EMDR Process & Theory
EMDR is heavily researched (over 30 years), is endorsed by leading health authorities around the world and is one of the leading treatments for processing trauma and decreasing symptoms of PTSD.
We have seen EMDR completely change the lives of our clients in a way they never expected or imagined. Many clients wish they had done it sooner but felt discouraged believing things could never change.
We believe the payoff in personal progress by engaging in EMDR vs talk therapy is worth the financial and emotional investment as you will get to the root of the targeted issue and results, in our clinical experience, will come sooner and last long term. We would not offer a service that we didn't 100% believe in.
EMDR Therapy: 8-Phase 3-Prong Protocol
EMDR-NOT YOUR AVERAGE THERAPY
EMDR is vastly different from traditional talk therapy, it follows a structured standard protocol that has been proven to give meaningful clinical results in a shorter time than talk therapy. Talk therapy can be great for self-discovery, managing life stress, or once a trauma has been integrated to reflect on- but its not the most effective form of treatment to resolve trauma. EMDR therapists know that it's not generally productive for a client to repeatedly share their trauma story without clear direction and often leaves clients exhausted. It is also known that many clients have a hard time giving a cohesive recall of their trauma because of the fragmented and maladaptive way trauma is stored in the brain. Much of the talking in EMDR is done in the initial phases of history taking and treatment planning, for rapport building and in preparation for facing the targeted trauma in later phases. So you can be assured that when you share your story with an EMDR therapist you will be guided through a process in which you will see therapeutic progress and it will be worth the emotional investment. It may feel a little different at first and not what you expected therapy to be like, but most clients get on board once they start making progress-often quickly-and feel motivated to keep going with this unique treatment.
EMDR psychotherapy is an integrated approach but primarily is classified as an Adaptive Information Processing Therapy. This theory focuses on how maladaptive information is stored improperly in the brain following a trauma and how this plays out over time, often negatively. Adaptive Information Processing Therapy aims for you to reassess your understanding of your trauma which was stored maladaptively when you were in a trauma state in the past -then during EMDR therapy you will work to re-assign new meaning, present day while you are in a regulated state-usually much older and wiser- to let your brain know that you are currently not in danger and are able to cope now-thus able to process the stuck trauma memory.
EMDR therapy has an “8-Phase 3-Prong Standard Protocol” that targets memories from the past (Prong 1), issues, patterns of behaviour and triggers from the present (Prong 2) and fears of the future (Prong 3) for desensitizing and reprocessing.
EMDR therapy integrates “bilateral stimulation” (bls) (Eg: Eye movements, self administered “butterfly hug”), tactile devices etc.) that better enables the information processing to occur. There is extensive research and theories of why and how bls works. Bls is a key component of EMDR and is used throughout the phases.
"Don’t lose what you have now because of what you lost then."
- Tara, in reclaiming your life post-trauma
EMDR protocol starts with “History Taking & Treatment Planning” (Phase 1) mostly done in Intake then moves into a stabilization and “Preparation Phase” (Phase 2) that sets you up for successful self-regulation as you move to the next phases. This is also when bls is first introduced and used as a way to reinforce positive links to calm/pleasant feeling states and positive imagery when being taught self-regulation activities. Phase 2 may take multiple sessions it just depends on your readiness to face and cope with re-visiting the traumas being targeted.
Next comes “target selection” the client can choose as many targets as they want but they will be only worked on one at a time. A subjective “Assessment” (Phase 3) of the chosen target will occur next and will include identifying maladaptive thoughts, emotions and body sensations connected to the specific target. You will You will next be asked to score the "disturbance" of the trauma out of 10, 10 being the worst and 0 being neutral or nothing. In the standard protocol the client will be re-directed from this particular “current target” to “float back” in time in their mind to identify other earlier feeder memories (Prong 1: Touchstone memories) that are similarly related to the current target. This is an excellent way to get to “the root” of the current target’s disturbance.
Then “Desensitization” (Phase 4) begins and will start with the touchstone memories including the worst memories of your past related to the target before the target memory happened, then move forward from there to the present target, then to future fears. This 3-pronged approach of desensitization is a thorough way to clear ALL disturbance related to the target. Several "sets" of bls will be used to facilitate the desensitization and clients will be asked periodically to report any changes related to the trauma target following the bls. This process continues until the disturbance goes to 0.
“Installation” (Phase 5) occurs once the maladaptive thoughts, emotions and body sensations related to the trauma are desensitized hence better able to be re-storied and understood in an adaptive way then reinstalled into the brain in a regulated state using bls to be moved from short-term memory to long term memory storage to be understood as something that happened in the past.
Next, the therapist will lead a “Body Scan” (Phase 6) to check for any unpleasant sensations related to the target that may be left over. If there is, it will then be desensitized.
Once the body is cleared the therapist will ask you to imagine a future event semi-related to the target, that could be challenging for you and to imagine yourself handling it well and using your newly formed positive self-beliefs as you play it out while also using bls thus creating an adaptive "Future Template” (Prong 3).
The entire EMDR process takes time any many sessions end incomplete which is normal but still need to be “closed” (Phase 7: Closing) as to “contain” the disturbing material you were working on. Therapists will close sessions with a calming and stabilizing activity.
In the following session the target and progress will be re-evaluated (Phase 8: Re-Evaluation) then the EMDR process will continue.
How Long Will It Take?: In general the standard EMDR protocol is always followed (modified protocols can be used as required) but certainly is not completed in one, two or three sessions. Therapists that rush the process are doing you a disservice and it will inevitably be counterproductive. Clients don't always have to target multiple traumas its okay to do one at at a time for emotional or financial reasons. Often times even just some relief from one processed trauma helps you cope better in life. But, its best to ensure you budget for multiple sessions (whether you do therapy with us or not) so whatever your treatment plan is can be moved to completion and not left unprocessed and open. There is often a sense of urgency when treating trauma as the effects can be difficult to manage but the therapeutic process needs to be respected, paced and done collaboratively with the counsellor and client. The client needs to feel relatively comfortable and prepared to move forward-yes your window of tolerance will be pushed- but emotional flooding will always result in going back to the Phase 2 Preparation and resourcing phase. Your history of trauma and personal resources and support out of the office will all be factors in the length of time needed to complete therapy. You can book longer appointments (75-120 mins) and more frequently for faster results.
How Trauma Interferes with Mental Health
People have been experiencing trauma for thousands of years. Arousal is the physical reaction to a perceived threat that energizes all animal's survival responses. It is also known as the fight, flight, freeze or collapse mechanism. Designed for a physical world, arousal either activates, or shuts down certain physiological reactions that prepare the body to fight danger, to run away from danger, or to numb the pain response if the danger proves fatal. These responses are instinctual; they pre-date even the most primitive parts of the brain.
The roots of trauma lie in an instinctive physical fear response that has become suspended in the brain and nervous system unprocessed. Thus, initiates troublesome symptoms such that interfere in your daily life and future goals Eg: as avoidance, addiction, sleep problems, forgetfulness, headaches, irritability, intrusive thoughts, phobias, anxiety attacks, depression and so many more. These are all symptoms of hyper-vigilance (fight, flight, or freeze). When your body cannot sustain constant hyper-vigilance, the collapse response is activated (hypo-arousal). Symptoms include a loss of motivation, tiredness, indecision, confusion, physical pain, numbing, fatigue, body tension, isolation and depression. Sometimes, indicators of trauma can remain hidden for years and then, suddenly surface after being triggered by something.
Sometimes traumatic events can eventually be processed over time with out a lot of intervention. But many times a traumatic experience keeps its power and doesn't fall into the past. In these cases the original traumatic event remains stored in a flawed way in your brain in short-term memory because it cannot be processed and put into long-term memory until it can be re-understood and reprocessed while you are in a regulated state. Until then it will remain frozen in its original state.
Trauma experiences can be conceptualized as existing on a spectrum and can be responsible for a variety of trauma symptoms the following are examples, inevitably the client is the one to acknowledge where their trauma lies on the spectrum of big or little.:
“Big -T” Trauma has been conceptualized as higher on the spectrum and higher in disturbance and duration, this is often also called complex trauma. The origins are buried in experiences such as:
Childhood abuse, neglect and a lack of basic safety
Critical events (Eg: experienced crime, hate crime, accidents, fire, terrorist attacks, torture, natural disaster, refugee, immigration experiences etc.)
Sexual abuse, sexual assault, rape, exploitation
Birth trauma and other pregnancy related issues or losses
Medical and surgical injuries
Accidents & Injuries Eg: car, terrible injuries, loss of identity, witnessing tragedy etc
Death of a loved one-worse if violent or not natural causes
Experiencing or witnessing domestic violence or other adult violence experiences
Institutionalized trauma (Eg: foster care, prison, psychiatric stays)
Racism, sexism, homophobia and other discrimination or targeted prejudicial experiences
While most people recognize the negative effects of extreme forms of trauma, such as abuse, violence and being the victim of a crime, they may be unaware that seemingly benign child- or adulthood situations can lead to widespread and hidden after-effects that are just as debilitating.
The origins of "little-t” trauma lie in those unresolved-and often unvalidated moments, in childhood, when you felt overwhelmed, powerless, embarrassed, ashamed, humiliated, and or confused. On the smaller end some examples could be: being seriously scolded by a teacher in front of the class, or a single statement made by an authority figure that you still hear clearly to this day such as, “You’re a loser and will never amount to anything.” Also, an often overlooked trauma can be caused by the cultural norms of "the time" you grew up in and you were expected to "suck it up" because everyone else had to, or was never even acknowledged as something harmful.
In adulthood, when we reflect on these moments we frequently regard them as unimportant and may be embarrassed or ashamed to admit we are still being effected by these experiences and invalidate yourself like others did in your past. But often these experiences can actually be the "root", of a negative belief that you've since carried into adulthood without even realizing it and could be connected to a current issue.
As an adult we are exposed to a lot of little t's relatively consistently at some level just by simply existing and moving through the phases of life. A lot of times we recover quickly but sometimes these experiences can create a significant amount of stress, negative physical symptoms and even cause shifts in personality.
“Little - t” traumas can pile up and create problematic symptoms, but at first glance, may not appear at the same intensity and could be on the lower part of the negative impact spectrum from one’s own point of view. Certainly though even some things classified a little t's may be a Big T for any given person. These incidents could include:
Workplace harassment, stress, conflict, and termination
Invalidated negative childhood experiences
Being gossiped about
Vicarious trauma (Ongoing indirect exposure to traumatic experiences)
The ending of a relationship or friendship
The death of a pet
Significant or sudden change you aren't prepared for and have a hard time adjusting to
Living in an unsafe community
Impacts of growing up or living in poverty
Not meeting family or cultural expectations
Impacts of divorce
ANYTHING YOU PERCEIVE AS TRAUMATIZING