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In the past I've written other articles about EMDR therapy including:
In the current article I want to focus on Phase 2 of EMDR Therapy: The Preparation and Stabilization Phase.
Before focusing on Phase 2, let's review the eight stages of EMDR therapy.
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| The Preparation and Stabilization Phase of EMDR Therapy |
What Are the 8 Phases of EMDR Therapy?
The eight phases of EMDR Therapy:
Phase 1: History Taking and Treatment Planning:
- Taking a thorough family history
- Taking a history of the problem
- Establishing a rapport with the client
- Selecting target memories to process with EMDR
Phase 2: Preparation and Stabilization:
- Teaching the client about EMDR processing
- Helping the client to develop the necessary coping and relaxation skills to process the trauma with EMDR
- Ensuring the client is ready to process the trauma with EMDR
Phase 3: Assessment:
- Identifying the client's negative belief
- Identifying the images related to the traumatic memory to be processed
- Helping the client to identify their level of disturbance about the memory (Subjective Unit of Disturbance or SUD)
- Rating the level of disturbance (SUD)
Phase 4: Desensitization:
- Using bilateral stimulation (tapping, eye movements or tones) while the client focuses on the traumatic memory
- Reducing the client's disturbance (SUD) to a manageable level
Phase 5: Installation:
- Helping the client to identify and integrate a positive belief that contradicts the client's negative belief
- Strengthening the client's positive belief with bilateral stimulation
Phase 6: Body Scan:
- Helping the client to recognize any residual body sensations associated with the trauma
- Addressing any residual discomfort client has with regard to the trauma
Phase 7: Closure:
Phase 8: Reevaluation:
- Assessing the client's progress and revisiting the traumatic memory
- Deciding whether any further processing of the traumatic memory is needed
Phase 2, known as the Preparation and Stabilization phase of EMDR, is essential because it:
- Builds Resources: The EMDR therapist helps the client to identify and strengthen internal resources and external resources as well adaptive memory networks to support the client in processing the trauma.
- Helps to Build Coping Skills: The client learns various coping skills such as a breathing exercise, a container exercise, imagery, and grounding techniques to manage any intense emotions so the client can remain stable.
- Establishes a Relaxing Place Imagery: The client creates a mental image of a relaxing or safe place that they can return to if the processing feels overwhelming or between EMDR sessions.
- Increases Trust and Safety: This phase helps the client to develop trust and a sense of safety as well as enhance the therapeutic alliance between the client and therapist.
- Provides Psychoeducation: The therapist educates the client about trauma, the processing of trauma and what to expect in EMDR therapy.
- Assesses the Client's Readiness to Start EMDR Processing: The therapist assesses the client's readiness to do EMDR therapy, determining if the client is sufficiently stabilized to proceed with the processing of trauma or if the client needs additional resources or more attention to stabilization.
Why is the Preparation and Stabilization Phase Important in EMDR Therapy?
Without the necessary preparation and stabilization phase of EMDR, a client can become overwhelmed or retraumatized.
They might be unable to stay in the present moment during the processing of the trauma or between sessions.
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| The Preparation and Stabilization Phase of EMDR Therapy |
Preparation and stabilization ensures the client has the necessary internal stability and resources to safely process trauma using EMDR therapy.
This phase also helps to reduce the risk of negative experiences and to a better overall outcome for the client.
Clinical Vignette
The following clinical vignette, which is a composite of many different cases to protect confidentiality, illustrates the importance of the EMDR Preparation and Stabilization Phase:
Tom
As a US veteran who experienced significant trauma during the Iraq war, Tom suffered with Posttraumatic Stress Disorder, which is also known as PTSD (see my article: What is the Difference Between Trauma and PTSD (Posttraumatic Stress Disorder)?
After he heard about EMDR therapy, he had consultations with a few EMDR therapists in his area.
When the therapists spoke to Tom about the need for preparation and stabilization before processing his traumatic memories, he felt discouraged about the time this would take. Understandably, he wanted to get rid of his PTSD symptoms and he wanted it now.
One of his friends, John, an unlicensed mental health intern, told Tom that he had read books about EMDR therapy. Even though he had no formal training in EMDR, John felt he could help Tom to overcome his trauma, so he offered to do EMDR for Tom.
Aside from John not being a licensed mental health professional and having no training in doing EMDR, Tom jumped right into Phase 4 of EMDR (Desensitization) by skipping Phases 1-3.
Within minutes of processing the trauma, Tom went into a dissociated state and believed he was back in the battlefield. He had no awareness of the present moment with John. He began shaking, crying and cowering on the floor. It was obvious to John that Tom was being retraumatized.
Panicked and not knowing what else to do, John called 911 and the Emergency Medical Technicians were there with 10 minutes. They helped to stabilize and calm Tom so that he became aware of his current surroundings. They also suggested he contact his primary care physician.
In addition, the EMTs told John that, as an unlicensed intern, it was unethical and dangerous for him to undertake doing any type of therapy.
A few weeks later, Tom's primary care doctor referred him to a licensed mental health professional who had advanced training in EMDR therapy.
Although the therapy took longer than Tom would have liked, by the time his therapist prepared him for EMDR processing, he felt safe enough with her and prepared to do EMDR.
The work was not quick or easy, but by the time Tom completed EMDR therapy, he was relieved of his trauma symptoms and he felt ready to move on with his life.
Conclusion
EMDR is a safe and effective therapy to process and overcome trauma when done responsibly by a licensed mental health professional who has advanced EMDR training.
This article seeks to explain the importance of the Preparation and Stabilization Phase of EMDR (also known as Phase 2).
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| The Preparation and Stabilization Phase of EMDR Therapy |
All the phases in EMDR therapy are important, however, as illustrated in the clinical vignette above, it's important not to skip any of the phases, including Phase 2, because of the risk of experiencing negative mental health consequences, including retraumatization.
Some clients who seek help in EMDR therapy are initially disappointed that they cannot immediately start processing their trauma on Day1 in therapy.
They might seek help from unlicensed and untrained people because they think it will be quicker, but many of these individuals become retraumatized and in a worse state than they were originally.
Only seek help in EMDR therapy with a licensed mental health professional who has advanced training in EMDR.
About Me
I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Somatic Experiencing and Certified Sex Therapist.
I work with individual adults and couples.
One of my specialties, as a trauma therapist, is helping clients to process and overcome trauma (see my article: What is a Trauma Therapist?).
To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.
To set up a consultation, call me at (917) 742-2624 during business hours or email me.
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