When I was trained in EMDR Therapy in 2006, I never realized the way it would shape my practice. I looked at it as an intervention. In 2016, I attended a training that incorporated mindfulness into EMDR as a part of Phase 2. That is when I began to understand that EMDR Therapy was a complete, evidence based modality that had phases of treatment. Most individuals look at EMDR as the "eye movement thing". The therapy is so much more that that. The 8 individual phases of EMDR Therapy are what makes it an effective modality for treating clients. Let me dive deeper from my perspective.
Phase 1 - History taking.
Each client begins a relationship with a therapist with an intake appointment or maybe even the first email or phone call. This is where is starts. Taking a complete history of the individual experiences of the client is what makes up their story. The relational experiences that begin at intake start to develop the therapeutic relationship. I believe that the quality of the relationship is a good indicator of the outcome of therapy overall. Taking a thorough and complete history of the client's experiences is important in developing a complete cohesive narrative of their life. These experiences have shaped the internal and implicit beliefs that we each hold. Through an attachment focused and relational psychotherapy approach, I aim to make each client feel heard, understood and validated.
Phase 2 - Preparation
I have learned over time and through many experiences that preparation differs for each individual. Some clients have skills already developed. Many need skills to help them regulate their emotions. In reality, some individuals may not even know what they are feeling or how to name the emotion. Some may feel fragmented and disconnect from their body. Preparation is where I place the therapies that I have been trained in. I used mindfulness based interventions, guided imagery, Dialectical Behavior Therapy skills, Cognitive Behavior Therapy, Sensorimotor Psychotherapy, and Somatic Experiencing to provide each client with the level of insight, self awareness and knowledge that they may need to manage their symptoms and feel better. This also prepares them for the journey of healing they have begun.
Phase 3 - Assessment
As I am teaching skills, practicing using them with clients, naming emotions and body sensations in real time, I am also assessing for the impact of the life experiences that inform what each individual thinks about themselves. These beliefs typically fall in one of three categories - Responsibility (I am not good enough), Safety (I am not safe) or Control (I have to be perfect). There are many negative cognitions that result from traumatic experiences. I allow each client to name their own traumas. They are either Big Ts or Small Ts as defined by the client and NOT me. I am always assessing negative cognitions in every interaction with clients and noting them as possible future targets for EMDR processing.
I will continue to detail the phases of EMDR Treatment in my next blog post. Thank you for reading and I certainly hope this was helpful. - Dr. Marci
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