PTSD and EMDR Care, How Long Will It Take?
Many times, when I answer the first call from someone seeking therapy for feeling better from the symptoms of PTSD, the voice on the other end of the telephone says, “I’m looking for PTSD therapy, but I’m wondering how long I will have to see you until I feel better?”
Answering the question is not straight forward.
In my opinion, saying “you will feel better in X-number of sessions” poses ethical issues. Since the core of PTSD therapy is the therapeutic alliance between the client and the therapist, this question needs to be answered with 100% truth.
There are therapeutic interventions that are certainly more effective than others and there are also therapeutic interventions that claim to be faster than others; however, I stand behind the statement that it is downright difficult for a therapist, on a 15-minute consultation call, to assess the full scope of what it will take to work with your set of unique life circumstances. A first phone call with, for example, a 35-year-old prospective client suffering from years of trauma cannot be summed up in 15-minutes and a therapist cannot assess the length of time needed to assist in that 15-minutes.
No shoe fits two people the same, and that couldn’t be more true for therapy or therapeutic interventions; the brain is just too complex.
So, how then is it that some therapists tell someone they’ve never met that they will help them feel better in “x” sessions? I’m not really sure.
When I get asked this question, I answer the question by turning to past examples and refer to the modality I use most: EMDR. I don’t break confidentiality, but I paint a picture that the potential client can easily comprehend, using plain language. And, if I haven’t treated a particular circumstance, I am honest and talk about how EMDR may be able to be applied to that concern or issue.
When someone reaches out for therapy they are most often in a very vulnerable place in their life and waiting to grab onto any morsel of hope. My answer, therefore, is balanced in honesty about the science behind EMDR (and other modalities) and provides conceptualization based on that first 15-minute call, including my history of working with similar cases or diagnoses from both my private practice and my past work in other settings.
You are still asking, how long? how long will I have to see a therapist for PTSD therapy?
The truth is that there are two extremes, and most clients fall in the middle. I have worked with a client with severe PTSD–suffering from symptoms of depression and hopelessness–disengaged in their life who saw me for 8 sessions of EMDR and was able to return to a fully functioning social life and work life after those 8 sessions. But there is a back story to this client that is critical to understand. Prior to witnessing one of the most horrific acts of violence one can fathom, this person had an “ideal” life, a life defined by good social support, good financial security, living in a stable household, and having had a “good” upbringing with secure attachments throughout. In other words, witnessing the event did not open up a box of terrible memories they had stuffed away of other traumas.
On the other end of the spectrum, I’ve worked with clients for years who still have more therapy ahead of them but feel better throughout the process. I like to say, these are my clients on a long hike with me. There are peaks and valleys, but in each session, they are walking closer towards the peak (their goal) and feeling better with each therapy session.
So why is there this range from a low number of therapy sessions to years of therapy. The first client had a single incident trauma. The latter client suffered decades of abuse, attachment wounds, and adult relationships in work and personal life that reinforced the wounds of childhood. And, like I said before, the majority of my clients fall somewhere in-between these two extremes.
Therapy is such a unique experience for personal growth, self-reflection, and healing that there is no clear answer on how long it will take. Many times, a client engages for one “issue” or “life event” and 2-months later is on a new path of discovery from all the insights they have gained from the experience.
My advice to anyone starting a therapeutic journey is to go in with an open mind and trust your gut when you call and speak with a possible therapist. Remember that you can change therapists and likely want to if it isn’t a good fit. Like all relationships, the therapeutic alliance is one of the most sacred. Try to enter the first appointment with an open mind and remember what it is like to meet someone for the first time. You’ll know if it is the right fit. And guess what, if the therapist thinks it is not the best fit for your needs, they actually have an ethical duty to refer you to someone who is a better fit. This isn’t a sign there is something wrong with you. It is the sign of a good therapist who has your best interest at heart.
In sum, how long will you be under care? Really, it is up to how you respond to the therapeutic alliance and therapeutic intervention. Make sure your treatment plan is clear. This will help focus attention and be a marker for you to gauge progress. And remember, you can heal from PTSD.