EMDR, or Eye Movement Desensitisation and Reprocessing, is a type of therapy that is effective in helping people process traumatic and negative experiences. Whilst each client’s experience of EMDR will be different, EMDR therapy involves specific techniques and phases. A client at any given point in their therapy should be able to say which phase of EMDR therapy they are in.
Having an overview of the 8 phases of EMDR can help you understand the treatment process, gain clarity on your own EMDR journey and help you to feel more confident and prepared for your sessions.
So here they are:
An EMDR therapist will ask the client about their past experiences and current symptoms. This helps the therapist understand their clients difficulties, and to tailor the EMDR treatment to the issue that’s keeping them stuck. The aim of the history taking phase is to understand how the events of a clients life have contributed to the problems in the here and now. A timeline of difficult experiences will be created. At the end of this phase it is useful to have an idea of the key areas to focus on. A case conceptualisation is formed identifying problem in the present moment, goals for the future and the relationship of both to past key moments.
The therapist will help their client to develop coping strategies to use during the treatment. The aim of this stage is that it helps clients to feel prepared and in control of the treatment process. This is done by teaching self regulation skills. Clients are taught how to bring themselves back to a window of tolerance when triggered. Most clients find this stage soothing as is helps create lots of internal resources and involves imagery exercises. Some exercises may include safe space, resource installation and breathing exercises. Some clients find that this stage alone can be extremely powerful and it is essentially the start or at least a glimpse of the ‘internal work’ process. Moving forward on to the next stage only happens when the client feels resourced up from this stage. Feeling prepared and stable enough to do the trauma work is the overall aim of the preparation phase.
The case conceptualisation from phase one, is used as a basis to understand what to focus on in this phase. An agreement is made about what, from the past, is having a negative impact on the present moment. In this way target memories are assessed in this phase. Some clients find it surprising at this phase that only certain memories need to be worked on, rather than spending time on each and every single incident. The assessment will bring the trauma memory into the working memory loop. This happens as the therapist guides the client through questions about the image and the resulting cognitions, emotions, sensations and level of disturbance it creates.
During this stage, the therapist guides the client through the process of recalling their target memories while simultaneously engaging in a bilateral stimulation activity, such as eye movements or tapping. The therapist will not intervene much, but will guide the client initially by pausing every so often and asking them what they are noticing. This helps the individual process the memory and reduce its intensity. The job of the client is to notice what comes up for them. In this way they keep one foot in the present and one foot in the past as they watch the scene in their mind and notice the experience in their body. This is the core of the EMDR treatment and can be a powerful tool for resolving traumatic memories. The client does not need to give a lot of detail about what they are experiencing which is different to other talking therapies.
Warning: Now before anyone thinks it’s as simple as waving a finger around or moving your eyes from left to right whilst thinking about a painful past memory, please know that this stage requires skill, clinical judgement and reasoning to determine how to process the memories; where to start and stop and where, when and how to intervene.
This is where your therapists EMDR training will come in as essential to help you through this process. The desensitisation stage can vary enormously in terms of the time taken and will depend on the clients presentation, difficulties, target memories and goals.
The next phase focuses on reinforcing positive beliefs and coping strategies to replace the negative emotions and beliefs associated with the traumatic memory. This stage can help the client develop a healthier and objective perspective of previous traumatic experiences. It can change the experience of the previously held pain.
6) Body Scan
In this phase, the therapist will ask the client to think about the original traumatic memory and to pay attention to any physical sensations that come up. This helps the individual become more aware of the connection between their emotions and physical sensations. It also helps both the client and therapist to understand if the original level of distress still exists or whether it has been lessened or completely neutralised. It is important for people to know about this stage because it can help them understand the connection between their emotions and their body. The aim is for there to be little to no impact when the memory is brought to mind. If a sensation is reported that is uncomfortable, further processing will take place until the discomfort subsides.
Attention is always paid to the closure of the session to help the client feel grounded and have coping strategies to use if they experience any distress after the session. The therapist will use their clinical judgement to decide how much time needs to be given to closure and how to complete the closure. The therapist will watch the clock closely to avoid closing the session at a difficult point and to allow enough time to check in with the client and help them with grounding and reflection on the exercise. Tasks to complete or work on between sessions may also be discussed to help the client feel grounded and safe.
This stage is important as it involves checking in with the individual’s progress to see how the client feels in comparison to before they started EMDR. It can also be used to decide if any more EMDR sessions might help. This helps the therapist track the individual’s progress and ensure that the treatment has been effective for them.
Overall, the goal of EMDR is to help people who are struggling with painful memories, emotions or patterns of behaviour, to target, process and resolve their traumatic memories. The aim is to reduce feelings like anxiety, stress and depression and to stop feeling stuck. Knowing the process will help you to feel more in control of your EMDR journey.
If you are interested in learning more about EMDR or seeking treatment, get in touch by contacting us via out online enquiry form today. Dr Kaur offers EMDR treatment in a variety of forms to suit your time commitments.