EMDR THERAPY: An 8 Phase Model

EMDR Therapy is a powerful therapy created by Francine Shapiro in the late1980”s initially to help people who had experienced trauma and were suffering from Post Traumatic Stress Disorder symptoms. Today, EMDR is a well researched, scientific and evidence based therapy that is the gold standard in the treatment of trauma and PTSD.
EMDR (Eye-Movement, Desensitization, and Reprocessing) enables people to heal from the symptoms and emotional distress that are the result of distressing life experience. Through EMDR, therapists are able to help clients activate their natural healing processes.

EMDR Therapy is an eight-phase treatment model. Dual Attention Stimulus (DAS) or sometimes referred to as Bi-lateral Stimulation (BLS) are used to activate the right and left hemispheres of the brain. This stimulus can be achieved by various means such as following eye movements, self tapping, audio tones and other methods. The effect of DAS is similar to what happens during REM sleep.

During passes of DAS, clients are asked to “notice what comes up” or “notice that” as internal associations arise and the client begins to experience desensitization and reprocessing of the memory. A client may notice emotions, thoughts, or somatic experiences during these passes.

EMDR focuses on three time periods, the past, present, and future. Attention is also given to the first, worst, and most recent parts of a specific memory or experience.

The 8 phases of EMDR Therapy

Phase 1: History Taking

This phase begins during the first session (usually with the intake). The therapist will focus on gathering information about the client related to what brings them to therapy. Equal focus is given to past events as well as current stressors. As part of this phase, the therapist will evaluate client readiness for EMDR and develop a treatment plan. This is a collaborative effort between therapist and client.

The therapist and client work together to identify targets or specific distressing memories and experiences for processing. These can include past incidents, current situations that cause emotional distress or memories. Targets can also be single incident experiences like a car accident, medical trauma, work accident, etc. Targets can also have a long range focus such as childhood related trauma or losing a loved one over an extended period of time. Sometimes these targets will be developed by creating a timeline of events and giving ratings of current distress levels for each event or memory.

Phase 2: Resourcing

An important component of EMDR or any trauma treatment is creating containment and a calm place so you can begin to work through past and current experiences safely. In this phase the therapist ensures the client has several different ways of handling emotional distress. Skills will be introduced, taught, and practiced inside of session so clients are able to use them successfully outside of session. Some of these resourcing skills may be imagery related, grounding, using senses and breath/somatic skills. Many of the skills are drawn from other types of therapy such as mindfulness and DBT.

Resourcing also includes using already existing networks in the brain by strengthening positive feelings, thoughts, and memories. The therapist may use the client’s innate abilities to create positive resources to draw on during times of distress or when needing support, especially during reprocessing.

Although resourcing is identified as the second phase, it can occur throughout all the phases of EMDR Therapy. Once sufficient resourcing has occurred, the therapist and client will transition to phases 3-7.

Phase 3-6:

The tasks in these phases include assessment, desensitization, reprocessing, installation of positive cognition, and finally a full body scan.

A target is identified and processed using EMDR therapy procedures. These involve the client identifying four things:

● The vivid visual image related to the memory
● A negative belief about self
● Related emotions
● Body sensations

In addition, the client identifies a positive belief. The therapist uses scales related to the levels of distress and the strength of the identified positive belief (SUDS and VOC) throughout these phases.

Once this is accomplished, reprocessing can begin. Clients are asked to hold together the image, negative belief about self and related emotion and body sensations and “notice” what comes up. DAS is applied at this time.

After each pass of DAS, the client is asked to report about what they are noticing which can be a thought, emotion, somatic response, or another memory. Depending on the client’s report, the therapist will continue to ask them to “notice” or will supply an interweave to assist with the reprocessing. As reprocessing continues, clients will notice a desensitization to the memory occuring. The emotions become less intense. The image is less vivid. A reduction in somatic symptoms and experience occurs.

At any time, if the client is experiencing a high level of distress or requests to stop during these phases, the therapist will employ containment and calming strategies to ensure client safety.

When a client is able to report a distress level of 0 or a number ecologically appropriate, the positive cognition is paired together with the image of the memory and installed.

Finally, the client is asked to do a body scan head to toe and notice any disturbance. If clear, body scan is paired with positive cognition and target image and then installed all together, again paired with DAS.

Phase 7: Closure

This phase is one of the most important for any trauma treatment, but especially EMDR Therapy. If reprocessing is not completed, clients can use a variety of skills taught in earlier phases to contain the material worked on until next session. Closure ensures the client leaves the session calm, safe, present, and hopefully better than when the session began.

During this phase, clients are provided information of what to expect between sessions and are encouraged to keep a log of what they notice and use calming and container skills if needed.

Phase 8: Reevaluation

This phase begins with the next session as the therapist checks in with the client about what they noticed in between sessions, evaluating progress, and addressing any questions or concerns. This phase is vital in evaluating progress overtime. Future templates may also be identified and installed during this phase. Just as it is important to finish a full dose of antibiotics, it is also important to finish all 8 phases of EMDR Therapy.

Call today to find out more about EMDR therapy and how it can help you.