EMDR FORUM ARCHIVE, 2000
Re:General comment and comment on Point #1
Sandra Paulsen Inobe, PhD · 10/28/02 at 5:05 PM ET
As to the no data disproving that EMDR-is-no-better-than-EMD argument, its common sense. Safety precautions for fragile people is the only ethical and logical way Francine could have proceeded once she realized that people don't automatically know about the vulnerability of trauma patients and the risks of flooding. In those early years, she started hearing occasional reports of adverse consequences for some clients. some of these are horror stories, usually, she says, of undiagnosed dissociative clients. It wouldn't be ethical to let the public of treating therapists continue to think that it is an easy intervention to make, or that there are no risks, once she saw that the treating masses were not particularly prepared in traumatology and dissociation. The only logical and ethical step was to get the information out there that is needed for safe and effective use of the procedure. We don't suspend the requirement for supervised clinical experience in training programs just because we don't have dismantling research on whether training is needed or whether it can be gotten solely from written articles. Maybe surgical residency programs should be required to research in controlled randomized sampling studies whether surgical residents can learn to do surgery without coursework and supervision, and with only articles. Too risky you say? Any procedure that lances dissociative barriers and potentiates flooding is more like surgery than talk therapy. Anyone using such a procedure should be trained in a number of key clinical skills, like how to handle abreactions, and how to assess for degree of dissociation, and how to handle clients with poor ego strength, and what to do when the process (whether you call it exposure or something else) gets stuck, and more. For the mental health community, there is a wide wide of disparity of training backgrounds. Some are marriage/family therapists with lots of knowledge of counseling couples and little or no background in trauma or cbt, some are social workers with plenty of genogram experience but not much training in PTSD or anxiety disorder treatment per se. Some are MD's with lots of training in pharmacology but not in trauma and cbt. Some are psychologists with lots of knowledge of psychodynamics and not of trauma. Some are psychologists with lots of understanding of CBT but not of emotional processing or traumatology and dissociation. (etc) The EMDR training covers some basic bare bones across these areas and more, including the steps of the EMDR protocol. I've been facilitating EMDR trainings since 1992, and rare is the person who gets the procedure right away. Most people have had grabbed only one piece of the elephant in their training, and need practical hands on experience to get the EMDR essentials down. Much more typical is that practitioners are still shaky after training levels 1 and 2 and have lots of questions that remain about how to do EMDR, so different is it from their usual practice. No scientific controlled research to prove it, but it's really obvious to observe, that many mental health professionals are not prepared to conduct EMDR on traumatized patients without considerable training to augment their backgrounds. Serious researchers/scholars who wish to attend EMDR trainings to see the training components for themselves might contact the EMDR Institute in Pacific Grove, California. Contact me in Fair Oaks California for assistance.
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