I've had this experience a number of times and think that the suggestions Sandra has given you are excellent.

I generally simply tell people some of the things I have heard of that have gone wrong, and explain that I understand their urgency because they've heard about how powerful EMDR can be and I affirm that YES EMDR is extremely powerful but if used at the wrong time, with the wrong person, in the wrong situation, or without putting adequate resources in place, that it can also do powerful harm, and lead to people feeling much worse rather than better.

Sometimes it is very helpful to explain to people - especially those with complex trauma or who have significant levels of dissociation - that sometimes going more slowly helps to move things more quickly.

If you go too fast, then you end up in the long run needing to do more work, have more sessions, have extra emergency sessions, etc... because you keep having to do repair work and to try to fix that problems that were being created by rushing in - as well as the cost in their personal and even professional life if things felt very destabilized.

If you take things more slowly and do the proper assessment and get to know each other so you know what is helpful for them and they feel comfortable enough to communicate that for you AND you have the positive resources installed, etc... then it can go smoothly without so many bumps and bruises and their personal lives and professional lives should remain relatively undisturbed during the healing process.

I have not thought of this before but some kind of construction work might be a good analogy - building the foundation of a house maybe? You want to make sure the foundation is good and strong and has all the chinks patched up and reinforced and is nice and solid before you put up the rest of the house - because later if the foundation crumbles and falls apart the rest of the house may follow suit.

I have, by the way, encountered the same kind of pressure even when I worked in a setting in which there was no cost to clients. The implication that I was doing it for my own benefit was not necessarily there but there was at times very heavy pressure, anger and even overt harrassment.

Sometimes those clients who really push can end up being very enjoyable to work with, and it can help a great deal to try to get inside the reasons for the pushing which is invariably that they want to feel better as of yesterday, and they have read about EMDR or it's been recommended to them as a cure all, so it's a very good place to start and look at and talk about expectations.

And you do not ever want to go against what your own clinical judgement is because ultimately if they DO have fallout and a hard time, you will know that you had concerns about it but let them persuade you (they don't know the risks in an experiential way), and you ultimately have to watch and clean up the mess that ensues afterwards, which is NOT fun.

Sooner or later you will start having people come to you with stories of their EMDR that went bad with therapists who didn't think they needed to do all that pesky prep work, and you'll feel much more confident and strong in maintaining your boundaries in this area.

In the big scheme of things, it seems to me that there are potential liability issues and certainly ethical concerns when therapists rush in without doing the adequate groundwork first.

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Carol Ann Rowland, MSW, RSW