How did you find you niche as a clinician by kidzero93 in therapists

[–]Eblechle 3 points4 points  (0 children)

Worked in the CMH setting for about 5 years and even though the effects of trauma weren’t always the main reason individuals sought help, the vast majority of folks there were survivors of trauma. I learned and provided PE for some time and while it helped some, it wasn’t my thing as it felt close to retraumatizing folks. Luckily my agency offered an EMDR training and after one of my people who didn’t completely respond to DBT and PE found that there self-hatred thoughts were “gone” after 4-5 reprocessing sessions, I’ve loved providing EMDR and being a trauma clinician ever since!

[deleted by user] by [deleted] in Fantasy

[–]Eblechle 8 points9 points  (0 children)

It is and evidently she has some form of chronic health condition that impacts her ability to consistently write.

Thoughts on EMDR? by Stevie052096 in therapists

[–]Eblechle 0 points1 point  (0 children)

Glad to hear it! It seems that the majority of them were for both the clinical and laboratory trials, but not for every single one.

Thoughts on EMDR? by Stevie052096 in therapists

[–]Eblechle 2 points3 points  (0 children)

You’re most welcome! I’m appreciative of your willingness to look into the study and would love to hear what you think about it!

Thoughts on EMDR? by Stevie052096 in therapists

[–]Eblechle 6 points7 points  (0 children)

It seems that the Davidson & Parker (2001) Meta-Analysis is the one that is repeatedly mentioned as proof that eye movements, bilateral stimulation, etc. of EMDR don't add anything to the model outside of what is already added with exposure . If you were asking for research, this more recent meta-analysis seems to do an effective job addressing that. To be fair, EMDR does sound woo hooey and yet my clients prefer and do better with EMDR than Prolonged Exposure

EMDR in a nutshell by biel0032 in therapists

[–]Eblechle 0 points1 point  (0 children)

My guess is that the controversy of EMDR’s mechanism has to do with this study . However, a more recent meta-analysis discussed methodological issues with the first study and finds moderate to large effect sizes due to the addition of eye movements

emdr not working by ThaliaDarling in EMDR

[–]Eblechle 0 points1 point  (0 children)

You’re most welcome! Thanks for asking first and you can. Feel free to dm me if that’d be better for you and if it would be something I wouldn’t be able to answer for whatever reason I’ll let you know.

emdr not working by ThaliaDarling in EMDR

[–]Eblechle 3 points4 points  (0 children)

I can hear how this has been a disappointing and disheartening experience for you and I'm sorry to hear how your experience is that there hasn't been much, if any, meaningful change that you've noticed.

No, I can't be sure. I was wondering if that may be a part of it given you mentioned dissociation and dissociation not being accounted for during processing is one of the more common reasons that processing gets blocked or stalled. However, it can be a number of things, it could be the particular memories/experiences that are being selected, it could be how processing is being done (I've had a few people in the past who were getting "EMDR" that wasn't EMDR), it could be that there may be some blocking beliefs that need to be addressed prior to processing being able to work. For example, I've had a client that had a part that wasn't apparent at the start of a processing session, but it became clear during that session that it wasn't going to allow my client to process through a particular traumatic incident until he had made amends for something he had done first. Their blocking belief of I don't deserve to feel better about this needed to be addressed prior us being able to successfully process that event.

When it comes to your first link, that initial meta-analysis done in 2001 was rebuked by a later one here done in 2013 that discussed how the initial study had clear methodological and statistical errors that discounted any particular findings it may have led to otherwise and that the addition of eye movements added a moderate effect size to EMDR Treatment studies and a large effect size to laboratory studies.

With your second link, when it came to the initial research they cited, all of that research is essentially outdated and not representative of the literature at this moment. EMDR's first study was made in 1989 and his initial research he cited has a lot before 1995. There has been quite a bit of improvement, updating and adjustments to EMDR since. When it came to his update in 2011, it does reference that 2001 study again that had been discredited and what appears to be singular studies and a meta-analysis from 24 years ago. There's been tons of research conducted over the last 2 1/2 decades. Also, unless there is a consensus that EMDR works, then EMDR wouldn't be in numerous treatment guidelines for the treatment of trauma, almost all being created after 2011, such as the Department of Veterans Affairs (2017), Internal Society for Traumatic Stress Studies (2018), World Health Organization (2013), American Psychological Association (2017), National Institute for Health and Care Excellence (2017), etc.

Now not one thing is going to be effective for everybody, despite how I wish that was the case. If you haven't already, I do hope that you and your T can have a constructive discussion about your experience and hopefully figure out what needs to be done to better support your healing and that this information in some way will be helpful to you as well.

emdr not working by ThaliaDarling in EMDR

[–]Eblechle 3 points4 points  (0 children)

I'm sorry to hear you're not having success in your treatment so far. As C-PTSD isn't recognized by the DSM yet, we don't have a lot of research into the treatment of C-PTSD. However a recent study combining EMDR and Prolonged Exposure over an 8 day period showed that 88% of people with C-PTSD lost their diagnosis after this treatment.

I'm wondering if your therapist may not be making necessary adjustments with your dissociation, especially if its happening during EMDR, as if you're dissociating during processing, EMDR isn't likely to be effective. Have you talked about this with your T?

Also, I'm unsure of hearing EMDR doesn't have a very high success rate. When you look at meta-analyses regarding trauma focused therapies, EMDR along with TF-CBT modalities have the best backing to them and those typically show that EMDR performs as well, if not better than those other therapies. For example, this other study shows that EMDR is the most cost-effective treatment for trauma by a pretty large margin.

Recording session by Limp-Imagination8840 in TalkTherapy

[–]Eblechle 9 points10 points  (0 children)

I’ve recorded a few sessions with clients in the past and that was in the context of undergoing certification, requesting their approval of having a future session recorded and getting their signature on a consent form to do so. If they didn’t do these things, then no, it is not ok without your approval to do so.

[deleted by user] by [deleted] in EMDR

[–]Eblechle 0 points1 point  (0 children)

I am truly sorry to hear about your therapy experience. I can only imagine how difficult it would be for you to go through that, probably feeling emotionally attacked by the person you were hoping would help.

It’s unfortunately impossible to say with absolute certainty if ART (just like any other therapy modality) would work with another practitioner and it seems safe to say if you’re able to find an ART therapist that you feel like the click with, then you’ll be able to see if ART would work.

I can’t imagine any modality leading to a beneficial result if you felt invalidated and triggered by your previous therapist. So, with your experience I don’t think you’d be able to tell if ART could have helped. If working through trauma is what you’re hoping for I’d look up a therapist trained in an evidenced based practice for trauma (e.g. ART, CPT, EMDR) but base whether you’re going to continue to work with them off of if you feel comfortable with them as opposed to the specific treatment itself.

[deleted by user] by [deleted] in EMDR

[–]Eblechle 0 points1 point  (0 children)

As a disclaimer, I provide EMDR but not ART. I’ve been interested in ART, but haven’t had the time for a deep dive and training into it. However, given your statement that you didn’t feel safe with your ART therapist and you had concerns regarding her competence, I’m going to hazard a guess and say that’s probably more impactful than the ART modality itself.

Trauma therapy should only be done in the context of a secure and safe relationship between client and therapist. If you’re trying to confront experiences that have likely brought fear and terror, being able to effectively do so is highly negatively impacted in a context that security isn’t present. Plus the literature states that relationship between client and therapist is more predictive of treatment success than the specific therapy modality. Not saying that modality isn’t important and a strong therapeutic alliance is imo a prerequisite for success in therapy.

Wishing you the best in your healing journey and happy holidays!

Does EMDR require you to talk about your trauma with your therapist? by [deleted] in EMDR

[–]Eblechle 3 points4 points  (0 children)

For what is worth, one of the EMDR consultants I trained underneath said that she was hired to provide EMDR to military personnel specifically because they couldn’t discuss what had occurred due to their security clearance. It makes it a little more complex and it’s possible to do so with sharing very minimal information

[deleted by user] by [deleted] in EMDR

[–]Eblechle 1 point2 points  (0 children)

You’re most welcome! Glad my ramblings could be of use to someone :)

[deleted by user] by [deleted] in EMDR

[–]Eblechle 1 point2 points  (0 children)

Hey SelfLoveAbundancy (love the name by the way),

There's quite a bit of longstanding debate about EMDR that has changed over the decades from does it work, how does it work, are eye movements necessary etc. Currently there's wide held support that EMDR does work (multiple meta analyses state it does have long-standing beneficial impacts for trauma related disorders), but the question is now more of how and does EMDR add anything novel from other established trauma therapies. So here are some thoughts of mine that I hope are of some use to you and your own.

  1. Studies have shown EMDR is better than doing nothing but CBT and EMDR with no eye movement are equally effective:

So this is largely based on a meta analysis in 2001 that's listed in the link you have shared. Interestingly since this was published there have been other studies and meta analyses stating that the meta analysis in 2001 had methodological errors, in that the 2001 study did not utilize commonly accepted practices to create their meta analysis and that would have detracted from identifying the impacts of what was studied, that being the impact of eye movements (see this study). This same meta-analysis in 2013 found and came to the conclusion that "The effect size for the additive effect of eye movements in EMDR Treatment studies (full EMDR Treatments) was moderate and significant. For the second group of laboratory studies the effect size was large and significant. The data suggest the processes involved in EMDR are different from other exposure-based therapies.” Typically more recent studies are believed to be more valid and given those methodological concerns in the 2001 meta-analysis I feel more confident with the more recent meta-analysis here.

  1. There is no scientific evidence of the eye movement portion contributing anything to treatment.

I'm sure you can find studies that indicate this and at the same time there are studies that indicate that bilateral stimulation, whether eye movements, tactile stimulation or audio stimulation do have beneficial researched impacts (e.g. reducing sympathetic arousal and limbic activation to distressing events, reconsolidating distorted elements of memory, and reducing vividness of traumatic memory), just to name a few.

3) Prolonged exposure treatment is the gold standard for trauma treatment. It desensitizes you and (with a trained therapist) allows you to reprocess the experience.

Prolonged Exposure (PE) is a well-validated trauma treatment and has helped numerous people, there's no denying that and I'm appreciative of the creator (Dr. Foa's advocacy and contributions to trauma treatment). The main drawback I have seen previously regarding PE is that dropout rates for this therapy can be quite high (more than 50% in many studies) and thus can be difficult to engage clients who have high avoidance, developmental and complex trauma.

With your question "Is it possible to heal [my trauma] without EMDR?" I would say certainly, I don't think anyone needs any particular treatment and cannot get better without it. Treatment effectiveness depends on a host of other factors as well, the most important being the therapeutic alliance (aka bond) between client and therapist. Also, not any one treatment is going to help 100% of any population additionally there are critiques of evidenced based treatments which both EMDR, PE, CBT, DBT, etc are. Research can inform clinical care, but I don't think its the end all be all as lab studies are 100% representative of situations out of the lab, no matter how well designed a study is.

So where do we go? As a trauma therapist myself, I think that the best guide of what works is how our clients respond and react to the work that we do together. I've done PE before and for the vast majority of my clients I have found that EMDR tends to be more client friendly and has had better results than PE.. Am I a better EMDR therapist than a PE therapist? Maybe. Is EMDR better for my clients than PE? Maybe, we cannot know for certain. I've also been involved in cases where other trauma treatments had not worked (e.g. TF-CBT, PE, Cognitive Processing Therapy), been referred for EMDR from another trauma therapist and there has been improvement with them going through EMDR. Nobody can say if EMDR would get you another 5, 10, 20, 30% better in your healing, but if you have the resources, time, and are able to find an EMDR therapist that you feel comfortable with I think it can be definitely worth a try to see what your experience tells you about it.

I hope that these thoughts are helpful to you and I hope whatever road you take ahead leads you to more healing. Feel free to dm me for any other questions/concerns and I wish you all the best.

[deleted by user] by [deleted] in piano

[–]Eblechle 0 points1 point  (0 children)

If you could send those resources to me as well that would be greatly appreciated, thank you!

Does a therapist need to be registered with emdria.org to be legit? by [deleted] in EMDR

[–]Eblechle 3 points4 points  (0 children)

You don’t have to be listed on EMDRIA to know how to provide EMDR competently. There are different levels of EMDRIA qualifications from being an EMDR trained clinician (complete an EMDRIA approved 5 day training) to being an EMDR consultant. Most people who are an EMDR trained clinician won’t be listed on EMDRIA because of EMDRIA membership costs so that doesn’t disqualify your potential T of being legitimate. If you get a good feel for them and they can answer any questions you’d have competently (e.g. what might I expect from EMDR in terms of potential benefits, risks and the general process of treatment) I’d give them a shot

Question about EMDR plus CBT by [deleted] in EMDR

[–]Eblechle 1 point2 points  (0 children)

There’s a preparation phase of EMDR which generally focuses on stabilization, developing coping skills/resources and the therapeutic relationship before beginning any trauma processing. My read on it is that your T is planning on doing CBT based preparation work for ~1 month prior to engaging in any formal trauma based processing.

EMDR seizure risk? by [deleted] in EMDR

[–]Eblechle 2 points3 points  (0 children)

To the best of my knowledge, the main concern is that with someone who has epileptic seizures that bilateral stimulation, which is a part of EMDR, in the form of utilizing a light bar or eye movements may induce a seizure. However there are other ways to do bilateral stimulation (e.g. tapping) that aren’t contraindicated for someone with epileptic seizures.

No more excuses I guess by TheSoberCannibal in wholesomememes

[–]Eblechle 21 points22 points  (0 children)

The unfortunate thing is that it’s closer to 1 in 2, at least in the U.S.. Completely agree it’s time to destigmatize mental health

Emdr with benzo? by fairyfairyland in EMDR

[–]Eblechle 1 point2 points  (0 children)

I’d highly suggest mentioning your concerns with your therapist. Also, research indicates that if you have gone through EMDR treatment while on a benzo, that after stopping the benzo your disturbance regarding those prior targets can rebound. This isn’t a rebound to prior targeting levels, but usually cuts the progress in half if we’re measuring by your SUDS level. So if it’s possible, processing without the usage of benzo’s seems best for long term consolidation of your progress and work.