Talk Therapy in EMDR Therapy?

A common dilemma I encounter in my practice and a consulting question I receive is, can we integrate talk therapy into EMDR Therapy?

A common value across all therapy approaches is, meeting the client where they are. This is true whether we are practicing for instance psychodynamic therapy or EMDR therapy. This is an important therapy value that needs to guide our treatment plan.

EMDR Therapy has 8 treatment phases and three prongs (Past, Present, Future), this means we have several options and points of assessment.

Phase 4 the desensitization phase is commonly referred as the beginning of the reprocessing. During the reprocessing, we as the therapist want to allow the person’s organic brain & body healing to occur without much interference from the therapist. By interference, I mean, allowing as much as possible for the insight, the connections, patterns to be made by the client and not the therapist. Insight-oriented talk therapy if still needed is preferred to be had once the reprocessing of the target memory has been completed.

Now, what if, using the 3-prong conceptualization, a person is processing a past memory and in the present is experiencing a stressor, can we use talk-therapy to help them with the present situation?

Remember that common therapy value? meeting people where they are, Yes, you can pause processing, tend to the present prong and then resume the past prong when the client and you agree to resume.

But wait, what if the client starts talking about the present stressor and then the past (target)? No worries, listen empathetically as you already do, take note of any material connected to the past target and gently help the client contain the material and invite the client to think about resuming reprocessing. You can interweave the disclosed material when reprocessing is resumed.

Another option, one that I integrate is starting therapy by integrating narrative therapy into phase 1 and 2. This means, intentionally allowing the space and time that is needed for the clients to share their stories about their memories as you organize target themes for possible reprocessing. Additionally, I allow for RDIs to be organically created as you listen to the needs during the stories. I refer to this approach as an extended narrative approach to phase 1-2.

In conclusion, Talk-therapy can be integrated into EMDR Therapy with discernment and intention.