Re:Contraindications for EMDR therapy

There are a list of red flags that several of us put together -- red flags that contraindicate use of EMDR listed in the appendix to Francine Shapiro's book -- most of those are indicative of an especially labile or fragile patient, often a dissociative patient. For example, if people are worried about survival issues, or have a history of suicide attempts or other acting out and are not stabilized, we don't jump in with EMDR. Similarly, individuals who are actively drug abusing or alcohol addicted would do better to stabilize and detoxify before initiating EMDR for best results.

With highly dissociative people, there are special steps that must be taken before using EMDR. It is contraindicated to use EMDR with an individual with DID unless the practitioner has taken those preparatory steps and is prepared to deal with DID.

Individuals with secondary gain issues may not be ready for EMDR. Individuals with impending legal procedures should have their lawyer's go ahead before proceeding with EMDR.

Amassing case reports and clinical anecdotes, there are to date no other contraindications to the use of EMDR that I know of. Head injuries per se nor epilepsy are contraindicators. As a specific side note, however, eye pain is an indication not to use eye movements as the form of bilateral stimulation - another medium such as auditory or tactile stimulation would be indicated in such a case. Someone with vertigo or dizziness associated with post-head injury status may do better with one or another form of bi-lateral stimulation.

Finally, dizziness that is observed following an initial EMDR may be a sign of a dissociative process that has been tapped into by the EMDR, and an indication that other groundwork may need to be accomplished before attempting EMDR again. It is not, however, a contraindication to EMDR, just a cue to use the appropriate protocol.

Replies:

Re:Contraindications for EMDR therapy, by miki@metropola.net, 04/01/04 Re:Contraindications for EMDR therapy, by Sandra Paulsen PhD, 04/01/04 Re:Contraindications for EMDR therapy, by Latoya, 04/16/04 Re:Contraindications for EMDR therapy, by Sandra Paulsen PhD, 04/17/04

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