What to expect during EMDR Therapy
EMDR is an 8-phase treatment but for ease of explanation; the phases are consolidated into three phrases: Beginning, Middle and End. Each phase will be described as what you might expect during your course of treatment but keeping in mind that this is a guideline and may slightly differ depending based on individual needs of each client. All EMDR sessions are scheduled for the standard 55-minute sessions as many insurances do not cover extended sessions. Extended sessions for EMDR are available but will be considered an out-of-pocket expense.
1. Beginning phase of treatment: History Taking and Preparation
During this part of the EMDR therapy process, we will be working on:
- Building rapport
- Gathering historical data about presenting issue(s)
- Assessing for appropriateness and readiness to EMDR Therapy
- Learning about the EMDR therapeutic model and the rationale for EMDR Therapy
- Learning how trauma impacts the mind and body
- Identifying treatment goals and “targets” for reprocessing.
- The targets that we identify will be the cornerstone of what we will be working on in sessions. Targets are typically based from presenting issues, and historical data gathered -including specific traumatic events, intrusive thoughts or memories -which might be contributing to the presenting issues.
We will spend a great deal of time building a foundation of emotional and physical safety and stabilization during the preparation phase so that you are well-resourced and equipped to “ride the waves” of big emotions and sensations during the reprocessing phase of treatment.
Explore and increase body awareness
- Learn the the three levels of the nervous system and how trauma impacts the nervous system
- Learn guided relaxation practices such as progressive relaxation, body scan, light stream, calming breath
- Identify non-verbal communication
- Increase boundary development
- Identify and attend to distressing body sensations
Increase window of affect tolerance
- Explore and identify maladaptive beliefs, emotions, and triggers
- Build and strengthen positive internal and external resources
- Identify and strengthen access to existing positive experiences and resources
- Learn containment skills for setting aside distressing thoughts, emotions, and body sensations
- Pendulation awareness to distressful thoughts, feelings, and emotions to positive resources
Attend to relational wounds through co-regulation and relational repair practices
- Identify patterns of emotional expression throughout childhood and adolescence
- Identify relationship problems in adulthood that replay dynamics of childhood
- Observe and identify moment-to-moment verbal and non-verbal interactions in therapy sessions
Integrating disowned emotions and traumatic memories through Parts Therapy
- Identify and explore parts of self
- Differentiate from parts of self that are self-critical or self-harming
- Identify and explore maladaptive defenses
- Understanding emotional dysregulation as a part
- Connecting to adult self
Length of time spent in Phase 1
The amount of time and sessions needed to prepare for trauma processing will vary depending on the complexity and severity of presenting issues. Often times, clients who present with more complex or traumatic histories may need to spend a longer period of time in this phase before moving forward with to the middle phase of treatment. We will discuss this in greater details during your sessions. We will not move to the next phase until we both have assessed that you are ready.
2. Middle phase of treatment : Trauma Processing
Once it has been determined that you are sufficiently prepared and resourced, you will transition to the middle phase of treatment -reprocessing and desensitization of a target; and installation and integration of positive experiences/beliefs.
In short, in this phase we will turn toward the discomfort of the traumatic event, memory, or issue in a slow modulated manner by focusing on small, manageable amounts of discomfort and returning a resource as needed. This
Reprocessing and Desensitization of a Target
- We will begin the session(s) with the identified target that you agreed to work on.
- You will be asked to bring up an image that bests summarizes that target.
- You will then identify the negative thoughts, feelings, beliefs, and body sensations related to that image
- We will explore if there is a past or earlier event that is connected same thoughts, emotions or body sensations connected to that image.
- We will then begin the reprocessing and desensitization through the use of bilateral stimulation (BLS) for increments of 30-120 seconds.
- At the end of each set, we will pause the BLS and you will be asked to briefly share what you noticed during the BLS such as thoughts, images, emotions and body sensations.
- BLS will continue until the identified target has been fully reprocessed and desensitized and is no longer distressing.
- Often times due to time restraints in sessions, we may not be able to complete the full processing of the target so we will close the session through grounding and containment activities.
Installation and Integration
- Once the reprocessing and desensitization of the target is complete, we will work on installation and integrations of new thoughts, feelings, beliefs, and perceptions about self surrounding the target using guided imagery techniques and bilateral stimulation.
- In other words, this part of the therapy involves integrates the knowing part of the brain and the feeling part of together.
- We will also identify any potential “bumps in the road” to determine what may be needed to handle those obstacles.
- During the follow-up session, we will review progress made on the processing of the target.
Length of Trauma Processing
The length of trauma processing will vary depending on the complexity and severity of the presenting issues; how long it takes to reprocess and desensitize the target(s); and the successful integration of new beliefs and perceptions about the target(s).
3. End phase of treatment: Future planning
This phase of treatment is where we will review overall progress made with EMDR therapy and identify the next course of action. Typically it will include the re-assessment of symptoms and impact on current functioning, re-assess coping skills, and begin to plan for other future “bumps in the road” that may not have been addressed earlier.
If you are ready to start EMDR Therapy, you can request submit a request for a new client appointment.Get Started