Barbara Myerhoff’s poignant observation, “Unless we exist in the eyes of others, we come to doubt our own existence,” resonates for anyone who has felt unseen or invisible in their journey. Originally written about the lives of abandoned senior citizens, this insight transcends its original context, offering a universal truth about the human need for acknowledgment and connection.
If you've been considering Eye Movement Desensitization and Reprocessing (EMDR) therapy, you may have a mix of anticipation and apprehension about your first session. EMDR is a powerful therapeutic approach designed to help people process and heal from traumatic experiences, but stepping into something new can naturally stir up some nerves. Here’s a glimpse into what you can expect from your first EMDR session to help you feel more prepared and at ease.
First, our initial session will typically begin with an introduction to therapy in general, including the practice policies and procedures, as well as introductions for us as the therapist and client, and then the assessment phase begins. I will start by getting to know you, your history, and your current concerns. This is an opportunity for you to share your background and any specific issues or traumas you want to address. It’s also a chance for you to ask me any questions, and we can begin to establish what safety feels like for you in the therapeutic process.
I will also explain the EMDR process in as much detail as you’d like. You are always welcome to ask questions and clarify any doubts you may have about the process.
Then, once your history and concerns are understood, I will work with you to identify your therapeutic goals. These goals will guide our EMDR process and help tailor the sessions to your specific needs. The treatment plan will outline the steps involved. It can be as simple or as detailed of a treatment plan as we want to create together.
Here’s an overview of the 8 phases of EMDR therapy.
This is what I described above.
This involves building trust together and explaining the EMDR techniques, including the bilateral stimulation (typically involving guided eye movements), as well as tons of other exercises. This stage can sometimes be the longest, and we often return to this phase between other phases.
Identifying specific memories to target and the sensations, emotions, and negative beliefs that come with them.
Using bilateral stimulation to process the traumatic memories. This is the part that most people understand as EMDR. It is the part where you brain is very active in healing itself and updating the system.
This phase is what we do when we install the true positive beliefs about yourself or the world. We are replacing the old programs with new chosen ones.
This is what I often refer to as “double-checking our work.” Here, we bring up the target and check for any residual tension or distress related to the memory. Sometimes it brings up a new layer of the onion that allows us to heal even more deeply.
This gives you a moment to let the learning settle in, before the session ends.
We re-evaluate where we are as we re-engage each session.
Some of the time, the therapy follows the 8 phases in order, but there are times when we will do things “out of order” for good reasons. You can ALWAYS ask if you’re curious about something we’re doing in therapy. I like making decisions together with my clients, so that they have voice and choice and vote about what gets prioritized. You’re the expert on your own life after all!
As you can see, EMDR is a very thorough therapeutic approach. Even with an intensive session (2 hours or more) we may not get through very many stages, depending on the level of complication of the traumas.
It’s important to know that each and every stage IS EMDR therapy. A lot of time the 4th phase “Desensitization” gets all the hype. However, the bi-lateral stimulation won’t magically cure you of your panic attacks or other symptoms if we just start there. Every phase that we work in is making progress towards that healing.
In a traditional 50-minute therapy session, often we will only get to phases 1 and SOMETIMES 2 and 3. (This is partially why I offer longer sessions, it allows us to do less of phase 8, and more of the other phases which seems to move us along the therapeutic journey more effectively.)
If you decide to start therapy with me, please reach out and ask about access to my For Clients Only page. There I have journal prompts and videos that you can use to prepare in order to get the most out of our time together. This allows you to start on phase 2 before we’ve even met in person.
I hope this is helpful as you get a feel for what EMDR therapy can look like. A big part of my therapeutic approach is permission. I want you to feel comfortable giving and NOT giving me permission for different things that arise in therapy. (For example, if a certain exercise doesn’t work well for you, I want you to feel like you can say “I don’t want to do that exercise anymore, it doesn’t work for me.”) A big part of our first several sessions together is working to create that space for us to learn how to communicate with each other.
I hope that you have the chance to experience EMDR therapy and decide if it is a good fit for you. As always, if you want to schedule a consultation, be sure to reach out.
Take Care,
~Molly
The concept of dissociation is beginning to make its way into popular culture. This is great! Let’s talk about mental health and de-stigmatize it! The concept of dissociation is even brought up in the new Inside Out movie- I can’t wait to see it!
I’m not on social media (I found that my mental health is correlated with less time on social media. The more time I spent there, the less content and more anxious I became, but I digress), but I hear from people who are on these platforms that this idea is discussed on Tik Tok and Instagram.
Unfortunately, often the word that is being (mis)used on these platforms is “disassociation.” There’s an extra syllable in there, and there’s a big difference between these two words.
It can be anything from going on autopilot while driving, to repressing memories. Often we compartmentalize in big or small ways, and we can leave certain things in a file deep in our subconscious. This is a normal part of life for all humans, even though there are extreme uses of this as deemed necessary by trauma.
In fact, right now, I’m trying to disassociate the word disassociate from dissociate. Make sense?
For example, my friend’s dog learned that when the word “cheese” was said, they would receive a treat from the fridge. This dog lost its mind when a photo was being snapped and everyone said “cheese” but they didn’t get the snack! They needed to disassociate the word “cheese” from the dog receiving a snack if they ever wanted to meal plan or take a picture while the dog was around. In this case, they might have wanted to re-train the dog to associate the word “treat” with the cheese treat. Disassociating is a hard task!
You can see how easy it is to mix these ideas together.
Sometimes associations happen when a traumatic event occurs. For example, a woman who is sexually assaulted associates the smell of the cologne of her attacker with the attack itself. In this case, as she works through her trauma, eventually the smell of the cologne may be disassociated with the trauma.
She might even have this association, even if she dissociated during the attack and doesn’t remember other details. Her body may remember the smell deep in her subconscious.
In this case, both disassociation and dissociation are important aspects of the conversation, and the meanings of these words are significant.
When I was first practicing therapy, I used to use the term “Graduating from therapy” - as if a client could walk across the stage, receive their diploma, and be done, never to look back again (as some people feel about their high school or college graduation.)
But that image doesn’t seem to fit the kind of work that I find myself doing with clients these days. Graduating from therapy feels like a one way ramp- you can only get off, you can’t get back on. That doesn’t sit well with the type of work I do.
I am in therapy myself, and I don’t think there will ever come a day when I “graduate.” Life continues to have transitions, even up until we die. Having a trusted therapist along the journey with me is something I value. Sometimes I need to just plop down on the couch and receive, hear a different perspective, do some EMDR to get through some traumatic things, sometimes I need someone else’s mind along with mine to work through and process something. I don’t want to graduate from having needs or being a human.
I’ve come to change my thoughts about the ending of therapy- now it feels more like a pause. Some of my clients will pause, and they know that they can come back at any time and we will pick back up wherever most needed. I take pauses from my own therapy from time to time, and then I return, because it is good to not be alone on this journey of life. It is good to continue learning. It is great to keep unlearning some of the unhelpful-to-me-now habits and strategies that I needed in the past, but I don’t need anymore. Sometimes I pause with one therapist, only to pick back up with another who feels like a better fit for this season of life.
Can we work through our traumas and “come to completion” on some of our EMDR targets- the answer is both yes and no. Yes, the memory can no longer disturb you. Yes, you can live without having nightmares all the time. Yes, you can have loving and fulfilling relationships.
And No, we’re never done with the work. You might not need to process it in therapy, but you are growing and learning and metabolizing the life events that have happened to you. You may not need therapy weekly, bi-weekly, or even monthly, but knowing that you have a safe place to process anything that might come up feels important, even if it is years later. The only time we are static is when we are dead.
I hope that my clients know that they can always come back to therapy with me.
Whether it is working through a new level of healing from the same story we were working on before, or a new transition, I want to be the therapist that you can come back to whenever you feel a need. I am grateful to the therapists I have had who have been that for me. I also believe that different therapists can help in different seasons. So I hope that my clients feel free to explore what it is like to sit in someone else’s therapy office and learn from that relationship new and different things.
I love celebrating growth, and I believe it is a lifelong process.
I hope that you are finding yourself with some good companions along the way whether that be a therapist, your friends, your given or chosen family.
I just spent a few days immersing myself in a Somatic Integration and Processing Training. I really loved it, and one of the ideas that kept my brain kept circling back to was how often we accidentally leave our bodies out of the “mental health” conversation. It doesn’t work when we just try to re-train the brain and re-write our thoughts and we leave our bodily felt sense out of the equation.
"What is rewarded gets repeated. What is punished is avoided."
~James Clear from his book Atomic Habits
I enjoyed the book Atomic Habits. I thought it was excellent. I appreciate this quote. But it doesn’t tell the whole story.
Let's talk about what I mean.
You might have been rewarded in ways that aren't obvious.
Were you really being selfish? Or were you in survival mode without realizing it?
This is a question that I often ask my clients when they say “I feel like I’m being selfish.” In order to understand the question, we need to go into a bit of therapy lingo.
Adaptive Information Processing, or AIP for short (not to be confused with the diet) is the theory behind EMDR.
