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Lynne Johnson November 17th, 2009 04:11 PM

EMDR & Hx of stroke
I have new client requesting EMDR who has a hx of 3 strokes, the last in 1999. She is a physician and reports that her blood pressure is controlled now. She has a hx of emotional abuse by her parents. I'm concerned about the possibility of effects of high emotionality raising her blood pressure and the danger of another stroke. Anyone have experience working with a client with a hx of stroke? Tips/advice?

Sandra Paulsen November 19th, 2009 08:41 AM

Re: EMDR & Hx of stroke
A couple of thoughts:
- more clinicians post to the emdr listserve of the emdr institute than here, if you haven't tried there already. the procedure for getting on that list is in the back of your institute training manual. I'm the only clinician that regularly posts here, or answers questions here, usually.
- Since the question is medical, I'd certainly get her MD to clear her for intense emotion,
- The Early Trauma protocol is very useful for clearing very early abuse and emotional neglect. It's very gentle and tends to not have abreactions. Once that is used to age 3 or so, subsequent processing of trauma later in life using the standard protocol tends to be gentler, easier as well, and without the abreactions. The ET protocol is described in Robin Shapiro's second book, Solutions II, and is being taught in Seattle in March, 2010. See my website for more information, or ask me here. I'll be offline friday through monday 11/20-23 this weekend so check back next week if you have more questions for me.

Bristol EMDR Practitioner April 25th, 2010 10:55 AM

Re: EMDR & Hx of stroke

Is there some relevance about her being a physician herself? Perhaps that you are inclined to trust her info that her BP is fine, where with anyone else, you would be contacting their doctor, just to ensure you were protected should anything go wrong? I think if it was me, I would contact her doctor to confirm that they feel it's ok to proceed, just as I would, probably, with anyone else who'd had a serious medical issue.

Best wishes,


Sandra Paulsen May 1st, 2010 09:33 AM

Re: EMDR & Hx of stroke
Strokes can affect a person in various ways, depending on the part or parts of the brain affected. Some strokes will affect very little, some will completely incapacitate the person, and all shades of gray in between.

Some strokes may make someone perseverate during EMDR, not be able to associate freely, without jump starting. Some strokes may make someone unable to have big insights, they may be quite concrete. Some will make it hard or impossible to talk, making EMDR difficult. Some will make it hard to access or describe or shift emotional states. Or some will color the work with an emotion that is more about the biological substrate and less about the issue being processed. So its important to know the nature of the impairment, make sure the person is medically stable, have a game plan for restabilizing and soothing in the event the EMDR doesn't proceed well, if it is clinically indicated to do. Having said all that, sometimes EMDR can help someone with a stroke. I worked with someone for whom regular EMDR was the only way to get relaxation after a brain injury, not the way we usually use EMDR. So its variable and requires full clinical judgment.

Jasper May 5th, 2010 12:53 PM

Re: EMDR & Hx of stroke
Sandra Paulsen, I agree with you

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