If you’re on TikTok or Instagram reels, there’s a good chance you’ve come across ‘MentalHealthTok’ and seen a video or two talking about the magic of EMDR therapy. With new research comes new therapeutic approaches and interventions, and while EMDR isn’t necessarily a new approach it is definitely becoming more popularly requested. However, despite popularizing EMDR, TikTok can also portray a variety of ‘sus’ misconceptions about therapy. So what is EMDR? Let’s spill the tea.
EMDR stands for Eye-Movement Desensitization and Reprocessing and includes an eight-phase procedure that aids in the reprocessing of traumatic memories. When we aren’t provided the tools and resources to process trauma in real time, the associated beliefs and sensations from the trauma are stored incorrectly in the limbic system, resulting in symptoms of PTSD and depression that can be triggered any time after the trauma occurs.
EMDR is used primarily for acute single-event trauma, but can also be used for processing chronic trauma, depression and anxiety triggers that ‘live rent-free’, addiction-related issues, and even phobias. The eight phases of EMDR consist of History Taking and Treatment Planning, Preparation and Resourcing, Assessment, Desensitization, Installation, Body Scan, Closure and Re-evaluation.
Phase 1
In Phase 1 – History Taking and Treatment Planning, the clinician and client will spend a good chunk of time getting to know each other – also known as a ‘vibe check’. This is where they build trust and rapport, which is very important when navigating the vulnerability that comes with experiencing and exploring past trauma and current stressors. The clinician also gathers ‘the lore’ about the client’s background, including but not limited to family history, childhood upbringing and history of trauma. The clinician will utilize this background information, in addition to the client’s current needs and goals, to develop a treatment plan. This process can take anywhere from a few weeks to a few months to even a year depending on the client’s history and current needs. It’s important to set realistic expectations of healing, as it is something that absolutely should not be rushed!
Phase 2
EMDR emphasizes the importance of emotional safety and stability, which is where Phase 2 comes in. The Preparation and Resourcing phase is all about assessing the client’s window of distress tolerance, developing coping skills and relaxation techniques, and installing internal resources that can be used to support the client through reprocessing. Essentially, we’re ‘safetymaxxing’. This can also take a few weeks to a few months depending on the client’s window of distress tolerance, and is, in my opinion, the most important phase of the process – so this also can’t be rushed!
Phases 3
Phases 3 through 7 typically happen altogether in the same session. The client will engage in a memory floatback, identifying a core or touchstone memory that falls along the same neural network as the client’s current triggers. The touchstone memory will oftentimes be the first memory to be reprocessed, and together the clinician and client will identify the associated negative beliefs the client holds about themselves that were formed and stored as a result of the touchstone memory. Next, the client will identify the worst image from the memory (think of this like a mental screenshot) to use for reprocessing. Using the touchstone memory, the negative beliefs and the worst image, the clinician will guide the client into reprocessing.
Phase 4
Phase 4 utilizes dual awareness and bilateral stimulation to engage the client into reprocessing. Dual awareness means simultaneously giving attention to both past experience and present moment; and bilateral stimulation is an alternation of stimuli on either sides of the body via eye movements, audio tones, or physical buzzers. The client will bring up the mental image and the negative beliefs associated with the trauma, and utilizing the dual awareness and bilateral stimulation tools, the image should become less and less distressing. The client will begin to process the emotions and beliefs about the trauma in a safer and more controlled setting than when originally stored – ‘it’s giving’ emotional healing #hopecore.
Phase 5
When the distress level of the image reaches the lowest possible level, we move into the Installation phase of EMDR. Still utilizing dual awareness and bilateral stimulation, this is where we replace the negative belief with a more positive, empowering belief. This action not only helps to keep the trauma desensitized, but engages the client in their own strength and capability to be accessed outside of session; basically, we turn an ‘L’ into a ‘W’.
Phase 6
We then engage the client in a Body scan to assess for and attend to any residual tension or stuck feelings. The client closes their eyes, focuses on the target memory and the new positive cognition, and scans their body for tension/residual distress. If tension is present, the client will process through any disturbance with bilateral stimulation until body feels clear.
Phase 7
Lastly, phase 7 provides closure to the reprocessing and breaks down the positive work conducted throughout the session. It provides processing to the reprocessing, if you will.
Phase 8
Phase 8 is where the clinician will re-evaluate the client’s targets and goals, and possibly explore the next target if the client feels ready. At the start of the next session, the client and clinician review the previously processed target and identify if the distress remains low, if the positive cognition holds, and if any new material that comes up in the process needs addressing.
As convoluted as this process sounds, it really isn’t as scary as it seems, and can be a very effective way to help those who feel stuck in their trauma move on – ‘no cap’. The idea is to remove stuckness and powerlessness from an experience (or multiple experiences) that made a lasting negative impact. Because every client is different, the process of EMDR can take anywhere from a few weeks to a year, so it’s important to set realistic, non-’delulu’ expectations. Effective and lasting EMDR is not a quick fix, but it is a way to increase distress tolerance, develop coping skills, find inner strength and empowerment, and help your current, safe self connect to and support your past self stuck in trauma time.
For more information, please feel free to reach out to our office and ask for me, Alex, Ken or Alexus – we’d be honored to help you achieve your ‘glow up era’.