Bonus Episode: EMDR Intensive Therapy Q&A with Steve Bock and Carie Bock, LPC-MHSP

Carrie and her husband Steve are excited to bring you a bonus episode on EMDR Intensive Therapy. 

• What is EMDR Intensive Therapy and what are the issues it can help with?
• What happens in an EMDR Intensive Therapy session?  
• How long does the session usually last?
• How to receive EMDR Intensive Therapy?

If you want to find out more about intensive therapy, go to https://www.bythewellcounseling.com/intensivetherapy/

Transcript

Carrie: Welcome to a very special episode of Hope for Anxiety and OCD. This is a bonus episode that I wanted to get out to you earlier than putting it kind of in the lineup. Since we have several episodes that are already planned out for the next couple of months. And I have my amazing husband, Steve here with me. Say Hi Steve.

Steve: Hey

Carrie: Glad to have you here. You interviewed me once before on the show for episode 33 of What it’s like to be a Counselor. And I thought it would be good for you to interview me on our today’s topic, which is EMDR intensive therapy. Since it’s something that you’re not familiar with. When I get in the zone and tend to talk about therapy things, I don’t tend to always explain them for the lay audience to understand and break it down very well. So I thought it would be good. And you can ask little filler questions here and there that people might be wondering about, or you might be wondering about.

What is EMDR Intensive Therapy

Steve: Okay. My first question is what is an EMDR intensive therapy session?

Carrie: This is a session that is longer than a typical therapy session. It occurs either for a half day of three hours or a whole day, which is six hours with a lunch break and some small breaks in between it’s for a very specific purpose.

So someone that’s trying to achieve a very specific counseling. It may be that they know, for example, that they’ve experienced some sexual abuse that is getting in the way of their relationship with their spouse. Now it may be a situation where they’re trying to overcome a phobia or a situation where maybe they just know they have a lot of trauma.

They’re going to need to process in a sense, kinda wanna get a kickstart to that process. Another way we use an intensive therapy session for say anxiety or even possibly OCD is to work on some day-to-day level coping skills that people could use as maybe a baseline for them. So it doesn’t have to be used to process trauma.

The idea behind it is to have dedicated time and dedicated space to work on a very specific issue.

Steve: A long therapy session that seems like it might be kind of exhausting.

Carrie: It can be tiring, but it just depends on how you break up the day. Usually what we’ll do is we’ll have kind of a introductory period.

So to explain a little bit deeper, these are situations where I may have been working with someone for. Session a few sessions and they make a decision to do an intensive, or it could be that somebody wants to travel in from out of state and do even multiple days with me, which I would just have to make sure that I had all of the office space available during those days and times.

If people are traveling in and I haven’t met them before the structure, obviously of the day is gonna be a little bit different because there’s going to be a chunk where we’ll have to do a little bit of more history taking kind of getting a clear picture of the problem. Then we can go in and make an EMDR treatment plan.

Basically identifying what memories we need to target that are contributing to their present-day issues. When we go back and we reprocess those memories. In EMDR, we look at the past and then we look at how that’s affecting and present, and then how that person would like to respond in the future.

Typically, with a more condensed intensive session, we would probably process the worst memory that came up on that treatment plan. And the first memory that came up on that treatment plan, sometimes those end up being the same memory. If it’s a more recent traumatic event, we would structure it so that we would really just be focused on that recent traumatic event.

There’s restricted protocols with EMDR to help you process more like within the past month type of trauma. If we were able to get someone in that quickly, So there’s lots of different ways that we can structure it with, uh, phobia, for example, we can structure, you know, starting with, when did the phobia first occur process?

You know, usually like if, if somebody was bit by a dog, for example, when they were a child, they’re afraid of dogs, now we could go back and we could target that memory where they bit by the dog. Then we can look at potentially exposures and desensitizing the present triggers. So we could show them a picture of a dog.

How to stressing is that to you do some EMDR surrounding that as a present issue, we could, you know, show them a video of a dog. There’s different things that we could kind of target. I probably wouldn’t have a live dog, but, you know, I would encourage at some point or another, eventually, them working up to that process as kind of gradual exposure.

It’s kind of a little bit hard to get a live dog in a counseling office sometimes, but you understand where I’m coming from. There’s so many different ways that we can approach things depending on what the person’s presenting issue is. For example, panic attacks. If someone had a history of panic attacks that they would like to focus on resolving, we can often process their first panic attack and their worst panic attack, their most recent get that done in one day. And that will show significant symptom relief for them, preventing them from having future panic attacks.

Steve: Why did you decide to start offering intensive therapy?

Carrie: That’s a really great question. I was actually encouraged by two of my mentors. One of them was Laura Mullis who we had on the show on episode 21, Healing from Childhood Wounds: The key to Unlocking Anxiety. Laura, as well as one of my other EMDR mentors, Alice Strickland had really asked me, first of all, was I doing intensive therapy? And then if I wasn’t interested in doing it because sometimes they have cases they may not be able to take on or might not be the best fit for them that they may want to refer to me. So that was part of it. And the other reason was after doing a few with my clients, kind of during the COVID period online, I did some three-hour sessions with clients where we took kind of a 15-minute break in the middle to target very specific EMDR memories that they wanted to work on.

There’s a few problems that can come up, like in terms of weekly therapy, someone comes in and they may really wanna work through certain issues in their life. But then as we know, like life just happens, you know, then they come in next week and something’s happened with one of their kids or their coworker was really mean to them. Or, you know, somebody went off on them as they were driving their car. I don’t know. And they just feel like, okay, I need to really process what was going on in the present.

A lot of times we can tie that back into how that was a trauma trigger and sometimes work through some of those things. And that can be very helpful. Oftentimes, what I see is that we end up delaying the EMDR treatment process because a lot of times we’re having to go back and forth between working on these present issues and then working on past issues.

If we can devote specific time to working on the past issues. A lot of the present issues will be resolved because they won’t continuously be getting triggered by the same stuff over and over again, in these challenging relationships or situations. So much of therapy too is spent on helping people develop skills to manage their day-to-day present.

And like I said, if we can go back and just kind of clear out some of the junk, there will be less that they have to manage in the present, not to say that they won’t have anything. Going on, but at least it’ll get the symptoms maybe more to a manageable level. Once the trauma is resolved. So it’s really a combination of a couple of different things.

Sometimes another issue that we have in terms of processing memories with EMDR is that we will take some time at the beginning of the session to get the client into the memory to say, okay, now, as you bring up that memory right now, how distressing is it? Where do you feel it in your body? Even before we do that, the client will come in. They’ll say, “Well, you know, I had, after last session I had a nightmare” or they may be updating me on symptoms. Either of the symptom got better or symptoms got worse. That’s helpful for me to kind of know and guide the process as to where we need to go to next. That takes a little bit of a chunk of time, say that takes 10 to 15 minutes. And then at the end of the session, we really wanna make sure that people have time to calm down that they have time to contain, especially if they didn’t finish processing the memory. So then we’re taking another, you know, let’s say 10 minutes to say, “okay, like, you know, kind of ground, put your feet on the floor, take a deep breath, contain the memory.”

No, it doesn’t have to leave you here. When you walk out the door today, go to your safe place, whatever. There’s a lot of different ways we can do that. But the point is, is that we’re taking that chunk of time in the beginning of the session. And we’re taking that chunk of time at the end of the session, whereas in an intensive, you don’t have to do that because you’re not having those times in between sessions.

You’re actually saving time and energy and not interrupt that trauma work because the brain doesn’t know, “oh, wow. I only have about, you know, 30 minutes to work through this.” Your brain doesn’t know that. So it’s gonna kind of continue to be working on things even after that session is over, which can sometimes be distressing for people.

What are the Issues EMDR Intensive Therapy Can Help with?

Steve: Okay. What are some of the issues that you’ve seen be helped by intensive therapy.

Carrie: I talked about some of them previously, things like phobias, panic attacks, very specific recent trauma, definitely anything that we would consider to be a single incident trauma, not like, you know, I’ve had a whole lifetime of childhood, but Hey, my childhood was pretty stable and things were going well.

And then this thing kind of just completely shifted me off track, near-death experience or illness, injury, car accident, things like that. I know that you and I had talked about, even my experience in episode 10 of really building up the confidence again, to be able to go out dating after my divorce, I had had quite a bit of therapy and there were just kind of some lingering remaining things that I needed to process through. And I really needed to do that from a somatic body sense, rather than just talking about it because I had already talked nausea about it. So that’s another area. Theoretically, I could have done an intensive on for myself. I didn’t, but I went at probably 10 sessions had I had an intensive opportunity.

I might have been able to get that, that work done and say probably two days, you know, instead of 10 sessions over, I was probably going every other week. So you think about that if you’re going every other week to therapy too, that’s about say five months that it took me to get through that process. I know.

A lot of times, people are very interested in today’s day and age of getting better, and faster. We have such a microwave generation. This can be good and bad. Sometimes these situations work and you can find relief faster. It’s not for every person or every situation, but as you can see, there are lots of different ways that we can apply the intensive therapy model to help people get relief. Another example would be for someone who’s having difficulties setting boundaries. Oftentimes this relates back to either like very strong authoritative personalities in their childhood or just people were straight up abusive and crossed their boundaries.

So if we can go back to those places, help them process through that realize like, you know, you’re not a child in this dynamic anymore. This is an adult-to-adult dynamic. You have a right, like your needs are important, whereas they weren’t important. Then your values and your desires are important. And you have that takes a certain level of self-confidence to set a boundary, right. To be firm with. So that is something that we could target in an intensive, really like creating a treatment plan surrounding the difficulty with setting boundaries. A lot of times I see people who have emotional trauma that is feeding into disordered type eating, even though I don’t work with eating disorders.

So I kind of wanna make that clarification if you have serious eating disorder like anorexia or bulimia that I’m not saying that this type of intensive therapy is for you, but for people who, for example, would say, “Hey, I’m an emotional eater. I really want to eat healthy. I’m trying, I may have been on every diet under the sun. But just the way that I grew up, there was a lot of shame surrounding food, or there was even abuse situations involving food resolving.” Some of that trauma will shift the way that people approach food in the present. That’s one, depending on how much is back there, they may need a little bit more than one day. It just kind of depends. And we have to create a plan together. I think that’s, what’s really important. Intensives is having a very specific plan and intention that the client and I are both on the same page about what they’re wanting to accomplish so that there’s no confusion and that we stay very focused and targeted for that limited amount of time.

Steve: So who would not be appropriate for intensive therapy?

Carrie: If someone has a serious problem where they may need a higher level of treatment, such as a serious addiction, addictions are typically not something that I worked with. I’ve worked with a lot of people who had an addiction in their past, say a few years ago, and they’re trying to resolve the trauma that led to the initial addiction.

I do work with several clients that have experienced that, but we really want people who are clean and sober to be engaging in this work. I mentioned eating disorders. If somebody has a really serious eating disorder and where they need to be in some kind of hospital or treatment program, if someone finds that they’re dissociating a lot, they’re disconnecting from reality due to their trauma.

They’re losing a lot of periods of time or they don’t have any connection to their body or their emotional experience. Now I will say that if there’s a client that’s really having difficulty connecting to their body or to their emotional experience if they wanted to do an intensive, what we would really focus on is not processing the trauma, but we would more focus on developing that body awareness, developing that emotional awareness. Doing a lot of what we would call resourcing activities, which would be trauma preparation that may be incredibly valuable for that person to do that, and may help them really cope better in the present with that. But I wouldn’t say that they need to come in and, and just start processing trauma because they’re not gonna be able to do that.

You really have to be connected to your mind, your body and your emotions in order to benefit from EMDR, having. I’ve worked with a ton of clients that don’t have all of those things online. And so our first step in therapy is really building those up before they can go through and process trauma. If somebody has a personality disorder or something just very serious going on, then they’re probably not appropriate for intensive therapy.

Steve: And my last question is, are these covered by insurance?

Carrie: They are not. We don’t have a code for this type of intensive therapy session that we could code for insurance. I actually even asked Cigna the insurance that I work with and they, you know, I’m sure if we were sitting face to face, the lady would’ve looked at me, like I had four eyes.

I was trying to explain it to her, but she was just kind of like, “No.” They are used to typical things like individual therapy, group therapy and things that there are codes for. This is not something we can code and charge insurance for. It’s really more for someone who is looking to make an investment in their mental health and they, they know kind of what they want.

And they realize that this pathway is going to save them, you know, time, energy, and money. It’s hard for people to. Sometimes to coming to weekly therapy, they may get started with it, or they may start coming every other week and then childcare becomes a problem or work is adding on more responsibilities.

I can’t get off in time. There’s all kinds of barriers that can happen in terms of people getting the therapy that they need on a consistent ongoing basis. Sometimes there’s certain time limited situations where someone will say. I know I’m going to be moving or going out of the country. And I know this is some, or I’m getting married.

This is just something that I know I wanna resolve before. Maybe a major life event happens as well. And so these people are kinda willing to take that leap and invest in this process. And so also just really great for people who have had a lot of therapy, haven’t been able to get their goals achieved that they wanted to, but feel like this would be something that would help them just as a different approach.

Thank you, Steve, for helping me out by asking some of these questions and allowing me to explain intensive EMDR therapy.

Steve: Yeah. You’re welcome. And glad to be here once again. And it’s actually really good for me to hear that I got to learn something, so it’s good.

How to Receive EMDR Intensive Therapy

Carrie: Yeah. And if people would like to find out more about intensive therapy, they can go to www.bythewellcounseling.com./intensive therapy. If you get to the homepage By the Well Counseling, there’s also a button that you can click on for intensive therapy. There’s a form on the webpage that I’ll ask that you fill out in order to be able to, for us to have a, hopefully, a short video chat, where we can have a consultation, where we can talk about what you’re hoping to get out of the intensive, and I can share whether or not I think that that would be appropriate for you.

It’s really important that we’re able to make sure that you’re gonna be getting what you need from this modality if you’re investing the time and money in it. So I want to take a little time to make sure that that you’re appropriate and that this is appropriate for you kind of, as we talk through some of those things.

One thing that I’m really excited about with this intensive therapy opportunity is that I get a lot of inquiries from the people who listen to the podcast and they say, “Hey, I know that you do online therapy. Can you see me?” But they live out of State. They may live in Kentucky or Connecticut or wherever, and I can’t see them online due to licensure laws and limitations. I’m only licensed in Tennessee right now to see people there. So this will allow people to be able to travel if that’s something that they’re interested in and receive therapy from me. So that was kind of another contribution of why I wanted to do this, that I didn’t mention. Earlier, thank you so much to everyone who is listening to this podcast right now, I will tell you the very first people who heard about the intensive opportunity were our email subscribers.

And Steve, why should you get on our email list for the hope for anxiety and OCD podcast?

Steve: We’re giving away. T-shirts

Carrie: Yeah, Steve, it was actually your idea to start giving away t-shirts to encourage people to subscribe to the podcast newsletter. So since we have currently, as we’re recording 73 email subscribers, I want you to help me pick our first t-shirt winner by people who’ve already subscribed to the newsletter.

So pick a number between 1 and 70.

Steve: I’m gonna go with 14. It looks like Lisa D is our winner. Congratulations, Lisa!

Carrie: She is our 14th email subscriber. I will be emailing Lisa to let her know that she has won a t-shirt and once I get her size and address back, we will go ahead and ship that out.

You also get to pick which color shirt that you want. And if you are not a t-shirt winner this time, because you are not subscribed to our email list, then hop on the email list. We don’t have that far to get from 73 to a hundred. Right Steve?

Steve: That’s right.

Carrie: So once we get to a hundred, I will be giving out another t-shirt for somebody in between the 50 and 100 mark and maybe about every 50 subscribers or so we will give away a t-shirt.

I would love to have 500 subscribers on the email list. That would be amazing. So it’s a great way for you to know firsthand what’s going on with me and what’s going on with the Hope for Anxiety and OCD Podcast. You can subscribe by going to our website, hopeforanxietyandocd.com. You are certainly welcome to go through our website and buy one, If you are really itching for some podcast merchandise. Thank you so much, everyone, for listening. And I hope to hear from some of you soon.

Hope for anxiety and OCD is a production of By the Well counseling. Our show is hosted by me, Carrie Bock, a licensed professional counselor in Tennessee. Opinions given by our guests are their own and do not necessarily reflect the use of myself or By the Well Counseling. Our original music is by Brandon Mangrum. Until next time may you be comforted by God’s great love for you.