A four part series written by an EMDR Therapist in Westchester, NY that answers the "What", "Why", and "How" each phase of EMDR Therapy works.
Part One: Phases 1 & 2 of EMDR Therapy
First of all... What is EMDR Therapy?
EMDR Therapy is an evidenced based form of psychotherapy that is based on the trauma-informed approach. This means that EMDR Therapy looks at life experiences from the past as the source of present day symptoms of stress, such as anxiety, depression, PTSD, etc.
EMDR attends to three important time periods including past, present and future. Using an 8-phase approach, each time period is addressed as it relates to the issue you are looking to work on in treatment with your EMDR Therapist.
EMDR Phase 1: History Taking and Treatment Planning
What is Phase 1 of EMDR?
The History Taking Process of EMDR Therapy involves your EMDR therapist getting to understand what your goals are for treatment in EMDR Therapy, what your present day symptoms are, and creating a list of possible target memories that those symptoms are connected to. This is typically when most EMDR Therapists create that Target Sequence Plan, which lists present day triggers, the past memories those triggers are connected to, and the ideal way of handling future scenarios.
During the History Taking and Treatment Planning phase of EMDR Therapy, you and your EMDR therapist are starting to get to know each other. Without trust, safety and connection, you most likely won't be able to get to the deeper stuff, which is where we are aiming to go for successful treatment outcomes in EMDR Therapy.
Together, you and your EMDR therapist are working on identifying themes (also referred to as "Negative Cognitions" or "Negative Beliefs"). Using the AIP Model (Adaptive Information Processing), you will explore past, present and future triggers relating to the issue you are working on. This is where we begin to develop a target sequence plan.
Why is Phase 1 of EMDR Therapy important?
Often people come into therapy thinking: "This is the issue I want to work on". During Phase 1 of EMDR Therapy, it is common to find what actually needs to be worked on is not what you originally thought; however, it is connected. You also may uncover additional areas of unintended growth.
Collaboratively, you and your therapist will come up with a treatment plan to target each 'issue' or 'trigger' appropriately and most effectively.
How can I expect Phase 1 of EMDR Therapy to look and feel?
History taking doesn't mean that you have to tell your therapist the nitty-gritty details of your traumatic experience. That's actually not recommended by most EMDR Therapists. This is because doing so can activate you, and a great EMDR Therapist does not want to do that in the very beginning of the EMDR Therapy process.
You may feel an urge to pass through this phase rather quickly, but it's important to slow down and take your time here. In doing so, you will find ways to anticipate and create plans to manage any blocking or looping that may happen in the reprocessing phases of EMDR Therapy. In turn, this will actually make the EMDR Therapy process go faster and reduce the likelihood of stalling.
An analogy for Phase 1 of EMDR Therapy is this:
If you planned to drive across country from NY to CA, there are many different routes you could take. Before you get behind the wheel and start driving, you need to come up with a plan. Which roads are we taking? What do we need to bring or have with us? Where can we take breaks? Without that guide, you might get lost, you might get stuck, or it might just take a lot longer to get there. Your treatment plan is like your road map, you know pretty much what to expect along the way and you should feel safe, confident and prepared.
Phase 2 of EMDR Therapy: Preparation
What is Phase 2 of EMDR Therapy?
Phase 2 of EMDR Therapy is often referred to as Resourcing or Stabilization. In other words, this is where you and your therapist identify what skills you need in order to feel safe enough to move into the reprocessing phases.
This will include some psychoeducation. Part of trusting what is such a vulnerable and tender process that we call EMDR, requires understanding of what trauma is, how it affects us, as well as knowing what to expect during your course of treatment. Some common things that your therapist may cover during Phase 2 of EMDR Therapy is understanding what your Window of Tolerance is, how your Autonomic Nervous System (ANS) has been impacted by the trauma you experienced, Co-regulating and Self-regulating skills, and much more.
Why do we need Phase 2 of EMDR?
For those with CPTSD (Complex Post Traumatic Stress Disorder), it may be too triggering to start with your history. In this case, your therapist may switch the order of the first two phases and start with preparation and resourcing before taking any history or developing a target sequence plan.
Your EMDR therapist will assess for the following during Phase 1 of EMDR Therapy:
What current coping tools/skills you have that have helped you manage your symptoms
What tools or skills don't you have at this time that may be helpful to acquire and practice before reprocessing your target(s)?
Any concerns you have about addressing your symptoms or memories with EMDR Therapy?
An assessment for dissociation, to also evaluate what skills you may need before beginning the reprocessing phases of EMDR Therapy
How can I expect Phase 2 of EMDR Therapy to look/feel?:
The problem is not the problem, it's a solution". Yes, this may sound radical, but it is true. Coping skills are coping skills. Sme may be considered "adaptive", while others appear "maladaptive". [For example, dissociation is a powerful tool that protected you from experiencing pain at the time of the traumatic event. Long-term dissociation may impact your ability to function or tolerate being present. This once adaptive coping tool may have become maladaptive over time, and may need to be replaced with something more functional.]
By identifying and exploring 'problematic symptoms', you and your EMDR trauma therapist can find a window into the question: "What is it that my nervous system needs to handle this?". Exploring your symptoms from a frame of curiosity versus judgement will allow space for self compassion. In turn, this will promote the replacement of these maladaptive behaviors with more adaptive behaviors for coping.
Some common resources in EMDR Therapy include:
Calm-State/Place
Container
Installation of Attachment Figures (such as nurturing figures, protective figures, wise figures, etc.)
Depending on your unique needs, you and your trauma therapist will work together to identify and strengthen the specific resources that will be most helpful for you during your EMDR Therapy journey.
Your therapist may integrate other trauma-informed practices during Phase 2 of EMDR Therapy. Some commonly integrated practices may include (but are not limited to): Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), Mindfulness, Polyvagal Exercises, Ego-state or IFS parts-work.
To build on the analogy previously used...
Phase 2 is like getting ready to get in the car for that cross-country road trip. We wouldn't start driving the car until our seatbelts are safely fastened, and everything that we need is packed in the car with us (our treatment plan and resources). Once we have all those components, THEN we can start driving (or moving into the reprocessing phases of EMDR.)
Continue to learn more about how EMDR Therapy works by reading Part 2 of Breaking Down the 8 Phases of EMDR Therapy.
Annabella Lipson is a Mental Health Counselor at Peaceful Living Mental Health Counseling in Scarsdale, NY.
She enjoys working with young adults & adults who are dealing with stress, anxiety, grief, PTSD and other challenges.
Annabella incorporates a combination of Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), EMDR Therapy, Ego-state Interventions and Mindfulness practices with her clients
Are you curious about learning more about EMDR therapy and understanding how a treatment plan can get you on a path of healing your trauma? Our own practice owner, Dana Carretta-Stein, authored The EMDR Therapy Progress Journal geared toward the client's perspective and to guide you to reach your goals with your therapist.
Available in E-Book, Paperback and Hardcover