What is EMDR therapy?

Eye Movement Desensitization and Reprocessing Therapy (EMDR) is one of the world's most effective forms of psychotherapy.

It has been used by psychologists, psychiatrists, counselors, and social workers for many years to help people overcome trauma, recover from illness, and improve their overall quality of life.

EMDR therapy uses rapid eye movements while a therapist guides you through your memories and experiences. It breaks down the memory into "chunks" that you can process separately. This allows you to learn new ways of dealing with your past experiences.

Research shows that Eye Movement Desensitization and Reprocessing Therapy is an effective treatment for post-traumatic stress disorder (PTSD), and it's recommended conditionally by the American Psychological Association. It involves “watching” disturbing or traumatic past images while engaging in some bilateral movement. Traditionally, this was done by rapidly moving the eyes from left to right. However, there have been many new innovations, including bilateral tapping and other forms of bilateral movements. This helps you become desensitized to the images, which can help make it easier to manage your PTSD symptoms.

EMDR History

Francine Shapiro, a California Psychologist, developed eye movement desensitization and reprocessing therapy (EMDR) when she strolled in Central Park in 1987. She was preoccupied with troubling thoughts and noticed that her eye movements reduced negative emotions associated with her distressing memories (1). She discovered that her anxiety subsided after she moved her eyes around while watching her surroundings. Incredulous, Shapiro experimented with different versions of the procedure with her clients, and they also felt better. That was how EMDR was born. It’s important to note that indigenous cultures worldwide have used bilateral movements to process and express themselves. This was the first time modern-day culture found this immutable truth about movement and trauma.

The theory behind EMDR is that the brain has two separate processing systems: an observed response system and a mental set system. The former deals with what happens in the present moment, like how you feel or think about an event. The latter would deal with how you remember past events—for example, if someone mentioned something that reminded them of an event from their childhood.

What Is the Goal of EMDR?

The goal of EMDR treatment is to help clients integrate the trauma about what happened during a traumatic event so they can let go of the associated emotions and move on with their lives. By enhancing the individual's ability to replace negative emotions with positive ones, by strengthening their positive beliefs, they can overcome the symptoms and can begin move forward. (2) This process works by helping patients recall what happened during a specific incident while simultaneously focusing on images and ideas related to the traumatic memory.

An EMDR therapist will usually start by preparing you to revisit your trauma and do what is called creating a container. The container helps when one becomes distressed and needs to be grounded and stabilized, as being present is vital to any successful EMDR session. Next, your therapist will ask about your symptoms, such as flashbacks, nightmares, or general distress. They'll also ask you questions about how things were before the event happened—for example, did you feel safe at home? If so, what was your life like?

Once it’s been established that you are ready to begin EMDR treatment, you will start the process. You may be invited to close your eyes and relax briefly before being instructed to recall what happened through imagery. During the process, you will be checked in on regularly and observed by the therapist to see how you are handling this exposure to the trauma. Often, a rating scale is used between 1-10, with ten being the most distressed. Typically, the therapist would not want your level of distress to go over 6 or 7. If your level of distress goes by doing this, or if you start dissociating, you will be brought back to your container and supported to ground and restabilize. Once you can hold more of the traumatic memory while maintaining a level of presence and tolerate revisiting the trauma, you will contribute with the bilateral stimulation to process and integrate the memory.

Once ready, the therapist will ask you to repeat the steps of remembering the trauma while engaging in bilateral stimulation quickly back and over some time (sets can last anywhere from 10 seconds to 3-5 minutes). Each time you do a group, there is often some relief felt. However, as with many kinds of therapy, emotions can become more intense as they peak in distress before they begin to lessen in intensity.

The Eight Phases of EMDR

EMDR Therapy has eight phases to help the therapist and the client achieve their goal. These phases are briefly described in History Taking, Client Preparation, Assessment, Desensitization, Installation, Body Scan, Closure, and Reevaluation of Treatment Effect (3).

History Taking

Phase 1:  The Client's History and treatment plan are the first phases of EMDR. The therapist can use this information to determine the client's readiness for treatment and any secondary gains necessary to address the current problem. Next, the therapist will choose the most appropriate target for therapy by analyzing dysfunctional behavior, symptoms, and other characteristics.

Client Preparation

Phase 2: The Preparation Phase is where the therapist explains the EMDR therapy process, its terms, and expectations of EMDR therapy. In this phase, the client and the therapist establish a safe therapeutic alliance as the client's questions and concerns are addressed. In addition, they both work together to develop specific strategies to deal with any emotional disturbance.

Assessment

Phase 3:  The third phase is Assessment, where the client and therapist identify the event that needs to be processed (also called the Target event or target memory), along with images, beliefs, and feelings. The patient will be asked to identify the most striking image associated with the memory.

The following 3 phases are also known as the “reprocessing” phases.

Desensitization

Phase 4:  In the Desensitization phase, the client is asked to simultaneously manage both the target image and the side-to-side eye movements (or other bilateral movements) and is instructed to be receptive to whatever arises. Side-to-side eye movements or bilateral tapping are performed while focusing on a traumatic event.

Installation

Phase 5: Once desensitization has been completed, Installation starts. In this phase, the therapist aims to increase the strength of positive cognition. This is where the client strengthens a positive belief in the target event until it feels entirely genuine.

Body Scan

Phase 6: During the Body Scan, the client is asked to get the body scanned while thinking about the target event and the positive belief and see if any lingering disturbance or tension would need further reprocessing.

The final two phases of EMDR ensure safety for the client at the end of a current session and the beginning of the next session.

Closure

Phase 7:  Closure is the seventh phase in which self-control techniques are used when reprocessing is incomplete. The client is asked to return to a calm state, bringing them into equilibrium. Reprocessing is complete when the client feels neutral about the target event, the body is clear from disturbance, and the positive belief feels entirely authentic. The client will then be asked to keep a log documenting anything that may arise for the week.

Reevaluation

Phase 8:  Reevaluation examines the progress made where a review is carried out to process events. These incidents prompt distress and identify future target trauma that needs to be processed.

EMDR Treatment benefits those who can maintain a presence, manage dissociative tendencies, and handle a certain level of heightened distress. In addition, it has been shown to reduce PTSD symptoms significantly. Overall, it can help improve your health, relationships with the people around you, your work, and more by changing your negative beliefs and associations with the trauma. This will help you unlock your true potential, visualize a more positive future and achieve inner peace.

We at the Phoenix Rising Centers have providers on our team who are EMDR trained and would be happy to help you process trauma. So if you are looking for this type of healing, please reach out to us and get started to regain (or have for the first time) a sense of meaning and purpose in your life.

References:

1. How Was EMDR Therapy Discovered? - Maiberger Institute. [online] maibergerinstitute.com. Available at: https://maibergerinstitute.com/how-was-emdr-therapy-discovered/ [Accessed 1 Jan. 1970].

2. Eye Movement Desensitization And Reprocessing (EMDR) - Therapedia. [online] theravive.com. Available at: https://www.theravive.com/therapedia/eye-movement-desensitization-and-reprocessing-(emdr) [Accessed 1 Jan. 1970].

3. The Eight Phases of EMDR Therapy - EMDR International Association. [online] emdria.org. Available at: https://www.emdria.org/public-resources/the-eight-phases-of-emdr-therapy/ [Accessed 1 Jan. 1970].