In EMDR therapy, the therapist helps you focus on past traumatic events or experiences following guided eye movements, sounds, taps, etc. This
therapy reprocess distressing memories and reduce their emotional impact. This article delves deep into what happens in EMDR therapy sessions, covering its phases and what you can expect.
What is EMDR Therapy?
EMDR therapy is a mental health treatment technique that employs sets of side-to-side eye movements, sounds, or taps to process traumatic memories. EMDR therapy is different from traditional talk therapy, which often involves extensive discussion of distressing issues. This therapy focuses on changes in images, feelings, or beliefs tied to regarding traumatic experiences. The sets of eye movements, sounds, or taps are repeated until that traumatic event becomes less disturbing. EMDR therapy also involves healing from trauma or distressing life experiences. It helps to process traumatic memories through bilateral stimulation and guided techniques during therapy sessions.
How Long Does EMDR Therapy Take?
An EMDR therapy session may last from 60-90 minutes. It could take one or many sessions to process the traumatic experience. EMDR therapy prime focuses on the complete processing of the traumatic experiences or events that are causing problems by replacing them with new ones required to acquire good health. The duration of complete EMDR treatment for traumatic events will depend upon the client’s history. EMDR treatment targets a three-pronged protocol to alleviate the symptoms and address the distress thoughts related to traumatic events.
The three prongs include past memories, present disturbances, and future actions.
EMDR therapy may produce results more rapidly than other forms of therapy. However, it may take time and proceed slowly because it solely focuses on the client’s needs. Each client is different from others and has different mental health issues. For example, one client may take weeks to establish sufficient feelings of trust (Phase 2). At the same time, another may proceed quickly through the first six phases of treatment and provide insight into something even more important that needs treatment.
Processing in EMDR Therapy
In EDMR, processing does not mean talking about traumatic experiences or events. Processing means setting up a learning state to help your brain digest and store those traumatic experiences that cause problems appropriately. You only store good emotions and things you learn from that experience or event. You can use this to guide your brain positively in the future.
It also helps to discard inappropriate emotions, beliefs, and body sensations. Negative emotions, feelings, and behaviours are caused by unresolved earlier experiences or events pushing you in the wrong direction. EMDR therapy can teach you to leave yourself with emotions, understanding, and perspectives so you can work with them and replace them with healthy and useful behaviours or interactions.
Eight Phases of EMDR Therapy Treatment
EMDR therapy has eight phases: initial history discovery and treatment planning, preparation, assessment, desensitisation, installation, body scan, closure, and reevaluation. These phases ensure that the therapy is systematic and effective in addressing the complex nature of trauma.
Each phase can help clients process their traumatic memories and achieve emotional healing.
Phase 1: History and Treatment Planning
This phase generally takes 1-2 sessions at the beginning of therapy. It may be continued throughout the therapy, especially if new problems are revealed. In the first phase of EMDR treatment, the therapist takes a detailed history of the client and develops a treatment plan. They discuss the client’s life relationships and possible targets for EMDR processing. The goal is to identify specific problems and symptoms that are causing those problems.
The therapist may ask you many questions about the specific problem that has brought him or her into therapy. The therapist uses this information to develop a treatment plan. They use EMDR for specific targets like:
- The events or experiences from the past that created the problem.
- Present situations cause distressing thoughts and behaviour.
- The key skills or behaviours the client needs to learn for his future well-being.
Many people feel uncomfortable to discuss any of his or her disturbing memories in detail. This can make it difficult for therapists to start EMDR therapy for the person seeking treatment. The therapist may understand their issues by the general picture or outline they provide. However, some individuals are comfortable with giving specifics. The therapist may ask, “What event do you remember that made you feel worthless and useless?” The person may answer, “It was something my brother did to me.”
Phase 2: Preparation
For most clients, this phase will take between 1-4 sessions. However, for those who have very traumatised backgrounds or with specific diagnoses, a longer time may be necessary. In this phase, the therapist will teach you some specific techniques so you can rapidly deal with any emotional disturbance that may arise. You can generally proceed to the next phase if you successfully do that.
One of the primary goals of the preparation phase is to establish trust between the client and the therapist. It is crucial because if the EMDR client does not trust his or her therapist, they do not have to provide great detail about his or her disturbing memories. He or she may not accurately report what is felt and what changes he or she is (or is not) experiencing during the eye movements. The therapy will not work if the client just wants to please the therapist and says they feel better.
The therapist will explain the theory of EMDR during the Preparation Phase. They describe how it is done and what the person can expect during and after treatment. The therapist will teach various relaxation techniques to the client to calm him or herself if any emotional disturbance arises during or after a session. If a person goes for any form of therapy, it is best to facilitate or guide the therapist. They must tell anything hurt, needs, or disappointments that help the therapist achieve the common goal.
EMDR therapy involves much more than eye movements, and the therapist needs to know when to employ any necessary procedures to keep the process going. Learning these tools can help anyone who has stress or disruptive thoughts. Remember, the happiest people on the planet have ways of relaxing themselves and unwinding from life’s inevitable and often unsuspected stress. One goal of EMDR therapy is to ensure the client can take care of himself or herself.
Phase 3: Assessment
In this phase, the client will be prompted to access each target in a controlled and standardised way to be effectively processed. And we describe above processing does not mean here talking about it. The EMDR therapist identifies which parts should be targeted to be processed. The client must select a specific image from the target event or experience (identified during Phase One) that best represents the memory. Then, he or she chooses a statement that expresses a negative self-belief associated with the event.
Even if the client knows the statement is false, he or she must focus on it. These negative self-beliefs are verbalisations of the disturbing emotions that still exist. Common negative self-beliefs include statements such as “I am bad,” “I am helpless,” “I am worthless,” “I am dirty,” “I am unlovable,” etc. The second step is for the client to pick a positive self-statement that he or she would rather believe. This statement will bring an internal sense of control, such as “I am a good or worthy or lovable or in control a good person” or “I can succeed.”
This will work when the primary emotion is fear, such as when a natural disaster occurs. The negative self-belief can be, “I am in danger,” and the positive self-belief can be, “I am safe now.” The fear is inappropriate, and this negative cognition of “I am in danger” is locked in the nervous system, but the danger is past. However, the positive self-belief should reflect what is good for them in the present. The therapist will then ask the person to rate how true a positive belief feels using the 1-to-7 Validity of Cognition (VOC) scale.
On this scale, “1” equals “completely false,” and “7” equals “completely true.” The person must give a score that reflects how the person “feels,” not” thinks.” We may logically “know” deep down something is wrong, but we are most driven by how it “feels.” The person also identifies the physical sensations (tightness in the stomach, cold hands) and negative emotions (fear, anger) he or she associates with the target during the Assessment Phase.
The client also rates the negative belief using another scale, the Subjective Units of Disturbance (SUD). This scale assesses the client’s feelings, rating the feeling from 0 (no disturbance) to 10 (worst). The main goal of this phase is to decrease the scores of disturbance SUD and increase the scores of positive belief VOC.
The reprocessing for a single trauma may be completed within three sessions. Do not worry if it takes longer; you should see some improvement within that time. Phases One through Three provide the firm structure for the comprehensive treatment and help reprocess the specific targeted events. Eye movements (or taps or tones) are used during all these three phases and are only one component of a complex therapy. As the eight phases of therapy proceed step-by-step, experienced, trained EMDR therapists maximise the treatment effects for the client in a logical and standardised manner. The client and the therapist can easily monitor the progress during every treatment session.
Phase 4: Desensitisation
This phase primarily focuses on the client’s disturbing emotions and sensations measured by the SUDs rating. In this phase, the person’s responses (including other memories, insights, and associations that may arise) are monitored because the targeted event changes and its disturbing elements are resolved. It allows the client to identify and resolve similar events associated with the target. This way, clients can excel in their initial goals and heal more quickly than expected.
During desensitisation, the therapist will continue to use sets of eye movements, sounds, or taps with appropriate shifts and changes of focus until his or her SUD-scale levels are reduced to zero (or 1 or 2 if this is more appropriate). They may start with the main target event or experience, and the different memories of that event may follow in the mind. A person may start with a traumatic event and soon move to other associations with it. The therapist will guide the client until the target event or experience is completely resolved.
Phase 5: Installation
In this phase, the therapist guides clients to concentrate on and increase the strength of the positive belief. This positive belief that the client identified earlier during the therapy replaces his or her original negative belief. The client might begin with a mental image of being beaten up by his or her father and a negative belief of “I am powerless.” During the Desensitization Phase, that client will reprocess the terror of that childhood event. He or she fully realises that as an adult, he now has strength and choices that were not when he or she was young.
The person’s positive cognition, “I am now in control,” will be strengthened and installed in this fifth phase of treatment. The positive cognition is then measured using the Validity of Cognition (VOC) scale to see how the person deeply believes that. The goal is to score 7 (completely true), which shows the person fully accepts the truth of his or her positive self-statement. Luckily, EMDR cannot only make anyone shed appropriate negative feelings, but also it cannot make the person believe anything positive that is not appropriate. So, if the person needs to learn some new skill, such as self-defence training, they are truly in control. This validity will give rise to the corresponding level of 5 or 6 on the VOC scale for that positive belief.
Phase 6: Body Scan
The therapist will ask the person to bring the target event or experience to mind after the positive self-belief has been strengthened and installed. They do this to see if any residual tension is noticed in the body after recalling that traumatic event or experience. If so, these physical sensations are the target event or experience for reprocessing. A study of thousands of EMDR sessions shows there is a physical response to distressed thoughts. This finding has been backed by independent studies of memory. It suggests that when a person is negatively affected by trauma, the traumatic event information is stored in body memory (motoric memory).
Unlike the narrative memory, it retains the original event’s negative emotions and physical sensations. When that information is processed, it can then move to narrative (or verbalisable) memory, so the v and body sensations associated with it will also disappear. This is why an EMDR session is not considered successful until the client can reveal the original target event or experience without feeling any stress in the body. Positive self-beliefs are important, but they have to be believed more than just at an intellectual level.
Phase 7: Closure
Closure is at the end of every treatment session. It ensures that the person leaves with a better feeling at the end of each session. If the processing of the traumatic target event or experience is not complete in a single session. The therapist will help the client learn various self-calming techniques to regain a sense of equilibrium. The client has been in control throughout the EMDR session.
The client is instructed to raise a hand in the “stop” gesture at any time. This will help the client feel in control outside the therapist’s office. At the end, he or she is also briefed on what to expect between sessions, what calming techniques could be used to self-soothe if the client faces life situations outside of the therapy session, and how to use a journal to record these experiences.
Phase 8: Reevaluation
The Reevaluation Phase is the opening of every new session. It helps the therapist to develop treatment plans for dealing with the client’s problems. This phase is vital to determine the success of EDMR therapy over time. Clients may feel relief immediately with EMDR. For effective EMDR therapy, it is essential to complete the eight phases of treatment, just like completing an entire course of treatment with antibiotics.
