What are the Stages of EMDR?

Since first devised by psychologist Francine Shapiro in 1987, EMDR has proven to be a reliable method for easing stress linked to traumatic memories. In this article, I explain what EMDR is, outline the stages of EMDR, and debunk common misconceptions. 

What is EMDR?

Eye Movement Desensitization and Reprocessing (EMDR) is a psychotherapeutic approach that aids in trauma recovery and is an effective treatment for PTSD and other mental health conditions such as anxiety, substance use disorder, and depression. Utilizing bilateral stimulation (BS),  through eye movement, taps, and tones the therapy stimulates both sides of the brain, developing strategies for dealing with traumatic memories.

The 8-phase process serves as a guide for EMDR therapists to navigate, with each step addressing a specific aspect of the treatment. While each phase plays a role in the overall effectiveness of EMDR therapy, it's important to note that not all phases may be utilized in a single therapy session, and their duration can vary based on the individual needs of each client.

EMDR is meant to break the connection between traumatic memories and negative symptoms.

What are the 8 Stages of EMDR?

Note: Phase 1 is intended to trigger the negative memory

1. History taking and treatment planning
   In this initial phase, the therapist gathers information about the client's history, past traumatic events, and current symptoms. Observing connections between past traumatic events and any current triggers or situations that cause distress is important. The thoughts, feelings, and behaviors associated with these events and triggers will help guide the treatment plan. Next, goals are integrated into a personalized treatment plan to assess the client’s strengths and resources. 

Note: Phases 2-3 focus on processing the event and unwanted behaviors

2. Client preparation
   The preparation phase ensures that the client knows what to expect and what the objectives are for the EMDR therapy. The therapist will explain how EMDR works, what’s expected of the client, and what reactions may be experienced throughout the process.  Trust is established and collaboration begins to take root. Various coping strategies and relaxation techniques are introduced to equip the client with the skills needed to manage distress during EMDR processing.
3. Assessment
   During the “assessment phase”, the therapist focuses on identifying specific memories or experiences that require processing and a resolution through treatment. Specific details, emotions, and beliefs related to the chosen targets are explored to create a comprehensive understanding of the traumatic experiences. Once the assessment is complete, the next three phases will begin. 

Note: Phases 4-6 are known as the “reprocessing phases” to desensitize the trauma

4. Desensitization
   This stage aims to reduce distress when thinking about a target memory by using bilateral stimulation, through guided eye movements or sound, to facilitate memory processing. The client concentrates on the target memory while simultaneously engaging in bilateral stimulation to promote the gradual desensitization of emotional intensity.
5. Installation
   Once the desensitization therapy session is complete, the client will have a more positive perspective on the memory. During the installation phase, those beliefs and emotions are now reinforced and "installed" to replace the negative or distressing thoughts. This stage aims to build self-awareness, self-esteem, and resilience until it feels completely true.
6. Body Scan
   In this phase, the therapist and client assess the body for any remaining physical tension or discomfort related to the traumatic memory. Bilateral stimulation is used to target and release any of the remaining sensations.

Note: The final two phases are used at the end of each session to guarantee the client's safety at the end of a current session and the beginning of the next.

7. Closure
   Every session of reprocessing ends with the closure phase to ensure that the client is in a stable state at the end of each session. If processing is incomplete, the client is provided with additional coping strategies to manage any residual distress until the next session.The therapist identifies 3 areas to complete this phase:
   • • • The client feels neutral about the event
       • The positive beliefs feel completely true
       • There’s no longer disturbance in the body
         
8. Reevaluation
   The therapist reassesses the client’s current distress level related to the traumatic memory. If the client reports a decrease in distress, they proceed to the next target memory. In cases where the reduction is not observed, additional sessions may be needed to address the trauma comprehensively. The overall goal is to sustain positive effects and address any remaining distress effectively.

The goal of EMDR treatment is to rapidly metabolize the dysfunctional residue from the past and transform it into something useful.”

- Francince Shapiro, Psychologist who developed EMDR therapy

Common Misconceptions about EMDR

1. 1. • EMDR is hypnosis
        Clients remain fully conscious and aware of everything happening during the process, without entering any trance-like state.
      • EMDR erases memories
        Instead of erasing memories, EMDR assists in alleviating some or all of the distress linked to them.
      • Eye movement must be used
        Tapping or other auditory signals are also commonly used for bilateral stimulation.
      • EMDR is a quick fix
        While some individuals see results faster than others, it’s common for the process to be extended and require multiple sessions to address different aspects of their trauma.
      • EMDR is suitable for anyone with trauma
        Professional evaluation is necessary to determine if EMDR will be an effective treatment. Some mitigating factors may prevent or delay the start of EMDR.

Learn How EDMR Can Help

EMDR is used to help people process and heal from traumatic experiences, effectively removing trauma’s imprint from their memory. While the journey looks different for every individual, the outcome brings a clear resolve and a more optimistic perspective. 

If you know someone who struggles with anxiety or depression, or is experiencing Trauma & PTSD, encourage them to seek out EMDR therapy.

 Creating Connections Counseling in Pittsburgh & Wexford, PA offers both in-person and virtual therapy. Our team of skilled clinicians can evaluate and develop a personalized plan that helps reclaim a fulfilling life. Contact us today at (412) 229-7353 or fill out our online intake form to get started. It may just be the solution they’ve been hoping for.