How Exactly Does EMDR Work?

Eye Movement Desensitization and Reprocessing (EMDR), developed by the renowned psychologist Francine Shapiro, is a powerful and transformative therapeutic approach designed to help individuals heal from trauma and distressing life experiences. Shapiro's groundbreaking work in the late 1980s revolutionized the field of psychology by providing a new, effective method for processing traumatic memories. By understanding how EMDR therapy works step by step, we can better appreciate its profound impact on mental and emotional well-being, and the legacy of healing that Shapiro's innovation has brought to countless individuals.

Image of a man standing by a lake during the sunrise. If you struggle with past trauma and are looking for ways to heal, work with a skilled EMDR therapist in St. Paul, MN to manage your symptoms.

How to Do EMDR Step by Step?

EMDR is structured into eight distinct phases, each serving a specific purpose in the healing process. Here’s a step-by-step overview of how EMDR therapy unfolds:

History Taking and Treatment Planning

In this initial phase, the therapist gathers detailed information about your past experiences, current symptoms, and treatment goals. This helps create a tailored treatment plan that addresses your unique needs. Understanding your personal history and the specific traumas or distressing events you've experienced is crucial for developing an effective EMDR strategy.

Preparation

The therapist explains the EMDR process and teaches you various coping strategies and relaxation techniques to manage any distress that may arise during sessions. Building trust and ensuring you feel safe is crucial at this stage. You'll learn about the Adaptive Information Processing (AIP) model, which is the theoretical foundation of EMDR. The AIP model posits that trauma disrupts the brain's natural ability to process information, leading to the storage of distressing memories in a fragmented and maladaptive manner.

Assessment

During this phase, specific target memories are identified for processing. The therapist asks you to recall a distressing memory and identify the negative belief associated with it, as well as any physical sensations and emotions tied to the memory. This process helps pinpoint the exact aspects of the memory that need to be reprocessed. The therapist will also help you identify a positive belief that you would like to adopt to replace the negative belief.

Desensitization

This phase involves the use of bilateral stimulation (BLS), such as eye movements, taps, or auditory tones, to help reprocess the traumatic memory. The goal is to reduce the emotional charge and distress associated with the memory. BLS helps activate both the logical, present-centered part of the brain and the part of the brain responsible for housing unresolved traumatic material. This dual activation facilitates the desensitization of past distress and allows your brain to update the outdated, distressing information with new, adaptive beliefs.

Installation

Positive beliefs are strengthened and installed during this phase. The therapist helps you replace negative beliefs with positive, adaptive ones, reinforcing a healthier self-perception. This is achieved by focusing on positive beliefs while continuing the BLS. The goal is to fully integrate the positive belief into your core understanding of yourself and your experiences.

Body Scan

The therapist guides you through a body scan to identify any residual physical tension or distress related to the target memory. The goal is to ensure that the body is fully aligned with the new, positive belief. This step helps ensure that all aspects of the trauma, including any physical sensations, have been addressed and resolved.

Closure

At the end of each session, the therapist ensures you feel stable and safe. Coping strategies and relaxation techniques are reinforced to manage any lingering distress. This phase is crucial for helping you transition from the intense emotional work of EMDR back to your daily life. The therapist will also provide guidance on what to expect between sessions and how to handle any distressing emotions that may arise.

Reevaluation

In subsequent sessions, the therapist evaluates your progress and determines if further processing of the target memory is needed. New target memories may also be identified for future sessions. This ongoing assessment ensures that the therapy is effectively addressing your needs and allows for adjustments to the treatment plan as necessary.

Understanding these phases helps demystify the EMDR process and highlights the structured, supportive approach therapists use to guide you through healing.

What Type of Therapy Does EMDR Fall Under?

EMDR is considered a form of psychotherapy, specifically falling under the category of trauma-focused therapy. It integrates elements from various therapeutic approaches, including somatic therapy and psychodynamic therapy. The distinctive feature of EMDR is its use of bilateral stimulation to facilitate the reprocessing of traumatic memories.

At its core, EMDR relies on the Adaptive Information Processing (AIP) model. This model posits that trauma and distressing experiences can disrupt the brain’s natural information processing system, leading to the storage of fragmented and maladaptive memories. EMDR aims to reactivate this system, allowing the brain to process and integrate these memories in a healthier, more adaptive way. By addressing both the cognitive and somatic aspects of trauma, EMDR provides a holistic approach to healing that targets the root causes of distress.

Who Is a Good Candidate for EMDR?

EMDR can be highly effective for individuals dealing with a range of issues, particularly those related to trauma and distressing life events. Good candidates for EMDR typically include:

  1. Individuals with PTSD: If you struggle with PTSD you may wonder, does EMDR work with PTSD? EMDR is widely recognized as an effective treatment for post-traumatic stress disorder (PTSD), helping to alleviate symptoms such as flashbacks, nightmares, and hypervigilance.

  2. People Experiencing Anxiety and Depression: EMDR can also benefit those struggling with anxiety and depression, especially when these conditions are linked to past traumas or unresolved emotional issues.

  3. Survivors of Abuse and Violence: Individuals who have experienced physical, emotional, or sexual abuse can find significant relief through EMDR, as it helps process and integrate these painful memories.

  4. First Responders and Military Personnel: EMDR is effective for those who have been exposed to high levels of trauma in their line of work, such as first responders and military personnel.

  5. Individuals with Phobias and Panic Disorders: EMDR can help address the root causes of phobias and panic disorders, reducing the frequency and intensity of panic attacks.

If you're wondering what conditions is EMDR used for, anyone experiencing distressing memories or emotional responses that impact their daily life may benefit from EMDR.

Who Is Not a Good Candidate for EMDR?

While EMDR is effective for many, it is not suitable for everyone. Certain individuals may need to consider alternative therapies, including:

  1. Those with Severe Dissociative Disorders: Individuals with severe dissociative disorders may find EMDR too overwhelming, as it can trigger intense emotional responses and further dissociation. EMDR is great for dissociative disorders once the individual has been introduced to state therapy prior to activating memories from the past. Jumping straight into EMDR is not recommended for this population 

  2. People in Crisis: Those experiencing a major life crisis or significant instability may need to stabilize their situation before engaging in EMDR, as the therapy can bring up intense emotions. For people in crisis, there are specific EMDR protocols that veer from the standard method. These instances require a skilled and specially trained EMDR therapist. For individuals in abusive situations, EMDR is not advised and will need to wait until safety is established and the abuse has stopped. 

  3. Individuals with Certain Medical Conditions: Conditions such as epilepsy or severe heart disease may require careful consideration and consultation with a medical professional before starting EMDR.

  4. People Unable to Maintain Focus: EMDR requires a certain level of concentration and engagement. Those unable to maintain focus during sessions might struggle with the process. Although not impossible. Individuals with ADHD or dissociative tendencies will require more time in the preparation phase of EMDR. 

It’s essential to work closely with a qualified therapist to determine if EMDR is the right fit for your specific needs and circumstances.

What Do Therapists Ask During EMDR?

During EMDR sessions, therapists ask a variety of questions to guide the process and ensure effective reprocessing of traumatic memories. These questions are designed to help you access and articulate your thoughts, emotions, and physical sensations associated with the target memory. Some common questions EMDR therapists ask include:

  1. “What memory do you want to work on today?”: This helps identify the specific memory or issue to be addressed in the session.

  2. “What negative belief do you have about yourself related to this memory?”: Identifying the negative belief is crucial for understanding how the trauma has impacted your self-perception.

  3. “What emotions do you feel when you think about this memory?”: This question helps you connect with the emotional aspect of the memory.

  4. “Where do you feel this in your body?”: Trauma often manifests physically, and recognizing these sensations is important for comprehensive processing.

  5. “What positive belief would you like to have about yourself instead?”: This helps in the installation phase, where positive beliefs are reinforced.

  6. “How disturbing does this memory feel now on a scale of 0 to 10?”: This helps track progress and the reduction of distress associated with the memory.

These questions facilitate a deeper understanding and processing of traumatic memories, paving the way for healing and resolution.

Close up image of a woman's blue eyes. This image represents how EMDR therapy in St. Paul, MN can help you heal from your unresolved trauma with eye movement therapy.

Do You Talk During EMDR?

Yes, talking is an integral part of EMDR therapy. Throughout the sessions, you will communicate with your therapist about your thoughts, emotions, and physical sensations related to the target memory. This dialogue helps guide the reprocessing of the memory and ensures that you feel supported and understood. However, the nature of the conversation during EMDR differs from traditional talk therapy. While you will discuss your experiences, much of the session focuses on observing and processing internal experiences rather than engaging in lengthy discussions. The therapist will prompt you to notice your thoughts, feelings, and bodily sensations as you undergo bilateral stimulation, but you won't need to provide detailed narratives continuously. You also get to choose what details you are comfortable sharing and can remain vague for your comfort- EMDR still works. 

Additionally, there might be moments of silence or brief pauses where you are encouraged to simply observe what comes up for you. This introspective approach allows you to deeply engage with your internal experience without the pressure of constantly verbalizing. It's a balanced process where verbal communication and silent reflection work together, creating a holistic path to healing. Your therapist is there to support you, offering prompts and questions when necessary, but also giving you the space to connect with your emotions and bodily sensations at your own pace.

Is It Okay to Cry During EMDR?

Absolutely, it is okay to cry during EMDR sessions. In fact, emotional release is a natural and expected part of the healing process. Crying can be a sign that you are processing deep-seated emotions and unresolved trauma, which is essential for healing. Your therapist will create a safe and supportive environment where you can freely express your emotions.

 They will guide you through the process, ensuring that you feel comfortable and validated. Crying can help release pent-up emotions and facilitate the desensitization and reprocessing of traumatic memories. Remember, EMDR is about addressing and healing from past distress. Allowing yourself to feel and express your emotions is a crucial step in this journey.

What Questions Are Asked in EMDR Phase 1?

Phase 1 of EMDR therapy, the History Taking and Treatment Planning phase, involves gathering detailed information about your past experiences and current symptoms. During this phase, therapists ask a variety of questions to understand your background and develop a personalized treatment plan. Some common questions include:

  1. “Can you tell me about your history and any significant life events?”: This helps the therapist understand the context of your experiences and identify potential target memories.

  2. “What are your current symptoms and how do they impact your daily life?”: Understanding your symptoms provides insight into how trauma affects you in the present.

  3. “Have you experienced any past traumas or distressing events?”: Identifying past traumas is essential for determining the focus of EMDR therapy.

  4. “What are your goals for therapy?”: Clarifying your goals helps create a targeted and effective treatment plan.

  5. “Do you have any coping strategies that help you manage distress?”: Knowing your existing coping mechanisms can inform the preparation phase and enhance your ability to handle distress during sessions.

These questions provide a comprehensive understanding of your history and needs, setting the stage for a successful EMDR therapy experience.

EMDR therapy is a powerful approach that targets the brain’s adaptive information processing system to heal from trauma and distressing life experiences. Through its structured eight-phase process, EMDR helps reprocess and integrate traumatic memories, reducing their emotional charge and facilitating the development of healthier, more adaptive beliefs. By engaging both cognitive and somatic aspects of trauma, EMDR provides a holistic approach to healing. While it may not be suitable for everyone, EMDR can be profoundly beneficial for those struggling with PTSD, anxiety, depression, and other trauma-related conditions. Understanding the process and recognizing the signs of progress can help you stay motivated and committed to your healing journey. Whether you talk during sessions, experience emotional releases like crying, or navigate the specific questions posed by your therapist, EMDR offers a supportive and effective path to overcoming the lingering effects of trauma. With the right support and a dedicated approach, you can move towards a brighter, more resilient future.

Begin Your Healing Journey with EMDR Therapy in Saint Paul, MN

If you're struggling with the weight of past traumas or present distress, you don't have to face it alone. EMDR therapy in Saint Paul, MN, offers a transformative path to healing and a brighter future. At Sage Leaf Wellness, we are committed to providing a safe and nurturing environment where your healing journey can flourish. Our team of compassionate and experienced therapists specializes in EMDR therapy, guiding you through the process of overcoming life's challenges. We understand the complexities of trauma and are here to support you every step of the way. Take the first step towards reclaiming your life:

Additional Therapy Services at Sage Leaf Wellness

At Sage Leaf Wellness, we believe in the right of everyone to heal and live a fulfilling life. EMDR therapy in Saint Paul, MN, is just one of the many tools we offer to support your mental and emotional well-being. We also provide a range of other evidence-based therapeutic techniques to address your unique needs. We understand that each person's journey is different, which is why we offer various therapy options to accommodate individual circumstances. Our services include Anxiety Therapy, Trauma Therapy, Marriage and Couples Counseling, and more. Our goal is to help you find peace and empowerment through our comprehensive therapeutic practices. In addition to our in-person services in Saint Paul, MN we offer online therapy for those in the state of Minnesota. Let us support you on your journey to well-being with EMDR therapy and other effective treatments.

Benjamin Kelley