If you are reading this, you are probably thinking about EMDR treatment but want to know more about how each of its steps works and how successful it is in general. You are at the right place if your therapist determines that EMDR treatment is a good fit for your mental health issues. (1)
This blog will guide you step-by-step through each of the eight distinct EMDR phases, describing what to expect from sessions throughout each step, how long they last, and what they include. But first, let us take a quick look at what EMDR is and what it can do for you before we delve deeper into the eight steps of EMDR.
What is EMDR
Eye Movement Desensitization and Reprocessing (EMDR) is a form of trauma-focused treatment that combines bilateral stimulation with processing upsetting and traumatic memories and false beliefs. It is a very effective method initially created to treat post-traumatic stress disorder. (2) EMDR attempts to connect memories of traumatic situations with adaptable, beneficial ideas and skills to minimize pain and trauma sensations when a person thinks about the incident.
Depression, anxiety, and other mental health conditions can all be helped with EMDR. EMDR for PTSD (3) is a widely accepted and most effective treatment. Furthermore, EMDR for sleep has been demonstrated to reduce stress and anxiety in trauma patients by improving their sleep habits. (4)
EMDR therapy changes how memory is stored in the brain, as opposed to other treatments concentrating on directly stimulating the emotional responses, sentiments, and reactions brought on by traumatic experiences. This should help to lessen and eventually eliminate the problematic symptoms.
How Long Does EMDR Therapy Take?
Although every person’s response to EMDR treatment is distinctive, a typical session lasts between 60 and 90 minutes. It might take three to twelve sessions to fully reprogram your brain and get to the root of a horrific experience. The number of sessions required will depend on the type of trauma and how badly you have been impacted. While most people only need three sessions, some may require as many as 12 sessions to reprocess all unpleasant memories associated with the traumatic incident entirely. (5)
Objectives of EMDR Therapy
EMDR treatment aims to properly comprehend the traumatic experiences that are the source of the problems and incorporate new experiences that are essential for overall health. A three-pronged strategy is used to completely treat a single EMDR trauma target, alleviating symptoms and addressing the clinical manifestations. Past memories, current disruption, and prospective acts make up the three parts. (6)
Although EMDR treatment could provide benefits more quickly than other types of therapy, therapy’s objective is not immediacy, and it is crucial to remember that every client has distinct needs. While it could take one client weeks to build enough trust, another might go swiftly through the therapy phases.
EMDR will eliminate negative feelings, thoughts, and bodily sensations. Negative thoughts, attitudes, and actions are frequently brought on by unresolved past trauma pulling you in the wrong direction. Your emotions, comprehension, and viewpoints should be left behind as a result of EMDR treatment for you to engage in activities and relationships that are constructive and healthy.
How is EMDR Therapy Performed?
The initial sessions will discuss what the patient wants to work on and strengthen the client’s ability to handle distress.
The client will be encouraged to concentrate on a particular incident when they are prepared for the following stages of EMDR treatment. The therapist will first motivate the client to discuss a negative picture, belief, emotion, and physical sensation connected to this occurrence, followed by a reasonable presumption that suggests the problem has been handled.
The foundation of EMDR treatment is processing, which comprises creating a learning environment that enables problematic events to be processed appropriately and retained in your brain. This implies that you will learn from experiences, store them in your brain together with the right emotions, and be capable of using them to your advantage later. (7)
The therapist will start making sequences of side-to-side eye movements, sounds, or touches as the client concentrates on the traumatic experience. After each set, the therapist will instruct the client to pay attention to their thoughts. Changes in vision or adaptations to their perceptions, emotions, or beliefs concerning the incident may occur. (8)
Phases of EMDR
You must complete the eight steps of EMDR treatment for the therapy to be successful. Although the stages are meant to be finished in the same sequence, it is typical to go back and forth between them in a circular pattern. Depending on the client’s capabilities, we can return to any step at any moment. (9)
Let us review each phase of EMDR:
Phase 1: History and Treatment Planning
This phase often lasts for one or two treatment sessions and may continue afterward, especially if new issues emerge. In the initial stage of EMDR therapy, the therapist gathers detailed information about the patient and creates a treatment strategy.
This stage will cover the specific issue that has led to the client’s enrollment in therapy and the associated habits and symptoms. Your therapist will get to know you and your background and may do the usual tests that they employ. You tell your experience, learn about your therapist’s approach, and establish the first steps of your treatment regimen during this session.
Your therapist will establish a strategy for you that outlines the precise goals for using EMDR, including the previous incident that gave rise to the issue, the troubling current circumstances, and the essential abilities or actions the client needs to acquire for his long-term wellbeing.
One of the unique aspects of EMDR is that the patient does not have to go into great detail about their troubling memories. As a result, while some people are at ease and even favor providing information, others prefer to offer more of an overview or generalized description. The therapist just needs that information to pinpoint the incident with EMDR.
Phase 2: Preparation
This phase will typically need 1-4 sessions for most individuals. More extended periods could be required for some people, particularly those with severely traumatic experiences or specific diseases.
The therapist will give you some particular skills during this time to help you quickly handle any potential emotional disturbances. You are now becoming more familiar with EMDR and determining whether or not you are prepared to go through the stages. You can usually go on to the next step if you can accomplish it.
Your therapist will assist you in imagining a safe environment while you are learning new grounding techniques, coping skills for anxiety, or strategies for changing your state of mind.
Developing a trusting connection between the client and the therapist is one of the main objectives of the preparation stage. While it is unnecessary for the person to go into extensive detail about their upsetting memories, if the EMDR client does not feel comfortable with their therapist, they may not adequately describe how they feel.
The therapist will discuss the concept behind EMDR, how it works, and what the patient may anticipate during and after therapy in the preparation phase. You will explore bilateral stimulation (10), eye movements, sounds, or touching sensations to help interpret a traumatic event and activate the brain’s Adaptive Information Processing (AIP) mechanism. (11) During this stage, your therapist may discuss resourcing and using the BLS to aid you in accessing other uplifting experiences, thoughts, and imagery before going on to the following EMDR phases. Lastly, the therapist will teach various relaxation methods to help them calm down when they experience emotional upheaval.
It is essential to think of the therapist in any kind of therapy as a facilitator who needs to hear about any pain, necessity, or frustration to reach the shared objective. EMDR treatment involves much more than eye movements, and the therapist must know when to use any necessary methods to continue the processing.
Phase 3: Assessment
During this phase, the therapist will instruct the client to access each objective in a regulated and consistent manner so that it can be processed successfully. Processing does not imply discussing it. The EMDR therapist determines which elements of the target need to be processed.
The first part is for the client to choose a particular image or mental representation that best portrays the recollection of the target event during phase one. The client should then select a phrase that indicates a negative self-belief related to the occurrence. Even if the client is cognitively aware that the assertion is incorrect, they must concentrate on it. These negative beliefs are merely thoughts of the still-present unsettling feelings.
Then client chooses a positive self-statement that he prefers to believe. This assertion should provide a feeling of internal security. When the predominant feeling is fear, such as after a natural disaster, the negative cognition might warn you that you are in danger, while the positive cognition says that you are safe. The dread linked with negative thoughts is unnecessary. It is stored in the neurological system, although the threat has passed. What is suitable at the moment should be reflected in positive cognition.
At this stage, the therapist will ask the client to use the 1-to-7 Validity of Cognition scale to assess how real a positive thought feels. On the VOC scale, 1 represents completely false, while 7 illustrates completely accurate. (12) During the Assessment Phase, the individual recognizes the unpleasant feelings and bodily symptoms he links with the objective. The client assesses the negative belief as well, but on a separate scale known as the Subjective Units of Disturbance (SUD). This scale measures the emotion in which 0 implies no disturbance and 10 indicates worst disruption. (13)
Phase 4: Desensitization
This stage focuses on the client’s upsetting feelings and sensations as indicated by the SUDs assessment. This phase addresses the person’s reactions, including flashbacks, thoughts, and connections that may emerge when the focused experience alters, and its unsettling components are addressed. (14) This phase allows you to find and resolve comparable events that may have happened and are related to the target. In this manner, clients might outperform their initial objectives and heal above expectations.
BLS is beneficial during this stage. As you process the disruption you are looking for, all of your senses get engaged. You will not speak with your therapist during this process; instead, you will check in briefly and then return to the procedure.
During desensitization, the therapist guides the person through a series of eye movements, voices, or tapping with suitable transitions in concentration until the SUD-scale level is zero or close to it. The different connections to the memory are followed, beginning with the main target. For example, a person may start with a traumatic occurrence and soon develop additional associations. The therapist will assist the client in accomplishing the aim.
When the target genuinely seems neutral and not disturbing, and the level of disruption is assessed as zero on the scale, we may move on to phase five.
Phase 5: Installation
The positive cognition that you selected with the BLS is installed in this stage, but first, we examine to see if it has altered at all. The Validity of Cognition (VOC) scale is then used to gauge the extent to which the subject holds positive cognition in high regard. At a level of 7, the objective is for the person to accept the reality of their positive self-statement fully.
The objective is to focus on and strengthen the client’s discovered sense of optimism to replace their initial negative belief. The person will develop and install positive cognition.
In the same way that EMDR cannot force someone to let go of acceptable negative sentiments, it also cannot force someone to think something positive is not suitable. Therefore, the validity of that positive belief will only increase to the relevant degree, such as a 5 or 6 on the VOC scale, if the individual is conscious that a particular skill must be acquired to be fully in charge of the situation.
Phase 6: Body Scan
The therapist will instruct the patient to recall the initial target event and check for any lingering tension in the body after the positive cognition has been improved and installed.
Unresolved thoughts cause a physical reaction. Many Independent memory tests have confirmed this conclusion that when a person experiences trauma, knowledge about the traumatic experience is kept in body memory rather than narrative memory and preserves the original event’s unpleasant physiological and emotional feelings (15)
However, once that information has been processed (done in EMDR), it may be transferred to narrative memory, where the bodily sensations and unpleasant emotions attached to it vanish.
The client should be able to recall the first target without feeling any physical strain after a successful EMDR session. Positive self-beliefs are essential, but you must have a more profound belief in them than just a logical one.
Phase 7: Closure
This phase refers to one last assessment after the session completes. Various techniques, including images, are employed to manage the unprocessed content.
In each session, closure ensures that the client feels better than they did at the beginning. If processing the traumatic target event cannot be completed in a single session, the therapist will collaborate with the client to apply various self-calming techniques to attain stability. For the client to feel in control outside the therapist’s office, they must feel in control throughout the EMDR session.
The client is also told what to expect during sessions, how to keep a diary to track these experiences, and what calming techniques they may use to help themselves when they are not receiving therapy. Fidget toys, anxiety bracelets, and several calming exercises, including meditation, are commonly recommended. (16)
Phase 8: Reevaluation
The reevaluation phase cycles backward as if it were the first step, even though it looks to be the last. Your EMDR therapist will do a check-in at the beginning of your subsequent session, which will include reassessing your level of disturbance in light of the objective from the initial session. This makes it easier to determine if your distress is still neutral and if your optimistic thoughts are still valid. The cycle would restart at step four if the previous EMDR session were unsuccessful.
Like any effective therapy, the Reevaluation Phase is essential to evaluating the treatment’s long-term effectiveness. Although EMDR can almost immediately bring clients comfort, it is necessary to complete all eight distinct phases of treatment.
The goals of EMDR treatment must be achieved before considering the client’s potential future skills, present unsettling circumstances, and problematic memories. Moreover, a qualified therapist who is familiar with each stage of the therapy can assist you in doing so.
The eight EMDR therapy phases provide a foundation for comprehending the therapeutic process. They serve as a guide for the EMDR therapist. The eight stages are named by what occurs in each phase, and each phase concentrates on a different component of treatment. Although not all eight stages may be utilized in a single EMDR treatment session, they all contribute to the therapy’s effectiveness.