On becoming a client-centered EMDR therapist

HOW TO TREAT YOUR CLIENTS WITH EMDR THERAPY AND KEEP A CLIENT CENTERED APPROACH

In this article, I will describe the challenges newly trained EMDR therapists deal with when first starting to practice EMDR and what to do about it. I strongly believe that in order to help your clients benefit from EMDR therapy, you have to maintain a client-centered approach.   

If you are new to EMDR, you may feel like treating your clients with EMDR therapy has been affecting your therapeutic relationship. EMDR is more structured than most forms of therapy. EMDR requires changing the way you work (and the way you think!). Sometimes it may feel like you are not putting the relationship with your client first.

This can be a real challenge or feel like a paradigm shift, especially if you are used to practicing a more intuitive style of therapy.

MAINTAINING A CLIENT CENTERED APPROACH IN EMDR

Studies have found that our interpersonal skills are as important as the technique we use. Education, training, and experience are important, but as a therapist, you should never forget the relationship.

Regardless of what type of therapy you practice, your clients have to feel that you are fully present, accepting, and warm. Unconditional positive regard and acceptance are the basic ingredients of the therapeutic relationship. Developing a sense of trust and safety is an important aspect of your work with every client. It is especially important with those clients who had experienced early childhood trauma and don’t usually feel safe around other people.

Developing a trusting relationship with clients can be challenging for a number of reasons. It was even challenging for Carl Rogers, who asked:

Can I let myself experience positive attitudes
toward this other person
attitudes of warmth, caring, liking, interest, respect?

And concluded:

It is not easy.

(Carl Rogers, On Becoming a Person).

It wasn’t easy for Rogers. And he didn’t even practice EMDR!

BECOME A CLIENT-CENTERED EMDR THERAPIST

Remember that everything you do in therapy, including EMDR, should happen after you establish a therapeutic relationship with your clients. For EMDR therapy to be successful, your clients will need to trust you and let themselves become vulnerable when reprocessing.

Also, remember that healing does not happen only thanks to the therapeutic alliance. Healing occurs when unprocessed material is being processed. Healing (or elimination of symptoms) happens when maladaptive neural networks rewire and become adaptive.  

The therapeutic alliance – your relationship with your clients – is one component that is essential for healing, but not the only thing your client needs from you.

WHAT AM I SUPPOSED TO DO WHEN MY CLIENT WANTS TO TALK BETWEEN SETS?

If you’re new to EMDR, you may find yourself confused when your client wants to talk between sets. On one hand, you want to be attuned to your client’s emotions and listen. On the other hand, you want to keep the processing going.

5 THINGS TO REMEMBER WHEN YOUR CLIENT WANTS TO TALK BETWEEN SETS

  1. Educate your clients. Make sure your client understands why it is important to keep the reprocessing going.
  2. Schedule longer sessions. If your client needs more talk-therapy, in addition to EMDR, schedule a longer session. Toward the end of the session, spend some time doing “post-processing” – have a discussion about your client’s processing experience, and discuss any insights she gained from the EMDR work.
  3. Structure your session. If you cannot schedule a longer session, make sure you leave enough time to do some grounding, RDIs or integration work at the end of a regular session.
  4. Be attuned. Keep track of the balance between the relationship and the processing. You want to be attentive and let your client talk, and you also want to keep the processing going.
  5. Remember the exceptions. In some cases (for example, when your client dissociates), it is clinically appropriate to stop the reprocessing.

WHAT TO DO WHEN YOUR CLIENT BECOME EMOTIONAL?

Some EMDR therapists feel that if they keep reprocessing when their client is in a highly emotional state, they are not attuned to their clients’ needs. A common mistake done by beginner EMDR therapists is to stop reprocessing when the client’s affect changes.

Many of your clients will become emotional when processing. Some will cry when processing painful memories. Many clients will try to stop reprocessing and share their emotions. You can offer support while continuing the processing, and find the balance between being attentive to your clients’ needs and the need to keep the processing going.

Remind your client that she needs to press the gas pedal and reach the other side of the tunnel. If you stop processing every time your client becomes emotional – you leave her in the middle of the tunnel.

Don’t leave your client in the dark!  

YOU’RE NOT CONTROLLED BY THE EMDR PROTOCOL

For many therapists, it is hard to follow a protocol. As therapists, we are not used to reading questions from a piece of paper. We are used to having an intuitive conversation with our clients.

Don’t let the EMDR protocol keep you disengaged from your client! When you know the protocol inside out – you don’t have to look at the sheet in front of you all the time. This will help both you and your client. It will create more flow in your EMDR session. If you know your protocol – you will be able to maintain eye contact with your client while following the EMDR protocol.

In summary, to become an effective EMDR therapist you have to find the balance between following the EMDR protocol and maintaining the relationship with your client.

To help you remember the importance of your relationship with your clients, I will end this article with a quote by Irvin Yalom:

A great many of our patients have conflicts in the realm of intimacy and obtain help in therapy sheerly through experiencing an intimate relationship with the therapist. Some fear intimacy because they believe there is something basically unacceptable about them, something repugnant and unforgivable. Given this, the act of revealing oneself fully to another and still being accepted may be the major vehicle of therapeutic help. Others may avoid intimacy because of fears of exploitation, colonization, or abandonment; for them, too, the intimate and caring therapeutic relationship that does not result in the anticipated catastrophe becomes a corrective emotional experience.

(Irvin Yalom, The Gift of Therapy)

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