Understanding the Best Time for You to Start Trauma-Focused Therapy

Doing an EMDR intensive is a transformative and empowering experience, but the question often arises: When is the "right" time to start this specialized form of therapy? I’ve learned a lot about answering this question throughout the years of providing EMDR therapy intensives and I have some specific expectations about when I believe a client is ready for my process. Like any kind of therapy, timing plays a crucial role in the effectiveness of the therapeutic process. Trying to rush into a therapeutic alliance too soon often leads to disappointing outcomes.

Met Criteria Before Starting an EMDR Intensive

There are some minimum standards that must be met for a person’s timing to be right for my intensive process.

The client is not immersed daily in the trauma.

Before diving into trauma-focused therapy, it is essential that clients are no longer experiencing the original trauma on a daily basis. Active trauma situations, such as ongoing domestic violence or substance use, will hinder the therapeutic process. This may seem counterintuitive, but part of what makes EMDR effective is the client being able to experience and identify when there is danger and when there is safety. If a client comes to process trauma that they are continuing to live through, they don’t have the ability to experience the juxtaposition of danger and safety in their lived experience. It is essential to my intensive process that I can create a safe and stable environment in the therapy space for clients to explore and process their traumatic experiences without the interference of ongoing threats. I should also be clear that PTSD symptoms and triggers feel like the trauma is still being experienced, but those are the issues I seek to address and eliminate for clients in intensives. Those are different than clients actively in their trauma.

Your Basic Needs are Met

Abraham Maslow's Hierarchy of Needs illustrates the foundational requirements for well-being. The bottom two sections of the hierarchy, encompassing physiological needs (e.g., food, water, shelter) and safety/security needs, must be adequately met before engaging in trauma-focused therapy. Addressing these fundamental needs lays the groundwork for a more successful therapeutic journey. When I talk with perspective clients about readiness for an EMDR intensive, I ask them questions that may seem like they don’t relate to their trauma. I explore their social and emotional connections, financial and vocational security, the quality of their self-care and ability to tend to their activities of daily living.

All these needs being met, or having a plan for those needs to be met and sustained are invaluable to the success of my EMDR intensives. As the name suggests, intensives are intense. I need my clients to have a level of certainty about their life’s stability for them to be able to move at the swift pace and depth we dive into during an intensive.

Insight into the Impact Trauma has on Your Day-to-Day Functioning

One thing that might seem obvious, but is not always clear for clients when they first meet with me to discuss intensives in a Good-Fit Call is that they should have a basic understanding that their trauma impacts their day-to-day functioning. A lot of people come to me wanting to do EMDR because they heard it can help their mental and emotional well-being but are sometimes in denial of how deeply the trauma has impacted their lives and how they function. Acknowledging the connection between past experiences and current challenges (and even current strengths!) is a crucial step in the healing process. What I often see is that a person is in pain, and to me, it seems clear that they carry their trauma everywhere they go. But despite the triggers and other symptoms, the client doesn’t believe that their past has impacted them so much. In this situation, a client usually has a part of themselves that is afraid to let go of their relationship with the trauma, they are afraid of who they are without the trauma, or they downplay the impact of experiences because they believe that they are a bad or weak person if they admit the impact of their experiences. Having awareness, or at the very least, acknowledgment that you experienced traumatic situations, forms the basis for meaningful exploration and understanding during trauma-focused therapy that brings healing to the parts of ourselves we abandoned to survive the trauma.

You’ve Developed Emotion Regulation Skills

Emotional regulation is a key component in trauma-focused therapy.

Clients need to have developed effective coping mechanisms and skills to stay within their "window of tolerance." The window of tolerance is the optimal range of emotional arousal (or intensity of emotions) where an individual can process information and engage in therapeutic work without becoming overwhelmed or dissociated. There are many EMDR therapists that work with clients that have limited windows of tolerance, and EMDR can be an amazing treatment for individuals with high dissociation or even dissociative disorders.

However, that kind of EMDR treatment takes months to years, instead of days to weeks – like an intensive does. While there are offerings for healing this level of trauma, a person without grounding skills, emotional regulation skills, or people who are easily pushed out of themselves when emotions start to flow are not a good fit for my EMDR intensive process.

There are ways to gain these skills. Conventional psychotherapy is almost always helpful for skill building in this area, and I work closely with client’s primary therapists to understand clinically how wide a client’s window of tolerance is based on their time in therapy. Psychoeducational and skills-based groups can also help teach specific techniques for emotional regulation and help client’s understand the basics of their brain, body connection. I’m teaming up with Erika Prano, LPC to offer such a group starting later this year. (Sign up for that group can be found here). Other methods of mind-body connection such as meditation, yoga, martial arts, connection to nature, crafts, art, music, and playing sports can also help a person’s baseline for emotional regulation to help them prepare for an intensive.

Timing is Everything

In the realm of trauma-focused therapy, timing is indeed a critical factor. Ensuring that clients have clarity around their trauma, their basic needs are met, they possess insight into the impact of their experiences, and they have developed emotion regulation skills, lays the groundwork for a more effective and transformative therapeutic journey.

As an EMDR-certified therapist who has been doing intensives for several years, I recognize the significance of these factors and work collaboratively with clients to assess their readiness for trauma-focused intensive therapy. By considering these elements, I try to provide a safe and supportive environment where individuals can navigate the complexities of their past traumas and current triggers to ultimately foster healing, resilience, and post-traumatic growth.

If you or someone you know is contemplating an EMDR intensive, please reach out by filling out this form and scheduling a Good-Fit Call. I can help determine if my program is right for you or provide you with referrals to other talented providers who would be the best fit for you. There’s no harm in exploring the possibility of permanent, brain-based relief from the impact of trauma and traumatic stress!