By Jamie Sedgwick, LCPC, NCC
Entering into mental health treatment can seem daunting and scary. Oftentimes, people know they need help, but feel overwhelmed by treatment options and the process of determining which treatment modality will best alleviate distressing symptoms. A quick Google search of various treatment modalities will result in confusing and conflicting information, littered with terminology and jargon that’s difficult to understand if you don’t have a Psychology Degree.
One such treatment modality is EMDR or Eye Movement Desensitization and Reprocessing. EMDR has become increasingly popular and many people are seeking this treatment. You may be wondering if it is right for you and, if it is, what you should expect from the treatment process. Before making a decision, here are some things you’ll want to know.
What is EMDR?
Eye Movement Desensitization and Reprocessing, or EMDR, is an evidence-based treatment modality for Posttraumatic Stress Disorder (PTSD) that was developed by a doctoral student, Francine Shapiro, in 1987 (Shapiro, 2018). The eye movements that helped EMDR get its name are a form of Dual Attention Stimulus (DAS). DAS is alternating bilateral stimulation utilized during EMDR that assists with the process of desensitization and reprocessing of distressing material during an EMDR session. Today we know that DAS is not simply limited to eye movements, but could be auditory or tactile as well. In fact, eye movements are contraindicated for individuals with a history of seizures or Traumatic Brain Injury (TBI).
DAS is an essential part of EMDR treatment because it is the mechanism that drives desensitization and reprocessing. DAS allows the brain to make necessary connections in order to dispose of maladaptive information that causes distress when recalling certain memories, leaving only adaptive material. The distressing memory is not erased or forgotten, it’s still there, however, it will no longer be distressing when the memory is recalled. Distress refers to maladaptive cognitions, emotions, or body sensations associated with the memory. EMDR is a “bottom up” treatment approach meaning that it incorporates the body as part of treatment ensuring that an individual is healing and not simply learning a variety of coping mechanisms to “put a bandaid on the problem”.
As more memories are desensitized and reprocessed, individuals begin to experience a decrease in distressing symptoms and an increase in adaptive thought patterns and responses. Ongoing research of EMDR has shown it to be effective in treating more than just PTSD including, but not limited to: C-PTSD, Depression, Anxiety, OCD, Eating Disorders and Personality Disorders.
What To Expect
You may have started to deduce that EMDR looks a bit different than traditional talk therapy modalities. Let’s consider what you should expect from the EMDR process and an EMDR reprocessing session.
The 8 Phases of EMDR
EMDR Therapy consists of 8 Phases. While there are phases to this modality, it is not a “one size fits all.” Each phase of treatment will be adapted to meet the individual client’s needs and will take course over a varying number of sessions from one client to the next.
Phase 1 of EMDR is History and Treatment Planning. During this phase, the therapist is gathering important information to help formulate an EMDR treatment plan. The therapist is likely to ask questions about what experiences brought the client into treatment as well as explore areas of strengths. An EMDR therapist typically will NOT ask you to detail all of your past traumas during this phase. There is a reason. When humans talk about an event in detail, it lights up that memory network of the brain and they can begin to experience the feelings, thoughts and body sensations as if they are reliving the event all over again. An EMDR therapist will be mindful of being sure a client is fully prepared for trauma work before asking for information that lights up the memory networks.
Phase 2 is called Preparation. This is usually the phase that differs the most from one person to another because different people will need different skills in order to be prepared for trauma reprocessing. Don’t get discouraged in this phase. The work that happens here is so important to be sure that the trauma reprocessing that happens later goes as smoothly as possible. The therapist will be focused on establishing important coping skills and building therapeutic rapport. EMDR is a very relational therapy because a good relationship is important in order to feel safe during trauma reprocessing. It is also during Phase 2 that the therapist will introduce Dual Attention Stimulus (DAS) for the first time.
Phases 3 – 8 typically occur over the course of two sessions and happen repeatedly – depending on how many memories are being reprocessed. It is during these phases that memories are identified and the appropriate protocol is utilized to desensitize and reprocess the identified memories.
During a reprocessing session, you can expect your clinician to ask a series of questions intended to activate the memory network being targeted for reprocessing. Once the memory network is activated, your therapist will utilize long, fast sets of DAS to assist in reprocessing the distressing memory. Once the memory has been successfully reprocessed so that no distress remains, the clinician will end the session with a focus on using slow, short sets of DAS to strengthen adaptive networks associated with the memory. Your clinician will follow up at the next session to be sure that no new distress content related to the targeted memory network came up between sessions.
After all of the past memories have been identified and successfully desensitized and reprocessed using Phases 3-8, the therapist will assist the client in identifying and desensitizing present day triggers. Finally, the therapist will utilize protocols to assist the client in preparing for possible distressing situations in the future.
It is also important to note that some memories may take longer than one session to complete reprocessing. If this is the case, your therapist will utilize skills taught in Phase 2 to ensure that any incomplete distressing material is contained prior to the end of the session and will revisit the memory to complete reprocessing at the next session.
Finding an EMDR Therapist
If you are interested in EMDR therapy, please contact the Norooz Clinic Foundation at 714-386-9171 or you can visit emdria.org to choose “Find a Therapist” to connect with an EMDRIA trained EMDR therapist. It is important that you be sure your therapist completed an EMDRIA Approved EMDR Training.
At minimum, you want to ensure that a potential therapist has completed the full EMDRIA Approved Basic EMDR Training. Many EMDR therapists will also pursue advanced training and consultation after completing the Basic Training. It’s important to inquire with a potential therapist regarding the details of their training and consultation and any areas of special interest (dissociation, personality disorders, psychosis, eating disorders, etc).
About the Author
Jamie Sedgwick, LCPC completed an EMDRIA Approved EMDR Basic Training in 2017. She credits this training with completely changing her therapy practice. Jamie is now an EMDR Consultant and Director of Training and Consultation at Trauma Specialists Training Institute. She provides EMDRIA Approved EMDR Basic Training, Advanced EMDR Trainings and ongoing EMDR Consultations. For more information, visit traumaspecialiststraining.com