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  #1  
Unread July 20th, 2005, 08:21 AM
daisy7 daisy7 is offline
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Default tired

HI,

I am just wondering if it is common for a person to be extremely sleepy after an EMDR session. Lately, after each session, I go home and go into a deep sleep for an hour and I am usually pretty tired the next day. Is this common in general? if so, does it indicate anything about the processing itself.

As well, is there any indication of the amount of sessions one would need to deal with attachment injuries, physical abuse and a 20 year history of holding on to negative beliefs about self. I feel the more I bring up this stuff during the sessions, the worse I feel.

Thank you.

Last edited by daisy7; July 20th, 2005 at 10:22 AM.
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  #2  
Unread July 20th, 2005, 12:21 PM
Sandra Paulsen Sandra Paulsen is offline
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Default Re: tired

Again, in general, not necessarily applicable to you, a few comments:

1) sleepiness often occurs when ones defenses are being pushed against, its tiring. In parts work, we say that the part of the self that is protecting against work gets exhausted by the task.

2) Anytime anyone is getting worse with EMDR, the EMDR should stop, the therapist should rethink the case formulation, and often its wise for the therapist to get consultation. Sometimes the defenses are outdated, and don't realize that its 2005 and its safe now to do the work. Sometimes the defenses are there for a good reason, namely, because the necessary preparatory work needs to be accomplished first.

3) No client is obligated to continue with a process that is making them worse. In my experience with EMDR this occurs sometimes when a therapist hasn't considered the degree of dividedness of the self and proceeds prematurely with EMDR. I don't know if that applies in your case.

4) Sometimes clients feel they have to continue but in a way they are reenacting the way they felt they had to allow someone with power to do something that hurt them in childhood.

5) Having said all that, its normal to feel temporarily worse after EMDR but there should NOT be a downward slide over the course of treatment. That's the very definition of destabilization.

In sum, I don't know if this applies to you at all, but what I say to people in this situation, in general is this: You might print this off and take it to your therapist for discussion. I'm confident that if he is a well intentioned and responsible therapist he will consider all these things, openly discuss it with you and if necessary seek consultation. Safety is paramount.

Respectfully submitted,

Sandra Paulsen PhD
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  #3  
Unread July 20th, 2005, 12:25 PM
Sandra Paulsen Sandra Paulsen is offline
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Default Re: tired

PS. I didn't address the other question about number of sessions. Its hard to say, because it depends on many things. If there are attachment problems, there are often other things that need to be done as well as EMDR. The relationship with the therapist is paramount. For some people there is a necessary period of working on stabilizing and containing and developing emotional regulation skills, or doing inner nurturing work with or without BLS, depending on how well it works. The bottom line is this: a person shouldn't be getting worse over the course of treatment. If they are, some preliminary steps have been skipped.
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  #4  
Unread July 20th, 2005, 01:52 PM
Sandra Paulsen Sandra Paulsen is offline
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Default Re: tired

One more thing. As you know by now, I don't know if this applies to you or not. I am intending it as a general reminder to all EMDR practitioners out there, and to any clients who might see themselves in this description.

It is not appropriate for an EMDR therapist to do EMDR on any client with active self-mutilation, or cutting. Active cutting is evidence of insufficient stabilization, suggesting that the emphasis on treatment should be very very different than trauma retrieval or trauma processing. Rather the emphasis should be on stabilization, containment, decreasing internal conflict as evidenced by the self mutilation. This is not just a suggestion, it is a strong guideline for safety. Its straight out of Shapiro's book, both editions. its out of EMDR training, its out of treatment guidelines for treating complex trauma survivors.
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  #5  
Unread July 20th, 2005, 02:37 PM
daisy7 daisy7 is offline
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Default Re: tired

Hi,

I really appreciate your expertise and especially your information about the cutting. I was cutting when I first saw him but had stopped quite early in the process...it was almost an episodic cutting, if that makes sense. I experienced a traumatic time which was preceded by a very long depression and I was cutting off and on for a month or so, and that was the first and last episode of cutting. I am not sure if this makes any difference in terms of the safety reasons for not doing EMDR. You did mention "active cutting" and I have not cut in a while. I have to admit though, the urge has been strong lately since doing the abandonment work.
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  #6  
Unread July 20th, 2005, 02:39 PM
daisy7 daisy7 is offline
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Default Re: tired

Hi,

If I were to mention to by T about resolving internal conflict, what type of methods could I ask him to use? My T does know that my urge to cut has returned as yesterday in our session, I completely stopped seeing my memories durind the BLS and instead kept seeing a picture of myself a couple of months ago, cutting.
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  #7  
Unread July 21st, 2005, 12:52 AM
Sandra Paulsen Sandra Paulsen is offline
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Default Re: tired

A client can only do so much. The therapist has to have their own methods for handling these things.

I really can't give you specific advice, but the preceding posts have many points to discuss with your therapist. If you print this off and bring it to him, you can discuss whether they apply in your case or not.

In general, when processing is blocked and a person instead has thoughts of self harm, it suggests the possibility that a part of self intends to punish the self instead of allowing the processing. As I've said here many times in regards to many many cases in general, often its important for preliminary work such as stabilization and ego state therapy to untangle the internal dynamics before ever doing EMDR.

It is neither safe nor wise for ANY therapist or client to ignore these cautions and continue with EMDR in the presence of 1) destabilization or 2) increased self harm potential. These general statements may be found in Shapiro's texts including the Appendix that addresses contraindications to proceeding with EMDR.

I can't be more clear and I can't give you specific comments on your case, truly I can't, so I don't know if any of the above applies to you or your situation.

Respectfully submitted,
Sandra Paulsen PhD
Bainbridge Island WA
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