EMDR Therapy

Eye Movement Desensitization and Reprocessing (EMDR) is a therapy approach that can effectively treat the emotional disturbance from past memories. EMDR is an alternative to traditional talk therapy that is more efficient, less time consuming, and effective. Below is an explanation of the 8 Phases of EMDR Therapy. 


Phase 1: History Taking 

Phase 1 is comprised of gathering information and developing an understanding of a client’s past trauma history, family life, current symptoms, ways of copings, and other information. This may take two or more sessions, depending on the client’s presenting concerns and mental health history. 


Phase 2: Preparation: 

In this phase, the clinician and client seek to understand a client’s Window of Tolerance and develop coping and somatic resources. The Window of Tolerance is the extent to which a client can handle emotional or physical disturbance such as emotional reminders or external disturbances. When someone is within their window of tolerance, they are able to be present in the emotional or physical pain. On the other hand, if someone is outside their window of tolerance then they are no longer present and experience a state of fight, flight, or freeze that leads to dissociation. During Phase 2, memories are also identified for re-processing and the client is becoming more comfortable with noticing body cues and being present. Phase 2 can take two or more sessions depending on the client’s window of tolerance and ability to manage emotional disturbances.


Phase 3: Assessment 

This phase occurs right before Phase 4 and involves identifying the specific aspects that make the memory disturbing. In this phase, the client identifies the worst part of the memory, the negative belief attached to the memory, what the client is feeling in his or her body, and then the client rates how disturbing the memory feels in the present before starting the next phase.

 

Phase 4: Desensitization 

This is the phase that many people associate with EMDR, and it is also called re-processing. In this phase, re-processing occurs by using a form of bilateral stimulation to keep the client present as they process the memory and its accompanying body sensations, emotions, and feelings. Bilateral stimulation keeps both sides of the brain engaged to promote healing of the whole person. Forms of bilateral stimulation used in therapy can include pulsers that vibrate back and forth in one’s hands or eye movements where a client is following an object back and forth to keep their eyes moving. Re-processing creates the opportunity to experience what the brain protected a person from feeling and experiencing at the time of the traumatic event. This phase is continued until the client no longer feels any disturbance from the memory, and can take one or more sessions for each memory. 


Phase 5: Installation 

Phase 5 involves strengthening a positive belief after a memory is no longer disturbing. Because negative beliefs associated with memories are part of what keep a memory disturbing in the present, the negative belief is replaced with a positive, reality-based belief in this phase.


Phase 6: Body Scan 

This phase provides the opportunity for the client to notice any body sensations that are present, whether disturbing or positive. During this phase, the sensations are experienced until any discomfort has subsided or positive feelings are strengthened.


Phase 7: Closure

Phase 7 is part of every re-processing session.  If a memory is still disturbing, this phase involves using a calming resource or technique so that the client feels safe and complete before leaving session. After a memory is no longer disturbing, this phase is the end of the session where the therapist reminds the client to record any disturbance outside of session and that processing may continue.


Phase 8: Reevaluation: 

Reevaluation occurs the session after each re-processing session and also may be for intermittent maintenance session. In this phase, the therapist checks in with the client to see if the previously desensitized memory is still disturbing and continues to Phase 3 if the client reports disturbance is still present. If the memory is no longer disturbing, the client may process other memories that are still disturbing or ending treatment may be indicated. Some clients prefer to have a follow-up appointment after a month or two to check in with the therapist. 


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