Disclaimer
This blog post includes an outline and an imaginary example of what EMDR sessions will look like, and is intended to be used for educational purposes only. Please do not try this independently without a professional present.
EMDR is a type of psychotherapy treatment that stands for Eye Movement Desensitization and Reprocessing. This modality of treatment is commonly used for individuals who have experienced trauma(s) that affects their quality of life and how they perceive themselves and the world around them. EMDR is also not strictly for someone who has PTSD, because it is also effective for diagnoses such as depression and anxiety.
History of EMDR
EMDR was created by a psychologist named Francine Shapiro. The development of EMDR started in 1987 when Shapiro was taking a walk and she noticed a decrease in distress levels when she moved her eyes back and forth. This method was originally called Eye Movement Desensitization (EMD). She began conducting case studies to test the effectiveness of the eye movements, which led to profound results.
The name soon transitioned to Eye Movement Desensitization and Reprocessing (EMDR) when Shapiro discovered the Adaptive Information Processing (AIP) Model. The AIP Model describes the cognitive aspect of how EMDR is able to find these traumatic memories, because when we go through a trauma, it is stuck in the brain in a maladaptive form. Our negative thoughts, beliefs, and maladaptive behaviors are symptoms of the memory being stored improperly.
What to Expect in Session
We all want some form of predictability, especially when doing trauma work. Here is what you can expect to happen during sessions using the 8 phases of EMDR. **This outline is for educational purposes only. Please do not try this at home.
Phase 1: History Taking and Treatment Planning
You’ve made it! The first step in the EMDR process is similar to a traditional intake session, but with this session you will get to decide on a single topic you would like to focus on first. When choosing a topic for the first time, feel free to pick something that is less disturbing than a severe trauma. Your therapist will ask questions pertaining to what support you have outside of sessions, and your medical history.
During this phase, there is what’s called a Three- Pronged Approach, where you can expect to be asked questions regarding past experiences that serve as triggers for the topic you would like to work on, present triggers that are causing stress, and how you would like to manage a situation in the future.
Phase 2: Preparation
During this phase, you can expect to hear about the science of EMDR and what the procedure looks like. As mentioned earlier, when we experience a traumatic event, it gets stored improperly in the brain. In order to get this information “unstuck”, you will be engaging in what is called Bilateral Dual Attention Stimulation (BLDAS). Our brains already do this when we are in REM sleep, but for EMDR you will be awake and in control. If you choose not to do eye movements there is another procedure called Butterfly Taps. This looks similar to the way you would cross your arms when going down a slide at a water park. It looks like the image to the right.
You will also learn about effective coping skills to use, because it is important that we have a plan for what to do when we are feeling very distressed. Butterfly taps will be incorporated into those coping skills, because using both sides of our body activates both sides of our brain, which can also regulate our nervous system. This is why you may notice a decrease in anxiety levels when you go for a walk or tap your feet/hands back and forth to music!
Additionally, as with all other types of therapy, your therapist will ask for informed consent before you begin EMDR. Trauma work is a challenge, and you will notice some distress.
Phase 3: Assessment
During this phase, you will get to choose a target memory to work with. A target memory is an example of the presenting issue that you shared with your therapist during the history taking session. Then, you will get to choose a target image. An image is a piece of material that you will be prompted to focus on when processing a trauma. It can be a person, place, object, or anything that reminds you of an event, such as a physical sensation.
Here is an example:
Presenting Issue: “I have an anxiety attack whenever my wife yells at me.”
Target Memory: “Last Monday when I got home from work my wife yelled at me for forgetting to pick up groceries for dinner. I felt shaky and my heart rate went up.”
Target Image: “ I am envisioning myself standing at the same spot by the counter facing my wife as she yells at me, and my body is shaking”.
Once you identify a target image, your therapist will ask you what negative belief you have about yourself as you think of that image, as well as what you would like to think about yourself. It is very important that you pick a negative belief that you feel is accurate. Your therapist can help you pick one based on what you may have said about yourself already during the history taking session.
Here is an example:
Negative Belief: “I am not good enough”
Positive Belief: “I am okay just the way I am”
Once you have picked a negative and positive belief, you will then be asked to rate from a scale of 1-7 (1=completely false, 7= completely true) how true you feel the positive belief to be. This would be known as a Validity of Cognition (VOC). You will also be asked to rate from 0-10 (0=No distress, 10= Highest distress) how distressing the image is to you. This would be known as a Subjective Unit of Disturbance (SUD). Then, you will be asked about emotions and physical sensations as you think of the image.
Here is an example:
VOC: “3”
SUD: “8”
Emotions: Anxiety, fear
Physical Sensations: Body shaking, fast heart rate
Phase 4: Desensitization
Okay, now we are officially at the part where we are getting into the hard stuff. Based on your preference, you get to choose if you would like to do eye movements or another form of Bilateral Stimulation. If you choose to do butterfly taps you can close your eyes. The therapist will check in with you about the speed of eye movements/butterfly taps. The BLDAS will be at a faster pace, but please let your therapist know if the speed is too fast and/or you notice any discomfort. Once you complete a set of eye movements/tapping, your therapist will ask you, “What do you notice?” After every set you get the opportunity to share what new things are coming up for you. They can be thoughts, physical sensations, or anything that you notice that is different. You will be prompted to, “Go with that”. Once your SUD goes down to 0 or as low as it can get, phase 5 will begin.
Phase 5: Installation
Once the SUD is heavily decreased, the next step is focusing on increasing the VOC. You will also have the opportunity to change your positive belief. Your therapist will ask if “Insert positive belief” is still a good fit for you. It is normal to want to change it, because during processing you may notice that something else fits better. You and your therapist will resume fast BLDAS to strengthen your positive belief.
Phase 6: Body Scan
Once the positive belief has been installed, you will be prompted to do a head to toe body scan. Let your therapist know if you still have any physical sensations that need to be taken care of. If you notice anything, another set of fast BLDAS will take place until the sensation is no longer present.
Phase 7: Future Template/Closure
Phase 7 is called closure, but you can expect to do what’s called a Future Template with your therapist before the session ends. Future Template is when you imagine coping with a situation effectively. Following the Future Template, your therapist will remind you to practice self-care and make a note of anything new that comes up before your next session.
Phase 8: Reevaluation
During your next session, you will have the opportunity to share how you have been feeling and if anything new happened after your previous session.
If you're interested in learning more about EMDR and how it can support your healing journey, contact Therapeutic Counseling today. Our team is here to help you take the next step toward healing and resilience. Schedule a consultation to see if EMDR is right for you!
Source:
History of EMDR. EMDR Institute - EYE MOVEMENT DESENSITIZATION AND REPROCESSING THERAPY. (2024, January 3). https://www.emdr.com/history-of-emdr/
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