There are eight phases of EMDR. But do any of us fully know what they mean from a keyword search? Well, in this article I’m giving you a full rundown on what they are and what you should expect. In last week’s article, I answered the most commonly asked questions. The various tools the therapist uses to stimulate eye movement during EMDR processing, its side effects, and most importantly, why we should have a strong foothold in our trauma before attempting EMDR. The key takeaway of course is that EMDR is intense. If we choose this as our first therapy, we risk being retraumatized instead of reaping the benefits of EMDR. So, before we cover the eight phases of EMDR, I do recommend you read all the fine print from last week. That article is here.
The First Two Phases of EMDR: The Prep Work
Phases 1 and 2 are not intense. We are giving our therapist their tool (phase 1: the timeline) to keep up with our traumas. And then we are building our tool (phase 2: safe place). Phase 2 will help us manage the overwhelm of the next two phases of EMDR. (phases 3 and 4).
Phase 1: The Timeline
We share our most painful memories with our EMDR therapist, who will want to know two things:
1) The emotions we feel when we remember it. Remember, EMDR deals with Big T traumas. So, if we can’t pull enough emotion from the memory, then there isn’t enough for EMDR to work with.
2) How old we were in each trauma. It’s okay if you’re unclear on the exact age of some, as long as you and your therapist can work through the correct order of your traumas. This is how we construct the timeline. And why is that important?
The theory holds that each trauma influences our emotional reaction to the next. And that each trauma solidifies the negative beliefs we develop. So, if we start with our earliest trauma, it can potentially loosen the stranglehold of the next trauma in our timeline, and so on. And then, by the time we get to the last trauma in our timeline, we may very well find that its disturbance level is so low, processing it in EMDR is no longer necessary. This actually happened to me, whereas by the time we got to my age fifteen trauma, I had achieved such amazing clarity, we didn’t have to process it.
Phase 2: Creating Safe Place in Your Mind
We are asked to find a safe memory or an experience to help calm and bolster us up. Was there a safe person in our lives? If so, we can use that person as we create our safe place. Then the therapist uses whatever tools, flashing lights, moving finger, or vibrating pads to help us turn this into a rich and vivid safe place. We are encouraged to use our five senses while our eyes move back-and-forth to mentally experience our safe place. For example, if our grandparents’ house was a safe place, we may smell maple syrup while Grandma is serving us pancakes (the visual image). Or we might remember someone’s kindness, and so we “hear” their soft and soothing voice. And so on.
Once we use our five senses and fully process this safe place into existence, we work with our therapist to find a single word or phrase to describe it. Then our therapist increases the tool’s frequency to make that word or phrase “stick” with this safe place we have built. Using the above example of grandparents’ house, the word could be pancake or maple syrup.
This becomes a tool we are encouraged to practice using outside the therapist’s office. It’s to stay present so that we can “catch ourselves in the act” while experiencing life’s daily stressors. Then we pull that word or phrase to our mind and test our safe place’s calming effect. For example, if we tend to get irritated by slow walkers, instead of darting around them, we can test our tolerance for walking slower by using the word associated with our safe place.
A final tip. Don’t be ashamed if you feel you need another session or two building and strengthening your safe place before proceeding to the next phase.
The Next Two Phases of EMDR: Game On!
Now it’s time to start processing those traumatic memories. These two phases of EMDR are intense and this is where we get the side effects I wrote about in last week’s article.
Phase 3: Assessment
Now we are ready to start processing the traumas we’ve organized in our timeline (phase 1). We start with our earliest trauma, known as our cornerstone memory. There are four things our therapist needs from us before they pull out their tools for processing. 1) The image that springs to mind when we think of this trauma. 2) The dominant emotion attached to this memory. 3) Where we feel it in the body. 4) The dominant negative belief we had in this memory. And this is where our therapist introduces us to the cognition sheet. See it here.
You see, in traumatic events, there tends to be so much emotion and confusion, we have a hard time finding our thoughts. So, the cognition sheet acts as a prompt for those hidden thoughts. It helps us find the words for what was going on with us internally. This sheet is for giving you ideas on what those were. You may discover you had multiple negative thoughts at the time, but you’re asked to choose the most dominant thought. So, you may choose one from the list, or find your own single sentence statement that best describes your thoughts at the time.
Once we’ve figured out what that negative cognition is, our therapist asks us to search the positive column. This time, we’re asked to find one positive thought that can counter the negative. This depends entirely on what we want to get out of it and it does not have to be directly across from our negative cognition. So, we stay mindful of the image, emotion, body sensation, and negative cognition and hold onto them as we proceed into phase 4.
Phase 4: Desensitization
It’s bilateral stimulation time, which is EMDR lingo for using eye movement while we reprocess the trauma. The therapist will utilize whatever tool they used in phase 2 that helped us build our safe place. Only this time, they are using it to help us process a not-so-safe memory. The sensory and images we get in this phase are just as vivid as the ones we had in phase 2. But since it’s a traumatic memory this time, it’s intense. This is why we take breaks every few minutes and go to safe place for a minute or two.
Then the therapist will ask how we are and if we are ready to return to the traumatic memory. It’s okay if you feel you need more time with safe place first. Just let your therapist know. This helps them determine if they can increase the frequency (cause faster eye movement) with their tool, or if they should keep it the same for now.
Our therapist will need to know everything we are seeing, hearing, and sensing in phase 4. So, open communication is key. Our therapist may ask what’s going on or even prompt us to explore what happened next. We are trying to gather as much information as we can about this memory so that we can fully process it. While the images are all truthful, they also tend to be downright weird. For example, in a young memory, we may “see” an accusatory finger surrounded by shadows while we “hear” a raging voice.
The Next 3 Phases of EMDR: Winning
Only in rare cases do we proceed to the next phases of EMDR in a single session. That’s because the traumatic memory needs its due process. We need time to explore it, allow the intensity of phase 4 to settle, and then develop a better understanding of it by our next session. It isn’t uncommon for us to require three or more sessions just on phase 4 before we are ready to move into phase 5. But once we do, it’s fast. How fast? Phases 5-7 of EMDR are achieved in a single session.
Phase 5: Installation
Certain clues in phase 4 tell us that we are getting desensitized. For one thing, our emotions settle and we start viewing those in the memory as having significantly less power over us. And another is that the images tend to get a little weird, but this time it happens in a good way. We may sense ourselves growing bigger than our abuser, or those in the scene take on a more holographic image. Whatever it is, we know we are ready for phase 5 because we can feel and sense it.
So, phase 5 is the part where we use that positive cognition we chose in phase 3. Just a note: it’s okay to change your mind if you find a more suitable one than your original choice. Our therapist will still be using their tools from phase 4 to help us install this new cognition as an “overwrite” to the old negative one. And we use this cognition on the memory until it feels completely true.
Phase 6: Body Scan
We imagine ourselves being slowly scanned from the top of the head to the bottom of our feet. We hold on to our new belief and the traumatic memory while checking in with our body. Be sure and pay special attention to where you felt it most in the body originally. For example, if in phase 3, you reported feeling it most in your shoulders, keep the “scan” on that area a little while longer and explore it. If you still feel it anywhere in your body, let your therapist know. They will repeat phase 5 and then ask you to scan your body again until the disturbance clears from your body.
Phase 7: Closure
I refer to this phase as the “double-checking” phase. The therapist puts their tool away. Then they make sure we have returned to a calm state and that we are fully present. We discuss the memory from a neutral perspective and share our overall insights on it. This tends to be the last five or ten minutes of the session with our therapist. But even if there is more time in the session, we will not proceed to the next memory in our timeline. That’s because the “triple-checking” phase must happen first.
The Last of the EMDR Phases
Between the last session and the upcoming one, it’s a good idea to check in with ourselves and note anything that comes up. Especially if it’s related to the recently desensitized memory. Do expect a vivid dream or two similar to the ones you were having in phase 4. The bilateral stimulation tools tend to cause those side effects in general. But there should also be a marked difference in them. From feeling neutral, to feeling a sense of empowerment.
Phase 8: Reevaluation
On the very next session, we start by sharing everything that has come up since our last one. This is the “triple-check” phase. Our therapist needs to know two things. 1) Is the disturbance of the memory still low? 2) Is the new positive cognition still strong? If not, we return to phases 5-7 of EMDR. But if we answer yes to both questions, our therapist names the next trauma in our timeline and asks if the disturbance level is still high for that one. (Remember, some reprocessed traumas can release the stranglehold on a later one. So, it isn’t an invalidating question. It’s a check-in question.) At any rate, we proceed with the next Big T trauma in our timeline and start over at phase 3 with it.
It’s noteworthy that we begin each session with phase 8 and end with phase 7. Regardless of whether we have achieved closure and lowered our disturbance level. Confused? Well, let me explain. We always begin each session by telling our therapist what has come up since the last session (phase 8). Then the last few minutes of each session, our therapist puts away their tool and makes sure we return to a calm and present state (phase 7, minus the “closure”). EMDR is intense, and so we need this calming buffer period before we leave the therapist’s office.
Next week, I will guide you through the EMDR process from my personal experience. I will share with you my first traumatic memory that was reprocessed in EMDR, my side effects, and the crash course it gave me on the importance of self-compassion. I think it will help round out the overall understanding of the EMDR experience.