EMDR: What To Expect
You may have heard about EMDR. It’s the weird therapy where you watch a light go from right to left and/ or use tappers that buzz from one hand to another. It’s the therapy where your therapist doesn’t ask you to go into detail about your trauma. It’s the therapy that you notice people have a hard time explaining. While all of this may be true, EMDR is so much more.
So what actually is EMDR? EMDR (Eye Movement Desensitiation and Reprocessing) therapy is a structured approach that helps you process and heal from the emotional distress and symptoms associated with traumatic or disturbing life experiences. It is often used to treat Post Traumatic Stress Disorder (PTSD), anxiety, depression, and panic disorders.
There are eight phases of EMDR therapy, although you likely won’t notice being in any particular phase until stages 4-6 when you are actively reprocessing memories. The Eight Phases of EMDR Therapy are:
History and treatment planning: In the first phase, we’ll gather information about your history and help identify specific targets for EMDR processing, including past memories, present triggers, and future goals. We’ll also assess your coping mechanisms and current stressors to determine if EMDR is the right fit for you.
Preparation: We’ll discuss EMDR in more detail and I’ll teach you grounding techniques to manage any emotional distress that may arise during or between sessions. This last part is important- you will not go into any trauma reprocessing without feeling comfortable with specific grounding tools. This is to make sure that you feel prepared to think about intense (and often painful) memories.
Assessment: We’ll identify the target memory, along with a negative image, belief about yourself, emotions, and bodily sensations related to the event. You'll also identify a positive belief you'd like to associate with the memory.
Desensitization: This is the core of EMDR processing and what many people think of when they think about EMDR. You'll focus on the target memory and its associated negative aspects while engaging in bilateral stimulation (BLS) like eye movements, alternating sounds, or alternating taps. This helps reduce the emotional charge of the memory and allows new thoughts and insights to emerge.
Okay, but what actually happens during this stage? You’ll be asked to bring to mind the target memory while using bilateral stimulation (generally electronic tappers that alternate gentle buzzing from one hand to the other hand). You’ll be in this memory for about 30 seconds before you will be asked to pause and take a deep breath. I’ll then ask, “What are you noticing right now?” and you’ll provide a brief summary (almost like a headline) of what you just experienced. You’ll then be invited to continue with that memory and the tapping will resume. This pattern will continue until your level of distress decreases significantly. If at any point it feels like too much, we’ll pause and utilize a grounding technique.
Installation: Once your level of distress is as low as it can imaginably go, you'll focus on strengthening the positive belief you've chosen. This process will be similar to stage 4, although this time you will be focusing on the positive belief while using the bilateral stimulation (ie alternating tappers).
Body Scan: After the positive belief feels as true as it can imaginably feel, you'll mentally scan your body for any residual tension or uncomfortable physical sensations related to the trauma. These sensations are then targeted for further processing with bilateral stimulation (ie alternating tappers).
Closure: If processing is not complete in a session (which is very common), I will guide you through relaxation techniques to help you feel grounded and stable until the next session.
Reevaluation: At the start of each new session, we’ll assesses your current state, review progress on previously processed targets, and determine if further work is needed on those or new targets.
It’s completely normal to experience physical sensations during reprocessing such as crying, laughing, shaking, and/or sighing. This is a somatic response to revisiting incredibly stressful (and/or painful) memories. You’re in control of the process and can ask to stop or pause at any time.
After an EMDR session, many people report feeling a sense of lightness, feeling more tired than usual, and feeling less distressed. Your brain may continue processing between sessions and new insights, memories or feelings may emerge. You might experience some temporary discomfort or heightened emotions between sessions, especially if you haven’t fully processed a memory. It’s important to be kind to yourself during this process and make sure you’re hydrating well and getting proper sleep.
Ultimately, EMDR helps lessen the intensity of traumatic memories so it goes from feeling extremely distressing to a memory that you’re aware of yet not fully impacted by. The adage, “you have to feel it to heal it” applies here, yet we do this in a safe, gradual way where you have control at every stage.
