What Are the 8 Phases of EMDR Therapy?

Reviewed on 4/29/2021
EMDR therapy
EMDR therapy treats people with trauma and has eight treatment phases

Eye movement desensitization and reprocessing (EMDR) is a type of psychotherapy used to treat people with mental health issues such as:

EMDR therapy was originally designed to relieve symptoms associated with an unhealthy processing of traumatic memories. The therapy is intended to reboot the brain cells and help the brain reprocess these traumatic memories and develop healthy coping mechanisms. 

8 treatment phases of EMDR therapy

EMDR is based on the concept that certain eye movements reduce the intensity of negative emotions such as anxiety and depression. The therapy has eight treatment phases:

1. History taking and treatment planning

The first phase involves taking a thorough medical history to identify the specific trauma affecting you, as well as its intensity and potential triggers. Your therapist will then map out treatment goals, which are prioritized for sequential processing.

2. Preparation

Your therapist will help you talk out the problem and provide you with an overview of the treatment plan. They will explain in detail what they think is causing your symptoms and how you can start learning to process your trauma in a healthy way. They may teach you some self-control techniques (deep breathing, progressive muscle relaxation, etc.) to help you calm your mind and reduce your anxiety. 

3. Assessment

You and your therapist will work together to identify the target memory that triggers emotional distress:

  • What incident caused the trauma? (Was it sexual assault, an accident, the death of a relative?)
  • What is the most consistent image associated with the memory?
  • How is the traumatic incident relevant to the present? (What is the chance it will recur?)

During this phase of EMDR therapy, a positive belief may be introduced (“You are safe now”) to help counteract the negative emotions caused by the trauma.

4. Desensitization

In this phase, the disturbing event is evaluated rationally. Your therapist will try to help you change the way your brain associates trauma with its trigger

You will be asked to focus on an image that evokes a negative reaction while simultaneously making eye movements using bilateral stimulation. The bilateral stimulation is done in a series of sets that last around 25 seconds each. After each set of eye movements, you will be instructed to take a deep breath and asked to provide feedback on your experience during the preceding set. 

Depending upon the intensity of your response to the trauma, your doctor may adjust the length, speed and type of stimulation used to cause your eye movement.

5. Installation

Here, your therapist will work with you to “install” a positive belief deeply into your thought process, meaning they will help you strengthen the positive belief so that it replaces the negative one. For example, if you were physically assaulted as a child, you will be helped to realize that as an adult you are capable of resisting assault. 

This process will continue until your feelings of distress reduce and you experience more positive feelings after each set. 

6. Body scan

After the installation phase, you will be asked to bring back the traumatic event to reevaluate it. The purpose of this is to help your therapist see whether there is any residual trauma; in other words, whether the event elicits a somatic response such as raised pulse. raised blood pressure or muscle tension. If you are still experiencing negative emotions related to the event, your therapist will continue with sessions of bilateral eye movements.

7. Closure

Your therapist will emphasize stress reduction techniques and ask you to maintain a record of disturbances that occur between sessions and coach you on how to manage them. 

8. Reevaluation

Your therapist will evaluate the effectiveness of the treatment and the need for further sessions and then plan a follow-up session if needed.

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References
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3122545/

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