Quick reminder: Phase 4 of EMDR is called Desensitization. This is typically the stage that people think of when they hear about or reference EMDR therapy. BLS sets will get faster than what they were during Phase 2 of EMDR in order to “digest” or reprocess information in the brain.
Reprocessing BLS can be administered in the following 3 ways:
EMD
EMDr
EMDR
EMD, or sometimes referred to as EMD Prime or EMD^, consists of short and fast sets of BLS, typically ranging from 5-10 seconds or passes (for eye movement). EMD is referred to as Restricted Reprocessing. There is also a specific format to follow. If using EMD, the clinician will bring the client back to the target or the “spicy image” after every set and will ask what the Subjective Unit of Disturbance (SUD) is each time. After the 4th set, the clinician will ask the client if anything has changed about the target or “spicy image.” This will continue until a SUD of 0 or an ecological rating is reported. Once this occurs, the clinician and client will begin Phase 5.
**It is important to remember that if only using EMD for reprocessing, you do NOT go to Phase 6: Body Scan**
Why use EMD? EMD is used to desensitize a small part of a target and only that. It does not get further into the neural network or life experiences. I’ve used this when clients get stuck with a particularly disturbing image or body sensation. Once the SUD drops to a lower rating, I have found that clients are able to transition back into EMDR reprocessing sets.
EMDr, or EMD Little R, consists of slightly longer sets of fast BLS, typically ranging from 10-15 seconds or passes. EMDr is referred to as Contained Reprocessing. With EMDr, the clinician will administer the BLS set and ask the client what they noticed during that set. If the client reports something related to the event being reprocessed, the client may go with that and continue reprocessing. If the client reports something unrelated to the event being reprocessed, the clinician may cue the client to use their Container so that it may be addressed at another time.
Why use EMDr? EMDr helps with reprocessing specific images, thoughts, emotions, and/or body sensations attached to a particular event but does not necessarily get further into the neural network or other life experiences. This can be a particularly useful way to reprocess a singular event without activating similar events or other traumas the client is not ready to reprocess.
EMDR, or EMD Big R, consists of the longest BLS sets, typically ranging from 15-30 seconds or passes each set. EMDR is referred to as Unrestricted Reprocessing. This is the typical flavor of EMDR utilized during Phase 4. These longer sets of BLS will allow the client’s brain to reprocess and digest just about anything along the neural network or in the life experiences that have been activated in Phase 3. Here, it is okay for the client to notice a plethora of images, thoughts, etc even if those stray away from the original target.
Why use EMDR? This is the flavor of EMDR that will get you the most bang for your buck so to speak. This will help the brain digest information across the neural network in a more comprehensive way. EMDR may also help with reprocessing across the whole life experience. If a client can handle EMDR (i.e., staying in their window of tolerance, able to self-soothe as needed, displays ability to state shift through the use of adaptive skills such as Inner Peaceful Place), this is the preferred flavor of EMDR.
Regardless of the flavor of EMDR, if the client reports a 0 or is ecologically relevant (i.e., it makes sense there’s still some disturbance), Phase 4 is complete and the client can move on to Phase 5.
If you are curious to learn more about EMDR or are interested in beginning your EMDR therapy journey, please reach out to me via the Contact Me page on my website. You can also learn more about EMDR as well as additional EMDR therapists in your area by visiting the EMDR International Association’s website here.
Reminder: these blog posts are meant to be purely educational and/or entertainment tools and do NOT replace psychotherapy and/or other medically necessary treatments.