No, EMDR Doesn’t Work For Everyone, And Here’s Why
EMDR Therapy, also known as Eye Movement Desensitization and Reprocessing, is a popular form of healing, powerful healing. As people become more comfortable talking about their mental health concerns, we see more people discussing EMDR, especially celebrities. What is EMDR? When something terrible happens to us, it is stored in our brain and nervous system in a different way than our everyday experiences. Memories and sensations show up when we are least expecting it, just like that, your day has been hijacked. EMDR therapy helps to make the memory less disturbing.
Research reveals that EMDR is a powerful therapeutic approach for resolving symptoms of PTSD and for processing trauma and negative experiences. EMDR has been extensively researched and is recognized as effective by organizations such as the American Psychiatric Association and the World Health Organization for treating PTSD. Many individuals experience significant symptom reduction and improvement in their overall well-being after undergoing EMDR therapy.
what does EMDR Treatment help people heal?
According to EMDR theory, traumatic memories are stored in a fragmented or dysfunctional manner within the brain's memory networks. Targeting specific memories through bilateral stimulation (such as eye movements) helps activate these networks and facilitate the brain's natural healing processes, leading to integration and resolution of the trauma.
Does EMDR therapy work for everyone?
While EMDR therapy has shown significant benefits for many people, it may not work for everyone or may require modification or supplementation with other therapies in some cases. EMDR (Eye Movement Desensitization and Reprocessing) therapy can be highly effective for many individuals, but there are several reasons why it may not work as expected or may not be suitable for everyone:
It’s not safe to be well, or healed - It's essential to remember that you have underlying beliefs about your safety that may prevent EMDR from being effective for you. This may seem counterintuitive because you seek treatment to alleviate your pain and suffering. However, the unconscious is a powerful driver in our everyday lives. If your unconscious holds a belief that you are not safe, EMDR may not be effective for you. Beliefs about safety, whether conscious or unconscious, shape how individuals perceive and respond to their environment, relationships, and even therapeutic interventions. If someone holds unconscious beliefs that they are fundamentally unsafe or that processing traumatic memories could lead to further harm or distress, they may instinctively resist or sabotage the therapeutic process.
Unconscious beliefs about safety can also activate defense mechanisms designed to protect individuals from perceived threats. These mechanisms, such as avoidance, dissociation, or denial, can manifest during EMDR therapy sessions, hindering the ability to engage fully in trauma processing and emotional exploration.
Fear of change or fear of confronting deeply held beliefs can create resistance to therapeutic interventions like EMDR. This resistance may stem from a subconscious desire to maintain familiar patterns, even if these patterns contribute to ongoing distress or dysfunction. In light of these considerations, therapists trained in EMDR and other trauma-focused therapies are skilled at navigating and addressing underlying beliefs that may impact treatment effectiveness.
Complex Trauma and Belief Systems: In cases of complex trauma, where individuals have experienced multiple and pervasive traumatic events over time, beliefs about safety and trust can become deeply entrenched. These beliefs may require targeted therapeutic interventions, such as cognitive restructuring, to address and reshape perceptions of safety and self-protective mechanisms.
Therapist lacks experience - Effective EMDR therapy requires a therapist who is well-trained, experienced, and skilled in trauma treatment. If the therapist does not have sufficient experience with EMDR or trauma-focused therapies, the outcomes may be less successful. A therapist with advanced trauma training and EMDR supervision consultation is more likely to achieve positive results. ideally, EMDR clinicians have achieved 50+ training hours through an EMDRIA-approved program in addition to post-training practice. Certification by EMDRIA is not necessary, but putting in practice and supervision is.
You don’t trust your therapist - Feeling comfortable with your EMDR therapist is important. Research indicates that 80% of the effectiveness of therapy is based on your comfort and “fit” with your therapist. Establishing trust with your EMDR therapist is essential for your safety and outcome. It’s a good idea to move on if your intuition tells you it’s just not right.
EMDR therapist has not prepared you with sufficient resourcing - Many want to dive right into EMDR, however good EMDR therapy and practice require a certain amount of “getting to know you” to ensure that you are ready and stable enough to do the work of EMDR. Resourcing is a term that you will hear early in your EMDR experience, and many EMDR practitioners feel this is the most important part of successful EMDR. If an individual is not adequately prepared or resourced, EMDR can become problematic very quickly.
What is resourcing? In Eye Movement Desensitization and Reprocessing therapy, resourcing refers to a set of therapeutic techniques used to help clients build inner resources, develop coping skills, and establish a sense of safety and stability before addressing traumatic memories. Resourcing is an essential preparatory phase in EMDR therapy and serves several purposes: improving emotion regulation, feeling empowered, enhancing self-esteem, and establishing safety.
Examples of resourcing techniques used in EMDR therapy may include:
Safe Place Exercise - Guiding clients to visualize and fully experience a place in their mind that feels safe, calm, and secure. This place serves as a refuge during distressing moments.
Container Exercise - Helping clients mentally create a container to temporarily store overwhelming emotions or memories until they are ready to process them in therapy.
Positive Imagery - Encouraging clients to visualize positive outcomes, strengths, or supportive figures that evoke feelings of comfort and strength.
Grounding Techniques - Teaching clients sensory-based techniques (e.g., focusing on breath, noticing physical sensations) to anchor themselves in the present moment and regulate emotional arousal.
When it comes to EMDR resourcing, the amount of time needed varies from person to person. For some, just one session is enough to feel resourced, while for others, it may take weeks or even longer to feel comfortable in therapy and fully resourced.
Misapplication of EMDR technique - Improper application of EMDR techniques or failure to adhere to the standard protocols can also reduce its effectiveness. Therapists need to follow established guidelines and adapt the therapy to each individual's needs. This is how EMDR has been studied. However many advanced practitioners get creative at times; they weave in other therapies such as Internal Family Systems, Parts Therapy, and Somatic Experiencing to enhance effectiveness. This can be highly effective but should only be done by more experienced practitioners. Ask your therapist how strictly they adhere to protocol.
EMDR target memory is inappropriate - In EMDR therapy, the “target memory” is crucial because it serves as the specific traumatic event or experience that EMDR therapy aims to process and alleviate. It needs to be meaningful and create enough discomfort for processing to be effective. When people say that you do not need to relive the experience, well, that’s not exactly accurate. You do, somewhat. The target memory becomes the focal point of EMDR therapy sessions. This approach focuses on addressing specific incidents that have had a lasting negative impact is emotional and psychological well-being. The goal of Eye Movement Desensitization and Reprocessing (EMDR) is to reduce the distress associated with these memories and promote healing. A skilled EMDR therapist assists the client in working through the distress to prevent it from becoming overwhelming. Throughout EMDR therapy, progress is often measured by how the client's distress level associated with the target memory decreases. Working through and processing the target memory effectively can indicate therapeutic success and motivate further healing and growth.
Dissociation occurred during EMDR - Dissociation during EMDR (Eye Movement Desensitization and Reprocessing) therapy can occur when a person mentally disconnects from their thoughts, feelings, memories, or sense of identity as a way to cope with overwhelming emotions or traumatic experience(s). It’s a highly-adaptive process and offers great protection when needed. Unfortunately, some individuals continue to use dissociation in their lives even when safe. An experienced EMDR therapist is trained to recognize when this is happening and will offer grounding and reorienting techniques. They will also modify their technique to lessen the dissociation.
Complex trauma is at play - Individuals with complex trauma histories, such as multiple or prolonged traumatic experiences, may require longer or more comprehensive therapy than EMDR alone can provide. In these cases, additional therapeutic approaches, modifications to technique, or a phased treatment plan may be necessary. Prolonged exposure to danger, compounding losses, or severe abuse and suffering can create additional complexities when working with EMDR.
Complex trauma often results in fragmented or dissociated memories, making it difficult to identify and target specific traumatic events for processing. This fragmentation can complicate the application of standard EMDR protocols, which typically focus on discrete memories.
Complex trauma frequently impacts attachment patterns and interpersonal relationships. EMDR, which primarily focuses on internal processing and bilateral stimulation, may need to be supplemented with relational interventions to address attachment wounds and relational dynamics that contribute to ongoing distress.
Clients with complex trauma may experience recurring themes or patterns across various traumatic experiences. Addressing these themes effectively within the EMDR framework may require adapting standard protocols to accommodate the complexity and interconnectedness of these experiences. Processing traumatic memories through EMDR can evoke intense emotional and physiological responses.
Clients with complex trauma may have a lower threshold for managing such intensity, necessitating a gradual and phased approach to therapy. Individuals with complex trauma may experience dissociative parts or distinct aspects of self that hold different memories, beliefs, and emotions. Integrating these parts and ensuring cohesive processing across these fragmented aspects of self is essential but may require additional therapeutic strategies beyond standard EMDR techniques. EMDR can work for complex trauma but it will not be treated quickly. Lasting healing and resolution of symptoms related to complex trauma can take years and is enhanced greatly by a trusting, safe therapeutic therapist-client relationship.
Incorrect diagnosis or complicated diagnosis - Sometimes, symptoms that appear similar to PTSD may stem from other underlying issues such as personality disorders, dissociative disorders, or medical conditions. In such cases, EMDR may not address the primary cause of the symptoms. Individuals with additional diagnoses may do best when EMDR is offered in phases and with modifications to technique when symptoms arise. Individuals with personality disorders may exhibit resistance or ambivalence toward therapy, including EMDR. Therapists should address these issues through empathic exploration of client concerns, managing expectations, and fostering collaboration in treatment planning. Building trust and ensuring a collaborative therapeutic relationship is essential for engaging clients with personality disorders in effective trauma processing.
Resistance or ambivalence towards EMDR - Some individuals may have subconscious or conscious resistance to EMDR therapy, particularly if they are not fully committed to the process or if they have doubts about its effectiveness. Trust issues can significantly impact the effectiveness and feasibility of EMDR (Eye Movement Desensitization and Reprocessing) therapy for some individuals.
Inadequate treatment duration - EMDR therapy typically requires several sessions to achieve optimal results, and this is for single-event trauma. more complicated trauma(s) need more time in treatment. If therapy is prematurely terminated or if there is insufficient follow-up, the benefits of EMDR may be limited.
External Stressors - External factors such as ongoing stressful life events, lack of social support, or environmental factors can impact the effectiveness of EMDR therapy. During times of stress, clients may experience impaired emotion regulation, reduced capacity to process and integrate, and be prone to re-traumatization. If a client is experiencing acute stress or crisis, therapists may initially focus on stabilization techniques, building coping skills, and providing support to help the client regain a sense of safety and emotional stability. Many therapists will revert to supportive therapy.. Once the client's stress levels have decreased and they are better able to manage emotions, EMDR therapy can be considered as part of a comprehensive treatment plan.
Mismatch with personal preferences - Therapy effectiveness can also depend on the fit between the therapy approach and the individual's preferences and personality. EMDR treatment may not be a good fit for you, even if friends, family, or your doctor have recommended it. Some individuals may prefer or respond better to other therapeutic modalities such as Trauma-Focused CBT (TF-CBT), Dialectical Behavior Therapy (DBT), Prolonged Exposure Therapy, Sensorimotor Psychotherapy, as just a few examples.
Unrealistic expectations of EMDR therapy - Like many forms of psychotherapy, EMDR may take time to show results. Some people may see it as a last-resort option for healing. Others begin EMDR therapy with the notion that it is a quick fix. Certain clients may begin therapy expecting immediate and drastic changes, but healing often happens gradually, which can be frustrating. When we're in pain, we naturally want to feel better as quickly as possible. While EMDR aims to significantly reduce symptoms such as intrusive thoughts, nightmares, and emotional reactivity associated with PTSD and trauma, it may not eliminate every symptom. Some individuals may still experience occasional triggers or mild symptoms after completing EMDR therapy.
Managing expectations in therapy involves clear communication between the therapist and the client about what EMDR can realistically achieve, the expected timeline for progress, and the collaborative nature of the therapeutic process. Educating clients about the potential benefits and limitations of EMDR therapy helps set realistic goals and fosters a more informed and effective therapeutic relationship. Therapists can and should address any unrealistic expectations early in therapy to ensure that clients approach the process with openness and realistic optimism.
So there you have it, some common reasons that EMDR has not been effective for you or someone you love. While EMDR therapy has shown significant benefits for many people healing negative or traumatic experiences, it may not work for everyone or may require modification or supplementation with other therapies in some cases. It's essential for individuals considering EMDR to consult with a qualified therapist to discuss their specific situation and determine the most appropriate treatment approach. EMDR is a significant investment of time and money. Whether to try EMDR therapy again depends on a thorough assessment of the reasons for the initial lack of success, your readiness and preferences, and consultation with other professionals if needed. By approaching the decision collaboratively and thoughtfully, therapists and clients can work together to determine the most effective path forward in their healing journey. If you have the fortitude, consider working with another EMDR therapist who likely has a different style and approach and may be a better fit for you.
About Holistic Psychotherapy & Wellness Manhattan
Kimberly Seelbrede, LCSW is a New York State licensed Psychotherapist, EMDR Practitioner and Couple Therapist with a private practice in New York City, Montana and virtually. As a wellness psychotherapist and holistic consultant, she has received advanced, extensive training in Trauma Therapy, Psychoanalytic Psychotherapy, Internal Family Systems (IFS), Eye Movement Desensitization Reprocessing (EMDR), Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), Somatic Experiencing (SE), and Nutrition & Integrative Medicine For Mental Health. She is passionate about honoring the exquisite interplay of the mind-body connection. Kimberly Seelbrede specializes in anxiety & mood disorders, trauma and women’s mental health. She brings over 20 years of counseling, coaching, and healing experience to her holistic practice and transformational work. She specializes in helping dynamic women improve their mental health.
In addition to online therapy for anxiety, depression, trauma and relationship struggles, Holistic Psychotherapy & Wellness offers a wide variety of online services to fit the needs of busy professionals. New Yorkers often lead fast-paced and complex lives, which makes work-life balance and managing career, family and social obligations a challenge. Psychotherapy and wellness practices provide the support to help clients cultivate resources, resilience and enhanced emotional health, as well as uncover conflicts and obstacles that may interfere with having the life they desire.