Phase 4
With Phase 4, you have reached the heart of EMDR. This is where the processing begins. As the name of the phase demonstrates, the goal of this phase is desensitization, and this is achieved through eye movements, memory engagement, and assessment. Memory processing always begins with this phase, even if you have already completed it for the current memory. For example, if you are in Phase 5 when the last session ended, you will still go through Phase 4 in the following session.
Desensitization
The goal of Phase 4 is desensitization of the memory. If you remember from Phase 3, a measurement of the disturbance level for the memory was taken. Desensitization means taking that number all the way down to zero. At the end of Phase 4, the memory will no longer disturb you. It is important to note that this does not mean you forget the memory or that the images disappear. It means that you will be able to think about what happened, and it will no longer bother you.
For many people who are weighed down by intense traumas, this can sound unrealistic. However, it is possible! Healing is possible for those willing to do the work. It is hard work, to be sure, but the goal of EMDR is to get through the disturbance as rapidly and as safely as possible.
Eye Movement
The secret of the rapid healing in EMDR is the eye movements. More specifically, it is the bilateral stimulation, which is a fancy way of saying it activates both sides of your brain. This actually can be done by other means. Eye movement has the most research backing, but vibrations, sound, and tapping are also used to process memories.
For eye movements, your therapist will have you move your eyes back and forth as quickly as possible while still being comfortable for you. This is done either by the therapist moving their fingers side to side in front of you, or through a light bar or computer program that moves light back and forth for you to follow. The movements tend to be side to side, but the therapist may also shift to diagonal movements if processing appears stuck. Everyone responds differently to different movements and speeds, so your therapist will work with you to find what works best for you.
Memory Engagement
The other part of memory processing is engaging the memory. This is done as you do the eye movements. You will play the memory in your mind as if you are watching it on a movie screen or as if you were watching the memory go by like scenery outside the car window. Important: you do not engage the memory in the first person. You want to be viewing the memory, not experiencing it as if it were happening again. You want to engage the memory without it taking over your nervous system.
As you engage the memory, other thoughts, emotions, and body sensations may come up. Your mind knows what it needs for healing, so your therapist will direct you down certain pathways that are not the core memory.
As you can guess, memory engagement can be intense. You may experience remembering more of the original incident, the image of the memory changing, tastes/ smells from the incident, and physical sensations you felt during the incident. The therapist is monitoring the processing the whole time to assess these occurrences, maintain safety, and point you in the right direction.
Checking In
Processing the memory is broken up into manageable chunks. The therapist counts how many passes your eyes make back and forth, and will check in around every 25 passes. During the check-in, the therapist will stop the eye movements, allow you to take a deep breath, and then ask something like, “What are you noticing?”
At this time, you will share with your therapist what you experienced during the last set of eye movements. This could be an image, emotion, thought, physical sensation, sound, smell, or taste. There are no wrong answers here. Just report whatever you experience honestly, so your therapist can guide you on what to focus on for the next set. Once they tell you what to focus on, the eye movements will begin for another set. The sets will be longer or shorter depending on what works best for your processing.
Success!
Phase 4 is complete when all pathways of the memory are “cleared,” and you report a 0 out of 10 for disturbance when thinking about the original memory for two sets. There are some cases where a complete 0 won’t be achieved; however, this is not the norm. Even if you do not reach a 0, you will at least be at a 1 or a 2 before moving on to the next step. Your therapist will assess when this is appropriate and when to continue working toward a 0.
What to Expect
During Phase 4, you can expect to engage in some sort of bilateral stimulation (eye movement, vibrations, etc.) as you engage the memory as if you were viewing it, not as if it were happening to you. Your therapist will check in with you every 25 sets or so, and you will report what you noticed in the previous set. The therapist will tell you what to focus on during the next set, and this repeats. Once the disturbance is at a 0 for two sets of focusing on the original memory, the memory is considered complete, and you will move on to Phase 5.