Therapy modalities like EMDR have become more well known and increased in popularity the past few years. So what is EMDR therapy? EMDR stands for Eye Movement Desensitivation and Reprocessing. Per the EMDR International Association (EMDRIA), EMDR uses the Adaptive Information Processing (AIP) model. AIP is a theory that describes how the brain processes and links memories according to EMDRIA. EMDRIA states that both positive and negative experiences influence a person’s present state. Per EMDRIA, some problems (anxiety, depression, etc) are rooted in traumatic experiences or adverse life experiences. The goal of EMDR is to reprocess traumatic memories or adverse life experiences. “EMDR therapy is designed to create the conditions to activate the brain’s processing abilities and aid in the recovery process” (EMDRIA AIP Model). More information and resources on EMDR can be found on the EMDRIA website under “About EMDR Therapy”. EMDRIA is the group that oversees EMDR therapy. EMDRIA is where counselors can become certified in EMDR, and credential EMDR training. People can also go on the EMDRIA website to find an EMDR therapist. Counselors can find EMDR training on the EMDRIA website that are credentialed with EMDRIA. Research on EMDR effectiveness can be found on the EMDRIA website also. According to the National Center for PTSD, EMDR is an evidence based treatment for PTSD.
What does an EMDR session look like? First steps will be the intake session. This is where the counselor would typically complete a biopsychosocial assessment. In the intake session the counselor will get the history of the client, current problems, family history, etc. This will be what the counselor will use to create a treatment plan. Next the counselor will ensure the client has proper coping skills in place to begin EMDR. This will involve introducing and teaching grounding techniques, coping skills, and doing EMDR specific techniques like safe/calm place. This part of EMDR therapy does not take a set amount of sessions, and will depend on client readiness. This can vary per person, and the goal is to ensure the client can cope, ground, and state change prior to starting EMDR therapy. This is because EMDR will be focusing on traumatic memories and can be more distressing if the client does not have appropriate skills to cope. Safe/calm place is a state change exercise that is taught to assist clients with switching from a state of anxiety to a calm state. This exercise uses Bilateral Stimulation (BLS) and is a good introduction to show clients what the structure of an EMDR session will be. BLS is a stimulus that is presented to both sides of the body. BLS is said to activate both sides of the brain which is what aids in memory reprocessing in EMDR therapy. There are different kinds of BLS. The gold standard of BLS is eye movements, but other BLS can work just as well and depends on the person. Other BLS is using tappers, shoulder tapping or butterfly hug, audio tones, drawing, and more. Lights bars can be used for eye movements or a counselor may use their hand to guide a client’s eye movements.
After coping skills are established, a counselor will work with a client on memory identification. Counselors have different ways of doing memory identification but some examples are direct questioning, floatback, or affect scan. Once memories are identified, the counselor will begin reprocessing with the client. Personally, I tend to pick a memory that is not as distressing as other memories for the first EMDR memory. This is so the client can understand what the EMDR process is and so we can work up to some of the harder memories, instead of starting right away on the hardest. This can also vary per client and is typically up to clinical discretion. After a memory is reprocessed the counselor will work with the client on identifying the next memory. EMDR uses what is called a three pronged approach. This means EMDR will focus on past traumatic events, present triggers, and future challenges.
EMDR sessions can look differently depending on the counselor. Every EMDR therapist has found their own way to provide EMDR therapy, and EMDR therapy can look different depending on the client too. EMDR is a structured therapy and counselors tend to not verbally engage a lot while the reprocessing is happening. Typically the counselor will check in with clients at the beginning of session and debrief with clients at the end of session. Some people also prefer to rotate between EMDR and talk therapy sessions. This can also depend on the client and the therapist. Overall, EMDR is a therapy that can bring a lot of relief for trauma or negative memory symptoms. It is an evidence based therapy that has grown in popularity.