Eye-Movement Desensitization and Reprocessing (EMDR)

EMDR (Eye-Movement Desensitization and Reprocessing) is a trauma therapy that aims to reduce distress and assist in managing overwhelming emotions associated with traumatic memories. EMDR utilizes bilateral stimulation (BLS) via eye-movements, tapping or audio to reprocess and rewire memory networks to bring about an adaptive resolution. In doing so, there is a reduction of negative thoughts, physiological symptoms and emotional distress. 

EMDR therapy involves 8 phases of treatment designed to help you process and heal from trauma-related emotional distress. These phases include reviewing your personal history, identifying specific target memories, and using guided techniques to reprocess traumatic experiences.

The EMDR Couple Protocol is an 8-phase approach that is summarized below 

• Phase 1 (History-taking): The first phase is problem identification and takes place over three sessions: One couple session, and one individual session for each partner. 
• Phase 2 (Preparing the client): This is a preparation phase to the second phase of the standard EMDR protocol, but both partners attend the sessions and complete the preparation together. Unlike the standard EMDR protocol, the goal is to promote safety in the couple relationship as a resource instead of giving separate resources to each partner. 
• Phase 3 (Assessing the target memory): This is the assessment phase where the therapist helps the couple determine target memories for EMDR processing. 
• Phase 4 (Processing the memory to adaptive resolution): This is the desensitization phase. This is where the EMDR processing is done, but it is done with both members of the couple simultaneously. 
• Phase 5 (Processing the memory to adaptive resolution): The installation phase is the same as it is in the standard protocol, but the couple decide the positive cognition about the relationship together, and it is installed to both partners at the same time. 
• Phase 6 (Processing the memory to adaptive resolution): During the body scan phase, the couple give bilateral stimulation to each other. First one partner, then the other, gives bilateral stimulation to their partner until a clear body scan is achieved. 
• Phase 7 (Processing the memory to adaptive resolution): This is the closure phase in traditional EMDR and is intended to be done at the close of a session. This is when the partners can give feedback on their experiences in the session, do any calming needed before the sessions ends, and homework is given for the week. 
• Phase 8 (Evaluating treatment results): The beginning of sessions after the first, this is intended to be a re-evaluation of how the processing has worked with feedback from the couple’s week, how they are feeling since the last session, and what needs to be targeted in the current session. 

A typical course of EMDR therapy consists of 6 to 12 sessions, though the number may vary depending on individual needs. Many people notice improvement after just the first few sessions.

Also include is resourcing. Resourcing involves developing personalized coping strategies to manage emotional responses during or between sessions. Your therapist will help you develop strategies and techniques that can reduce distress and enhance emotional regulation.

When one or both partners in a relationship have trauma, it can adversely affect the relationship. EMDR can be used in couple therapy to work with couples to help reduce the effects of trauma as well as foster relationship intimacy.

Where, when and how to start EMDR with a couple

First assess the stability of the relationship by asking questions like these: 

· Do they have the same goals for therapy? 

· Are they comfortable sitting in each other’s presence?

· Do they look one another in the eye when listening and speaking?

· Do they listen and respond thoughtfully?

· Are they able to let each other finish talking before responding? 

· Can each partner take responsibility for their behavior rather than blaming the other?

· Can each partner own their own part in communication breakdowns?  

Then I explore the capacities of each partner:  

· Can each partner see the part they play in their problematic interactions? 

· Can each see the past-present connection in their current behavior with their partner?

· Can each partner maintain dual awareness and shift states in the “safe place” exercise?  

· Do they affirm their commitment to one another in both joint and individual sessions?

Finally—and this is critical—no couple is ready for EMDR when there are secrets, different goals for therapy, ongoing affairs, addictions or serious dissociative disorders. 

 EMDR is compatible with EFT in that both teach clients to pay attention not only to thoughts, but also to emotional content and what is going on in the body during times of stress and healing. When negative emotional content and body sensations come up in EFT and cannot be moved past by the couple, EMDR can be of use to process this content so that clients can move forward in couple therapy.

Before EMDR can be used with EFT there must be enough emotional safety in the relationship to make conjoint EMDR beneficial. EMDR can be integrated by helping the client heighten and share their emotions underlying the negative cycle. 

The integration of EMDR into EFT is often done as individual EMDR with the client’s partner witnessing the EMDR process and providing quiet support. At this point, all phases of EMDR can be incorporated into the couple therapy before moving on to the next step in EFT. It is important to note that the target for EMDR in this case should be the partner’s underlying attachment needs and wounds. The goal is not to process all the client’s individual trauma, but to process the trauma that is stopping them from moving forward in the EFT process. 

Just as not all couples are appropriate for couple therapy, not all couples are appropriate for doing EMDR as a couple. EMDR works best with couples when there is already a sense of emotional safety or somewhat secure attachment between the partners. For this reason, we would recommend doing EMDR later in couple therapy. It is also best used with couples who are committed to their relationship and who can be vulnerable in front of each other. 

Conjoint EMDR is not appropriate for couples who are highly reactive or who might be critical of each other’s experiences during processing. It is also not appropriate when the partners may use information learned during processing against each other. EMDR should be used in couples work only when both parties are able to self-soothe, and there is enough emotional safety for the processing partner to know that whatever comes up in EMDR will not cause relationship problems. They should also be sure that the viewing partner will not interrupt the EMDR process before deciding to integrate. 

Benefits of using EMDR in couple therapy is that the positive emotions of healing from successful EMDR becomes connected with the client’s partner instead of with the therapist which can promote a more positive view of the partner, leading to a better relationship.    

EMDR integration into couple therapy can be helpful when clients are stuck due to trauma, especially shared trauma. Adding EMDR into couple therapy treatment can help get past this barrier. 

1. Healing Relational Trauma: Couples often come into therapy with relational traumas that can be traced back to childhood or previous relationships – these may come in the form of anxieties, fears, insecurities, and      abandonment wounds. EMDR can help individuals process these traumas, leading to a reduction in emotional triggers and reactive behaviors within      the relationship and resulting in more secure attachment.
2. Improving Emotional Regulation: Traumatic memories can disrupt emotional      regulation, causing disproportionate responses to minor conflicts. EMDR helps individuals process these memories, allowing them to respond more calmly and rationally to relational stressors present today.
3. Enhancing Empathy and Understanding: By working through traumatic experiences, partners can gain a deeper understanding of each other’s emotional worlds and past pain. This process can cultivate empathy, helping partners support each other more effectively.
4. Strengthening Communication:  Unprocessed trauma often manifests as communication barriers. EMDR can help clear these blockages, enabling more open, honest, and effective communication between partners. 
5. Promoting Individual Growth: EMDR not only addresses relational issues but also promotes individual growth. As partners heal from their traumas, they become more self-aware and emotionally resilient, which positively impacts the relationship.

 About EMDR Therapy

What is EMDR?

Introduction to EMDR Therapy

EMDR Therapy and Couples - EMDR International Association