Harper O’Neill, MS, LCMHCA
How Does EMDR Work?
As you may have read previously, Eye Movement Desensitization and Reprocessing (EMDR) is a treatment form that uses bilateral stimulation to move memories, thoughts and beliefs we have about ourselves, from the emotional side of the brain, to the more logical side of the brain. Thus allowing us to choose what we would rather believe about events or experiences. While there can be a lot of information and history behind what EMDR is and what makes it so effective, a good place to start is exploring what is called the “Adaptive Information Processing Model” which is based on the idea that our brains were created to heal. With this in mind, it makes sense that EMDR can be very powerful for those who get to experience it within counseling.
When thinking of EMDR and the structure of how it works, there are many minor forms and elements of bilateral stimulation and its principles that can be used based on the presenting needs of the individual. There are two less intensive branches of EMDR which are effective in unique ways that are known as CID and A-TIP. CID stands for “critical incident desensitization” and is the best choice for the minutes or hours after the traumatic event has occurred. CID is only 8 steps and runs individuals through limited eye movement desensitization principles to desensitize them to the experience they have just had. A-TIP stands for “acute-traumatic incident processing”, which is the most helpful for individuals in the days and months after a trauma, up until 6 months following the experience. These are short term and less invasive tools that use the same principles of EMDR to directly reduce distress from immediate and intense traumatic experiences. Thankfully, EMDR provides much flexibility to use with clinicians and clients alike, so they are sure to get what will best serve them in the moment.
Many clients tend to be curious about what the process of EMDR will look like once their clinician has brought it up to them and determined they may be a good fit for it. This treatment protocol is split into different phases and stages, which can be confusing at times to understand as the client. An overview of the process clients will go through with their therapist is broken down below!
STAGE 1: Broken into two phases, focuses on case conceptualization and resourcing. During this part of the process individuals will create what is known as a “container” and a “peaceful place” to help them in regulating as they move through the process. This is also the part where the individual creates what is known as the “target sequence plan”. The target sequence plan is the part of EMDR that is most like traditional talk therapy… the client works with the clinician to identify “core negative beliefs” (or, beliefs we all have about ourselves that have come from birth and childhood, that have been validated through life experiences which keep us stuck in harmful ways of thinking and acting) and explore what events have led to these beliefs being validated in their lives, both in the past, present and future, as well as exploring the first time they felt this core negative belief. Stage 1 lays a good foundation for the processing that will occur as individuals work through the process.
STAGE 2: Holds the traditional elements of what individuals know EMDR as. This is where the processing occurs, where individuals are given measurements for each belief and asked to rate the emotion they feel when thinking about it, where they feel it in their body and the intensity of the belief. Through this stage, the clinician will administer DAS (dual-attention stimulation) in the form of tapping, eye-movements or sounds as the client makes new neural connections related to the belief. Once the client reflects that the negative belief they hold about themselves through this experience has been lessened, they will finish with the desensitization before moving on to “install” the new belief. EMDR allows space to choose what people would rather believe about themselves given their experiences, which is known as the “adaptive belief”. This stage of EMDR can take quite a while to complete, especially for individuals with multiple core negative beliefs and previous traumatic experiences. It is important to be patient with yourself during this process and try to release any preconceived ideas or beliefs about this process if you are not moving through it at the pace you may have hoped.
STAGE 3: The final stage of the protocol where potentially the smallest amount of time is spent. This is reserved for checking to make sure previous outcomes from processing remain stable, that all events from the target sequence plans have been completed and that the client has processed for past, present and future oriented events.
EMDR allows for a lot of freedom within the process when used within the protocol, shifting to a positive mindset allowing the individual to choose what they believe about their experiences, with separate exercises to enhance positive beliefs, and flexibility to use EMDR tools with children in a playful way.
There is much more information about EMDR than can be shared online, so, if you are interested in beginning treatment, or believe you may be a good fit please reach out to one of our trained clinicians at Cornerstone: Joy Tanner, Abby Anspach, April Thompson, Bailey Wilkinson, Hannah Whisler or Harper O’Neill.