How Can You Do EMDR Remotely?
Explaining how EMDR is done even for in-person treatment is challenging because the mechanics of it are what everyone gets excited about, but EMDR is more of an approach to psychotherapy than a technique in itself. However, I’ll do my best to explain this without getting too convoluted.
EMDR as an approach to psychotherapy consists of eight phases:
Client history and treatment planning.
Preparation. I work with you to set expectations, answer additional questions about the process and help you develop strategies to manage any discomfort that arises between sessions.
Assessment. We choose a target memory to work on and rate the level of disturbance it has for you now on a scale by SUD. (Subjective Units of Disturbance.) We also identify the way you would like to think about this memory in the future and rate how real that thought/belief feels to you now in association with the disturbing memory. (Typically, at this stage, the SUD will be relatively high—like an 8 on a scale of 1-10 and the “Validity of cognition” or how real the ideal thought is to you will be low—on a scale of 1-7, maybe a 2.
Desensitization. This is the fun part where we break out the tools for eye movements or the paddles that buzz in your hands. (No, nobody gets electrocuted.) This is where things get interesting for remote therapy because while some therapists find it effective to move their finger back and forth across the computer screen, I feel like it’s silly and my clients do too. What we have found to be the most effective is for both of us to tap on our knees which also sounds silly, but it works. Interestingly, I just completed a training online about the FLASH Technique, and that’s essentially what the Dr. Manfield does. So, there you go. (You can also find me in the directory of FLASH trained practitioners. I’m official.)
Installation. It can take us a while to get here. I have found that for complex trauma, we need a few sessions of desensitization because in order for us to “install a future template” or basically reinforce your desired way of thinking about the disturbing memory in the future, we need to reduce the level of disturbance to a reasonably low level and find a positive cognition that replaces it and feels real enough to you.
Body scan. No, you don’t need an MRI or anything weird like that. This is a noninvasive mental exercise where I walk you through a simple scan from head to toe to make sure all your bits are on board with this new way of thinking.
Closure. It feels weird to mention this as the 7th phase because we have to close every session and it’s rare to get through all 8 phases in one session. Each session has some version of closure. We agree on a stopping point. Then, we work on getting you to a place where you feel stable and ready to take on the world again when you leave the office, or at least have a self-care plan so that you can go home and curl up with a comfy blanket and your kitten or something that will keep you happy. We also discuss a plan for between sessions.
Reevaluation. This is where we sit down and run through future situations where something might trigger the disturbing memory and just see how how do with it. From there, we evaluate whether or not other memories might be getting in the way of processing the original target completely. It sounds a bit new-age, but in more EMDR terms this is a time to ensure that the “channel is cleared.”
As you have probably guessed from this overview, most of EMDR can be conducted remotely without changing much of anything at all, and the bilateral stimulation (eye movements/taps) can be done remotely. It just takes some patience and a sense of humor, but you really need both of those for EMDR anyway.
EMDR is a wonderful approach to psychotherapy and I’ve seen it help a lot of people in an extremely short period of time. If you’re experiencing panic attacks, persistent depression, recovering from a traumatic experience (including vicarious trauma—common for medical personnel and first responders) this is a great option to try. Feel free to set up a consultation with me if you want to find out more about how EMDR can help you.
