Brittany Wilson Brittany Wilson

EMDR THERAPY

Written by Brianna Sanborn, LPC

Trauma and other distressing experiences come in all different shapes and sizes, and it’s not a one-size-fits-all process when it comes to emotional healing. Trauma can stem from one or more events like sexual assault or witnessing a terrible incident, or even a long period of repeated events, like being bullied or neglected. According to the American Psychological Association (2023), some long-term reactions to trauma include, but are not limited to, strong and unpredictable emotions, anxiety and panic attacks, flashbacks, strained relationships, and physical symptoms like an upset stomach, heart palpitations, or headaches. 

It can be difficult to process and cope with difficult life experiences, especially without being given the space, tools, and guidance in doing so. Although there are many methods in healing from the emotional and physical effects of trauma, Eye Movement Desensitization and Reprocessing (EMDR) therapy (Shapiro, 2001) has been shown to be an effective approach. EMDR therapy was originally founded in 1987 as a treatment for Posttraumatic Stress Disorder (PTSD) to effectively process memories associated with individuals’ experiences with trauma. It can also be useful for other mental health issues such as anxiety disorders, Obsessive Compulsive Disorder (OCD), addiction, eating disorders, and phobias. 

How it Works

According to The Journal of Neuroscience (2023), rapid eye movement (REM) sleep may provide conditions that allow for the processing and consolidation of emotional memories. In other words, when our eyes are naturally moving quickly from left-to-right while we are sleeping, our brains are able to process and store emotional memories. When one has experienced trauma or other distressing events, these emotional memories may not be stored adequately, which can result in Posttraumatic Stress (PTS) symptoms such as flashbacks, nightmares, or panic attacks. EMDR is designed to simulate the REM sleep process in therapy to help store memories in the brain properly.

Phases of EMDR Therapy

There are eight phases of EMDR that the therapist will follow with the client during treatment. Each phase may differ in how long it takes to get through and move onto the next. The duration of each phase also might vary among client to client. So, for one client, a given phase might take one session, while for others it might take a few. The phases of EMDR and brief explanations and examples of each phase is as follows:

  • Phase 1: Case Formulation

    • The first phase is called “case formulation” where the therapist will gather information on the client’s history and what brings the client into therapy for EMDR. This phase also includes learning and practicing grounding and calming techniques in preparation for EMDR. The therapist and client will develop a plan on what events will be focused on, and explore “negative” and “adaptive” beliefs associated with the difficult event(s) being processed.

  • Phase 2: Preparation 

    • The therapist will explain what will happen during EMDR sessions and what the client can expect throughout the process. A “stop signal” will be identified among the therapist and client in case reprocessing (phase 4) becomes too overwhelming.

  • Phase 3: Assessment

    • The client and therapist will review the plan made in phase one, including the event being processed and the associated negative and adaptive beliefs established in phase one. The client will rate the level of disturbance (on a scale of 1-10, with 10 being the most disturbing) when thinking about the event and the negative belief associated with it, and then will rate the level of trueness (on a scale of 1-7, with 7 being the most true) when thinking about the adaptive belief. The client will also explain what negative emotions are associated with the incident, and what sensations they are experiencing in their body. An example of what this might look like is as follows:

      • Problem: Getting bullied

      • Event: Bully pushed me to the ground

      • Negative belief: “People don’t like me”

      • Adaptive belief: “I am likable regardless of how some people treat me”

      • Negative emotion: Anxiety

      • Body Sensation/Location: Tightness in chest

  • Phase 4: Desensitization and Reprocessing

    • This is when the therapist will either use eye movements or body tapping to simulate REM sleep when thinking about or discussing the difficult event or negative thoughts and emotions associated with the event. The therapist will either use their fingers to dart back and forth for the client to follow with their eyes, or the client can use body tapping to get a similar effect. For body tapping, the client would cross their arms over their chest, tapping each shoulder or bicep back and forth rapidly. The therapist will ask the client to take breaks between the eye movements or body tapping to see how the process is unfolding for the client.

  • Phase 5: Installation

    • During the installation phase, the therapist will check in with the client regarding the adaptive belief, also known as the “positive” belief,  previously established. The therapist and client will continue eye movements or body tapping when thinking about the positive belief until the level of trueness increases for the client. 

  • Phase 6: Body Scan

    • The therapist will prompt the client to scan their body and report any sensations experienced. This may be repeated until the body feels more calm, if and as needed. 

  • Phase 7: Closure

    • The therapist will ask how the process went for the client, and may even visit some grounding and calming techniques to end the session with. It’s important to be aware that processing may continue after a processing session, and self-care and additional grounding methods can be a good protocol for the client to engage in after the session has ended.

  • Phase 8: Revaluation 

    • This phase occurs the next session, and aims to evaluate what happened for the client after the session, any triggers experienced, any new insights, responses, or attitudes regarding the event or negative/adaptive beliefs, and the level of disturbance since the last session. 

Benefits of EMDR

The goal of EMDR therapy is to decrease symptoms resulting from distressing life events, and to process the memories associated with the events so they can be stored in the brain properly. The process and benefits of EMDR will be different for everyone. During EMDR processing, some people might see images or memories, have different thoughts come up, experience body sensations, go through various emotions, etc., and the process may differ from person to person. EMDR can be a quicker treatment to one’s symptoms resulting from a traumatic event(s) compared to alternate types of therapy, like CBT, and doesn’t involve much work on the client’s part outside of sessions. It can also be a less distressing way to process trauma, as there is not as much focus on the actual event(s) as there is with other treatments. If you are interested in seeking EMDR as a treatment for you, please contact us and we will pair you with an EMDR trained therapist to explore your options. 


- Brianna Sanborn, LPC

References

American Psychological Association. (2023). Trauma. American Psychological Association. https://www.apa.org/topics/trauma 

Rho, Y.-A., Sherfey, J., & Vijayan, S. (2022). Emotional memory processing during REM sleep with implications for post-traumatic stress disorder. The Journal of Neuroscience, 43(3), 433–446. https://doi.org/10.1523/jneurosci.1020-22.2022 



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