What is EMDR and how does it work?
As an Integrative EMDR therapist in Oakland, CA, I often hear confusion about how EMDR works. Here’s a brief overview of how EMDR was developed, how it can help, and what to expect in a typical EMDR session.
When you go through a difficult experience, your mind stores thoughts and feelings from that experience in your memories. Sometimes, those thoughts and feelings from that difficult experience can be brought about, or triggered, by seemingly insignificant things.
For example, You're walking down the street and hear a loud noise- you feel jumpy and startled. Your boss makes a comment about your work performance- you feel embarrassed and believe that you are not good enough. A friend doesn’t call you back- you feel sad and like they don’t like you.
Eye Movement Desensitization Reprocessing (EMDR) was developed by Francine Shapiro in 1987 while she was walking through the park mulling over her own distressing memories. She noticed that as she walked, her eyes went side to side and the distressing memory became less intense, and the thoughts and feelings no longer felt so distressing.
How Does EMDR Work?
EMDR works to reprogram your brain by turning off the alarm system in your mind that was originally turned on to help protect you from a distressing or dangerous event or moment. In essence, EMDR trains your brain to know that you are safe in the present moment, and you are no longer in danger (and thus no longer need to send danger signals through your present-day symptoms (panic, overwhelm, anxiety, negative thoughts/ beliefs, etc). EMDR follows an 8-phased protocol and requires advanced training and experience to effectively and safely administer it.
What happens during an EMDR Session?
It depends! EMDR can look super different depending on what phase of treatment you are in. Here’s a brief overview of the 8 phases of EMDR reprocessing.
The 8 Phases of EMDR Reprocessing
1) History taking:
First, the therapist will take your history and discuss what your goals are for therapy, and orient you around how they will help you reach those goals. The therapist will help you determine which events to focus on for processing, and develop a treatment plan to do so. This typically takes 1-3 sessions.
2) Preparation:
Then, the therapist will work to prepare you for reprocessing. This might look like learning grounding exercises, or coping skills to regulate intense emotions when they come up. The therapist will explain EMDR, and teach you about bilateral stimulation (back and forth movements either through eye movements, tactile stimulation, or sounds) which helps activate your brain’s unique ability to heal distressing memories. Sometimes, the preparation stage can take a few sessions, and in many cases, much longer in order to safely prepare you for the next phase. Taking the time to fully prepare makes a huge difference in being able to safely and effectively work through the distressing material (and reduce your present-day symptoms bringing you into therapy).
3) Assessment:
The next phase typically takes less than a full session (often a few minutes) and helps set up the memory you are about to move into during the next phase, desensitization. The therapist will ask you questions about the distressing memory, including the negative belief about yourself you currently feel when you think of the distressing memory, the intensity, and a positive belief about what you’d like to believe about yourself instead.
4) Desensitization:
The therapist will work with you to activate the disturbing memory and administer bilateral stimulation (BLS) in order to allow your brain to move through the distressing material related to that memory. Sometimes, this might look like thoughts or feelings related to the memory, or sometimes additional memories or body sensations. The therapist will periodically stop administering BLS and check-in around what you are experiencing, sometimes offering helpful insight or questions to allow your brain to move through stuck, or difficult material.
5) Installation
Once the intensity of the memory is down and you no longer feel presently distressed when you think of the memory, the therapist will check in around the positive belief you discussed in the assessment phase. Sometimes, that belief can change. Once you have a positive belief that feels true, the therapist will help you install that belief together with the memory to correct the negative or distressing belief to something that’s more helpful/ or true. For example: I am not enough might become I am capable and more than enough.
6) Body Scan
The therapist will ask you to scan your body and see if there’s any emotional charge still remaining in that original memory. If so, the therapist will go back to continue desensitization.
7) Closure
The therapist will close the session. If the memory is incomplete, the therapist will support you in grounding so you feel less triggered between sessions.
8) Reevaluation
If the desensitization was incomplete in the previous session, this phase opens the next processing/ desensitization session. The therapist will reevaluate the memory and start over at phase 4.
