Kim Howard  00:06

Welcome to the Let’s Talk EMDR podcast brought to you by the EMDR International Association or EMDRIA. I’m your host Kim Howard. In this episode, we are talking with Dutch EMDR Therapist and clinical psychologist Tjeu Theunissen about new technical innovations in EMDR therapy. Let’s get started. Today we are speaking with Dutch EMDR therapist, clinical psychologist and founder of two E health startups, Tjeu Theunissen to talk about new technical innovations in the delivery of EMDR therapy. Thank you, Tjeu, for being here today. We are so happy that you said yes.

 

Tjeu Theunissen  00:42

Thank you very much. Yeah, I’m happy to be here.

 

Kim Howard  00:45

So tell us about your path to becoming an EMDR therapist.

 

Tjeu Theunissen  00:49

I started being a therapist shortly after graduation. It’s quite a while ago, I think 2013. And in my first job as a basic psychologist, a lot of different techniques. And I saw someone else a coworker of me doing EMDR. And I was fascinated by I heard a lot about it. But I was fascinated in how fast it could yield to an effective result, especially when it comes to very severe complaints or complaints. We got the opportunity to do an internal training program, which was not official. And that’s how I learned it. And the more I practice it, the more enthusiastic I got and wanted to learn more. So I did the formal trainings in the Netherlands and things kind of escalated from there, I would say.

 

Kim Howard  01:35

Yeah, we hear that a lot on this podcast, somebody either was introduced to it by perhaps a college professor, or they learned it on an internship or later in their career, somebody that they worked with who’s using it, and they found out about it and, and was interested enough to add it to their, to their offerings in their clinics. So yeah, it’s, it’s pretty uncommon to have somebody who learned it in college or before that. So it’s always we always like to find out from people kind of how they started EMDR therapy and how they came to it. So that’s a good story. Thank you for sharing, what’s your favorite part of working with EMDR therapy?

 

Tjeu Theunissen  02:14

I would say, to be very close to an observable emotional effect. Right? So a lot of the therapeutic work that has been done in other techniques is done during sessions, or during the time client is reflecting on things. Or you can slowly see improvement over a period of time, where I find in EMDR, you can directly observe the effects of it on the client, and the client observes too and is surprised. And that large change you can see in people and you can feel it, especially if you’re in the same room with one another. That to me is very gratifying and valuable. As a as a therapist.

 

Kim Howard  02:58

Yeah, it’s good to get that almost almost immediate response in a positive way, when you’re working with somebody. So we hear that a lot too from our members, whether we interview them, but they’ve read for the magazine, or we’ve talked to them, and are they present is that the impact of the therapy is so immediate, you can see this almost light bulb, and then this sense of relief that the client or the patient experiences when the therapy works, you know, for them. And it that’s part of the bonus of offering EMDR therapy is you get that little jolt of positivity that happens. So you have founded two E-startups. So you obviously are not afraid of technology. Which leads us to our next question, which is what successes have you seen using technology during an EMDR therapy session?

 

Tjeu Theunissen  03:48

To give a little bit of context, maybe in the Netherlands, our EMDR protocol, is being taught to follow quite strictly in the beginning as a starting EMDR therapist, and me being instructed to read out this protocol, I felt like well, I’ve been doing this over and over and over for the same words. This is something that maybe technology could help into optimize some some aspects of it. And my first venture was called EMDR VR, in which we built a self help EMDR tool in which a client could put on VR glasses and then with a virtual avatar could interact and do an automated EMDR session so that the client could help himself. Right. So that’s, it was a very bizarre idea when we started out and the more we read about it, the more it started to make sense. You know, in VR, you can use the full visual space and making those large eye movements. And we developed the program in which you can use reactions of a client towards a moving stimulus to measure the performance of eye movements and how fast they could go and how fast they should go. And there was a lot of a lot of possibilities to research EMDR, we got very far that we got into an American accelerated program called Y Combinator. So it was super cool, we were able to start a business around that concept. Well, coming from a clinical and scientific background, there was a kind of a dilemma, in the sense that this, I think it’s very important that we research technology step by step, and we do it in a very cautious manner. Right. So launching a self help EMDR tool like that should be done with a lot of research, a lot of caution. And you should create the boundaries or the context to do that in a safe manner, right. Because of that, I left that initiative and started the second eHealth company, in which I developed the tool to support the EMDR therapist, so not to take over a session or to automize. But to take well, to take a supportive for all. So the therapist in this case, wouldn’t have to do those finger movements, while having done EMDR a lot like full day, every day, got a very sore in my right shoulder at some point. Maybe some therapists can relate. So I thought, well, if there will be a tool or technology that could do this dual bilateral stimulation and those attention tasks. Yeah, that that could be actually something to really support the therapist instead of replacing it. I’ve done a lot of research with that. So to answer your question, was it very long introduction, what astonished me is that with technology, I could make my EMDR sessions much more effective. I saw that using the technology instead of using my own well, non technical techniques to to initiate the working memory load or the dual tension tasks, it helps. And I as a therapist could focus on different aspects that makes the therapy more efficiently as well.

 

Kim Howard  06:57

And I would also think a technology like that would help a therapist who might be physically impaired, someone who might have an issue with a hand movements either early in their career or even later if they develop something like a Parkinson’s situation or some other kind of condition where or they’ve been hurt or injured, and they can’t use their arms or hands to wave their fingers in front of the patient. And so tools like that would help, basically a community like that as well. So it’s good that there are options out there for people to look at. And think about adding to their practice if they need it. So yeah, that’s great. Thank you.

 

Tjeu Theunissen  07:33

Yeah, I think the most common technology that is used is a light bar, right? So it’s a static bar in which a light moves. So the therapist wouldn’t have to use the arm anymore, which is a solution in the not only just for the physical effort, but also that you can create some physical distance to what your client, you don’t need to sit that close to the client, which could be uncomfortable, awkward. Or maybe the client would feel judged having a person looking at him or so close to him. Yeah, so using technology to create distance, literally, actually, you could use it to treat clients online on this. So you don’t need to be in the same room even that can solve a lot of practical complications or limitations for clients to find therapy.

 

Kim Howard  08:14

Yeah, yeah, well, I mean, the pandemic, it’s changed how therapists have approached their work, because they, we had no choice. Everybody was in lockdown, nobody was going anywhere, you know, and nobody was seeing people face-to-face. And so we had to, we had to find alternatives for that. So that’s where technology really is extremely useful in situations like that. And then I presume it becomes very secondhand and commonplace for them to just continue to use it. And then they just integrate it even after we get back into in person sessions, you know, because they’ve already used it so much online, that they just naturally integrated into the session. So yeah. Are there any myths that you would like to bust about using technology during EMDR Therapy?

 

Tjeu Theunissen  09:01

Oh, I’d love to, yes.

 

Kim Howard  09:04

Like if your answers are super long, just give me like your top three or five.

 

Tjeu Theunissen  09:08

We’ve done research with the Dutch EMDR Association about the attitude that other EMDR therapists had towards online EMDR. So using technology, specifically computer version that could be used to assist in long distance online EMDR. And a lot of therapists thought that therapeutic relation would suffer because of that, because you’re not in the room together. You would you couldn’t really feel or it would make the therapy less effective or you couldn’t pick up on a visual cues or bilateral stimulation or the working memory load was too low. And well, we tested this with them. So they these therapists did a pre measurement, stating their attitude on different aspects of it. Then they tried online EMDR and it turned out that a lot of their negative assumptions they turned out to be disproven afterwards. So it turned out that afterwards using EMDR, they, the therapist thought that therapeutic relation was actually as good as face to face therapy, they experienced that it was even better when it comes to stimulation that you could provide. Because they, you could use technical tools, they noticed that sessions became more effective, using support tools and technology, and more comfortable and efficient because they could just, you know, work from home, they had less travel time. So I’m a big thing that maybe the top three combined in one in one study, actually were quite positively surprised about that.

 

Kim Howard  10:41

Yeah, that’s good. That’s good that those those tools were available to help. So there are there any specific complexities or difficulties with using technology during EMDR therapy?

 

Tjeu Theunissen  10:53

There is, yes. A lot of tools rely on internet to work. So you have to establish a connection with those tools. And for instance, with the EMDR light bar that works on Bluetooth. Sometimes devices have a battery that needs to be charged before using. Also, it’s prone to notifications, like if you would use online EMDR on your phone, for instance, then you could get popup messages, emails, phone calls. So this advice before doing digital session like that, to put your phone on silent, make sure you know you’re in a calm environment where you will not be disturbed have your battery charged to have stable internet connection, especially what while working on distance. So that can be a little bit tricky. Plus, the therapist mostly would need to be comfortable with using a program like online EMDR, or your computer program. And well lots of programs have a lot of options nowadays, for instance, adding exposure function, so integrating video or sound or photo material, different options to offer different kinds of bilateral stimulation. And if you’re not used to that you’re using the program for the first time, it can be a bit of a puzzle in what to use, at what point so I would say always try to practice a lot. And with time experience will build up.

 

Kim Howard  12:19

How do you introduce that to your client? I mean, I know you need to practice with it and make sure the technology is working and make sure you’re comfortable with it. But how do you approach the client who may be coming to a EMDR therapy for the first time and, or the second time? And they’re like, whoa, what do you mean, we’ve got all this light bar in front of me? And what are we going to do? How do you ease their concerns? If they have any about using that as part of the therapeutic process?

 

Tjeu Theunissen  12:45

I think the biggest reassurance is, that well, I cannot speak for other tools that I’m not involved in in its development or research. But the tool that we’ve created with company called Moovd in the Netherlands, it’s called WeMind EMDR. We have scientifically researched and it showed that our sessions are equally effective and even more effective than the alternative traditional methods, which I think is an important criteria to launch technical tools and clinical practice, I think it’s very important to validate the novice ideas that psychologists have, before putting into practice. Then again, in practice, we’ve seen that the tool works for many, many, many clients and sessions become shorter too. And this information I can share with the client, too. Well, coming from an authority base, we have studied the effect if you have a product we’ve studied, why do you think it work based on a working memory theory, and turns out to be a safe and probably as good as or even better alternative than traditional methods.

 

Kim Howard  13:52

I interviewed, I think it was Marshall Lyles, who said it and he said, you know anybody who comes to therapy, they’re they’re such brave human beings to even make that step to go and to talk to somebody about their their issues. And so he said, you know, we just have to honor the the fact that they’ve taken that step and what a big step that is for somebody to, to do that. So anybody out there who’s ever been to therapy, thank you and anybody who’s considering going to therapy, you are brave. So thank you as well for doing that. Your biography says that you practice EMDR therapy in India. How do you practice cultural humility as an EMDR therapist?

 

Tjeu Theunissen  14:32

That’s a very good question. And I’m not sure if I can answer it because I work online. And I work mostly with Dutch patients, or patients not actually from India. I only moved here a few months ago, so I’m still climatizing. And I think that EMDR is not that well known in this part of the world. And it should be, but I think as a therapist going into a different culture, it’s appropriate to first learn and take the things that you learn into consideration. I would be hesitant to applying my Western style immediately on non western clients without knowing what the downfalls of it could be.

 

Kim Howard  15:14

Right. That’s a good answer. Yeah. Do you have a favorite free EMDR related resource that you suggest either for the public or other EMDR therapists?

 

Tjeu Theunissen  15:25

I do. But I’m biased, I mean, our old, our own tool is available for free, at least for first month. So I would recommend one just to try it, but not just because of the product, but also just to try how it feels to do online EMDR. To use technology as a supporting tool in your sessions. There are a lot of free videos on YouTube that you could use, like that’s mostly a little dark moving from left to right, or a ball. But that’s the video. So you cannot really adjust the speed of the ball moving. So the speed of eye movements or the stimulation that would give. Unfortunately, the market also works that most free tools are not the most developed in the sense that they’re, they can be quite basic, they can be prone to stability issues. And I would not recommend using all free tools in therapy, but I would recommend trying it out and see and get a feeling of how what’s out there available and compare and see like, Okay, this works for me, or this I can use in my work setting. And this is less preferable.

 

Kim Howard  16:33

Yeah, shopping around is not not a bad idea if you’re going to integrate any kind of technology into your therapy. So thank you for that suggestion. What would you like the people outside of the EMDR community to know about using technology for EMDR?

 

Tjeu Theunissen  16:48

I would like them to know that the technology is already quite far advanced, we are doing research on using algorithms to determine how much bilateral stimulation or how much working memory taxation a patient would need live during a session. So we use algorithms to adjust automatically the stimulation to the client’s specific needs in the moment. And based on that, we found a lot of interesting results showing that titrating so adapting the life working memory load or live stimulation on the client really has a big effect on the effectivity. Also aligned with EMDR 2.0. That’s movement started from Professor Ad de Jongh and Dr. Suzzy Matthijssen. They integrate exposure aspects of it to to really activate the working memory and the memory representations of the brain. Because a lot of patients with PTSD they avoid, right, they don’t want to think about unpleasant things. Or we can use technology using exposure functions to consciously or unconsciously activate the fear network in the brain. And we can help our clients to do so. So clients who are hesitant to think back of a trauma we can help by displaying related image or a video while desensitizing. And especially the combination also exposure and EMDR within one system makes therapy even more effective. And we can really personalize with technology the EMDR sessions to clients. That’s really cool, yeah.

 

Kim Howard  18:37

Yeah, that is. If you weren’t an EMDR therapist, what would you be? There’s no wrong answer. We just like to ask because we’re curious.

 

Tjeu Theunissen  18:45

What other therapy looks like in EMDR? Now that’s a good question. I think I would be still a psychologist, but focusing on different trauma techniques. There are several of course, but to be honest, this kind of maybe cliche answer, but without EMDR, I would have been probably a different therapist or a different person because working a lot with it. I feel it has an impact on me personally. And yeah, helping clients using this technique got me a lot. And in my career, but also in my personal life.

 

Kim Howard  19:20

You’re not the first guest to say they would, they would still be an EMDR therapist, I truly believe that what you guys do for a living is a vocation and not a career path, that you have to be called to do this when you help people. Whether you’re in the medical profession, or public service or first responders that kind of work is, is so crucial to humanity as a whole. But you can’t just do it as a career and kind of go away just forget about it at the end of the day. It’s it’s part of sort of who you are. And so that’s why I think it’s really truly more of a vocation than a career path and it kind of finds you you don’t choose it, it chooses you I believe that about people who do what you do for a living so thank you You guys, aren’t you and everyone else out there who helps to heal humanity? Because there’s certainly a lot out there to heal. That’s for sure. So we appreciate all the work. Is there anything else you’d like to add?

 

Tjeu Theunissen  20:11

Yeah, well, I totally agree with what you just said, I think to add technology can solve several problems that now exist around the whole world in connecting clients with therapists that could not be connected because of physical distance because of unavailability of therapists. I’d like to add that, while giving digital EMDR trainings myself, I got a lot of response from my students in that they had their own bias their own negative expectations in how it would go, they would find it scary or too difficult. And it could be a little boundary or to to use technology within therapy. And I would really advise all the therapists that are listening to try to step out of your comfort zone within a safe setting. And to be open to experience what not only technical advances can do for your therapy for your client, but also for yourself in how much more comfort you could get or less discomfort with, you know, moving your arm for hours, or working more efficiently, saving time, not only for your client, but only for yourself. So, like I would advise my clients to be brave, and you know, to motivate them to step over their boundaries, a comfort zone and getting therapy, I would advise other therapists to do the same. And yeah, maybe do some research and how technology could help you.

 

Kim Howard  21:45

It’s a good way to end the podcast. Thank you.

 

Tjeu Theunissen  21:48

Thank you very much.

 

Kim Howard  21:50

This has been the Let’s Talk EMDR podcast with our guests, Tjeu Theunissen. Visit www.emdria.org for more information about EMDR therapy, or to use our Find an EMDR Therapist Directory more than 15,000 therapists available. Like what you hear? Make sure you subscribe this free podcast wherever you listen. Thanks for being here today.