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Eye Movement Desensitisation Reprocessing (EMDR) is an interactive therapy that was originally designed to treat post-traumatic stress disorder (PTSD) and is now used to treat all sorts of mental health issues including complex trauma, anxiety disorders, depression, eating disorders and more. This therapy is effective for many mental health conditions and has helped many people.
The therapy involves bringing your attention to thoughts, feelings and sensations associated with traumatic memories while moving your eyes. Using 30 – 60 second periods, you will follow a moving point of focus with your eyes (either the moving signal of the therapist’s arm or a light box). As your eyes move from left to right, both hemispheres of the brain are activated and the working memory is engaged. The parts of the brain involved in EMDR are the emotional activation, sensory storage and reasoning. By increasing the activation of these parts of the brain, the patterns in our neural pathways can change. EMDR is a type of trauma therapy that helps process and integrate traumatic memories.
These changes in our neural processes can change our stored traumatic memories. The images associated with the memories may become less intense. The bodily and physical sensations associated with the trauma (hyper-arousal and hypo-arousal of our nervous system) tend to calm, relax and soften. Emotional and cognitive changes are also apparent as through EMDR processing we can change the way we think and make meaning of our traumatic memories. This is key to trauma healing as our traumatic memories often hold painful cognitive distortions that perpetuate distress and anxiety. By moving to a healthier and more self-enhancing EMDR we can resolve our trauma and move on.
EMDR helps manage distressing memories by targeting the memories in the brain and the underlying traumas. It also helps with emotional regulation and builds emotional resilience so you can cope better with future stressors.
EMDR has been endorsed by international bodies including the Australian National Centre for Excellence in Post Traumatic Mental Health, International Society for Traumatic Stress Studies and the National Health and Medical Research Council.
EMDR therapy is one of two treatments recommended by the World Health Organisation (WHO) for the treatment of Post Traumatic Stress Disorder (PTSD), the other being trauma-focussed cognitive behaviour therapy. Some people prefer EMDR therapy over CBT, as they find it less invasive and more client-centric.
While the clients who will benefit the most from EMDR therapy experience PTSD or trauma, this powerful psychotherapy can also benefit clients who have:
EMDR therapy can improve emotional regulation and enhance emotional resilience, making it beneficial for a wide range of mental health issues.
EMDR therapy is particularly effective in addressing traumatic events, which can lead to various mental health issues.
Dialectical Behaviour Therapy (DBT) can be used in conjunction with EMDR to build emotional resilience and address emotional regulation. Cognitive behavioural therapy (CBT) can also be used in conjunction to address distorted thinking and overall mental wellbeing.
Before EMDR therapy starts you may need to develop some new skills to manage and reduce your emotional arousal. Some clients may not be ready for EMDR therapy straight away – sometimes other forms of therapy are needed before EMDR treatment can commence.
What are the 8 phases of EMDR therapy?
EMDR is an integrated and structured trauma therapy with 8 phases. The 8 phases guide the treatment though are not always worked through in exact order. For example, the early phases of treatment which focus on assessment and preparation often run concurrently. During an EMDR session you can expect to go through these phases, processing traumatic memories and working towards healing.
Phase 1 History taking: This phase is about understanding your past (physical and mental health) and present (current life challenges or difficulties you may be experiencing).
Phase 2 Preparation: In this phase your therapist will assess your ability to tolerate painful emotional states. This is important because during trauma processing there is a level of emotional discomfort that needs to be managed and it’s important this is considered before EMDR can proceed safely. In this phase you may learn new skills to manage distress and regulate emotions and practice these skills to ensure they work.
Phase 3 Assessment: In this phase you and your EMDR therapist will set up your treatment targets. This involves identifying memories to target in the treatment and different aspects of the memory including the images, level of distress, body sensations and negative cognitions.
Phase 4 Desensitisation: In this phase you will focus on a memory whilst doing bilateral stimulation (BLS). BLS in EMDR is where you move your eyes from left to right following your therapist’s fingers. The process engages both hemispheres of the brain and your working memory. If eye movements don’t work there are alternatives which include tactile sensations or auditory stimulation. The goal of this phase is to reduce the emotion and physical sensations in the memory and make the images less vivid.
Phase 5 Installation: In this phase you will work on installing a healthy or self enhancing belief to process the memory.
Phase 6 Body Scan: In the body scan phase you will scan your body for physical/emotional sensations. These can then be targeted for further processing.
Phase 7 Closure: The closure phase is where you and your therapist will wrap up the processing in the session and prepare you for the next few days. So you leave the session feeling grounded.
Phase 8 Re-evaluation: In this phase you and your therapist will review the outcome of the trauma processing. Here you will decide if the processing is complete or if some memories need further work.
The number of sessions in each phase of EMDR therapy can vary greatly depending on your needs. EMDR therapists play a big role in planning and conducting these sessions to ensure they are tailored to the initial phases and the trauma processing phases (phases 4 onwards). Your EMDR therapist will discuss time frames with you during the assessment process.
The initial phases of intake assessment, history taking, setting up targets and goals is usually done over the first 2-3 sessions.
In terms of preparation for trauma processing it may become clear during assessment that emotion regulation and distress tolerance skills need to be learned and practiced before moving into the desensitisation phase. The time it takes to master the skills varies from person to person.
The mid to latter phases of EMDR therapy is where the trauma processing happens and again individuals spend different amounts of time in these phases. For single incident trauma processing it may be as short as 1-2 sessions, for complex PTSD it may be more extensive. For many people who are in long term therapy EMDR may be built in as one part of their treatment where their trauma processing sessions are spaced out over time.
It’s important to remember that the preparation phases of the treatment are to help you regulate and tolerate the discomfort you may experience during EMDR therapy. During trauma processing you will feel more intense emotions which may include upsetting thoughts and feelings and you may feel physical pain associated with these feelings. Sometimes when you focus on a memory other traumatic or distressing memories will arise which can be disturbing.
Your therapist will guide you through this process at a pace that feels comfortable and safe for you.
In the days following an EMDR therapy processing session you may notice some changes in your emotional state. These are part of the trauma processing and your EMDR therapist will prepare you for them. Although generally less intense than the emotions experienced during an EMDR therapy processing session, post processing experiences may include residual feelings from the session, feeling more emotional or vulnerable, some agitation and dreams related to the emotional experiences being processed. Your therapist will prepare you with a plan for how to manage your emotional experiences and support you with that as the therapy progresses.
EMDR therapy tends to be offered by Allied Health clinicians such as psychologists, clinical psychologists, mental health accredited social workers and occupational therapists. The fees for EMDR therapy will be the rate of the allied health clinician you see.
In the early phases of EMDR therapy (phases 1 to 3) sessions are usually 50-60 minutes and are the clinician’s standard rate. After these phases some practitioners will do longer sessions for the trauma processing part of EMDR therapy (usually 90 minutes) and these longer sessions may be a higher rate.
Yes! As of 2020 EMDR therapy is included as a therapy that can be claimed through Medicare under the Better Access to Mental Health initiative. To access Medicare rebates for EMDR therapy you will need a referral from your general practitioner (or psychiatrist). This will allow you to access up to 10 psychology sessions per calendar year.
There have been 9 studies that have looked at changes over time with EMDR therapy for civilians with PTSD (studies that do not include veteran participants), clients were followed up at various time points including 3, 4, 9, 15 months and 5 years after treatment. In 8 of these 9 studies the treatment effects were maintained over time. Studies with veterans suggest that if EMDR therapy is not completed the effects of treatment may not last over time.
Overall the research suggests that for many people mental health and mood improves over time after EMDR treatment.
No. EMDR is a comprehensive and integrated therapy that involves assessment, planning, trauma processing, reviewing treatment goals and so on. Many of our clients report significant benefit from the treatment but improvements are achieved through the comprehensive EMDR treatment protocol not just one session.
No. There have been many studies that have compared EMDR therapy to treatments not specific to PTSD. For example EMDR therapy has been compared to active listening, standard outpatient care using CBT, relaxation training with biofeedback. The research has found clinical significant and meaningful changes with EMDR therapy compared to these approaches and therefore researchers have concluded it’s not a placebo treatment.
Although research has found EMDR therapy (also known as reprocessing therapy) to be an effective treatment for trauma and PTSD the exact mechanism behind it is not clear and is still being researched.
The role of eye movements (or bilateral stimulation) in EMDR therapy has been questioned where some researchers think eye movements may not be necessary. Others who advocate for EMDR therapy and particularly clinical therapists who do the treatment think eye movements (and bilateral stimulation in general) are an essential part of the treatment.
We will continue to advocate for more research so we can learn more about this trauma therapy and the mechanism behind EMDR’s success.
Most people can do therapy within the EMDR model. Some people may need a longer preparation phase where they build skills and develop emotional regulation. Sometimes people think this means they are not “doing EMDR” which is not true, the preparation phase is part of the EMDR model.
Many people come to EMDR therapy after they’ve agreed with their therapist that EMDR therapy could be helpful after a traumatic event. As part of exploring this option some people find they prefer talk therapy to EMDR or would like to do other work first and so decide to stop. We encourage you to be honest with your therapist about your comfort level and preferences around EMDR therapy so they can tailor the treatment to you.
At Cova Psychology we practice from a trauma informed perspective, providing evidence-based therapies for trauma processing such as EMDR. The psychologists at Cova also receive ongoing EMDR supervision and training. As a team we stay up to date with the latest EMDR research by sharing new and emerging findings. We love this therapy and have seen first-hand how powerful and healing it can be.
We most often do EMDR in person at our Melbourne CBD clinic. If you can’t attend in person we may be able to do EMDR via telehealth.
Get in touch with our reception team to learn more about EMDR therapy in Melbourne or to book an EMDR therapist at Cova Psychology.
Like this? Also see our blog on EMDR myths.
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Let’s discuss your needs and match you with the right Melbourne psychologist.
Let’s discuss your needs and match you with the right Melbourne psychologist
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Cova Psychology acknowledges the Traditional Owners of the land where our Melbourne CBD practice is located—the Wurundjeri Woi-wurrung and Bunurong/Boon Wurrung peoples of the Kulin Nation. We pay respect to their Elders, past and present, as well as the Elders of other Aboriginal communities in Melbourne and beyond.
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