EMDR

EMDR stands for Eye Movement Desensitization and Reprocessing. It is an 8 phase approach (described below) to trauma therapy, but can be used for anything that clients feel stuck on: depression, anxiety, negative self-worth, relationship patterns, and more. It uses bi-lateral stimulation (BLS) to stimulate both the logical and emotional hemispheres of the brain to get you past that stuck feeling. The goal is for traumatic memories or stuck problems to be just another memory. It won't turn a tragedy into a good memory, but it doesn't have to be a devastating one anymore.

EMDR can be done in weekly sessions (I recommend 90 minutes) or intensive sessions.

One part I love about EMDR is the respect and empowerment of the client. Each client has a stop signal that we come up with together for you to use to let me know if you're getting overwhelmed, need help, or need to take a break from focusing on the trauma.

The Beginning Phases

Phase 1 - History Taking and Treatment Planning

The first phase of EMDR really starts with the very first appointment. It doesn't necessarily look any different from other ways therapists begin. We want to understand your current symptoms, your context, your past, and your goals for the future.

An EMDR treatment plan has 3 parts: Past, Present, and Future. When making an EMDR treatment plan, we identify targets (memories or experiences) that will be worked on later. I refer to this as making a table of contents. We're not writing the chapter or going into detail of the story of your life at this point. We're just naming some things that have happened that still have an impact on your life today. After we have a good table of contents, we rate how distressing each item is, then I will make a recommendation on what target to start reprocessing.

However, it's always your choice and if you want to start at a different place than what I recommend, we will discuss it and make a decision collaboratively. I will never push you to go somewhere you aren't ready to go. I balance challenging and encouraging you to believe that you are strong and capable while also respecting your limits on what feels like too much.

Many people wonder "how long does EMDR take?"

It's a fair question but unfortunately not one that any therapist would be able to predict for you, especially before getting to know you. Phase 2 can take years for people who have had chronic lifelong trauma. For clients who don't have a safe or stable enough environment present day to withstand the toll of processing old trauma, phase 2 is the majority of the work.

Preparation is not only about teaching you relaxation or calming techniques, but also connecting you with other resources (internally and externally) that you'll need to have in place for therapy to be successful. For example, finding child care so you have some time to yourself or finding a safe group of people outside of therapy who can support you as you do the work. It can also look like helping you with your finances or time management - really anything that would get in the way of successful processing, we try to problem-solve and pave the way for the processing phases to go much more smoothly. You never really leave phase 2. You don't graduate and forget about the resources established here. These are the foundation that carry you throughout everything else we do in therapy.

The Processing Phases (Where the Magic Happens)

Phase 3 - Assessment

In phase 3, I'll ask you a few questions just to get the memory network and limbic system (emotional part of the brain) activated. We'll identify images, thoughts, and sensations that go with the target memory. This shouldn't take more than about 5-10 minutes, then we move right along into phase 4.

Phase 4 - Reprocessing the Negative

Phase 4 is what most people think of when they're talking about EMDR, because it's where we start the fast bilateral stimulation (eye movements, buzzers, tapping, etc.) and get to the traumatic material. This is the meat of the meal or where the *magic* happens. In Phase 4 I often ask "what do you notice now?" You'll hold the buzzers and let your brain go wherever it needs to go while holding in mind the target. The therapist just watches for signs that emotions are moving you - like how fast or slow you're breathing, if your face turns red, you're crying, etc, and uses their judgment to decide when to stop the buzzers and ask "what do you notice now?" You'll give a short answer about the last thing that was in your mind or body, then I'll usually say, "Ok, go with that." We just let your brain do its thing, because we trust that it will take you to a place of healing naturally. However, if you get stuck, I'm here to help you find another perspective or figure out how to move forward.

I'm watching and listening for if things sound like they're getting better or worse. When it seems like we might be coming to a plateau, I'll ask you to rate your distress on a 0-10 scale. Our goal is to get to a 0 or 1, meaning that whatever was bothering you about the target memory no longer feels bothersome in the moment. When it feels like a 0, we move on to phase 5.

Phase 5 - Strengthening the Positive

While phase 4 is about desensitizing you to the negative, phase 5 is about making the positive thoughts or associations as strong as possible. We have a scale of 1-7 where 1 feels completely false, and 7 feels completely true, that we use to help you gauge how strong the positive thoughts feel. When it feels like a 7, we move on to the body scan.

Phase 6 - Body scan

The body scan is such an interesting part of EMDR! Usually in phase 4 and 5 body sensations come up and get reprocessed as part of the memory. The body remembers things that you may not even have language for. Sometimes our bodies need to fight or exert energy to feel like the past is in the past. In situations where we felt weak and powerless, our bodies need to feel stronger to not feel stuck in the memory. When you can scan your body while thinking about the memory and feel no discomfort, then we say you have a "clear" body scan and you've completed the memory!

Wrapping Up Phases

Phase 7 - Closure

Phase 7 is for the sessions when we have worked on a memory but we haven't finished it yet. We will save some time at the end of session to debrief the experience, practice a phase 2 resource, and prepare you for getting back into your day.

Phase 8 - Reassessment

Phase 8 is how we start each session after we begin processing. I'll ask you questions about how your brain has continued to process the information between sessions and what progress you're noticing. This only takes about 5-10 minutes before we start over with phase 3 to resume working on the memory.

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