Francine Shapiro developed Eye Movement Desensitization and Reprocessing (EMDR) to address acute traumatic events. But many people come into therapy without being able to pinpoint a trauma. Childhood was fine enough, but you didn’t quite feel like you fit in. Maybe there wasn’t a single event,
Can EMDR treat complex trauma?
The short answer is yes. But the longer answer is yes, with a few modifications depending on your experience.
What Is Complex Trauma?
Complex trauma is a term coined by Judith Herman. She used complex trauma to describe chronic, often attachment-related traumas.
In addition to leading to PTSD symptoms including hypervigilance, avoidance behaviors, flashbacks, and nightmares, complex traumas also impact relationships. Someone with complex PTSD (which is recognized by the WHO, but not the DSM yet) experiences a disturbed sense of themself that negatively impacts their relationships. This is as much an attachment disorder as it is a trauma disorder.
EMDR for Complex Trauma
The EMDR International Association (EMDRIA) regulates EMDR training and credentialing in the USA, Canada, and Ukraine. EMDR was developed for acute, single event traumas. While EMDR therapists have always completed a “float back” to assess for earlier experiences that connect with the present stressor and impacted negative self belief (NC), an acute, single event will not connect with as many memories in a memory network as a more chronic, repeated trauma.
EMDR is absolutely useful for complex trauma, but it is important to know that it will last more than a few sessions.
Complex trauma is about chronic or repeated stressors that are often relational or systemic in nature. This means that there are more trauma memories in the network and networks may overlap with multiple symptoms.
4 Things To Know About EMDR Therapy For Complex Trauma
Here are some things to know before starting EMDR for complex trauma in Denver, Colorado or NYC:
- EMDR for complex trauma is typically a longer course of treatment. How long depends on your history, your treatment plan, and your therapist’s treatment approach. I always offer good faith estimates and treatment plans based on 12-26 weeks of work at a time. These are open conversations in therapy.
- EMDR for complex trauma may not be completely linear. Your therapist should set an expectation that EMDR has 8 phases. However, if you have a complex history, don’t expect to go directly from history taking into preparation, resourcing, and then desensitization/reprocessing without sometimes going back and forth. Sometimes we start processing and realize that we need to build more capacity to tolerate uncomfortable emotions and sensations, which means going back to preparation. Sometimes it becomes apparent that there are earlier memories or preverbal sensations and experiences connecting to the present disturbance. It’s important to process those first.
- EMDR for complex trauma will impact your relationships. Complex trauma is relational and creates disturbances in emotional regulation, relationships, and a negative sense of self. As a result, when you begin to heal, it will change your relational patterns, too. Some of the work we do in therapy will be supporting you as you navigate new dynamics with your loved ones and come to terms with their responses. There might be grief and anger.
- You might feel grief during complex trauma healing. Going beyond what happened to you into recognizing the support and care that was absent in your childhood brings up complex feelings. It is normal to grieve what was missing and what might have been if you had received it. All phases of grief (denial, anger, bargaining, depression, acceptance, and meaning-making) are common throughout therapy for complex trauma. We leave space for it all.
How do you start EMDR for complex trauma?
EMDR is an 8-phase modality for treating trauma. Whether I’m treating an acute traumatic stress or complex trauma, I always begin with a thorough history taking. In my practice, I’ll often integrate some resource development into history taking. What this means is that when you can connect with “adaptive information” (positive beliefs about yourself, experiences, sensations), we’ll use bilateral stimulation to strengthen the connection.
The thing I find about history taking with complex trauma is that it transcends a linear phase 1 to phase 8. Often, we’ll be months in and a new piece of the puzzle comes into place that might shake up my understanding. That’s OK – honestly, that’s even normal. When your nervous system has been accustomed to taking little hits, it is protective to disconnect from parts of your experience. Part of the healing work means that there is more tolerance to see more of the picture, so it comes into view.