What to do when you’re feeling stuck.

In EMDR basic training we're taught to go back to Target, to alter forms of or change speed of BLS, and to use interweaves. However, when practicing EMDR there are times when these techniques are not enough to help clients continue to move adaptively through the network. When a patient keeps looping back with similar themes and triggers or the SUD for a target is not going down significantly after multiple sessions, these can be signs of nervous system hesitation. It may be a cue that the nervous system does not feel completely safe to move through the issue or target...yet. Two factors that could be causing this: THE FIRST IS A PHASE 1 ISSUE We are missing information about the system or person’s history THE SECOND IS A PHASE 2 ISSUE The client lacks access to or ability to use more adaptive networks.   These two factors can occur together or separately. When we begin to unpack the many reasons for a nervous system to hold onto things long after they seem to be helpful, they are all rooted in survival. The brains' main purpose is to keep us alive. Therefore, it’s our job as psychotherapists to invite curiosity and help identify the function of the dysfunction. A good way to check is to ask ourselves, “Based on what I know about them, how do their symptoms make sense?"  If you cannot answer this question based on your training, knowledge of the nervous system, the AIP model, and other theories of human development, it may be a good time to pause reprocessing and gather more information or add more specific resources for your client. Our brains are hardwired for survival and designed for resilience. However, in order for our systems to make adaptive change, we have to convince our brains that the new way of being is not a direct threat to our survival.  When it comes to getting stuck in processing, sometimes offering a general nudge or shift in perspective is all we need to help facilitate profound change in the neural network. If the client's brain keeps bringing the system back to the same point…there is a good reason for that. I encourage you to respect the system and look for other ways to offer the same level of safety through better understanding and validation of the function of that dysfunction or the creation and combination of a more adaptive way to provide the same function. One way to think about it would be if your house needs major repairs to be safe or up to code, how you approach the project greatly depends on whether or not you have another place to stay while the project is being completed. If you have to live in the house during the remodel, we are going to have to approach the project much more carefully, constantly thinking about the function of each beam, appliance and how we limit access to parts of the house as we go. We don’t want to have someone get hurt or not be able to function in their day to day lives in the process of trying to fix up their house.   In basic training we learned several things from Dr. Shapiro’s Standard Protocol and the AIP Model for working with stuck points in processing. Something that is often taught very quickly is that one of our main jobs during phase 4 is to help “keep the train moving down the tracks”.  We offer the least intrusive possible intervention to help the client achieve a shift in perspective or to keep moving them down the tracks. Oftentimes clinicians will be looking for something profound to say as an interweave when a much more subtle intervention like changing BLS will also work.  The patient may not be ready for such a big shift in perspective. One of my mentors once said, “Your client's words to answer their problem will always be more profound for their system than your words' '. Our job is to provide support and a framework for their brain to shift, heal and grow.  If you're not in the habit of checking in, now may be a great time to revisit that tool. You do this by going back to the target more often. By checking in with the target you give a chance for their system to orient differently and notice their own shifts in perspective.  You can even play around with getting a SUD or body sensation as a way to orient differently to the target and monitor the progress. Don't be afraid to go back to basics...there is good information there. Another aspect to keep in mind is the directional aspect of EMDR. We use back and forth eye-movements and work to get rid of a SUD. Switching directions or orientation to movement can be very helpful. This can include directions of eye movements or types of tactile stimulation or even shifting how you orient to the SUD. One of my favorite interweaves when we are stuck at a SUD of 1 while processing is, “What would it be like to give that 1 permission to be there as long as it needs to?” Sometimes the shift is our energy and what we are asking of our clients is all their system needs to shift. Remember, it's all just information so here's an invitation to stay curious about how what it wants us to know.