Re:Duration of Treatment

This is one of those questions that is highly complex to answer, and impossible to answer briefly.

Indeed, for many individuals, especially those with focused and specific presenting complaints, EMDR can take from 3 - 15 sessions. For individuals with complex trauma histories THAT BEGAN IN CHILDHOOD, the treatment can be more extended, and in fact, in a few cases, can be highly protracted. This is because we are all tapestries, the weaving of which began at birth. If people are exposed to hundreds of traumas in early life, the very warp and weft of the tapestry is much more complex and occasionally tangled in knots than if there is a single snarl or two that occur later in life, when the basic fabric is already established. It is hard to predict early on where on that continuum a given client may fall. Presence of significant levels of dissociation is one indicator that trauma may have been present early and often. For a few others, however, there may not be as much dissociation as complex character issues and elaborate defense strategies that are not apparent immediately in treatment.

Another issue is the one mentioned by the second postor above, regarding being overwhelemed by processing. There are numerous posts above about containment strategies and ego strengthening (or resource development) as ways to make painful processing less significant and more manageable.

Finally, there are no controlled studies on lengthy use of EMDR for character issues or how it compares or combines with other treatments. Findings to date are anecdotal. EMDR therapists vary widely on how complete their training is for non-EMDR therapy. EMDR therapists vary widely on how perfectly they can target the complicated tangles in the tapestry I mentioned above. That is, it is easy to target the EMDR work if someone presents with a focused symptom, and more challenging if someone presents with a panoply of symptoms or signs of life disturbance or dysfunction. A client's own defenses may interfere with their adequately or accurately reporting those problems in a way that make target selection apparent. That statement isn't to blame the client, just to make it clear that some things must unfold over time.

If we had only one sound bite, though, to describe the length of treatment to be expected for EMDR therapy, it would be that it is likely to significantly shorten treatment relative to non-EMDR treatment based upon controlled studies of its use for PTSD and based upon clinical anecdotal evidence for non-PTSD related presenting complaints.

Replies:

Re:Duration of Treatment, by YR/Bonnie, 04/18/01

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