Rebecca Saunders (00:03.886)
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'm Dr Caroline Lloyd and I'm coming to you from Wurundjeri land. So before I start talking about EMDR, I'd just like to pay my respects to the elders past, present and emerging.
So today I'm feeling a little bit inspired. I'm on a bit of a high actually. So the reason for this is that I've just come from Gabrini where I work in Melbourne and we've just done our first of the group EMDR for this program that we're running currently. So what we do there is we admit a few women for a program of EMDR and over around about 10 days
give them the opportunity to do EMDR in a group setting, in an inpatient setting, which gives all the safety alongside the admission and we work on their most difficult traumas. So today was our first EMDR group with this particular cohort and I have to say they did so well, they worked really hard and at the end of it there were a lot of reports of memories that had just gone from
you know, maybe an eight or a nine out of 10 in terms of distress, right down to virtually nothing. And I checked in with them all afterwards and they're feeling really settled and well. And it just reignites my enthusiasm and my dedication to EMDR because such a great therapy. And if we can develop a program to be able to deliver it in groups, then we can help more people with less time.
Rebecca Saunders (02:24.31)
and help them feeling better really quickly. So that was my day today. So I'm home now and reflecting on my day and I have that warm and beautiful feeling of a job well done and mission accomplished. And I've helped these women start their EMDR journey and that feels just so rewarding. Sometimes I think to myself, you know, I have the best job in the world and actually I think that often.
So I have changed my plans tonight. I was going to talk to you about trauma, but instead on the back of today's success and enjoyment, I thought I would talk to you about different kinds of EMDR. Well, not so much different kinds of EMDR, but different formats of delivery of EMDR. So most people know about the usual one, which is one to one therapy, which is the classic model.
You know, one person goes to the therapist's room usually and does an in-person session which lasts maybe 50 minutes. Mine lasts about 75 minutes. I planned for 75 minutes because I just like to be a little bit more relaxed and have time to work through things in a more relaxed way. But many therapists do that in 50 minutes or 60 minutes. So that's the classical delivery of EMDR.
So one person, one therapist, usually a weekly visit and they plan for perhaps 10 sessions and then take it from there if more is needed. So that's one way to do it and it's very effective. It's awesome. You get that personalized attention. So your therapist is able to speak to you directly and personally. You're able to get to know each other very well.
and your therapist can hone the treatment to you to make it, as I said, very personalised. So one of the negatives about this delivery is firstly the expense. So one-on-one therapy can be out of reach for a lot of people and often they can afford a few sessions, but after that it becomes a little bit too much of a financial burden.
Rebecca Saunders (04:48.288)
So that's one of the negatives. Another negative is time. So a lot of people find that carving out what is probably two hours a week by the time you actually get to your therapist's office, have your hour long session, pay, organise another session, leave, get back to the car, drive home. You know, that whole thing is probably two hours. And for some people, two hours out of a week is asking quite a lot.
So it's not always ideal, but for some people they do like that personalised attention and I have to say as a therapist, know, one-on-one is lovely and being able to plan for that person individually is lovely and being able to tailor the therapy from moment to moment is a beautiful thing to be able to do. The other beauty about one-on-one in-person EMDR is that you can adjust what
kind of bilateral stimulation you use for the session. So by bilateral stimulation, I'm talking about the mode with which we use EMDR. So that is usually eye movements as per the name of the therapy, eye movement desensitization and reprocessing. So that involves the therapist either waving their fingers backwards and forwards or sometimes waving a pointer or sometimes a light bar.
So something for you to follow with your eyes as you think about the memory and as you work on the memory. So that's the eye movement part of EMDR. So eye movements are not for everybody. Sometimes people have contact lenses, for example, that they don't, that feel uncomfortable with rapid eye movements going backwards and forwards. Sometimes they have an eye injury or a condition that prohibits that. We don't tend to use them in epilepsy.
Eye movements and epilepsy are possibly a bad combination. We don't know for sure, but we just try and avoid that as a general rule. Other people just find that eye movements for a while are okay, but after a little while they become too tiring. So they prefer not to use eye movements. And if you're in person, there's a range of other things that we can use. I like to use buzzy's with
Rebecca Saunders (07:10.518)
all my clients, it's just kind of my standard go-to. I use eye movements and the buzzy's at the same time. So buzzy's are these little devices that you hold in your hand, so one in each hand, and they vibrate left and right. So they give us sort of a pleasant buzzing sensation. So if anyone's ever used a TENS machine, it's a little bit like a TENS machine on a low setting. It's just a pleasant, gentle vibration that goes left, right, left, right.
And we can adjust the settings to personalize that. Buzzes are one thing that you can't use doing it remotely. Say the other things that we can use are things like throwing a ball from hand to hand. And that's a bilateral stimulation in that you're using your left hand and then your right hand and you're concentrating on the ball going backwards and forwards. And quite often you will actually be watching the ball go from left to right as well. So it actually facilitates eye movements, which is
you're kind of getting double benefit from throwing the ball from left to right. With children, there's other ways of using different tactile kind of things. Children can draw with left hand or right hand. They can point to things or some child therapists who use EMDR use little puppets. And that's quite a cute way to help children get that bilateral stimulation. So there are a couple of different forms of
bilateral stimulation that we use and they're kind of best used in person. So the other way of doing one-on-one EMDR work is online and we are all very familiar with online therapy now. Thank you, COVID. Many people have gone back to one-on-one in person rather than online and there's a couple of reasons for that. So online, there is just that little bit of disconnect.
So as a therapist, it's harder to see what you're doing if you're on the other side of a screen and there's a small picture rather than a life-size person in front of you. And so you get less of those kind of nonverbal cues. So we can't see your face quite so easily, which for us as a therapist is a little bit of a negative. But for clients,
Rebecca Saunders (09:34.014)
Some people really do prefer that. So they feel a little bit more private. They feel a little bit more protected and that's a benefit for them. So it kind of works both ways. Some people as clients don't like being a little bit removed from their therapist via the screen. Other people really prefer it. And one of the great benefits of doing online therapy is that it saves time. So people can do it from the comfort of their own home.
so they don't have to get in the car, drive to the therapist's room, settle in there, etc. So they're already there in front of their computer, there's no commuting time. So that's a really great benefit for a lot of people and especially for people who live remotely or rurally, that benefit is just infinitely precious. So online therapy for them has been really a game changer. We've been able to deliver therapy.
to people who otherwise would not have had that opportunity. So that's some pluses about online therapy.
The other plus about online therapy is that if it is an intense session, you then don't have to go to the car. You don't have to see people. You don't have to worry about your eyes looking red or, you know, you don't have to worry about driving in traffic or being in control of a car or battling, you know, to get home or taking public transport, which can be a little bit of a hassle if you're not feeling.
particularly, you know, upbeat and together. So with online therapy, you don't have to then get yourself home. One of the other negatives about online therapy, however, is that some people don't have their own space at home and we can adjust for that in certain ways. So during COVID, I can't tell you how often I did therapy with people in their car because their kids were inside doing their homeschooling or
Rebecca Saunders (11:38.286)
You know, their partner was doing their job or their work or their dogs were going crazy. And so the only safe, comfortable place for them was in their car. And that was a beautiful solution for a lot of people. Some people would drive to a nearby lake or a nearby park. And if they felt they had enough privacy there, then that was a fantastic solution. And other people would just sit in their garage or in the car park outside of their work.
and do their EMDR therapy in the car on their phones, which was, had its downside, but also was safe, private, warm, comfortable, and easy. So that's some of the positives and negatives about doing online therapy. And they're kind of the one-to-one methods of therapy that are, you know, very common and very well accepted nowadays.
So we also have group EMDR, which is what I started this podcast with today. So I do group EMDR in two ways. I do it in person in the inpatient setting. So that's at Cabrini Women's Mental Health Center, which is a private hospital for women only. And we do small groups of generally we aim for six. Occasionally it's a little bit less. Occasionally it's a little bit more.
Six is a really great number. So there's myself and another co-facilitator. And when I admit my women for the program, we go through the history and we sort out which targets or which memories they want to work on. And we kind of put them in order of priority and do some target planning around that so that they're all ready to go when we when we start the group. And then in the group, we use eye movements that are facilitated
by the women are tapping between two points on the table and so they're tapping their fingers left and right in front of them and they're watching their fingers go left and right. So that brings the eye movements into the picture, so to speak. So they can also do tapping on their shoulders or on their legs, which is also a very common way of delivering that bilateral. Or they can do the ball throwing. So that's another
Rebecca Saunders (14:01.31)
or they can tap their feet. So there's a lot of different ways we can do the bilateral stimulation. Once again, it's in person, which I really enjoy. And the women who have done these group programs of EMDR with me have reported back that there's a sense of community, like they are working on their own memories. There's no memory sharing. So we don't share any of the trauma that we have been through in that group.
So we don't talk about the memories that we're working on. It's all very private, but you're just working privately in a group scenario. So we do a bit of planning before the group. And then when the women come into the group, they work privately on their own memory. And I'm just leading the group and, you know, taking them through the eye movements and the checking in process. And we use
a kind of a reporting back process of how the distress is going by using what's called a SUD, which is a subjective unit of distress, which is just as very technical term, but that is just a way of measuring distress between zero, which is absolutely no distress and 10, which is the worst distress you can ever imagine. So quite often with women in the group, their memories start at, say,
and seven or an eight out of 10. And then gradually as the group progresses, they report back that the distress level is coming down and down and down and down. And then usually by the end of the session, it's down around the one or two mark. Sometimes down to zero just depends on what we're working on at the time.
So that's how we work in group in person. I also have an online group EMDR program and this happens at intervals throughout the year just according to how busy I am and when I can fit them in. The next one will likely be happening around November, but I haven't set a date yet due to some other commitments that I've got. The online groups are weekly sessions for six weeks.
Rebecca Saunders (16:16.086)
And once again, we meet often via Zoom to start with because women for this group can be anywhere in Australia or probably the world. But we would have to sort that out on a case by case basis. But most of the women who come to the online group are in Victoria and country Victoria. So we'll meet first via Zoom to take a history, sort out what targets or what memories they want to work on.
do some target planning around that, do some education. I've got some online resources that I share and a course about trauma that they are invited to watch. Most of them, to be quite honest, don't watch it, which is absolutely fine. It's just there as optional information. But the value of the course is coming to the EMDR sessions. That's when the real work is done and that's where the real value lies. So for the online group, we all do it via Zoom. So come.
Usually Thursday night at 7 p.m. everybody logs in and we start working. And for that I use eye movements. People can also use tapping and they often use both. So I deliver the eye movements via my screen, via waving my little pointer backwards and forwards in my zoom screen. And they watch that and that helps the eyes go backwards and forwards and gives us the eye movements.
And people can also tap along at home if they want that double level of bilateral stimulation. And once again, usually by the end of the group, all the levels of distress have come down to zero or virtually zero. And we can always have a little bit of a debrief one to one thereafter if need be.
So another benefit of the groups is that they're very time effective. There's no need to skip work because they're held in the evenings in our time zone. And they're also very cost effective. So it's a great way to deliver cost effective, effective therapy to people in a very time wise fashion. So that's the groups in a nutshell. Another way of delivering EMDR is in couples. And this is really
Rebecca Saunders (18:33.818)
Such a fascinating thing to do. So I don't actually do it because I'm not a couples therapist and I can't work outside of my level of expertise, but I just find it incredibly fascinating. So there are a few therapists in Australia who do this work and what they do as I understand it, they're trained couples therapists and they do some sessions with nutting out what actually is the problem in the relationship and how
the individual's past is impacting on the relationship. So that might be, for example, it might be a history of childhood sexual abuse, which impacts on a person's ability to remain present with any kind of physical touch. And so what they might do is work a little bit on that abuse in a group of three, the therapist and both of the couple.
are working on the individual's past trauma and the partner is involved in either delivering the bilateral stimulation, like they're either tapping on their partner's knees or they're just there for support and encouragement and just their presence. And it's often a really enlightening experience for both of them and the person who
is having the EMDR therapy gets a real insight into their past and how it's impacting on their present and so does the partner. So the partner is in this really privileged position of being able to witness this really powerful therapy and it helps them to understand their partner's past and what's manifesting in their relationship actually in the present which is
such a beautiful gift to be able to share with a couple. just enhances the level of emotional intimacy and understanding to a huge degree. So if you are interested in this, let me know and I can point you in the right direction to a couple of therapists that I know who do this work. Or you could probably just do a Google search for it and see what you can find.
Rebecca Saunders (20:57.422)
It's an amazingly powerful and successful way to work with couples on their current issues. So as far as I'm aware, couples EMDR is only delivered in person. But, you know, I suppose that just depends on people's imagination. I'm sure it will be a thing in the future. So just because I haven't heard of it doesn't mean that it doesn't exist and doesn't mean that it can't exist. So one extension of this...
is EMDR in the retreat scenario. So EMDR retreats are done fairly commonly overseas. I know that there are a couple of them that happen here in Australia. And my goodness, what a wonderful way to explore and to resolve your past trauma.
than be in a fantastic setting with not much else to do and no dinner to make alongside other people who are going through a similar process and with that air of collaboration and the support that you can receive from a group. So I don't personally do it. I think that it would be something that I would love to do in the future. So if you're interested, message me. I think a retreat for EMDR would be an absolutely wonderful way to do that.
and it does exist. So if you're interested in that maybe have a little Google search for that. I do know a couple of people who do that. So if you're interested let me know. And before I finish up I'll just talk about another thing that I've heard about recently and that is EMDR and equine therapy combined. Now this combines two of my favorite things in the whole world. So I used to own a couple of horses.
and I just love equine therapy. It's a wonderful way to help people gain a lot of knowledge about themselves and to be able to connect with another amazing being. So I think the combination of the two things would be really purely magical. I don't know very much about it. I'm not sure how you use the horse for the bilateral stimulation or whether the horse is just there for regulation.
Rebecca Saunders (23:13.452)
in terms of helping people connect to themselves and connect to their emotions whilst using EMDR. I can imagine a couple of ways that you could do it. Maybe patting the horse with left and right hands, something like that. I must listen. There's actually a podcast about this. Tracy Lynch has an amazing podcast and she's done a podcast with an equine therapist. And I must have another little listen to that because
Yeah, it's fascinating way to deliver EMDR. The other thing that I have heard about recently is the combination of EMDR and drumming. that sort of combines really quite an ancient healing ritual of drumming, which many Indigenous peoples use as part of their Indigenous healing, combining the drumming with EMDR. So I think that that's another really exciting way.
to deliver EMDR. And just recently I was talking to somebody who used drumming, African drumming, as a healing modality. Yeah, they were really incredibly passionate about that. my mind just lit up, you know, thinking how could I combine EMDR with drumming? I know it does happen already. People have been there and done that already. And I think that that would be a really exciting avenue to explore.
Not for me, just at the moment, because I have some other things to concentrate on, but certainly in the future. So I haven't spoken about EMDR intensives very much today. They are another part of my own practice. Many therapists do do intensives. And what that means is basically doing a fair few sessions of EMDR in a short period of time. So for me, what that looks like is an initial session to take history and do some planning.
And then the client and I get together on a Saturday morning usually for a four hour session and we blitz probably three difficult memories. Some people do four, some people it's only two and that's okay. We work really hard and we work really intensively and what that format allows us to do is to really do a deep dive into those memories and just allow them to unfold and allow us to do some really deep work.
Rebecca Saunders (25:30.306)
which then generalizes really quickly. So that is really great for people who have trouble getting to those weekly one-on-one sessions. If you are in that situation, but you can carve out one morning a month, for example, or one morning just here and there, then we can really fast track things and really get to the heart of the matter in a few extended sessions. So.
A lot of therapists do sort of two hours, say three two hour sessions for a couple of weeks and that's their format of an intensive. Some people do an intensive over a weekend and do say eight hours of therapy on a Saturday and then eight on a Sunday. Now, obviously they can't do eight hours of EMDR in a day because it would just fry your brain too much. It would just be way too intense and irresponsible to do that sort of.
incredibly intensive work, but I think what they do is they combine it with some art therapy, they combine it with some talk therapy, maybe some other somatic therapy, maybe some trauma-informed yoga, something like that. And all of that helps to embed the therapy in the body and it helps the therapy work on a deeper level in the body. So they combine the EMDR with some other therapies to kind of extend the day out to that really long day.
So different therapists have different ways of delivering their intensives and whatever works for that therapist and for that client is fantastic and it's great that we have a choice now of how we deliver therapy and we can tailor it really to people's needs and what they can afford, what they can, what time they can afford, how they can manage to do the work.
It's really wonderful that we've got these options that allow us to tailor our therapy to the individual. So I think that that's about all I wanted to cover today. So we've talked about the pros and cons of in-person and online, one-on-one and in group, intensive or milder therapy and retreats and some other.
Rebecca Saunders (27:50.228)
more creative ways of delivering EMDR like the Equine EMDR and the Drumming Assisted EMDR. So I hope that's been helpful to you. I've really just so enjoyed being able to experiment a little bit with EMDR and how to deliver it to my clients. And I love being able to offer people a range of different experiences for their EMDR journey. So I hope that's been helpful and given you a little bit of an idea of what's
out there what's available and what might be right for you. So have a great week until next week. Stay well. Bye for now.
