Safe Harbor

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What is EMDR and How Does It Work?

Eye Movement Desensitization and Reprocessing is a unique form of psychotherapy that is designed to decrease the disturbing feelings associated with traumatic events. EMDR differs from forms of talk therapy because it focuses more on the negative emotions and symptoms instead of the actual event itself. EMDR has helped many people overcome a variety of psychological stress.

EMDR focuses on the understanding that unprocessed memories contain thoughts, beliefs, emotions, and physical sensations that occurred during the event. The treatment centers directly on the memory with the goal of changing the way the memory is stored in the brain. EMDR aims to decrease and eliminate the problematic effects these emotions have on the individual.

Using EMDR Treatment

During EMDR therapy, individuals briefly focus on the traumatic memory and simultaneously experience bilateral stimulation in an effort to reduce the emotion of the memory. The bilateral stimulation includes eye movements as well as tones and taps.

EMDR therapy has a structured eight-phase approach that includes:

  1. History and Treatment Planning

    Usually, this phase lasts 1-2 sessions at the beginning of treatment. It can also be used throughout therapy if other issues arise. This is the development stage, where the therapist works with the client to design an individual treatment plan.

    The client and therapist will discuss the specific issues and negative behaviors associated with the problem. After that, the therapist will evaluate and set specific targets to use EMDR. What sets EMDR apart is that the individual does not have to share specific details of the event. Instead, they provide a general outline and the therapist works to identify and target the event with EMDR.
  2. Preparing the Client

    During this phase, the therapist explains the treatment methods and introduces the client to the necessary procedures. This includes practicing eye movement and other bilateral components. This typically takes 1-4 sessions, or sometimes more for others with a very traumatized background.

    It is important to establish trust between the client and therapist during these sessions. The client will learn what to expect during and after treatment as well as tools and techniques for calming themselves during distress.
  3. Assessment

    The third stage of EDMR is all about accessing each target so it can be processed effectively. It activates the targeted memory by identifying each of the memory components: image, cognition, affect, and physical response.

    During this phase, the therapist will ask the client to select a picture or visual scene from the target event. Then, they will be asked to choose a statement of negative self-belief associated with that scene. After that, they are asked to choose a positive self-statement that they would rather believe. The therapist will ask how true they believe the positive statement to be using the 1 to 7 Validity of Cognition (VOC) scale. The therapist may also use the Subjective Units of Disturbance (SUD) scale during this phase. This scale is 0 to 10, where the client ranks the level of disturbance they feel from a specific emotion.
  4. Desensitization

    This phase focuses on the client’s emotions measured by the SUDs rating. The therapist will lead the client through a series of eye movements or other bilateral stimulation while focusing on the memory. This stage also provides the opportunity to resolve other similar events that may be associated with the target.

    The desensitization phase leads patients through the bilateral movements with appropriate shifts in behavior and focus until the SUD scale is reduced to lower amounts of zero, 1 or 2. The process continues until the memory is no longer distressing to the client.
  5. Installation

    The installation phase aims to increase the strength of the positive belief that the person has identified and effectively replace the negative belief. During this fifth stage of treatment, the positive cognition is strengthened and reinforced. The VOC scale is used to measure how deeply the person believes the positive self-statement. The main goal of this stage is for the person to accept the full truth of the positive self-statement at level 7 on the VOC scale.
  6. Body Scan

    After the positive self-statement has been installed and strengthened, the therapist will ask the person to bring the original target to mind and see if there is any residual tension in the body. The clients are asked to observe their physical response while recalling the memory. While positive self-beliefs are important, they must be believed on more than just an intellectual level. The EMDR treatment is not considered successful until the client can bring up the original target with no sign of body tension.
  7. Closure

    Each EMDR session ends with closure. Closure ensures that each person leaves the session feeling better than the beginning. If the individual has not completely processed the traumatic event, the therapist will teach the person a variety of self-calming tools and techniques. The client will be briefed on what to expect between sessions and how to record these experiences and keep calm.
  8. Reevaluation

    This phase opens each new session to ensure that positive results have been maintained. The therapists checks and ensures that the positive results of low SUDs, high VOC, and low body tension have been maintained. During reevaluation, the therapist will also identify any new issues that need treatment. Similar to other forms of therapy, the reevaluation stage is important in order to determine the continued of success over time.