Eye Movement Desensitization and Reprocessing (EMDR) is a structured therapy designed for individuals, aimed at addressing trauma memories. During EMDR sessions, patients are guided to briefly concentrate on traumatic memories while experiencing bilateral stimulation, often through eye movements. This process is intended to reduce the intensity of emotions and vividness associated with the trauma. Developed in 1987 primarily for treating posttraumatic stress disorder (PTSD), EMDR therapy typically involves one to two sessions per week, totaling 6-12 sessions.
PTSD is thought to arise from unresolved traumatic experiences, where memories remain unprocessed, leading to ongoing distress. These memories are believed to retain the original emotions, beliefs, thoughts, and physical sensations associated with the trauma. When triggered, these memories resurface, manifesting as PTSD symptoms. EMDR therapy targets these memories directly, aiming to reprocess them in a way that reduces or eliminates associated symptoms by altering how they are stored in the brain.
The processing of a specific memory typically takes place within one to three sessions in EMDR therapy. Unlike other trauma-focused therapies, EMDR does not involve prolonged exposure to the distressing memory, detailed recounting of the trauma, challenging of dysfunctional beliefs, or homework assignments.
The Eight Phases of EMDR Treatment
Phase 1: History-taking and Treatment Planning
The therapist and patient start to identify targets for treatment after a through history is obtained. The targets can include past memories, current triggers and overall goals of EMDR treatment.
Phase 2: Client Preparation
The therapist provides an explanation of the EMDR treatment process to the client and introduces them to the procedures, such as practicing the eye movements. Additionally, the therapist ensures that the client has sufficient resources for managing emotions and feels safe within the therapeutic environment of the office.
Phase 3: Assessment of the target memory
In this phase of EMDR, the therapist initiates the targeted memory processing by identifying and analyzing different aspects or elements of the memory. This may include discussing the image associated with the memory, the thoughts or beliefs related to it, as well as the emotions and physical sensations it evokes.
During EMDR therapy sessions, two measures are commonly employed to assess changes in emotion and cognition. These measures are the Subjective Units of Disturbance (SUD) scale and the Validity of Cognition (VOC) scale.
Phase 4: Desensitization
In the desensitization phase, the patient directs their attention to the targeted memory while participating in bilateral stimulation, such as eye movements or tapping. Throughout this phase, the patient communicates any new thoughts or insights that arise. The therapist follows a standardized protocol to determine the focus of each set of bilateral stimuli. Typically, the content associated with the memory becomes the focal point for the subsequent set of brief bilateral stimulation. This process continues until the client indicates that the memory no longer causes distress.
Phase 5: Installation
The fifth phase of EMDR is installation, which strengthens the preferred positive cognition.
Phase 6: Body Scan
In the sixth phase of EMDR, known as the body scan, the patient is instructed to observe their physical reactions while recalling the memory and the associated positive cognition. They are encouraged to identify any distressing physical symptoms, such as heart palpitations, sweating, or a sensation of unease in the stomach. If the patient reports experiencing any disturbance, standardized procedures involving EMDR stimuli are employed to address it.
Phase 7: Closure
Closure is always used to end the session. If the targeted memory was not fully processed during the EMDR session the therapist will instruct the patient how to contain memories and emotions until the next session.
Phase 8: Evaluation of treatment results
In the final phase, the therapist assesses the patient’s current psychological state, evaluating whether the treatment effects have been sustained and if any new memories have emerged since the last session. The therapist assists the patient in identifying any new targets for the current session as necessary.