The 8-Phase Process of EMDR to Resolve Trauma
So you’ve finally decided to try EMDR! Maybe you’ve read that it can really help deal with trauma or patterns where you keep getting stuck, or heard firsthand from a friend who had amazing results to help them feel better. But what the heck is it actually and what can you expect when you start working with a therapist who uses EMDR?
EMDR stands for Eye Movement Desensitization and Reprocessing. As the name states, it does often mean that you’ll be moving your eyes back and forth to deal with past painful memories and negative beliefs. But there is actually an 8-phase protocol that makes up the entirety of EMDR treatment.
Many therapists adhere strictly to the protocol, seeing themselves as an “EMDR Therapist”, while others see EMDR as an additional tool in their toolbox, and they are more flexible in their approach. Some therapists like to do longer session to help you deal with traumatic memories, and others may just offer regular 50 minute sessions weekly. Maybe you have a talk therapist that you want to continue working with; EMDR can be a great temporary adjunct to help get you through traumas or issues you haven’t been able to talk your way through.
Phase 1: Client History and Treatment Planning
This is the intake, getting-to-know-you phase with your therapist. You’ll provide a history and collaboratively plan your work together, including determining if EMDR is right for you at this time. Your therapist will gather your symptoms and talk about what your goals are. You might be asked for the “newspaper headlines”, including both difficult and positive events. In this phase, your therapist is starting to think about what memories you both will “target” together once you start reprocessing (i.e. doing the eye movements). This typically will last 1-2 sessions.
Phase 2: Prepping & Resourcing
In Phase 2, your therapist will provide you with more information about EMDR so that you can understand what you’re walking into. Together, you’ll be working on ensuring there are enough resources (both within you and in your life) to handle the intensity that can arise around processing your trauma. Often a therapist will use a “calm place” visualization with you, and use tapping or eye movements to strengthen your ability to handle stress. Sometimes prepping may include breathing exercises, mindfulness, and other visualizations. Sometimes it may be simply talking and continuing to build trust with your therapist. The ability to manage stress if an important skill for all of us humans, so this is a very important phase. Sometimes clients move through phases 1 and 2 in a session or two, and other times it can take several weeks or months to be fully ready to move into reprocessing your memories.
Phases 3: Assessment (i.e. Setting up a Target memory)
In this phase, your therapist will ask you some questions about the target memory. These include what negative beliefs you have about yourself related to the memory (aka Negative Cognitions), as well as what you’d like to believe instead (Positive Cognition) and how true that feels on a scale of 1-7 (1 - completely false; 7 - completely true). It’s ok if you can’t imagine believing the positive belief just yet.
Your therapist will ask you what emotions you are feeling as well as any bodily sensations. He or she will ask you for your “SUDS” (Subjective Unit of Disturbance) related to the target memory, on a scale from 0-10 with 0 being no charge and 10 being the worst distress you can imagine. Once the setup of phase 3 is complete, it’s time to reprocess.
Phase 4: Desensitization
Phase 4 is the phase most people think of with EMDR, where your therapist will wave his or her fingers rapidly in front of you, telling you to follow back and forth with your eyes. This is called “bilateral stimulation” (BLS) and it doesn’t necessarily have to be eye movements. In fact, many therapists offer alternatives, like watching a light move back and forth along a bar, holding little vibrating paddles in each hand that alternate back and forth, or using audio tones/headphones.
You therapist will ask you to focus on the target that you set up in phase 3 and will start the BLS. Your job is just to let your mind and body process however it needs to and to be honest about what is coming up. In between sets of BLS, your therapist will ask you what you’re noticing and you’ll provide short reports about what’s coming up. These reports could include thoughts or emotions or physical sensations. Your therapist will continue to offer BLS sets until your SUDS is 0 or 1. There’s nothing that you need to force or say to appease your therapist. As the unfolds, your brain will be making new connections towards healing. Sometimes reprocessing a target can take a few minutes, and other times it can take several sessions. When a target is fully processed, it can feel very strange to clients, as they then try to pull up the original target image and find that it’s no longer particularly vivid or accessible.
Phase 5: Installation - Reinforcing the Positive
Once your distress level reaches a 0 or 1, your therapist will continue in a phase called “installation”, using BLS to strengthen the positive belief about yourself that you’re now aware of. She’ll pair that belief in relationship to the old memory or trauma to help strengthen your sense of well-being and reinforce the positive effects of phase 4.
Phase 6: Body Scan
Your therapist will ask you to check in with your body to see what is physically present. She’ll do more BLS if there is still some level of bodily distress until it decreases. Since trauma often is held in the body, this is as important as step 5, to ensure that the memory or trauma has been “cleared”.
Phase 7: Closure
Towards the end of a session (or if you need to stop for any reason), your therapist will stop and help you come back to the “now” and decompress if needed. You might do a grounding or relaxation exercise, talk about what to expect between sessions or be asked to monitor or journal about anything that comes up before you meet again.
Phase 8: Reevaluation
When you return to your next session, your therapist will check back in on the target you reprocessed to see if there is any residual disturbance or distress, and to determine if anything new has arisen that would be important to address. This is an important phase to ensure that you are continuing to get positive effects from your hard work!
It’s common to have some fear or uncertainty around what might happen when seeking out EMDR treatment, but it’s a systematic process that’s been well studied and refined over the last 32 years to help clients get rapid results and relief. And it’s ok if there are sessions where you just want to talk! There are many variations on this 8-phase protocol, so if you have questions about your therapist’s approach, don’t hesitate to ask about the work that is being done.
If you’re looking for a therapist in Santa Monica or the Westside of Los Angeles and are curious if EMDR might be able to help you, please click the button below to set up a free phone consultation.