When EMDR Doesn't Work- A Checklist For Patients (2024)

You have heard about how effective EMDR therapy is. Your friend or your loved one shared with you about how healing and transformational EMDR therapy was for them. You “gave it a try”, but you didn’t get the result you wanted. Now what? What Should You do When EMDR (Eye Movement Desensitization and Reprocessing) Doesn’t work?

What Does It Mean That “EMDR Didn’t Work”?

When my therapy clients tell me they “did EMDR but it didn’t work”, here’s what they reported:

1. no trauma symptom reduction
2. no reduction in painful emotional memories

Unfortunately, the “EMDR doesn’t work” story is one that is told to me every few months. When I seek out more details about what they mean, there are usually a few things that I hear.

1. They were in “regular talk therapy” and their therapist suggested they “give EMDR a try” to see if it would help. In these cases, the client often didn’t seem to have an understanding of what they were doing and why. There was little education about EMDR and it’s rationale as part of a comprehensive treatment. Little time was spent setting therapeutic expectations. Generally, EMDR was attempted haphazardly in only a few sessions, and it was not employed as the full treatment modality that it is.
2. The client faced symptoms that had deep and complicated roots. Their symptoms stemmed from a more complex trauma presentation than was acknowledged. The client had a significant co-morbity which was not overtly discussed as part of the treatment plan.

When EMDR Works Like A Charm

EMDR treatment can indeed work very rapidly for the client who has only experienced what we call “a single incident trauma”. I’ve seen it myself in my own practice. Occasionally a very psychologically healthy person has something really bad happen. What do I mean by this? I mean that it’s rare that someone walks in the door to my therapy practice who has had a healthy, supportive childhood, no history of drug or alcohol abuse, no history of psychiatric drug use, and generally happy intimate relationships with loved ones.

As an EMDR therapist, I’ve worked with the people who get fantastic results from EMDR. People with single incident trauma and no co-morbidities exist, and EMDR tends to help them pretty quickly.

But in fact, the reality for many patients is quite different. Most of the women and men who find their way to my practice have a long term history that complicates their treatment. Many got their start in very high stress families. These families struggled with emotional problems, substance abuse, divorce, depression, anxiety, mental illness and host of other problems. Many times, these clients don’t recognize the impact this stress has had on them. Like fish in water, they view intense stress as unremarkable.

Good therapy helps your brain and your nervous system to learn. EMDR changes your brain and can speed along in this learning process. But a brain that is dealing with a multitude of stressors often takes longer to learn.

So what should you consider if you are not satisfied with the EMDR treatment you have received?

Your EMDR Troubleshooting Checklist

If you are finding that EMDR doesn’t work like a charm for you, it might be helpful to reflect on the following questions;

• Am I using drugs and alcohol with any regularity?
• Is my life unsafe, very stressful and/or unstable?
• Do I have symptoms that predate the trauma?
• Do I suffer with chronic anxiety or depression that pre-dates the traumatic incident?
• Am I secretly, or openly, seeking a quick fix?
• Do I dissociate?
• Am I uncommitted to therapy, kinda committed, or “just checking it out”?
• Am I impatient with therapy?
• Do I avoid giving my therapist feedback, being actively engaged in therapy, or avoid asking questions of my therapist?

If the answer to any of the above is yes, it’s probably a good idea to discuss this with your EMDR therapist. Remember, good therapy is teamwork. That’s true of any psychotherapy. but it’s especially true of trauma treatment.

Before You Say “EMDR Doesn’t Work” For You Read More:

Let’s have a word about about Complex PTSD (CPTSD), Therapy and EMDR (Eye Movement Desensitization and Reprocessing)

Here is an important factor about getting good results from EMDR. Something called “Complex PTSD” can arise if you have experienced repeated trauma, neglect and abuse. If so, then it’s important to work with a trauma therapist who knows how to adapt EMDR, and therapy in general, to your specific needs. Treating CPTSD is a specialty, and clients who work with a generalist often find themselves “spinning their wheels in therapy”.

In fact, one of the major indicators of CPTSD is lack of treatment response to therapy.

This lack of therapeutic progress happens for two main reasons:

1. Early stress has shaped a nervous system that is unstable and reactive or
2. The brain and nervous system have gotten very adept at disconnecting from emotions

Many of the clients that told me “EMDR doesn’t work”, fit into one of those two profiles. And what likely happened is they were working with a therapist who could not effectively help them address these obstacles.

Consider Another Trauma Treatment Method In Addition To EMDR.

Because their nervous systems were chronically dysregulated, some of the CPTSD clients I’ve work with benefited greatly from EMDR only after we did Neurofeedback brain training. With Neurofeedback treatment that was tailored to the specific needs of their nervous system, they gained enormous calmness and stability. Only then were then able to go on and make great use of EMDR processing.

If you want to learn more visit my EMDR therapy page.