Does virtual EMDR work?

Back in March of this year when the sh** storm, COVID, first hit, I decided that it was time to start working remotely. A lot of time and consideration went into this decision but ultimately, it made the most sense for my business because I could not regulate my own nervous system when I was seeing clients in-person at the office. My mind was racing and exhausted by all the new things my body and brain needed to orient to when working with clients. Since moving my practice completely virtual, I have been able to feel myself again in sessions. I am present, grounded and able to focus on my clients in their sessions.

While some aspects of therapy have seamlessly transitioned to video therapy, there still remain a great deal of unknown and negative aspects. One of the unknown aspects that many new and potential clients have concerns about is around EMDR. EMDR processing traditionally utilizes tappers, following the therapist's hand/fingers side to side, a lightbar or auditory head set for the bilateral stimulation phase. Not exactly ideal for virtual therapy where even just sitting still can cause many individuals to experience exhaustion, nausea, headaches, and a long list of other physical and emotional side effects. So could virtual EMDR actually work? The answer is, yes.

If you're considering starting virtual EMDR therapy, here are some things to take note of:

1. EMDR is an entire theory and process with many steps along the way. There are many steps in EMDR prior to the more active phase of EMDR, the desensitization and reprocessing phase, that most are familiar with. In my sessions with clients who use EMDR, we sometimes never even get to this phase. Many clients begin to look at the event(s) that brought them in with a new, trauma-informed lense and feel better before we get there. There is so much amazing work you can do in EMDR therapy without actually reprocessing the event.

2. You can get creative with bilateral stimulation. In 1:1 therapy, therapists will be in charge of this part of therapy, monitoring the number of times the light/buzzer will go side to side. Therapists will still monitor this part of therapy in virtual sessions but if you're a client who gets dizzy or nauseous just at the idea of watching your therapist move her fingers from left to right for several minutes while you reprocess trauma or a stressful event over the computer, you can take on this part.

Bilateral stimulation done by the client is actually not very difficult at all and really just requires a little bit of creativity from the therapist and client. If you're a client and you have the money, purchasing a theratapper machine for therapy might be worth the investment. The therapist will monitor and let the client know when to start and when to end. Some EMDR therapists even use programs like RemotEMDR or Active EMDR that can display bilateral movements through the screen.

In my training on using EMDR with children, I learned lots of different creative ways to do this. One of my favorite, more affordable options is for the client to take something like a toy car and move it back and forth on your desk quickly while the client watches and the therapist monitors sets. The free-est option would be for the client to simply tap on themselves in a butterfly hug as they engage in this part of EMDR. Many of my clients report positive results from scanning the top of their laptop or computer, or any two fixed objects in their view from side to side. In other words, there are lots of different creative ways to play with virtual bilateral stimulation.

3. Your therapist might use attachment-based or a more holistic style of EMDR which might or might not even need the use of bilateral stimulation. As a more holistic, somatic-based therapist, I have a love/hate relationship with EMDR. Some aspects of EMDR, such as reading off the protocol scripts, are just too rigid for my personal therapy approach and for many of the clients I work with. I love talking with my clients and I find that the secure attachment created through talk therapy can be invaluable for many clients who have experienced trauma or who have been in abusive relationships or families. Many other EMDR therapists are with me here and utilize a more "organic" or attachment-based version of EMDR. This version of EMDR will sometimes utilize bilateral stimulation when needed, but for the most part, the therapist will interweave attachment-based EMDR tools throughout the session. This means, you might not even need the bilateral stimulation piece very much at all if you prefer this approach.

4. The environment the client is in while doing virtual EMDR therapy is important. One big piece of EMDR, is ensuring environmental safety. Without a private office for clients to go to, many clients are forced to do therapy in less than ideal environments such as vehicles, at their work office, or in a closet at home. Although many clients are able to find a safe environment to have therapy sessions, many other clients live in close quarters with family members/roommates who can't or won't leave or who are/have been abusive or manipulative in the past. Before starting EMDR therapy virtually, the client will want to spend some time making sure they can find a private, safe space to really be able to stay fully present and engaged in the session.

EMDR therapy experts are currently studying the efficacy of virtual EMDR to give us all the final results but so far, everything coming out sounds promising. If you've been considering EMDR therapy and live in Austin, I'm happy to share feedback on whether EMDR might be an option for you in a free phone consultation session. In the session, we can discuss a plan of action and approach that works for you.

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