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