The Power of Being Curious
As EMDR therapists, we understand that a client’s narrative unfolds through their day-to-day experiences and what is going on in their body, their affects as well as their defenses. So, how do we attune and listen to understand?
This insight aligns with the Adaptive Information Processing (AIP) model. Clients rarely walk into our offices telling us why they are struggling. Instead, they present the how: the anxiety, depression, relational difficulties, grief, shame, or somatic complaints that disrupt their daily lives.
Our task, as EMDR therapists, is to get curious!
Like our favorite TV sleuth, we ask:
➡️Why this struggle?
➡️Why now?
➡️What is driving these symptoms beneath the surface?
Listening for What’s Spoken…and What’s Not
We mindfully listen with curiosity as our clients unveil patterns, non-verbal cues, mismatched body language and words, their struggle, attachment history and difficulties, all while developing a hypothesis of the problem.
We listen to not only what they are telling us but also taking in their lived experience in the present-day.
Collaboratively, we determine a mutual understanding of how the past informs the present day symptoms, creating a therapy contract around: What is the problem? along with developing a therapeutic treatment goal: What will our clients be thinking, feeling and doing differently at the end of our work together?
A Case Study: The Loss of a Child
My client arrived in therapy carrying the devastating grief of a child lost too soon. We worked together for a year and a half, making progress along the way. My client began honoring her feelings of grief, anger and hurt as she processed the loss of her young child.
Through EMDR reprocessing, she resolved the emotional confusion around defectiveness, no longer seeing herself as the cause or as a failure.
With resolution to her emotional confusion, my client had a new space open to attend to and nurture herself, as she began to break open and heal the pain of this immeasurable loss of her beloved child.
She began advocating for herself more and speaking to others about her needs, while working on understanding and accepting their reactions was about them and not hers to fix or carry.
My client found a number of meaningful ways to honor and create an everlasting bond with her child, finding him in present moments of joy and laughter and holding him in her heart during moments of profound grief and sadness.
We had been transitioning treatment planning from trauma work to supportive counseling when she came in and announced she was pregnant. We shared excitement and processed the natural, bittersweet feelings that arose of her child who died.
For weeks, she was reporting her capacity to provide space for all the feelings surfacing: the full range of emotions any grieving and expecting mother might have. She lovingly shared stories of her deceased child’s early years while planning for this new baby.
Then abruptly, something shifted.
She came in reporting nausea, low energy, and feeling fearful. She was suddenly uninterested in daily activities and wanted to be alone. It could have been easy to normalize what she was going through, assuming it was related to her being pregnant.
I did validate and acknowledge her experience. Then we got curious and discovered there was more.
As EMDR therapists, these are the moments where case conceptualization matters the most. I asked myself:
- Why is she struggling in the way that she is?
- Why NOW?
- What in her past might be informing the present symptoms?
These are questions we consider when using the AIP learning model in EMDR case conceptualization.
How the AIP Model Opened the Path Forward
We decided to explore this significant and drastic shift with an Affect Scan. We tuned into and accessed the felt sense of nausea and floated back to an earlier time...
Her system pretty quickly recalled the memory of being told that her child was going to die. She was in her child’s hospital room and after the doctor left, she threw up. After processing this memory, she was finally able to share her excitement about her pregnancy and started planning her baby shower.
As Bessel van der Kolk says, the body keeps the score.
In retrospect, I appreciate that it wasn’t enough to grieve the traumatic loss of her child. She needed to mourn. She had to be able to go on in her life without him in it. Mourning the loss of her son restored her sense of purpose in life in a way that felt revitalizing as well as peaceful.
Her system pretty quickly recalled the memory of being told that her child was going to die. After his doctor left, she purged the news into the sink. She agreed to reprocess this memory, which we successfully completed. The next session she came in sharing
her excitement about telling her family about her pregnancy and planning her baby shower.
As Bessel van der Kolk says, the body keeps the score.
In retrospect, I appreciate that it wasn’t enough to grieve the traumatic loss of her child. She needed to mourn. She had to be able to
go on in her life without him in it. Through memory reprocessing we metabolized this inadequately processed and maladaptively stored memory; not to move her past her grief but to provide fluidity, flow and revitalizing energy for her body to lean into and through her new experience with purpose, compassion, connection and peace.
The Stories That Stay With Us
Heartwarming stories and the image of her little boy’s radiant smile framed by hospital tubes stayed with me long after our session ended. I cared deeply for this client.
Yet I was reminded that the very qualities that draw us to this work, our compassion and our desire to help, are also our vulnerabilities. When we over-identify with a client, we risk blurring the boundaries of responsibility, carrying pain that is not ours to hold. It was hard to accept that I couldn’t take away her loss. I could, however, help her find a way to be in her life with the loss.
Deany says, “while there’s not always a cure, there can be healing.” This client taught me about healing in a way that allows me to truly BE with what is true, however hard it is.
The Power of Consultation
I am also profoundly grateful for the steady presence of my consultation group during this time. As captivated as I was by her story, my colleagues helped me return to the core of our case conceptualization. They reminded me that my role was not to fix her grief (an impossible task!), but to understand my own sense of helplessness that her pain was activating in me.
I was ultimately brought back to what I already knew: grief cannot be repaired, solved, or hurried.
But what I can offer is a compassionate space where she can meet her grief with greater acceptance, warmth, and attention. Throughout our work, I observed my own rescuing impulses with care, even as I supported her to lean into her emotions and gently accompany her through them.
Transformational Impact Shared in Connection
I will always hold dear the memory of her returning to session after we reprocessed this last memory.
She shared a different ending to a recurring dream which often left her feeling helpless and hopeless. I will protect and hold sacred the details and imagery of her dream, but I can share that as my client reported the new ending to her dream, she conveyed the message she received from her child:
“You will be okay, Mommy. Keep your heart open and we will always be together.”
Once we clear what is lodged in the client’s system, more adaptive information finds a home in its place, providing space for healing, growth, and life promoting energy.
Final Reflections
Thinking about the “why” of our client’s suffering, keeps us open and curious. EMDR case conceptualization and treatment planning is essential, especially in complex cases as it is our guiding light as we travel through the darkness.
If you are interested in group consultation, to refine conceptualization, sustain yourself emotionally, and find shared support when the work feels heavy, I invite you to reach out to The Center for more information.
We must do this work in connection with our colleagues who know what this work is about.
References
- Van der Kolk, Bessel. (2014) The Body Keeps the Score: Brain, Mind & Body in the Healing of Trauma. New York: Viking Books.
- Laliotis, D. (2020-2026). EMDR Therapy Basic Training Manual. The Center for Excellence in EMDR Therapy. Washington, DC.
- Laliotis, Deany. Personal Communication.