What is EMDR and How Does it Work?

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When you have been through a difficult or traumatic life experience, it may have been suggested to you that you try EMDR— a new and promising form of treatment.  Although it has become more popular in recent years, many still struggle to understand what EMDR looks like, and perhaps even more importantly, how it works. 

Treatment with EMDR—Eye Movement Desensitization and Reprocessing— does look different than our classic idea of “talk therapy”. Although at first, it may appear to be at odds with so many traditional therapeutic practices, it is actually not so different from “experiential” and “exposure-based” approaches used in anxiety and trauma treatment. 

Many value EMDR for its ability to help provide quick and efficient relief from traumatic memories and experiences that have sometimes been haunting us for years. EMDR can be both a stand-alone treatment for specific traumatic experiences, or it may be worked into your overall therapy plan. 

The science of EMDR is built on the idea that intentional bilateral eye movements (or bilateral stimulation in general) used while processing a painful memory replicates the brain’s dream- state processing system (what happens when we dream and process the day’s events). By putting the brain into this state, triggering both hemispheres at once, we are in essence able to target “stuck” memories and move them through the processing system. 

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How EMDR Works: Step by Step

In EMDR, painful and troublesome memories are addressed using an eight-phase treatment approach.

1.History-taking and Treatment Planning

Like any other traditional therapy, the initial work of EMDR is to gather information related to your history, and the problematic symptoms you are experiencing. My role is to help to guide the discussion to identify the most pressing concerns and create a plan to address the target memories. 

Typically, at this point in our work together, you can expect to have a more in-depth introduction to the process of EMDR, and individualized conversation where we talk about what to expect from treatment. 

2. Preparation

In this second step, we will continue to build upon your understanding of what treatment looks like, and may practice with different aspects of the process in order for you to feel comfortable. In addition to teaching you which prompts to expect throughout the intervention, we’ll also talk about the methods of bilateral stimulation that will be used. 

Another important preparation for EMDR involves making sure that you are capable of handling distress and are armed with the knowledge of how to soothe yourself. We may review particular guided imagery, relaxation, or other stress-reduction techniques for you to use during or in-between sessions. 

3. Assessment

Moving into the next phase of EMDR, we will get more specific about the memory that is being targeted. In the first part of the session, we will describe and assess each of the memory components:

1.  The visual image that accompanies the memory

2.  The resulting negative belief about yourself

3.  Related emotions and body sensations

In addition, I will also have you identify a positive thought or belief that is in conflict with the traumatic memory. We will use this as a way to check-in and evaluate changes in thoughts and emotions, as we move away from the negative and closer to the positive. 

All throughout the process, you can expect me to be checking in with you, to make sure that we are moving at a good pace, and that you’re able to tolerate the emotions that may be brought up during the process. 

4. Desensitization

In this fourth phase, the actual intervention, I’ll have you focus on the different aspects of the memory identified in the third stage, while engaging in eye movements or other bilateral stimulation (tones or tapping). You will next be instructed to pay attention to whatever thought, feeling, image, memory or sensation arises in the moments following each set of stimulation. Using this information, I will determine our next focus. This progression continues numerous times throughout the session, pausing to check in whenever you may need to attend to any particular emotions arising, or work to recenter yourself. 

5. Installation & Phase 6. Body Scan

Similar to the previous step, phases five and six of treatment will repeat the process, working now through strengthening the preferred positive belief also identified in phase three, while additionally attending to your physical responses or any resulting somatic distress. Any distress reported is discussed and processed through the same steps until it is no longer present. 

7. Closure

Nearing the end of each session, I will make sure to check-in and work to contain any unfinished feeling, thought, or bodily sensation until the next scheduled session. This step is important so that what was stirred up and discussed in the session does not continue to haunt you throughout the week. 

8. Re-evaluation

As the next session begins, we will evaluate how well the process seems to be working for you so far and will work to identify targets for the current session. 


The process of EMDR therapy can feel intimidating at first, and you may be nervous about getting started. However, EMDR has helped countless people work through their traumatic memories and gain victory over the parts of their past that had once brought them only pain and suffering. If you have questions about EMDR or think that this might be the right treatment path for you, don’t hesitate to reach out to me today to schedule a free initial consultation!

 

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