feet. At the same time, they exhale to bring them to a sense of calm and confidence again.”

 

*** Gary Scarborough – “Helping Clients have more positive and effective experiences reprocessing begins before the reprocessing starts. Starting with future templates, recent events, or tiny targets as first experiences gives success and positive feelings and sets a positive foundation. Doing retrieval or Flash before reprocessing takes little time and usually knocks the SUDS down and keeps reprocessing from getting stuck. Checking the window of tolerance and back of head scale before one starts BLS is quick and effective. Check as needed as you reprocess. If a Client is out of the window of tolerance or is too deep in reliving the memory, reprocessing effectively is blocked. The Client is stuck in awful. EMDR therapists can use their tools and judgment to help the Client keep in the zone where they can reprocess.

 

*** Kathleen Whyte, LMFT – “I am specifically interested in how each client’s system responds to all phases of EMDR, especially bilateral stimulation and reprocessing. When clients indicate intense responses, providing psychoeducation can assist the client on a cognitive basis. Additional grounding and resourcing can assist on a physical and emotional basis. In providing psychoeducation I compare EMDR to other therapies acknowledging that the process of therapy itself usually includes exploring areas of our lives that are unsettled and uncomfortable. The end goal is greater ease in life. Responses to reprocessing can differ greatly, however, I find there are some similarities that occur. I often describe the level of discomfort as a bell curve that often lasts for 24-48 hours, sometimes longer, and may be followed by a sense of lightness. Some clients have referenced a sense of euphoria. Normalizing the discomfort as part of the process can be helpful. After reviewing grounding and coping skills to use outside of the office, between sessions, I also encourage my clients to reach out to me between sessions if needed, providing them with a sense of being “tethered” to me for support if they wish. Also ensuring clients that we can slow down. Remind them they are in control. Hold space for their intuitive healing process. And assist the client in noticing areas where they may have experienced even the slightest sense of relief.”

 

*** Christine Wilson, LMHC – “Preparing them ahead of time is important. I tell them that the actual event is over but the part of their brain that stores the memory doesn’t know that yet, so they might feel the feelings as if it is happening in the present. They will probably feel those feelings at the developmental stage they were in at the time it was happening. The relationship with the therapist is imperative. They need to know we have their back and are strong enough to handle the intensity. I had a client who found his murdered 19-year-old son. It is a small town and he knew I had a son that age. We had to talk about him wanting to protect me from the horror. He had to trust that I could handle that.”

 

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Additional Resources

If you are a therapist interested in the EMDR training:

If you are EMDR trained:

If you are an EMDRIA Member:

Date
August 23, 2024

Practice & Methods
Your EMDR Practice

Series
EMDRIA Members Respond

Audience
General/Public

Language
English

Content Type
Blog/Blog Post

Original Source
Focal Point Blog

Access Type
Open Access

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