How to Best Prepare for EMDR Therapy (& What to Know)
If you’re planning to start EMDR therapy soon, you might be feeling a bit uneasy and unsure what to expect. That’s totally normal at this point. EMDR therapy is a highly effective treatment for trauma and other mental health conditions, but it can be intense and emotionally challenging. Proper preparation can help you get the most out of your EMDR therapy sessions and ensure that you feel safe and supported throughout the process.
Fully preparing for EMDR therapy involves several key steps. First, it’s important to find a licensed therapist who’s trained and experienced in EMDR therapy. Look for someone who has completed advanced training in EMDR therapy. You can also ask for referrals from your doctor or from family and friends, or check online directories. Once you’ve found a therapist you want to work with, definitely schedule an initial consultation to discuss your goals for therapy and ask any and all questions you have about the process and themselves.
To help prepare yourself, you can also practice relaxation techniques (like deep breathing or meditation), journaling about your emotions and thoughts, and setting specific goals for your therapy. Your therapist may also recommend specific activities or exercises to help you prepare for your EMDR sessions. By conscientiously taking these steps, you’ll feel much better that you’re ready to engage fully and get the most out of your EMDR sessions.
Understanding EMDR Therapy
It’s pretty essential to understand EMDR therapy’s foundations and how it all works. EMDR therapy stands for Eye Movement Desensitization and Reprocessing, and it’s a psychotherapy approach that helps individuals overcome traumatic experiences and certain mental health conditions.
Foundations of EMDR
EMDR therapy is based on the Adaptive Information Processing (AIP) model, which says that the brain has a natural ability to process and heal from traumatic experiences. However, when a traumatic event occurs, the brain may not process the information correctly, leading to symptoms such as anxiety, depression, emotional dysregulation, and post-traumatic stress disorder (PTSD).
The goal of EMDR therapy is to help the brain process the traumatic experience correctly, reducing the symptoms associated with it. This is achieved through a series of bilateral stimulation, which can be eye movements, taps, or sounds. The bilateral stimulation is believed to activate the brain's natural healing process, allowing it to reprocess the traumatic experience correctly.
How EMDR Works
EMDR therapy consists of eight phases, starting with a comprehensive assessment of your mental health history and symptoms. Your therapist will then work with you to identify the specific traumatic memory (or memories) that needs to be reprocessed.
During the reprocessing phase, your therapist will guide you through the traumatic memory while providing bilateral stimulation. You’ll be asked to focus on different aspects of the memory, such as the emotions, sensations, and beliefs associated with it. The bilateral stimulation is believed to help the brain reprocess the memory correctly, reducing the intensity of the associated emotions and sensations.
All in all, EMDR therapy is a highly effective approach for treating trauma-related disorders. Originally developed in the 1980s, it’s been extensively researched and validated since then.
Preparation for EMDR Therapy
When preparing to kick-off your EMDR therapy journey, be sure to find a qualified licensed therapist who has completed the necessary training in EMDR therapy. You can find a therapist through a referral from your primary care physician, mental health provider, by searching online, or asking around to family and friends (if you feel comfortable to do so).
Finding a Qualified Therapist
When searching for the right therapist, ensure that they have completed advanced training in EMDR therapy. A qualified EMDR therapist should have completed an EMDR Basic Training program, which includes a minimum of 20 hours of didactic instruction and 20 hours of supervised practice. You can verify a therapist's EMDR training by checking their credentials or contacting the EMDR International Association. As of writing, I’m currently EMDR trained and almost done with becoming a certified EMDR therapist through The EMDR International Association (EMDRIA).
What to Expect in Sessions
During your first session, your therapist will conduct an assessment to determine if EMDR therapy is the appropriate treatment for you. This assessment will include a review of your medical history, current symptoms, and any past trauma. Your therapist will also explain the eight phases of EMDR therapy in detail and how they’ll be used throughout your therapy sessions.
Once the assessment is complete, you and your therapist will develop a treatment plan that’s tailored to your specific needs and goals. This plan will include the specific issues that’ll be addressed and the goals of your therapy.
Throughout the treatment process, you'll work with your therapist to process past traumatic events using bilateral stimulation, which can include eye movements, tapping, or auditory sounds. Your therapist will guide you through the eight phases of EMDR therapy, which include history taking and treatment planning, preparation, assessment, desensitization, installation, body scan, closure, and reevaluation over multiple sessions. Don’t be worried if it takes a bit longer than initially expected to begin to see positive effects from the sessions. Everyone reacts differently to therapy, so someone else’s timeline won’t match up with your own.
The EMDR Process
Preparing for EMDR therapy can be an intimidating task, but don’t worry, understanding the whole process can help alleviate some of the anxiety you might be feeling right now.
Phases of EMDR Therapy
The eight phases of EMDR therapy are as follows:
History Taking and Treatment Planning: In this initial phase, you and your therapist will discuss your history and develop a treatment plan that’s tailored to your specific needs.
Preparation: During this phase, your therapist will teach you various coping techniques to help you manage any distress that may arise during the therapy sessions.
Assessment: In this phase, your therapist will target specific memories or experiences that are causing distress and work with you to identify negative beliefs associated with those memories.
Desensitization: This is the phase where the actual EMDR therapy takes place. Your therapist will use bilateral stimulation, such as eye movements, taps, or sounds to help you process the targeted memories.
Installation: During this phase, your therapist will help you replace negative beliefs associated with the targeted memories with more positive ones.
Body Scan: In this phase, your therapist will help you identify any residual tension or discomfort in your body and work with you to release it.
Closure: Your therapist will use various techniques to help you feel grounded and safe before ending the session.
Reevaluation: In the final phase, you and your therapist will evaluate the progress you've made and determine appropriate next steps.
The Role of Bilateral Stimulation
Bilateral stimulation is a key component of EMDR therapy. It involves using alternating sensory input, such as eye movements, taps, or sounds to help you process traumatic memories or other negative experiences. Bilateral stimulation is thought to work by engaging both sides of the brain and promoting the integration of information.
During the desensitization phase of EMDR therapy, your therapist will use bilateral stimulation to help you process the targeted memories. You may be asked to follow your therapist's finger or a light bar with your eyes, or to listen to alternating sounds or feel taps on your hands. The goal of this phase is to help you process the targeted memories in a way that reduces their emotional intensity and promotes healing.
Addressing Emotional and Psychological Trauma
It goes (almost) without saying that if you’re considering EMDR therapy, it’s likely that you’ve experienced some form of emotional or psychological trauma that has left you feeling distressed. Trauma can take many forms, including abuse, neglect, accidents, natural disasters, or violence. As you may have experienced, traumatic memories can be triggered by a variety of stimuli, such as sights, sounds, smells, and physical sensations. These triggers can lead to intense negative emotional and physical reactions, including anxiety, panic, and flashbacks.
Traumatic Memories and Triggers
Traumatic memories can be difficult to process and can cause you to feel overwhelmed and helpless. EMDR therapy can help you process these memories in a safe and controlled environment. During EMDR therapy, you’ll be asked to recall a traumatic memory while also focusing on a specific visual or auditory stimulus. This process helps desensitize your brain to the traumatic memory, making it easier to process and reducing the intensity of your emotional and physical reactions.
Of course, due to this, you may experience very intense feelings. You should know that this is expected during your sessions, as you’re accessing traumatic memories. This may sound scary, but please rest assured that your therapist will guide and fully prepare you to handle what may arise in your body and mind. You’ll never be left alone during your therapy sessions.
On a different note, identifying triggers is an important part of preparing for EMDR therapy. Triggers are stimuli that can cause you to experience intense emotional and physical reactions, such as anxiety, fear, or panic. By identifying your triggers, you can learn to develop coping strategies to manage your reactions. Your therapist can help you identify your triggers and develop strategies to manage them.
EMDR for PTSD and Anxiety
EMDR therapy has been shown to be effective in treating PTSD and anxiety. PTSD is a mental health condition that can develop after experiencing or witnessing a traumatic event. Similarly, complex PTSD (C-PTSD) can develop after experiencing prolonged trauma or abuse. Symptoms of PTSD can include flashbacks, nightmares, and intense emotional and physical reactions to triggers. Anxiety can also be a symptom of PTSD, as well as a separate condition. EMDR therapy can help to reduce the intensity of these symptoms, making it easier to manage your emotions and reactions in your daily life.
Preparing Mind and Body for Therapy
Before starting EMDR therapy, you should prepare your mind and body for the process. This’ll help you get the most out of your therapy sessions and ensure that you’re able to handle any emotional or physical responses that may arise. Know that intense feelings will most likely come up when you’re accessing traumatic memories, so strengthening your coping strategies beforehand will help a lot in this process.
Relaxation Techniques
Relaxation techniques can help you calm your mind and body before and during EMDR therapy. Some techniques you can try include deep breathing exercises, progressive muscle relaxation, and visualization. Deep breathing exercises vary, but most involve taking slow, deep breaths in through your nose and out through your mouth. This can help slow down your heart rate, release tension, and calm your mind. Progressive muscle relaxation involves systematically tensing and relaxing different muscle groups in your body. And visualization techniques typically involve imagining a peaceful scene or place, which can make you feel calm and relaxed.
Understanding Your Responses
During EMDR therapy, you may experience a range of intense emotions and physical sensations. It’s important to understand that this is a normal part of the process and that these responses are not a sign of weakness or failure. Some common responses include feeling anxious, sad, scared, or angry, or experiencing physical sensations such as tension, warmth, tightness, or tingling. Some individuals report dreams or nightmares in the days following their reprocessing work, which is totally normal and can be addressed with your coping skills. Be sure to communicate these responses to your therapist so that they can help you work through them in an effective and easeful way.
The Role of Cognition in EMDR
Negative and Positive Beliefs
Beliefs play an important role in EMDR therapy. Negative beliefs can be deeply ingrained and can lead to persistent negative thoughts and behaviors in your daily life. Positive beliefs, on the other hand, have the power to help you overcome your negative beliefs and thoughts. During EMDR therapy, you’ll work with your therapist to identify negative cognitions or beliefs that are holding you back and replace them with positive cognitions or beliefs.
Cognitive and Emotional Effects
EMDR therapy sessions will likely have both cognitive and emotional effects. During the therapy session, you’ll be asked to recall a traumatic memory while also focusing on a specific external stimulus, such as eye movements or tapping. Over time, this process can help to reprocess the traumatic memory and reduce the emotional distress associated with it.
After EMDR Therapy
Congratulations! At this point, you’ll have completed your EMDR therapy sessions and have worked hard to process your traumatic experiences. Now that you’ve finished your therapy, it’s important to take some time to reflect on your progress and prepare for the future.
Here are some things you can do after your EMDR therapy ends:
Re-Evaluation and Closure
You’ll want to re-evaluate your progress after completing EMDR therapy, either on your own or with your therapist. Reflect on how far you’ve come and what you’ve achieved. Consider the changes you’ve made in your thoughts, feelings, and behaviors, and how they’ve affected your life. Revisiting your initial treatment goals and assessing your progress can paint a clearer picture and better understanding of the effectiveness of your EMDR therapy.
Closure is an important part of the therapeutic process. Your therapist will guide you through the process of ending therapy in a way that hopefully feels good and meaningful to you. You may be asked to write a letter to yourself or to your therapist, expressing your thoughts and feelings about the therapy process. This can be a helpful way to feel a solid sense of closure and to acknowledge the hard work you did.
Continued Personal Growth
EMDR therapy is an effective treatment for trauma, but it’s not a cure. As an experienced licensed therapist, I recommend continuing to work on your personal growth and development after completing therapy. You may want to consider continuing therapy or seeking other forms of support to help you maintain the progress you’ve made - whatever feels right for you.
The Adaptive Information Processing (AIP) model, which is the theoretical foundation of EMDR therapy, suggests that our brains are constantly processing information. Therefore, it’s useful to continue to engage in activities that promote healthy processing of information, such as journaling, mindfulness, and physical exercise. These activities can help you maintain your progress and continue to grow and heal.
Completing EMDR therapy is a significant accomplishment, and it’s best to take some time to reflect on your progress, appreciate the journey, and prepare for the future. Healing from trauma isn’t easy, but it can pay off so much for the rest of your life. I hope you now feel highly prepared and ready to embark on this important journey.
If you’re a resident of California or Florida and are looking for an online therapist who genuinely cares, contact me or consider booking a free, no-commitment consultation call with me, Laura Jasen, LPCC, LMHC here at Sage & Sunshine Therapy.
Written by: Laura Jasen, LMHC, LPCC
