EMDR Therapy Phases
EMDR therapy is one of the best therapies for trauma, PTSD, depression, or negative beliefs about oneself. However, EMDR therapy can seem strange for many people. The eye movements bring up thoughts of hypnotists or magicians more than a therapist. In this series, I will demystify EMDR therapy by going through what to expect in each of the 8 phases of EMDR therapy. It is important to know that the phases are not always done one by one in order. Also, some phases can be done simultaneously, such as phases 1 and 2. Some phases are repeated for each memory, such as phases 3 through 8. We will begin with the first phase: history taking.
The Beginning
History taking is something EMDR therapy shares with other therapy types. This phase marks the beginning of the relationship between client and therapist. This relationship building is critical for the successful outcome of any form of therapy. The therapist in this phase will ask questions to get to know you regarding your career, family situation, and goals for therapy.
Is EMDR Therapy Appropriate?
One of the most important parts of the history-taking step is deciding whether the client is appropriate for EMDR therapy and what preparation is needed to begin processing memories. Safety is the biggest factor that determines whether a client is appropriate for EMDR therapy. To engage with EMDR therapy safely, a client must be physically healthy enough to withstand the high levels of emotional arousal common during memory processing. Also, a client needs to be stable enough to process disturbing memories without engaging in self-harm or other risky behaviors.
Memory Identification
Another important part of this phase is identifying the memories that will be processed. This is often done by the floatback technique, where the therapist will ask you to think of a recent disturbing experience, a negative belief about yourself related to this experience, and notice any physical sensations. They will then say, “Now hold the image and negative belief in mind, and notice the sensations in your body, and just let your mind float back to an earlier time and tell me the first scent that comes to mind where you felt this way before.”
Dissociation
PTSD is often accompanied by dissociation and sometimes a dissociative disorder. Dissociation has a big effect on treatment planning, so you can expect an assessment for these symptoms during this phase. If dissociative symptoms are severe enough, you may be referred for a formal assessment.
What to Expect?
So, what can you expect in phase 1 of EMDR therapy? You will be asked a lot of questions by the therapist regarding your goals, stability, and safety factors. The floatback technique mentioned earlier or other similar methods will be used to identify memories to target. You and your therapist will be building trust and rapport during this phase. Also, you will be asked questions about experiencing dissociative symptoms. Next, we will look at phase 2: client preparation.