After many years of practicing EMDR Therapy and working with addictions, I have noticed that there are key moments in therapy where the therapeutic alliance is necessary to support the client’s ability to have successful treatment, which I call the Pocket of Trust. The Pocket of Trust is an emotional space developed through the therapeutic alliance. This alliance is tested often as the client’s layers of emotion unfold through the 8 phases of EMDR Therapy treatment. Clients struggling with addiction often report how the layers of emotion that unfold in EMDR Therapy often influence barriers that come up, defense mechanisms that are reignited, which move both client and therapist outside of the Pocket of Trust. Forging an environment that is safe for the client to experience the various layers of emotion is essential for clients working through addiction in EMDR Therapy.
In order to create the Pocket of Trust, the therapist needs to create a space devoid of criticism and judgment where the client is able to tolerate vulnerability and to be confronted on behaviors, rituals, and routines related to their relationship to substances. Historically in looking at the treatment of addictions and even some agencies today, focus on heavy confrontation of the clients use and relationship with their substance is used as a method to treat the client. I have discovered with the proper awareness and application of the Pocket of Trust clients grow to understand and accept confrontation of their use and relationship with their substance from the therapist. Clients are also better equipped and supported in therapy to manage the layers of potentially intense emotion that may accompany the dual attention stimulation used in EMDR Therapy to help reprocess trauma associated with the clients addiction.
The book, “Treating Addictions with EMDR Therapy and the Stages of Change,” (Abel and O’Brien) reinforces the concept that the use of intense confrontation as the primary modality is not effective long term; that creating trust within a therapeutic relationship is an effective mechanism for helping clients cross over from addiction into recovery.
The Pocket of Trust ebbs and flows throughout the process of EMDR Therapy. It is through the on-going co-creation between client and therapist that the Pocket of Trust is established in the preparation phase of EMDR Therapy, allowing the safety for the client to experience barriers in the areas of trust and vulnerability. As the trust ebbs and flows and the client tests the relationship, the therapist must reestablish the Pocket of Trust by demonstrating acceptance for the client and where they are in their process, being careful to avoid displays of power and control at key moments as defense mechanisms may be reinforced as a result.
The Pocket of Trust is as much what you do, as well as, it’s as much what you do not do. When trust is established in EMDR Therapy there may be a tendency on the therapist part to take it for granted; that no further work is needed in this area. As defense mechanisms emerge during processing in EMDR Therapy, it is essential the therapist be attentive and recognize they are outside the Pocket of Trust and need to be patient to reestablish it. Therapists will observe that their clients are sharing less, being less vulnerable, appearing to avoid more challenging topic areas, and may give responses during processing that appear like dissociation from the trauma they are working on. When the therapist asks what the client notices during processing, typical answers from the client sound like, “nothing, not a lot, don’t know.” It will appear the client is more distant from the emotional charge of the traumatic event and also will feel incongruent to the therapist of what appears to be happening.
A significant part of introducing clients to EMDR Therapy is to discuss in detail the Pocket of Trust; how the therapist and client must establish it, how it may change especially during the desensitization phase, where the work may need to pause to take the time to reestablish the therapeutic alliance before continuing to desensitize the trauma.
For example, when introducing a client to EMDR Therapy, I discuss with the client how we must have the trust so that they can be vulnerable and that I will display respect, courtesy, and patience throughout the process. Patience is needed when we may encounter a hurdle or barrier due to defense mechanisms arising. The client’s trust in the therapy may be questioned at this point to some degree not because the therapist is doing anything wrong, instead, the territory of emotion and/or the situation that is being brought up at the time may trigger a habit response that warns the client to go into protection mode. Therefore, the pace at which EMDR Therapy occurs is discussed, letting the client know they are in charge of how fast or slow the therapy can unfold. This way, when we encounter one of these barriers I reiterate to the client that they are in control. I let them know that I respect them for having the courage to work on their issue/addiction/trauma. I will also respect the trust they have given me, and will honor being a part of their process. This discussion is a continuation from the client preparation phase in EMDR Therapy, and is brought up again during the desensitization phase if a bump in the road appears during processing. We might stop and reestablish the trust in our relationship which can deepen and strengthen our bond. Once the Pocket of Trust has been reestablished, EMDR processing can continue.
In the EMDR Advanced Workshop, “EMDR Therapy Tools for Addictions,” Barb Maiberger and I will present more on how to develop the Pocket of Trust by looking at tools on how to create more safety, develop trust so that the client is able to deepen their experience, become more vulnerable and be able to work more successfully with shifting their relationship to their addictions as well as healing the underlying trauma associated with their addiction.
About Guest Blogger John Gray, MA, LPC, CACIII
Related EMDR Trainings and EMDR Workshops
John Gray is a Certified EMDR Therapist and Consultant. John has fifteen years of experience as a psychotherapist. With his ten years of experience as a University Instructor of Sociology and Psychology, he brings a unique perspective to his work. His experience in how we develop a sense of self and maintain this sense of self through various methods of interaction forms the essence of his therapeutic approach. John strives to co-create a safe environment for all who choose to embark on the rewarding work involved in taking more control of their lives. He has presented at national and international conferences and continues to guest lecture at colleges and universities.