EMDR Therapy in Massachusetts and Washington: A Guide for Adults Considering Trauma Work

If you've found your way to this page, you've probably been thinking about EMDR for a while. Maybe a friend mentioned it. Maybe a previous therapist suggested it. Maybe you've read about it and recognized something in the description, the sense that the work you've been doing in talk therapy has taken you as far as it can, and that there is something else underneath.

I want to give you the kind of guide I wish my clients could find before our first conversation. Not a sales page. Not a glossary. A real answer to the question of what EMDR actually is, who it's actually for, what the work looks like, and how to think about whether it might be useful for you.

I'm Jessie Mastrangelo. I'm a licensed mental health counselor in Massachusetts and Washington, with a PhD in Counselor Education and Supervision and EMDR training through EMDRIA. I work with adults via telehealth, and EMDR is one of the central tools I use in my practice. This guide is written from inside that work.

What EMDR actually is

EMDR stands for Eye Movement Desensitization and Reprocessing. The name is unfortunate. It is a clinical mouthful that does not capture what the experience is like, and it leads people to imagine something stranger or more mechanical than what actually happens.

Here is the simpler version. Some experiences get stored in the brain in a way that keeps them feeling current. You can know intellectually that something happened a long time ago, that you are safe now, that you have grown and changed, and still find that your body, your reactions, your patterns in close relationships behave as though the old thing is still happening. EMDR is a structured method for helping the brain reprocess those experiences so they get stored the way ordinary memories are stored: as something that happened, not as something that is still happening.

It uses bilateral stimulation, typically eye movements, sometimes tapping, to help the brain do this reprocessing. There is a substantial body of research showing it works, and it has been recognized as an evidence-based treatment for trauma by the World Health Organization, the American Psychological Association, and the Department of Veterans Affairs. It is not new. It has been studied for over thirty years.

It is also not what most people imagine. You do not lose control. You do not enter a trance. You do not have to relive an experience in graphic detail. You stay present, you stay in conversation with your therapist, and you remain in charge of the process the entire time.

Who EMDR is for

The clinical research supports EMDR for post-traumatic stress, but in practice, the population it helps is much wider than people with what they would call trauma.

Many of my clients arrive describing things they would not have called traumatic. A childhood that looked good from the outside but felt lonely. A parent who was not unkind but was emotionally unreachable. A relationship that ended years ago that still seems to influence how they show up now. A pattern in their professional or personal life that they recognize and cannot stop running. None of these are what the public imagines when they hear the word trauma, and yet all of them are exactly what EMDR is well-suited to address.

The way I think about it clinically: if there is an experience or a pattern that your conscious, reflective mind has worked with thoroughly, that you understand intellectually, but that still has a charge, still influences your behavior, still shows up in your body or your reactions, that is often a signal that the experience is stored in a way that needs reprocessing rather than more insight.

This is one of the reasons EMDR is particularly useful for the kinds of clients I tend to work with: thoughtful, self-aware adults who have already done significant work in talk therapy and have hit a ceiling. They know themselves well. They can articulate their patterns. And they are tired of articulating them, because articulation has not been enough to change them.

Who EMDR is not for

I want to be honest about this because too few resources are.

EMDR is not appropriate for everyone, and it is not appropriate at every point in someone's life. It is not the right fit when someone is in active crisis, when they do not have stable enough resources to handle reprocessing work, or when there is an urgent practical issue that needs to be addressed first. It is also not a good fit when someone is hoping it will be fast, dramatic, and require nothing of them. The work asks something of you. It is structured, but it is not painless.

I also want to say this clearly: EMDR is not a magic intervention. There is a kind of cultural framing of EMDR that suggests one or two sessions can resolve significant material, and that is not how it works for most adults processing layered, longstanding patterns. The clients I see who get the most from EMDR are the ones who come in with a willingness to do the work over time, integrated with the rest of their therapy.

How I use EMDR in my practice

I rarely use EMDR as a standalone therapy. In my practice, EMDR is integrated with relational, depth-oriented talk therapy. The talk therapy is where we make sense of what is happening in your life right now, where we work on the patterns you can see and the ones you are starting to see. EMDR is what we use when we identify something specific that needs reprocessing rather than further understanding.

This integrated approach matters because trauma and identity and relationships do not actually live in separate boxes. The patterns you came to therapy to work on, the family-of-origin material that keeps surfacing, the things you do in close relationships that you wish you did not, the questions of meaning and identity that come up at certain stages of life, all of these are connected. A good course of therapy moves between these levels. EMDR is one of the tools we use, not the entire treatment.

When clients ask me what their work will look like, I do not give them a session-by-session map. I cannot, honestly, because the work is responsive to what comes up. What I can tell them is what the early phase looks like in general terms, and how we will know when we are doing the right work.

The early phase: what tends to happen

In the first several sessions of working together, whether or not we end up using EMDR, we are doing assessment. I am getting a sense of you, your history, your current life, the patterns you are noticing, the resources and supports you have, what you have tried before, and what you are hoping for. You are getting a sense of me, my thinking, my approach, and whether this feels like the right fit.

If we decide EMDR makes sense as part of the work, there is a preparation phase. This is where we build the internal resources you will use during reprocessing, identify the specific targets we will work on, and make sure you feel oriented to what we are doing and why. This phase is not a bureaucratic step. It is real clinical work, and skipping it is one of the reasons EMDR sometimes does not stick. Reprocessing without preparation is not advisable.

Once we move into reprocessing itself, sessions look different from talk therapy sessions. There is structure to them, and there is a felt sense of doing focused work. Most clients describe it as more tiring than ordinary therapy and also more productive when it is going well.

The more honest answer to "how long will this take" is: it depends on what we are working on and how it shows up. Some patterns reprocess in a handful of sessions. Some require longer. The clients who tend to ask this question are usually the ones who would benefit from holding it more loosely. The work moves at the pace it moves.

How to know if it is working

This is one of the most important questions, and one I take seriously with my clients.

Signs that EMDR is doing its work include:

• Changes in the felt charge of memories or experiences. They begin to feel older, less current.

• Reductions in physical or emotional reactivity to triggers.

• Shifts in the patterns you have been running in relationships and in your inner life.

• A felt sense of more space between you and the experiences you have been carrying.

Often, the changes show up in your life before they show up in session. A partner notices something. A reaction that used to happen does not happen. Something that used to derail you for a week derails you for a day, then for an hour.

Signs that the work is not getting traction include a sense that we are circling the same material without movement, an absence of changes in your life outside of session, or an increased sense of dysregulation that is not stabilizing. When I see these signs, I name them. We adjust. We figure out whether we are working on the right target, whether we need more preparation, whether something else is the right next step. Part of doing this work well is being willing to say when something is not working.

How my training shapes the way I work

I want to be honest about credentials, because I think the way they are talked about in therapy marketing is often misleading.

I am a licensed mental health counselor. That is the license under which I practice, and it is the same license held by many of the excellent clinicians doing EMDR and other deep work in Massachusetts and Washington. The license is what authorizes the clinical work.

What I bring in addition to the license is a particular kind of training. My PhD is in counselor education and supervision, which is a discipline focused on how clinicians develop, how cases are conceptualized, how supervision works, and how clinical thinking is taught. It is not a clinical license. It is an academic and pedagogical training that shapes how I think. It informs the way I approach case conceptualization, the questions I ask about when to use a particular intervention, and how I integrate EMDR with the rest of the work. It is also why I supervise other clinicians and teach in a CACREP-accredited counseling program.

I name this because I think clients deserve a clear answer to "what does that PhD mean for my therapy." The honest answer: it shapes how I think, not whether I am qualified. The qualification is the LMHC license. The way I think is what you experience in the room, and that is something you should evaluate by talking with me, not by counting letters after my name.

Practical details: telehealth, location, and how to start

I work via telehealth with adults located in Massachusetts and Washington. EMDR can be conducted effectively via telehealth, and current research supports this. There are some clinical considerations that we work through together, including how we structure sessions, what bilateral stimulation methods we use, and how we manage the boundaries of the work given that we are not in the same room. None of these are barriers. They are just clinical decisions to make together.

I am a private pay practice. I do not file directly with insurance, though many of my clients submit superbills to their insurance for partial reimbursement.

If you are considering EMDR and you want to talk about whether it might be the right fit for you, I offer a free fifteen-minute consultation. The purpose of that call is for me to hear what brings you to therapy and for both of us to get a sense of whether working together makes sense. There is no pressure to move forward.

Is this you?

You are an adult, probably in your thirties or forties, who has done significant work on yourself already. You can articulate your patterns. You have read the books. You have probably been in therapy before, possibly more than once. And you have arrived at the sense that there is something that talk therapy alone has not reached, something that lives below the level of language and explanation, that is still shaping how you live.

If that is the work you are ready to do, EMDR may be part of the answer.

Related reading:

• What Family-of-Origin Work Actually Looks Like in Your 30s and 40s (forthcoming)

• How to Submit a Superbill for Out-of-Network Therapy Reimbursement