Re:ptsd & emdr

If you are a new reader here, you may not be aware that we don't do individual case consultations here because we don't have enough assessment information to do a good job for you. However, I will offer some general comments that may or may not apply in your case. You can talk to your therapist about whether they do.

20 year history of PTSD that started in adulthood is very different from a 20 year history that started in childhood. If it started in adulthood, proceeding with EMDR is often appropriate. If it started in childhood, there are a number of preparatory steps that need to be considered, including ability to tolerate "safe place" procedure, ego strength, presence or absence of dissociation and red flags contraindicating proceeding, etc. All these must be evaluated before initiating EMDR.

The presence of a specific visual image is not a prerequisite to doing EMDR, and it doesn't matter if it fades during the the processing, in fact, we expect it to change. That should be part of the therapist's instructions, that there is no right or wrong as to what comes to mind during EMDR. Whatevever comes up is just fine. People with attention deficit may need their therapist to return them to target more frequently than someone else might need.

If someone doesn't have a specific image, the target can be the thoughts or body sensations associated with the traumatic event, or the place "where the image would be if there was one" often does the trick.

Individual responses to EMDR are quite variable.

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