What are people talking about when they refer to the eight phases of EMDR? Let’s get into it.
Phase 1: History Taking & Treatment Planning
We always begin with establishing your goals for therapy and getting a detailed history, including a timeline of your symptoms and the emotions, beliefs, and bodily sensations that go along with them. Then, we use that information to find memories related to your symptoms. Don’t worry if you struggle to find memories; your therapist has tools for that and will help you find relevant ones.
This phase may require one to three or more sessions to ensure a thorough understanding of your unique issues, needs, and goals.
Phase 2: Client Preparation & Stabilization
In this phase, your therapist will explain EMDR and what you can expect from the process. You and your therapist will collaborate to choose a memory to start with. At the same time, your therapist is assessing what inner resources you have, so this phase may include learning coping tools to help your emotional stability and tolerance of difficult material.
This phase can be anywhere from part of one session to multiple sessions.
Phase 3: Target Assessment
Here, your therapist will ask you questions about the memory to activate it, including what emotions, physical sensations, and negative beliefs come up when you think of the memory. Your therapist will also have you identify one image from the whole memory that gives you the most tension in your body.
In this phase, you are activating the memory to begin reprocessing it and thus should flow quickly into phase 4, Desensitization.
Phase 4: Desensitization (eye movements / bilateral stimulation)
Now that the memory was activated in phase 3, your therapist will have you focus on the image you chose, along with the content that goes along with it, and then you will begin eye movements while focusing on those things.
Bilateral stimulation is done in “sets.” These sets are usually about 30 seconds but generally range in length from 15-60 seconds. At the end of every set, your therapist will ask you, “What are you noticing now?” or a similar question. Your job is to simply say what came into your mind during the set.
Many different things can come up once you begin bilateral stimulation, including emotions, memories, images, thoughts, beliefs, and physical sensations. Don’t judge what comes up – just notice it and know it will pass as you continue. You continue doing sets like this until you can look at the image again and not feel any physical tension/disturbance in your body. Your therapist will direct you as you go and tell you when you should return to looking at the image.
This phase can range from part of one session to multiple sessions for a single memory.
Phase 5: Installation (eye movements / bilateral stimulation)
Once you no longer feel much physical disturbance when thinking of the image from the memory, your therapist will move you on to the Installation phase. This refers to the “installation” of a new, positive belief to replace the old, negative one you started with.
For example, you could have started with the belief “I’m not safe” – a positive belief to choose might be “I am safe” or “I am safe now.” Whatever you choose should be a generalizable statement and something you want to believe instead of a negative belief. The positive belief should not feel true at first – that’s part of why you’re installing it!
For this phase, you will look at the same image you chose earlier, but this time, add the positive belief with the image and just do more eye movements.
Phase 6: Body Scan (potential eye movements / bilateral stimulation)
Once the positive belief you chose feels completely true, you are ready to move to phase 6. This is a full body scan to ensure there is no lingering tension/disturbance felt in your body. Essentially, we are making sure the body and mind agree. If residual bodily sensations arise, your therapist will have you do additional bilateral stimulation until there is no more tension in the body when thinking of the memory.
This phase can be as quick as a few minutes or a significant part of a session.
Phase 7: Closure
Closure is often a more casual check-in to see how the experience was for you and how you are feeling. This could simply be some small talk between the two of you. Your therapist will also remind you that you can have some after-effects from EMDR, including tiredness, vivid dreams, or feeling up and down in your mood (these after-effects will go away after 24 hours, just so you know).
Phase 8: Reevaluation of Treatment Effect
In this final phase, we take a look at the effect reprocessing this memory has had on your mental health and symptoms. You will most likely choose the next memory to reprocess – or the symptom you were bothered by could be gone! But here we are, essentially getting a new lay of the land and deciding what to do next that would help you the most. Remember, these phases are very flexible – you can skip around or move quickly between them. You will return to all of them throughout your time doing EMDR.
So there you have it – all eight phases of EMDR! I hope this was helpful for you in understanding what the heck EMDR is and what it looks like in a session.
Feel free to reach out to Firefly Therapy Austin if you want to try it for yourself.