- The Body Keeps the Score, by Bessel Van der Kolk
- Waking the Tiger, by Peter Levine
- The Body Remembers, by Babette Rothschild
The Essential Stages of EMDR
(from Laurel Parnell, A Therapist's Guide to EMDR)
1. Start with Safety
EMDR therapy starts the same as any other type of therapy, with a solid assessment of the presenting concerns, and building of the therapeutic relationship. We move then into the resource-building phase where coping skills are instilled to help clients stay stable before processing their traumatic memories. The below guided imagery exercises can be used to build resources.
- We might in great detail imagine a container for the difficult mental experiences, and practice placing thoughts, feelings, memories, situations in this container when we don't have the energy or desire to manage them.
- We might create in the mind's eye a nurturing figure that can accompany us to ease painful experiences, and ask this figure to stay with us while we are hurting. The figure can be a real person, an imagined, person, an animal or object.
- We might imagine the most comfortable place we can. This place is relaxing, calming, and safe, and it's accessible to us at any time. We use this place when we need comfort.
2. Stimulate the Memory Network
Once these resources and coping skills are in place, clients are ready to work with the traumatic material. The speed and way in which this traumatic material is worked through is always dependent upon the client's ability to stay emotionally stable while doing so. Clients are asked to recall what represents the worst of the trauma for them, including any emotions, beliefs or bodily experiences.
3. Add Bilateral Stimulation
Bilateral stimulation activates the resources and coping skills needed while processing the traumatic material. Alternating bilateral stimulation activates the prefrontal cortex, keeping clients present in the moment while also intentionally contacting the traumatic memory, Activation of the prefrontal cortex moves memory from implicit (unconsciously retrieved such as in flashbacks and triggers) to explicit (retrieved when we consciously try to.) We work at the client's pace, stopping at any time the client wants to stop. A key part of trauma treatment in instilling the sense of personal choice.
4. End with Safety
It's essential that after a session of trauma processing, clients are able to leave feeling safe and emotionally stable. This can be accomplished by a few moments of wrapping up, speaking about what they will be doing when they leave the session, going over other treatment goals and making a plan for the next session, having a few moments of silence, taking a few moments of intentional breathing, or using any of the resourcing activities described above that can maintain emotional stability.