EMDR is a powerful and useful intervention, and it can be tricky to do well.
Phase III, known as the Assessment Phase, is so important. We have seen many therapists rush into this phase, accidentally missing some important components. Phase III is used once you have a strong relationship and a clear case conceptualization, and you are ready to begin processing. How the past is being lived in the present is understood, and you know that the client can shift states and stabilize.
Once you’ve got all of that, move on to Phase III to activate a memory for processing.
Start with one specific memory
We have seen trainees miss the first part of Phase III.
The first thing you do is select a specific memory. It has to be one specific memory, showing how present-day behavior continues to create suffering.
It is important to be clear and intentional, making sure the specific memory is understood. Have the client speak about it, briefly yet specifically.
What happened? You want to hear what the client remembers and experienced. How old was the client? Where was the client? What happened first, second, third? What did the client experience?
Once the client speaks about the memory, repeat the memory, and ask, “Am I understanding it?” Give the client a moment to add or make changes, and repeat it one more time before moving on to the next part of Phase III.
You and your client will feel more attuned, and you’ll feel more confident. This does not take a long time if you are truly ready for Phase III and moving into reprocessing.
When there’s no specific memory: the prototypical memory
We emphasize the specific memory because we have found many of our consultees and trainees launch into EMDR processing without one. For example, a client may be talking about how distressing it was in childhood when Mom ignored her. The therapist may then ask for a negative cognition, go through the rest of the assessment and go straight into processing. But a specific memory was not isolated!
If this client has trouble isolating a memory of Mom ignoring her, the next step is to develop a “prototypical memory.” The clinician can ask: What was the typical scene of Mom ignoring you? Where would you be? What would she be doing? What would you be doing? How old do you see yourself as?
So the client might say, “I see myself as five years old. My mom is at the table drinking coffee and reading. I am in the corner of the room looking at her and waiting for her to notice me, and I am sad.”
The bottom line is, if you can’t get a specific memory from a client, work with them to get a prototypical memory. This will ensure more effective processing!
We hope this helps you!
Take good care, Kathleen and Liz
