The Ultimate Guide to EMDR: starting emdr therapy and looking for an EMDR therapist
Are you considering EMDR Therapy? Are you here to learn about how to find an EMDR Therapist who is going to be a good fit for you?
Let’s get started!
what is emdr therapy?
EMDR stands for Eye Movement Desensitization and Reprocessing. EMDR Therapy is a structured psychotherapy with a step-by-step protocol delivered by a trained or certified professional. It originally focused on treating trauma and PTSD and has expanded to treat addictions, chronic pain, anxiety/OCD, and depression. It is a heavily researched treatment modality loved by psychologists, clinical social workers, marriage and family therapists, and professional clinical counselors.
How Does EMDR Therapy Work?
The hallmark of EMDR is bilateral stimulation. The side-to-side movement, often through eye movements, activates your so-called emotional brain to access information about your memory. This bilateral stimulation can also be tactile—meaning that you can use your hands to tap each side of your upper arms, chest, thighs, or face.
You are asked to hold a particular memory in your awareness and notice what comes up while following the fingers of a therapist or a dot on the screen that is moving side to side, just to assist your eye movement. You are thinking less about your eye movement and more about the particular memory of focus. If the movement is too fast, you may feel distracted and find it difficult to focus on your memory. If the movement is too slow, it may not do much to stimulate your brain. When it’s done just enough, it reduces the level of distress that you have about the memory through finding new insights, perspectives, expressed emotions, understanding, and more. The memory is not focused on only one aspect—being “traumatized”—but is fully integrated as with all other naturally processed memories of experiences.
Is EMDR Only for Trauma?
The short answer is no. EMDR Therapy is helpful for many issues with which a person is struggling even though there is no clear trauma in that person’s history.
In EMDR Therapy, trauma is defined as any negative life experience that has not been fully processed yet to move on. You may continue to feel intense emotions like sadness and anger and get stuck in distressing memories as if you are back in the past re-experiencing them just by talking about what happened. You may not think about these distressing memories as often in your daily life now. But, when you revisit the memories, it can bring up unexpected strong reactions.
When people naturally process their experiences or memories, they start putting less emphasis on what happened, maybe not remembering it as much in detail, and no longer feeling bothered by it. Anyone can relate this to—let’s say you watched a scary movie: you screamed, sank into your seat, and could easily recall those scary scenes right after the movie. Do you think you will remember it in great detail after a month or have the same type of reaction just by thinking about it? Probably not. Though it depends on how upsetting the event was, it can normally take a day, several days, or a week to get over what happened by venting to others or thinking through to make sense of it.
Let’s think of performance anxiety as an example. You are feeling anxious, jittery in your body, and shaky in your voice as you are presenting a PowerPoint in front of your classmates, colleagues, or stakeholders. You are asked to notice these sensations in your body and feelings and go back to the past where you felt similar. Somehow, an image pops up in your head back when you were in elementary school. You were in front of your class, maybe not feeling confident in what you were saying at that time and feeling embarrassed. You remember how stressful it was as you connect with that memory now. This memory is not a “trauma” per se, but it is a memory that is associated with your current life issue that you are not happy with. Once we work on this memory that is related, you may no longer feel that intense anxiety, stress, and lack of confidence. At least, your response or reaction becomes as normal as in other situations.
What Happens During an EMDR Session?
You will first talk about what is the current issue you are trying to address through EMDR therapy. You and your therapist will browse which memories are related to the current issues you are facing in your daily life. You will collaboratively choose a list of memories to work on. Even though this sounds simple, it really depends on each individual how long this is going to take. It is not necessary to go into great detail about each memory or each experience.
After this memory assessment, you will do some exercises that are helpful for managing your stress or symptoms so that you can practice these skills in between the EMDR sessions. These exercises are somatic-based and imagery-based, meaning you get to attune to your body and use your imagination to be creative. It helps you to notice and express your emotions. In a way, you are practicing the skills to address your trauma. This is a very important step to get you ready. This is also time to be comfortable with your therapist and familiarize yourself with its EMDR process. If you notice it is difficult to access your emotions and sensations in your body, your therapist will continue to work with you until you are ready. This is part of trauma work — building the readiness and creating a safe space.
Targeting the distressing memory is only one of the many components of EMDR therapy. When you get to this phase of EMDR, you are now asked to hold the particular memory in your awareness while moving your eyes or tapping parts of your body. It is the emotional experience and the pain you are trying to address. You may be tempted to use your logical brain here - but you are going to put that aside and pay attention to how you felt at that time in that memory. It is expected to bring up intense emotions while you hold that memory in the back of your mind. You are in contact with that memory. After the simple movements of bilateral stimulation, you will be asked to pause and give feedback as to what is happening. You are continuing with this process until this memory becomes no longer disturbing. This does not mean that you will forget about what happened or ignore your pain. You know what happened. You know it hurt. However, this memory now has a new insight, a new perspective, and a new meaning that you can live with and no longer feel stuck. This memory will not give you the same level of intense feelings anymore. This phase is the hardest and the longest. It may take one session or several months. You may only have one memory to work on or several. However long it takes, you will start to notice that you are feeling less triggered and better able to manage the stressors.
Now the majority of the work is done. Many people say that they no longer feel the need to continue with therapy. You will likely experience positive changes already in your daily life. If you were to continue, you would address with your EMDR therapist any remaining presenting issues, current challenges and triggers, and potential concerns that could arise in the future. You can decide with your EMDR therapist when to graduate from therapy.
How Long Does EMDR Therapy Take?
It really depends on each individual. If it is a specific issue and you have a great supportive network with resources, you may be more than ready to begin this work and experience fast results even from one session to four sessions (a month). It also depends on whether you have been seeing this therapist for regular psychotherapy before beginning the EMDR therapy.
Let me clarify — EMDR therapy is a form of trauma therapy. It may take a few months to several months to feel comfortable, open up about feelings, and ready to work on difficult issues. The whole process applies to EMDR therapy. This is the art of psychotherapy. The main components involving bilateral stimulation may take a few sessions for one memory at a time. It is going to take longer if you are addressing multiple memories.
The recommended length of an EMDR session is 90 minutes so that you can get enough time to check-in or settle in, work on the issue, and wrap up with coping skills at the end. However, the therapy hour - 50 minutes - is typically offered and effective in most cases.
Does EMDR Therapy Have Side Effects?
The side effects would typically refer to unpleasant experiences that might come up after an EMDR session. You may feel exhausted for a few days. You may recall some memories that you have not thought about for a long time, have nightmares, or notice unexpected intense feelings about new perspectives. This is normal. You are not alone. It is essential to share with your EMDR therapist what has come up in between the EMDR sessions. That gives a lot of information about what is associated with the emotional pain you address in your memories. You may decide with your EMDR therapist to target these new memories or nightmares.
It remains “side effects” and problematic if you do not share this with your EMDR therapist. So just like in any other therapy, it comes down to the relationship between you and your therapist.
Can EMDR Therapy Be Done Online?
Yes! EMDR Therapy can be done online. Though phone sessions can be set up, it is best to connect with your therapist over a video platform so that they can see your face and your response and adjust how the stimulation is delivered.
Since the pandemic in 2020, the means of EMDR therapy have developed to accommodate the growing interest and need to deliver it virtually. Even EMDR training for clinicians is available online and focuses on how to produce the same effective results virtually.
WALTZ Trauma Care and Therapy offers online EMDR therapy in California. Learn more about how we deliver EMDR therapy virtually. We have compassionate EMDR therapists who have expertise in addressing PTSD symptoms from sexual trauma, childhood trauma, and medical trauma as well as phobia and performance anxiety.
Is EMDR Effective for Everyone?
The short answer is — it varies. Many factors may affect its effectiveness. Examples include the frequency and the intensity of your dissociative experiences, safety and trust in the relationship with your therapist, the appropriate type and frequency of stimulation delivered, readiness through resourcing and pre-work with your therapist, and much more!
Generally speaking, individuals who have a strong foundation of support in a relatively stable condition, with fewer triggers and less exposure to ongoing stressors, will experience fast results. Individuals with a complex trauma background will need a careful approach. This may mean more emphasis on building the ground for trauma work. So it will take more sessions and more time. It does not mean you. When this strong foundation is built with your EMDR therapist, the reprocessing can take place quickly.
Will I Have to Reveal Painful Details?
What’s fascinating about EMDR therapy is that you do not have to share the details with your therapist. You may focus on some painful aspects briefly during the work and may choose to share what comes up. It ultimately comes down to your own process of discovering and making sense of the experiences. Your EMDR therapist is there as a guide to assist with processing. If the process becomes too overwhelming to the extent of making it difficult to continue, your therapist may notice that and ask you to focus on something else or you can tell your therapist what is happening with you.
Is EMDR Covered by Insurance?
Yes, EMDR therapy is covered by insurance just like any other type of psychotherapy. Typically when you are seeking EMDR therapy, you likely have a qualifying diagnosis under behavioral health, which is a medical necessity to be covered.
Whether you are using in-network benefits or out-of-network coverage through your PPO plan, check out WALTZ Trauma Care and Therapy for EMDR therapy and Trauma Therapy.
How Do I Choose an EMDR Therapist?
You may look into the years of experience and expertise of your issues in each therapist to find the right fit. Some specialize in Anxiety, Addiction, Early Trauma, Dissociative Disorders, etc. It is also important just like looking for a therapist in general whether you feel comfortable and can open up to your EMDR therapist. Whether a therapist is EMDR trained or certified, an effective EMDR therapist is someone who continues to seek training or consultation and regularly uses EMDR therapy with their clients.
EMDR Trained: For a mental health professional to practice EMDR, they must go through EMDR Basic Training, approved by the EMDR International Association, that requires them to complete 50-hour lectures and 10-hour consultations that include delivering EMDR therapy to clients, typically over the course of a 6-month period.
EMDR Certified: After completing the Basic Training, the EMDR certification requires trained professionals to further seek advanced training (i.e., utilizing EMDR with the specific population of their interest, learning an integrated approach with a different modality), and to continue with 20 hours of consultation with Approved Consultants to improve the quality of work and adhere to the appropriate protocols. The renewal of certification requires the professionals to continue with education and training related to EMDR.
At WALTZ Trauma Care and Therapy, the Founder Ashley Lee is an EMDR-certified therapist. Learn more about Ashley. We have EMDR trained therapists who bring excellent insight and clinical practice to offer trauma therapy for adult individuals.
How do I know I am doing EMDR ‘right’?
It is the EMDR therapist’s job to assess which memories are associated with your presenting issues and to help you find the painful irrational beliefs that continue to serve your perspectives in your daily living. When it comes down to ‘noticing’ what is happening during the stimulation, there is no right answer.
What if I want to stop EMDR?
You can certainly let your EMDR therapist know! It is an open conversation, where it is important for you to feel comfortable sharing with your therapist what is going on or what is not working for you.
Are there alternatives to eye movements?
Yes! Eye movements are only one of the ways. The other popular stimulation is simply tapping your own body (tapping) side to side. For example, a butterfly technique is where you cross your open hands and have your thumbs cross-touch each other, and place that butterfly hands in the middle of your chest right under the collarbone. You’ll be asked to tap your chest side by side, with your eyes closed. This can last for about 40 secs to 60 secs or more.
