Is EMDR usually 90 minutes?

We have 50 minutes sessions. When we delve into EMDR is he likely planning some cushion time in there?

Also, what happens if time is up and I'm an effing wreck? Do I just suck it up and leave? Do I have other options? What is my T expecting?

Many first one was 2 hours, because we were not at a good stopping place and she had the time... after that, they were only 1 hour. You can always talk to your t about your concerns. There is nothing wrong with having "cusion time".

But the problem is (or ONE problem is) what if he has a client after me? He is very good at being on time for me -- and we always end on time. As a therapist does he realize could fall apart? I mean, I'm a "big girl" (41) and can stuff **** well enough to get out of the office, but should I? When do I ask for special consideration? I seriously don't understand when or if this is ever appropriate.

I think most Ts are good at letting a session go over by a bit if they see their client needs it.

This is definitely something to address with your T before starting EMDR. Ask them how long the sessions would be and if there is "down" time factored in where you can regain your composure.

I think that if your T is experienced in EMDR, they know to leave enough cushion time between the actual "work" and when the session ends.

My T told me early on that 90 minute sessions are available if I need them. I just need to let him know when I make the next appointment. Sometimes I've even changed my sessions from 50 to 90 minutes the day before my session.

The 90 min session for EMDR is standard. The reason is to allow that grounding time before you leave. EMDR is very tough work. But WOW can it work!!!!

T will know how to let you bring up one specific event or feeling that is currently triggering you the most. Then you let T know how it makes you feel about yourself. T will guide you through the emotions and memories. Do not force it at all. Just allow whatever it is to come out honestly.

T will do the work to keep the train on the track and not follow too many side roads. They record those side roads and you can visit them at a following session.

Then T will do things to help guide you into transforming the negative cognition you stated into a positive one. For example, if the negative is "I am powerless," T will have you decide on the positive you want to be the reality such as "I am able to stand up for myself."

T will end the session with the grounding activities. The first part of the EMDR work is supposed to be having the client establish their special safe place. This is a place where your mind goes at the end of EMDR to ground. Mine is a special spot on the beach. We have a locked chest there that we put in it all the unresolved bad things that may have come up that we did not get to clear that session. I put the thoughts in that chest and lock it up then toss it into the ocean where it is guarded by sharks. I do not get anything out of the chest durring the week. If the bad stuff tries to come back up, I see it going back into the chest. The next EMDR session my T goes into the water for me and retrieves the chest. He open it together and I take out what I need to work on for that session.

After we have everything put away, my T plays me relaxing ocean sounds. He makes sure I am safe to drive and if I am still a little ungrounded, he invites me to sit in his waiting room until I am safe and for me to know he is right there.

It is very brave of you to start this work for healing.

Wow, WePow, that is a great description and very helpful to know what to expect.

I wonder about your saying it is brave though. I mean, I keep hearing how hard EMDR is and that usually centers around how acutely one feels pain. I told my T that I'm used to feeling pain, bad pain, and being alone -- and while EMDR is "supposed" to be daunting I actually look forward to having someone with me in the crappy/painful places.

But it's even deeper than that, isn't it? That's the sense I get. That it's like nothing I've experienced before. That's so incredibly hopeful, and also scary as hell.

Big hugs to you! I am so sorry you know the pain like that. I hear you!
It does take courage because with EMDR we allow another human to witness that deep pain that is like a cancer eating us inside. We know the pain, but it is dangerous to allow others to see us injured. That is our protective animal instinct. So to do EMDR work takes a tremendous amount of courage and trust. We must know that when we are emotionally vulnerable, we are 100% safe.

Doing EMDR has been one of those difficult parts of my trauma work. But I was with my T 1.5 years before we started EMDR work. We have been doing that now for a year plus. The EMDR was like talk therapy on super steroids!

My recomendation is to make sure you use the TICES log between sessions. It lets you record the trigger, Image, Cognition, Emotion, and Sensation. That is very valuable to healing. Also drink a lot of water after the EMDR to flush the toxins the body releases.

Usually the therapist will stop the EMDR with enough time for grounding for me. That way I don't leave a dissociated wreck.

Either 90 minutes - 2 hours when we do EMDR coupled with hypnosis.

Good luck. Certainly talk about your concerns.

It's recommended that an EMDR processing session be 80-90 minutes. Some therapists are forced into the insurance model (50 minutes) or are constrained by their agency or practice. There should DEFINITELY be cushion time!! Here's more info...

I’m a therapist who uses EMDR as my primary treatment psychotherapy and I’ve also personally had EMDR therapy for anxiety, panic, grief, and “small t” trauma. As a client, EMDR worked extremely well and also really fast. As an EMDR therapist, and in my role as a facilitator who trains other therapists in EMDR (certified by the EMDR International Assoc. and trained by the EMDR Institute, both of which I strongly recommend in an EMDR therapist) I have used EMDR successfully with panic disorders, single incident trauma and complex/chronic PTSD, anxiety, depression, grief, body image, phobias, distressing memories, bad dreams and more…

It’s really crucial that a professionally trained therapist spends enough time in one of the initial phases (Phase 2) that involves preparing for memory processing or desensitization (memory processing or desensitization – phases 3-6 – is often referred to as “EMDR” which is actually an 8-phase psychotherapy). In this phase resources are “front-loaded” so that you have a “floor” or “container” to help with processing the really hard stuff. In Phase 2 you learn a lot of great coping strategies and self-soothing techniques which you can use during EMDR processing or anytime you feel the need. So if you start feeling overwhelmed or that it’s too intense, you can ground yourself (with your therapist’s help in session, and on your own between sessions) and feel safe enough to continue the work. While EMDR therapy (and no efficacious treatment for trauma) should go “digging” for buried memories, sometimes memory does become more clear, and related memories emerge which can then become targets of their own for EMDR processing. In my practice, after the Phase 2 work lets us know that my patient is safe enough and able to cope with any emotion and/or physical sensation both during and between EMDR processing sessions, I often suggest we try a much less intense memory first if there is one that happened BEFORE the trauma(s). If there isn’t one, then I suggest we start developmentally with the least disturbing memory and work our way “up” to the most disturbing event(s).

Grounding exercises are indispensable in everyday life, and really essential in stressful times. Anyone can use some of the techniques in Dr. Shapiro’s new book “Getting Past Your Past: Take Control of Your Life with Self-Help Techniques from EMDR.” Dr. Shapiro is the founder/creator of EMDR but all the proceeds from the book go to two charities: the EMDR Humanitarian Assistance Program and the EMDR Research Foundation). Anyway, the book is terrific. It’s an easy read, helps you understand what’s “pushing” your feelings and behavior, helps you connect the dots from past experiences to current life. Also teaches readers lots of helpful techniques that can be used immediately and that are also used during EMDR therapy to calm disturbing thoughts and feelings.

As I’ve mentioned about Phase 2, during EMDR therapy you learn coping strategies and self-soothing techniques that you can use during EMDR processing or anytime you feel the need. You learn how to access a “Safe or Calm Place” which you can use at ANY TIME during EMDR processing (or on your own) if it feels scary, or too emotional, too intense. One of the key assets of EMDR is that YOU, the client, are in control NOW, even though you likely were not during past events. You NEVER need re-live an experience or go into great detail, ever! You NEVER need to go through the entire memory. YOU can decide to keep the lights (or the alternating sounds and/or tactile pulsars, or the waving hand) going, or stop them, whichever helps titrate – measure and adjust the balance or “dose“ of the processing. During EMDR processing there are regular “breaks” and you can control when and how many but the therapist should be stopping the bilateral stimulation every 25-50 passes of the lights to ask you to take a deep breath and ask you to say just a bit of what you’re noticing. (The stimulation should not be kept on continuously, because there are specific procedures that need to be followed to process the memory). The breaks help keep a “foot in the present” while you’re processing the past. Again, and I can’t say this enough, YOU ARE IN CHARGE so YOU can make the process tolerable. And your therapist should be experienced in the EMDR techniques that help make it the gentlest and safest way to neutralize bad life experiences and build resources.

Pacing and dosing are critically important. So if you ever feel that EMDR processing is too intense then it might be time to go back over all the resources that should be used both IN session and BETWEEN sessions. Your therapist should be using a variety of techniques to make painful processing less painful, like suggesting you turn the scene in your mind to black and white, lower the volume, or, erect a bullet-proof glass wall between you and the painful scene, or, imagine the abuser speaking in a Donald Duck voice… and so forth. There are a lot of these kinds of “interventions” that ease the processing. They are called “cognitive interweaves” that your therapist can use, and that also can help bring your adult self’s perspective into the work (or even an imaginary Adult Perspective). Such interweaves are based around issues of Safety, Responsibility, and Choice. So therapist questions like “are you safe now?” or “who was responsible? and “do you have more choices now?” are all very helpful in moving the processing along.

In addition to my therapy practice, I roam the web looking for EMDR discussions, try to answer questions about it posted by clients/patients, and respond to the critics out there. It’s not a cure-all therapy. However, it really is an extraordinary psychotherapy and its results last. In the hands of a really experienced EMDR therapist, it’s the most gentle way of working through disturbing experiences.

Pattijane, thank you for your detailed description of EMDR. My T recommended "Getting Past Your Past" and I found it interesting.

She used to do EMDR with me and our sessions were always 90 minutes. However, many times I wanted to talk first so we didn't start until later in the session but we still had an hour. I'm not sure if it worked for me or not. I had trouble accessing past memories and always thought I was doing EMDR "wrong". My T said there is no right or wrong to the process, and whatever came up was okay. I didn't have any major trauma to work through and when I concentrated on the target, often nothing seemed to happen. T said it will help to change my brain anyway.

I will say that I have always been afraid of fire and of lighting matches. We did EMDR about that, and ever since, I've been able to light matches (at least the long kitchen ones) without any problem! It must have been the EMDR that helped. I tended to be skeptical about the process, so maybe that affected its effectiveness for other targets.

Now my T thinks somatic experiencing is better for me though she still does EMDR with other clients. I think EMDR is kind of weird but it can and does work for many people! My T had training in it so I agree that it's important that the T be qualified. Good luck!