EMDR Therapy Roadmap: What to expect from EMDR Therapy
When starting your therapy journey with EMDR, it is often quite normal to wonder what it will look like. EMDR is distinctly different to many other therapies and often people aren’t really sure what to expect. Many people often ask if we ‘start eye movements right away’, however, there is much more to EMDR than it would seem at first glance.
EMDR is a complete, structured and multi-phased therapy that unfolds over time. The pace is guided by your readiness, history and goals. This guide is designed to give you an EMDR roadmap so that you can better understand the nature of EMDR and what to expect from the process.
How EMDR Works: A quick overview
EMDR helps the brain to be able to process experiences and memories of traumatic events that have remained stuck. Often, when events were overwhelming at the time of their occurrence, the memory of the event remains ‘stuck’ and the individual continues to remain on high alert. This is often seen in strong emotional reactions to events that are ‘similar enough’ to the original event (i.e. triggers). EMDR supports our brain to be able to process these events so that they can be remembered without triggering intense emotional and physical reactions in the present.
The Eight Phases of EMDR Therapy
EMDR is an evidence-based, eight-phase protocol which is carried out over multiple sessions. Each course of therapy is personalised to the unique individual circumstances of those engaging with EMDR. It’s important to know that there is no ‘one size fits all’ approach.
Phase 1: History Taking & Treatment Planning
The first phase of EMDR involves the therapist understanding your history, life experiences, present difficulties and your overall goals of therapy.
Your therapist will ask about significant life events (recent and historical), current triggers, patterns in past relationships, past work history, and any underlying self-beliefs. Together, you’ll begin to understand the potential targets for EMDR and the specific memories, triggers and future situations, that we will aim to reprocess in a safe and therapeutic way.
Phase 2: Preparation and Stabilisation
Before we can begin the process of working on distressing memories, your therapy will go through a series of steps to prepare for the latter stages of EMDR therapy. This phase is crucial in being able to ‘apply the brakes’ and stabilise our nervous system. Your therapist will also provide psychoeducation around how EMDR works to reprocess distressing memories. In this phase, we will go through a number of techniques such as:
- Grounding and stabilisation
- Deep breathing and muscle relaxation
- Resources specifically for use in EMDR (calm-safe state, etc.)
This phase is crucial in helping prepare for reprocessing of difficult memories and people often report significant benefit from this step alone.
A brief note on Phases 1 & 2
Typically, we will spend several sessions in these two phases of treatment as this will better prepare ourselves for the reprocessing phases (i.e. phases 3-7). The latter phases of the therapy are typically carried out multiple times for each of the target memories.
Phases 3 to 7: Reprocessing of distressing memories
Phase 3: Assessment
In this phase, you and your therapist will identify the elements of the memory that will form the basis for reprocessing.
Your therapist will help you to identify:
- The image that best represents the memory
- The emotion(s) associated with the memory
- Where you feel the memory in the body
- The negative beliefs attached to the memory (e.g. “I’m not good enough”) along with a more desired belief (e.g. “I am good enough”)
From here, this provides a stable and ‘starting point’ for helping you to begin reprocessing.
Phase 4: Desensitisation
Phase 4 is the phase where EMDR earned its name. During this phase, the therapist will assist you with activating your working memory through using bilateral stimulation. Most commonly, this is done with eye movements, however, there are other modalities that are often chosen (such as tapping or sounds).
During this phase, your brain commences reprocessing of the distressing memory. Your therapist will regularly check in with you and guide you through this process. The aim of this phase is to reduce the level of distress associated with the memory in a safe and therapeutic manner. Once this has been achieved, we are ready to move onto the next phase, installation.
Phase 5: Installation
Once distress has significantly decreased, the focus of EMDR shifts to strengthening more positive beliefs surrounding the memory. For example, beliefs such as ‘I am good enough’ and ‘I am safe now’ are incorporated with BLS as they are also reprocessed.
Phase 6: Body Scan
During this phase, your therapist will check in with you around the level of distress remaining in the body. In this phase, you’ll notice if there is any residual tension in the body when thinking about the memory. Further reprocessing will take place if there is still residual distress still being experienced in the body.
Phase 7: Closure
Every EMDR session ends with stabilisation. In this phase, resources from Phase 2 are typically utilised to assist you to feel grounded and present before leaving the clinic. Your therapist will typically utilise grounding exercises, positive resources and review coping strategies in this phase. Your therapist will also discuss what to expect between sessions.
Phase 8: Re-evaluation
At the commencement of the following session, your therapist will engage in re-evaluation. During this phase, your therapist will ask about the level of distress associated with the memory from last session and whether there have been any triggers or difficulties that you have experienced in between sessions. If there is still some residual distress, your therapist will continue with reprocessing (e.g. phase 4) to assist with further reducing the distress from this memory. Your therapist will then move on to the next steps in your EMDR journey (i.e. the next target memory).
How long does EMDR therapy take?
Like any therapy, there is no ‘one size fits all’ timeline. Typically, there are a number of factors that can influence the length of time for EMDR therapy such as:
- Simple or complex trauma
- Current life stresses and circumstances
- Client and nervous system stability/regulation
- Goals for therapy
Whilst some people can notice significant change in a short period of time, others engage in EMDR as part of a longer-term therapy.
What changes do people often notice?
Over time, clients typically report:
- Reduced reactivity to past events and current triggers
- Fewer intrusive memories and flashbacks
- Feeling more calm throughout the day
- Healthier relationships and better boundaries
- A general feeling that those memories are ‘just like any other memory’ or ‘in the past’
Summing up
EMDR is not about reliving the pain or forcing memories. It’s about allowing your brain and your nervous system to process the memory to be able to move forward in life.
If you have any questions, please feel free to discuss these with your therapist during your session.
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