What Is EMDR Therapy?

Medically reviewed by Andrea Brant, LMHC
Updated March 11, 2023by BetterHelp Editorial Team

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EMDR Meaning And Therapy Goals

EMDR therapy, or EMDR,  or eye movement desensitization and reprocessing therapy, was developed by Francine Shapiro. It started in 1988 and has since become a popular form of mental health treatment and trauma therapy. EMDR can help people who have experienced severe trauma in their lives. Traumatic events sometimes have a way of sticking with people and can make it difficult to function when you're experiencing flashbacks to your trauma. 

During EMDR therapy, the client has an opportunity to confront their trauma in a safe environment. The individual recalls upsetting or distressing images while the therapist moves their finger back and forth in front of the client's eyes to encourage rapid eye movement stimulation. This rapid eye movement therapy is a type of bilateral stimulation.

Another way that EMDR therapy is conducted is through hand tapping. The therapist guides the client to tap places on their body that stimulate brain activity while discussing their traumatic experiences. Regardless of the method, EMDR therapy aims to help the person recall the different memories they have surrounding trauma to desensitize themselves to these distressing memories.

The EMDR Therapy Process Explained: EMDR Bilateral Stimulation And The EMDR Therapy Phases

During EMDR therapy, the client is asked to recall their traumatic experience. The therapist asks the person to tap their body or move their eyes while recalling said traumatic memories. EMDR therapy can help both the mind and body heal from psychological trauma. Traumatic stress studies and statistics show that it works for PTSD and other instances of trauma. According to Kaiser Permanente (a healthcare company), in one study, 100% of trauma victims and 77% of people who had experienced complex trauma benefited from EMDR therapy. It can also be a helpful tool in aiding multiple trauma victims, such as war veterans and soldiers at large.

When you read about EMDR therapy, you will likely see the term bilateral stimulation, which is a core component of how EMDR works. What that means is the therapist helps a client stimulate both parts of their brain. The way this is accomplished is the client tracks different stimuli with their eyes. For example, an EMDR therapist may move their finger back and forth while the client follows it to stimulate different parts of the brain. As mentioned above, tapping is another example of bilateral stimulation. The therapist shows the client where to tap on their body to stimulate their brain. Alternatively, some therapists use light sources as another external stimulus to help the client engage in bilateral stimulation. The individual in treatment follows the light back-and-forth with their eyes to engage different brain hemispheres. Bilateral stimulation is a significant part of the phases of EMDR therapy.

Eight Phases

EMDR therapy has eight phases. EMDR counseling/therapy can be an intense process, as it involves confronting trauma. A therapist may first spend a long time gaining background information on the client's traumatic experience before using bilateral stimulation and confronting the trauma.

Below are the eight stages of this treatment:

Phase 1: Obtaining Client History And Treatment Planning.

Phase one can take one to two therapy sessions and involves the client stating what happened to them that created their trauma. They discuss what situations in their life caused them to experience emotional distress or flashbacks. The individual may also identify what coping skills they need to learn to begin to feel better. During this phase, the person tends to identify the problem, which is the traumatic memory, and then begins finding solutions.

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Phase 2: Preparation

Phase two can take anywhere from one to four sessions and can be a more involved process for people who have severe or complex trauma. During phase two, the therapist prepares the client to engage in bilateral stimulation, such that they don't have to talk about their disturbing memories in detail. However, they may talk about what they experienced generally and what they feel about it now. During this phase, the client tends to discuss how the trauma made them feel prepared for the intensity of phase three.

Phase 3: Assessment

During the third phase, the client selects a specific memory or mental picture to target during the EMDR therapy treatment. Then the client is asked to choose a statement or a negative connotation that they have about their trauma and emotional distress. For example, one negative belief, mantra, or association could be, "It was my fault," or "I'm a bad person." Then the client chooses a positive statement to replace or reframe these negative beliefs and statements, such as, "I don't have control over what happened to me, but I can heal," or "I did the best that I could." During phase three, the therapist may ask the client on a scale of 1-7 how much they believe the statement. One means that the statement seems false, and seven means it feels entirely true. In this way, they identify how much they believe the negative statement. During the EMDR therapy assessment, the client may also talk about the emotions that accompany the trauma and their belief system.

Additionally, they rate their beliefs using subjective units of disturbance (or SUD) from 0-10. Zero means it doesn't disturb them at all, and 10 means it's the worst thing they have ever experienced. During this phase, they are working on reprocessing and changing the negative cognition they’re experiencing. If they experienced a single traumatic event, it may take around three sessions of EMDR practice to make progress. However, it can take longer with a complex traumatic situation.

Phase 4: Desensitization

During this phase, the client tends to focus on their distressing emotion and how they feel, and the therapist measures the SUD. The therapist aims to help the client by using the different eye movements or tapping techniques, starting with the target memory and moving forward from there.

Phase 5: Installation

The installation phase aims do away with the negative sentiment toward the targeted memory and replacing it with an affirmative one. The therapist aims to instill in the client the validity of cognition, or VOC. The goal is to help the person get to a certain level of truth on a scale of 0-7 (0 = I don't believe it at all, and 7 = I believe it is entirely true). One thing to note about EMDR therapy is that one may not be able to completely erase negative thoughts and memories. Still, it may help you feel better, and you may begin to change your relationship to specific ideas or memories.

Phase 6: Body Scan

After the therapist helps the client understand a positive way of thinking about the situation, they may focus on how the traumatic event affects the body. Trauma can embed itself in a person's physical being sometimes without the person affected being consciously aware of its presence. Through the body scan, the therapist aims to help their client understand where in the body they are feeling trauma and how to work through those physical sensations.

Phase 7: Closure

Following the scanning of body sensations, the therapist helps the client get back to a state of grounding. The therapist usually continues to use bilateral stimulation, i.e., the back and forth eye movements, and ends the session by taking the client out of the memory, thereby helping them come back to a sense of stasis.

Phase 8: Reevaluation

During reevaluation, the client is usually asked to reassess how traumatic the memory is to them after having used the bilateral stimulation or hand tapping. They are asked to tell their therapist how much their thoughts have changed about it.

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The EMDR Therapy Benefits

According to establishments such as the American Psychiatric Association, U.S. Dept. of Veterans Affairs, and the World Health Organization, anybody who has experienced a traumatic event or complex trauma may benefit from EMDR counseling. EMDR is a process that aims to help people let go of negative thoughts and experiences surrounding their trauma and get to a place of acceptance and positive belief. Emergency Medical Technicians (EMTs), being the first responders of medical emergencies can experience trauma too. An EMDR can be an effective EMT emotional therapy.

Is EMDR Therapy An Emotional Process?

EMDR counseling can be intense at times, so the therapist may use the beginning phases to prepare the client accordingly. This process may help the client prepare psychologically to process the memories and feelings that EMDR counseling sessions can elicit.

Preparing For EMDR Therapy—How Can I Find Out More About EMDR Therapy?

During the early stages of therapy, you might talk to your therapist about your trauma to understand whether or not EMDR counseling is an appropriate form of treatment for you. You can learn more about EMDR counseling by consulting with a licensed mental health professional and discussing whether you're ready to engage in this potentially effective treatment process.

Before you make a decision, you might do some research on this form of treatment and talk to a mental health provider with training and experience in EMDR therapy. 

You might consider meeting with an online mental health professional and discussing the best trauma treatment for you and whether EMDR therapy might be right for you. Research has shown online therapy to be just as effective as in-person therapy, and you can talk to a therapist from the comfort of your own home, which may be helpful if trauma-related memories make it difficult to leave home. With BetterHelp, you can be matched with a therapist experienced in treating trauma, and you can contact your therapist via in-app messaging if you have questions or concerns in between sessions.  

Takeaway

If you are experiencing anxiety related to past trauma, know that you are not alone. There are licensed therapists with experience helping people work through trauma via EMDR and other methods suitable for PTSD. Whether you are ready for eye contact therapy or simply have questions, reach out to BetterHelp today.

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