EMDR

What is EMDR?

EMDR is a specific psychotherapy designed to help reduce trauma symptoms. Shapiro initially developed it to decrease the distress associated with chronic PTSD. It can sometimes lead to faster healing than traditional talk therapy. 

EMDR doesn't need clients to give extensive details about the past. Or do homework assignments. This is unlike many conventional treatments. Therapists can intervene effectively. They don't need to know every aspect of the client's life.  

Instead, EMDR focuses on how the brain reacts to unprocessed traumatic memories. Emerging neuroscience continues to support the brain’s ability to rebuild neuroplasticity. Proper interventions can alter how the brain understands and processes information. Over time, it can “retrain” itself in how it responds to triggering material.

EMDR follows eight distinct phases. These allow clients to gradually feel desensitized to their targeted material. After completing these phases, the client has reached a point of resolution. At that point, the trauma no longer has a significant hold over them. 

What Are Some Common EMDR Phrases & Terms?

Intake: Intake refers to the assessment process of psychotherapy. This is a standard protocol in all mental health treatments. During the intake, your therapist will gather relevant details about: 

• your mental health history 

• treatment episodes 

• other important information 

 This information helps with laying the groundwork for your therapy. 

Release of Information: Although it’s not unique to EMDR, an EMDR therapist may ask for a release of information Especially if the client is working with another provider. You always have the right to either allow or deny these requests. This information can help EMDR therapists understand your history and current treatment goals. 

Informed Consent: Informed consent refers to your therapist reviewing the logistics of therapy. Including what to expect and any risks involved. They want to ensure that you understand the process. At this time, it’s reasonable to ask your therapist any questions you have about how EMDR works. 

Treatment Planning: Therapists use treatment plans to create goals and objectives for their clients. This report helps keep you on track. You always have a right to inquire about your progress. If you believe things aren’t moving in the right direction, it’s essential to speak up. 

Target: A target is a specific issue that causes distress. A target can include a past event or present situation. EMDR therapists use targets to initiate their trauma-focused work. 

Bilateral Stimulation: Bilateral stimulation refers to the alternating right and left stimulation. Therapists achieve this by engaging in rhythmic movements like tapping or moving their fingers. This stimulation can be either visual, auditory, or tactile. You will be engaging in bilateral stimulation while sharing your target. 

Bilateral stimulation isn’t unique to EMDR. We engage in it during our daily routines while walking or shaking our heads. It can induce a relaxing effect and help you feel a sense of distance from your stressors. 

Desensitization: Desensitization refers to feeling less reactive to certain stimuli. The intensity of anxious or depressed feelings reduces over time. The goal is to have little to no physical tension once completing EMDR. 

Self-Soothe: To self-soothe means to calm and reassure yourself. People can achieve this by practicing positive affirmations. As well as engaging in healthy coping skills that foster emotional well-being. . Your therapist will teach you various self-soothing techniques during your treatment. 

Resource Tapping: Resource tapping supports self-regulation. It involves using your imagination to raise awareness of internal resources. When practiced effectively, this technique can help rebalance the central nervous system. It helps decrease hyperarousal and anxiety. 

Termination: Termination refers to the end of therapy. During this time, you will review your progress. Your therapist will also provide you with any ongoing referrals for additional care. 

How Does EMDR Work?

After determining that EMDR is appropriate, the work begins with your therapist. They start by asking about your goals and your current ability to cope with distress.  Let’s review the eight treatment phases. 

Phase 1: History and Treatment Planning 

The first phase can take 1–2 sessions. During this phase, you will provide your therapist with a thorough overview of your mental health history. If you release information to your therapist, they may review those notes and ask you to clarify certain details. 

If you share information with your therapist, they may review those notes and ask you to explain certain details. You will also discuss the main issues that brought you into treatment. You can provide either specific details or offer a loose outline—it’s your choice. EMDR does not need you to share an in-depth analysis of your past. 

Phase 2: Preparation 

Preparation can take 1–4 sessions. Although it may take longer for clients with extensive trauma histories. Or those with co-occurring mental health diagnoses.  

In this phase, your therapist will teach you particular techniques to cope with emotional distress. These techniques will help you self-soothe if you become anxious or depressed during the EMDR treatment. 

This phase will include informed consent and a review of your treatment plan. Your therapist will teach you different relaxation skills. You can practice these during and after the session. Some common relaxation skills include: 

• Imagining a safe place 

• Progressive muscle relaxation 

• Grounding with your five senses 

• Taking deep breaths 

• Practicing positive affirmations 

Trust is essential within the therapeutic relationship. You should feel safe and secure with your therapist before diving into trauma work. Trust can take time. Especially when there is a history of trauma. But this rapport is essential for healing. 

Phase 3: Assessment 

During the assessment phase, your therapist will ask you to review your target. You will choose a specific image that best depicts the target. You will also choose a statement indicating a negative self-belief associated with it. 

Common self-beliefs include I am bad or Everyone will hurt me. These beliefs tend to be self-defeating and limiting. They can undoubtedly impact your daily functioning and create significant inner turmoil. 

Your therapist will ask you to rank the level of disturbance this belief gives you on a scale from 0–10. While identifying this negative belief, you will also indicate any accompanying physical sensations or uncomfortable emotions. 

You will then choose a positive self-belief that you would rather believe. This belief should integrate a sense of empowerment and control. For example, a belief might be I am able to be safe now or I am worthy of love. You will rank how accurately you feel this positive statement to be true on a scale from 1–7. 

Phase 4: Desensitization 

The desensitization phase focuses on your targets and all their associated elements. During this time, you may identify other similar events that have happened to you. 

Your therapist will use bilateral stimulations while discussing your main target with you. They'll also continue to assess your SUD-scale levels (subjective units of disturbance) at the same time. The goal is resolution—your target should no longer have the power to cause you immense distress. 

If you become uncomfortable at any time, your therapist will be there to support you. EMDR is not about pushing through complete discomfort. It’s about moving at a pace that feels comfortable and safe. 

Phase 5: Installation 

Installation involves strengthening the positive belief you identified to replace your negative belief. After reprocessing your target in the desensitization phase, you may experience increased awareness and empowerment. 

This process can reinforce the positive belief. The main goal is for you to fully accept this positive statement at a level 7 (meaning that it’s entirely true). 

Phase 6: Body Scan 

After strengthening and installing the positive self-belief, your therapist will ask you to address your original target. They will continue assessing for any remaining tension or negative thoughts. 

EMDR sessions are not considered successfully completed until you can discuss your target without experiencing any physical distress. Depending on the trauma severity, this phase may take some time. 

Phase 7: Closure 

Closure means wrapping up the session and ensuring that you feel safe. Before finishing your session, your therapist will help you achieve a sense of balance. 

Your therapist might also instruct you on techniques you can practice between sessions if you become activated. Practicing these can help strengthen your ability to self-soothe. 

Phase 8: Reevaluation 

During the reevaluation phase, your therapist will assess the treatment and review your goals and progress. This is the last step of treatment, and it’s a critical one to complete. 

How Does EMDR Work with PTSD?

Research shows that nearly 1 in 11 people will experience PTSD during their lifetime. Like most mental illnesses, this statistic may be underreported due to: 

• Ongoing stigmas 

• lack of accessible treatment 

This makes it harder to get accurate data.  

PTSD is a chronic condition that includes a cluster of trauma-related symptoms. These symptoms can vary in severity, but they may include: 

• Hyperarousal 

• Avoidance of certain places, people, or things 

• Depression 

• Substance use 

• Flashbacks or re-experiencing the traumatic event 

• Intense feelings of guilt or worthlessness 

• Intrusive thoughts 

• Night terrors 

• Regressive behaviors (often seen in young children) 

PTSD can cause significant impairment in someone’s quality of life. It can affect anyone, and symptoms can be residual for several months or years. 

EMDR can be an excellent resource. Especially for clients who have not benefited from traditional therapies. It can also be the first response for clients wanting help processing trauma. 

EMDR will help clients: 

• understand their targets 

• practice appropriate relaxation skills 

• become desensitized to the traumatic responses 

It can support people with single traumas or with a history of complex trauma. 

What Kind of Training Do EMDR Therapists Have?

All therapists must have extensive training to provide direct clinical services. First, any practicing clinician must have a qualifying degree in: 

• counseling 

• psychology 

• nursing 

• social work 

They must also complete all clinical internship hours. As well as pass all required board exams. 

Similarly, EMDR-certified therapists need specialized training and certification. Specific EMDR requirements include passing an approved training. They have to complete the least number of EMDR sessions with approved consultation. All therapists must complete continuing education units. It allows them to remain on top of current trends and topics.

If you are unsure about a potential candidate’s certifications, ask them. Additionally, you can also inquire how long they have been practicing. 

What Should You Know about EMDR for Youth?

Most studies have focused on the efficacy of EMDR in adults. But, Dr. Ricky Greenwald helped pioneer EMDR in youth. He has authored several articles and books on the subject. 

His work has demonstrated that EMDR can show promising results for youth. Today, there are increasingly more articles about EMDR success rates for children. In 2013, the World Health Organization (WHO) recommended EMDR and CBT as the primary standards of care for treating PTSD in children, adolescents, and adults.

How Long Does It Take for EMDR Therapy to Work?

While the treatment tends to be brief, every individual responds to EMDR differently. With that in mind, there's no definitive answer for determining the exact duration of treatment. 

Most sessions last 60–90 minutes. Therapists may meet with their clients once or twice per week. Sometimes they will arrange for sessions to occur on consecutive days. 

Single-incident traumas may be resolved in just a few sessions But complex, developmental traumas may require more intensive work. EMDR may also take longer if you have co-occurring issues. 

Many clients report noticing significant improvements after as little as 1–3 sessions. Still, it is crucial to remain committed to your entire process. Keep in mind that dropping out of treatment prematurely can prolong healing. In some cases, it can even exacerbate trauma symptoms. If you have concerns about EMDR providing the right results, speak up to your therapist. 

While EMDR is offered on an individual basis, Idaho Youth Ranch also offers a variety of group therapy options. Learn more about our upcoming groups.  

What Are the Limitations of EMDR Therapy?

Even though EMDR can be highly effective, all therapies pose some inherent risk. It is important to be aware of these inherent limitations before starting your treatment.  

Some common side effects of EMDR include: 

• Increased awareness and reexperiencing of traumatic memories 

• Feeling lightheaded or dizzy 

• Disturbing nightmares 

• Recognition of new traumatic material 

• Increased cravings to engage in escape behaviors after the session 

Insight can be painful. It may feel challenging to think about some of these awful experiences. In most cases, the symptoms naturally resolve themselves as treatment progresses. If you have any concerns about reemerging or worsening symptoms, speak to your therapist. 

What Is the EMDR Success Rate?

Extensive research demonstrates high efficacy rates for EMDR. It is impossible to cite exact statistics. But some studies suggest that upwards of 84–90% improvement in single-trauma victims. This means they no longer meet the criteria for PTSD. Improvement was marked after completing three 90-minute EMDR sessions.

Other studies highlight its benefits in treating psychosis, depression, and anxiety. 

EMDR is one of the gold standards of trauma treatment. It can be highly beneficial for children, adolescents, and adults. Similarly, therapy results may occur faster than in other forms of talk therapy.