EMDR Therapy

EMDR can be done via telehealth sessions and from the comfort of your home or a space that feels safe and confidential to you. The therapy takes place in eight phases. Phases may take multiple sessions to complete or you may move through multiple phases in one EMDR Therapy session. Your therapist works hard to go at a pace that feels manageable and meaningful to you. 

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You and your therapist work together to determine your goals for therapy and determine the best place to start EMDR therapy work. Some clients prefer to start with their most upsetting past events and others like to start in places that will offer immediate relief to them, but that might be less upsetting overall. Both are great approaches and your therapist can meet with you to determine what is a great fit for you. 

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The Eight Phases of EMDR Therapy:

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1. History and Treatment Planning

 

History taking may take place once during EMDR therapy or it may be a place you return to multiple times with your therapist as you pick different issues to work on with EMDR. Although the therapist will look at past history in detail, an important distinction in EMDR therapy is that the client does not have to disclose all details about past events for EMDR therapy to be effective. For clients who are utilizing EMDR for upsetting and traumatizing past events, it can be a relief to know that they don't have to relive the event details in their entirety to benefit from treatment. The goal is for the therapist to have enough details to develop a treatment plan individualized to the client's needs.  

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2. Preparation

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Preparation can take place over 1-4 sessions for many clients. For clients with a difficult past history or with certain diagnosis this part of treatment may take longer. The goal is for the client to have resources that they can utilize inside and outside of sessions to regulate emotions that arise during EMDR therapy. This is also the time period where trust between therapist and client is established and you should begin to feel like you have a therapist who is on your team and ready to be a resource for your to help you work toward your goals. 

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3. Assessment

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During the assessment phase of EMDR, the client identifies that specific memory or moments they want to focus on with EMDR. The therapist asks a series of questions to help the client describe what they have chosen to focus on and record the level of upset that occurs prior utilizing EMDR. At the end of treatment the level of upset associated with the event should be greatly reduced. The therapist also has the client identify what negative belief about themself the memory holds. The client also identifies a positive belief they would like to hold instead when then remember the incident. 

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4. Desensitization

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During desensitization, the therapist utilizes bilateral stimulation (BLS) like tapping back and forth, moving your eyes back and forth rapidly, or bilateral sounds to move the client back through the memory in a way that feels controlled and ultimately helps the memory carry less emotional disturbance with it. The goal is to bring the emotional disturbance down to no disturbance or a barely noticeable amount. The therapist is there to support the client emotionally and ensure that the client is able to resolve any momentarily stuck moments. 

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5. Installation

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Once the emotional disturbance of the memory has come down completely or to a barely noticeable amount, the therapist "installs" the past event with a positive belief of the client's choosing. For example, where the client once held a memory of failing an important test and the negative belief "I am a failure" they may now carry the belief "I am capable" following installation in EMDR therapy. It can be a very powerful moment for the client to notice the rapid shift from a belief that was so harmful and negative to move toward something that can ultimately be helpful to them and their sense of self in the future. This is often a shift from what you know about yourself in your head (ex: I am capable) to actually experiencing that belief as true in your heart. 

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6. Body Scan

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The old saying "the body keeps the score" is true and during the Body Scan Phase of EMDR Therapy the client works to relieve any tension or unpleasant sensations the body continues to hold when they think back on the past memory they desensitized and reprocessed. The therapist will not consider the EMDR session successful until the client can bring up the original target without feeling any body tension or unusual sensations present in their body. 

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7. Closure

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Closure happens at the end of each EMDR session throughout the client's weeks or months of treatment. The goal is that the client feels good leaving session regardless of whether all the phases of EMDR therapy were accomplished or they left session in the middle of a treatment plan and EMDR work. Resources are utilized by the therapist to help the client transition back into daily life between sessions. Furthermore, EMDR is not a therapy that requires homework outside of sessions so the goal is to not continue to think about what is being worked on after sessions. Closure helps with this. 

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8. Re-Evaluation

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EMDR therapists complete re-evaluation at the beginning of each session. It can be brief or lead back into more EMDR work, but the goal is to evaluate the success of EMDR treatment. EMDR treatment has measurable results that can be monitored by the client and clinician. Both the therapist and client should have a good feel for successes occurring following a recent EMDR session by completing re-evaluation.

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