In a world pre-COVID, telehealth was a difficult pill to swallow for anyone — insurance companies most of all, but clients too, and the counselors they wanted to work with. There were some people who understood the advantages, like the ease of use for anyone with full schedules, or that it broke barriers for anyone who didn’t have the capacity for in-person therapy. You don’t need a car or two free hours for transportation and the session. You don’t need to eat beforehand or find time to change after the gym.
And now, even if you are stuck in isolation after a COVID scare, you can still see your therapist. At the beginning of the pandemic and before, most people didn’t feel comfortable with it, and therapy had and always would be sitting on chairs opposite one another, privately discussing emotions.
I love in-person therapy but mostly because I love doing therapy in general. To sit across from someone whose journey led them to pouring their soul out in front of me, trusting me to help them with this process — it feels like my purpose. So when the pandemic moved into full-swing and I had been working in schools with teenagers who had been pushed through the system, it was hard to understand that I could still do my job while not being in the same room.
It was tough, especially for the teenagers. They had just been dismissed from school for an undisclosed period of time, things were exciting and terrifying, and they had more free time than they knew what to do with. I was losing their attention after 10 minutes and unsure how to share activities with them over video. I felt overwhelmed and burnt out.
Two months later, I began my journey with learning EMDR. EMDR, or Eye Movement Desensitization and Reprocessing, is a type of psychotherapy that “enables people to heal from the symptoms and emotional distress that are the result of disturbing life experiences” (EMDR.com). It is one of the first types of psychotherapy that move away from the widely used talk therapy model of early theorists and into memory reconsolidation, a modality that has now been shown to be at least three times as effective than talk therapy in 12 sessions, a vast difference from the norm for talk therapy which can last months or years.
I completed my basic training for EMDR online in June of 2020, the first of its kind. Before this, every training was, of course, in person at a hotel convention center or something like it, and that was thought to be the only way to get the full effect. It made sense – we wanted human connection, as we always had as participants in therapy. But if there was one thing that we were forced to learn over Zoom calls with our nieces and nephews or FaceTime calls on Thanksgiving with our immunocompromised parents, it’s that human connection supersedes physical presence. When our hand is forced, we can find love and a feeling of safety wherever we are.
In working with EMDR, in healing ourselves from the memories and self-doubt that impair us, discomfort is a necessity. It hurts to hear it, and as a clinician it hurts to see it, but moving a few inches out of your comfort zone is the way that processing occurs. So step back and think a moment: If you have discomfort about virtual therapy, or EMDR, or anything that feels new and difficult, where is that coming from? Research has shown that EMDR online has been proven to be just as effective as in-person, so that anxiety comes instead from the unknown.
What I have laid out here is an overview of what online EMDR could look like, if just as a way to familiarize this strange new phenomenon.
EMDR ONLINE: WHAT IT LOOKS LIKE
We meet online. You’re in a comfortable, safe space for yourself. This could be your bedroom or your office. You made sure to be in a space where it feels private. I am in my office, and we can see each other in our own familiar spaces. You can be wearing pajamas, if you want, or whatever makes you feel most comfortable.
We have a conversation. This doesn’t mean I’m going to ask you to pour out your life story to me just yet – you need to make sure you can trust me, and that’s okay. I’ll get to know you the best way I can, and I’ll tell you about my journey to get here, if you’re interested.
Then, at some point, you start feeling more comfortable with me. If you don’t, that’s okay too, and I’ll make sure to help you find someone who can be that therapist for you. If you do, though, then we start building skills together that encourage coping and help keep you safe when your thoughts begin to spiral out of control.
Once we both feel comfortable with this toolkit, we begin the treatment planning and eye movement. This looks almost the same as it does in person, the only difference being that I will use a website and link you to it so that you can see what I see. Like in real life, there are multiple options for the action of processing, and we will talk through all of them to see what works best for you.
At the end of each session, we will decompress and move back into a safe space so that you can feel comfortable continuing your week as you’d planned. I’ll let you know to take note of any processing that happens during the week, and we will talk about it when we meet again.
We repeat this process until our treatment goals have been met. This often includes a more universal sense of safety, newfound meaning in your life and your relationships, and a new perspective on the world around you.
All in all, it really doesn’t feel all that different. I am an EMDRIA-Certified EMDR clinician, and I have worked with many different clients in many different settings, including virtually and in-person, and I have seen staggering progress from both. If you are navigating this for the first time, however, it makes perfect sense to feel anxiety. Anxiety is okay. Discomfort is part of the process. I welcome it, and I would love to consult with you about what could make you feel safe during our time together, virtually or not.