What to Expect with EMDR therapy
I wanted to outline some of the different phases or things that we will do in sessions if we decide to use EMDR in addressing your needs. The goal for EMDR therapy is to help you find adaptive ways of perceiving and thinking about memories or situations that have happened or are about to happen without the "punch in the gut" (or major triggering reactions).
You will likely still remember the negative experiences or feel negative emotions post EMDR therapy. However, the way you perceive yourself (resulting in negative cognition) is likely to change (to a more healthy/positive cognition) along with the intensity of your emotions and reactions.
It’s totally okay that you do not remember the details of those memories. I just need your interpretation of what has happened. There is no correct or incorrect way to do EMDR therapy, let me guide you in the process. The method is very robust, so you won’t “mess it up.”
We will take as much time as needed for you to feel ready. I also want to manage expectations; that I too may need more time to assess if we should use EMDR therapy to address your needs.
It may be challenging at first as we start, as you learn to trust yourself, me and the process. The phases of EMDR involve the following:
Phase 1 - History taking and planning your goals for EMDR.
Here, I collect information about what has happened and we start identifying themes of these key memories. We pick what you want to work on first as part of the plan. I will not need to know every detail of the trauma, situations, and/or memories but will ask for the impact which they have on you now.
Phase 2 - Preparation
This involves understanding your coping, tolerance, and adding to your coping resources, including "installing" a calm/safe place, or a nurturing figure). I will assess how you can stay here in the present while having a part of your brain go to the memory or situation. We may likely review the other tools and coping strategies we have discussed in the past.
Phases 1-2 can take many, multiple sessions and a longer period of time depending on the concerns, history and specific personal needs.
Phase 3 - Assessment
We pick a "target memory" and review the emotions, thoughts, bodily sensations with a distress rating scale that is linked to this memory or its representation of the cluster of memories with the same theme. All these are done by me asking you a series of 7 questions. This helps to link both hemispheres of your brain together to start processing.
Phase 4 - Desensitization
We pick the actual EMDR methods that you are comfortable with (eye moment, butterfly tap, sound/buzz, thigh tap, etc) and start with the “processing.” We let your brain process how it now may adapt to its thinking about that situation. During this phase, I may recommend that we meet more frequently.
We focus on your report of what you have noticed rather than criticizing or judging what you “saw” or “experience. It’ll be like you going on a train and witnessing the scenery outside of the window passing by. And you can stop the “train” anytime by giving me a hand signal.
Knowing how you feel and react to the memory or situation will be important, rather than relying on how you “think” about what could have happened or should be happening.
We may identify obstacles or hurdles in your processing. Your body will likely experience the emotions and sensations that may be related to how your brain is linking the situation/memory to these emotions and sensations. But instead of doing too much talking, we may likely stay on track with letting your brain process and do its work during this phase. Also know that you do not have to report all the details back to me for it to work. We are relying on your mind to do the work but I will be there to facilitate the process.
Phase 5 - Installation
We complete the processing with how you may be thinking and reacting about the situation/memory now after the last phase. And I will check your current cognition related to the memory or situation.
Phase 6 - Body scan
I will ask for your distress level and may ask you to put aside what we have done today into a “container.” You’ll be asked to do a body scan. This is to check your body's tension using the rating scale, and help it regain some calmness again. We may bring up your calm/safe place, nurturing figure installations again to restore some groundedness if needed.
Phase 7 - Closure
Here you will end the session. We do not always complete all phases for one target memory from 3-7 in one session. But we always will end with some body scan/check and closure.
Phase 8 - Re-evaluation
In the next session, we will debrief to check for any shift in new ways of behaving, thinking, dreams, triggers, and or symptoms which you have noticed.
Then we decide whether we can pick the next “target memory” and start the cycle from phase 3-7 again.