What is EMDR?

Feb 29

If you have spent any amount of time with me, chances are you heard me talk about the wonders of EMDR therapy. But what is it actually?

EMDR stands for eye movement sensitization and reprocessing. It is a form of therapy that follows the AIP model. This model follows the belief that our system is typically able to process information and experiences, and return to its baseline.

However, when we go through experiences that overwhelm our nervous system (think, trauma) the experience gets stuck. Meaning, our brain and body continue to relieve the experience as if it is still currently happening.

For many, this manifests as symptoms of trauma or PTSD, anxiety, depression, poor self-esteem, and relationship issues. Following the AIP model, we work to understand how early negative experiences have gotten stuck in our system, impacting our current functioning.

EMDR is a three-pronged approach, meaning it targets the past, present, and future. This allows for comprehensive treatment, true healing, and sustained change.

Who is EMDR For?

Traditionally, EMDR has been utilized to treat trauma and PTSD, and is highly effective in doing so. EMDR has also been found to be helpful for people dealing with anxiety, depression, low self-esteem, eating disorders, OCD, chronic pain, relationship issues, and more.

The EMDR Treatment Process Has Eight Phases, Which Are:

Phase One: History Taking

This phase looks similar to history taking in other therapeutic approaches. Your therapist will ask you lots of questions about yourself and your life, symptoms you’re experiencing, and what your past was like. An EMDR therapist will be more sensitive to early experiences that may be impacting your current functioning.

Phase Two: Preparation

Phase two of EMDR is all about helping you build upon your self-awareness, improve coping skills and resources in order to be able to manage distress, and regulate your nervous system when it becomes dysregulated. You will learn about your strengths and areas for growth, as well as your default responses to stress. During the preparation phase, you will also work with your therapist to identify current symptoms and work backward to identify earlier experiences that have fed this negative belief system. These identified memories will become target memories for reprocessing. This phase is such an important component of EMDR, as it helps you to feel prepared and safe when accessing traumatic or overwhelming material in later phases.

Phase Three: Assessment

The assessment phase occurs just before reprocessing, and is meant to “light up” your limbic system, or get your system into the space of feeling and accessing the target memory. Your therapist will ask you specific questions about the target memory, such as the image that represents the worst part, the belief you have about yourself, what you would prefer to believe about yourself, how believable to positive cognition is, how distressing the memory feels to you, and where you feel it in your body. This moves you right into phase four.

Phase Four: Reprocessing

Phase four incorporates bilateral stimulation while accessing the target memory. As a client, your therapist will lead you through sets of bilateral stimulation (left-right eye movements, tapping, sounds, etc.) while thinking about the target memory. During this phase, the goal is to step out of the way and allow your brain to reprocess the memory in whatever way it needs to. Throughout this phase, emotions often get intense and you may feel some of the original thoughts, feelings, or physical sensations you had during the original experience. Over the session, the memory will likely shift in some way, with the ultimate goal for the memory to feel entirely neutral to you, with no sense of distress.

Phase Five: Installation

Once you are experiencing no distress or disturbance related to the target memory, your therapist will move you into the installation phase. During this phase, you will review the positive belief you identified during phase three and potentially update it to something that feels more fitting. Your therapist will continue to utilize bilateral stimulation while having you focus on the positive belief connected to the memory. The goal of this phase is for you to fully believe the positive belief about yourself while it is associated with the target memory.

Phase Six: Body Scan

The next phase is a body scan, where your therapist will encourage you to scan from head to toe and make note of any tension, tightness, or unusual sensation. If you notice anything, your therapist will work you through more sets of bilateral stimulation focused on the physical sensation. This phase helps to fully clear your system of disturbance related to the memory.

Phase Seven: Closure

Phase seven occurs at either once a memory is fully cleared, or when you need to end the session due to time constraints or other reasons. During this phase, your therapist may encourage you to practice a resource in session to help return to baseline. They will also let you know some symptoms you may experience after the session as your brain continues reprocessing.

Phase Eight: Reevaluation

Phase eight occurs during the following session, where your therapist will ask you questions about changes in symptoms, thoughts, or behaviors that you have experienced. Your therapist will also ask you about the target memory, checking in to see if it still holds any disturbance. This phase is a lot more discussion-based, and less structured than some of the other phases.

**A note on the phases of EMDR: The phases often occur one after the other, but you may move in and out of phases or back to an earlier phase at any time. For example, it is common to work through phases 3-8 on a few memories and then move into the preparation phase for a while before continuing to work on a more distressing memory. The phases simply represent a framework, rather than a rigid plan.

What Can You Expect From EMDR?

There is no right or wrong way to go through EMDR, as everyone’s system processes experiences uniquely. Some clients notice the memory changes completely, while others feel as though the memory becomes blurry or feels distant.

Here’s what you can expect from EMDR:

Decreased triggers
Fewer and weaker negative beliefs
Increased ability to manage distress
Improved quality of relationships
Better sleep

When Does EMDR End?

EMDR is a structured therapeutic approach that has a clear start and end. While the timeline varies from person to person, the end of EMDR comes when you have worked through all of your identified target memories as well as present triggers and have completed what is called a future template. The future template can be used throughout treatment, but is often utilized at the end in order to visualize you responding effectively in the future. The future template helps you to feel more confident in your ability to continue coping and responding to stressors in the way you want.

Do you feel like EMDR would be a good fit for you? If so, reach out today to get started!