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EMDR-Phases 3&4 Eye movement desensitization and reprocessing therapy, commonly known as EMDR, is a mental health therapy approach that works to reduce distressing emotions that are linked to traumatic memories. EMDR treats the mental health conditions, often anxiety, depression or other symptoms, which occur because of the memories we have stored from these traumatic […]
Eye movement desensitization and reprocessing therapy, commonly known as EMDR, is a mental health therapy approach that works to reduce distressing emotions that are linked to traumatic memories. EMDR treats the mental health conditions, often anxiety, depression or other symptoms, which occur because of the memories we have stored from these traumatic events.
In my first article on the phases of EMDR we looked at Phases 1&2-Client History/Treatment Planning and Preparation. Now we will look at Phases 3&4-Assessment and Desensitization.
Phase 3- Assessment
In phase three the client and therapist will work together to identify
the target memory that triggers emotional distress. This includes what incident caused the trauma? (Was it sexual assault, an accident, the death of a relative etc.?),and what is the most consistent image associated with the memory?
The first step is for the client to select a specific image or mental picture from the target event that best represents the memory. Then the client chooses a statement that expresses a negative self-belief associated with the event. Common negative cognitions could be statements such as, “I am helpless,” “I am worthless,” “I am unlovable,” “I am dirty,” “I am bad,” etc.
During phase three of EMDR therapy, a positive belief is also chosen to help counteract the negative emotions caused by the trauma. The client will pick a positive self-statement that he would rather believe. This statement could be “I am worthwhile/lovable/a good person/in control” or “I can succeed.”
The therapist will then ask the person to estimate how true the positive belief feels using the 1-to-7 Validity of Cognition (VOC) scale. “1” equals “completely false,” and” 7″ equals “completely true.” It is important to give a score that reflects how the person “feels,” not” thinks.”
During the Assessment Phase, the person identifies the negative emotions (fear, anger) and physical sensations (tightness in the stomach, headache) he or she associates with the target. The client also rates the level of disturbance, but uses a different scale called the Subjective Units of Disturbance (SUD) scale. This scale rates the feeling from 0 (no disturbance) to 10 (worst) and is uses this score to assess the disturbance that the client feels throughout the processing.
The goal of EMDR treatment, is for SUD scores of disturbance to decrease while the VOC scores of the positive belief to increase.
Phase 4- Desensitization
Phase four is where the processing of the memory and negative beliefs takes place. The therapist will use some form of Bilateral Stimulation (BLS) to stimulate the mind/brain to process whatever trauma is currently being held in the conscious mind. This usually involves instructing the client to follow hand movements back and forth or hold tappers in each hand.
After a number of eye movements or other form of BLS occur, the therapist will stop and ask, “What are you noticing now?” The client will comment in just a few words what they are noticing. This may be part of the memory, a feeling, or a body sensation. Most of the healing happens while the client is reviewing the memory with the BLS. The therapist will ask the client to continue by stating “Go with that”. The process then continues.
Depending upon the intensity of the response to the trauma, your therapist may adjust the length, speed and type of stimulation used to create the eye movements.
The therapist may have to “circle back” to the original memory multiple times depending on how deep or complex the trauma is, but the process remains the same. The therapist will keep asking the client to hold the memory and the belief and the feelings in mind, while also completing the BLS.
Eventually the memory will feel different. It will have less energy.
The therapist will keep offering BLS until the client is able to grade the memory at a much lower level of disturbance on the 1-10 scale, ideally at a zero –now the memory no longer bothers them. This is the goal of EMDR; to get the client from a point where the memory goes from 8 or 9 out of ten for intensity and unpleasantness, down to a 0-1 out of ten.
During reprocessing, maladaptively stored events are desensitized, integrated, and adaptively stored.
In my third and final segment of the phases of EMDR we will look at phases 5-8-Installation, Body scan and Re-evaluation.
If you have experienced trauma of any kind, and feel you could benefit from EMDR to reduce symptoms and to improve quality of life, feel free to reach out to me at Marsh Psychology Group.
Carol Van Kampen, LMSW is an individual private practice psychotherapist who specializes in anxiety, depression, grief, and trauma treatment at Marsh Psychology Group. Carol is EMDR trained. Contact her at marshpsychologygroup.com
cvankampen@marshpsychologygroup.com
” https://marshpsychologygroup.com/carol-van-kampen-lmsw/
Resources:
https://www.emdria.org/public-resources/the-eight-phases-of-emdr-therapy/
EMDR Phase 1&2 Eye movement desensitization and reprocessing therapy, commonly known as EMDR, is a mental health therapy approach. EMDR treats mental health conditions that occur because of the memories we have from traumatic events in the past. In this article I will be addressing phases 1&2 of EMDR. I will follow up with an […]
EMDR Phase 1&2
Eye movement desensitization and reprocessing therapy, commonly known as EMDR, is a mental health therapy approach. EMDR treats mental health conditions that occur because of the memories we have from traumatic events in the past.
In this article I will be addressing phases 1&2 of EMDR. I will follow up with an additional article addressing phase 3&4 and finally in my third and final article, I will address phases 5-7.
Phase 1: History and Treatment Planning
Phase 1 generally takes 1-2 sessions but can continue throughout the therapy process, especially if new issues are revealed. In the first phase of EMDR treatment, the therapist takes a thorough history of the client and develops a treatment plan. This phase will include a discussion of the specific problem that has brought him into therapy, the clients behaviors stemming from that problem, and the symptoms.
The therapist will assess the client’s readiness for EMDR. The client and therapist start toidentify possible targets for EMDR processing. These include distressing memories and current situations that cause emotional distress. Other targets may include related incidents from the past.
Initial EMDR processing often are connected to childhood events rather than to adult-onset stressors. Clients generally gain insight into their situations; the emotional distress resolves and they start to change their behaviors. The length of treatment depends upon the number of traumas and the age of onset.
EMDR therapy is most effective when a client feels a connection with the therapist – a sense that the therapist: 1. Has the client’s best interest in mind (that sense of ‘I’ve got you’): 2. Will help the client to feel safe: 3. Will help the client to feel grounded and present
A big part of Phase 1 and 2 is establishing this relationship between the therapist and client.
Phase 2: Preparation
For most clients this will take 1-4 sessions. For others, with a very traumatized background, or with certain diagnoses, a longer time may be necessary.
During the second phase of treatment, the therapist ensures the client has several different ways of handling emotional distress. The therapist may teach the client a variety of strategies and stress reduction techniques the client can learn and practice during and after sessions. In Phase 2 we are preparing for the worst. We are looking for the client’s ability to regulate, their ability to stay safe, and their ability to connect. We are investigating what they are currently doing and looking for any imbalance. In this phase we are making sure the client has all the tools and resources needed to begin the reprocessing of memories. We are looking for the dangerous issues and safety issues, as well as the annoying things and connection issues, that will impede the healing process. The therapist may talk about the Window of Tolerance and strategies to make your window larger.
Once a client can reduce emotional distress using the tools they were taught, they are generally able to proceed to the next phase
We want the client to get through the processing as quickly and safely as possible. We want to address all questions and concerns the client may have. The therapist’s task here is to understand what it is like to be the client as completely as possible.
An important goal of EMDR therapy is to make sure that the client can take care of him or herself.
In my next article on EMDR, we will look at phases 3&4.
Carol Van Kampen, LMSW is an individual private practice psychotherapist who specializes in anxiety, depression, grief, and trauma treatment at Marsh Psychology Group. Carol is EMDR trained. Contact her at marshpsychologygroup.com
cvankampen@marshpsychologygroup.com
” https://marshpsychologygroup.com/carol-van-kampen-lmsw/
Sources:
https://www.emdria.org/public-resources/the-eight-phases-of-emdr-therapy/
Image: https://britishpsychotherapy.co.uk/emdr-2/
You know you got your hairline from your Dad’s side of the family and your eye color from your mom. You know diabetes runs in your family, as does heart disease and Parkinson’s. But do you know that many families also pass down trauma to their loved ones? It’s not just our physical makeup and […]
You know you got your hairline from your Dad’s side of the family and your eye color from your mom. You know diabetes runs in your family, as does heart disease and Parkinson’s.
But do you know that many families also pass down trauma to their loved ones? It’s not just our physical makeup and risk of disease that we inherit from our family, it is also the emotional wounds as well.
Before you were born you were in your mother’s womb and very susceptible to her emotions. As your mother felt joy, her body released hormones that made you feel joy.
When she felt sad, scared, or angry, her body released hormones that made her experience these same emotions.
Eventually, you were born and raised in a house that may not always be happy or harmonious. Your parents may have been emotionally distant or even abusive because they may have been brought up by parents who had their own reasons for being emotionally absent or abusive.
Many families have unresolved trauma that works its way through one generation to the next. Those families who have dealt with addiction, depression, anxiety, terror, racism, and the like, often continue to pass on negative emotions, poor behaviors, low self-esteem, and maladaptive coping strategies. These not only lead to a painful and hard life, but they can also lead to chronic health conditions.
If you have a history of family conflict or trauma, you can be the individual who puts an end to the cycle. You can be the one who begins a new cycle, one of passing down loving communication and positive self-images.
Of course, it will take work on your part to overcome the pain of your family history. That’s why it’s a good idea to work with a mental health professional who can offer you the right tools and coping strategies that you can then pass down to your own children.
If you’re interested in exploring therapy, please get in touch with me! I’d love to help you end the cycle of trauma in your family.
SOURCES:
Many of us grew up in households that were dysfunctional, where boundaries between parents and adults were blurred in unhealthy ways. Emotional incest is not of a sexual nature, but it does describe unhealthy emotional interactions between adults and children that are psychologically inappropriate. What this looks like in a real-life is a parent treating […]
Many of us grew up in households that were dysfunctional, where boundaries between parents and adults were blurred in unhealthy ways. Emotional incest is not of a sexual nature, but it does describe unhealthy emotional interactions between adults and children that are psychologically inappropriate.
What this looks like in a real-life is a parent treating their child as a partner, relying on them for emotional support and care. Here are some of the classic ways parents cross this line:
When a parent turns to their child for advice about marital issues, sexual problems, financial worries, etc. this blurs the boundaries and causes the child to feel anxiety they should not be privy to.
Narcissistic parents often look to their children to give them a much-needed ego boost. With the parent’s ego being a priority, the child’s emotional needs take a backseat.
A parent should never be best friends with their child as this results in many boundaries being blurred. And a child should never be a trusted confidante to their parent.
Parents that turn to their child for comfort during an emotional crisis rob the child of learning age-appropriate socialization. These children will, most likely, grow into codependent adults, seeking approval from others by taking care of THEIR emotional needs.
Emotional incest is sometimes called “covert” incest because while it’s not sexual, the outcomes of this family dynamic are often similar.
When a child grows up and leaves the unhealthy environment and dynamic, that does not mean they won’t experience any lasting repercussions. Most adults will suffer from at least one of the outcomes I just listed.
The good news is, through counseling, victims of emotional incest can heal and live a healthy and satisfying life filled with strong emotional connections.
If you believe you are suffering from lingering effects of emotional incest and would like to speak to someone who specializes in this area, please reach out to me.
SOURCES: