EMDR Therapy Session

hey everybody we are back with dr alexa altman and we're here to run you through part of what an emdr session would look like now obviously in like 10 15 minutes we don't have time for all of the like treatment planning history gathering resourcing what else am i missing right all the prep basically and the setup and and we might not even close it down the way this would typically be a 90-minute session an emdr session typically is 90 minutes we're gonna do just uh just a showcase of what it could look like yeah so

that for those of you out there who are considering it it's not as scary you get an idea of what the tapping could look like you know so it's not so bizarre maybe when you first try it out yeah i think that's a good word it can be bizarre yeah it's unlike traditional talk therapy totally even talk therapy is bizarre the whole situation of going to a stranger to talk about tough things is in weird and can we can be nervous and so hopefully this will help you better understand what it can look like and

there's certain protocols and she'll she's the she's a specialist okay tell us and i'll like we'll do some demo and then i'll explain through it which your therapist is not gonna do but um so emdr follows an eight-step protocol and it's pretty structured in the sense of how you achieve a target to reprocess what you do with that target what desensitization means and looks like in a session and how you know when you're done okay so we pick like a because it's a target always a memory or as a target because target really means something

that's emotionally charged right or a trauma potentially if that's what you're working on right is usually it's a symptom oh okay well that's how we get into the target right what is the symptom you're having what's the memory that's attached to that symptom or the present day stressor so a target can be a present day experience it can be a past memory and the target can sometimes be a future experience so typically an emdr will start at the first or worst experience to then work through the present day kind of triggers or how it's elicited

in the in the present day and then we do something called the future template is we imagine the future experience that was distressing in the present and how you would respect react or respond in that future so we kind of clear past present and future okay so for today's demo what we thought we would do is talk about a present-day stressor and in the mgr we do something called a float back technique which is we float back to an earlier experience or life event that we think has kind of it's the root of maybe why

the present day stressor might be causing some maladaptive behavior or some of the symptoms gotcha okay okay cool so what why don't you tell me a little bit about what's currently going on and some of the symptoms you're having or beliefs you're having or some of the things that we talked about might be a bit distressing yeah so i have uh my book coming out this september um called traumatized and because i'm not a trauma specialist i had to do a ton of research and reading and preparation and like i felt honestly with my first

book i'm worried that people are going to hate it or that it's not going to be received well or i'll be thought of as stupid or not good enough or something like that right so that present-day stressor what we're really looking for are the symptoms and the negative beliefs really that you have about yourself or the maladaptive beliefs so some of the things that you said is i would look stupid or people won't like it it might not be good enough yeah and kind of the i think i definitely struggle a lot with like self-talk

around kind of what people call imposter syndrome where you're like what do i know who am i um and so i think that that has kind of fed into this and it definitely is the like i'm not good enough believe not good enough okay and then when you think about that belief i'm not good enough in the present-day stressor where do you feel that in your body throat throat okay what does it feel like like a heavy okay so happiness and throat and is there an emotion attached to it um it's probably sadness sadness okay

good and so something we're going to get into in emdr is what is your subjective unit sufficient how distressing is that to you yeah in your throat the like a six or seven okay six or seven okay what would you like to believe about yourself that i am enough and that you know um yeah more confidence more confident okay so what we're going to do is we could in emdr process this present-day experience and we get some good out of that but where we get really the biggest punch out of it is for us to

go back into the history into your history and really kind of float back and discover was there an earlier experience of not being enough or not feeling enough that may have some of the kind of creating a little more gusto in the present day experience of having to perform and having to bring something into the world or something like that yeah i mean i definitely i played a lot of sports growing up which is kind of performative i remember i think it had to be like middle school um i played for this like select softball

team and my coach was like he wrote us hard like it was a like very intensive very competitive um situation and there were multiple times where i'd be yelled at or like i got yellow for saying sorry a lot you guys know how hard that is for me and then i like apologized for that because i got yelled at and you're like i'm sorry and he's like right there like stop it um and i remember this particular like tournament i don't remember where we were but i remember being yelled at and then i just sucked

like the rest of the weekend um like struck out all the time like missed things like because i was so upset essentially like feeling like i wasn't doing good enough that feels like a good place just a good place for us to land so the target if we're kind of defining some of our emdr terms the target's going to be this particular experience and what we're looking for in it really discover and explain the target is what's the image that best represents the worst part of this experience for you um being yelled at through because

the coach was out in the field and i was in the dugout and he was yelling at me from there i remember it like okay vividly okay coach yelling at you threw the duck out in the dugout okay and then what were you believing about yourself that i was terrible that i don't belong on this team right i suck it's bad okay and then what's the emotion you attached to that i think sadness by the time i was very angry okay oh okay so some sadness but i definitely do puffer fish why am i protective

of myself okay i'm like you know okay and where do you feel that in your body um probably in my arms and my throat still okay so arms and throat and then your subjective units of distress how distressing is that on a scale of one to ten probably like a seven or eight so moved up a little bit okay so i'm gonna this might take you out of it a little bit some therapists do this some do not okay we're also looking for a positive cognition what would you like to believe at your about yourself

now when you think about this experience um i guess i mean it's tricky because i i think part of it could be like oh um that it made me better or that i learned something about myself because it was like a teaching moment um or that i am good enough because i i was good at softball i know i was like looking back like if i think about it i know i was i don't know does that work yeah okay so actually i am good enough we're looking for a positive self-statement about yourself yeah i'm

enough i'm good enough right and how valid does that feel one being um not valid at all seven being completely true probably like a three two okay okay yeah right okay that makes that's that's good that makes sense so so here's what we were what we would do next we'd move into can i pause for a second i want to make sure i did that radiant scale right because i don't i don't use that one hang on hang on okay i did do it perfectly i don't use the i don't use the poc yeah i

found its hate readings i hate reading so i don't know people and it's just yeah people are like and it takes you out of it yeah so did you know you were feeling it and then i had you read it you went cerebral yeah we have to think about it you have to get like logical do it yeah so okay okay so i'm going to talk to the audience again so what we just did was identify the target and we activated the memory network by noting the emotion the sensation the cognition and the image and

so what that does it really opens up the memory capsule or the memory storage and then the reprocessing phase starts and what the reprocessing stage is essentially just to kind of demystify it all it means is you're going to bring up all that material i'm going to recite it back to you please do not try this at home do this only with a trained professional yeah and then we're going to elicit the bilateral stimulation or you're going to self you're going to self elicit it and do it to yourself and then as a therapist i'm

just going to invite you to notice whatever comes up so it's really kind of a free associative experience you cannot do it wrong you cannot do it wrong in traditional talk therapy at this point a therapist might respond or give you you know a statement or something soothing in emdr therapy the therapist is actually much more quiet and just present because you're in a memory channel we don't want to take you out so if you're used to talk therapy it's a bit different what i invite patients to do when they're bringing up the experience it's

kind of like sitting on a train watching the scenery go by you're you're watching it you're not in it reliving it you're just gonna kind of watch again that dual awareness of kind of watching the scene watching the scene when when i invite you to pause the tapping and you might know when you want to pause but oftentimes the therapist will say like okay take a pause right and then the therapist is going to ask what do you notice and you just report anything that you noticed okay it could be a change in thought a

change in feeling a change in sensation okay um and again you might feel like is this going anywhere where it's going for i can tell you what we're looking for but i think it's kind of better to not know that's right because then you get two in your head right right right almost like with the rating skill and you're like i don't really do this because it pulls you out and it does like right it does kind of pull you out or forward and i wouldn't we wouldn't normally all this explanation would happen before the

session yeah i would do a ton of explanations so before you even start emdr you know what the tapping looks like you know what's going to be asked of you you know that you're going to kind of be free associating when we bring up the memory some people like to close their eyes and go inside and some people like to keep their eyes open because it feels more safe or comfortable there's no wrong way to do it okay okay okay okay so yes so what i'm going to invite you to do just because we've been

talking it got you out of a little bit i'm going to invite you to go back inside okay and i'm going to invite you to pull up the experience the worst part of that image where your coach is yelling at you through the dugout and you can feel that sadness in your throat and your arms and some of that anger and that belief i'm not enough and once you have it you really have that felt experience i'm just gonna invite you to tap okay i'm gonna invite you to pause and then you're just gonna make

a really big deep breath let it all the way out okay and whenever you're ready just let me know what what came up what you know that was crazy it like first of all was hard to focus on it for a bit and so i had to keep pulling almost like meditation for me where i have to keep bringing it back to the breath i was like keep bringing it back to that experience and then because i know i tend to my therapist always said like it's why i got strep throat as a kid because

i hold things in my throat and i could literally feel it soften and lighten good not a ton but like let's say 30 40 okay um yeah okay we're gonna go with that so you can hear your therapist say that all the time go with that meaning we're on a train track we want to stay on the track so i'm gonna invite you to close your eyes okay and just go with it okay yeah tapping stuff doing great be working yeah just gonna keep it moving letting all that material go by okay i'm gonna invite

you to pause again take another big breath yeah what did you get that time kind of more sadness it was weird it it felt like it kind of floated not floated away completely but it was like oh yeah that was that was hard and i remember it it was like i was in it but it wasn't as as intense i wasn't as angry good go with that more okay we'll do one more okay so good good just to notice it okay invite you to pause again okay another big breath okay what'd you get that time

it was hard to stay there it's interesting i don't know how people feel but like i felt like it was easy to get pulled into other directions because it wasn't so emotional for me like it was but it wasn't at that level anymore i was like oh my dad was there and oh i miss my dad and like i could have like my brain was like distract let's go somewhere else and i was like no no we're still trying to hold so i could see that to like that'd be difficult so here's and i think

because this is a demo what happened which is a really great example first we're able to see oh wait the sensation lessened right then the second time we were able to see and this doesn't always happen this way that then an emotion came in and then you got kind of pulled into larger parts of the story right dad was there or dad intervened or something else happened and a typical emdr session we would just we'd let that go we'd let you move it's actually not a mistake your your mind and body is pulling in other

aspects of the experience maybe that were helpful or resources sometimes you'll go we go back to the original target and kind of pull you back in but actually what we saw was pretty typical in that like it's not not a linear process it's not like we we get it we're done it'll continue to shift and change we know we're done done with the session when you're subjective you know the sad score which is how intense does it feel on a scale of one to ten when you bring up that memory zero okay and we also

know we're done when that belief of i'm not enough has really shifted to i am okay and there's a sense of like i'm a seven i totally believe i'm enough when i look back at that experience got you so that's how we know we're done sometimes you know in therapy you're like when am i done well you know you're done when you're close to a one or two maybe it's not a one or you know that those that that distress is really down so we'd finish processing that memory and then we'd go back to your

book oh okay and see how it applies and see how it applies or imagine you're having to let's say now present your book or do a talk and that might come up again in a future experience like does that change the future experience of it yeah because it's interesting even thinking about resources because my dad was there and he stood up for me so he was like my protector kind of person so it was like even my brain was like no no you weren't alone like remember he was like don't talk to her that way

you're gonna it's gonna like mess with her she's not gonna be happy it's not gonna work out she's actually gonna play worse and then my coach stopped doing that it was like kind of the like went to this peak and then it never happened again i kind of wish we had 10 more minutes and we would have let your dad come in because that is really a great example of what would happen is in the your dad comes and he's protected we would tap that in okay right and maybe the positive belief is maybe it's

i am enough maybe that's where it goes to or maybe sometimes in a little session it's like i'm safe i'm protected yeah or i'm okay yeah you know or i am okay or i was okay but i really am okay so it's like where we start and what we start to achieve sometimes it can change through the work and you're like no i actually feel like what's a better belief is i'm all you know it's okay yeah i'm okay i'm okay interesting okay well that's kind of good too because i think sometimes we can get

so caught up on what we think it's supposed to be like i'm supposed to feel like i'm enough and that can shift over time you know but if it is it might shift to i'm safe i'm okay i'm protected right yeah how we define that the other thing that i think was i don't know if if it well i hope it'll be helpful to see is the therapist's role in an emdr session is to kind of get out of the way and the processing happens within the health of the person you're sitting across from that

once you activate the experience you create a safe enough container and enough resources that the person system is doing a lot of the reprocessing we're there as a guide and sometimes things get stuck along the way and we have interventions to get it unstuck but for the most part it's a less verbal exchange and for people that have been in traditional talk therapy that's difficult they want to talk about everything and that's great but in emdr it's a lot less of that exchange i think that's what makes it so powerful and different too because if

talk therapy is not enough as we know through research it's not always enough often for people with trauma specifically um it would be that extra layer it'd be a little different because that's very different what we did than what because i've never done emdr personally but i've done a ton of talk therapy and it what that experience was was very different one thing though as a somebody who's received dmdr and provides emdr what's really interesting is maybe there's not as much verbal exchange but the presence and the quality of sitting with somebody in these spaces

the therapist is still very much with you even if i'm not necessarily saying as much sometimes i think that can even be more powerful because you kind of really get the sense of that person holding that space with you and for you yeah and i think it's also uh confidence-building in a way because you're like i'm okay for me at least it's like instead of having someone to ask questions or talk me through it i'm like it's okay to just feel this which i think often personally is not always the way you know i know

therapeutically it's you're supposed to like just sit with it we say stuff like that all the time but i know how uncomfortable that can be and emdr like welcomes that and allows you to feel okay in it and stay in your own experience and not get pulled out like by talking yeah yeah cause talking is so again it's like a different part of your brain it's like i'm tapping into like my uh thoughtful processing trying to make sense of it when i don't i maybe don't need to it's so funny the emtr therapist and me

wants to finish our session i might we might need to complete that some other time but um it does feel so sometimes sessions do end incomplete where you don't go maybe your uh subjective units of distress oh you're fine sometimes emdr sessions don't complete where the 90 minutes or 15 minutes depending how much time you have you don't finish and the memory is still distressing so a therapist often at the end of the session will give enough time to close down the session and that might look like pulling in a resource doing some grounding you're

not going to leave the office typically if you can if you know it works well in a you know that your levels of distress are manageable and that you have some resources on board before you leave the session yeah same with talk therapy too you want to like wrap things up lighten the conversation a little bit so they can kind of calmly leave because you don't want to leave session completely maxed out right i often say to people though the processing continues two to three days later you probably find that in talk therapy too so

keep a journal dreams often are vivid sometimes that dream material is great material for to target emdr with and so also what i say to people unlike any other kind of therapy maybe keep your day light after because it's tiring it's exhausting yeah i've heard that too yeah many of my patients have told me they go home and nap yeah so perfect well thank you so much this is helpful and actually very interesting to experience it myself i know it was very short-lived i'm not pretending anything here it was just again it was just a

very different experience from talk therapy and i could i could understand the benefit thank you so much for watching i hope that was helpful and thank you for sharing that and it was really cool to get to do it myself to get to experience it because it is very different from talk therapy i've never done emdr personally and i wasn't making anything up uh it's just it's a very different experience it was really cool and hopefully that at least helped you see what it can be like obviously we're explaining a little bit more and it

is not exactly like again the treatment planning the resourcing all of that it would have happened before but that kind of shows you a little bit about the quote unquote processing component yeah which is i think the part that kind of scares people the most yeah because it's different it's different but i think it's really powerful and hopefully if you've experienced emdr and found it helpful or had issues or questions or whatever leave it in the comments down below because you never know who you might help and also we'd love to have alexa back on

to answer some of those thank you so much for watching and we will see you next time bye uh