I agree with what Dr. O'Brien has has here as it applies to most cases. I'd also add that sometimes EMDR processing gets complicated if the processing starts "looping". I'll describe a most complex situation to make the point. Looping is the term used when EMDR processing gets stuck - almost like a broken record. Looping itself is quite common. There are ways to get the looping unstuck that involve dialogue between the therapist and client, and therapists learn some of these basic methods during the level II training. However, in my experience, looping is a sign that some part of the trauma or material being processed is "disowned" by the self, held apart, as if to say "that's not my feeling", or "it's not safe to own that feeling", whether it is rage, shame, or whatever. The EMDR can't complete unless the material held apart from the self is owned long enough to process. By "owned" I mean that the client recognizes and accepts that the feeling or experience was theirs. Though scary, owning the feeling means that the processing can continue and the intensity of the emotion will soon reduce. Now back to mute processing. In cases involving severe dissociation, there can be some parts of self that experience themselves as being infantile, mute, or in danger if they were to speak. EMDR can sometimes pull forward such a part of the self if that part contains a portion of a traumatic event being processed during EMDR. If a mute part or ego state is pulled forward during a part of the processing, and then the processing loops, it can potentially get very problematic. Since the client can't speak, the therapist can't easily determine what the nature of the looping is, or even whether or not there is looping occurring. One solution is that often another part of the self can explain what is happening internally, so that the therapist can design a way to alter the processing for a successful resolution. Or the therapist can help the client (or parts of the client) to feel strong enough to tolerate and own the feeling long enough to get the looping unstuck. This discussion is not intended to speak to the specific case posed above, or to imply that the case above is dissociative, but rather, to illustrate that there can be complicated things happening that the therapist can't easily see, that can lead to mute looping during EMDR. These are among the most difficult, but not impossible, EMDRs to complete. It requires a resourceful therapist, a courageous client, and a trusting therapeutic relationship to resolve these mute looping moments. Any client who finds that their EMDRs seem stuck and also finds that they can't easily tell the therapist about their experience during the EMDR needs to speak with their therapist as candidly as they can (between EMDR sessions if they can't speak during EMDR). This way they can work together to create a successful EMDR outcome where the client 1) is free to speak and 2) can own his/her feelings.
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