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What happens during an EMDR Session?

In a recent post I described what EMDR is. Now I’ll describe in general terms what may happen in an EMDR session.

Keep in mind, therapy is an art: each therapist has their own style and background and thus may use the tool of EMDR a little differently.

This post should, however, give you some sense about what work with an EMDR-trained therapist may look like.

An EMDR therapist will take a thorough history.

During this the therapist may gather information about many things including:

  • childhood experiences,

  • important relationships

  • education

  • and other things that help to give a good overall picture of the client

The therapist is working to develop a full picture of the client--

Both strengths and struggles.

Prior to beginning any work on traumatic material, a therapist will take the time to make sure the client is at the point where they have good resources and good coping mechanisms to allow the work of reprocessing traumatic memories to begin.

If the client gets too easily aroused and upset, or if they feel numb and disconnected, the therapist will work with the client to increase tolerance for the work.

This may include increasing the positive resources and enhancing ways to cope with distress in order to keep the work safe and to avoid retraumatizing the client.

After determining the client has sufficient coping resources to manage distressing memories, and the client is able to avoid being overwhelmed by past experiences, the work of EMDR reprocessing can begin.

Riding on a train

The metaphor commonly used to describe EMDR processing is the metaphor of riding on a train.

EMDR utilizes a dual awareness: the client is aware they are safe and present here and now, while at the same time able to “watch” the images, sensations, and feelings associated with a memory pass by much as the scenery passes by for a passenger on a train.

During an EMDR session, the therapist may guide a client to hold an image of a memory in mind. Through discussions, the client may have gained some insight about what negative belief the memory is linked to, and may discuss what they would prefer to believe.

In addition, the therapist may ask the client about what sensations they notice in their body as they hold the image in mind.

As the client notices what comes up for him or her, the therapist guides the processing using bilateral stimulation (guided eye movements, alternating sounds, or sensory “tappers,”) to process the information by stimulating one side of the client’s brain followed by the other.

Similar to riding on a train, the sights, sounds, feelings, thoughts, images and body sensations related to the memory pass by like the scenery outside a train window.

The client and therapist work together to reprocess the memory, often resulting in decreased disturbance for the client related to the memory as well as a new, more adaptive beliefs about themselves and the meaning of the experience.

One of the really neat things is that our memories are stored in networks. As a result, work related to reprocessing a particular memory and associated negative belief can generalize to other memories connected to the initial memory processed. This can thus decrease distress around related memories!

EMDR can result in decreased distress around memories and an increased ability to cope with old triggers.

Sometimes sessions need to close before processing is complete. In that case the therapist will work with the client to "put away" the work to be returned to in a later session. This can be done in many different ways, a container or a mindfulness calm place exercise can be utilized among other techniques.

Ultimately EMDR is one tool that can be very helpful when client's are working with long held memories and beliefs.

The sessions can stir some things up, but overall the goal with EMDR is to provide a safe place to reprocess traumatic memories in a way that does not retraumatize, but rather promotes healing.

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