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EMDR (short for Eye Movement Desensitization Reprocessing) is an integrative therapeutic approach that was developed by Dr. Francine Shapiro. It integrates a unique blend of elements from Cognitive Behavioural Therapy (CBT), psychodynamic theory, mindfulness, and neuroscience, just to name a few.
Research studies show that EMDR can help people heal from disturbing experiences so that they no longer suffer from the symptoms that are related to those painful experiences. The World Health Organization and the American Psychiatric Association recognize EMDR as an effective form of trauma therapy – it is practiced by therapists all around the world!
Our bodies are wonderful natural healers. But when we’re wounded, our bodies sometimes need extra help (e.g. medicine, stitches, surgery) to get back to normal. The brain is no different! Our brains are naturally designed to help us heal and adapt in a healthy way. But when we experience a single or chronic trauma, our brains can become overwhelmed and stuck. Our bodies and minds re-experience the painful incident each time there’s a reminder. This can significantly impact our quality of life, but EMDR helps facilitate the brain’s natural ability to heal.
EMDR is a powerful way to help our brains become unstuck. It allows us to break free from painful experiences so that we can fully experience life and live in the present. EMDR uses eye movements or other bilateral stimulations, which activates the brain similarly to what happens during REM sleep – when we are in REM sleep, our eyes rapidly move back and forth as we dream and process the events of the day through symbols and images. These movements allow the brain to reorganize and make sense of your past experience in a healthy and helpful way. Rather than be preoccupied by the past or worried for the future, you can just be in the moment and fully participate in your life!
EMDR therapy isn’t just about eye movements and exploring traumatic experiences. It involves various phases that set the stage for effective trauma reprocessing. Many find the analogy of surgery helpful in understanding the beginning phases of EMDR.
Surgeons gather a comprehensive history of their patient and symptoms, and they also assess the patient’s ability to tolerate the surgery before proceeding with the procedure. EMDR therapists do the same so that the EMDR reprocessing goes smoothly and quickly, with minimal complications. This allows for optimal healing…which is one of the reasons for not jumping into EMDR reprocessing right away!
Phase 1: History Taking – Getting to Know Each Other and Creating a Road Map
In Phase 1, we focus on getting to know you, understanding your current struggles, and identifying your goals. We take this time to create a road map that shows where you have been, where you are now, and where you would like to be in the future. If appropriate, we identify both positive and negative memories from your history. For some clients, we may postpone the history-taking to focus on developing skills to help you cope with current difficulties.
Using the information we have gathered during this phase, a plan is co-created and specific memories are identified for EMDR reprocessing. Connections between past experiences and current difficulties are made to help you understand how EMDR will be used to help you reach your therapy goals.
Phase 2: Preparation – Getting Ready for EMDR
Phase 2 is dedicated to preparing you for EMDR reprocessing. The different types of bilateral stimulation (BLS) are introduced and grounding exercises are taught so that you can practice them during and between sessions. We may also spend some time building up your strengths so that you can tolerate the trauma reprocessing and not become overwhelmed by it.
All throughout the phases, we are getting to know each other and building a relationship. As it is important for you to feel comfortable with your therapist, there needs to be an open line of communication. If you are unsure about the therapy or the therapist at any point, you are strongly encouraged to let them know. Your therapist needs your help in understanding whether you are on the wrong track or whether the track seems unclear.
Phase 3: Assessment – Gearing Up for Reprocessing
Phase 3 involves identifying the memory for reprocessing and lighting up the memory network through a series of questions. These questions are asked to identify the worst part of the memory along with the associated image, beliefs, emotions, disturbance level, and body sensations. Following the assessment phase, you will immediately proceed to the fourth phase also known as the desensitization phase.
Phase 4: Desensitization – Reprocessing the Memory
Phase 4 is when the painful memory will be integrated into your memory network so that it no longer disturbs you! Your therapist will ensure that you are ready to reprocess and clarify any concerns or hesitations before moving forward.
During this phase, BLS of your choice is used to facilitate the reprocessing – you may choose to use eye movements, tapping, or auditory tones. The BLS is stopped periodically so that the therapist can check-in with you. Questions like, “What are you noticing now?” are asked throughout this phase to encourage mindful noticing and to ensure that things are progressing. At times, the therapist may help “jump start” the reprocessing by directing your focus of attention or by adjusting the length, speed, and type of BLS.
Phase 5: Installation – Enhancing Your Positive Self-Belief
Once the memory is no longer disturbing, you will move onto Phase 5 called the Installation Phase. The positive self-belief that was identified in Phase 3 will be enhanced. For example, if the belief “I am powerless” was associated with the memory and the preferred positive belief is “I now have choices”, that preferred positive belief is strengthened and integrated into the memory system with BLS.
Phase 6: Body Scan – Clearing Out Any Left Overs
Phase 6 involves the body scan. The purpose of this phase is to check and clear out any residual tensions, discomfort, or negative sensations related to the memory. You’ll be asked to think of the memory and the positive belief, and to mentally scan your entire body. Whatever sensations you notice will either be cleared (negative sensations) or enhanced (positive sensations) using BLS.
Phase 7: Closure – Ensuring Stability and Wrapping Things Up
If necessary, grounding/containment exercises are done to help you transition out of the session. We may talk about the session, address any questions, and prepare you for what may come up in between sessions.
Phase 8: Re-evaluation – Checking-In On Your Progress and Tying Up Loose Ends
At the next session, triggers or positive changes since the last reprocessing session are discussed. The target memory is assessed and you may proceed to reprocessing the same memory or move onto the next target memory.
These phases serve as a framework – it is totally normal to bounce back and forth between phases. The important thing to remember is that as a client, you can’t do EMDR wrong. Your job is just to notice and allow whatever’s coming up to come up. Just breathe and observe!