Eye Movement Desensitization and Reprocessing (EMDR)

EMDR is recognized as a type of therapy that is effective for the treatment of a wide range of mental health conditions. EMDR protocols and procedures are centered around bilateral stimulation, which gives the brain and nervous system space to process previously overwhelming experiences.

The goal of EMDR is for you to feel relief by transforming negative experiences into adaptive experiences. You will not forget about or erase the past. Rather, you will work with a therapist on a series of tasks intended to help you build a healthier, more balanced, and more productive present.

The popularity of EMDR is on the rise. This increases the importance of vetting your potential EMDR therapist to ensure they are properly trained. Minimum training requirements for practicing EMDR include the completion of an EMDRIA (EMDR International Association) approved course. Approved courses include education, direct practice with, and consultation hours around use of the modality.

The general fit between you and your EMDR therapist is as important as in any other type of therapy. Questions that help assess both EMDR outlook and personality match include:

There are eight phases in the process of EMDR therapy. They include:

This is where you talk with your therapist about why you are coming in for sessions. Your therapist will focus on building a trusting, stable relationship with you during this phase. They will also assess and talk with you to determine if EMDR may be helpful for you.

Your therapist will talk you through the reprocessing components of EMDR, making sure to address any questions or concerns, during this phase. You will create a calm, safe space to return to as you start moving further along in the therapy. Preparation is an excellent time to discuss questions about expectations and potential outcomes. Psychoeducation about the science and theory behind EMDR will also be provided.

Assessment is the start of identifying negative experiences that you would like to transform into adaptive experiences. You will be asked to select a single image as the focus of treatment. You will also be asked to identify the negative cognition associated with the event you have selected. The correlated emotions, body sensations, and level of disturbance will be pinpointed. All of these factors together set you up for the accelerated processing of information that occurs in phases three through seven.

A major part of EMDR is reducing the disturbances you experience in association with what you have chosen to focus on. Desensitization involves getting your perceived disturbance level to zero. This is defined as one phase in the EMDR process, however you will revisit your disturbance level more than once as you are working through your negative cognitions, emotions, and body sensations.

Once your perceived disturbance level has been reduced to zero (or a very low number such as one), EMDR works to install and enhance a positive cognition instead of a negative one. An example of this might be going from, “I can never do enough,” to, “I’m doing enough at this moment.” Installation is not meant to make you think in an unrealistic way, but rather to help you move toward a life that feels less fearful and more fulfilling.

Paying attention to body sensation, including where you may be feeling tension or tightness, is an important part of EMDR. Your emotions live in your body and often manifest in a physical way. They provide information on what parts of the experience you are working with may still be challenging.

A properly trained EMDR therapist will take care not to allow you to end a session in a state of high emotional disturbance. They will bring up tools, such as your calm safe space, that you developed in the preparation phase. This allows you to better regulate and engage in your life between sessions.

The eight phases of EMDR repeat until you feel you have sufficiently worked through an experience. Reevaluation is where you review the process and decide with your therapist what still needs to be done.

Everyone responds to therapy differently, and EMDR therapy is not excluded from this. What comes up for you in the process may be completely different than what comes up for someone else. However, there are several common threads in regard to expectations, including:

EMDR is not about discovering a historically accurate timeline of events. There will likely be many memories, thoughts, emotions, and sensations that arise as you reprocess experiences. Your therapist will encourage you not to look at what arises as factual, but rather to follow the feelings as a means of finding relief.

You will likely have sensations from EMDR sessions that carry over in the days following. It is also common to have more vivid dreams and/or new realizations regarding the experiences you are reprocessing. There is a possibility that these sensations will become intense or overwhelming. This is why it is important to remember and use the regulation and safe space tools you learn as part of the process.

There is no one set timeline for how long EMDR takes. If you are looking to work with one experience, it may only take a few sessions. If you are looking to work with many experiences, it may take months. The pace of EMDR also varies based on the types of experiences you are reprocessing, your emotion regulation skills, and your desire to interweave other modalities such as talk therapy.

EMDR is generally effective with:

• Trauma and PTSD (both complex and single incident)
• Anxiety
• Panic Disorders
• Depression

This list is not exhaustive, and every situation is unique. Having an open discussion about the potential benefits and drawbacks of EMDR with your therapist is a vital part of the process. Your therapist will be able to help you determine if you may be able to find the relief you are looking for through participating in EMDR.

EMDR should generally not be used with:

• Active Substance Use Disorders
• Unmanaged Bipolar Disorder
• Unmanaged Personality Disorders

Again, this list is not exhaustive and cannot take into account every individual situation. Talking to your therapist is the best way to find out if EMDR is right for you. If you struggle with one of the above and are still wanting to try EMDR, there is a chance that building up your coping and emotion regulation skills could make you a good candidate in the future.