Horsham | Sussex

t: 01403 541012
m: 07732 532 891

e: mia@miaphillipstherapy.co.uk

 

The 8 PHASES OF EMDR TREATMENT

The use of the step-by-step eight-phase approach allows the EMDR therapist to maximise the treatment effects for the client in a logical and standardized fashion. It also allows both the client and the therapist to monitor the progress during every treatment session.

Phase 1: History and Treatment Planning

The therapist takes your history; develops a treatment plan for your specific issues, behaviours and symptoms; identifies significant past events that created the problem, the present situations that cause distress, and the key skills or behaviours you need for your future wellbeing. A great advantage of EMDR Therapy is that it has a separate protocol for people who cannot or do not wish to recall highly disturbing memories.

Phase 2: Preparation

Your therapist will share some specific techniques to help you deal with any emotional disturbance that may arise during or after a session. You will need to show that you can use these techniques, e.g. using a calm place exercise before going on to the next Phase. One important goal of EMDR Therapy is to make sure that you can care for yourself. EMDR theory is explained, how it is done, and what you can expect during and after treatment.

Phase 3: Assessment

You choose a specific event (from Phase 1) then isolate a picture or scene from it  that best represents the worst part. You choose a statement that expresses a negative self-belief associated with the event, e.g. I am not good enough, I am a disappointment. A second statement is chosen by you that expresses a positive self-belief that you would prefer believe. A measurement of between 1-7 is taken (a V.O.C.) to show just how true you feel that positive statement is now when recalling the scene. It is important to give a score that reflects how you "feel," not "think." Finally, you identify the negative emotions and physical sensations associated with the target. You also score your level of distress/disturbance between 1-10 (a SUD score).

Phase 4: Desensitisation

During desensitisation, the therapist brings to your attention the chosen scene from a disturbing event, your negative self-belief plus the emotional and physical responses to the scene.  Sets of eye movements or other forms of bilateral stimulation (BLS) begin. The key to this Phase is that you do nothing other than notice what your body, memory and brain are bringing up. At the end of each set of BLS you will be asked “What do you get now?” or “What do you notice?” A short answer is all that’s required before the BLS begins again. The expectation is that your distress level will reduce to zero on the SUD score and that you will experience resolution of the traumatic event.  It is quite common for someone to start with a specific event and discover that there are other associated disturbing memories as well, which may need to be resolved.

Phase 5: Installation

Once Phase 4 is completed, this Phase is where you seek to increase the strength of the positive belief that you identified to replace your original negative belief. BLS is used for this. How much you accept your positive belief as true is measured. The goal is for you to accept the full truth of your positive belief and reach 7 on the VOC scale.

Phase 6: Body scan

After the positive belief has reached a VOC of 7 and has been strengthened and installed, this Phase is to identify possible residual disturbance. The therapist will ask you to close your eyes, bringing up the original event and your positive belief and to scan your body from head to toe. If you notice anything coming up, e.g. an image, a physical feeling, a memory, just let the therapist know and a set or sets of BLS will begin and continue until the discomfort is cleared. Evaluations of thousands of EMDR sessions indicate that there is a physical response to unresolved thoughts. Therefore, an EMDR session is not seen as finished until you can bring up the original event without feeling anybody tension.

Phase 7: Closure

If the processing of the traumatic event is not completed, the therapist will help you use a self-calming technique in order to regain a sense of equilibrium. It is important that you continue to feel in control outside the therapist's office and, if needed, you would use the techniques in Phase 2 preparation. In between sessions, reprocessing may continue and some new material may arise. You will be asked to keep a note of these experiences. On the following session, the therapist will ask you if you experienced any dreams, thoughts, images or memories. Usually, you would return to the event, take a SUD level check and continue reprocessing until resolution is achieved.

Phase 8: Re-evaluation

Once you have completed Phase 6, the therapist will check in the next sessions if the positive results (low SUDs, high VOC, no body tension) have been maintained.  New disturbing memories may have been identified that need treatment. The Re-evaluation Phase is vital in order to determine the success of the treatment over time. Although you may feel relief almost immediately with EMDR, it is as important to complete the 8 Phase treatment, just as you would with a course of antibiotics.

PAST, PRESENT, AND FUTURE

Although EMDR may produce results more rapidly than other therapies, speed is not the issue and it is important to remember that every client has different needs. For instance, one client may take weeks to establish sufficient feelings of trust (Phase 1 & 2), while another may proceed quickly through the first six phases of treatment only to reveal something even more important that needs treatment. Treatment is complete once disturbing memories become part of your working memory and can be recalled without distress, resolution of current difficulties takes place and you have gained the skills you need for the future.

With thanks to F. Shapiro & M.S. Forrest (2004) EMDR: The Breakthrough Therapy for Anxiety, Stress and Trauma. New York

Accredited Psychotherapist | Counsellor | Supervisor
and Europe Accredited EMDR Practitioner

Horsham | Sussex

t: 01306 44 00 56
m: 07732 532 891

 

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