When EMDR is Not Right: When Something Else is Better | Hey Tabi

Is EMDR therapy right for everyone? In this episode of Hey Tabi, licensed trauma therapist Tabitha Westbrook breaks down when EMDR (Eye Movement Desensitization and Reprocessing) might not be the best approach for trauma recovery.

You'll learn:
✅ Why EMDR may not be suitable for clients in unsafe environments or those struggling with emotional regulation.
✅ How dissociation, unresolved trauma, or prior negative EMDR experiences can impact effectiveness.
✅ Top alternative trauma therapies like Brainspotting, Somatic Experiencing, Internal Family Systems (IFS), and Narrative Therapy.
✅ The importance of therapist flexibility and tailoring trauma treatment to individual client needs.

If you or someone you know is navigating trauma recovery, this episode provides valuable insights into finding the right healing approach.

💬 What’s been your experience with trauma therapy? Drop a comment below! 👇

#EMDR #TraumaTherapy #MentalHealthPodcast #Brainspotting #SomaticExperiencing #IFS #TraumaHealing #TherapyAlternatives #HeyTabi #ComplexPTSD #HealingJourney

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Transcript

Welcome to Hey Tabi, the podcast where we talk about the hard things out loud with our actual lips. We'll cover all kinds of topics across the mental health spectrum, including how it intersects with the Christian faith. Nothing is off limits here, and we are not take two verses and call me in the morning.

I'm Tabitha Westbrook, and I'm a licensed trauma therapist, but I'm not your trauma therapist. I'm an expert in domestic abuse and coercive control, and how complex trauma impacts our health and well being. Our focus here is knowledge and healing. Trauma doesn't have to eat your lunch forever. There is hope.

Now, let's get going.

Hey, welcome to this week's episode of Hey Tabi. So glad that you are joining me today. In our last episode, we talked about EMDR therapy or eye movement desensitization and reprocessing therapy. We talked about how it does not go against the Christian faith. And we took a little bit of a deep dive into what EMDR is, how it works, and then how it can fit with a client's Christian spirituality and is not against the Bible.This week, I want to talk about though, when EMDR is not right for a client. So like I said, last time, not all therapies are the right fit for a given client. And there are times when EMDR is not the right fit. So I wanted to take a few minutes and help you understand when it might not be the right fit for you.

So EMDR is a very powerful therapy and it does work for lots of people, but again, not for every people. And thankfully there are a ton of different therapies out there that are very effective for complex trauma. for overcoming traumatic events. And we are going to talk about some of those as well, but we know EMDR is not a good fit in certain circumstances.First, if you are in an actively unsafe space. So if you are living in an unsafe environment, opening up trauma and trying to reprocess it when you are actively being traumatized might not be the most helpful. Now, there are times that can be really helpful if we are helping you cope better, if we are helping you gain skills to be able to deal with the environment that you're in, but can't leave in a given moment that maybe is abusive or unsafe, all of those things, we can use aspects of EMDR for it, but we are not going to be able to reprocess deep traumas in those spaces, because it's just too activating.

You're in the middle of it. So you're still in that environment, drinking in that space and the trauma and being actively traumatized. And so trying to reprocess deep things only leaves you in a place where you're gonna feel really tired. And then have less resources as you're trying to deal with all of it.

So there are times parts of it can be really helpful. And then there are times when it wouldn't be the right fit. Now, every client that is traumatized, to be honest, has some degree of struggle with regulating emotions.Either they're over regulated, meaning they keep everything on lock or they're under regulated and things just come spilling out or some combination of both, right? We can be at any given place at any given moment sometimes. But if we can't get some stabilization, then it is really, really tough to be able to reprocess some of those things and have the client be okay.

So we do have to be able to access the emotion, access the experience, and then also regulate and get back into our bodies and make sure that we,  So EMDR is very much like a one foot in the past and one foot in the present kind of therapy, where we are touching all of these things from the past while keeping you here in the present moment in a lot of ways.

And so when that's a real struggle, we have to do that work first for our client and really help them have a little bit of at least baseline ability to regulate and settle emotions. When that's not possible, because maybe there's just been so much, our client is very, very highly activated that we may need to do some other things or a completely different therapy altogether.And again, the good news is there are lots of really great therapies that clients can engage with that can also help reprocess. Another time that EMDR therapy might not be the right choice is when a client had a really bad past experience. I have had the unfortunate or maybe fortunate cause I've gotten to work with great people, but I've had to help a lot of clients who maybe had a practitioner who wasn't as trained as they had hoped or stumbled across something that they or the client did not expect and then didn't handle it super well.

And then damage was done. And I've had a number of clients  deep childhood developmental traumas open up while they were dealing with something more current. So for example, I had a client that had been in a very recent traumatic experience.

But it touched things from their developmental childhood traumas. And the practitioner did not let this client know that that could happen. And when those things came up, the client was shocked and it really caused the client to have a lot of problems, a ton of anxiety, a lot of fear, because they didn't know that some of those things were there and they didn't know the severity of them.And they didn't know that they tied together. So if you've had a really terrible EMDR experience, and you might not want to do that again, Sometimes it's worth retrying with a different therapist. And sometimes you say, you know what, I don't want to go through that again in case it's terrible. And I think that is such a fair statement for people.

You don't have to do a particular type of therapy just because folks say that it's good. You know, if you're like, you know what, I had this terrible EMDR experience and I don't want to do that again. That's okay. It's completely fine. And you can say, you know, I'd really rather not revisit that.

I'd like to try a different therapy. Or you can say, maybe I'd like to try EMDR again with a different therapist, or I'd like to try it in a different way. Now the eight phases are what they are, but there are a lot of different ways to walk through those eight phases that might be a better fit for you.that's also another aspect that you can look at. I'll also say that If there is not adequate preparation, So we do want clients to have good skills to be able to regulate. We do want clients to be able to go in and touch that trauma and process through it and be safe while they do it.

So there are therapists, unfortunately, out there that Do not do enough preparation of their clients, and that ends up being a really difficult space. and I've seen harm done because of that. We don't want to do that. One of our chief ethics for all licensed types that do therapy is do no harm.

So we want to be really mindful with our clients that we are really good at what we're doing, or at least really well versed and functional, or that we're getting really good supervision. There's a lot of ways to be able to. be learning it and still be really good to your clients. And also just making sure that we are following the proper procedures.We are following adequate preparation for our clients so that they are not left in a place that is not good for them. Again, we want to be really good at this. We are dealing with people's souls. So we want to be really mindful not to enter into a place that we're not quite ready for. And if you're listening to this and you're a therapist and you're like, Oh man, maybe I need a little more work there.

I totally think consulting should take place, no matter what. I think that no matter what kind of modality you practice as a therapist, it is always wise to have some peer support, whether that is full on supervision or a peer supervisor or a peer consultation. We only know what we know, and sometimes we can only see what we can see, right?

So it's really helpful when we can engage with other practitioners who are great, who can talk with us through a case, especially the more complex a case might be. Another time EMDR might not be the right therapy is if there is some sort of neurological issue or traumatic brain injury that would prevent EMDR from being therapeutic or appropriate.For example, Doing something with eye movements with a client that has epilepsy would be incredibly unwise. Now, the good news is with EMDR, there are several different ways to get that bilateral stimulation. You can use eye movements. You can use audio sounds that go in one ear and then the other ear. So they alternate back and forth.

You can use little handheld buzzers that buzz alternately back and forth. you can use self tapping where the client. taps like on either side of their legs or does a butterfly tap which is tapping where you cross your arms and tap your shoulders. Those things can all be forms of bilateral stimulation that do not use eye movement.

So yes, I know it is called eye movement desensitization and reprocessing, but what they have found through all of the research is that any bilateral movement is helpful in this. So if a client has a neurological issue like a traumatic brain injury or like some sort of other issue like epilepsy. And eye movements would not be helpful, then it could be done another way.But I would always encourage a provider to check with any neurological team that is on board. so if a client is working with a neurologist, then we would most definitely want to have a release and connect with that neurologist to make sure that EMDR, the reprocessing and all of the bilateral stimulation was going to be safe for the client.

Again, at the end of the day, what we don't want to do is make things worse or harm somebody. So there are times when it just wouldn't be appropriate. Again, that's where other therapies come in. Another reason EMDR might not be the right fit is client doesn't like it. It's just not a good fit for them.

And I think that is something that as therapists, we really have to consider if a client says, I literally hate this and I hate coming in, but I'm doing it because I was told it will help me. Then maybe that isn't the right therapy. Now, there are times that we feel angry towards something or that we might feel discomfort and say, I don't love doing it, but I know it's helping me.Kind of like exercise, right? Like the times when your muscles are sore after you've been lifting weights or things like that. You're like, man, maybe I don't love that sore feeling, but I do love that I'm strengthening my muscles. That's different. There are going to be people who just don't like it. Maybe they struggle to visualize.

Did you know that not everyone sees pictures in their heads? That is a true statement for those of you that see pictures in your heads that might weird you out, that there are people that do not have imagery up there. They don't. Now there are other ways to access,  memories and do things with EMDR and reprocess things that do not need a picture.

However, clients might just not like it. They may say, this is not a therapy I enjoy doing at all, and I'd rather not come to therapy. Then do this again. And I think as therapists, we really need to honor that. And like I said, in our last episode on EMDR, if your therapist is worth their salt, they will have other tools in their toolkit because again, nothing is going to fit every single person that you see.So let's talk about what some of those other tools actually are. I'm going to name a few different therapies and we're going to talk pretty briefly about them, but we can always come back and do a full episode on each one. One of the alternate therapies for EMDR is brain spotting. Brain spotting actually came out of EMDR and uses a fixed point of vision versus bilateral stimulation.

Now sometimes brain spotting will use sound,  but most of the time you don't have to do that. It can just be a fixed point of vision, For folks that really struggle with the bilateral movement or really just hate EMDR or have the neurological struggles like the traumatic brain injuries or epilepsy, brain spotting can be really effective.

I use it with lots of clients, so I am EMDR certified, but I am also trained in brain spotting and have done developmental trauma,  training for brain spotting as well. And that can really be helpful if EMDR is not a fit. I would say that the two therapies that I use the most are brain spotting and EMDR.

Another treatment modality that is really helpful for a lot of people is somatic experiencing. And that's really where you are using the body sensations and allowing trauma to process through noticing body sensations.It's a little more complicated than that, but we can do a whole episode on that at some point. But with somatic experiencing, you really are bringing in the body and what is happening in the body as trauma is engaged. Now, you can also use somatic experiencing with EMDR and with brain spotting and with other modalities.

So it doesn't have to be a standalone therapy either. I tend to use somatic experiencing with EMDR and brain spotting because again, I'm very much a whole body therapist. And I find that that works really, really well. another therapy is internal family systems. And this one is pretty complicated to explain in a short period of time.

But basically, it's just looking at different aspects of ourselves and different ways that we process through our trauma in ourselves. So there may be protective aspects of us, younger and older aspects of us, and so on and so forth. It is not uncommon for me to also use this in conjunction with both EMDR and brain spotting, depending on what my client needs.

Again, we're probably going to use some combination of all of these things in therapy with a client. again, it's going to dictate what we do.One other therapy I want to talk about is narrative therapy. And I am trained in narrative focused trauma care,  it is a particular way of engaging a client's story. So in that we are looking at developmental stories, particularly, and we are looking at how the client experienced that.

We're having the client look at it a little bit differently. So it's a different way of engaging with your story. Now, I have used this again in conjunction with Somatic experiencing, internal family systems, EMDR, and brain spotting, because you can combine all of these things together. And I found it really effective.

So again, your toolkit is going to be unique to you. So there may be a ton of EMDR reprocessing. There may be some brain spotting. There may be some somatic experiencing, or you may say, EMDR is not for me. Or the therapist may note, Hey, EMDR is not for you. Let's try something different. And you can totally do that.

I also think that as a client, it's really important to tell your therapist what is working and what is not working. And I know when you are a trauma survivor, it can be very scary to say, I don't like this. I'm not comfortable with this. Could we try something else? And I want to just encourage and empower you to do that.I don't want you to run from hard things. Obviously we want to work through them because we want to get to that post traumatic growth and the healing, of course, but your therapy is yours. And it's important for you to be able to say, Hey, this really works, or I really like it when we do X, or you give me this type of homework, or I get to engage in this kind of journaling, or when we do more reprocessing, more than narrative therapy in a session, those things are really important.

And hopefully the therapist will say, Oh, absolutely. And if for some reason the therapist says, Hey, I don't think you're quite ready for that, or maybe this is a better fit, then they should be able to explain to you why. They may say, man, you are really, really emotionally reactive and every time we get close to that trauma, you really have a hard time for several days.

So we need to do more of the regulation piece, more of making sure that you're prepared before we go into reprocessing, because I don't want you to feel discombobulated for days on end afterward. So let's work on that a little bit and then let's return to this. And so a good therapist, even if they can't say, Hey, I think this is a great idea.They're going to tell you what idea might be better for you and why, and your treatment is an open book. You should absolutely be able to talk with a therapist about why he or she is doing what they're doing, why he or she is choosing what is being chosen. He'd say, I would like to try this. And if your therapist doesn't know how to do it, so let's say you go read up on internal family systems and your therapist doesn't know a thing about it, then you can ask a couple things like, hey, do you have a referral for somebody that I could try this with?

Or are you willing to learn a little bit of it and we can try it together? And those are all totally great things. Like, I understand if you love your therapist and you're like, but they don't know internal family systems or somatic experiencing, but I would love for them to, if they're willing to learn a little bit about it, maybe that is something that they will enter into.

And you can keep your therapist and they learn stuff. Now, know, they're going to be learning, so they won't be as experienced as someone who's done one of those for like 35 years or something. But that might be a way to enter into a partnership on your treatment. in that sort of way. And look, every good therapist wants you to partner in your treatment.We are not just trying to tell you what to do. In fact, we try very hard not to ever tell you what to do. Now we may make suggestions from time to time on like, hey, this might be wise, or you might want to consider this, but we're not going to ever. dictate, at least not in a good therapist are going to dictate what you should and should not be doing and what you need or do not need to do.

Now, if you're doing something that is dangerous, I will say that is not going to likely have a good outcome. And that's a little bit dangerous. You might want to be careful and that's okay, but no therapist should tell you what to do. So I hope this helps expand on when EMDR maybe isn't right for you or isn't right for a client in general.

And I hope that it also empowers you to take hold of your therapy and say, Hey, here's something I need. If you want more scripture brought into your therapy, that is something you get to ask for. Again, you're in the driver's seat in a lot of ways. We want you to have autonomy. We want you to give us that feedback.We want to know how we're doing. I am all for when a client says, Hey, this didn't work for me, or Hey, this session was great, but I wish we could also do this. I want to know that. Now, I can't always say yes to everything because that is just not how it always works, but I can absolutely tell you why I might not be able to say yes, right?

If you're like, I would love to go hang gliding during therapy. That is not something that we can do. My liability insurance definitely does not cover it. But if you say I'd like to do more internal family systems, or I'd like to try out brain spotting, I got you, right? So again, I hope you find this helpful.

If you did, please be sure to let us know, leave a comment and like, and subscribe. Otherwise we'll see you on the next episode of Hey Tabi. 

Thanks for joining me for today's episode of Hey Tabi. If you're looking for a resource that I mentioned in the show and you want to check out the show notes, head on over to Tabitha Westbrook. com forward slash Hey Tabi. That's H E Y T A B I. And you can grab it there. I look forward to seeing you next time.