What to Expect

It is good to know just what to expect from an EMDR session! What follows is a description of the various steps in the process.

Life enhancement is the goal of all our services. Even if you are addressing some very disturbing post-traumatic stress symptoms with therapeutic EMDR, we believe that it is your desire for life enhancement that motivates you and draws you toward your goals for life improvement. Our life enhancement counseling along with EMDR will help you reach that goal. When you first come to CenterPoint, we also will give you an information sheet that contains a description of various Life Enhancement Activities that we offer. At any time during your work at CenterPoint, feel free to let us know if you would like additional information about these activities and if you are interested in individual consultation or group meetings to explore these activities in more depth.

Preparation: All EMDR treatment begins with the clinician getting to know you and you getting to know the clinician. It is especially important that you are comfortable and happy with the services offered and the clinician's personal style. While working together to identify the goals that you wish to achieve, you will begin to form a clearer picture of the potential for life change that EMDR represents.

Explaining EMDR and the target: In your first session, the clinician will explain how EMDR might be used to address the specific concerns you have identified. We are especially interested in helping you identify the "target" for EMDR reprocessing - the particular feeling, memory, belief, or situation that has been problematic for you. We want to help you target the right events, beliefs or feelings so that you can begin to move comfortably toward your goals.

Choosing the type of bilateral stimulation: We will then explore the different types of bilateral stimulation. You can choose tones delivered via ear phones, tappers that provide a tactile sensation to the palm, lights that can be followed by your eyes, and various types of music with embedded bilateral sounds. You will most likely feel a preference for the type of stimulation that suits you. Often client's quickly learn which form of stimulation enables them to process material in the most efficient and comfortable manner.

Developing positive resources: Using bilateral stimulation, we then guide you in an exploration of the positive resources in your mind. EMDR is very effective at enhancing positive images, thoughts, and memories. Later, when working with upsetting targets, we can return to these positive resources as a place of safety, support, and calm.

SUDS rating: The clinician will help you to identify the components of the target and rate how distressing those components are. One measure we use is the SUDs score ("subjective units of distress"). This is rating scale from 0 to 10 in which 0 means "no disturbance" and 10 means the worst disturbance you could imagine. We use SUDS ratings to track how your feelings of distress change during the EMDR session.

Reprocessing, desensitization, and adaptive resolution: As you think about the target, the clinician applies the bilateral stimulation to help your mind "reprocess" the target by allowing your mind to open up to new thoughts and feelings. "Desensitization" occurs when this reprocessing leads to a decrease in the anxiety or negative emotions that you associate with the target. When you no longer find the target disturbing, we call this "adaptive resolution" We measure this treatment effect with your SUDS rating. Desensitization generally continues until the SUDS rating of the target reaches O or 1. This may be very rapid or may take several sessions. There may be different types of disturbance (or "channels") associated with the target and each channel will process through in it's own way.

Installation and Validity of Cognition: When the target has been desensitized, we use bilateral stimulation to strengthen the new positive thoughts and feelings that have now formed in your mind. This is called the "installation phase". We use the Validity of Cognition Scale - which ranges from 1 to 7 - to help you rate how strong or "true" this new positive belief is for you. A value of 1 means "this feels totally unbelievable" while a value of 7 means "this feels totally believable."

If an adaptive resolution has not been reached on the material targeted in that session, you can return to the positive resource states that were developed earlier. They can provide a sense of safety, support and calm to help you to return to your daily activities.

Between sessions: Even wonderful, profound improvements in your life can have stressful effects. Good change is still change that we must adapt to and become comfortable with! You will be asked to keep a brief record of any significant thoughts, emotions, memories, dreams and behaviors that occur between sessions. You may use e-mail to keep up us to date between sessions (see Menu of Services). This information helps us to understand the effects of the treatment and helps guide reevaluation of the target at the next session.

How many sessions will be needed?: Repeated studies show that by using EMDR in as few as three sessions, trauma survivors can experience benefits that once took years in more traditional forms of therapy (see the Journal of Anxiety Disorders, vol.13,1999). But there is no way to predict just how many sessions will be comfortable and effective for any individual person. The pacing of the work will largely be determined by your comfort and personal goals.