One of the things clinicians have difficulty with when coming for EMDR Basic training, is being afraid to start EMDR reprocessing (Phases 4-6) with their clients. We do warn clinicians they need to do a thorough assessment of their client for readiness to reprocess.
In the early days of EMDR we learned that some clients do not have a stable core sense of self due to their early development and/or trauma. And, that DID clients did not do well since their dissociative states are there to protect them from some very gruesome memories in some cases. And, even mildly dissociative clients did not reprocess so they need tools to stay connected during reprocessing.
In this day and age people are encouraged to numb out, medicate and disconnect making it normal to avoid. So rather than find their core stability that they can always trust they will choose avoidance. By the way, did you know there are a few developmental experiences we go through that are there to specifically help us develop the skill to go through a challenge and be successful? And, when these stages are interfered with we do not develop the capacity to work through challenges?
I cannot say that graduate school did a good job of training me to look for core stability, the developmental origins of what was causing the instability, or how to help my clients rectify the issue. It was my constant quest for what would help people get real change, ongoing relief that allowed me to build skills to assess and help clients find and trust their core stability.
So if you are new to EMDR therapy, or stopped using it because you were working with more complicated cases, consider developing skills in identifying the state of a person’s core sense of self and tools for them to get in touch with it and trust it. This will be an ongoing process. Keep adding to your tool kit.