EMDR was first developed in the 1980s. EMDR is a psychotherapeutic approach that has been proven successful in the treatment of Post-traumatic Stress Disorder (PTSD) and Complex PTSD.  In 2013, EMDR was recognized by the World Health Organization as a psychotherapy of choice in the treatment of PTSD in children, teenagers, and adults.  EMDR can also be used with other mental health issues that a client with C-PTSD may also experience, such as anxiety or depression.

EMDR has been scrutinized by multiple studies and meta-analyses that confirm its efficacy (Balboa, et. al, 2019; Valiente-Gómez, et. al, 2017).

According to Balboa, et. al., (2019) and Menon & Jayan (2010), EMDR consists of 8 phases (or stages).

• Phase 1: clinician and client identify key traumatic or highly stressful situations from the client's life that may have contributed to the development of C-PTSD or other mental health difficulty.  During this stage, the clinician and client will agree on a therapeutic plan which first addresses past memories, then focus on current triggers, and then prepare the client for the future.

  • There are several methods to target those key memories, including (but not limited to) looking for cognitive distortions, use of attachment theory to find moments that may have contributed to a disorganized attachment style, and somatic attention to body reactions to memories.

• Phase 2:  The clinician helps client prepare by setting expectations, teaching them relaxation techniques, create a visualized "safe place" - such as the client's favorite place, create metaphors and stop signals to give client's a sense of control during sessions. During this time, the clinician may also explain the symptomology of C-PTSD as well as the active processing of trauma.

• Phase 3: During Phase 3, the clinician and the client decide together on the memory that will be targeted. One image from the memory will be used to focus the memory and the client will be asked to visualize that one image as completely as possible.  Negative beliefs about self that stem from this memory and image will be drawn out, and the counselor will assist the client in selecting an opposing positive belief that the client would prefer to have.

  • "The validity of cognition scale (VOC) and subjective units of disturbance scale (SUDS) are assessed to understand the appropriateness of positive cognition (how much he/she considers a particular statement is true for the target memory) and how distressing is the stored memory, respectively. Both these assessments are used as baseline measures" (Menon & Jayan, 2019, p. 137).

• Phase 4: During this phase, the client is asked to picture the traumatic image agreed upon in Phase 3 and keep that image firmly in mind while completely the eye movement practice.  The clinician will use their fingers or a device to elicit horizontal eye movement of the client. ("Follow my finger with just your eyes as I move my finger from right to left and back.")  As the client is moving their eyes and keeping the mental image in place, they are instructed to be open to whatever happens - what thoughts or emotions that may arise - to notice them as they arise.

• Phase 5: The clinician will work to increase the positive belief that should be replacing the negative belief the client has regarding the memory.

• Phase 6: The clinician will ask the client to do a body scan for any physical feelings of stress, trauma, or tenseness. If there is still tension, the clinician will continue processing the memory using the eye movements.

• Phase 7: This is a closing phase, where the clinician will have the client complete the self-control techniques that were previously discussed in order to bring the client back to a sense of peace. The clinician will also explain what to expect between sessions and ask the client to keep a record of emotional disturbances between sessions.

• Phase 8: This is a re-evaluation phase where the counselor and the client review progress in processing the traumatic memory and check for additional memories that may need EMDR treatment.