Eye Movement Reprocessing and Desensitization
                                                                  EMDR Client Handbook



















                                                          Gretchen Laporta MSW, LCSW, CH
                                                                          Revised 2007
                                  










How did EMDR Develop?
In 1987, Dr. Francine Shapiro was observing how when she moved her eyes back and forth in a
sustained way she was able to release disturbing feelings.  She continued to experiment with the rapid
eye movement and found that it helped her friends as well.  She developed her theory and tested it.  She
then started working with clients who were willing to participate in clinical trials to validate EMDR as a
treatment for anxiety disorders.  Today EMDR is a class A intervention for the treatment of posttraumatic
stress in the military.

What is EMDR?
EMDR uses bilateral stimulation to release negative emotion.  Bilateral stimulation allows the two sides of
the brain to communicate.  The analytic and creative sides of the brain are powerful when they work
together!  Some examples of this stimulation can be moving the eyes from side to side by focusing on an
object or light, alternating tapping of the hands, sounds in alternating ears with a set of headphones or any
combination of these.  I preferred tapping and so have the majority of my clients.

Your brain is a powerful tool.  Every second of your life is recorded in your mind.  This recording is like a
net and as we age we collect more experiences in our net.  To make sense of life we connect the
experiences thus forming the net.  So for instance if we think of dogs, we could easily access this theme
of dogs and dog experiences because this net exists.  

During EMDR we tap into the net using a disturbing vivid event, a feeling or sensation.  Since this event
may have happened sometime ago there may be events that have happened since then that have
reinforced how that main event made you feel.  As an example: Your father beat when you made mistakes
as a child and you felt you were never good enough.  As an adult you had several old boyfriends and an
ex-husband who withheld love or mistreated you because of perceived mistakes.  In doing EMDR we
have to clean out the main event of the father and the channels of each boyfriend and ex-husband to
release the negative feelings that this person has related to the events.  You don’t have to know how you
are going to change that perception of yourself.  

Why is EMDR used?
·        To help the client learn from the negative experiences of the past
·        Desensitize present triggers that are inappropriately distressing
·        Incorporate templates for appropriate future action that allow the client to excel individually and in
     relationships.

How does it work?
The research is ongoing but the answer is no one is really sure.   There is a substantial amount of people
who have been able to benefit from EMDR over the years.  The research supports that it works but the
brain is relatively unexplored territory because of the risks of opening the skull and brain to the elements.


What does EMDR cure?
EMDR is used to treat traumatic events as defined by the client not by a clinical definition.  I am able to
treat any type of disturbing event from a break up of a relationship, harsh words from a parent, to sexual
abuse, rape, shell shock, physical abuse, phobias, addiction, eating disorders, grief over a loved one and
much more.  They are investigating more uses for EMDR now.  At the time I am writing this EMDR is
approved for anxiety disorders of all types.

Do the effects of EMDR last?
Once EMDR is complete you may notice that these memories start to fade and become like other old
memories.  You may find that it is hard to recall the image and the details may be fuzzy.  If you need this
detailed information for a court case I would strongly recommend that you wait to do EMDR.  The effects
of the therapy are lasting and you will not regress once the therapy is complete.

What is the process like?
It can be like seeing your life on a movie screen, or thoughts that come into your awareness, or
conversations.  Remember you cannot do this incorrectly.  Your unique brain and experiences will create
a unique experience.  Your mind knows the path to healing all you have to do is allow it to happen.  Some
of the images can be odd and you may wonder how it all fit together at first but in time you will come to
understand their meaning.  There can be a strong use of metaphor and theme.  

How long does EMDR therapy last?
EMDR can last for several sessions or only one depending on the issue.  We are all unique with unique
life experiences.   The processing is layered at times and may take a longer amount of time.  Remember
to be patient.  The relief you will have at the end of the process is something that traditional therapy cannot
compete with.  Journal about your experience so you can see how far you have come!  If you quit before
the installation phase the process is incomplete and you will not be able to have the full benefit of this
therapy.

Is there a right or wrong way to respond as an EMDR client?
There is only your personal journey of healing.  Your experiences are unique and so is your net and we
cannot force a direction.  Your mind is the tour guide and it will take you where you need to go to heal and
we only observers.  

Who can administer EMDR?
EMDR is a type of therapy that only offered to Masters or Doctorate level therapists.  Clinicians who are
certified in EMDR have undergone two sets of courses through the EMDR institute to learn the proper
techniques.  You may think that it seems easy enough that you can try it out on your friends or family.  
Please do not do this because it can be dangerous!  There is a website for the institute that has a
therapist finder (anywhere in the world) who is a qualified professional who can assist.  www.EMDR.com   
Any therapist who is certified has also had EMDR so there is an understanding of what you are
experiencing.

What is the process?
Step 1:  Preparation
We need to establish stress management and relaxation techniques to cope with some of the information
that may come up during or after a session.  Due to time issues we may not have a perfect stopping point
or complete the EMDR processing.  We only have 50 minutes to work each session (so please be on
time.)  You may continue to process information after the session is over and you need to be armed with
the skills to meet any challenge.  Here is a list of several relaxation techniques we will review for your
arsenal.
·        Journaling
·        Safe place
·        Deep breathing
·        Meditation
·        Progressive relaxation
·        Exercise

Now list at least five of your own ideas!

1.

2.

3.

4.

5.

Step 2:  Safe Place
Safe place is positive exercise that we will do to introduce you to EMDR.  We will create a safe or calm
place and use your senses to bring it to life.  During this exercise you will imagine a safe or calm place.  
This can be a place you have been to or you can imagine being.  Some clients choose a place in nature
and some choose a place they create in their mind.  You can add or subtract things from this place to
make it calmer or safer.  I discourage you from having someone you know in your safe place.  You may
have an argument with this person and your safe place is no longer calm or serene.  I will encourage you
to use all of your senses to make this place very vivid.  We will then pair your place with a word that best
represents it and this will be your safe cue word.  You need to practice using your safe place to make its
power grow.  You will use your cue word whenever you have a mild annoyance.  Don’t forget to use it!!!

Stop Code
Sometimes when the processing is occurring you may want to say stop to someone you are visualizing
and you don’t want to stop the processing.  We need to establish a stop word that is a code that you want
to stop the EMDR processing and take a break.  
My stop code word is _______________________.


Step 3:  Assessment
This is where you select ten disturbing events that you would like to work on using EMDR.  These events
may be linked in your net and may come up when you are working on another event.  That is perfectly
fine.  You may have more or less than 10 events and that is okay too.  If you find that this exercise is
causing to many overwhelming reactions stop and we will work on this together in session.  You can use
the list on the next page to help you select the negative and positive feelings for each event.


Event _____________________________________________________

What picture represents the worst part of the event?



What words go best with the event that express your negative belief about yourself now?


When you bring up that event in your mind what would you like to believe about yourself now?  
__________________________________________________________________


Step 4: Desensitization
I will use the information you provided above about your event to begin the processing.  I may ask you
these questions again to confirm your feelings did not change between the time you filled out the
description of the event and the time we begin the processing.  If they do change that is okay.   

I will ask you some scaling questions at the beginning and end of the sessions.  During the processing I
will do sets of stimulation and stop.  Then I will ask you, “Open your eyes and take a deep breath, what did
you get?”  I am only determining that the processing is continuing and if the information is distressing.  
You can disclose as little or as much as you like.  This type of therapy is different because the therapist
does not interpret the information.  The insight will come to you with your own mind.  Sometimes this
process is very fast and sometimes slower.  Remember there is no wrong way to do it!  We can stop at
any time if the process is overwhelming.  However, the path to resolution is through the event.  There are
tools to decrease the intensity of the experience for a short time to allow you to gain perspective so you
are able to complete the processing.  

Step 5:  Installation
During this short phase we will make sure that there is not any remaining negative emotion.  I will then
match the positive thought you wanted to believe about yourself from the beginning to the event.  

Step 6:  Body Scan
This is where you will scan your body from head to toe and notice any sensation good or bad that you are
feeling in your body.  If there is any negative feelings we will work to rid the body of that muscle memory
until it is replaced with a positive feeling.  We will then pair the positive sensation with the original event.

Step 7:  Closure
We will review the session and give closure to the EMDR experience.  I am interested in making sure that
you are okay before you leave the office.  If you feel disconnected, or any discomfort please let me know
before leaving the office.  The processing can be draining you may want to nap or rest afterward this is
natural.  

Incomplete Sessions
Many times we will not be able to complete the processing in a 50-minute session.  So we will take steps
to close the session prematurely.   Once the portal to the event is opened you will be processing after you
leave the session, in sleep or dreams or even while you are awake.  Your mind is trying to resolve the
issues and get relief.  New insights may happen spontaneously.  The things that occur to you during
processing may seem odd and will cause you to think about why that image or memory came to you.  This
is common and nothing to worry about.  If you have disturbing information come to you in between
sessions use the relaxation techniques.  If you continue to feel overwhelmed and need to contact me feel
free to do so.   

Tips
·        Wear comfortable clothes to the sessions.
·        Use the restroom before we begin.
·        Plan to do EMDR during a time when you do not have extra demands at work, school or home
·        Plan to take some time after the session to rest if you can.





HOMEWORK!!!!!!!!!!               TICES SCALE
It is a good idea to write down any thoughts, triggers, images, emotions, sensations or insights that occur
to you between sessions.  These experiences are normal.  If these are negative or disturbing rate them
using the scales included in this packet.  This is also a way to track your progress you experience outside
of the session.  This will be your ongoing homework after every EMDR session.  Please take the time to
write these down because you may forget them!!





I, ________________________________ have read the EMDR handbook and had an opportunity to
ask all questions I have about the process and they have been answered to my satisfaction.  I consent to
using EMDR in my treatment.



________________________________                                _________________
Client signature                                                        Date




_________________________________                                __________________
Guardian name                                                        Date




__________________________________                                __________________
Guardian Signature                                                        Date