Licensed Marriage & Family Therapist
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Matthew Lindgren is available to consult with mental health professionals about the suitability of EMDR referrals for their clients.
I am very happy to discuss working with you and your client to determine if a referral for EMDR for a particular trauma are appropriate. Below I outline some of the situations in which referrals work well, as well as considerations I use to help determine if it is appropriate for your client to do referral work with me. I generally do not charge for professional phone consultations, and I enjoy introducing other professionals to these powerful and useful techniques.
I usually receive phone calls from therapists when a client suddenly begin to remember some enormous event of abuse or trauma. Often the client will report feeling extremely overwhelmed, and the client usually cannot regulate his or her emotional states or sleep very well. The therapists are usually concerned that their client is having an abreaction or is decompensating.
Unless you're working with someone who has a psychotic or delusional disorder, or who has a borderline personality disorder or other severe mental illness, I generally see these situations as positive. Often, when old material begins to surface into a client's consciousness, it is a sign that the person's entire nervous system is ready to work through it. This surfacing of old material may not feel very positive to you or you client, but most of the time I find that it means the material is quite amenable for work with EMDR and Somatic Experiencing.
Of course, during such times, it is important to maintain close contact with your clients and make sure they have contact with as many available resources as possible. During such an event, a client may be tempted to fall back on unhelpful defensive strategies such as alcohol or other addictions.
If your client is suddenly coming into contact with old material, and you're not trained to work with it, you owe it to your client and yourself to consult with a therapist trained in EMDR who knows how to handle abreactions and decompensation. Abreactions and decompensation can be wonderful opportunities to help your clients successfully integrate old material and transform their lives.
You may wonder how a referral session might work. First, I might consult with you on the phone and get a general picture of what you and your client hope to accomplish. If you and I feel it makes sense to move forward, I would want to schedule a session with both you and your client, if possible, to evaluate your client and possibly do direct work. I prefer to have the treating therapist in the room with me, so that we can use your existing relationship with the client and your therapeutic fame as a safe place and resource. You and I would check in together after each session to evaluate the client's progress and determine if or when another session is necessary. In my experience, we can often limit referral sessions to two or three if we are dealing with trauma that is more amenable to fast recovery.
EMDR techniques are specifically designed to help people work through discrete traumatic events within very few sessions. It is not unusual for a person to work through a given event within one or two sessions, though there are many factors involved in these kinds of therapy, like any other therapy, so that one cannot predict or guarantee any particular results. Generally, the factors that improve a client's ability to successfully negotiate a trauma depend on both the nature of the trauma and the resources available to the client.
In general, discrete traumatic events that are not part of a larger developmental life pattern are easier to treat in a few sessions, such as a car accident that happens to a person "out of the blue" who has no history of accidents. In general, larger patterns of trauma that repeat themselves over a period of years, such as domestic violence or combat trauma, can take more time to treat as the trauma has created a more pervasive change in the person's personality, as do work on grief and bereavement. In general, the kinds of trauma that tend to take the most time to treat are those that originated in childhood and continued as a pattern of abuse or ways of relating to others or the world in adulthood, such as child abuse: emotional abuse, physical abuse, sexual abuse, and neglect.
The EMDR technique leverages client resources to process trauma, so clients with fewer resources tend to take much more time. Resources can include friends and social support, spirituality, a connection to one's children, and positive childhood experiences with safe and nurturing adults, among many other things. I find that clients who have developed very strong resources often have the ability to process trauma faster, even for those traumas that I describe above as more time consuming. The clients I find who take the most time to process trauma tend to be those who have almost no internal resources, such as people with personality disorders. I would surprised if I would find it appropriate to provide referral sessions to such clients, for a variety of clinical and ethical reasons related to how long it takes to see progress.
Even though there may be certain situations where it takes longer to work through a specific traumatic event, I would encourage you to contact me about a referral session if you and your client believe you could focus on one particular event. Even if you're unable to completely process the event, it's likely that you'll make a significant shift that you can continue processing in therapy.
I strongly encourage you to contact me if you would like to meet informally for lunch to talk about "shop", or if you'd like company to an event. I often talk with other clinicians who share an interest in EMDR, and I am happy to share and learn with you.
(I am not approved at this time to provide EMDR sessions or consultations that count toward the supervision or personal requirements of the EMDR training programs.)