Before EMDR processing occurs, your therapist will spend a few sessions doing preparation and history-taking (please see What to Expect in the First Few Sessions). Preparation and history-taking typically takes 3 to 5 sessions but may take longer depending on your history of trauma and your current sense of personal resilience.
You should not expect to do EMDR processing in your first couple of meetings with a therapist. Through preparation and history-taking we establish an infrastructure to be able to do the processing. As well, we are building a therapeutic relationship. Being able to trust your EMDR therapist and have faith in EMDR are important and those early sessions help to establish that.
EMDR uses an eight phase approach
EMDR uses an eight phase approach. Preparation and history-taking occur in Phase 1 and 2. An EMDR processing session might include Phases 3 through 7, and these phases may occur in one 60 or 90 minute session, or may take two or more sessions.
In Phase 3 we identify the problem to work on and ask a series of questions about it to identify an image, a negative belief associated with the situation (for example, I am unsafe or I don't matter), the emotion and body sensations that are evoked when the memory is recalled.
Phase 4 is the processing phase where desensitization occurs. During this phase the therapist moves his/her fingers back and forth (the client follow's with their eyes) (or the therapist uses alternating hand taps) or uses a machine with pulsars that vibrate back and forth (or headphones with alternating sounds). The mind and body respond to this by recalling fragments of the memory, for example, "now I have an image of my teacher looking stern at the front of the classroom; now my stomach feels upset; now I feel ashamed; now I hear the other children laughing" and so on. The goal of this phase is essentially metabolizing or digesting the memory or situation that 'got stuck' in the body at the time the incident occurred. Through the process the discomfort reduces throughout the session and eventually is neutralized.
Once the incident is neutralized, the therapist moves on to Phase 5. Here we reconnect with the corresponding positive belief and how that feels in the body (for example, I am safe now.) The process is similar with eye movements or pulsars but the body starts to feel stronger and more grounded and the person tends to recall related incidents from the past when they felt safe.
Phase 6 tends to be brief and clears any residual discomfort in the body.
Phase 7 is a wrap up but tends to involve relaxing and grounding into the present to prepare to leave the therapy room. It may involve conversation, imagery or exercises for mindful presence.
Phase 8 occurs in the following session, and it is where we re-evaluate the work done in the previous session. Part of the goal is to see what has integrated between sessions, and part of the goal is to see if there is more to work on from that issue.
Virtual EMDR Therapy
Read about Virtual EMDR Therapy and what to look for when looking for an EMDR therapist to do virtual work.