What to know about EMDR…
Starting any type of therapy can be a bit nerve racking in the beginning, but sometimes deciding to do EMDR therapy can often add an additional layer of confusion and unease. I mean, let’s be real…no matter how many stories you hear or how much it is explained, EMDR is a bit of an abstract idea to grasp. It seems a bit mystical or too good to be true. So, I put together a list of things I wish my clients knew before starting EMDR.
Not all EMDR therapists are the same.
There are many different trainings on how to do EMDR and each of those trainers have their own tweak to the EMDR process that aligns with what they have experienced in their therapy room. Also, each therapist has their own perspective on how to best serve the client. For example, I have completed various advanced trainings in EMDR and each one has brought a new concept or intervention to the table to create an entire charcuterie of flavors for me to choose from for each individual’s needs. Therefore, your EMDR treatment plan will not be the same as others because each person is unique in both their experience and goals, and each therapist has their own personal style by which they serve their clients.
EMDR is 8 phases…not 1.
I have often been asked, “When will we get to EMDR?” I legit had one client stare at my lightbar every time they came into the room to see if it was plugged in and ready for session because they were wondering when we would do EMDR. There are 8 phases to EMDR, and how we go through each phase is unique to the client’s targets for treatment and their current circumstances. Truth be told, we are doing EMDR from the moment you walk into the counseling room.
Phase 1 is history taking, which is often completed during intake, but may take a few sessions if the client’s story has many layers. Phase 2 is preparation, which includes distress tolerance and resources to stabilize the client in the present day to day. If a client has a lot of present day triggers or an unstable living situation, this phase will be longer to ensure a client has the tools and stability they need to create capacity for trauma therapy. Phase 3 is assessment which includes identifying the target memory and the negative thoughts associated with the target. With childhood trauma, this might take longer than a single incident trauma. Phase 4 is reprocessing. This is when the lightbar, tappers, butterfly taps, sound, etc. (all types of bilateral stimulation) happens.
Some people get through Phases 1-3 during intake (like recent event, group, or ongoing traumatic stress EMDR protocols). Others take longer to get through those phases, and it can be frustrating. BUT I tell all my clients, no time in the therapy room is wasted. If a therapist jumps into Phase 4 too fast, a client might become dysregulated or blocked which can cause difficulty in treatment or frustration outside of the therapy room. It is important to honor each individual’s unique needs for effective treatment. Plus, the skills and information learned in the first three phases of EMDR can be enlightening and healing in their own way.
Treatment does not end after Bilateral Stimulation (Phase 4).
What I often see happen is a clients start to feel better after reprocessing a memory in Phase 4, and then they leave treatment to never be seen again. After reprocessing, they have more capacity for day to day activities and are less likely to become emotionally triggered so they think they are done or are good enough to not return. The truth is, there are still 4 more phases.
Phase 5 includes installation of positives. This phase is critical for a client to feel that the positive outcomes and thoughts from reprocessing trauma targets are real and true. Phase 6 is a body scan. Functional brain MRIs in 2004 showed that trauma is stored in the body. Therefore, you have to resolve the somatically (body) stored trauma for a target to be fully reprocessed. Skipping this step keeps physical and emotional triggers present. Phase 7 is closure. This part is so important! It allows you to feel empowered to handle difficult situations in the future with what you learned from trauma reprocessing. Finally, phase 8 is reevaluation, which is self-led. This is where you continually check in and make sure that the progress and changes are maintained.
In closing…
EMDR is incredible! A true game changer in the therapy world, but not all EMDR treatment plans will look the same. Some people will only work with me for 2-4 hours to meet their treatment goals, others might need much, much longer. The important part is to honor your own story and respect your own needs with a treatment plan tailored to you.
The truth is: YOU ARE WORTH IT!