It’s a common enough question and it does make a little bit of sense.  Have you ever seen a client completely resolve a memory (sometimes even a substantial one) and their experience didn’t seem to be terrible… they come back next session and don’t want to do EMDR.  They come back and are like, “Hey, can we just talk today?”

What is going on?  You spend weeks or months preparing and you help them clear something and they are done.  Let’s explore this through several case scenarios because my suggestions about resuming are going to vary based on the scenario. First, let’s assume that nothing particularly difficult emerged in their EMDR session, they didn’t report a horrible time after session, and let’s assume that the memory they worked on fully resolved.  They may have even expressed astonishment at the end of that session.  Why in the world would they not want to immediately resume work in this approach?

People can learn multiple things at once.  They can learn that they can heal from something quickly and profoundly.  They can have that information in their back pocket and it can be good there.  They might also learn that EMDR therapy is hard.  It kind of sucks, but it’s also great.  It can be exhausting.  And, it’s exhausting in ways that clients can’t predict, manage, or control.  And where it goes and how long they going to have to stay with what really really sucks in it, they also cannot predict.  So, here is what happens sometimes.  Clients can know that they can heal and they also know that this week has been hard, that they haven’t slept well, and they may need to see their mom one of the next few evenings and don’t want to be feeling a certain way.  So, clients come to session and they have a calculation to make.  They like you.  They can get a predictable benefit from your presence, kindness, and your attunement.  And they may take what feels like the safer bet today.  If this is what’s happening, none of that is about you, except that you are awesome and spending time with you is lovely.  If this is what is happening, have that conversation.  It’s okay to ask a client why they are choosing not to do EMDR therapy across multiple sessions.  It’s information.  Use that information in the service of the client’s recovery.  Some people just need you to ask.  Some people will have real concerns that they may need your help navigating.  Lots of people come to consultation and ask me this question.  Ask them.  And if you do it in a way that is open and doesn’t lead with a lot of agenda, you’re likely to get good information.

Here is a different scenario.  Some people have real difficulties in session or after.  None of us likes it when the lid pops off.  It is scary. Client’s don’t like when everything they have tried to stay ahead of starts to catch up all at once.  If clients have a difficult time, we anticipated that might happen.  We prepared for that.  And there are so many options you can suggest for more effective management of it.  EMDR is not binary and we need to work at the intersection of what it productive and tolerable.  We learn what that is by making our best guess and by starting this work.  If clients have a difficult session, that is not failure, that is information.  We have options.  We don’t have to return to that territory right now.  We can work on other, more tolerable memories.  We can strengthen your attachment figure resources if you got stuck in an attachment wound memory.  We can take steps to discourage the target from going everywhere.  You can show the client how to interact with the memory in ways that allow pieces of it to come into awareness a little bit at a time.  The book, EMDR With Complex Trauma, has chapters on these little guardrails we can put up if clients need them.  If the client had a difficult EMDR session, ask about those difficulties.  They do not know what their options, but they are pretty sure what their experience was.  Ask.  Again, difficulties are inevitable.  They are not failure, they are information.  Get and then use that information.

Here is another really common dilemma.  We see clients start with memories with a SUDs of eight and we see them in a single session process it down to a two.  And next session, they do not want to work on that two.  That makes perfect sense from their perspective.  That two SUDs is not causing them distress right now.  Lots of other things are.  They might argue with you about working on that two this session or next session.  Clients are looking for less distress.  We are in pursuit of generalization, because when a memory fully resolves, many other things we never have to touch may also resolve automatically.  So, when I have this type of dilemma, I want to share that dilemma with the client and also make it theirs.  I want to share why that two out of ten SUDs is like a tunnel that we dug from France to England, but we stopped four miles short.  We need to finish projects like this sometime (not necessarily today, but soon), so information can flow through that pathway for the rest of your life.  Finishing up unresolved memories is a great thing to do once clients understand that there are really good reasons for doing it other than therapist OCD. So, when you have a dilemma like this, invite the client into it.  Start with, “I hear that so many other things have your focus now and this seems like it’s not worth revisiting.  But, in EMDR therapy the memories that we fully resolve help build what we need to more easily resolve the others, including the ones you would like to work on today.  Does it make sense why I’m suggesting that we finish some of the stuff we have started before working on new things?”

Again, some ideas.  Talk with your clients about their hesitations.  Talk openly and without too heavy of an agenda for this session.  We want to follow our clients, but when doing this puts us in a dilemma, share that dilemma with them.  They are likely to give you information.  If you don’t know what to make of the information, come to consultation and we are likely to be able to help you translate it.

Thank you for the amazing work that you do in the world.  Be in touch.