What is EMDR Therapy actually like?
EMDR is described as an 8-phase, 3-pronged treatment based on the “Adaptive Information Processing Model” (AIP). So what the heck does that mean?
The AIP model states that the brain is wired to adaptively (positively) process all the sensory information it gets, but that sometimes an experience can get “stuck” with all the information present at the moment of the traumatic experience, including sights, sounds, smells, thoughts, body sensations, and emotions.
Instead of getting properly processed and sent to long-term memory, the “stuck” experience can be re-experienced over and over. But with the proper support and opportunity, the brain will move that stuck information in an adaptive way, towards health.
8-Phases
The 8 phases are:
- history-taking and treatment planning
- preparation
- reprocessing
- installation
- body scan
- closure
- reevaluation
History-taking is self-explanatory, and treatment planning is when the clinician and client agree on the problems to be targeted and goals to be met. Proper preparation ensures that the client has the skills, called “resources”, needed for the client to safely experience their distress during the treatment, and to be able to leave the session in a safe and emotionally stable state.
The reprocessing phase is where the “magic” happens, when the target memory or other problem is intentionally recalled along with a “negative cognition” that relates to what the client came to believe due to the experience, and the client notices the images, emotions etc that arise and rates their level of distress. The therapist repeatedly pauses to invite the client to share whatever is happening in their brain and body at that time.
One of the great things about EMDR is that the client does not need to share the details of the traumatic event itself or what may come up during the reprocessing. I have worked with numerous clients who have chosen not to share the details of extremely disturbing memories and were able to reprocess the experience successfully.
Throughout the reprocessing session, the memory or other target becomes progressively less disturbing until it evokes no distress at all. The installation phase involves reinforcing the positive ideas that feel truer as the negative cognition is displaced, the body scan makes sure that any residual “ick” or bad sensation in the body is gone. Closure refers to “closing up” the session safely, and reevaluation refers to assessing what changes have occurred after the work on the target memory is complete. Clients often ask if once we finish a target the disturbance around it will ever come back, and the answer is that it should be permanently deactivated.
The three prongs are the past, present, and future. The past event that resulted in the traumatic response (a mugging, for example), the problems caused in the present day due to the trauma (avoidance of public places and fear of being alone, perhaps, in this example), and the ways we hope to behave differently in the future (being comfortable making plans and enjoy going out, while taking appropriate measure to assure safety for example).
This therapy can be done in-office or virtually, but many prefer the in-person experience. Clients need to make sure that they have privacy and comfort for this kind of work as it can get intense and uncomfortable. In my office, my clients have a choice of a light bar that guides back and forth eye movements, hand buzzers, headphones with tones that sync up with the light bar, hand buzzers for those who prefer to close their eyes, or they can do bilateral self-tapping on their arms or legs. I have pillows and blankets, and people are welcome to bring any comfort item that appeals to them. We really work to make sure that the experience is as smooth and safe as possible. For virtual sessions, I use an online platform that provides eye movements, and people can always tap as well.
EMDR therapy can be hard, and sessions can get unpleasant as traumatic memories are dealt with. I do not take it personally when clients say things like “I really didn’t want to see you today” or even “I’ve been dreading this all week!”. But the payoff for doing this work can be tremendous, as I can personally attest.
One thing worth noting is that clients are asked to avoid alcohol, marijuana, or other substances both before and after the reprocessing sessions because the brain is continuing the reprocessing and reconsolidation of memory work after the session and should be able to do so unimpaired by any intoxicating or mood-altering substances. It’s also good to know that this work can be quite tiring, so keeping the schedule light and making sure to eat, hydrate, and rest after EMDR is important too.
Have more questions about what it’s like to do EMDR therapy with me? Please contact me to see if we should set up a free consultation call.