The Structure of EMDR Therapy: A guide for those considering trauma treatment

EMDR, short for eye movement desensitisation reprocessing, is a type of psychotherapy used to treat PTSD (post-traumatic stress disorder) and other types of psychological trauma, including complex trauma (C-PTSD.)

Although an effective treatment for trauma disorders, EMDR can also help treat the symptoms of other mental health conditions, such as depression, anxiety, personality disorders, dissociative conditions, and more. 

Initially developed by American psychologist Francine Shapiro, EMDR has become vastly popular in recent years, with many mental health professionals and rehab clinics adopting this framework as part of an integrated treatment program for those with substance use disorder and process addictions.

You may be wondering why EMDR is so commonly used to help those who have experienced trauma.

Put simply, unmetabolised traumatic memories or experiences often remain “trapped” in the brain and nervous system, causing many unpleasant symptoms that we recognise as PTSD

These symptoms or presentations can manifest in various ways but typically look like this:

  • Flashbacks related to the traumatic incident may occur —for instance, you may relive or re-experience the event in your mind as if it’s happening all over again.
  • Nightmares.
  • Avoidance.
  • Hypervigilance.
  • Social isolation and withdrawal.
  • Anxiety.
  • Unhealthy coping mechanisms such as drug or alcohol abuse to cope with or numb unpleasant symptoms. 

This article explores the structure of EMDR therapy for those considering trauma treatment.

In the meantime, if you are worried about your (or a loved one’s) mental health, contact us today for more information about our EMDR program or to discuss your concerns with a team that genuinely cares.

Camino Recovery specialises in treating many types of trauma and other emotional issues, including depression, anxiety, substance addiction, and more, utilising various methodologies and approaches, including EMDR, to ensure you get the most out of your treatment and feel better sooner.

Although it may not always feel like it, you are not alone in your struggles. Help and support are available. 

Speak to a team member today.

How EMDR can help treat the effects of trauma

EMDR gives traumatic memories a chance to be reprocessed and effectively stored under the safety and guidance of an experienced clinician, an opportunity that these experiences were likely not given when the original event took place.

For example, say an individual is being chased down the street by a knife-wielding assailant.

Under these circumstances, the organic reaction is for the person’s body to go into fight or flight, causing them to experience a range of physiological symptoms, such as increased adrenaline, fast heartbeat, shallow breathing, and so on.

The brain and nervous system signal these physiological responses to protect the person being chased, giving them the energy to fight or flee a dangerous situation.

Once the individual has returned to safety, it’s only afterwards that shock begins to kick in.

Why? 

Because the body now knows it’s safe to feel the impact of what did happen and what could have happened. It’s often at this point that the individual may experience a range of post-traumatic stress symptoms.

young sad mad sitting by the window in regret

These symptoms, as uncomfortable as they are, are often the brain’s way of trying to complete the processing of a particular memory, usually a distressing one.

Once effectively processed, the individual can move forward from the traumatic event, accepting that although what happened was deeply unpleasant, it is in the past, and they are free to get on with their life.

However, if, for whatever reason, the brain’s attempt at processing the experience is unsuccessful, the memory may hibernate in the body, often requiring some form of intervention such as EMDR to help unstick it.

If you are considering EMDR therapy, we have compiled a guide that explains the structure of this type of treatment so you know what to expect and can approach the process with more confidence and reassurance.

Let’s get to it!

The structure of EMDR therapy: A guide for those considering trauma treatment

The structure of EMDR varies between individuals and their specific needs and preferences. 

However, typically, EMDR therapy consists of around six to twelve sessions, which are facilitated once or twice a week. Again, the duration of EMDR treatment largely depends on the individual and their needs, such as the severity of symptoms. 

Some may need more sessions, while others require fewer.

According to research, an isolated distressing memory can be processed in as little as three sessions, making this type of treatment one of the most efficient and effective for treating trauma.

How does it all work?

EMDR structure

EMDR typically follows a structured approach to help address past traumas and the imprint these experiences can leave behind.

This treatment involves eight phases:

1. History taking

Communication session of woman psychologist and client

In the first phase of EMDR, your therapist will gather information about you, such as your history, symptoms, and any goals or preferences you may have for treatment.

During the history taking phase, you and your therapist get to know each other and create a trusting, mutual therapeutic alliance that works for both parties.

Your therapist may ask you some questions about what brought you to treatment and how EMDR therapy can be used to help alleviate your trauma symptoms and other emotional challenges you may be experiencing.

Once your history has been discussed and questions answered, you and your therapist will develop a treatment plan. 

This plan may include the frequency and duration of your sessions and the selection of memories you would like to target as part of your treatment.

Other aspects, such as your external and internal resources and anything else you feel is essential, will also be assessed before proceeding to the next phase.

2. Preparation

Here, you will learn vital coping skills and relaxation strategies to help you manage distress in preparation for processing the traumatic memories selected in phase one.

Your therapist will address any concerns and questions and explain the EMDR process, including terms, processes and what to expect.

Once you reach phase two, you should have established a trusting, comfortable relationship with your therapist. 

However, if you feel that a good therapeutic alliance has yet to be established, expressing any worries or apprehensions is essential before proceeding to the next phase of treatment.

Also, it is common and perfectly okay for clients to spend some time in phases one or two as they prepare for the following stages. 

Remember, this is your process and you must navigate the healing journey at your own pace and time.

3. Assessment

In the assessment phase, the memory you wish to target or reprocess is identified, including any ideas, beliefs, feelings, narratives and sensations you may have about the event you experienced.

Here, initial baseline measures are identified using the Subjective Units of Disturbance (SUD scale, as well as the Validity of Cognition (VOC) scale (The Eight Phases of EMDR Therapy, EMDR International Association, 13 August 2021.

Note: Once you complete phase three, you will be ready to start the reprocessing aspect of EMDR therapy.

These phases involve bilateral stimulation, such as tapping, side-to-side eye movements, and the use of specific sounds. Your therapist will gently explain the benefits of these techniques and why they are used during EMDR sessions.

4. Desensitisation 

Middle age male psychologist writing notes during a therapeutic session with his young adult female african patient who sitting in armchair

The above techniques will help you begin reprocessing the traumatic memory while simultaneously focusing on the distressing aspects as you engage in bilateral stimulation.

You will continue the above process until your SUD decreases to zero and you become more desensitised to the memory.

In this phase, new narratives, images, thoughts and beliefs will surface, replacing existing unhealthy presuppositions that no longer serve a purpose in your life.

5. Installation

Once you complete the desensitisation phase, you move into installation, where you begin associating and nourishing positive beliefs about your selected memory until it becomes true for you.

Positive beliefs are encouraged and reinforced here, replacing negative ideas, thus cultivating healing and resilience.

6. Body scan

Phase six involves a body scan. 

Your therapist will ask you to hold the target memory and positive belief in your mind simultaneously as you scan your body from top to bottom.

You may also be encouraged to notice any lingering physical sensations associated with your target memory as any trauma that may have been stored in your body is reprocessed.

If you have ever practised mindfulness meditation, you may be familiar with how body scans work and the many benefits this practice offers.

7. Closure

Female patient talks about her problems while lying on couch at psychologist appointment

Your EMDR sessions will typically end with closure, involving specific relaxation techniques to ensure you feel calm and grounded.

Reprocessing of a target event is complete when you feel more impartial about your experience, and the new belief system you have practised during your session feels true. 

Your body will also be free of any distress or disturbance as the traumatic experience and any sensations and feelings attached to it have been released.

8. Reevaluation

The reevaluation phase does what it says on the label. 

Each EMDR session begins with you and your therapist discussing the memories you processed at your last appointment to make sure your distress is still low and positive thinking patterns are sustained and substantial.

Once you and your therapist feel confident that previous target memories have been reprocessed effectively, the plan will be to discuss future memories for further EMDR sessions.

Is EMDR a suitable treatment for everyone? 

As mentioned, EMDR is an effective treatment for those who have experienced distressing or traumatic events and is a widely used treatment for PTSD, anxiety, substance addiction, and depression.

However, EMDR may not be suitable for everyone. Therefore, it’s essential to consider whether you are the right candidate for this type of treatment.

Some factors may help you determine whether EMDR therapy is the proper treatment for you, such as:

  • Severity of symptoms – Typically, EMDR is recommended for those with moderate to severe symptoms of trauma or other emotional issues such as depression and anxiety. Individuals with milder symptoms may benefit from less intense treatment.
  • Medical history – Some medical conditions may impact your ability to engage in EMDR therapy. It would help to speak to your healthcare provider for advice before beginning treatment.
  • Stability – Clients must be psychologically and emotionally stable to participate in EMDR treatment. Individuals experiencing a mental health crisis or other acute emotional difficulties may need to be stabilised and grounded before engaging in EMDR therapy.
  • Cognitive capacity—Due to the nature of EMDR therapy, such as cognitive processing and other techniques, individuals with cognitive impairments or other disabilities may find it challenging to engage in the treatment process actively.

What to look out for in an EMDR therapist

Another important consideration is the experience, skills and qualifications of your therapist.

It is highly recommended that you seek the help of a therapist who has substantial EMDR experience and training in treating clients presenting with similar issues as you.

Good questions to ask a potential therapist include the following:

  • Have you treated my type of challenges/symptoms before?
  • How do you monitor and track progress?
  • How can you tell if I’m a suitable candidate for EMDR?
  • What is a conventional EMDR treatment plan, and roughly how long will therapy last?

Bottom line

EMDR is a safe and effective treatment that has been used by trauma specialists and mental health professionals for a long time and is recommended by organisations such as the World Health Organisation (WHO.)  

However, like any mental health treatment, you must speak to your doctor or healthcare provider to make sure you are a suitable candidate before beginning EMDR therapy.

Camino Recovery: Specialists in EMDR therapy

Camino Recovery is a pioneering trauma and addiction treatment centre based in the stunning Andalucian countryside of Spain.

Our clinical team has a wealth of knowledge and expertise in treating and diagnosing various types of trauma and other mental health disorders, including anxiety disorder, depression, and multiple types of addiction.

We have crafted a bespoke treatment program that helps treat not only the symptoms of trauma but also the underlying cause(s) to help you sustain lasting wellness and recovery.

Our personalised treatment programs combine a wide range of evidence-based therapies to help alleviate your symptoms, explore the root cause(s) of your issues and ultimately, help free you of the clutches of trauma, addiction or any other emotional challenges you may be experiencing.

The treatment programs we provide include the following:

Our commitment to your recovery 

Our team is dedicated to guiding you and your loved ones towards sustainable healing and recovery, empowering you to build resilience and a solid foundation for lasting growth and transformation, a life you could have only imagined at the beginning.

Camino Recovery is deeply committed to expanding our staff’s knowledge in the field of trauma and other mental health specialisms.

Thus, we constantly evolve and upgrade our knowledge through training and development programs to ensure you get the utmost care, support, and treatment you need and deserve as you navigate the path to wellness and recovery.

Contact our friendly team today for further support and information about our EMDR treatment program.

We are here and ready to help.

Additional resources

  1. The Eight Phases of EMDR Therapy, EMDR International Association, 13 August 2021
  2. EMDR, Psychology Today
  3. The Five Powerful Benefits of EMDR Therapy, Camino Recovery, 14 March 2024
Ameet Braich - Camino Recovery Spain

Ameet Singh Braich, a distinguished Clinical Director at Camino Recovery, is renowned for expertise in addiction and trauma resolution. With 15+ years of experience, he transforms lives through a holistic therapeutic approach. His research focuses on childhood maltreatment's impact on cognitive, emotional, and social functioning.

A dynamic speaker and trainer, Ameet empowers clients to achieve lasting recovery, prioritizing trauma resolution and relapse prevention. His diverse training includes EAP, crisis intervention, and EMDR. Committed to positive transformation, Ameet equips individuals across fields to address challenges of addiction.

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