EMDR (Eye Movement Desensitization & Reprocessing) is the #1 treatment for trauma and traumatic stress.
As an EMDR therapist, it's important to know how to use each of the 8 phases of EMDR correctly for the resolution of traumatic memories.
So what do you do when you have 5 minutes left in your session but your target isn't clear?
How to End Your Session if the Target is Incomplete
When a session is incomplete, I always like to make sure there's enough time at the end of the session to ground a client. So we're not releasing them back into the world feelings hyper-aroused or activated.
This is where you can use some of your resources, including:
The Calm Place
These are some effective examples of how to end a session so that your client is feeling calm at the end of the session.
Why is stabilization at the end of an EMDR Session important?
If grounding is not done at the end of the session, the client may leave the office feeling that the EMDR process is not safe, so we want our clients to have faith in the process and faith in us to help them maintain stabilization in between sessions.
I always end sessions by saying, “as you know, once we start the eye movements or the bilateral (BLS), reprocessing can continue once you leave my office or the Telehealth session since so many of us are on computers right now."
It is also helpful for client's to log their progress in between sessions. This helps promote their awareness to any reprocessing that continues in between sessions.
A copy of the log I use with clients can be found in my free EMDR Handbook.
How to Begin the Next Session with an Incomplete EMDR Target
When beginning your next EMDR Phase 4 session, you always begin with Re-Evaluation.
I know EMDR is an eight phase model, but the eight phases does not mean we go exactly in that order. Re-evaluation is Phase eight, but it's also done at the beginning of
every session when you're in Phase 4.
During re-evaluation, you will first start with the global assessment. You'll ask them questions, such as:
what in your life is different right now?
Do you have any new insights?
How are your symptoms?
Is your anxiety different?
Is your depression different?
Any flashbacks or dreams?
The global questions are more about their level of functioning rather than information specific to the target memory.
Then you'll move to questions that are specific to the target memory that you have been working on. You may ask questions such as:
So related to the target (memory) that we're working on, do you have any different insights about that?
Do you have any different emotions when you think about that memory?
Do you have any different thoughts when you think about this memory that we're working on?
Then, when you go back and you're ready to start the reprocessing again,
you DON’T go back to those seven magic questions that make up the Target Assessment (Phase 3).
Instead, you get the 4 points of the memory:
It will sound something like this, "Now, when we go back to Target, when we think about that memory, what image comes to mind? What emotions do you feel? (You're not getting the NC (negative cognition) On a scale from 0 to 10 how disturbing is it? And where do you feel that in your body?
Then you start the BLS (bilateral stimulation).
The reason that we pickup an incomplete EMDR session this way is that we want to get a real-time snapshot of how the memory is affecting the client now. Since reprocessing can continue in between sessions, where you left off at your last session is not going to be where the client is in the present in regards to the traumatic memory.
Have more questions on how to use EMDR effectively with your clients? Schedule an EMDR Consultation with me today and see how I can help!
About the Author
Dana Carretta-Stein is a Licensed Mental Health Counselor and founder of Peaceful Living Mental Health Counseling, PLLC, and Carretta Consulting in Scarsdale, NY. She specializes in clinical psychotherapy to treat children, adolescents and adults with anxiety, behavior and trauma difficulties.
She is a certified EMDR therapist, consultant in training, and Regional Coordinator of the Westchester EMDR Regional Network. Dana is also a business coach for wellness practitioners who are looking to build and grow their private practice.