EMDR, or Eye Movement Desensitization and Reprocessing, is an incredibly useful technique that was originally developed for the treatment of Post-traumatic Stress Disorder. Since its inception, research has been done that has shown EMDR to be an effective treatment option for multiple mental health issues such as eating disorders, anxiety, depression, and more! As EMDR becomes more mainstream (it was featured on an episode of Grey’s Anatomy!), it’s important to know how the treatment works.
Phases of EMDR
EMDR is divided into 8 phases. Some of which are repeated in almost every session, and some of which don’t happen other than at the start of the treatment planning stage. Below are brief descriptions of each of the phases that are used in EMDR:
Phase 1, History and Treatment Planning:
In Phase 1, the counselor and client will work together to develop a treatment plan for their time working together. This phase begins with the intake session and continues with the counselor compiling lists of past events that created the problem the client is coming in for counseling on, the present situations or triggers that are causing distress, and the ways in which the client would like to change behaviors in the future. EMDR is a great way to confront traumatic experiences because this phase does not require an in-depth discussion of past events. Vague information is okay since the experiences are kept within the memory of the client.
Phase 2, Preparation:
Phase 2 is where the client and counselor will develop skills and coping techniques in order to make sure that the client will be able to manage the reprocessing that will take place. Counselor and client build trust in this phase, explains the theory and mechanics of EMDR, discusses stop and keep going signals. A counselor and client will also discuss grounding techniques that may be used if the reprocessing becomes overwhelming.
Phase 3, Assessment:
This phase is when a specific memory will be selected with the help of the counselor. The counselor and client will process through a series of questions that will activate the memory. This starts with selecting a specific image of the memory, a statement that expresses a negative belief about themselves that is associated with the event (I am bad, I am shameful, I am not safe, I am helpless, etc.), then a positive cognition that the client would rather believe about themselves when thinking about this experience. The counselor will then ask for a rating of the Validity of the Positive Cognition (VOC), from 1, completely false, to 7, completely true. After this, the counselor will ask about what emotions the client experienced when thinking about the event, the Subjective Units of Distress the client experiences when the event is brought to mind (from 0 to 10), and the body sensations that the client feels when considering the distress.
Phase 4, Desensitization:
The desensitization phase is the first phase in which eye movements are used. This phase is focused on the disturbing emotions, sensations, or thoughts, and works with the client’s responses to these experiences. The counselor will start eye movements and after stopping, will ask for a brief description of what the client experienced during the eye movements. This phase continues until the SUD for the original experience is down to a 0 (sometimes a 1 or a 2, if more appropriate).
Phase 5, Installation:
After the SUD for disturbing emotions and beliefs is at a 0, the counselor and client will then work to install or reinforce the positive cognition. The counselor will ask the client if the positive belief still fits. The counselor will also ask how valid the cognition feels as the client thinks of it now. Eye movements will be used to install the positive belief until the VOC is up to a 7, completely true.
Phase 6, Body Scan:
Once the VOC is at a 7, or ethically appropriate, the counselor will ask the client to bring to mind the original experience and the positive cognition. The counselor instructs the client to scan their body from head to toe. During this phase, the counselor is looking for any sort of tension, tightness, or unusual sensation. If any is found, the counselor will administer eye movements until this sensation has dissipated. If there are no body sensations reported, then the memory target is considered to be successfully reprocessed.
Phase 7, Closure:
This phase ends every session, ensuring the client is able to leave feeling grounded and not in an activated state. If the current target memory is not finished, calming techniques will be used. The counselor will brief the client on how processing might be experienced throughout the time in between sessions.
Phase 8, Re-evaluation:
This phase is used at the beginning of each new session. It is done at either returning to the treatment plan to decide on the next memory to be reprocessed or reactivating the current target memory that was left unfinished at the end of the last session. This will ensure that the client is progressing well through the treatment plan in EMDR.
About Jack Fox:
Jack graduated from the College of William and Mary with a B.S. in Psychology. He recently finished his graduate work at Regent University with an M.A. in Clinical Mental Health Counseling. Throughout his studies, Jack has seen and worked with many clients. His clients have been adolescents and adults, struggling with depression, anxiety, post-traumatic stress disorder, adjustment issues. He has even worked with people with a desire to get to know themselves just a little bit better! The more Jack has worked with people, the more a simple truth has come to light: You are not alone! To learn more about Jack, visit HERE.