Being an effective EMDR therapist is a mix of experience and intuition. They’re so closely related that when both are active it’s hard to talk about one without the other. However, it is possible to have a lot of experience doing EMDR and still have miserable intuition. I’ve seen it. It’s not good. The experience of doing EMDR teaches you a lot about how this type of recovery occurs. You’ll learn a lot in the first 10 reprocessing sessions that you do with clients. You’ll learn more by the 100th. By the 500th, you’ll have a lot of things figured out. There will still be much more to learn.
EMDR is a journey that we take with clients. Each session is a part of that journey. When you make a journey enough times with clients you start to recognize some landmarks and the general pathways become more predictable. Your confidence in how these roads connect can be reassuring to clients who have never made this type of journey before. However, this is their journey. They pick the roads. Often, you have to use your experience and intuition to pick the direction that they should turn on the roads they select. Poor decisions on your part can lengthen the journey unnecessarily or make it suck more than it needs to. Intuition helps manage the uncertainty and individual variables of the client’s journey. And, there are a lot of uncertainties and individual variables.
Target Selection and Order
All of my clients are poor. Most of them have severely complex trauma. Nearly all had extensive developmental trauma. Most of them have little “adaptive stuff” for the maladaptive stuff to merge into–I often have to help them create some. For most of my clients, trauma is a bucket filled to the brim with lava. When starting, it’s rarely wise to ask them to grab the biggest or hottest piece visible. To stretch the metaphor, it’s also difficult to know how the individual globs of lava connect. You may help the client pick a piece that seems relatively cool and innocuous, only for it to connect directly to a huge molten piece that the client is poorly equipped to handle right now. Is ever there a safe and manageable way to handle this kind of lava? Probably not. There are certainly ways that are less distressing than others–ways that will increase the odds that your client will return to see you to continue this work. When there is severe and life-long trauma with very little sunshine, helping clients pick productive yet tolerable targets is an art built at the intersection of intuition and experience.
What Part to Notice?
Inside reprocessing, clients may report that they are getting multiple things at once. It is frequently unclear which path to follow. Experience might suggest either or both. In some cases, it may not matter. Sitting for a long time at a four-way stop during reprocessing is usually counter-productive. Intuition comes in with a quick answer based on the flow of the session and the flow of the individual client’s recovery. It may be difficult to explain in language why your suggestion to notice one thing before another or instead of another makes the most sense. But, it’s often very clear if you have been paying attention to the client’s process.
What to Do When the Road Ends?
Sometimes the client’s reprocessing road abruptly ends. It’s not clear at all to therapist or client what needs comes next. Most clients will not have insight into what happened without the therapist eliciting it. Was this the wrong road? Is something blocking it? Where are we? Are we at the end of a road, or has movement just really slowed down because it needs to for some reason? Experience and intuition converge in addressing problems with reprocessing efficiently. Intuition allows you to hear things in client feedback that are helpful. Absent intuition, you may need to check each possible scenario before you arrive at a solution. Good intuition can get the client unstuck faster.
Ending Sessions Gracefully
We want sessions to end with as little residual distress as possible. Ideally, a target is fully reprocessed that session and the client walks out feeling great. Many things come up near the ends of sessions, often related to new targets. With 15 minutes to go in a session, is there time to incorporate this new memory into the current stream of reprocessing? It depends. It may be a great idea. It may be a terrible idea. Or, the therapist may intuit that the client has a good chance to close a target this session, but only 10 minutes remain. Does it make sense to keep going or should we close down some channels and start up a resource? It depends. Intuition can help.
Other Uses of Intuition
Inside EMDR, things come up for reasons. EMDR requires that we trust the process. Still, it is often not clear how two different memories connect. Sometimes you are able to intuit a connection, which might help inform how you assist your client in navigating and noticing them. Sometimes you can anticipate blocks that clients are likely to encounter when working on specific targets, based on things that have emerged in prior sessions. Good intuition is often helpful. Your intuition will be wrong sometimes. It happens. It’s important to eventually assess how reliable your intuition is. In what areas does it seem to work better? Again, good intuition helps clients navigate targets more efficiently and avoid sitting in unnecessary distress.
Without good intuition, EMDR can still work well. It just works the way first-generation GPS navigation systems worked in the 1990s–inefficiently. But, you will still arrive. If your intuition isn’t that good, you’ll want to get it out of the way of your clients and manage issues that come up through careful planning.