EMDR Headache Following Session
By Carol Ann Rowland, MSW, RSW off Blog Post
I have occasionally had clients experience headaches during EMDR sessions, and often this turns out to be related to ego states not feeling particularly comfortable with what is going on…generally I find that this is amenable to being resolved relatively quickly once addressed, and the headache is usually gone by the end of the session.
I have recently done an EMDR session with a client who I would suspect from the history might be somewhat dissociative. However the EMDR session we did processed relatively quickly and easily (just over an hour) for a first session with someone with complex trauma, the client felt great at the end of the session, etc…
Following the session – the day after – the person experienced a very severe migraine which is not typical for them.
I know that you can’t comment on individual cases and so it may or may not apply to this situation but I was wondering if sometimes there is a delay in such a symptom occurring, if it was caused by ego states discomfort during the EMDR? The client felt the headache must have been related to the EMDR as it was not something she had experienced for many years.
I suppose I have certainly had clients experience symptoms like this after a talk therapy session when stuff had been stirred up, so it should not be particularly surprising….I guess I just have tended to find such a reaction occurs during EMDR rather than afterwards. I had expected it to notice some kind of ego state conflict during the session and felt it almost proceeded too smoothly and easily so to some extent the headache afterwards almost made sense to me…the work also was not felt by the client to have “held” particularly well as she was still experiencing difficulties in some of the associated behavioural and emotional concerns related to the issue that had been worked upon, although the SUDs did remain at a 0 when she “tuned into” the picture in a subsequent session.
I’m just wondering if this is something that other practitioners have noticed or can comment on.
Are there other reasons that someone may experience headaches during or after an EMDR session? I was using auditory BLS rather than eye movements.
Re: Headaches & EMDR
Headaches during or after EMDR are, in my experience, nearly always related to latent dissociative conditions. The EMDR pulls forward a previously hidden conflict, whether its the front part of self that doesn’t want to “own” another state that the EMDR is pulling forward, or the back part of self that doesn’t want to be pulled forward or that doesn’t want a secret to come out, etc.
I wouldn’t recommend doing EMDR on a dissociative client without having done the preliminaries – the stabilization and containment, but also the ego state preparatory work. Then if a headache comes up during EMDR one can deal with it on the spot, but its less likely to come up.
In my opinion (no data, just my clinical impression), tapping or sound BLS its more possible for a latent ego state to “hide” during the EMDR than with the eye movements. With eye movements you can see when the eyes stop tracking because there is a dissociated part at arms length. That’s what’s possibly happening when the headache occurs the next day.
Generally, I’d interview “the part behind the headache the next day,” using ego state therapy, asking it to come into the conference room “so we can understand your concerns.”
Re: Headaches & EMDR
I agree with what you have said and it is consistent with my own impressions of the client, which I have discussed with her.
She has tried everything – extremely effective energy work techniques which normally work for anyone – and remains “stuck”, which was part of the reason I suspected dissociation.
I’ve tried talking about parts and tried doing some ego state work but I’m just kind of met with a blank expression and silence in return.
She is very stable in coping, however, and utilizes many very effective self-help techniques. Because of this, her apparently unconcerning DES score (although I never entirely trust that, from past experience), and because she was very insistent in wanting to try EMDR in spite of my reservations, which I discussed with her, I decided to proceed with caution. RDI was uneventful and truly even the EMDR session itself was not particularly eventful until the headache afterwards.
After the report of the headache, I suggested we back off from EMDR and continue with energy work instead which doesn’t tend to have the same contraindications with dissociative clients (if done respectfully & with an awareness of parts).
Thanks for your feedback,
Carol Ann Rowland, MSW, RSW