It’s 2023 y’all. Who here enjoys the reflection and intention setting that comes with a new year?
Hand raised over here. One of my main intentions in 2023 is to connect with nature in Philadelphia and the surrounding areas.
In the past few years, I’ve come to really enjoy setting personal and work intentions at the beginning of a year or quarter. Nothing complicated or even very specific, but something to act as a compass for my year.
One of my intentions for the new year is to continue to integrate movement into my day. Being an EMDR therapist entails a lot of sitting still which means that I have to be really intentional about moving my body.
One of the ways I fulfill this intention is to take walks – some days they’re only around the block and other days I plan on longer walks in a green space.
Here are some of my favorite spots to walk and connect with nature in Philadelphia, Pennsylvania:
The Woodlands Cemetery
Every time I walk past the gates into the cemetery grounds I feel a smile on my face and my body relaxes as I take in the trees, flowers and birds. Stepping away from the street and on to the grounds, I find myself frequently saying, “Hello Trees.” In the Spring, the flowers are beautiful and the place is full of life.
This is another favorite spot of mine. There’s a path to walk along the river and plenty of native plants to enjoy. If you haven’t taken a ride on the swing – it’s a definite “must do” if you can be patient and wait for a turn!
Back in the days when my knees allowed me to run, I trained for the Broad Street Run in Philadelphia here. Nowadays I walk the loop and enjoy the trees, the water, the blue herons and the turtles. This is a great place to ride your bike too. There’s a great boardwalk over the water where you can sit and bask in the sun like the turtles! If you’re a photographer, you’ll be in good company with the other nature loving photographers.
The Wissahickon Valley Park
This is such a gem in Philadelphia. When I was first taken here over 20 years ago, I was taken aback that we were still in the city. When all the trees have their leaves, it’s a green oasis in the gorge. There are so many trails here that you can explore. If you want some hills to get your heart rate up, you can find one here. I also really enjoy walking the wide, relatively flat trail next to the creek, especially if I’m with a friend and catching up.
Schuylkill River Trail
Walking, running, biking, rowing, scooting – you’ll see all kinds of activities happening along the Schuylkill. You can rent bikes at Lloyd Hall or just walk along the river. You can pick the trail up at different points along the city and beyond. I’m looking forward to when they connect the trail to Bartram Gardens.
Fairmount Park Trails
I just walked the Lemon Hill Rim Trail recently and it felt good to seek out and explore new trails in Fairmount Park. This is one of my intentions – to seek out new walking paths in and around the city.
Manayunk Canal
These last three places are walks that I plan to take, but haven’t been on yet. One of my children explores this canal regularly with friends and I’ve been meaning to walk along the canal as well. The Google reviews have some lovely photos and there are plenty of restaurants on Main Street to grab a bite before or after your walk!
This was a former estate of a Quaker family which is now open to the public and free to explore from dawn to dusk. It’s located in Germantown, Philadelphia. I’m looking forward to exploring the farm and Adventure Woods!
This park is located in Northeast Philadelphia and is the only state park located within the city boundary. I used to live in this section of the city and am embarrassed to say that I’ve never been here. The longest trail here is 3.2 miles, perfect for a longer walk and I’m looking forward to visiting it soon!
Walking and spending time in nature is a great way to improve or sustain your mental health and physical health. If you walk with a friend, that’s adding the connection piece which has also been shown to be essential for a happy life. However, if human relationships feel too unsafe or complicated at any point, connect with nature and feel the sustenance from that relationship. It’s the perfect way to start 2023.
Start EMDR Therapy in Pennsylvania, New Jersey or Delaware
If walking in nature isn’t enough to maintain a sense of wellbeing, you might be interested in EMDR Therapy. It is proven to be highly successful in processing and healing past distressing events. If you are struggling to live your best life because you are stuck in the cycle of reliving the past, we can help. At Prosper Counseling our therapists are here to guide you on your journey to healing. Follow the steps below to get started.
Angela is a Certified EMDR Therapist who loves working with adults who want to clear any unfinished business with their childhood trauma and other distressing life events.
She is able to provide therapy to individuals in Pennsylvania, New Jersey, and Delaware. When she’s not walking outside in nature, you can find her reading, drinking fair trade French Roast coffee, or engrossed in a Kdrama series.
“It’s the most wonderful time of the year…It’s the hap-happiest season of —” Whoa, whoa, whoa. Hold on. This isn’t THAT kind of blog post.
We have enough of that toxic holiday cheer going around. We need to know how to get through the dreadful and sad moments surrounding this time of year. Here are tips from 9 different therapists on how to survive the holidays this year.
The heaviness surrounding this time of year is all too clear to me as I sit with my clients. For some of us, the heaviness stems from internal and external expectations and obligations; and for others, the heaviness has to do more with the isolation and grief they’re feeling. For a lot of us we’re feeling all of these things and so much more. It struck me recently that as millions of people begin struggling with Seasonal Affective Disorder, we are being bombarded with messages that we should be feeling gratitude, joy and motivation. Oh, the irony.
So what is a therapist to do but gather the wonderful wisdom of her colleagues to help encourage anyone who is feeling disconnected and NOT full of celebratory cheer.
We hear you. We see you. You are not alone. This blog post is for you.
How to Survive the Holidays: Normalize and Set Boundaries
“If you are on social media over the holidays, keep in mind that you are not alone even if it seems that way. You will likely see pictures of others with their loved ones, but know that your experience of perhaps feeling alone or not being surrounded by people who understand or validate you is an experience shared by many – but one we often don’t post or talk about. It can be helpful to remind ourselves that social media is not always an accurate representation. It is also important to validate and normalize any feelings of loss/grief and sadness. This is a time when many of us feel a societal pressure to be happy, but many of us do not for many reasons such as memories of loss, trauma, or reminders of the lack of support or connection in our lives.
If you are spending the holidays with others who do not make you feel safe, respected, seen or heard, you are allowed to set boundaries and also have an escape plan if needed. Your right to feel safe does not require the permission or validation of others. I often suggest that clients rehearse boundary-setting responses if needed, or plan coping skills and private spaces (such as bathrooms, cars) you can use if you need to ground yourself.”
“If you are experiencing sadness, grief, or depression, acknowledge your feelings. If you are having anniversary reactions, which are normal reminders of things that have happened in the past during this time of year, acknowledge them. Take the time to grieve and talk to others who may be able to relate. Don’t put pressure on yourself to have only positive feelings, just because it is the holiday time of year. Also, reach out to others in your support system. Volunteering during this time of year can also be a great way to give back and connect with others.”
“The holidays are often associated with family, friends, and togetherness. We’re conditioned to think about giving and receiving gifts and large dinner gatherings when we think about how to celebrate the holidays. As someone who’s experienced loss and family strain, I’ve changed the way I experience and celebrate the holidays. Instead of thinking about others, I think about myself. How can I take care of myself during the holiday season? What needs can I meet and nurture? How can I celebrate myself? I buy and eat my favorite foods, buy myself little gifts, and decorate my house in a way that makes my space feel cozy and nurturing.”
“The “most wonderful time of the year” can also feel like the most lonely time of the year for those of us who are single. The holiday season puts a lot of pressure on us—pressure to be festive, pressure to spend money, pressure to overeat or drink to excess. Give yourself permission to spend this time in a non-traditional way, if that’s more aligned with your life right now. It’s okay to opt out of gatherings or social settings that feel obligatory instead of enjoyable. And remember that this is a finite period of time—we’re back to homeostasis in just a few weeks!”
“Here’s a simple practice to bring your nervous system back into the sweet spot of your most capable self this holiday. Smell something you love. Thanks to a fascinating part of the brain called the olfactory bulb — a tiny almond-shaped part of the brain that works with the amygdala to process smells and relate them to your emotions. Smelling something you love triggers a sense of joy and calm.
Here’s how:
Get something you love the smell of. I’m a big fan of Lavender essential oil.
Hold it about 2 inches below your nose.
Take a slow and smooth deep breath in to the count of 6 and exhale to the count of 8
Repeat 3 times.
Have the intention of sending the smell into every cell in your body.
Lastly, notice how you feel before and after. You can practice with different smells to see what works best.”
How to Survive the Holidays: Simplify and Form New Traditions
“Discover what will make your holiday meaningful this year. This may mean stepping back from the commercialism, the traditional holiday activities and other “shoulds” that you have gathered through the years and find out what your heart is calling for. Keep gifts simple. For example: an unhurried phone call to a friend or family member, a homemade casserole or soup to freeze or use for dinner, a book you’ve read or a piece of jewelry that you’re ready to pass on to its next home, for instance. Through the years, I’ve done a good amount of thrift gifting – shopping at thrift shops – which means I’ve saved something from the landfill, found a unique gift that is also a bargain and supported a good cause.
Rest, relax, nap, sleep. Also,notice if there’s a project that you’ve been wanting to do, but haven’t had time – refinishing a small piece of furniture, reorganizing your bookshelf, cleaning out a closet. Feel the satisfaction of completing the task. Sing, hum, dance, clap.”
“Undoubtedly, the holidays can be challenging, particularly for those grieving and/or feeling alone. Repurposing the old English rhyme ‘something old, something new, something borrowed, something blue’ these tips may help the holidays remain meaningful during difficult times.
Old: Oldharkens images of traditions passed down through generations – ornaments, meals, rituals, etc. Make time to honor traditions that bring joy and help you feel close to loved ones. Give yourself permission to pause from traditions that create stress or are too painful this year. New: Consider starting a new tradition or volunteering your time in the community. A new tradition may provide novelty; a new perspective. Volunteering often promotes a deep sense of meaning and satisfaction by helping others and being part of a bigger whole.
Borrowing can include tangible things like recipes or intangible things like attitudes. A neighbor’s famous sweet potato recipe might shift the dynamics at your dinner table. A resilient friend might provide support simply by thinking about how that person faces adversity. You might even consider borrowing or adopting a local community for companionship – a religiously affiliated group, a local nursing home or senior center, or your local library. Lastly, Blue: Since theholidays can be unusually busy and filled with an array of emotions, dedicate some time daily to the outdoors and be present in nature. Whenever you can, be still, take note of the blue sky, the quiet of trees in winter, feel the crisp air, allow yourself to feel your feelings, and take deep breaths.”
Surviving the holiday through awareness and choice
“For many, the holidays can feel anticlimactic and sometimes even painful, and this is in stark contrast to what the feverishly happy scenes in every TV commercial bombarding us since Halloween are suggesting they “should” be. If you are among the many people who, for whatever reason, are having a less-than-holly-jolly holiday season, know that you aren’t alone! Give yourself permission to feel whatever you need to feel, whether that be sadness, grief, anger, worry or joy. Most importantly, remember that you have the power to choose for yourself.
Become aware of the things that wear you down, create stress and/or resentment, and do what is in your power to reduce it. Try approaching stressful situations with a new intention. Visualize how you will respond differently ahead of time. A challenge doesn’t have to be a stressor if you have set your intention beforehand.
If these challenges involve interaction with difficult family members, instead of trying to change them or worrying about improving the relationship, focus on setting your intention for a successful interaction with them – whatever that means to you. And know your limits. Only you know how much you can comfortably do while staying true to yourself. Finally, it’s OK to grieve the family you wish you had, especially during the holidays. Focus on building meaningful connections with chosen family who will accept and cherish your most authentic self.”
I wholeheartedly agree with all the wise and validating words above. I’m finding myself taking a deeper breath in and feeling empowered to do what is right for me this year. I hope you feel that too.
In my work with clients who have had difficult pasts, it can feel especially daunting to trust other people. If that’s where you’re at right now, that’s okay. You’re not alone. Although this holiday may not involve social gatherings, it can involve connection. Connection can happen with nature, pets, plants, different parts of our self, ancestors, and imaginal figures that feel safe and nourishing to your nervous system.
My intention with this blog post is to encourage you and share practical tips for this holiday season. If you’re finding that you might need more support, reach out to me or any of the other therapists who contributed. Their website will tell you where they are licensed to see individuals. We hear you. We see you. You are not alone.
About the Author:
Angela is a Certified EMDR Therapist who loves working with adults who want to clear any unfinished business with their childhood trauma. She is licensed to see individuals in Pennsylvania, New Jersey, and Delaware. She loves collaborating with other therapists in blog posts AND helping clients move toward wholeness through adjunct EMDR intensives.
Start EMDR Therapy in Pennsylvania, New Jersey, and Delaware
Are the holidays bringing up difficult memories from your past? If you are reliving past trauma, EMDR Therapy can help. As a therapist at Prosper Counseling, I am here to guide you on your journey to healing. Follow the steps below to get started.
Set up your first appointment and begin your healing journey!
Other Mental Health Services at Prosper Counseling
Our in-person and online therapists in Pennsylvania specialize in EMDR treatment modalities. Additionally, we offer EMDR Intensives, EMDR Therapy, and online counseling in addition to EMDR Therapy services. We understand that life can be full of challenges that make self-care difficult if not impossible. Allow us to help you reconnect with yourself and live the life you want full of confidence and free of regret. To learn more about Prosper Counseling check out our FAQs and Blog!
You may have heard about EMDR through the media. Prince Harry and Sandra Bullock are just two famous people who have shared how EMDR therapy has made a difference in their lives. You may have heard about EMDR through The Body Keeps the Score by Bessel van der Kolk, MD. However you might have first heard about EMDR therapy, your curiosity has peaked. Now you might be wondering if this type of therapy can help you or someone you know. As a therapist who specializes in EMDR Therapy in Pennsylvania, Delaware, and New Jersey, I can attest to the value and effectiveness of this type of treatment.
Watch the video below for a quick visual explanation of what EMDR Therapy is.
How does EMDR work?
When people think of EMDR, they typically picture phase 4 of the 8 phases of EMDR therapy. Phase 4 is the desensitization part of EMDR therapy where some type of bilateral stimulation is used while the client is focused on the trauma. EMDR, however, is a comprehensive eight-phase treatment approach.
A Memory-Based Approach
EMDR therapy is a memory-based approach focusing on reprocessing experiences from the past, present, and future. This three-pronged approach is called the Adaptive Information Processing Model. The AIP model believes that the present issues a client is experiencing relate to some event or events from the past that is unresolved.
Our brains are naturally processing, integrating, and storing away our daily experiences. When a traumatic event happens, however, it can be inadequately processed and maladaptively stored in the brain with the components (images, thoughts, emotions, physical sensations, and beliefs) from that time. I often imagine it like a fragment set apart that can get “triggered” or lit up and re-experienced as if it’s happening in the here and now.
Common Triggers
The trigger can be a sight, sound, smell, taste, or image. It can also be a relationship that triggers core beliefs or emotions. In addition, many of my clients feel triggered by people who are in authority over them. Bosses trigger core beliefs of “I’m not good enough” or emotions of being threatened and a lack of safety.
Reprocessing Long-Term Memories
EMDR therapy asks the client to bring those memories out from long-term memory to working memory and then uses bilateral stimulation and other methods to reprocess these events. These inadequately processed memories and their stored components of images, thoughts, emotions, physical sensations, and beliefs change and shift during reprocessing. Clients’ brains make connections with helpful and adaptive information. During reprocessing, maladaptively stored events are desensitized, integrated, and adaptively stored.
Clients often report knowing that the event happened, but it feels neutral now. The physical, emotional, and psychological distress that was associated with the event is no longer there. Recently at the end of an EMDR intensive, a client reported, “I feel like someone has burned sage and cleansed me internally.”
Start EMDR Therapy in Pennsylvania, New Jersey, and Delaware
Traumatic memories can impact us in many ways, making it hard to function. If you are struggling because you are stuck in the cycle of reliving past trauma, EMDR Therapy can help. As a therapist at Prosper Counseling, I am here to guide you on your journey to healing. Follow the steps below to get started.
Other Mental Health Services at Prosper Counseling
Our in-person and online therapists in Pennsylvania specialize in EMDR treatment modalities. We offer EMDR Intensives, EMDR Therapy, and online counseling in addition to EMDR Therapy services. We understand that life can be full of challenges that make self-care difficult if not impossible. Allow us to help you reconnect with yourself and live the life you want full of confidence and free of regret. To learn more about Prosper Counseling check out our FAQs and Blog!
The Window of Tolerance refers to an ideal zone of activation where emotions ebb and flow and a person is still able to go on with normal activities and remain connected with others and themselves. At the top of this window is a state known as “hyperarousal” and at the bottom of the window is a state known as “hypoarousal”. Hyperarousal and hypoarousal are automatic responses of our nervous system in service of our survival.
The Autonomic Nervous System
Our autonomic nervous system has two major branches – the sympathetic nervous system and the parasympathetic nervous system. Hyperarousal is what is commonly known as the “fight or flight” response of the sympathetic nervous system. In this state, the body is mobilizing all resources toward action against a perceived threat.
When hyperaroused, you might notice:
Anxiety
Hypervigilance
Racing thoughts
Inability to sleep
Digestive issues
Inability to relax
Chronic pain
Panic
Overwhelm
Anger
Hypoarousal is what is commonly known as the “freeze” response of the parasympathetic nervous system. In this state, the body is shutting down in response to a perceived threat. An example of this is a mouse or possum “playing dead” in the face of a predator.
When hypoaroused, you might notice:
Numbness
Exhaustion
Feeling shut down
Disconnected
Depressed
Flat affect
Foggy
All of us have a nervous system. The goal of getting to know our nervous system and what all of these zones feel like in our bodies is to expand our window of tolerance or zone of resilience.
The Stoplight Approach for The Window of Tolerance
I encourage my clients to think of their nervous system as a special stoplight. The hyperaroused and hypoaroused states are red light zones. The window of tolerance is the green light zone. In between are yellow zones – zones where we are reaching the edge of our window. This is not easy work. It takes time, practice, and support. For many of my clients who have experienced trauma, the red zones are most familiar and the window of resilience is very narrow. Learning the signs that you are entering the yellow zone and practicing different techniques and tools to bring you back into the green zone increases your resilience.
The Window of Tolerance and Phase 4 of EMDR
It’s important for clients to be aware of their window of tolerance and when they are “out of the window.” Phase 4 of EMDR, the phase of reprocessing a distressing event with bilateral stimulation, requires a client to have one foot in the here and now and one foot in the past for optimal reprocessing. If a client is out of their window, it’s best to pause and practice coming back into their window. Oftentimes I’ll check with a client about what’s happening for them or if it’s okay to continue when I suspect they may be in the yellow zone. Sometimes simply asking the client to tell me about something or someone that I know is a positive resource for that person can help the client come back into their window.
Expanding the Window of Tolerance or Resilience
Trauma disorients. Trauma triggers hurl us into the past and we can no longer orient ourselves to our present safety. In order to expand our window of tolerance, we need to increase our capacity to return to a sense of relative safety. We can do that by orienting to internal and external safety cues.
Trauma therapist and educator, Linda Thai, encourages us to ask ourselves, “am I unsafe or am I uncomfortable?” I now ask my clients to check in with this question as well. If we are able to ask ourselves this question and orient ourselves to the present, we can take in an accurate picture of what is happening in the here and now.
Grounding Exercises
So how do we orient ourselves to the present moment?
Here are some body-based practices that can help:
Take in your environment through your eyes. Allow yourself to gaze out a window and take in the horizon. Coming back to the room, notice your exits and the route from where you are to your exits. Notice the spaces behind you, above you, in front of you, and below you.
Notice what you are in contact with. This could be your feet making contact with the ground. Name it – “I feel my feet making contact with the ground.” It could be your bottom on the chair. Name it – “I feel my bottom making contact with the chair.”
Use your five senses. Look around the room and name all the objects that are a certain color. Is there anything you can smell (a candle, essential oils, etc)? Do you have a mint or candy that you can put in your mouth and notice the taste of? Name several things you can hear. Gently squeeze the outline of your hand or arms or legs.
A helpful metaphor when thinking about expanding our window of tolerance or resilience is to think of hyperarousal and hypoarousal as opposite sides of a river bank. If our window is narrow, we can’t help but run our canoe into the shorelines or maybe even get stuck on one side or the bank or the other (or both at the same time!). However, when we expand our window of tolerance, there is more space and distance between the banks to navigate the ups and downs of daily life without going into hyper or hypo arousal. Every time we recognize we’re out of our window and practice returning to our green zone, we increase the size of the river.
Daily Practices to Improve our Window of Tolerance
It’s important to recognize that our windows fluctuate day to day depending on many factors. Being sick, under a deadline, or hungry can narrow our window.
Some daily and basic practices that can help increase our capacity to handle the ups and downs of daily life are:
Getting enough sleep
Movement
Eating nutritious and energizing food
Drinking enough water
Connecting with someone or something (a pet or nature)
Play and laughter
If you recognize that your window of tolerance is narrow and would like support in expanding your window, we invite you to reach out. Prosper Counseling LLC helps adult individuals in Pennsylvania and New Jersey increase resilience and resolve trauma.
Learn More About The Window of Tolerance With Trauma Therapy Online in Pennsylvania and New Jersey
Understanding The Window of Tolerance is a key component to healing from trauma and moving forward with your life. If you are struggling to live your best life because you are stuck in the cycle of reliving past trauma, trauma therapy online can help. At Prosper Counseling our therapists are here to guide you on your journey to healing. Follow the steps below to get started.
Other Mental Health Services at Prosper Counseling
Our in-person and online therapists in Pennsylvania specialize in EMDR treatment modalities. We offer EMDR Intensives, EMDR Therapy, and online counseling in addition to EMDR Therapy services. We understand that life can be full of challenges that make self-care difficult if not impossible. Allow us to help you reconnect with yourself and live the life you want full of confidence and free of regret.
When clients come to me looking for EMDR therapy, a part of them is eager to jump right into reprocessing the disturbing memories that they’ve been working so hard to submerge and avoid. Oftentimes clients don’t realize that EMDR therapy has a structured process that includes eight specific phases that help the client and clinician understand what has happened in the past, what is happening now, and how the client would like things to be in the future. This step-by-step process also allows the client and therapist to build a relationship and a sense of relative safety before jumping into trauma work together. At Prosper Counseling we are trained therapists in the use and application of EMDR. Read on to learn more about the EMDR process.
The 8 Phases of EMDR Therapy
History Taking
Preparation
Assessment
Desensitization
Installation
Body Scan
Closure
Reevaluation
Phase 1 in EMDR therapy: History Taking
After the free consultation and agreeing to work together, clients are sent several forms before the initial intake appointment. Clients are sent a questionnaire to get more detailed information on current symptoms, prior work with other therapists, and hopes for our work together.
They are also sent a set of screening tools to get a baseline measurement of depression and anxiety symptoms. At our practice, we use the Patient Health Questionnaire and General Anxiety Disorder. (PHQ-9 and GAD-7). In addition, we use the Adverse Childhood Experiences (ACE) measure to assess childhood abuse, neglect, and other adverse experiences. Generally speaking, as your ACE score increases, so does the potential risk of medical and psychological problems.
Understanding Your Past
During our intake appointment, I will also ask about where you grew up and who was in your household. Common questions that I ask to gain a better understanding of you and your relationship with your household members in the past are:
“If you had to use adjectives to describe this person, what would they be? What stories come to mind that is connected with those adjectives?”
“How would you describe yourself as a child, teenager, adult?”
“Who was important to you growing up? Were there any helpers or adult mentors that you remember?”
Understanding Your Present
An important part of the intake appointment is also gathering information about your present. I want to understand your top three problems and have you rate them on a scale of 0-10 as a baseline. We will reassess these top three problems weekly, or at the beginning, middle, and end of our EMDR intensive. I also want to understand:
who is important to you now,
what do you do, or what have you done in the past, that helps you feel better,
what are your strengths,
what do you envision the future to look like after our work together
Oftentimes my clients who have experienced traumatic events or relationships have isolated themselves in order to keep themselves safe. For good reason, people can feel dangerous. It can be a struggle to name any close relationships. I want to encourage you to consider pets, objects such as plants, or aspects of nature that feel nurturing and grounding. These are important resources.
Phase 2 in EMDR therapy: Preparation
Throughout our work together, my intention is that clients feel safe and stay within their “window of tolerance” or “window of resilience”. In order to do that, we will talk about what the window is and what it typically looks like for the client. We will also introduce and practice different tools and exercises to help your nervous system stay regulated. Two standard exercises are the Peaceful Place or Calm Placeand the Container as part of the preparation phase.
The Train Ride
A common metaphor for EMDR phases 4-7 is a train ride in which the client is able to maintain dual attention – one foot in the present, and one foot in the past. When we move into reprocessing trauma, we want the client to feel safe and present inside the train car with me sitting beside them, watching the images from the past move along outside the window. When a client feels like there is no window and they are in the past, they are most likely outside the window of tolerance.
In order to shift back into the window, we can shift our attention back to the present with grounding exercises and/or using the tools mentioned above. In the preparation phase, we will commonly reprocess a “sample” EMDR target with a low disturbance to get familiar with the process.
Phase 3 in EMDR therapy: Assessment
During this phase, my clients and I agree on the disturbing events that we want to reprocess together, also known as the Treatment Plan, or list of targets.
Listing Traumatic Events
In addition to the information I’ve gathered from the intake, I will ask my clients to list the traumatic events that they have experienced – not going in-depth, but just giving it a title. An example might be “Car accident, age 5”. We’re just lightly touching on the event, but trying not to open up or access the memory during this assessment phase.
After we have our list, I also ask the client to rate how disturbing that event feels on a scale of 0-10, with 0 being no disturbance or neutral and 10 being the highest level of disturbance. This will help inform our treatment plan.
Initial Caregiver Trauma
Oftentimes my clients have trauma connected to their initial caregivers. For relationship trauma, where there are too many traumatic experiences to name, we can process a cluster of targets – starting with the first memory, the worst memory, and the last memory. We won’t need to target every single event related to the person. The beautiful thing about EMDR is that there is a “generalizing effect.” When we desensitize the cluster of memories, other similar memories also fade into the past and feel neutral.
After we have our list of targets or clusters, we take each memory and set up the target for phases 4-7.
With each target we want to know:
The worst part about that memory: an image, a sound, a feeling
The body sensations associated with the memory
The emotions associated with the memory
The Negative Cognition (NC) about yourself connected with this memory (ex: I’m in danger)
The Subjective Units of Disturbance (SUD) – the level of disturbance on a scale of 0-10
The Positive Cognition (PC) that you would rather believe about yourself when you think about this memory (ex: It’s over. I’m safe now)
The Validity of Cognition (VOC) – how much do you believe the PC on a scale of 1-7, 1 meaning it doesn’t feel true at all, and 7 meaning it feels completely true.
Phase 4 in EMDR Therapy: Desensitization
During this phase, we take the information for the target memory and ask the client to focus on the memory while adding bilateral stimulation (BLS).
What is Bilateral Stimulation?
Bilateral stimulation can be eye movements following a therapist’s finger back and forth, or with the use of a light bar. For online EMDR therapy, bilateral stimulation can entail using an app with a ball that moves across the screen from right to left, or clients can use their hands and tap on their shoulders or knees repeatedly. All of these forms of BLS work to desensitize memory.
Bilateral stimulation is usually done for about 30 seconds. During this time, the client is asked to just notice what comes up for them as the train is moving and they observe the scenery outside the window of the train. Sometimes it will be a sensation, parts of the memory, an emotion, or nothing at all.
After each set of BLS, there is a brief pause where the therapist will ask the client what they are noticing. The client will briefly share, and then the therapist will say “go with that” and BLS continues. BLS continues until the memory is no longer disturbing or has a SUD of 0 out of 10.
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Phase 5 in EMDR Therapy: Installation
Once the SUD is down to 0 and the memory no longer feels triggering, we move to install the positive cognition (PC) in connection with the memory. We use bilateral stimulation during this phase to strengthen the positive belief to a 7 out of 7. Similar to phase 4, we ask the client to hold the PC and the memory while adding BLS. After about 30 seconds, there is a brief pause and the therapist will ask something along the lines of “Is that feeling more true, the same, or less true?” We want to strengthen the positive belief as much as possible.
Phase 6 in EMDR Therapy: Body Scan
Once the target memory has a SUD of 0 and a VOC of 7, we will want to check in specifically with the body and clear any distress that the body is still holding. The client is asked to hold the memory and the positive cognition together and scan their body from the top of their head down to their toes, noticing any sensations. Any lingering disturbance held in the body is processed with BLS until there is a clear body scan.
Phase 7 in EMDR Therapy: Closure
The closure is an important part of the process if the target memory is not fully reprocessed during the session. We want to use the end of the session to contain the memory until the next session and ensure that the client is grounded and calm before leaving the appointment.
One of the benefits of EMDR intensives is the potential to reprocess targets to completion in one intensive session. I love working with clients in this way, however, it’s not for everyone. Working weekly or intensively will get you the same results, it’s just a matter of how long it will take to get those results.
Phase 8 in EMDR Therapy: Reevaluation
At the beginning of each new session, clients are asked what they are noticing in general and in relation to the target that was worked on or reprocessed. Clients may choose to keep a written log of things that they notice in between sessions. This could include new memories coming up and/or helpful shifts in their thoughts, emotions, or relationships. During this phase, there is an agreement on what to work on during the present session.
Closing Thoughts
If you are curious about how EMDR might help you, please reach out for a free consultation. We offer EMDR therapy intensives and weekly EMDR therapy to residents of Pennsylvania and New Jersey. If you live in Philadelphia or are willing to travel to Center City Philadelphia, we can do in-person intensives. Otherwise, we are available to work with you for online EMDR therapy.
Start EMDR Therapy in Pennsylvania and New Jersey
EMDR Therapy is proven to be highly successful in processing and healing past trauma. If you are struggling to live your best life because you are stuck in the cycle of reliving past trauma, we can help. At Prosper Counseling our therapists are here to guide you on your journey to healing. Follow the steps below to get started.
Other Mental Health Services at Prosper Counseling
Our in-person and online therapists in Pennsylvania specialize in EMDR treatment modalities. We offer EMDR Intensives, EMDR Therapy, and online counseling in addition to EMDR Therapy services. We understand that life can be full of challenges that make self-care difficult if not impossible. Allow us to help you reconnect with yourself and live the life you want full of confidence and free of regret.
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