EMDR Treatment: The 6 components of effective eye movement therapy

A Quick Guide

EMDR therapy, as explained in our earlier articles, is a psychotherapeutic treatment approach that helps people process unresolved memories and negative experiences. Moreover, it is done in a way that negative emotions, cognitions, images, and beliefs associated with them are modified to be more adaptive. As a result, the past no longer triggers distressing symptoms in the person’s present.

Components of EMDR Treatment

Francine Shapiro developed EMDR therapy in 1987. As a treatment, it incorporates multiple components. Accordingly, effective EMDR therapy depends on how well the clinician and client decide and define the targets for these components. Its major components are stated as follows:

1. The Image

The person directs his thoughts on the distressing past event/memory and focuses on one image that is the most upsetting. It is not necessary for the image to be crystal clear as it is normal to have only vague images of past memories. The purpose here is just to retrieve the information from stored banks of the brain.

2. The Negative Cognition

The person identifies a negative cognition or a negative belief about his ‘self’ which goes along with the image. This is different from giving a description or stating one’s feelings about the image. Usually, these are negative self-attributions and are in the present tense. Likewise, they depict how the individual interprets his ‘self’ in the memory. For example, ‘I don’t deserve love’ or ‘I am a failure’.

3. The Positive Cognition

Next, the person decides a positive cognition that he would like to believe instead. He rates it on a 7 point VOC scale (1=completely false, 7=completely true) and indicates how much he believes it objectively at the present. Not how much he thinks he should believe it.  For example, ‘I am worthy of love’ or ‘I can succeed’.

4. The emotions and their rating

While keeping the image in mind, the person names the emotions he felt in the memory. Next, he gives it a rating on SUDS i.e. Subjective Units of Disturbance. (0=no distress, 10=highest distress) regarding how upset he feels due to it at the present.

5. The physical sensations

When focusing on the memory, the person elaborates about the physical sensations he feels in his body at the present due to the distress of recalling it. E.g. tight muscles, increased heartbeat, etc. In effective EMDR processing relaxation strategies are adopted so that no distressing physical sensations are left at the end.

6. Eye movements

To activate the information processing system, it is essential to decide the stimulation activity. Usually, it is done by eye movement but the person’s preference matters in deciding the exact activity. If he feels uncomfortable with eye movement, its speed, direction, and duration and finds it difficult to maintain it, alternative forms of stimulation are adopted. For example,

• The clinician taps rhythmically on the client’s palms rested on his knees.
• Alternate finger snapping near the ears is another method for dual stimulation.
• Usage of headsets to expose to rhythmic beats.
• Using hand buzzers for rhythmic tactile stimulation.

To find out more about EMDR treatment, check out the related articles.