What are the 8 stages of EMDR?
And 10 other frequently asked questions about EMDR Therapy.
EMDR, or Eye Movement Desensitization and Reprocessing, developed by Francine Shapiro, works by leveraging the brain's natural ability to process and integrate traumatic memories. When someone experiences a traumatic event, the memory of that event can become "stuck". This often causes nervous system dysregulation and ongoing distressing symptoms such as flashbacks, nightmares, and heightened anxiety.
What are the 8 phases of EMDR?
1. History-Taking and Treatment Planning: The therapist assesses the client's history and develops a treatment plan. This includes identifying past memories that might be targets for EMDR processing.
2. Preparation: The therapist ensures the client has various ways of handling emotional distress and teaches the client nervous system regulation techniques to use during and between sessions.
3. Assessment: The client selects a target memory to process, identifying the most vivid visual image related to the memory, a negative belief about self, related emotions, and body sensations. The client also identifies a positive belief.
4. Desensitization: This focuses on the client's disturbing feelings and sensations as they are then asked to focus on the image, negative thought, and body sensations while simultaneously engaging in EMDR processing using bilateral stimulation BLS.
5. Installation: The positive belief is then strengthened and "installed" with the goal of it replacing the negative belief.
6. Body Scan: The client is asked to think of the target memory and identify any residual tension or unusual sensations in the body. If there are any, these are targeted for further EMDR processing.
7. Closure: The therapist helps the client return to equilibrium, using several different techniques if necessary.
8. Reevaluation: At the beginning of subsequent sessions, the therapist checks to ensure the results of the work completed in the last session have been maintained, and reviews the client’s current state to determine if the treatment goals are being met.
It is important to know that this type of trauma therapy is a phased protocol.
And, that we often flow from one phase to another throughout treatment. Each phase deals with the past, present, and future of a troubling memory or trauma. Treatment is finished when you experience little to no distress about the traumatic memory.
If you've every asked, what are the 8 phases of EMDR, we hope this makes things a bit more clear for you!
How does EMDR work in the brain?
EMDR, or Eye Movement Desensitization and Reprocessing, is a psychotherapy treatment designed to alleviate the distress associated with traumatic memories. Despite its widespread use, the exact mechanisms by which EMDR works in the brain are not fully understood.
Research findings suggest the following on how EMDR supports the renegotiation of trauma:
Bilateral Stimulation and REM Sleep: EMDR's use of bilateral stimulation has been likened to the eye movements that occur during REM (rapid eye movement) sleep, a phase of sleep associated with processing emotions and memories. It's hypothesized that the bilateral eye movements in EMDR might similarly help the brain process and integrate traumatic memories.
Memory Reconsolidation: When a memory is recalled, it becomes susceptible to modification before it is stored again—a process called reconsolidation. EMDR facilitates this process, making it possible to support change in the emotional or cognitive context of the traumatic memory when it is re-encoded in the brain.
Reduction of Fight-Or-Flight Response: Traumatic memories can activate the amygdala, initiating a fight-or-flight response. EMDR assists in calming this response by stimulating the brain's information processing and aiding in the association of the trauma with more adaptive, less distressing information.
Prefrontal Cortex Activation: The prefrontal cortex is implicated in managing emotional responses. EMDR enhances prefrontal cortex functioning, helping individuals to better regulate emotions related to traumatic material.
Interhemispheric Communication: Bilateral stimulation is thought to enhance communication between the two hemispheres of the brain, thus improving the integration of left hemisphere (logical, verbal) and right hemisphere (emotional, feeling, nonverbal) functions.
Stress Hormone Reduction: EMDR leads to a reduction in cortisol, a hormone associated with stress, which could lessen the arousal associated with traumatic memories.
Allowing for Adaptive Learning: By accessing traumatic memories and processing them in a safe environment, EMDR allows for cognitive and emotional learning that gives individuals new insights and perspectives on their traumatic experiences, which can reduce the distress in the here and now.
It is important to note that neuroscience and research in this area continues to evolve, and that EMDR involves a complex interplay of these and other neurological processes. Clinical evidence supports EMDR's effectiveness, and it has been recognized as an effective treatment for trauma.
What is bilateral stimulation?
Bilateral stimulation is a distinctive element of Eye Movement Desensitization and Reprocessing (EMDR) therapy. It refers to the rhythmic, left-right pattern of stimuli that can be auditory, tactile, or visual.
The most commonly recognized form of bilateral stimulation in EMDR is side-to-side eye movement, where clients are asked to follow their therapist’s finger or another object as it moves back and forth across their field of vision.
This type of stimulation is thought to mimic the natural process that occurs during Rapid Eye Movement (REM) sleep, wherein the eyes move rapidly from side to side.
The mechanism of how bilateral stimulation aids in the processing of traumatic memories is not entirely clear, but it is believed to activate areas of the brain involved in the processing of negative memories and emotions, which can lead to a decrease in the intensity of emotional disturbance associated with a traumatic memory.
Other forms of bilateral stimulation (which are equally as effective) include:
Auditory stimulation: Sounds that alternate between the left and right ear via headphones.
Tactile stimulation: Tapping, buzzing, drumming, stomping, coloring.. anything that alternates between the left and right side of the body.
Here at Reclaim Therapy, we do our best to get creative with different forms of BLS.
Is EMDR Somatic Therapy?
Eye movement desensitization and reprocessing does include some somatic (body-based elements). EMDR focuses on the mind-body connection to facilitate healing from traumatic memories. The treatment process involves lighting up affective pathways (feeling and connecting to your feelings in your body) and bilateral stimulation, which is a somatic component in itself.
BLS (bilateral stimulation) engages the body and can be seen as a way to redirect and reorganize the way traumatic memories are stored, not only in the brain but also in how they affect the body.
Often, folks we work with report feeling more embodied or experiencing physical relief alongside emotional improvements after EMDR sessions.
EMDR therapists may also employ grounding techniques before and after sessions, which further enhance the somatic experience. Grounding involves focusing on breath, body sensations, imagination, and physical movements to reconnect with the present moment and support feelings of safety.
Can EMDR be harmful?
EMDR is a safe and effective therapeutic approach for the treatment of trauma, PTSD and CPTSD.
That being said, some people may experience negative effects from EMDR therapy.
Throughout consult calls, many times people ask, can EMDR make things worse?
EMDR is used to help renegotiate traumatic experiences, and at times, things might feel worse before they feel better. This is because trauma lives in the body, and throughout the EMDR process we are touching into that energy. As a result, some people experience:
Increased distress: EMDR involves recalling distressing events, which can lead to temporary increases in anxiety, distress, or emotional pain.
Emotional overwhelm: The rapid processing of traumatic memories may lead individuals to feel overwhelmed. This is why it is important to spend time in the beginning phases of treatment with a therapist you feel safe with.
Unanticipated memories: The process might bring up additional unresolved traumatic memories that the patient was not initially aware of.
Physical reactions: Some individuals might experience dizziness, lightheadedness, or nausea during the eye movement component of the therapy.
Dissociation: Some individuals, particularly those with complex trauma or dissociative disorders, might experience dissociation during or after EMDR therapy.
This isn't meant to scare you, but we like to be honest about what EMDR can look like. Like any type of trauma therapy, going slow and having a solid, trusting relationship with your therapist is paramount. Know that coming back to phases 1 and 2 as often as needed is the name of the game. We want you to have the tools that you need to feel safe in navigating any distress throughout the EMDR process.
How to prepare for EMDR
You might be wondering how to prepare for first EMDR session.
Start by educating yourself about EMDR therapy to understand its purpose and what to expect (if you’re reading this blog, you’re already doing that!).
Next, the very most important step is to find an EMDR therapist near me you feel comfortable with and trust.
Preparing for EMDR is similar to preparing for other types of therapy appointments.
Because of the 8 stages of EMDR, your initial appointments will spent getting to now your therapist, sharing pieces of your history and your current struggles and beginning to develop ways to manage distress and activation.
As you move through later phases of treatment, be ready to handle tough feelings and memories. Know that finding comfort and leaning on coping tools and nervous system regulation is an important part of therapy. Both in and out of the therapy room.
On a practical note, try to arrange your schedule so you have time to unwind after the session, as you may find it emotionally draining. Develop self-care strategies for post-session comfort, such as relaxation techniques, talking to a supportive person, or engaging in calming activities.
Reflect on your goals for therapy and share them with your therapist to align your expectations. Lastly, be patient with yourself and the therapy process. It can take time to notice significant improvements, but with consistency and readiness, EMDR can be a powerful tool for healing.
Can EMDR be done virtually?
Yes, virtual EMDR therapy is safe and effective. Working virtually increases your access to specialized EMDR therapists.
Wondering how to do EMDR therapy online?
Here at Reclaim Therapy we often use a virtual EMDR platform called Easy EMDR to facilitate auditory BLS and visual BLS. Many clients enjoy tactile bilateral stimulation, like tapping, or what is called a butterfly hug.
There are a few things to consider if you are wondering... can you do EMDR virtually?
Being in a space that feels comfortable and safe, that you will not be disturbed
Truly feeling safe with your EMDR therapist
Being sure that you have solid internet or data connection. There's nothing worse than being disconnected from your online EMDR therapist in the middle of reprocessing. We want to make sure that you have solid support and an open line of communication with your therapist.
How long does EMDR take?
Typical sessions last from 60-90 minutes, once per week. The duration of treatment depends on a number of factors.
People ask us all the time, "How many EMDR sessions do I need?"
It is hard to tell how many sessions will be needed to support you in renegotiating and reprocessing trauma. We tend not to quote a time frame simply because everyone's experience, and everyone's trauma history, is vastly different.
How long does EMDR take for complex trauma? How many EMDR Sessions for Complex PTSD?
Many people come to our practice for post traumatic stress disorder treatment, childhood trauma therapy or therapy for complex PTSD.
Folks with extensive trauma histories and high ACE scores may need more time to work toward and through the later stages of treatment.
In trauma therapy, we truly believe that taking things slow is the fastest approach.
Our goal for all of our clients is to do solid preparation work in phases 1 & 2 (see phases of treatment above). We do this in hopes of supporting folks to grow their window of tolerance to better navigate any distress that arises throughout the desensitization stage of treatment.
How to get the most out of EMDR
Like we shared earlier, finding an EMDR therapist that is the right fit for you is the most important step. The therapists at Reclaim prioritize safety, honesty and the repair process with our clients. First and foremost, we focus on the relationship.
Throughout the treatment process, honesty and openness are essential.
Feeling blocked?
Feeling overwhelmed?
Noticing more triggers outside of session?
Letting your therapist know so that you can slow down and address your concerns is important.
It's equally important to practice self-care and use tools to care for yourself and work to stay tethered to the present moment in and out of sessions. A stable environment and a supportive network can enhance your ability to cope with the emotional work involved.
Does EMDR work?
Eye Movement Desensitization and Reprocessing has been shown to be effective for folks suffering from psychological distress, particularly those related to traumatic events and PTSD. There is a substantial body of research supporting its use, including:
Recognition by authoritative organizations: EMDR is recognized by organizations such as the American Psychological Association, the World Health Organization (WHO), and the Department of Veterans Affairs as an effective treatment for trauma.
Clinical studies and meta-analyses: Multiple studies have demonstrated its efficacy in treating trauma and PTSD, showing that EMDR can lead to a reduction in symptoms and improvement in functioning.
Reports of decreased distress: Folks report significant decreases in the vividness and emotional charge of traumatic memories after EMDR treatment.
Like any trauma treatment, its effectiveness can vary from person to person. Factors such as the nature and severity of the trauma, co-occuring conditions, the therapeutic relationship, and individual differences can influence outcomes. Some individuals may respond exceptionally well to EMDR, while others may experience less benefit or may require additional treatments in conjunction with EMDR.
Here at Reclaim Therapy we’re a group of EMDR Therapists in Horsham, PA who specialize in providing therapy for Complex PTSD and PTSD treatment.
We believe that all people are deserving of healing from trauma and complex trauma. And, EMDR Therapy is another tool, another option, to support your healing.
If you’re interested in learning more about EMDR or getting started with EMDR Therapy in Pennsylvania, we would be honored to support you. Click here to schedule your free consultation.
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At our Horsham, PA trauma therapy center, we provide trauma focused eating disorder therapy, body image counseling, trauma treatment and grief counseling. We are passionate about helping people reclaim their lives from the impact of trauma, disordered eating and body-shame.