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Can You Do EMDR Therapy Online?

Written by Carrie Bock on . Posted in Counseling.

The History of Online EMDR therapy

Prior to the COVID-19 pandemic, there was much discussion in the EMDR (Eye Movement Desensitization and Reprocessing) community about whether or not EMDR therapy could effectively be done online. There were concerns from clinicians about their clients having intense emotional reactions or dissociation and not being present to help their clients calm down. The EMDR International Association (EMDRIA) was in the process of developing guidelines for virtual EMDR, which of course, was pushed to the forefront in the beginning of 2020.

Almost overnight, all EMDR therapists were seeing their clients online. Many clinicians who had been hesitant or scared to try EMDR virtually were thrust into a dilemma: Do I provide a technique I know that works for clients in distress or do I prolong their suffering indefinitely until we can be back with them in the office? For me, this decision was less of a dilemma. Due to moving therapy offices in 2019, my appointments were already about thirty percent virtual. I had even tried EMDR with a couple higher functioning clients, and they managed the therapy well.

Can EMDR therapy be done online?

The short answer is a resounding yes. There are many ways to achieve this, but a well trained EMDR therapist who has experience providing EMDR therapy online will tell you that the technique works just as well online as in person. There are three levels of training in EMDR. Therapists can either be trained, certified, or a consultant. Certified EMDR therapists have completed further training and consultation hours after their initial two weekends of training. Consultants have received additional training and supervision in their consultation of other EMDR therapists.  

How do you do EMDR therapy online?

EMDR requires what is often referred to as bilateral stimulation (BLS) or dual attention stimulation (DAS). These terms are often used interchangeably in EMDR literature. Most people see BLS/DAS being administered by eye movements. This is how EMDR is usually depicted in TV or movies. However, the same BLS/DAS can be achieved by the client tapping themselves on their shoulders or knees, following the therapist’s fingers, or using computerized software in which a client looks back and forth. Eye movements need to be utilized with someone on a computer rather than a phone as the phone doesn’t provide enough width.

What if I become overwhelmed during online EMDR therapy?

Whether EMDR is administered in person or online, it’s important to let your therapist know when things feel like they are getting too much. Having a good relationship with your therapist and proper preparation for EMDR therapy is the key to successful EMDR treatment.

What is EMDR?

EMDR Intensive Therapy

Carrie Bock, LPC-MHSP of By The Well Counseling is an EMDR Consultant who specializes in helping clients with trauma, anxiety and OCD get to a deeper level of healing through EMDR via online counseling across Tennessee and in person intensive therapy sessions. Carrie is the host of the Hope for Anxiety and OCD podcast, which is a welcome place for struggling Christians to reduce shame, increase hope, and develop healthier connections with God and others.

What is EMDR?

Written by Carrie Bock on . Posted in Anxiety, Counseling, OCD.

When people first hear about Eye Movement Desensitization and Reprocessing (EMDR), they are often skeptical. That’s OK because I was too once. I wasn’t sure how waving my fingers back and forth in front of my clients was going to change how they felt about the past. However, I was desperate. Cognitive behavioral therapy for the treatment of trauma just wasn’t cutting it for the complex client presentations I was seeing. We could talk for hours about how the abuse a client experienced wasn’t their fault. They could give me the right answers, but didn’t feel it. They could change their thoughts, but their bodies were still reactive. Once I started using EMDR and saw first hand how great my clients were feeling, I was hooked.   

What is EMDR?

EMDR is an experiential therapy that allows clients to process trauma at a brain level to access healing at a different level than traditional talk therapy. Other approaches to healing from trauma such as Exposure Therapy or Cognitive Processing Therapy (CPT) require the individual to tell the entire story of the trauma repeatedly in order to become desensitized from it. However, with EMDR, telling the story of the trauma is not a requirement. This brings a sense of relief for clients who do not want to retell the entire story, cannot remember the whole story, feel it would be too lengthy to tell, or are bound by security clearances. 

The other difference between EMDR and cognitive based therapies is that EMDR addresses body sensations associated with traumatic memories. A rape victim may no longer believe the rape was her fault (changing the thought), but may still carry a sense of shame and distressing body sensations that accompany that emotion. Trauma is often stored in the body can manifest as physical sensations such as chronic digestive issues or panic attacks. I have seen several clients have a reduction in physical symptoms after EMDR therapy. 

What is the EMDR process like?

There are eight phases of treatment in EMDR. The initial phases involve screening and preparing the client for being able to reprocess the trauma. The therapist works with the client on building awareness of their present experience emotionally, physically, and mentally. The client also develops skills to tolerate a variety of emotional states and cope with day to day symptoms such as anxiety, nightmares, or intrusive thoughts/memories about the trauma. Clients with an extensive trauma history may take months to prepare for trauma processing. On the other hand, clients who have had previous talk therapy and have coping skills to manage their day to day life may find more value in doing an EMDR intensive. 

The next phases are focused on targeting traumatic memories to reprocess the various aspects of the trauma. The client may see pictures, feel intense emotions, and experience body sensations that were happening at the time of the trauma. This process can be difficult and disturbing to the client, which is why not rushing the preparation phase for clients with complex PTSD is crucial. Bilateral stimulation to the brain is utilized through the use of eye movement, tactile stimulation, or alternating audio sounds. The bilateral stimulation is not painful and does not cause the client to go into a hypnotic trance. The client will be present during the reprocessing.   

EMDR allows the traumatic material to get unstuck and connect to more positive, adaptive material in the brain. At the end, memories that were highly distressing are no longer distressing to the client. Sometimes the change is very surprising because the client expected to always be bothered by the memory! By healing from these past wounding experiences, clients are able to respond to present situations in new ways. Sam no longer blows up every time there is a conflict at home. Susan is no longer having frequent pain attacks. John still has intrusive thoughts related to OCD, but he is able to dismiss them instead of giving into compulsions.    

How do you get trained in EMDR therapy?

If you are interested in learning more about EMDR therapy, you can visit www.emdria.org. This is the website for EMDRIA, the EMDR International Association. Therapists who have been trained in EMDR through a training approved by EMDRIA have completed six days of training and 10 hours of consultation. Training in EMDR therapy is an experiential process. The therapist has to perform EMDR on others and receive it themselves in the client role. Those who have been certified in EMDR have completed an additional 12 hours of advanced training along with an additional 20 hours of consultation with an EMDR consultant. An EMDR consultant has gone through additional hours and has had their consulting supervised by another consultant.    

I was initially trained in EMDR in 2013, pursued certification, and became a consultant in 2019. Over the years, I have been able to help clients suffering from PTSD, recent traumatic experiences, anxiety, phobias, panic attacks, OCD, depression, and dissociation to name a few. I have also started providing intensive therapy in EMDR for individuals who are looking to heal faster in a shorter amount of time. 

Carrie Bock, LPC-MHSP of By The Well Counseling is a Licensed Professional Counselor who specializes in helping clients with trauma, anxiety and OCD get to a deeper level of healing through EMDR via individual and intensive therapy sessions. Carrie is the host of the Hope for Anxiety and OCD podcast, which is a welcome place for struggling Christians to reduce shame, increase hope, and develop healthier connections with God and others.