What Happens in an Actual EMDR Session?
With the return of fall I’m excited to start back up with my series of posts answering everyone’s biggest questions about starting EMDR (Eye Movement Desensitization and Reprocessing.) You might have heard that EMDR is a great therapy for recovering from trauma, PTSD or very stressful experiences, and that its very different from your typical talk therapy or working on learning skills. Today we’re going to dive into what an actual EMDR session looks like and what you can expect over the course of the therapy.
In EMDR you are thinking about a stressful or traumatic experience while quickly moving your eyes back and forth, feeling taps or listening to tones in each ear. If you’re not sure what EMDR (Eye Movement Desensitization and Reprocessing) is you might want to start with this post first. If you’re ready to learn more about what an EMDR session looks like then let’s start with the eye movement part, otherwise known as bi-lateral stimulation (BLS)
BLS: BLS stands for “bi-lateral stimulation” and is the bread and butter of EMDR therapy. Bi-lateral just means cross-body; something happening back and forth on both side of the body. There are several techniques therapists can use for BLS and as the client you get to ask for any adjustments you need to be more comfortable. Your therapist might use any of the following methods:
Eye movements: you’ll move your eyes back and forth by following lights on a device, the therapists fingers, or a pointer. Child therapists will sometimes use a finger puppet.
Taps: This could be the therapist tapping your hands, holding a device that vibrates from one side to the next or doing self-tapping.
Audio: You might listen to alternating tones in each ear while wearing headphones. I personally don’t use audio methods because the research shows this to be less effective then eye movements or taps.
The great thing with so many options available is that they can be altered pretty easily to best fit your needs, and with so many techniques EMDR is still very doable for telehealth appointments .
The BLS is a vital part of EMDR and what comes to mind when most people think of the therapy. However, there’s more to know about it than just that. Let’s break down each phase of EMDR and how bi-lateral stimulation fits into the therapy.
Preparation: This is the phase of therapy where you and your therapist are still getting to know each other. Your therapist is asking questions to see if EMDR is a good fit for you and if so, how much advanced preparation work would best meet your needs- for more on who EMDR is a good fit for read here. This is also a great time for you to ask questions so you can learn if EMDR and the therapist is right for you. Once you’ve both decided to move forward with EMDR you’ll start using BLS for some more calming, soothing exercises. This will help you stay grounded when you start working with the hard stuff and give both you and your therapist a chance to see what EMDR is like for your unique brain.
History Taking: During this phase you and your therapist will be creating a road map of memories to work on together. You might be starting EMDR with a good sense of what memories are really bothering you, or you might have no clue. Either way is fine. EMDR has a specific method of thinking through past experiences that will help ensure that you’re working through the memories that are still effecting you today. This might mean you never work on a major trauma because you’ve already recovered from it. It could also mean you’re working on something you didn’t realize was deeply impacting you until you go through the history taking process. Your EMDR therapist will support you through these steps and you’ll decide together where to start.
Assessment: Once you’ve picked a memory to start with your therapist will guide you through a short series of questions to lay the foundation before starting BLS. This way both of you know where you currently are with that particular memory and where you’d like to be with it when its cleared up.
Reprocessing: Now we get to the spicy stuff! Your therapist will help you focus on the different pieces of the memory discussed in the assessment phase and do short sets of eye movements, taps or tones. You’ll take a break between the sets, breathe and share a bit of what you noticed during that set. Your therapist will help you focus on the things that came up for you that are an important part of your healing process. This will continue until the memory no longer feels disturbing, you can see yourself in a positive light, and your body isn’t holding on to any tension. This could take just one session, it could take several, it really depends on the nature of the memory and how a person needs to process it. This video is a great example of what reprocessing with EMDR can look like.
And that’s what actually happens during an EMDR session! All memories that are leading to difficulties still today are processed this way. Once all those memories are resolved your therapist will guide you through working through any remaining triggers and well as challenging situations that are likely to come up in the future. You might also find that there are times when other approaches are added in, or other EMDR techniques are used to make reprocessing more effective for you.
Want to learn more about EMDR or have questions? Feel free to reach out!