Rebecca Saunders (00:03.864)
Hello and welcome to the EMDR Doctor podcast. This is a podcast for clients where I share and explore information about all things EMDR.
My name is Dr Caroline Lloyd. I'm a mental health GP and an EMDR practitioner. And my goal is to demystify EMDR or eye movement desensitization and reprocessing to help you on your EMDR journey. EMDR is a powerful therapy, which helps to reduce the distress from difficult memories. And my goal is to make it accessible to everyone. I hope you enjoy this episode. Hello and welcome back to the EMDR Doctor podcast. I hope you're all doing well.
and enjoying a bit of warmer weather in Australia. We're just coming into spring so I'm recording this just before I go away for a week to Thailand so I'm going to be lazing around in the sunshine for the next little while. But in the meantime I am in that pre -holiday go -crazy mode where you kind of doubt whether holidays are actually worth the effort but I'm sure tonight when I'm on the plane everything will be alright.
So today I'm talking about a subject that comes up with virtually every new client that I see and many of the intake calls that I do. So how many sessions will I need? And just today I had the same discussion and really there is no right answer to this as every person is so different with different histories, different traumas, different ways of coping, different speed of processing and different goals for their therapy.
For some people, they may want to reduce their nightmares. Other people may want to date again. Other people may want to resolve their compulsive behaviour or their disordered eating or something like that. Each of these goals will require a different action plan and need different numbers of processing sessions and different amounts of time. So the question...
Rebecca Saunders (02:08.31)
of how many sessions will I need is about as easy to answer as that oldie, how long is a piece of string. So I want to say right up that everything is resolvable and everyone is an individual. So what I'm about to say may not apply to you as an individual or it may. And in general, in my experience, adult experience of a single episode trauma.
whilst being quite a rare presentation to most DMDR therapists, can resolve very quickly, maybe just a couple of sessions. And when I say it's a rare presentation, this is not because it's rare to have single episode trauma in your adult life, because many, many people do have that. But it's because many people, if they do have a single episode, it's not beyond their capacity to cope.
they can cope okay with it. So they might feel out of sorts, they might feel stressed or anxious or worried about things for a few weeks. They may not be able to sleep well for a while, but then they adapt, they do their own processing of that memory.
in their own natural way, they get back their equilibrium and they resolve it just by themselves without the help of a therapist or without the help of EMDR. So people do have a natural ability to get over things by themselves. It's just those stuck memories that we need to work on with EMDR. So people who have that ability to get over their own trauma or the trauma is quite small or single episode or they have enough support, they don't present for EMDR.
And I guess EMDR has a reputation as being the best therapy for complex and difficult issues. So as an EMDR therapist, we get quite a lot of referrals for those kind of more difficult to resolve issues that talk therapy doesn't help with. So there's no quick answer to the question, but some general guidelines are that adult experiences will often resolve quickly.
Rebecca Saunders (04:20.858)
Once -off experiences will often resolve more quickly. Prolonged or repeated experiences will need a bit more time. Things that involve a betrayal often need a bit more work. And at the other, at the kind of...
deep end of the pool, at the other end of the scale, the ongoing repeated experiences from childhood, especially those involving betrayal, and especially if that involves betrayal by a caregiver or a parent, those sort of traumas will be a long -term project. And what do I mean by long -term project?
Some people might need weekly EMDR for perhaps a year to recover from their childhood trauma and the results of the childhood trauma. So those are the two ends of the spectrum. So the single episode adult trauma, which may need a couple of sessions and the repeated betrayal trauma from childhood that may need 50 sessions.
And I just thought I would mention that in the Netherlands, they've done some amazing research that show that even people with quite severe levels of distress and a diagnosis of PTSD can come out of a five day inpatient stay, having resolved enough of their trauma to lose their diagnosis of PTSD. So in these studies in five days, their nightmares, flashbacks and hypervigilance have reduced to a more normal level.
Now, I would be very careful about promising that in terms of outpatient therapy because that would be a very high expectation and I don't want to lead you up the garden path with that. But it's just one example of how really inpatient therapy, which can be very focused, very directed towards the most difficult experiences or the most difficult memories, can have a really life changing effect.
Rebecca Saunders (06:33.504)
In the inpatient experience, we do get to focus on those very, very difficult memories easily than as an outpatient or in the community, because as an inpatient, you have all the wraparound support that we can offer so we can work really deeply and really quickly on difficult memories with that high level of safety built into the experience.
In my practice, I offer EMDR intensives in two formats. So I do the inpatient work and we would aim to do five sessions of processing over a 14 day, 10 to 14 day stay. And in that time, we would aim to process five difficult memories.
And my other way of offering EMDR intensives is as an outpatient. that's usually what that looks like is usually on a Saturday morning, we do an intensive for four hours where we would likely process three difficult memories.
So that is a very intense morning. It's four hours. It's very intense. And I love really working in this intensive format because we get really focused and we can get a lot done. And this really speeds up the recovery process. It kind of supercharges the recovery.
And I'm not going to pretend that that would be enough for most people. They would need an intensive and then we can proceed with either further outpatient therapy or another intensive. Some people like to do several intensives and space them out. Say do an intensive Saturday morning once a month for a few months. And they find that really easy to work with because it's just one episode of time. They have the rest of the weekend to recover.
Rebecca Saunders (08:16.492)
and they don't have to kind of fit it into their weekly routine, which is really helpful. But not everyone is suitable to that outpatient Saturday morning intensive, because say, for example, doing four hours on, say for example, childhood sexual abuse would be intolerable for most people.
and I wouldn't expect for them to be able to do that kind of very hard work. But say, for example, four hours on maybe bullying at work or a medical trauma or divorce trauma, that might be a really quick and efficient way to get traction and to get some really great results. So another related question to the first question that I posed of how many sessions will I need?
Another related question is this one. So how can I get results more quickly? People want to feel better sooner rather than later and they want to know how to make the process even faster. Often if people have had some regular talk therapy prior to EMDR, things do move very quickly and it seems like people know where they want to go. They just can't.
get there and EMDR just unsticks that difficulty and the emotion can just slide away from that memory. A group of people who process quite quickly are people with ADHD. So their brains just seem to move very fast given the right circumstances they can really unstick from that trauma very quickly. But on the flip side they often have some childhood trauma.
both from being neurodiverse in a neuro -typical world or from living in a neurodiverse family because sometimes that comes with its own set of difficulties. So they may have a little bit more of a level of complexity, but they move very fast when they get going.
Rebecca Saunders (10:19.564)
People who are prepared to face up to the trauma, kind of present bravely, or they're prepared to sit with the event and they're prepared to cry the tears and feel the anger and allow the distress within the session will often resolve their memories faster.
than people who are what we might say well defended. So people who distance themselves from their trauma either by over intellectualizing or living in their head and not allowing their emotions or not allowing themselves to feel their body will process more slowly. And I had a bit of a chat about this in episode seven. So if you want to get a bit more detail around that, maybe have a listen to that episode.
And another group of people who process quickly seems to be children. So I don't do therapy with kids, but I hear from my colleagues who do and in the literature that EMDR actually shifts things really extremely quickly in children. And so that can be really rewarding and it can be just surprisingly fast. And certainly my experience with young adults has shown me how fast some young brains
do get to process difficult things to a place of resolution.
So with treatment planning in Australia, we have what we call mental health care plans. So Medicare allows a rebate for six plus a further four sessions for people with specific diagnosis. And those sessions are subsidized by Medicare. So people get a certain amount back from Medicare if they attend a Medicare qualified practitioner.
Rebecca Saunders (12:08.526)
So for most people, six sessions will bring a really noticeable change and 10 will bring even more change. So that's one way that our government helps us in Australia to deal with mental health problems. So I know affordability can be a little bit of an issue and that's generally why people are asking the question of how many sessions will I need because they need to plan for it in terms of their budget and so on.
But I do need to say just this one thing. Every EMDR session is one more step towards healing. Sometimes we need to take baby steps and sometimes we can take giant steps, but every EMDR session is a step closer to where you need to be. Every EMDR session brings about some change, whether we've got to that critical mass of change where you can see it from the outside or if it's just happening below the surface.
So as they say, every journey begins with a single step. A little bit like a trip from Melbourne to Perth. When you first start out, you can't see the view until you reach the destination. And if you've ever driven across the Nullarbor, you know that an hour can go by and the view looks just exactly the same as it was an hour before. But the certainty is that every hour you drive in one direction gets you an hour closer to your destination. And
Soon you will see some changes in the landscape, so to speak. There will be some subtle differences in your mental health. Maybe triggers won't be so noticeable or responses to things won't be so pronounced. Or maybe your relationship softens with somebody. Or maybe you even start to enjoy the journey and then suddenly you find yourself in Perth.
So wherever you are in your journey, I wish you safe travels and I will speak to you again after my trip to beautiful Thailand. So until next week, stay well. Bye for now.
