First sessions are all about building rapport and understanding what you are wanting from your counselling experience. If it turns out that you are interested in EMDR, then what I'll share during this article may be of interest to you!
Please know that no therapy is one size fits all. There are many layers and approaches in counselling psychology and to the complex experiences people have. This information is intended to introduce you to EMDR therapy to inform your expectations prior to starting counselling.
First EMDR Session: Building Trust and Understanding
The initial session of EMDR therapy focuses on building a strong therapeutic alliance between you and your therapist. (Therapeutic alliance refers to the collaborative and trusting relationship between counsellor and client. A strong therapeutic alliance facilitates open and honest communication, ensures clients feel safe, supported, and understood, which in turn enhances the therapeutic process and outcomes.)
First Sessions May Look Like:
History gathering: Exploring your background, any trauma experiences, past and current symptoms. Sometimes a symptom checklist is included (such as the PCL-5 for exploring symptoms of post-traumatic stress, or the HADS for exploring symptoms of anxiety and depression). This information is important as it ensures your counselling experience is tailored to your specific needs and goals - you are in charge of sharing what feels comfortable to you.
All of this information informs my case conceptualization: my understanding of your history, presenting issues, and trauma experiences you've gone through. It includes your emotional, cognitive, and somatic responses to trauma, and any potential challenges that may arise during the process of therapy. It's this understanding that I use to formulate that tailored approach to address your unique needs and goals
Discussion of EMDR: We will talk about the process of EMDR, how it can help, and how we can use it for both emotion regulation skills building and trauma processing. This is a great opportunity to ask questions and have a demonstration of the bilateral stimulation (using the Theratap device).
Feeling safe, heard, and comfortable with your therapist and within the therapeutic environment is crucial. I strive to provide a rationale for all the therapeutic approaches I use, maintain transparency with the questions I ask, and build in emotion regulation to better ensure you are prepared for future sessions.
Treatment Plan: And lastly, we will collaboratively come up with a treatment plan that focuses on your goals and needs for counselling - this essentially sets the stage for what to expect during each session. But, please know that life happens. While we may have a set treatment plan, we can work with it flexibly if life throws you something unexpected. Your sessions are yours - so I will always ask what you want to focus on to explore any thing that may have changed since your previous session, rather than making assumptions.
Once the foundation is laid in the initial session, subsequent EMDR sessions typically follow a structured process that includes the following phases:
Preparation: Before delving into trauma processing, we will work on enhancing your emotion regulation skills. This phase ensures that you are equipped to handle the intense emotions that may arise during EMDR.
Desensitization: This is the heart of EMDR therapy, where we collaborative choose a starting point, and work on trauma processing. I will be your steady guide during the reprocessing of these memories, utilizing bilateral stimulation (eye movements, sounds, or tactile sensations using the Thera-tap device), working towards desensitizing the emotional charge associated with them.
Installation: As the emotional distress linked to the traumatic memories decreases, you'll work on installing positive beliefs and self-perceptions to replace the negative ones that may have developed as a result of the trauma.
Body Scan: In some cases, you may engage in a body scan to address any lingering physical sensations related to the trauma. I talk more about this in a moment (see below...)
Closure: Each session concludes with a focus on emotional containment, grounding, and debriefing. I often offer a home practice strategy so you can continue practicing the resourcing imagery or positive belief.
Reevaluation: Our next session typically beings with a re-evaluation of what we had worked on in the previous session. It's a way of assessing progress to see if additional work is needed on that experience to further you in moving towards your goals.
A Key Feature of EMDR: Tracking the Felt Sense of Emotion
One significant difference between EMDR therapy and traditional talk therapy is how they approach the tracking of the felt sense of emotion. In traditional talk therapy, clients often describe their emotions verbally, sharing their thoughts and feelings with their therapist through conversation. In contrast, EMDR therapy places a strong emphasis on tracking the felt sense of emotion. In EMDR, you will be encouraged and guided in connecting with the bodily sensations and emotions you experience while revisiting traumatic memories. This non-verbal tracking allows for a deeper exploration of emotional experiences, which can lead to profound insights and healing.
In summary, please know that EMDR is a highly individualized approach, with many different protocols for different experiences, all of which are tailored to your unique needs and experiences. And, in life, progress may not always be linear; it's normal to have ups and downs throughout the therapy process. The key is having a trusting therapeutic alliance where we can discuss these ups and downs and continually be modifying your treatment plan to ensure your needs for therapy are met.
Patience and self-compassion are key. Healing from trauma takes time, and EMDR is a tool that can help facilitate that process.
Susan Guttridge is a trauma-informed Master level Counsellor with the clinical designation of Canadian Certified Counsellor (CCPA). She has 20+ years experience providing individual and group therapy.