A guide to EMDR sessions

The first couple of sessions (Phases 1-3)

Focus on rapport building, getting to know you and ‘how big your boat is’, utilising screeners to understand your symptoms, history, challenges and goals. We will also chat about how your experiences impact you in the present, and how they may in the future in an effort to ‘map’ out the targets.

This is also an opportunity to understand how EMDR can help you.

We will be aiming to find appropriate ‘target memories’. In EMDR, as a guide, we will aim to work on the worst or first, however we can also start with the most recent. We can even start with a present trigger or fear.

We will also work through how distressing the target memories are (using a SUD scale 0-10) and how much you believe the negative cognitions associated with such a memory (using a VoC scale 1-7). We will also discuss what you would rather believe about yourself

Phase 4 - Desensitisation & Reprocessing (aka the finger waving!)

The irony is, whilst waving your fingers around is perhaps the most recognisable feature of EMDR, what it actually is, is ‘bilateral stimulation’. Whilst I will usually use my fingers to do this, there are also other ways we can explore if necessary.

During stage 4 we use bilateral stimulation to desensitise the target memory and negative cognition. There is not a lot of talking during the phase, and you may feel quite tired after these session/s. We will be aiming to get the memory to feel 0-1 on the SUD 0-10 scale.

Phase 5 - Installation

In phase 5 we use the now desensitised memory and pair it with a positive cognition (self belief). The aim of phase 5 is the continue reprocessing and integrate a new perspective on the target memory network (you could imagine this like the domino effect). We will be aiming to get the positive cognition to the most believable possible (ideally a 7 on the VoC scale).

Phase 6 - Body Scan

This is the phase where we assess if there is any residual tension or negative sensations. Depending on what comes up, it could be necessary to review our target.

Phase 7 - Closure

We will debrief the session in phase 7, sometimes if we have not been able to move on from phase 4 in one session, we will consider it an ‘incomplete’ session. This is okay and can be expected . It may mean we need to break the memory down into smaller parts and take things slow - this is completely okay.

Phase 8 - Re-evaluation

We will check in and re-evaluate. If since the last session, the memory is not fully resolved, we may repeat phase 4 or 5. If it is resolved, we can work on other memories if required in the past or present. We can also work on future fears.

Due to the complexity of mental health and trauma, no one can guarantee how many sessions it will take to resolve a traumatic memory. Through a really thorough and solid ‘case formulation’ and great preparation phase, this will help us to work as efficiently and effectively as possible.