- Trish Stephens
The 8 Phases of EMDR Standard Protocol
Trauma is an experience that almost all of us will go through at some point in our lives. Whether it is a car accident, an act of violence, a physical and mental assault, a death, a natural disaster, or any other form of trauma, we are all likely to be experience at least one traumatic event within our lifespan. Many people experience more.
The natural outcome of trauma are feelings of unease, anxiety, stress, grief, and depression. Over the course of time, some people will work through these feelings, either by talking with their support people, or on their own. However, many people experience difficulties when trying to overcome their exposure to trauma, especially if they do not reach out to a professional.
Although many individuals will not be officially diagnosed with post-traumatic stress disorder (PTSD), many will experience prolonged side effects such as nightmares, fear, anxiety, panic attacks, and flashbacks. Individuals may intentionally (or unintentionally) avoid people, places, or things, that trigger reminders of the trauma. Sometimes, a person may lose interest in activities that previously produced pleasure, or they may feel blame, guilt, or shame, as a result of the trauma. For some, substances such as alcohol or drugs may be used to self-medicate.
EMDR (eye movement desensitization and reprocessing) is a type of therapy that psychotherapists use to treat individuals who experience symptoms of PTSD due to trauma. EMDR allows individuals to reprocess traumatic memories, learn how to cope with them in a healthy manner, and disassociate any unnecessary emotions that cause difficulty in their everyday lives. Numerous studies have proven EMDR to be effective in treating both minor and severe symptoms of PTSD.
Eye movements are the most distinguishing aspect of EMDR, but the therapy involves several other therapeutic techniques, carried out through eight specific phases, and work within the past, present, and future time-frames.
As there are still a limited number of clinicians in Ottawa, ON who are trained to administer EMDR therapy, many people do not know what EMDR is, or what it involves. The outline below will allow the client can gain a better understanding about what to expect when they begin a standard EMDR treatment plan. Speaking with people who have participated in EMDR therapy, watching videos of EMDR therapy sessions, or experiencing it yourself with a trained EMDR clinician, is often the best way to understand and gain perspective about this effective and efficient therapeutic method.
The 8 Phases of Standard EMDR Protocol:
Phase 1 -
The initial phase of EMDR treatment involves the client’s history. The therapist and client will work together to identify past specific events, memories, or feelings (we call these “targets”) that are representative of the major or minor traumas one has experienced. These events are discussed in general terms, and the client does not go into specific details at this point. This phase is often called “target mapping” as it creates a map or guide for the following sessions. During this phase, the client will also gain additional information about the remaining phases.
Phase 2 -
In the second phase, the therapist will teach the client numerous stress-relief techniques, including a “Safe Place” exercise, a few mindfulness techniques, and other skills that will ensure the emotional and mental safety of the client throughout the EMDR sessions. The client may practice and utilize these skills in-between sessions, whenever they are experiencing stressful or anxiety provoking situations.
Phase 3 - 6 -
In the third, fourth, fifth and sixth phases, EMDR therapy focuses more specifically on the previously identified traumatic events (called targets).
During these phases, the client will go into slightly more detail or depth when identifying the image associated with the target. They will also be asked to identify a present negative feeling about oneself when they think about the target. Examples of this negative feeling or belief might be: “I am not competent”, “I am not safe”, or “I am not good enough”.
The client will also be asked to identify any physical or emotional feelings that are related to the trauma or target; anger, sadness, or a tightness in the chest for example.
Lastly, the client will then be asked to identify a positive thought they would like to believe about themselves in the present. Examples include, “I AM competent”, “I AM safe”, or “I AM good enough”.
At this point, the therapist will begin the external bilateral stimulation, either moving their fingers back and fourth or turning on buzzing nodes that the client holds in their hands, and they will ask the client to think of the memory or target as they focus on the external stimuli. Next, the client becomes aware of the thought, image, or feeling that they are experiencing in that moment, communicate this to the therapist in as much or as little details as they desire, and then continue to focus on the external stimuli again. This pattern is repeated until any distress that is felt has diminished.
Occasionally, the reprocessing phase will take more than one session to complete, but will rarely take more than two.
Phase 7 -
Phase seven emphasizes closure for the client. We review the stress-relief techniques learned during phase two. The client is grounded and oriented to the present moment. The client may also be asked to keep a log of any images or feelings that arise after their first reprocessing session, to be reviewed during the next appointment.
Phase 8 -
In phase eight, the client and therapist will examine the progress made in previous sessions, and then work together to identify any possible future events that might require different coping techniques, skills or responses. Due to client resources and timing, phase 8 is not always completed with an EMDR therapist. The most critical targets that impact a client’s life are almost always in the past. However, when resources and client schedule allow, future targets can be utilized as well, in order to prepare for a future event, such as a court hearing, or difficult meeting (for example). This can be a powerful step in helping to bolster the client's future coping skills.
EMDR is an effective and efficient form of therapy in treating depression, anxiety, and PTSD. If you have any questions about how EMDR can help your symptoms of depression, anxiety, or trauma, please feel free to contact me.