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EMDR and the Role of State-Change Skills

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My work with people often drives me to explore themes that are currently showing up in my counseling practice. If you are a counselor, you know what I mean. You may have many clients or therapist consultees presenting with the same needs, perhaps some who are saying similar things of late. That’s not to say that these issues are the “same,” for they are not. Nevertheless, there are topics that may repeat themselves. I pay attention to these because I believe that there is much to explore and learn by being aware of patterns.

A pattern I have seen of late is related to eye movement desensitization and reprocessing (EMDR) work, specifically about the process of being “ready” to do EMDR. I have had a lot of therapists inquiring about their clients’ readiness to do EMDR. Keep in mind that if you are doing EMDR, you are always doing EMDR; it just depends on the phase you are in. If you are one of my EMDR clients or therapist consultees, you know how much I emphasize this as key to understanding the EMDR therapy model. Keep this in mind: EMDR is a process, a model, and not a technique.

EMDR’s preparation phase is phase two of the eight phases of EMDR. EMDR therapists look for people to have a minimum of two state-change skills as part of this phase. In phase two we are making sure that the client has the ability to not only tolerate emotion, but also to shift into a relaxed state, a para-sympathetic response. In other words, can the person bring up a disturbing event, be “in it,” but then also utilize a relaxation skill or calming technique to then change states if needed?

Keep in mind that the concept of changing states may be something that sounds easy, but for many it is not. Some folks seeking to utilize EMDR therapy as part of their trauma recovery may need more extensive preparation-phase support. This is especially true in the case of those struggling with dissociation and addictions.

In its simplest form, a state change means being able to utilize a relaxation skill to settle down one’s system. State-change skills can help the EMDR client to become calmer and more settled while still maintaining “dual attention”—i.e., being present while bringing up traumatic disturbance(s). In contrast, and though it may appear like it, the ability to utilize state-change skills does not mean changing states via dissociation. Certainly, one’s ability to dissociate may appear similar to a state-change skill, and is a survival skill, but dissociation keeps us “away from” traumatic material and from integrating the somatic, visual, emotional, and cognitive aspects of it to then heal.

For example, dissociation takes one away from the present moment because the past feels as if it is happening now and it feels safer to leave the present. But to be able to heal and integrate the traumatic material requires that state of being present. We just have to learn the dance between feeling the disturbing material and being able to shift into a contrasting, calmer state.

In exploring the concept of EMDR and state-change skills, addictions can also be explored as an attempt to chemically or behaviorally illicit a state change. I often explain to people that substance abuse is often driven by an ill-fated attempt to chemically dissociate. One can easily become entrenched in the vicious cycle of using addictive substances and behaviors to shift “out” of traumatic material in order to feel something, anything, and everything different from the pain of a traumatic history. And, for many people, addictions have become a way to change states, to feel away from and out of traumatic material.

The bottom line is that to heal, trauma histories beg to be accessed, stimulated, and reprocessed. The challenge can be in our making sure that EMDR clients are fully supported in having the state-change skills in place to be able to come back, to ground, and to stay present first. Therefore, creating and implementing these state-change skills can be the key to supporting EMDR clients in their recovery and throughout EMDR’s eight phases.

© Copyright 2014 by Sarah Jenkins, MC, LPC, CPsych, therapist in Tempe, AZ. All Rights Reserved.

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Comments
  • junebug January 3rd, 2014 at 10:39 AM #1

    you sound very knowledgeable about this field.. how did you speciafically get interested in this area and how it could help your clients?

  • Judy January 3rd, 2014 at 4:34 PM #2

    Hi Sarah,

    Great article! So happy that we are on the same trail!

    Talk soon,
    Judy

  • Bethany January 4th, 2014 at 8:45 AM #3

    The more reading that I do I am constantly in awe of the advances and studies being made every day that are going to better the lives of so many people; and many in ways that I personally would have never even known about! This stuff sounds like it is from the future but this is treatment that is happening today in therapeutic settings all over the globe, and while it may be limited in scope and availability, if it has success who knows how much more prevalent it could become? It all has to start small sometimes to gain momentum.

  • Myles January 6th, 2014 at 3:47 AM #4

    Sounds as if this could be a great tool for some to use if they are prepared that this could work and then again it may not, and are given the right information ahead of time to know exactly what they should expect from the treatment and how they can prepare so that potentially they will receive the greatest outcome from the work.

  • Sarah Jenkins January 6th, 2014 at 9:21 AM #5

    Hi Junebug – Thanks for the feedback. I have been an EMDR therapist for over 13 years and have always been focused on trauma healing in my work with clients. I first was exposed to EMDR through the work of a mentor and as a result – got trained in it. I do EMDR with the majority of folks who come to my private practice.
    Myles – great point you made. And yes, as part of EMDR – especially the Preparation Phase – comes detailed descriptions of what to expect through the EMDR process and how to prepare – all as part of the consent to receive treatment. EMDR is an intense therapy and a very strategic model. I encourage folks to ask lots of questions about the therapy itself as it does truly help the process unfold and support their healing work.

  • Sarah Jenkins January 6th, 2014 at 9:55 AM #6

    Thanks Judy ;) Bethany – it sure can – in face EMDR has been around for 25 years now and has a pretty expansive scope in that it has helped millions and has research behind it. The WHO – World Health Organization has recommended it and it has been recognized by SAMHSA as an evidenced base practice. A great resource would be the EMDRIA Website as well. Thanks for having read the post and visiting this page!

  • EMDR February 11th, 2014 at 12:51 AM #7

    Hi,
    junebug it can help your clients by check my website and check emdr therapies you can full knowledge about emdr thanks

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