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ghost-town-collective · 8 months ago

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Some Basic Advice About EMDR for Systems

(drawing on our own experiences, reading about it, and comparing notes with our therapist)

This is mainly aimed at systems who are considering doing EMDR or planning on it, but want to know what the process is like and what to look out for, with some personal experiences sprinkled in.

Under the cut, because I talk a lot:

General Concept

I think the big picture in our experience is that EMDR is/was like…an intensifier for the kind of headspace/internal system interaction processing work that a lot of systems do naturally, at least a little, especially if they have decent internal communication. This has both upsides and downsides/areas to be cautious about.

A lot of EMDR pre-work (often called “resourcing”) is about making sure you have a good toolbox of “mental tricks/techniques” to be able to handle unexpected intense emotions, feelings, and/or imagery etc that often comes up when you get into trying to work with traumatic stuff. This is in my opinion very important, and something your therapist should take at least a few sessions to talk with you about even if you already have good tools for it already, just to make sure they know your strategies and you’re all on the same page. Also super common and normal to spend some time developing extra ones if needed—stuff like “the box” for temporarily containing crisis emotions when needed, having a mental “safe space” that you can come back to, etc. Also, EMDR specifically tends to often be a little rigid/scripted in the types of visualizations and metaphors you’re “supposed” to use, but in my opinion a good therapist should be flexible enough to adapt to equivalent images/techniques you may already have (like, “imagine you’re viewing the traumatic memory on a movie screen, or out the window of a train going through a tunnel” is a common instruction; if, say, your headspace has a lot of fantasy elements and it makes more internal sense to be viewing the memory via…scrying in a dish or something, your therapist should be down with you doing that instead, if you want to).

As for the sessions themselves, a big thing we don’t hear articulated a lot is that, in our experience and that of some other folks we know, EMDR has a tendency of being…like, sneakily intense: It doesn’t necessarily hit you all at once in the session, which may just feel like “ok, that was Some Therapy Work but I’m chill”, but then over the rest of the day and maybe even the next few days, it’s not uncommon to keep feeling a lot of emotional intensity/vulnerability, having more intense “internal conversations and/or realizations”, etc. For this reason, EMDR is generally supposed to start with a very mild memory-to-process, like 4-5 out of 10 max.

Notes of Caution and Stuff to Keep In Mind

Especially for folks who already heavily dissociate from emotional trauma, it’s super easy to think you’re “going too easy” only to find that the memory has a lot more emotional baggage than you realized—really go easy on yourself when you start, EMDR is like psychology power tools and you absolutely can hurt yourself. (We’ve heard from plenty of systems who had bad therapists who did not adequately support them in doing EMDR, and absolutely fucked them over by starting too big and retraumatizing the hell out of them— this isn’t meant as fear-mongering, especially if you really like and trust your therapist, but just genuine “hey, EMDR can be very volatile stuff, which is part of why it can be so helpful, but also means that it’s important to not skip out on the safety precautions and self-care”.) What this means in practice is often stuff like: (our recommendations at least) - trying to schedule breaks/easy days immediately after - possibly getting someone to drive you home, especially if you know you’re going after a Big Thing, because the dissociation hangover immediately after can be pretty real - start with a memory that feels "too easy", and scale up if a week later it still felt trivial/like you’re fully over it, because it’s way easier to ramp up than try to do damage control.

Our personal experience, in tl:dr form, was that it felt like the core of the technique was really useful for us, and mirrored some of the most useful instances of self-processing we’d had before while also kind of serving as a “shortcut” to it—but, it was pretty intense and we didn’t really like/fit well with the therapists who we were working with at the time, which is why we stopped (didn’t want to keep doing an emotionally intense thing with folks we didn’t trust).

Finally, a bit about EMDR and "maybe I'm plural but I'm not sure, and/or may not have great in-system communication": yeah, this is a case to be especially slow and careful, for all the aforementioned reasons; what my instinct/recommendation would be in those cases is to: 1) make sure you learn a lot of resourcing techniques 2) try to check in with yourself(s) frequently and with compassion/intent-to-collaborate, "ask the inside of your head how it's feeling" and even if you're not sure whether the "reply" was just your own thoughts or a headmate, listen and try to engage with/respect those responses and emotions 3) if you start getting warning signs/back-off signals/sudden intense feelings, listen to them and lighten up, pause the session if you need to, do some self care etc, even (especially) if you don't know why you felt that way and it seems 'odd/random', and really you're super curious about what's going on and just want to figure it out. Like...you and the inside of your head and/or other system members are trying to navigate a complicated D&D maze together, in the dark, and you each only have part of the map--so you have to work together and trust each other, especially listening to warning signals even when your "part of the map" doesn't show anything to worry about there. And the more you work together and trust each other, the better everything gets, including therapy work.

When it's "Death By A Thousand Papercuts"-type Trauma Instead

If you're not sure where to start because there aren't a lot of obvious "Big Bad Memories" that feel like they adequately explain the issues you're having, some recommendations:

-> First, note that "no Big Bad Memories are immediately coming to mind, idk" is super common in systems and also in CPTSD, way more than I think most folks realize, so know that you're not alone and also that it doesn't mean you don't necessarily have stuff deserving of help and support.

-> So yeah, there's kinda two things imo you can try. The first is, if your therapist is on the more flexible side, you can try doing EMDR with either "this specific memory wasn't too bad, but it's representative of an ongoing pattern or theme that wasn't great" (say, loneliness at school or something, and you pick a specific lunchtime memory, which wasn't really That Bad in the moment, but you were kinda sad and/or upset about it and it feels representative of the overall trend you're trying to process/heal). Or you can try just doing the EMDR process on the theme itself, at the abstract level, and see what comes up--again, I'd really recommend starting with a much lower-stakes issue/theme than you think you need, just because it's really easy to underestimate, especially for systems and other folks whose brains dissociate a lot. (And especially if you know your system has episodic amnesia--e.g. event-amnesia/blackout amnesia--as well as emotional amnesia.)

The second is, there are other "more flexible" types of similar somatic therapy techniques (brainspotting is the name of another one, and there's more I can't think of rn) that might fit better instead-- tldr, totally worth asking your therapist about the whole situation, and asking what they'd feel most qualified for/comfortable with, in my opinion. You don't need to be doing Specifically Exactly EMDR to do somatic trauma therapy, even though EMDR is one of the more well-known modalities for it, and finding a version that feels right and not like you're forcing anything is really valuable (and you're not 'being picky' if it takes a while to find one; you're allowed to want to find one that feels right).

#hmm. our old therapist had us jump straight in and didn’t give us any precautions #or tell us what to do of bad bad bad memories came up #and now we’ve blocked those memories out too #but thank you op #we have CPTSD and our new (good) therapist wants us to try EMDR

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