It’s probably fair to say that most of us EMDR therapists spend much of our time doing Phase 4 desensitisation work in our therapy sessions. We are always taught that we should not move on to Phase 5 installation of the positive cognition until the SUDs are at a 0. Find out more about why this is the case here. So it feels great for us and our clients when we can move into Phase 5. But because we spend less time in Phase 5 I think this can often confuse us as therapists. And we often can find that the VOC won’t shift.
Phase 5 usually takes about 5 minutes
We also need to be aware that when we are doing a Phase 5 Installation of the positive cognition it usually doesn’t take too long. For the majority of people, in my experience this usually takes around 5 minutes.
So when SUDs are 0 we move on with the question:
“When you think of that incident/event etc do the words (restate the original positive cognition) still fit or is there another belief you would like to have about yourself.
Often our clients may say something different as it has changed through all the processing that they have done, and that’s fine as long as it remains self referencing, positive and currently held.
We then say “Hold the incident/experience with the words (restate the positive cognition) how true do they feel to you now, on a scale of 1 – 7 if 1 is complete false and 7 is completely true.
The usual response tends to be a 5+ by this point. If it’s lower I usually think I have more processing to do or I really need to change the positive cognition.
Whatever score they give us anyway we would still aim to install it, by saying
How we install the Positive Cognition
“Hold the incident with the words …. And do a set of BLS (the speed is always fast). At the end of the set we say:
“Holding them together again, how true to the words (repeat them) feel to you now on that scale of 1 – 7, 1 completely false and 7 completely true. Usually the VOC would continue to rise but sometimes it does get stuck and we find that the VOC won’t shift. So here are some things you could try if it does get stuck:
When the VOC won’t shift, try these
Ask “What would need to happen for this to feel one point more true?”
You could ask what keeps it at a (repeat the score, 5,6 etc) the client could:
🦋 state a blocking belief ie. “I don’t deserve it to be higher”. “If I believe I’m safe, I’ll let my guard down”. “But if I believe I’m good enough, people will expect more from me”. “If I let this go, who am I?”
- we might need to address this belief.
🦋 say that it will never be higher because they are fearful that it could happen again in the future:
- We need to emphasize that we can work on the fear, at some point in our treatment plan. But that’s not what I am rating now. So I say something like. ”At the very moment as you are sat in this office with me. When you think of that incident and those words how true do they feel to you now.”
🦋 be rating the positive cognition in relation to every life experience and how they feel about themselves.
- Again we need to emphasize that that is not what we are asking. We come back to ”At the very moment as you are sat in this office with me. When you think of that incident and those words how true do they feel to you now.”
Sometimes if the VOC won’t shift it could be that the powerful positive cognitions is too difficult to believe. In those situations we can soften the positive cognitions by adding a few words ie:
I can learn to be ….
I am beginning to …..
It might be possible to …..
I am working towards ….
I am open to the idea that …..
Who am I?
Hi, my name is Dr Hannah Bryan and I am a Chartered Clinical Psychologist and a Europe Accredited EMDR Trainer & Consultant. In 2006 I trained as an EMDR therapist.
I am extremely passionate about helping clinicians improve their knowledge and skills in EMDR so that they improve their confidence and practice it more with their clients and more clients recover and heal from the traumas they have experienced.
If you want to stay up to date with my tips and tricks in EMDR or any new services I develop join my email list. You can join by downloading my free Cognitive Interweaves cheat sheet here.
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