Eye Movement Desensitization and Reprocessing (EMDR) is a comprehensive, integrative psychotherapy approach. Effective psychotherapy elements are included that are designed to maximize treatment effects, including psychodynamic, cognitive behavioral, interpersonal, experiential and body-centered therapies.
EMDR psychotherapy is an information processing therapy using an eight phase approach to address the experiential contributors of a wide range of pathologies. It observes past experiences that have set the foundation for pathology, the current situations that trigger dysfunctional emotions, beliefs and sensations, and the positive experience needed to enhance future adaptive behaviors and mental health.
Various procedures and protocols are used during treatment to address the entire clinical picture. One of the procedural elements is dual stimulation using bilateral eye movements, tones or taps.
While in the reprocessing phase, the client attends momentarily to past memories, present triggers or anticipated future experiences while simultaneously focusing on a set of external stimulus. During this time, clients generally experience the emergence of insight, changes in memories or new associations.
Eight Phase Therapy Process
Phase I
This is a history taking session, assessing the client’s readiness for EMDR and developing a treatment plan. During this process, the therapist identifies and clarifies potential targets for EMDR. Target examples include recent disturbing issue, related historical incidents, current situations that elicit emotional disturbance. The client will develop specific skills and behaviors that will be needed by the client in future situation.
Phase II
In this phase, the client needs to be in a relatively stable state. They should have sufficient coping skills as well as methods of handling emotional distress. If not, therapy focuses on providing these.
Phases III-VI
A target is identified and processed using EMDR procedures. These involve the client identifying the most vivid visual image related to the memory, a negative belief about self, related emotions and body sensations. The client also identifies a preferred positive belief.
The client is instructed to focus on the image, negative though and body sensations while simultaneously moving their eyes back and forth following the therapist’s fingers as they move across their field of vision. Eye movement is the most common external stimulus, but auditory tones, tapping and other types of tactile stimulation are used as well.
The dual attention and length of each set is customized to the client’s needs. Afterwards, the client reports on anything that happened, perhaps a thought, feeling, physical sensation, image, memory or change in any one of the above. Depending on the client’s feedback, the clinician will facilitate the next test. This process is repeated numerous times throughout the session. After several sets, clients generally report higher confidence in positive belief.
Phase VII
The closure phase. The therapist asks the client to journal any related material that may arise during the week, as well as remind the client of the self-calming activities learned in phase two.
Phase VIII
Re-evaluation of the results and progress from the earlier phases. The session begins with reviewing the client’s week, noting any new sensations or experiences. The object of this phase is to ensure the processing of all relevant historical events.
After EMDR processing, clients generally report that the emotional distress related to the memory has been eliminated, if not greatly decreased, and that they have gained important cognitive insight. These changes usually result in spontaneous behavior and personal change.