A Deeper Look into EMDR

EMDR (Eye Movement Desensitization and Reprocessing) was initially created by Francine Shapiro to help individuals process traumatic memories. Over the years, it has grown to be a modality that can help people with a variety of struggles, such as anxiety, phobias, attachment or relational wounds, and more.

If you would like a more general overview of EMDR and answers to some frequently asked questions before digging into its mechanics, I encourage you to read our other recent blog post.

The 8-Phase Approach

EMDR is a structured framework developed for safety and success. It's important to note that the phases aren't rigid or timed in any way. It is common for clients to move forward and backward through the phases. Sometimes clients will add memories to their treatment plan or need additional preparation or coping skills at times. Clients spend the bulk of their time in phases 3 through 6.

Phase 1: History-Taking and Treatment Planning

A couple of sessions are dedicated to building a relationship of trust with your clinician. If they are a new-to-you therapist, they will take a comprehensive history and discuss your goals. After that initial intake, the two of you will collaborate on an EMDR treatment plan where the client identifies the specific target memories they want to address.

Phase 2: Preparation

This is where you and your therapist discuss your current coping skills and habits, and the two of you work together to determine any additional tools you'll need. They might teach you new coping skills and relaxation techniques for managing emotional distress both inside and outside of your therapy sessions. Phase 2 skills are essential to practice to help establish a sense of safety and control. They can help you feel more grounded and prepared before processing begins.

Phases 3-6: Processing the Target Memories

Again, this is where clients spend most of their time when engaging in EMDR. This is where the identified memories from Phase 1 are reprocessed.

• Phase 3: Assessment: You and your therapist will select a specific memory from your treatment plan. You will identify different aspects you notice about your experience, specifically identifying the negative belief associated with it (e.g., "I am worthless"), and a desired positive belief ("I have many worthwhile traits" or "I am worthy of love and acceptance").

• Phase 4: Desensitization: You begin bilateral stimulation. While you hold the memory and everything it brought up (the negative belief, feelings, etc.) in your mind, you engage in bilateral stimulation for a time. The sets of bilateral stimulation continue until the memory no longer feels distressing.

• Phase 5: Installation: During this phase, you'll focus on strengthening the positive belief while simultaneously doing the bilateral stimulation. The goal is to make that positive belief feel genuinely true. Meaning you don't just think it's an okay thought, but you feel it to be true in your body.

• Phase 6: Body Scan: You'll bring the original memory to mind and then scan your body from head to toe. The goal is to notice any lingering physical tension or sensation from the memory. If anything is found, you target the sensation with more sets of bilateral stimulation until the body feels clear.

Phase 7: Closure

Each session needs to end in a stable place. Your therapist will guide you back to a state of calm using the techniques you agreed upon in Phase 2.

Phase 8: Re-evaluation

At the beginning of each new session, your therapist will check in with you about the previous week and the targeted memory. Typically, they will inquire about any changes in symptoms or behaviors, new insights, or dreams.

As is true with other modalities, starting EMDR is a brave step. It requires courage to face past difficulties, and the structured nature of the therapy is meant to help make the process as safe and efficient as possible. The goal is not to erase your memories, but to remove their distressing power.

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If you're interested in setting up a consultation to learn more about EMDR therapy, please reach out to jacquie@milescounseling.com.

References

Shapiro, F. (2018). Eye movement desensitization and reprocessing (EMDR) therapy: Basic principles, protocols, and procedures (3rd ed.). The Guilford Press.