EMDR: when knowing what to do is not enough
By Patricia Santos Durán · 8 octubre 2026
In my clinical practice I have worked for years from a solution-focused approach. I support people with very different difficulties, looking for their resources, their abilities and the small changes that can help them in the present. Adding EMDR to that way of working did not mean replacing it: it meant broadening the ways I can support people.
Knowing what to do does not always mean being able to do it emotionally.
That was the starting point of my approach to EMDR. I did not want to choose one technique over another, but to understand what each person needed when, despite understanding what was happening to them and having tools, they still felt stuck.
When understanding does not yet change what we feel
Solution-Focused Brief Therapy has taught me something I consider fundamental: we do not always need to understand our whole past to start building a different present. Identifying resources, developing skills and experiencing small changes can help us move forward.
Over time, however, I began to come across situations in which the person understood what was happening to them, had acquired tools and even knew what they needed to do to feel better, but something remained blocked at an emotional level.
Some phrases express that gap between knowing and feeling very well:
“I know that is over now.”
“Rationally, I know I have no reason to be afraid.”
“I know it is not my fault, but I still feel guilty.”
“I know what I should do, but when the moment comes I can't.”
These are examples of how that distress can be expressed, not patient testimonials. They do not mean the person is not trying, nor do they on their own indicate which treatment is needed. But they do invite us to listen to more than the rational explanation of the problem.
In therapy we can work on thoughts, behaviours, emotional regulation and coping strategies. Even so, some experiences seem to keep being triggered by present situations. A person can recognise their resources and still feel small or unable to cope when a particular trigger appears.
What EMDR is and the place it found in my practice
EMDR stands for Eye Movement Desensitisation and Reprocessing. It is a structured psychotherapeutic intervention that includes assessment, preparation and work on relevant memories; it may include bilateral stimulation, such as eye movements, within a process guided by a trained professional.
My interest arose from a clinical need: to have a different way of working with experiences that still carried a significant emotional charge. Not as a replacement for the models I already used, nor as an automatic answer to any difficulty.
Until then, in certain cases I could help the person build resources to cope with what was happening to them. With EMDR I found another way of addressing memories, triggers or anticipations that kept provoking intense responses, always after assessing whether that work was right for them.
It was like having a different key for a door that until then would not quite open. But no key fits every door.
From “I understand it” to “I feel it differently”
One of the things that has interested me most in my experience with EMDR is observing the gap that can exist between understanding something and feeling it differently. We can know that an experience belongs to the past and still react in the present as if part of us were still there.
The aim is not to remember for the sake of remembering, nor to talk endlessly about what happened. The work seeks to help process those experiences, taking into account the person's resources and what is present in their current life.
What happened is still what happened. The story does not change and memories are not erased. What can change is the distress associated with them, the meaning we give them and the way we respond. That change is not the same for everyone and cannot be promised in advance.
For me, this difference matters: it is not about demanding that someone stop feeling what they feel because they have already understood it. It is about supporting the process with the time, safety and tools it needs.
The present can also be a way in
It is not only past events that come up in therapy. We also find current situations that cause a lot of distress, and fears about what might happen in the future.
That is why, in the way I work, looking at the past does not mean losing sight of the present. Exploring what triggers an emotional response today can help us understand what to address and how. Future anticipations can also be part of the therapy plan, depending on the assessment.
This perspective fits my understanding of psychotherapy: looking at the person as a whole, respecting their pace and using the resources available without turning a technique into an explanation for everything.
EMDR and solution-focused therapy: integrating, not competing
My experience has led me not to approach the intervention as choosing a single model. For some people, a solution-focused approach brings about important changes. In other processes we also need to work on emotional regulation, relationships, behaviours or difficult experiences.
We can start by recovering resources, identifying strengths and building safety. If distress persists that calls for a different kind of intervention, we assess how to address it. EMDR can be one of those options, not necessarily the only one or the most suitable in every case.
I do not see this integration as a competition between models, but as a broadening of therapeutic possibilities. The question is not which technique should win, but what this particular person needs at this point in their process.
The key is not only the technique, but the person
EMDR is not about applying a protocol automatically. It requires assessment, preparation, resources and attention to the person's stability and safety. The pace and goals should be agreed within a trusting therapeutic relationship.
Today I see it as one more tool within an integrative approach. It can help me support people who have already done significant work on understanding and building resources, but need to explore other ways of working with their distress.
Sometimes a person does not need to know more, but to find a way of working with what they still feel.
That is one of the most valuable contributions EMDR has made to my practice: remembering that understanding and feeling do not always move at the same pace. Supporting that gap requires listening, assessment and respect. Not a promise of immediate change.
A note on the evidence
NICE guidelines recommend EMDR for adults with post-traumatic stress disorder or clinically important symptoms in certain circumstances after non-combat-related trauma. That recommendation does not mean that every emotional block is a trauma, nor that EMDR is the best option for every difficulty. This article shares a personal clinical perspective and does not replace an individual assessment.
