Have you ever experienced an event that was too upsetting to process and deal with at the time? Do you have recurrent nightmares or disturbing dreams, or negative thoughts that will not go away? If so, then EMDR processing could be a good therapy for you. In my experience, both as an EMDR therapist and also as a client of EMDR myself, I have found EMDR (Eye Movement Desensitization and Reprocessing) to be a transformational therapy with significant life-changing outcomes.
The reason why is that EMDR therapy can turn very distressing PTSD symptoms into a positive life experience though reprocessing the disturbing memories. This is because it is not the events themselves that disturb us, but our interpretation and beliefs about these events which can have a direct impact on our self-esteem and the way we think and feel about ourselves.
Increasingly, the psychotherapeutic technique of EMDR therapy is becoming a popular choice as a way of processing trauma and other mental health conditions such as anxiety, depression and OCD. You may have seen this therapy recently in films with Hollywood A-listers such as Nicole Kidman in Babygirl (2024), the film Huracán (2020), Grey’s Anatomy (2019), and the TV series Travellers and Russian Doll. As well as being portrayed in film and shows, the A-listers themselves are using this therapy and promoting it because it has worked for them.
Prince Harry is also a keen advocate of EMDR processing and has seen good results from this therapy technique. It works because it reprocesses traumatic memories in a fundamental and transformative way that can be profound.
Within my own practice I have been amazed by the results which repeatedly lift my clients from the depths of depression or despair to a more enlightened view of themselves and the events they are processing. This is achieved through what is called ‘bilaterial stimulation’ because it involves both sides of the body, either through eye movements, tapping or even through sound.
Bilateral stimulation is a technique used while focusing on the traumatic or upsetting memory which is then reprocessed from a negative, to a more positive and healthier memory or image. Interestingly, there is no clear agreement regarding how it works, but there is proven empirical evidence that it does work and works well. It is a therapy that can also be used by just about everyone, except those suffering from severe dissociation or active psychosis, due to the intense feelings involved.
The one down-side of EMDR therapy, however, is that in order for it to work there much be a ‘charge’ of negative feelings around the event to be processed. This does not usually last long, but it is important to get in touch with the difficult and painful emotions so that they can be transformed. Part of the EMDR preparation phase is about building up ‘resources’ to help with these strong emotions, such as establishing a safe place and ‘installing’ support figures who represent strength and safety. In this way, any intense emotions can be tolerated in the middle of the processing session where difficult memories are re-lived.
What are the eight phases of EMDR therapy?
EMDR therapy, developed by Shapiro (2012) is structured into eight phases which use a combination of CBT other counselling skills through a set procedure. How does it work, you might ask? Well, firstly, a history is taken of relevant and important experiences from childhood and current life, which often includes a treatment plan for the sessions. Secondly support tools are ‘installed’ in this ‘preparation phase’ in order to make the reliving of any trauma as easy and supportive as possible. Thirdly, the assessment phase identifies the negative beliefs and emotions related to the target memories that are to be processed. The fourth phase uses bilateral stimulation, and in this ‘desensitization’ phase the re-experiencing of the traumatic events using EMDR techniques occur.
The fifth phase is called the installation phase when the negative aspects of the trauma or issue have been reprocessed, and the positive beliefs are then strengthened so that more positive feelings are incorporated into any recollections of the event. The sixth phase is a body scan which checks if there is any residual trauma or negative feelings, followed by closure which ends the therapy, and then finally in the eighth phase a re-evaluation is used to make sure that lasting changes have been established and to make sure the process has worked.
How I can help
From the above description of the eight phases, it can be seen that EMDR therapy should be incorporated into more a general treatment of therapy and not as a ‘stand-alone therapy’.
Therefore, counselling skills are needed to ‘hold’ any strong feelings in the session and this should be managed in a structured and contained way. In order to do this the eight phases are used to integrate the new positive beliefs and resolve any lingering PTSD symptoms. It is important that you feel safe and secure in the sessions and ideally leave the session feeling better and more positive. If the target memory has not been fully processed there may be some negative feelings still around, but these can be managed in-between sessions until they can finally be processed in the next session.
Example: EMDR for trauma related to driving
While EMDR therapy was developed to help with PTSD from a single incident or event, it is increasingly being used for many mental health issues, such as anxiety, depression and OCD (obsessive compulsive disorder). However, for the therapy to work there should be some kind of specific event or issue that happened in the past to discuss in the session. This could be a car crash, an assault, or other sudden and unexpected events, or a general feeling of being overwhelmed, anxious or depressed. The example below is of a client who had experienced a car crash a couple of years before the therapy session in order to explain the eight phases of the EMDR process.
The Event
‘Tom’ comes to therapy to talk about a car crash he experienced on a motorway two years prior to the session. Since the accident he has been experiencing symptoms such as panic attacks and flashbacks while driving on motorways, and insomnia and nightmares. He has also had intrusive images of the moment of impact, physical tension when approaching junctions, and a general feeling of being unsafe on the road.
EMDR stages to process the event:
- History Taking & Treatment Planning
In our first session together, I spent some time getting to Tom in order to understand what had brought him to therapy. I checked his family history and any important life events, and the symptoms or experiences he was struggling with. We then created a clear treatment plan together which included identifying specific memories related to his car incident, and how it affected him, looking at specific symptoms. I also checked to make sure that EMDR was suitable and safe for him and whether he had any contraindications such as epilepsy or psychosis. - Preparation
Before going into the memory, I used grounding and emotional‑regulation techniques so that he would feel safe and supported. We then practiced these techniques to reduce any anxiety he had in the session and in his life generally, and I explained how bilateral stimulation works. Therefore, Tom understood the method so it would feel familiar when processing the target memory. - Assessment
We then identified the most disturbing aspect of the crash, which for Tom was the sound of the impact, and the feeling of losing control of the car. Tom chose a negative belief attached to this of ‘I am not safe and not in control’ and a preferred positive belief which would be strengthened later, ‘I am safe now and I am now in control’. We also noted down the emotions and physical responses that were triggered when he was recalling the memory. - Desensitisation
In this phase, I guided Tom through his recollection of the memory while using eye movement bilateral stimulation. As he processed the memory he relived some strong emotions, images, and body sensations from the crash. However, through the processing, the once‑vivid scene gradually lost its intensity, becoming more distant and less activating. We continued processing until the emotional charge reduced significantly and he visibly relaxed in the session. - Installation
Once the distress had reduced, I then helped Tom to strengthen his agreed new positive belief, also using bilateral stimulation so that he now felt safer and more in control while driving’. With bilateral stimulation, this belief became more deeply rooted so that Tom genuinely felt and believed it rather than simply saying it out loud. When it was clear that Tom completely believed his positive belief, I then guided him through the body scan. - Body Scan
In the body scan Tom closed his eyes and checked to see if there was any leftover tension, such as tightness in the chest or shoulders. We processed this with more bilateral stimulation until his body felt clear of any stress and relaxed. - Closure
At the end of each session, Tom was in a calm and stable state and felt a lot better about the car crash he had experienced a couple of years previously. His symptoms had gone and he looked a lot happier. It was clear that his confidence had grown from this processing experience, and he felt better about himself generally. Indeed, what tends to happen is that the new belief permeates into other areas of the client’s life so that they may feel safe and in control at work and in relationships as well. - Re-evaluation
At the start of your next session, we checked to see if there were any changes since his last session. Sometimes, new layers or related memories can come up. He said he felt fine and was more confident driving again, even on motorways and at fast junctions.
Outcome:
After completing EMDR processing, Tom reported being able to drive with far less anxiety. The intrusive images of the accident no longer appeared, and he felt calmer behind the wheel. He felt more in control, more confident, and no longer emotionally pulled back into the moment of the crash again. His driving became a normal part of his life again rather than a source of fear and panic. Through the EMDR process he had overcome his trauma, and this was now a distant memory far behind him, as he confidently drove into his future once again.
Resources:
Shapiro, F. (2012) Getting Past Your Past: Take Control of Your Life with Self-Help Techniques from EMDR Therapy. Harmony/Rodale/Convergent Publishers