Understanding EMDR Therapy—Frequently Asked Questions and Preparing for Sessions
Eye Movement Desensitization and Reprocessing (EMDR) therapy has become a widely recognized and effective treatment for various mental health issues, particularly post-traumatic stress disorder (PTSD).
As more individuals seek out EMDR therapy, many have questions about what to expect and how to prepare for their sessions.
This blog aims to address some of the most frequently asked questions about EMDR therapy and provide a guide on the necessary steps to prepare for beginning EMDR sessions.
What is EMDR Therapy?
EMDR therapy is a structured therapy that encourages the patient to briefly focus on the trauma memory while simultaneously experiencing bilateral stimulation (typically eye movements), which is associated with a reduction in the vividness and emotion associated with the trauma memories. EMDR was developed by Dr. Francine Shapiro in the late 1980s and has been extensively researched and validated as an effective treatment for PTSD.
How Does EMDR Therapy Work?
EMDR, or Eye Movement Desensitization and Reprocessing, is a type of therapy that helps people heal from trauma and emotional distress. It works by helping the brain process and make sense of traumatic memories, so they don’t cause as much pain or trouble in everyday life. EMDR therapy works on the premise that traumatic memories can get stuck in the brain's information-processing system. These stuck memories can cause distress and contribute to various psychological issues. EMDR helps to process these memories properly, allowing the brain to resume its natural healing process. The therapy typically involves eight phases:
History Taking/Understanding the Problem. First, the therapist will talk with you to understand your history and what issues you’re facing. This helps them know what specific memories or feelings need to be worked on.
Getting Ready. The therapist will explain how EMDR works and make sure you feel comfortable and safe. They might teach you some techniques to help you stay calm and relaxed.
Identifying the Target. You’ll pick a specific memory or thought that’s bothering you. This is called the “target.”
Desensitization or Processing the Memory. While you think about the memory, the therapist will guide you to move your eyes back and forth (or sometimes use other ways to stimulate both sides of your brain, like tapping your hands or listening to sounds). This helps your brain work through the memory and reduce its emotional impact.
Building Positive Thoughts. After processing the bad memory, the therapist will help you focus on positive thoughts and beliefs to replace the negative ones.
Checking Your Body. The therapist will ask you to notice any physical sensations you have when thinking about the memory to make sure all the tension and stress are gone.
Closure. Each session ends with making sure you feel calm and safe. If you feel upset, the therapist will help you use the relaxation techniques you learned.
Reevaluation. At the start of the next session, you and your therapist will talk about how you’re feeling and see how well the previous session worked. This helps plan the next steps in your therapy.
Is EMDR Therapy Effective?
Yes, EMDR therapy is highly effective for many individuals. Numerous studies have shown that it can significantly reduce symptoms of PTSD, anxiety, depression, and other mental health conditions. The World Health Organization (WHO) and the American Psychiatric Association (APA) endorse EMDR as an effective treatment for trauma and PTSD. Additionally, EMDR therapy is effective because it helps your brain process and make sense of traumatic memories, similar to how it processes normal memories during sleep. This reduces the emotional charge and distress associated with those memories, and many studies have shown that EMDR can help people recover from trauma faster than some other types of therapy.
Who Can Benefit from EMDR Therapy?
EMDR therapy can be beneficial for a wide range of individuals, particularly those who have experienced trauma or emotional distress. Some specific groups who may find EMDR therapy helpful include:
Survivors of Trauma
Childhood Trauma or Abuse. Individuals who have experienced physical, emotional, or sexual abuse during childhood can benefit from EMDR therapy to process and heal from these traumatic memories.
Military Combat Veterans. Veterans suffering from PTSD due to combat experiences often find relief through EMDR therapy.
Victims of Sexual Assault. EMDR can help survivors of sexual assault process the trauma and reduce symptoms of PTSD and anxiety.
Survivors of Natural Disasters. Those who have lived through events such as earthquakes, hurricanes, or floods can use EMDR to manage and heal from the trauma.
Accidents or Injuries. Individuals who have experienced serious accidents or injuries can benefit from EMDR therapy to reduce the emotional impact of these events.
People with Anxiety and Depression. EMDR therapy can be effective for individuals dealing with anxiety disorders, including generalized anxiety disorder, panic disorder, and social anxiety disorder. Those suffering from depression, particularly when it is linked to past trauma or adverse life experiences, may find EMDR helpful in alleviating their symptoms.
Individuals with Phobias. EMDR can assist people in overcoming specific phobias by processing the underlying traumatic memories or experiences that contribute to irrational fears.
Victims of Grief and Loss. Those struggling with the loss of a loved one can use EMDR therapy to process their grief and move toward healing.
First Responders and Healthcare Workers. Individuals in high-stress professions, such as police officers, firefighters, paramedics, and healthcare workers, who are frequently exposed to traumatic situations, can benefit from EMDR to manage and process these experiences.
People with Chronic Pain. EMDR has been used to help individuals with chronic pain conditions by addressing the psychological aspects of pain and reducing the distress associated with it.
EMDR therapy is a versatile and effective treatment that can benefit a diverse group of individuals facing various forms of trauma and emotional distress. Whether the trauma is from childhood, combat, accidents, or other life events, EMDR can help individuals process these experiences and reduce their psychological impact, leading to improved mental health and overall well-being.
What Can I Expect During an EMDR Session?
During an EMDR session, you will be asked to focus on a specific traumatic memory while following the therapist's hand movements with your eyes or experiencing another form of bilateral stimulation, such as tapping or auditory tones. The therapist will guide you through the process, helping you to reprocess the memory and reduce its emotional impact. Sessions can be intense, but many patients report feeling a sense of relief and decreased distress as therapy progresses.
How Long Does EMDR Therapy Take?
The duration of EMDR therapy can vary significantly from person to person, depending on several factors such as the complexity of the issues being addressed, the individual's specific needs, and their response to the therapy. Here's a general overview of what to expect:
Initial Assessment and Preparation. The first few sessions typically involve gathering detailed personal history, understanding the specific issues, and preparing the client for EMDR. This phase can take 1-3 sessions.
Therapy Sessions. A typical EMDR session lasts about 60-90 minutes. During these sessions, the therapist and client work through the eight phases of EMDR therapy, focusing on specific traumatic memories or issues.
Number of Sessions
Simple or Single Trauma. For individuals dealing with a single, less complex trauma, significant improvement may be seen in as few as 6-12 sessions.
Complex or Multiple Traumas. For those with multiple traumas, chronic PTSD, or complex psychological issues, the therapy may take longer, potentially spanning several months or even a year. The number of sessions can range from 12 to over 50, depending on the severity and number of traumatic events.
Progress and Reevaluation. Throughout the therapy, the therapist will regularly reevaluate the client's progress and adjust the treatment plan as necessary. The duration of therapy can be extended or shortened based on the client's ongoing needs and improvements.
What Are the Factors that Influence the Duration of EMDR?
Several factors can influence how long EMDR therapy takes for an individual:
Nature and Severity of Trauma. More severe or multiple traumas generally require longer treatment.
Client's Readiness and Stability. Clients who are ready and able to engage with the therapy process may progress more quickly.
Frequency of Sessions. Regular sessions (e.g., weekly) can contribute to more consistent progress.
Therapist's Approach. Different therapists may have varying approaches and speeds at which they work through the phases of EMDR.
While there is no one-size-fits-all answer to how long EMDR therapy takes, it is essential to approach the therapy with patience and an open mind. The duration will depend on your unique circumstances and the nature of your trauma or issues. Working closely with a qualified EMDR therapist can help ensure that you receive the most effective treatment tailored to your needs, leading to meaningful and lasting healing.
Is EMDR Therapy a One-Session Cure?
No, EMDR therapy is not typically a one-session cure. While some individuals may experience significant relief or progress after just one session, this is not the norm. EMDR therapy is a structured and phased approach that usually requires multiple sessions to achieve lasting results. Here’s why:
Complexity of Trauma
Multiple Traumas. Many people seeking EMDR therapy have experienced multiple traumas or have complex psychological issues. These require a thorough and gradual approach to treatment.
Severity of Trauma. The severity of the trauma can influence how long treatment takes. More severe traumas often require more time to process effectively.
Are There Any Side Effects of EMDR Therapy?
While EMDR therapy is generally considered safe and effective, some individuals may experience side effects. These side effects are usually temporary and part of the healing process as the brain works to reprocess traumatic memories. Here are some potential side effects you might encounter during or after EMDR therapy sessions:
Emotional Distress
Increased Emotions. It's common to experience heightened emotions during and after EMDR sessions. This can include feelings of sadness, anger, or anxiety as you process traumatic memories.
Emotional Sensitivity. Some individuals may feel more emotionally sensitive or vulnerable for a short time after a session.
Physical Sensations
Fatigue. Processing intense emotions and memories can be tiring, and some people feel physically exhausted after a session.
Body Aches. You might experience muscle tension or body aches, as the body often holds onto stress and trauma.
Vivid Dreams. Some individuals report having vivid or intense dreams following EMDR sessions. This is a sign that the brain is processing and integrating the material worked on during therapy.
Temporary Increase in Symptoms. In some cases, symptoms such as anxiety or intrusive thoughts may temporarily increase as the brain processes traumatic memories. This is usually short-lived and should decrease as therapy progresses.
Cognitive and Psychological Effects
Memory Recall. EMDR can bring up forgotten or suppressed memories, which can be unsettling but is part of the therapeutic process.
Cognitive Shifts. As negative beliefs are challenged and replaced with positive ones, you might experience shifts in your thinking patterns.
Will I Live The Trauma As Intensely As Before?
One common concern people have about EMDR (Eye Movement Desensitization and Reprocessing) therapy is whether they will have to relive their trauma as intensely as they did when it first happened. While it’s true that EMDR involves recalling traumatic memories, the experience is generally different from reliving the trauma. Here’s why:
Controlled and Safe Environment
Therapeutic Setting. EMDR therapy is conducted in a controlled, safe environment with a trained therapist who guides you through the process. This setting is designed to ensure you feel secure and supported.
Preparation. Before starting EMDR, your therapist will work with you to build coping skills and relaxation techniques to manage distressing emotions that might arise.
Desensitization Process
Gradual Exposure. EMDR involves gradual exposure to traumatic memories rather than a sudden, overwhelming confrontation. This helps to desensitize the emotional impact of the memory over time.
Bilateral Stimulation. The use of bilateral stimulation (eye movements, tapping, or sounds) during EMDR helps to process the memory in a way that reduces its emotional intensity.
Processing Rather Than Reliving
Different Experience. While you will recall the traumatic event, the experience of doing so in EMDR is different from the original trauma. The goal is to process and make sense of the memory, not to relive it.
Reduced Emotional Charge. As the therapy progresses, the emotional charge associated with the traumatic memory typically diminishes. Many people find that the memory becomes less distressing and more manageable.
Therapeutic Techniques
Controlled Recall. Your EMDR therapist will guide you to recall only as much of the memory as you can handle at a given time, allowing for a controlled and paced approach to processing the trauma.
Positive Beliefs. EMDR also focuses on replacing negative beliefs associated with the trauma with more positive, empowering ones, which can further reduce the intensity of the memory.
Emotional Safety
Supportive Presence. Your therapist is there to support you through any emotional responses that arise. They can help you use grounding techniques and other coping strategies to stay present and manage your feelings.
End-of-Session Stability. Each EMDR session ends with techniques to ensure you feel stable and safe before you leave, helping to prevent lingering distress.
In EMDR therapy, while you do recall traumatic memories, the process is designed to be different from reliving the trauma as intensely as before. The controlled, supportive environment, gradual exposure, and use of bilateral stimulation all contribute to a therapeutic experience that aims to reduce the emotional impact of the trauma. With the help of a trained therapist, you can process and make sense of your traumatic memories in a way that promotes healing and emotional well-being.
Can I Do EMDR Therapy If I Have Multiple Traumas?
Yes, EMDR therapy can address multiple traumas. Your therapist will work with you to prioritize and process each traumatic memory in a structured manner.
What If I Don't Remember My Trauma Clearly?
EMDR therapy can still be effective even if you don't remember every detail of your trauma. The therapy focuses on the emotions and beliefs associated with the memory rather than specific details.
Is EMDR Suitable for Children?
EMDR therapy can be adapted for children and adolescents! Qualified therapists use age-appropriate techniques and approaches to help young individuals process trauma and emotional difficulties.
Preparing for EMDR Therapy—What You Need to Know
Before starting EMDR therapy, there are several steps you can take to ensure you are well-prepared and can get the most out of your sessions.
Find a Qualified EMDR Therapist. Choosing a qualified and experienced EMDR therapist is crucial. Look for a licensed mental health professional who has completed specialized training in EMDR therapy. You should also schedule a consultation to discuss your needs, ask questions about the therapist’s experience, and ensure they are a good fit for you.
Understand the Therapy Process. Educate yourself about the EMDR therapy process. Your therapist will explain the eight phases of EMDR and what you can expect during sessions. Having a clear understanding of the process can help alleviate any anxiety or uncertainty you may have.
Set Realistic Goals. Discuss your goals for therapy with your therapist. Setting realistic and specific goals can help you stay focused and motivated throughout the treatment. Your goals may include reducing symptoms of PTSD, improving emotional regulation, or overcoming specific phobias.
Establish a Support System. EMDR therapy can bring up intense emotions and memories. It's essential to have a support system in place, whether it's friends, family, or a support group. Having people to talk to and lean on can provide comfort and encouragement during your therapy journey.
Practice Self-Care. Taking care of yourself is crucial when undergoing EMDR therapy. Engage in regular self-care activities such as exercise, meditation, journaling, and spending time in nature. These activities can help you manage stress and maintain emotional balance.
Prepare for Emotional Responses. Be prepared for the possibility of intense emotions during and after sessions. This is a normal part of the healing process. Create a self-care plan that includes activities and strategies to take care of yourself emotionally and physically between sessions.
Schedule Wisely. Plan your therapy sessions at times when you can allow for some recovery time afterward. Avoid scheduling important tasks or meetings immediately after a session. Also aim for consistent, regular sessions as recommended by your therapist to maintain momentum in your healing process.
Be Open and Honest with Your Therapist. Open communication with your therapist is vital for successful EMDR therapy. Be honest about your feelings, thoughts, and experiences. If you have any concerns or discomfort during sessions, don't hesitate to voice them. Your therapist is there to support you and make adjustments as needed.
Be Patient and Trust the Process. EMDR therapy can be challenging, and progress may not always be linear. It's essential to be patient with yourself and trust the therapy process. Healing from trauma takes time. However, each session brings you closer to your goals.
EMDR therapy offers a powerful and evidence-based approach to healing from trauma and emotional distress. By understanding the therapy process and taking the necessary steps to prepare, you can maximize the benefits of EMDR and work towards a healthier, more balanced life. Remember, the journey of healing is unique for each individual. However, with the support of a skilled therapist and a commitment to self-care, you can achieve meaningful and lasting change.
About the Author
Julia Salerno, M.S., LPC is licensed in Pennsylvania and New Jersey. She has a MS in Counseling from Villanova University. Her specialty is providing trauma therapy. This includes support for generational trauma healing. She does this through EMDR, IFS, DBT, mindfulness, and more! Julia fosters resilience, identifies triggers, and builds coping strategies tailored to those struggling with trauma
Besides working with clients as a trauma therapist she is also the Assistant Clinical Director at Spilove Psychotherapy. Ready to reclaim joy and fulfillment? Connect with Julia for virtual sessions in Pennsylvania.
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