What is the process for undergoing Eye Movement Desensitization and Reprocessing (EMDR) therapy?

The EMDR Therapy Process: An 8-Phase Protocol

Eye Movement Desensitization and Reprocessing (EMDR) therapy is conducted through a structured 8-phase approach that helps process traumatic memories and experiences by utilizing bilateral stimulation techniques. 1

Phase 1: History Taking and Treatment Planning

• Collect detailed client history
• Identify traumatic memories to target
• Assess client's readiness and stability for trauma processing
• Develop a comprehensive treatment plan
• Establish therapeutic relationship and safety

Phase 2: Preparation

• Teach self-regulation techniques (grounding, containment exercises)
• Explain EMDR process and mechanism to client
• Practice bilateral stimulation methods:
  • Eye movements (following therapist's fingers or light bar)
  • Tactile stimulation (tapping, handheld buzzers/"tappers")
  • Auditory stimulation (alternating tones through headphones)
• Establish "safe place" visualization for stabilization

Phase 3: Assessment

• Select specific traumatic memory to process
• Identify:
  • Visual image representing the worst part of the memory
  • Negative cognition/belief about self related to the event
  • Desired positive cognition to replace negative belief
  • Current emotions associated with the memory
  • Physical sensations experienced when recalling the event
• Rate distress using Subjective Units of Disturbance Scale (SUDS, 0-10)
• Rate validity of positive cognition using Validity of Cognition scale (VOC, 1-7)

Phase 4: Desensitization

• Focus on the target memory while simultaneously engaging in bilateral stimulation
• Process associated thoughts, feelings, and body sensations
• Continue sets of bilateral stimulation until distress level decreases (SUDS approaches 0)
• Address any new associations or memories that emerge during processing

Phase 5: Installation

• Link the positive cognition with the original memory
• Strengthen the positive belief through bilateral stimulation
• Continue until VOC reaches 6-7 (completely true)

Phase 6: Body Scan

• Mentally scan the body while thinking of the original memory
• Identify any remaining physical tension or discomfort
• Process residual physical sensations with bilateral stimulation

Phase 7: Closure

• Return client to emotional equilibrium
• Use self-calming techniques if processing is incomplete
• Prepare client for possible continued processing between sessions
• Document progress and remaining work

Phase 8: Reevaluation

• Begin each new session by reassessing previously processed targets
• Check for any new material that has emerged
• Determine if processing goals have been met
• Identify next targets if needed

Evidence and Efficacy

EMDR has demonstrated effectiveness for treating PTSD and trauma-related disorders. A non-randomized controlled trial of 83 Vietnam veterans showed EMDR produced significant improvement in nightmare severity compared to biofeedback and relaxation therapy (p < 0.01) 1. The therapy works by inducing processing of disturbing memories through neural mechanisms similar to those activated during REM sleep 1, 2.

Important Considerations

• Therapist Qualifications: EMDR should only be performed by properly trained and certified mental health professionals
• Client Safety: Adequate stabilization and coping skills must be established before trauma processing
• Treatment Duration: Typically requires multiple sessions (often 8-12) depending on trauma complexity
• Virtual Delivery: Research shows virtual EMDR can be as effective as in-person treatment 3
• Complex Trauma: EMDR can be effective for Complex PTSD but may require additional stabilization 4

Potential Challenges

• Emotional intensity during sessions may be high
• Some clients may experience temporary increase in symptoms between sessions
• Processing may continue between sessions
• Not all clients respond equally well to the same bilateral stimulation methods

EMDR represents a specialized approach to trauma treatment that has gained substantial evidence support over its 25+ year history 5. The structured protocol provides a systematic way to process traumatic memories and reduce their emotional impact on quality of life.