What Does EMDR Therapy Look Like?

Amanda Ann Gregory, LCPC, EMDR Certified 

EMDR (Eye Movement Desensitization and Reprocessing) is an 8-phase therapy that uses bilateral stimulation (such as eye movements, pulsars, and sounds) to process distressing memories and reprocess negative core beliefs. EMDR was originally created to treat trauma, but over time it’s been found to be helpful in treating complicated grief, substance abuse, anxiety/phobias, chronic pain, dissociation, stress, and personality disorders. EMDR has gained popularity among therapists and clients. Yet, there is still some mystery regarding what EMDR looks like. 

Let’s say that you are participating in EMDR therapy to address multiple experiences of childhood trauma. Here’s what EMDR therapy might look like for you: 

History Taking 

This is the first phase, in which your therapist will collect information about your history. This information is often focused on your life experiences, particularly those that were traumatic or that have had a strong negative impact on your emotions, your body, and your perception of yourself and the world. This phase does not involve creating trauma narratives or sharing details about your experiences. The therapist simply wants to create a brief roadmap of areas that need to be addressed.

Preparation 

This is the phase in which you learn specific coping mechanisms in order to calm and stabilize your mind and body. These skills might include cross tapping (crossing your arms and tapping on each side of your body), breathing exercises, creating resources to feel safe, or grounding. These skills are meant to help you feel safe and ready to engage in processing trauma. It’s common for clients to revisit this phase often throughout their therapy. 

Assessment 

You will work with your therapist to identify the target you need to process during each session. Targets are events, experiences, core beliefs, or physical sensations that negatively impact you. Targets can be gathered from the history-taking phase or include recent experiences. Targets are assessed based on how disturbing they feel to you. You will also identify any negative core beliefs that are associated with a specific target, as well as a more adaptive belief that you’d like to embrace. 

For example, say you and your therapist agree to focus on your memory of being bitten by a dog when you were 4 years old — this is your target. You experience the negative core belief of “all dogs are dangerous,” and you want to embrace the more adaptive belief of “some dogs are dangerous.” On a SUD (subjective units of disturbance) 0-10 scale, your report that this target feels like a 9. 

Desensitization 

You will spend most of your time in this phase. The goal of this phase is to become desensitized to the chosen target. Your therapist will use bilateral stimulation (such as eye movements, pulsars, and sounds) to help your brain reprocess the target in order to decrease the level of disturbance that you experience with respect to it. For example, your therapist may ask you to remember being bitten by the dog and to allow yourself to feel the disturbance and then you will be exposed to bilateral stimulation. 

Installation

This phase focuses on installing the positive changes that emerge during the desensitization phase. This helps the positive changes to take root. For example, you might start to believe that “some dogs are dangerous,” and you may remember positive experiences you’ve had with dogs. You will focus on these beliefs and experiences while receiving bilateral stimulation.  

Body Scan

This phase focuses on sensations in your body. Your therapist might ask you to focus on certain sensations in your body and to notice whether those sensations are changing while you are receiving bilateral stimulation. For example, if you notice tension in your neck, you might notice a decrease in tension as you focus on it. 

Closure

In this phase the therapist and client review what occurred during the session. The therapist shares any information or recommendations that might be helpful to you. This is also your opportunity to share insights, ask questions, or express concerns. For example, your therapist might encourage you to interact with a dog or go to a dog park and see what this experience feels like now. 

Reevaluation 

Your therapist assesses whether you are processing your target effectively. Your therapist might ask you to remember when you were bitten by the dog and ask you to give an updated number on the SUD scale. You might report a SUD of 2, which is a significant decrease in the disturbance. This phase can occur at the end of a session and also at the beginning of a new session. 

Are you interested in participating in EMDR therapy? Contact Symmetry Counseling today.