You may have heard of the acronym EMDR and may have even heard that it is a good treatment for individuals with trauma issues. But what exactly is EMDR Therapy? EMDR stands for Eye Movement Desensitization Reprocessing and was developed by Dr. Francine Shapiro in 1987. While on a walk when feeling distressed, she found that by moving her eyes back and forth rapidly, her distressing thoughts were disappearing or becoming much less negatively charged. From that point on, she began doing research and EMDR Therapy was born. So how does it work and what kinds of issues can be helped by using it? EMDR Therapy is divided into eight stages Below is an overview of the process and its phases.
EMDR Therapy Approach (Therapy in Philadelphia, PA and Ocean City, NJ)
EMDR Therapy is known for being a top treatment for Post Traumatic Stress Disorder and for different types of traumatic events including physical, sexual, emotional, developmental and racial trauma. EMDR Therapy can be used for both adults and children, for both recent and past events and for both small or big traumatic events. For example, a small traumatic event could be doing poorly on a presentation at work and feeling embarrassed and humiliated. A big traumatic event could include being physically abused or seeing someone shot and killed. EMDR Therapy can also be used for other clinical concerns such as anxiety disorders, mood disorders, addictions, pain conditions and other somatic concerns such as trauma surrounding dealing with different medical issues like cancer treatment and heart attacks.
Since Dr. Shapiro’s first research study in 1987, several randomized controlled trials have shown support in using EMDR for a variety of different trauma presentations for both children and adults. The Francine Shapiro Library contains the different research studies that have been conducted. EMDR Therapy understands traumatic memories as being “stuck” in the brain due to being incompletely or inadequately processed. A “stuck” memory means that the memory of a past event feels like it is being re-lived in the present with all of the intense sights, sounds, smells etc. that were experienced at the time that the event occurred. If a present situation occurs that is similar, it can trigger this past memory and a person can then feel like they are reliving the memory in the present. The use of bilateral stimulation (eye moments, taps, or auditory tones) while focusing on the memory helps the brain to fully process through the memory so that it is no longer in a “stuck” state and it becomes neutralized. The useful learning of the memory is then stored and the upsetting parts of the memory feel neutral. While this process will likely help with managing triggers in present situations, EMDR Therapy takes things a step further by using eye movements, taps, or auditory tones to process those present situations that felt similar, as well as preparing for any similar future scenario that could occur. EMDR Therapy can be effective for a variety of different troubling memories from small or little t traumas (being embarrassed in front of your coworkers) to big T traumas (sexual assault). One of the other good things about EMDR Therapy, is the client does not have to describe the event in detail to the therapist. Here’s an example:
You were in a car accident where you rear ended someone. There was some damage to the cars, but it was mild. No one was hurt. You heard the sound of a horn and a song that you really like was playing on the radio. You had just picked up some pizza that you were taking home. You came home from the accident and moved on. However, you have been having dreams of the accident and have had an increase in overall anxiety. You feel a lot of anxiety when thinking about driving anywhere and get anxious thinking about the accident when you hear the song that was playing, smell pizza or hear car horns. You know that accidents happen and that you are fine, but you can’t shake how these triggers make you feel. Through the process of EMDR Therapy, you would address this memory while using eye movements, taps, or auditory tones to assist this in being processed and no longer “stuck”. You would then address the present situation where you are experiencing the triggers and a future situation that could occur that would be similar. Addressing both the present and future help to reinforce this process.
Now that you have an idea of EMDR Therapy, let’s talk about the 8 different phases.
EMDR Therapy 8 Phases (Therapy in Philadelphia, PA and Ocean City, NJ)
Phase 1 - History Taking and Treatment Planning: In this phase, the client and therapist begin getting to know each other and work together to discuss the current triggers and past memories that are related to them. Often, there are a few memories that are related to the current triggers. These memories in the past are the first memories to be targeted in EMDR Therapy processing.
Phase 2 - Preparation and Stabilization: In this phase, the client and therapist continue getting to know each other. The therapist explains how EMDR memory reprocessing is done and determines if the client needs anything before reprocessing can begin. For example, if it is challenging to manage strong emotions or stay present with them. The therapist and client will work on that first by working on building resources and some relaxation exercises. When the therapist and client determine that the client has resources to manage distress and stay present, they are ready for Phase 3.
Phase 3 - Target Assessment: In this phase, the first memory to be reprocessed is addressed as it is currently experienced to determine subjective units of distress (SUDS), emotions about the memory, body sensations connected to the memory and a negative thought about oneself that is connected to the memory. The negative thought is rated on a scale of with regards to how much the client believes it. In Phase 3, clients are also asked to assign a positive thought that they would like to be associated with the memory.
Phase 4 - Desensitization: This is the phase where the reprocessing of the memory occurs. Clients are instructed to focus on the memory with the emotions, body sensations and negative thoughts while doing bilateral stimulation (eye movements, taps, or auditory tones). Bilateral stimulation is done in short segments with the therapist checking in on the client after each segment. The client and therapist have determined a stop signal should the client wish to stop. While this process can be intense, clients are reminded that they are revisiting a memory that has already happened, that it cannot hurt them now, and that they are viewing it to desensitize its effect. Subjective Units of Distress (SUDS) are taken throughout the process with the goal to bring the distress to a zero.
Phase 5 - Installation: This phase is initiated when the SUDS from the targeted memory is 0. The purpose of this phase is to install the positive thought with the desensitized memory to increase the connection of the memory to positive thoughts. Connecting the positive thought to the now desensitized memory involves using eye movements, tones or taps to build and strengthen that connection.
Phase 6 - Body Scan: The effects of a traumatic event can be stored in our body as different body sensations. The purpose of this phase is to scan to see if any elements of the memory still exist in the body as a type of physical sensation. The client thinks of the targeted memory and does a body scan with their eyes closed. If any type of sensation is found, the client tells the therapist, focusing on that sensation while doing eye movements, tones, or taps until no physical sensations connected to the memory are reported.
Phase 7 - Closure: As stated above, this phase is used after a client is no longer reporting physical sensations connected to the targeted memory. The purpose is to check in with the client about the memory being desensitized. Clients are also informed that processing can continue to occur after the session which could include new insights, dreams, thoughts, etc. Phase 7 is also used to close sessions, where Phase 4 (Desensitization) has not been completed on the target memory.
Phase 8 - Reevaluation: This phase is used at the beginning of each new session to discuss anything new that has occurred with regards to the memory, such as new thoughts, feelings, dreams, behaviors,or insights. The client is also asked to think of the memory and give a SUDS rating. The SUDS rating indicates if the memory needs more processing or if it is completed and a new memory can be targeted.
EMDR Therapy is a powerful tool to desensitize troubling memories that are affecting current functioning. If you think you may be interested in EMDR Therapy or have questions about it, please call us at 267-262-8515 to further discuss your particular concerns and how EMDR Therapy may be able to help.