Ep 78 - How to choose an EMDR memory target
Hello everyone, welcome to the EMDR Doctor podcast. If you are new here, welcome. I'm Dr. Caroline Lloyd, and this is episode 78, I believe.
And today we are gonna be talking a little bit about how to choose a memory to work on in an EMDR session. So this was a question from a beautiful listener, so thank you so much for sending that question in. I love the question because it is very oriented to how can I help myself best, and how can I get the best out of my therapy, and essentially, how can I heal? So I really do love the question. In answering it, it's actually a really big question. So if you are an EMDR practitioner, you might know that people have whole two-day trainings on case conceptualization and the best way to approach somebody's distress. But essentially, there is a kind of a basic answer, and what we always sort of bring it back to is how can we best alleviate your distress, and what does that distress kind of relate most to? What do we hang our hat on today? And buried in this is the assumption that we are not allowed to get it wrong, and I think that's a really destructive assumption to keep. Because any target is essentially gonna do something for your healing. So we can't really choose a wrong target. We might choose a target that is more or less effective, but we, we can't really go very far wrong. Every target that we choose, so long as there is some distress associated with it, will do something to alleviate the distress in your life. And in saying that, I don't want to take away from the importance of choosing, but I want to take away some of the anxiety around choosing. You know, it's not imperative that we get every detail right, and I see EMDR therapists getting a little bit caught up in this as well. Sometimes we get so caught up in, you know, drilling down and getting the exact negative cognition, the exact negative belief that pertains to that target. But in essence, what the negative belief is there for is just to bring alive that memory a little bit more so that we can access it a little bit more thoroughly. And the same goes for the target. If we choose an image that is not exactly right, that's okay. It might just take a couple of extra sets to get where we need to go, or we might go, you know, the scenic route instead of the direct route, and there's beauty in both ways. So, my message here is don't get too caught up with choosing the exact right target. If you start working with something, you will get some work done, and every piece of work is better than no work, and every piece of work that we do, every memory target that we choose, every session that we do will alleviate some of the trauma that is present in your life. So that's my first point. Don't get too worried about which target because they will all help at least a little bit.
So I'm going to share a little analogy or metaphor that I often share with my clients just to illustrate this point. I talk about people having a wheelbarrow of trauma. Now, some people's wheelbarrow might be quite light. It might just have a couple of rocks in it. Other people's wheelbarrows might just have, you know, a couple of handfuls of sand or maybe a couple of shovelfuls of sand. And other people's wheelbarrows might be full up to the brim of really big rocks, a few small rocks, and lots of handfuls of sand. So we are all different. We all have different memories, different levels of trauma, different experiences. So if we think about what's in the wheelbarrow of trauma, in terms of what targets we're going to choose to work on that day, we might not, and I would advise you, don't start with one of the really big rocks. Certainly if we remove a big rock, it's gonna make the wheelbarrow a lot lighter a lot quicker, but we also run the risk of destabilizing the wheelbarrow and maybe tipping everything over, which is not a good look. So I would suggest we, start with a target, especially if it's your first EMDR session, don't start with a big rock, start with a small one. Start with one that is manageable, that you can take out relatively easily, that won't tip the wheelbarrow over. You can start with a little handful of sand, in which case, fantastic. Get rid of that sand. Every handful of sand does make that wheelbarrow a little bit lighter. But it also may take a bit longer to empty the wheelbarrow if you just take a little pinch of sand here and there. So thinking about that in concrete terms, what memory do we actually start with? Well, the sand might be… I sometimes use this story of being run into at the, at the supermarket. Somebody ran up the back of my legs with their supermarket trolley one time, and yes, that was upsetting. It made me a bit cross, made me a bit confused, it maybe made me a little bit anxious, but it wasn't something that really impacted my self-esteem. It didn't impact on what I could do. You could say that that memory, being relatively small, is a, you know, little sprinkle of sand. If I had been robbed, at the supermarket, like say if I'd been at the supermarket and someone had grabbed my handbag and run away with it, that would be a little bit more of a rock. So that would be a little bit of a bigger target. I might have, might have caused me more injury, it might have caused me more distress, more interruption to my life and I might feel more scared about going to the supermarket if my handbag had been stolen. Now, if I had also in my past had a lot of things stolen from me, or maybe my house had been broken into, that would be an even bigger target. So if then I had my handbag stolen at the supermarket, that would kind of link to that other bigger target of other things being stolen from me. So you might call that a memory network. So the network would be things being stolen from me, and those two things would tie into the memory network. So if I then started with the supermarket experience, it might link in an EMDR session, and we might go to the home invasion or the house robbery. So memories are linked together in what we call memory networks, and we can always choose one memory that is part of that memory network. And if we resolve that particular memory, then it starts to dismantle the whole of the memory network And so they are often really effective targets to choose because that whole memory network, if that's causing a lot of distress in someone's life, the memory - network might be around bullying, say, or it might be around, "I'm not lovable," or it might be around childhood trauma of neglect, "I don't deserve to be looked after," say. There might be a big memory network to do with those beliefs or particular themes of trauma. And I guess, especially if it's the first EMDR session, I would be a little wary of choosing a memory that belongs to a really big memory network, because you are gonna enter that memory network. So I would possibly suggest, if it's your very first EMDR session, I would choose a standalone memory, not one that belongs to this big memory network, and I would choose something of small to medium distress, not the worst thing that's ever happened to you. Now, I'm just talking here about the first EMDR session, so I do take a little bit of care with that first session in choosing the memory, because I wanna figure out how my client interacts with me, how they interact with the whole EMDR process, what their level of tolerance is like for emotion, and how quickly they resolve it, and do a bit of figuring out as to their resilience. So in answering this question for you, my listeners, I don't know you, I don't know your EMDR history, I don't know your personal history, so I can't really suggest very precisely what to work on, but that's a bit of general guidance, in terms of choosing a memory to work on in the first EMDR session. So in that session, you'll be getting to know your therapist, your therapist will be getting to know you, you'll be just exploring things a little bit together, and so I'm not gonna be jumping in the deep end into that big memory network with that first target. I hope that makes a little bit of sense.
So EMDR therapists do often get taught to work on the first, the worst, and the most recent when they're working on a memory network. So the first might be the first time I had something stolen from me maybe, or the first time I learned I wasn't safe. So that might be the first one. The worst one might be the one that had the most impact in my life, so the, the worst time something was stolen from me, which might be, let's say, a home invasion. And then the most recent might be the time at the supermarket where my handbag got stolen. Maybe that happened to me last week, and it's very fresh in my mind. So in general, I would take that advice with a grain of salt. The first, worst, and most recent is not necessarily the sequence in which you should do targets. It's a reasonable suggestion, and may well work a lot of the time, but just bear in mind that you need to get to know your client a little better, and as a client, you need to get to know the process of EMDR and how it affects you and what goes on, and get to know your brain in terms of how you process.
In choosing a target, we want to choose something manageable in general. So I'm saying this in the knowledge that a lot of people listening will have really horrendous memories that feel completely unmanageable, and they want to resolve that with EMDR. So if we are doing that in the framework of, um, a standard psychology session or a standard therapy session, which often lasts for about 50 minutes, so my sessions go for usually 65, sometimes longer, and for my inpatients, that's a whole kind of different scenario because we have a lot of built-in safety with doing inpatient work, and that's my preferred way of working if we're going to do memories that feel completely unmanageable. So, for those really huge, exceedingly distressing memories, then that's the way that I like to approach them in a particular setting, but not everybody has that choice. So if we are going to choose one of those really huge targets, then I would chunk them down. So it might be just that first little moment of that terrible event, or just one little section of an event that sort of rolled out over a period of time. So we can chunk it down, we can choose small bits of it and work in a kind of a restricted way on those bits of the memory. And so when you're talking to your EMDR therapist about this, you may like to talk about how you can chunk down a really big memory and how you can work on small pieces of it at one time in order to, make your way through it in a way that's not going to overwhelm you or flood you or, leave you unable to kind of function for the next week. So definitely all targets are doable. I don't wanna imply that the big targets we can't touch, because we certainly can. And there are often ways to work with big targets, but that's probably a discussion that you need to have with your therapist if you have those really big and very distressing targets. But for the people who don't have things that are unmanageable, like for example, you've just been through a bad breakup with a partner, and there were lots of events leading up to that breakup, and then a few events after the breakup, and in general, you're feeling pretty upset and a bit devastated. But not, it's not a life-threatening kind of event. You know that you can talk about it even though you might get a bit teary. You can talk about it. You can make sense of it, but it's just bothering you a lot. So what would you choose in, in that kind of scenario? I would probably work with a client to figure out what the bothersome bits are. Of course, it all feels bothersome when you kind of think about it as a whole. But teasing out, and quite often this just comes out when you're, when you're telling your therapist about it, you might find that there are moments that make you a bit teary or m- m- moments that kind of make you quite angry. So just noticing what those bits are in your story that evoke that emotional response, they're the bits that I would probably choose to be working on. As a general rule, let's say in that circumstance, a breakup with a partner that sort of evolved over a few months, maybe there was some infidelity, maybe there was some bad behavior along the line, um, and then the breakup, and then the aftermath. I would probably start at the beginning of the breakup or when you first started to realize that things were going awry. It might be the first text you saw on their phone that brought some suspicions. So if we start there, then it kind of unrolls in a little bit of a chronological fashion, and that's often quite a good way to kind of work through a memory. So that's a possibility. Or you might choose a target that pertains to the worst part of the breakup. So if that whole memory network of the breakup and the aftermath, , is manageable, it's not a huge boulder in your wheelbarrow. It's, you know, a decent rock, but you know that you can pull it out. If it feels manageable, then I might go for the moment of the breakup, or the moment that you found out about the infidelity, or something like that. And what might that target look like? It might be the look on your partner's face. It might be the picture of the text that you saw on their phone. It might be when you got home and found an earring under the bed, something like that. So that might be the picture that you start with in the target, and the belief might be something around, "I'm not lovable." There might be devastation and betrayal and sadness and anger, and you might feel that in your hands or in your jaw or chest or stomach is quite a common place, and going from there. , So that might be one way in. Starting at the beginning might be another way in, or even starting with a trigger might be another way in. So a trigger is a current day target, a present day target, and it might be something like, if we're talking about that breakup, it might be something like, um, you and your partner always used to get on the train together to go to work, and now every time you see the train, you feel upset and sad and devastated and lost. So the picture might be standing at the train station, seeing those doors open, and the negative belief might be, "I'm alone." Might be sadness in the face or in the eyes, , and you would go from there. That would be your target. So that would be a trigger, so something that you are seeing or experiencing in your current day life that takes you back to that sad or difficult thing, which was the breakup and the loss of that partnership. Sometimes we can start with a future target. So this is not the future template, but it's a target of the future. So if we're talking about the scenario of a partnership breakup, the, the thing that might be bothering us most about that is, say, for example, the idea of going on holidays alone, or going to a party alone, or going to your family's Christmas do by yourself without your partner. So that might be , a flash forward, we call that. So it's a, a future imagined event that feels hard, or scary, or difficult. So say, for example, that might be, I've been invited to my cousin's wedding in a few weeks, and I'm going to go by myself. And, um, the picture might be telling all my aunties and cousins that we've broken up, and their look of pity, and my belief that I'm alone and I'm not lovable. So the target would be the, the picture of my auntie's face as I tell her I've broken up with my partner, and her look of pity, and the belief might be, I'm alone, I'm not lovable, and then we have the sadness, and the grief, and the everything that goes with that. So that might be a target that kind of sits in the future, so it's an imagined target. It's in my mind about something that's coming up in the future. So that might be a, a future target. - So I've talked a little bit about not starting with the worst one, starting with a smaller target, uh, chunking things down, how to access a memory network in a manageable way, past, present, and future targets. I might just briefly talk about non-visual targets because all of the examples that I've given so far today have been of a picture, of a visual image. So sometimes what we need to work on is not the visual, but another sense. So it might be a somatic sense, so like in the example that I gave of the supermarket, it might be, , the feeling of the supermarket trolley bashing the back of my legs or the feeling of my handbag being ripped off my shoulder. So that's, , a body sensation that can be a good target. So that might be the thing that's bothering me most about that memory is that feeling of having my, my handbag ripped off my shoulder. So that's a really good target to use. , It might be a trigger of, say, another sensation, which might be, , an olfactory sensation, so a smell. Smells are often really dominant as a trigger for an event. So it might be the smell of, , beer breath, say, for example, might be a really bad trigger for some people, or the smell of somebody's perfume or aftershave can be, , can be very triggering, or the smell of smoke, say, for example. If you've lived through, like so many of us in Australia, , and lots of other countries this year, so many people have lived through bushfires, so it might be the smell of smoke that might be a trigger towards a a bad memory So we can work with those kind of somatic sensations instead They can be really effective targets that really alleviate a lot of distress in the here and now. So they're well worth considering, well worth thinking about So I hope I've given you some ideas about how to choose a target, and really I want to close with there is no right and wrong targets. So every target will be valuable in some way, , and each target brings you a little bit closer to feeling good about yourself and your life and resolving all the traumas that you have to carry with you So if you're a bit unsure, feel free to chat to your therapist about this. Your therapist is there to guide you and help you choose the targets, so they will probably have some really good suggestions, and they know you very well. So, , they're someone that you can definitely lean on. You don't have to do it by yourself.
All right, I hope this has been helpful. All the very best, and I look forward to talking to you next week. In the meantime, take good care. Bye for now.
