I specialize in adjunct EMDR, which is when a client comes to me specifically for EMDR, based on a referral from their therapist. They may see an EMDR therapist alongside their regular therapist or during a pause in their therapy. I require an open consent to exchange information for the duration of treatment. I will have a conversation by phone with therapists about the referral before the client’s first visit.
Often, clients want to do EMDR to be relieved of longstanding difficult emotions or a feeling of being stuck. However, there are significant defenses that support keeping these emotions locked into their current configuration. That is actually quite adaptive. I trust clients’ instincts about proceeding with EMDR, but I do have some basic requirements for readiness, which you will find are fairly consistent among EMDR therapists:
Clients need to have a little bit of stability, enough to stay aware of the present moment while recalling their trauma. Having this dual awareness is important for EMDR to work. I want to know they can maintain their present level of functioning while in therapy and are not actively suicidal. EMDR can work to reduce dissociation, but being fully dissociated frequently would require an EMDR therapist who specializes in DID.
Parts Work/Internal Family Systems: I often do parts work alongside EMDR with clients who dissociate. Having parts of ourselves segmented and protected is quite common among those who have PTSD. So, some familiarity with this concept is good preparation. Another important preparation is having solid tools for getting grounded when upset and for containing discomfort. Those are skills that can be built in EMDR Phase 2.
