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  • Christie Pearl, LMHC, LPC

When talk therapy isn't working: What's different about EMDR therapy

Updated: Jun 27

Image of woman on laptop searching for EMDR therapist in Virginia because her therapy isn't working

Does this sound familiar?

You’ve been thinking about seeing a therapist for a while because there are some things that feel like they’ve gotten out of control. Maybe your anxiety is starting to get the best of you, or you and your partner are stuck in conflict over how much you’re working, or you’re stress eating a little more than you want to.

So you hop online and google something like “best therapists near me” or “therapy for…anxiety, depression, stress eating, adult ADHD…”.

What you quickly discover is that finding a therapist can be overwhelming. So many different types of professionals – LPC, LMFT, LICSW, PhD, MD, etc. And so many acronyms! ACT, CBT, DBT, ERP, EMDR, just to name a few.

Having a variety of treatment choices is a good thing. But it can be confusing for even the most educated consumer to navigate the alphabet soup of the mental health field and make an informed choice about which therapist and which therapy approach is going to be the right fit.

So you do your best, and you pick someone and go with it.

The next thing you know, you’ve been in therapy for a while, and although it’s nice to have someone to talk to, you’re not seeing the changes you were hoping for. You’re starting to wonder what therapy is doing for you that you can’t get from a night out with your best friends.

If you’re wanting more out of therapy, you’re not alone.

Closeup of therapist and client when therapy isn't working

Traditionally, most people expect that when they see a therapist, they will be doing talk therapy. In other words, they will be talking about what is bothering them, and the therapist will do some combination of providing support, offering new perspectives and helping them sort through their thoughts in a way that helps them understand things better.

The assumption is that if you understand it better, change your thoughts about it, or if you learn some skills and strategies to deal with it, then you will feel better. This is often called the ”top down” approach to therapy.

This approach isn’t necessarily wrong.

For some people, accessing top-down skills such as learning how to reframe their thoughts is enough to get them where they are trying to go, at least for a while. One way to think about this approach is in terms of symptom relief. You are temporarily relieving the symptom with new insight, skills and strategies.

But for many, if not most people, learning skills doesn’t produce the long term change they are seeking because it doesn’t address the underlying causes.

If all we needed was more insight – to cognitively understand the issue more – then most of us would be able to move beyond painful issues in our lives without much difficulty. But most clients who come to work with me have been in talk therapy for months if not years, and they are not lacking in understanding about their issues. What they are lacking is change.

So what do you do if you’re not getting the relief you’re seeking through talk therapy? You try a different approach.

Over the past few decades, the latest research in neuroscience, trauma and attachment has shown us that talking about the painful experiences in our lives is helpful and supportive, but sometimes it’s insufficient for resolving underlying issues and creating change.

Thanks to these advances, we now have therapeutic approaches that go beyond symptom relief and allow for resolving underlying issues. These “bottom up” approaches rely more on emotional and physical, or somatic, parts of the brain than on logical and cognitive parts. These somatic approaches to therapy are becoming more in demand as more people experience them and the powerful results that they offer.

One such approach, and my specialty, is EMDR (Eye Movement Desensitization and Reprocessing).

So what is the difference between talk therapy and EMDR?

When we engage in talk therapy, we are accessing the part of our memory that is about cognitively remembering events and experiences, using words and language to describe it with our “thinking brain.”

Image of peaceful woman with hands crossed over chest doing EMDR therapy in Virginia

What most people don’t realize is that we have other types of memory – emotional memory, physical memory – that live in other parts of our brain that are more subconscious and that do not respond to talk therapy since we are not accessing those parts of our brains when we are simply describing what bothers us.

EMDR helps us access those other aspects of our experience in our emotional and physical

memory, which is where painful unresolved experience is stored.

When we go through experiences that are overwhelming to us, our brain does not process them in the same way that it processes and integrates other experiences. Most of our daily experience gets processed into long term memory or sorted through during sleep each night. But some painful life experiences – such as growing up with a critical parent – are emotionally overwhelming and aren’t able to be processed through to completion.

Instead of being processed through, these unresolved experiences sit in a messy bundle along our neural pathways – a bundle of emotions, physical sensations, images, thoughts and beliefs about ourselves and others. Over time these unresolved experiences take on a life of their own and become survival strategies that we needed back then, but later become limiting in our adult lives.

For example, a child who adapts to a critical parent by trying to please them through exceling in school may grow up to be an adult who struggles with perfectionism and people pleasing, even though childhood is over.

The assumption underlying EMDR is that your brain can digest in the here and now whatever it couldn’t back then, and you can bring these unresolved experiences to completion. You can feel, think, believe and act out of a more present-day, adult perspective.

In other words, the adult who is repeating patterns of perfectionism and people pleasing can come to see this experience through a present-day lens and learn that it’s OK to be imperfect and to disappoint others sometimes, instead of continuing to react out of the unmet needs and survival strategies that they developed in childhood.

How do you know when it’s time to consider a bottom-up approach to therapy?

One of the most common phrases I hear from new clients is something along the lines of “I know what I 'should' be doing, but I just don’t do it.”

You want to be more visible in your industry, but you aren’t pitching yourself for any events. You’re trying to finish your dissertation, but you freeze up every time you sit down to write. Our conscious mind, in other words our thinking brains, have goals and make plans. But our subconscious minds and unresolved beliefs – for example, I have to be perfect – are in

conflict with those goals, so you find yourself unable to move forward. In other words, we get in our own way.

EMDR helps us access the subconscious emotions and beliefs that are interfering with and often sabotaging our ability to succeed.

When we access these parts of ourselves, we can bring them into conscious awareness and allow them to come to resolution. In this way, our thoughts, feelings and actions can all come into alignment with our goals and plans.

Are you ready to stop getting in your own way? You always have options.

Now may be the time to try something new. Get in touch today!

Image of EMDR Therapist and EMDR Consultant with friendly demeanor. EMDR therapy in Massachusetts 02138
About the Author

Christie Pearl is a licensed therapist in private practice in Virginia and Massachusetts. In her nearly 20 years of experience in the mental health field, she has specialized in trauma and trauma-informed care. Christie discovered the power of EMDR therapy a decade ago and became a Certified EMDR Therapist in 2016. Since that time, she has witnessed the transformation both in herself and in her clients. Christie believes that no one should have to "cope" with trauma, and that, with the right approach, healing is possible for us all.


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