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In summing up, I will let Steve return us full circle to the beginning of this analysis chapter as he talks about the compensations of trauma work. However, here he elaborates on the specific experiences of delivering EMDR Therapy that are so rewarding – the good

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outcomes, the speed, the client’s satisfaction and the way he feels EMDR seems able to clear trauma more completely than TF-CBT:

“But you know the rewarding side of [EMDR] are the outcomes. The rewarding side of it is really, really rewarding… because patients are like ‘WOW, that’s one session!’ I saw a guy the other day, he had lots of, a mix of things, GAD… Two sessions. And he was going through things and going through things, and he said to me, 'My God, that was magic'. Yeah, it’s rewarding because you get the money, but you get as well the satisfaction. In terms of EMDR, why I’m biased, is because it works faster, and it accesses other things that CBT doesn’t.” (Steve: 51:10).

It is striking how many clinicians, as well as clients like Steve’s above, refer to the idea that EMDR Therapy is somehow “magic”. According to Sara (24:20) “it’s the magic key”, which can unlock the mind’s healing potential. Woven throughout this analysis there have also been several references to an almost religious sense of a belief system with EMDR Therapy that a clinician needs to be able to “trust the process” (Annie: 25:10). As Sara identifies, in ceding control to the client, “you have to trust the client … knowing in full faith that they will get there”

(Sara: 26:18) and this can result in “a mini miracle” (Sara: 12.16). Perhaps this almost

superstitious belief in the magic of EMDR Therapy arises because we don’t yet fully understand the mechanisms by which these good outcomes are achieved. Perhaps too we should note

Alex’s caveat, again couched in religious terminology, about “the sort of slightly evangelical conversations about [EMDR]… that kind of put me off it.” (Alex: 03:42). As he also observes,

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“One of my difficulties with EMDR is that it seems to be very hard to say to EMDR people ‘Oh, that didn’t work that time’. They're not very amenable to that. Yeah. And I mean that's a superficial impression, but…” (Alex: 03:42).

Clearly, any therapeutic belief system needs to be able to withstand rigorous scientific investigation and EMDR Therapy is no exception. Part of the difficulty lies perhaps in the subtle shadings of meaning in therapeutic change which are so hard to capture quantitatively,

particularly by cognitive measures not designed to ask the right questions, as Sara noted above (12.16). Jo captures the difficulty in defining the ephemeral quality of the EMDR process, when she says uncertainly “It’s an inexact ... um, science - or whatever you call it - art, really.” (Jo:

20:53) and yet, this is not to diminish the apparent effectiveness of its power, whereby “people can come with diagnoses and leave without.” (Steve: 03:11).

When faced with such complex and challenging cases clinicians can feel trauma work is

“frightening” (Mattie: 21:23) and may be tempted to fall back on their first training in the solidly

evidence-based TF-CBT approach as their “comfort zone” (Annie: 06:43; Rose: 12:08). They may feel more competent, in control, and confident that they will be able to contain the often unexpected and extreme emotions arising both in themselves and their clients. However, as

Mattie (02:29) says, we need sometimes to be able to challenge “the dominant discourse” and

this is doubly important when both clients’ and clinicians’ well-being may be at stake.

Kate challenged her own usual TF-CBT practice of gathering a lot of information from

the client, when she reflected during our interview and came to the painful recognition “If I’m

slowing down treatment success because I need to know [all the details], it’s a bit heart- breaking for the client.” (Kate: 1:02:14). At the end of the interview, when I asked her if there

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“I just keep thinking that I should try to use EMDR more. I know it’s so useful and good and I set myself up for not using it, except for people who are blocked and not progressing in treatment. So, yeah, that's all that was going through my mind… [SMILES]” (Kate: 01:15:43].

Reflecting on the interview process itself, it seemed particularly valuable to allow space for contemplation and reflection as to why we, as clinicians, do the things we do. Several clinicians approached me later and spontaneously said they’d enjoyed having the rare luxury of time to think about these issues, echoing Jo’s comments, which were captured on tape:

“That’s why this is so interesting to ask the question. You raise very big questions! The thing is, we don’t, one doesn’t, well, we don’t talk like this. We’re not encouraged to talk about these things in supervision. We just don’t have time.” (Jo: 1:07:53).

I am left feeling poignantly aware of both the privilege and responsibility to record and express as honestly and completely as I can the voices of these clinicians, who have

generously gifted me with their time, and shared their thoughts and feelings with me about this aspect of their trauma work.

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