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Eye Movement Desensitisation Reprocessing (EMDR) is an interactive psychotherapy treatment that was originally designed to treat post-traumatic stress disorder (PTSD), and is now used to treat a whole range of mental health issues including complex trauma, anxiety disorders, depression, eating disorders and more. This psychotherapy treatment is effective for various mental health conditions, providing relief and healing for many individuals.
The therapy involves bringing your awareness to thoughts, feelings, and sensations that are associated with traumatic memories while moving your eyes rapidly. Using time periods of 30 – 60 seconds, 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 the eyes move from left to right, both hemispheres of the brain are activated and the working memory is also engaged. The regions of the brain involved during EMDR are associated with 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 in processing and integrating traumatic memories.
These changes in our neural processes can bring about powerful changes to our stored traumatic memories. The images associated with the memories may become less vivid. The bodily and physical sensations associated with the trauma (made up of hyper-arousal and hypo-arousal of our nervous system) tend to calm, relax, and soften. Emotional and cognitive changes are also evident, as through processing with EMDR, the way we think and make meaning of our traumatic memories can also shift. This is critical for trauma healing because our traumatic memories often hold painful cognitive distortions which can perpetuate distress and anxiety. By moving to a more healthy and self-enhancing moving EMDR, we are more able to resolve our trauma and move forward.
EMDR helps manage distressing memories by targeting the memories stored in the brain and addressing the underlying traumas. It also aids in emotional regulation and builds emotional resilience, helping individuals better cope 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, reporting that 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 a complementary approach to EMDR, enhancing emotional resilience and addressing emotional regulation issues. Cognitive behavioural therapy (CBT) is another complementary approach that can be integrated to address distorted thought patterns and improve overall mental well-being.
Before your EMDR therapy begins you may need to develop new skills to manage and reduce your emotional arousal. It’s important to note that some clients may not be suitable for EMDR therapy right away – sometimes other forms of therapy are required prior to commencing an EMDR treatment.
What are the 8 phases of EMDR therapy?
EMDR therapy is an integrated and structured trauma therapy consisting of 8 phases. The 8 phases guide treatment, though are not always worked through in exact chronological order. For example, often the early phases of treatment which focus on assessment and preparation run concurrently to each other. During an EMDR therapy session, you can expect to go through these phases, addressing traumatic memories and working towards emotional healing.
Phase 1 History taking: this phase is focussed on understanding your past in terms of both your physical and mental health history. This phase also focuses on the present and understanding any current life challenges or difficulties you may be experiencing.
Phase 2 Preparation: In the preparation phase, your therapist will assess your capacity to regulate painful emotional states. This is important because during trauma processing there is a level of emotional discomfort that must be managed and it is important that this is considered in order for EMDR to proceed safely. In this phase, you may learn new skills to tolerate distress and regulate emotions, as well as practice these skills in order to ensure they are effective.
Phase 3 Assessment: In this phase you and EMDR therapist will set up your treatment targets. This involves identifying memories to target in the treatment as well as different aspects of the memory including the images, level of distress, body sensations, and associated negative cognitions.
Phase 4 Desensitisation: During this phase you will focus on a memory whilst engaging in bilateral stimulation (BLS). BLS in EMDR therapy is where you will move your eyes from left to right whilst following the motion of your therapists’ fingers. The process engages both hemispheres of the brain as well as your working memory. If eye movements don’t suit there are alternatives which include tactile sensations or auditory stimulation. The goal of this phase is to reduce the intensity of the emotion and physical sensations in the memory as well as make the images less vivid.
Phase 5 Installation: In this phase, you will work on moving to a healthy or self-enhancing belief to assist with processing the memory.
Phase 6 Body Scan: In the body scan phase you will scan your body for physical/emotional sensations. These may then be targeted for further processing.
Phase 7 Closure: The closure phase is where you and your therapist will prepare to finalise processing in the session and prepare you for the coming days. This is to ensure that you leave the session feeling grounded.
Phase 8 Re-evaluation: In this phase, you and your therapist will assess the outcome of trauma processing. Here you will identify whether processing is complete, or whether certain memories would benefit from further work.
The number of sessions required in each phase of EMDR therapy varies widely depending on your needs. EMDR therapists play a crucial role in planning and conducting these sessions, ensuring they are tailored to both the initial phases and the trauma processing phases (phases 4 onwards). Your EMDR therapist will explore time frames with you as part of the assessment process.
Initial phases requiring intake assessment, history taking, setting up targets and goals is generally completed over the first two to three sessions.
In terms of preparation for trauma processing, it may become clear during assessment, that emotion regulation and distress tolerance skills will need to be learnt and practised prior to moving into the desensitisation phase. The time required for skills mastery varies depending on the individual.
The mid to latter phases of EMDR therapy focus on trauma processing, and again, individuals spend different lengths time working through these phases. For single-incident trauma processing may be as brief as 1-2 sessions, whilst for complex PTSD processing time may be more extensive. For many people who are undertaking longer term therapy, EMDR therapy may be built in as one component of their treatment, where their trauma processing sessions are spaced out over time.
It’s important to recognise that the preparation phases of the treatment are designed to help you regulate and tolerate discomfort which you may experience throughout EMDR therapy. During trauma processing, you are likely to feel increased intensity of emotion which may involve upsetting thoughts and feelings and you may experience painful physical sensations associated with these feelings. Sometimes when you focus on a memory, other traumatic or distressing memories arise which can be unsettling.
Your therapist will help guide you through this process at a pace which feels comfortable and safe for you.
In the following days after an EMDR therapy processing session, you may notice some changes in your emotional state. These are a normal part of trauma processing and your EMDR therapist will prepare you for them. Although generally less intense than emotions experienced during an EMDR therapy processing session, post-processing experiences may include residual feelings related to your session, feeling more emotionally sensitive or vulnerable, a level of 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 this 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 reflective of the rate of the allied health clinician being seen.
In the early phases of EMDR therapy (phases 1 to 3), sessions tend to run for 50-60 minutes and incur the clinician’s standard fees. Following these phases, some practitioners will encourage longer sessions for the trauma processing aspects of EMDR therapy (typically around 90 minutes), and these longer sessions may incur a higher fee.
Yes! As of 2020, EMDR therapy has been included as therapy which 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 exploring changes over time associated with EMDR therapy for civilians experiencing PTSD (studies that do not recruit veteran participants), clients were followed up at various time points including at 3, 4, 9, 15 months and 5 years after treatment. In 8 of these 9 studies, treatment effects were maintained over time. Studies with veterans suggest that if EMDR therapy is not completed, the effects of treatment may not be maintained over time.
Taken together, the research suggests that for many people improvements in mental health and mood are maintained over time after a course of EMDR treatment.
No. EMDR is a comprehensive and integrated therapy that involves assessment, planning, trauma processing, reviewing treatment goals and so on. Whilst many of our clients report significant benefit from the treatment, improvements are achieved through engagement with the comprehensive EMDR treatment protocol, rather than just one session.
No. There have been a range of studies which have compared EMDR therapy to treatments not specifically designed for PTSD. For example, EMDR therapy has been compared to an active listening approach, standard outpatient care using CBT, and relaxation training with biofeedback. The research has found clinical significant and meaningful changes with EMDR therapy in comparison to these approaches, and as such researchers have concluded that it is not a placebo treatment.
Although studies have found EMDR therapy, also known as reprocessing therapy, to be an effective treatment for trauma and PTSD, the exact mechanism behind its success remains unclear and this continues to be explored in current research.
The role of eye movements (or bilateral stimulation) in EMDR therapy has been questioned, where some researchers speculate eye movements may not be necessary. On the other hand, proponents of EMDR therapy and particularly clinical therapists who provide the treatment, feel that eye movements (and bilateral stimulation in general) are a vital part of the treatments effectiveness.
We continue to advocate for further empirical research so that we can learn more about this trauma therapy and the mechanisms behind EMDR’s success.
Most people can engage in therapeutic work which is within the EMDR model. Some individuals may require a longer period in the preparation phase, where they build skills and develop a greater capacity to regulate their emotions. Sometimes people perceive that this means they are not “doing EMDR,” which is incorrect, as the preparation phase is a vital part of the EMDR model.
Many people explore EMDR therapy as a treatment option when they reach an agreement with their therapist around EMDR therapy being of potential benefit after experiencing a traumatic event. As part of exploring this option, some people find that they prefer talk therapy to EMDR, or that they would like to delay until after working on other areas, and so decide to discontinue. We encourage you to be open with your therapist regarding your comfort level and preferences regarding EMDR therapy so that they can tailor your treatment to your needs.
At Cova Psychology we provide treatment through a trauma informed lens, and all of our psychologists are trained in EMDR. The psychologists at Cova also receive ongoing specialised EMDR supervision and training. As a team we stay informed regarding developments in the EMDR field by sharing new and emerging research. We are passionate about this form of therapy and have seen first hand how transformative and healing it can be.
Most often, we deliver EMDR therapy in person at our Melbourne CBD Clinic. If attending in person is not possible for you, we may be able to offer EMDR via telehealth.
If you’d like more information about EMDR therapy in Melbourne or would like to book an EMDR therapist at Cova Psychology, don’t hesitate to contact our friendly reception team.
If you found this page helpful, you may also find our blog on dispelling myths about EMDR to be valuable.
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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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We would like to acknowledge the Traditional Owners of the land on which the practice is located. We pay our respects to their Elders, past and present, and the Aboriginal Elders of other communities who may be here today.
