EMDR Therapy in Canada | First Session

Eye movement desensitization and reprocessing (EMDR) therapy is a modality used by therapists to help clients heal from difficult or traumatic events, overcome self limiting beliefs, and generally change the way they experience trauma. 

In Canada, EMDR is an increasingly popular form of therapy. Originally, EMDR was used to treat patients and clients experiencing post-traumatic stress disorder (PTSD). But today therapists use it to treat a wide variety of symptoms, as well as to improve clients’ overall quality of life.

Here’s what you need to know about finding EMDR in Canada, and what to expect when working with an EMDR therapist.

What is EMDR?

During an EMDR therapy session, a therapist guides a client through specific eye movements while the client accesses difficult or traumatic memories. These eye movements are mainly bilateral, going from left to right. The therapist may incorporate other bilateral stimulation, including sound and brief physical contact (knee tapping).

EMDR was developed in the late 1980s by the American psychologist and researcher Francine Shapiro. One day, while walking in a park and recalling painful events from her life, Shapiro found that it was easier for her to think about those events while moving her eyes back and forth. Curious, she began experimenting with the technique on friends and colleagues. 

From these early experiments, Shapiro built the foundations of eye movement desensitization (EMD) therapy. She later added the R to EMDR to emphasize the reprocessing element—asserting that the brain could learn to reframe and integrate traumatic memories with the help of her technique.

The earliest clinical successes with EMDR were in the treatment of PTSD. After its effectiveness was proven, EMDR was eventually endorsed by organizations such as the American Psychological Association (APA) and the World Health Organization (WHO).

What conditions does EMDR therapy help treat?

While EMDR was originally used to treat PTSD, its use has expanded to treat a wide range of conditions, including:

• Depression
• Anxiety
• Obsessive-compulsive disorder (OCD)
• Complicated grief
• Addiction
• Chronic pain
• Eating disorders
• Personality disorders
• Dissociative disorders and complex PTSD (CPTSD)
• Negative self-talk, limiting beliefs, and other undesired mental states 

How does EMDR work?

While numerous studies have shown the effectiveness of EMDR, the precise mechanism at work is still not fully understood.

Shapiro used the adaptive information processing (AIP) model to explain it. According to the AIP, the brain has a natural system for processing experiences and integrating them into networks of memory.

During distressing or traumatic events, this system fails, and memories are stored incorrectly. Rather than being integrated into the brain’s memory system, the events are “stuck,” or stored “maladaptively.” These “stuck” memories continue to trigger the brain’s fight-or-flight response when they are accessed, and may have more widespread effects on mental health.  

The eight phases of EMDR therapy

EMDR is divided into eight distinct phases:

1. History taking and treatment planning. The therapist gathers details about their client’s mental health history and what they hope to get out of EMDR treatment. They also work with the patient to identify target memories to be addressed, and develop a step-by-step plan for treatment. 
2. Preparation. The therapist builds trust and rapport with their client. They explain what the client can expect from treatment, and how EMDR therapy works. They also coach the client in emotional regulation—including grounding exercises like visualizing a “safe place.”
3. Assessment. The therapist guides their client through accessing a particular target memory, establishing a baseline. This baseline includes negative cognitions, emotions, and sensations. The client may be asked to rank how distressing the memory is on a scale from one to ten.
4. Desensitization. Phase Four is when the therapist begins guiding their client through EMDR eye movements while they access the distressing memory. The eye movements reduce the negative effects of the memory. As the client works through different parts of the memory and its effects, the therapist continually asks for input on their thoughts, emotions, and sensations.
5. Installation. The therapist works with their client to install positive cognitions (eg. “I am safe now”), attaching them to the memory. The client does this while performing EMDR eye movements.
6. Body scan. The client takes an inventory of their physical and emotional sensations while focusing on the memory and the new, positive cognition attached to it. If they detect any remaining negative sensations, they return to Phase Four to access and further process the memory.
7. Closure. Even if some negative sensations remain, the therapist guides the client to a calm state. In this state, the client may make use of emotional regulation techniques and grounding exercises developed in Phase Two.
8. Re-evaluation. At the next session, the therapist assesses the client to identify whether processed memories have been neutralized or whether they need further treatment. As treatment progresses, the therapist and their client may identify additional target memories to process.

What is an EMDR session like?

Although the therapist and their client speak during an EMDR session, EMDR differs from talk therapy modalities like cognitive behavioural therapy (CBT). Physical inputs and action are the main focus. 

Broadly, the process looks like this:

1. The therapist activates the difficult memory by having their client focus on it.
2. The therapist guides the client through the EMDR eye movements—and may provide auditory or touch cues—while the client focuses on the memory.
3. As they work through the EMDR movements, the memory is reprocessed and integrated into the brain’s wider memory networks (according to Shapiro’s AIP model).

EMDR is considered effective once:

• The emotional charge connected to a specific memory has faded
• The memory has been recontextualized (eg. from “I’m powerless” to “I survived”)
• The memory remains in place, but is no longer threatening or intrusive to the client

The actual EMDR sessions—with cues and bilateral eye movement—are just one part of overall EMDR treatment. The building of good rapport and trust between the client and the therapist (the therapeutic alliance) plays an essential role, and it’s not uncommon for a client to go through numerous talk therapy sessions with their therapist before beginning EMDR treatment.

EMDR has showed me empathy for myself that I never thought I would have. The intrusive thoughts are less powerful and I’m able to talk about the trauma without (a lot of) distressing symptoms. The memory has not been fully healed yet, but it has shined light on other dark corners that I was trying to hide. I feel more free and in tune with myself.

• Experience reported on r/EMDR  

How long does EMDR therapy take?

It’s typical for an EMDR therapy session to last longer than a typical 50- or 60-minute talk therapy session. Following an EMDR therapy plan, treatment in each session may last up to 90 minutes.

A full course of EMDR treatment usually runs from six to 12 sessions. The amount of sessions needed depends on the number of target memories to be processed, treatment goals, the intensity of the trauma, and the complexity of the case.

If you decide to undergo EMDR treatment with a therapist, they should be able to provide you with a clear treatment plan and timeline, including the length of each session and the total number of sessions to be completed. 

What is the difference between accelerated resolution therapy (ART) and EMDR?

Accelerated resolution therapy (ART) grew out of EMDR. While ART is similar to EMDR in some ways—namely in the client’s use of bilateral eye movement while reprocessing memories—it differs from EMDR in a few important ways.

The aim of ART is to help the client replace disturbing images in their memory with pleasant ones. Whereas EMDR is typically considered a modality, ART is a technique. It may be used in combination with, or as part of, other modalities. 

ART regards target memories as “scenes” to be processed. These scenes are addressed individually: A course of ART reprocesses one scene, whereas a course of EMDR targets multiple, interconnected memories.

Because of this, a course of ART is shorter than a course of EMDR. Usually, ART lasts for five one-hour sessions.

Also, it follows a strict protocol, using 40 set eye movements. Free association is not a part of ART, although this may be used by the therapist at their discretion. This is because ART focuses on one particular scene, without the aim of recovering and incorporating other target memories outside that scene.

ART has been shown to be particularly effective when treating veterans with PTSD. That may be because ART requires less verbal processing or revisiting of traumatic events, and because it is focused on resolving feelings attached to a single event rather than a range of experiences over the course of the client’s life.

You may decide to pursue ART if you or your therapist believe your condition is tied to one specific traumatic event. EMDR may be preferable, however, if your aim is to process a wide range of interconnected events while undergoing therapy for an extended period. A qualified therapist should be able to advise you on the best approach.

What are the dangers of EMDR therapy? Are there any side effects?

Some clients report short-term side-effects while undergoing EMDR, including:

• Emotional ups and downs
• Vivid dreams
• Headaches
• Fatigue
• Unexpected memories surfacing

These side-effects should resolve with time and with the completion of the full course of EMDR treatment.

If you experience side-effects while undergoing EMDR, your therapist can recommend ways of reducing them. That includes:

• Tracking side-effect symptoms
• Learning and practicing emotional coping skills
• Taking breaks, as needed, during therapy sessions
• Budgeting time after each session for rest and recovery (EMDR can be fatiguing)
• Learning ways to clearly communicate to your therapist any discomfort you feel during sessions

Where can I access EMDR therapy in Canada?

You can access EMDR through a physician-referred therapist, or through a therapist you seek out yourself. First Session features an extensive, searchable directory of EMDR therapists in Canada.

Before booking a session with an EMDR therapist, make sure that they are certified to provide EMDR therapy in Canada. (More on that below.)

How much does EMDR therapy in Canada cost?

Therapists providing EMDR therapy charge their normal session rates. Therapy rates vary widely across Canada, according both to your location and to the certifications and experience level of therapist you see. For therapists other than psychologists and psychiatrists, the hourly session rate ranges from $100 to $200 per session.

While EMDR sessions may last up to 90 minutes, some therapists may be able to accommodate 50- or 90-minute sessions. If sessions do last 90 minutes, it’s typical for a therapist to prorate their normal session fee for the longer timespan. For instance, if a therapist charges $150 for a one-hour session, then they will likely charge $225 for an EMDR session lasting 90 minutes.

How do I choose an EMDR therapist in Canada?

The typical guidelines for how to find a therapist in Canada also apply to therapists offering EMDR. However, you should also choose a therapist who is certified to provide EMDR treatment.

EMDR Canada is the national professional association for EMDR in Canada.

In Canada, EMDR training comes in three tiers:

1. Basic EMDR Trained Therapist (Level 1): A professional who has completed basic training requirements and may include EMDR in the services they offer as a licensed therapist.
2. EMDR Certified Therapist (Level 2): A professional who has completed basic training, but also performed at least 50 clinical EMDR sessions, completed 20 hours of supervision under a trained consultant, and completed 12 hours of continuing education. They are required to meet yearly continuing education requirements.
3. EMDR Consultant or Trainer: A professional certified to train and supervise other therapists in EMDR.

Note that these are certifications, not designations. Therapists operate under their designations or therapy license types, and only licensed therapists may be certified to provide EMDR treatment.

Can EMDR therapy be done online in Canada?

A 2021 study found that results from virtual EMDR sessions were on-par with those from in-person sessions.

Therapists offering online EMDR may adjust their technique to suit the setting. For instance, they may provide auditory cues (beating a rhythm on a drum, for instance) that you follow in order to perform knee-tapping on yourself.

There are also virtual tools available to therapists to help guide clients’ eye movements during virtual sessions.

Find EMDR in Canada

EMDR Toronto‍

EMDR Calgary
EMDR Vancouver
EMDR Ottawa
EMDR Montreal
EMDR Kelowna
EMDR Edmonton

Can I do EMDR therapy myself?

It’s possible to administer EMDR therapy to yourself. At least one study has found that subjects who self-administered EMDR over a three month period saw reduced symptoms of trauma, anxiety, and depression.

However, self-administered EMDR is not a substitute for EMDR administered by a trained, certified professional. As a general guideline, self-administered EMDR is best suited to the treatment of “small t” trauma, rather than the processing of major traumatic events or complex PTSD.

If you do decide to perform EMDR alone, take care to monitor any side-effects, including new symptoms, and stop treatment if they cause you serious discomfort. Contact a professional immediately—or phone a crisis line—if you are concerned about the effects self-administered EMDR may be having.

There are a number of online tools advertised as personal EMDR solutions, some of which include AI functionality. Take care to assess any tool you are considering before using it for self-administered EMDR. If possible, consult with a qualified therapist before beginning a course of treatment.

Will I need to talk about my traumatic experiences during EMDR?

The extent to which you discuss traumatic experiences during EMDR is governed by your comfort level. 

One of the core concepts in EMDR is the “window of tolerance.” This is the degree to which a client may focus on a distressing memory without becoming emotionally overwhelmed or having a trauma response.

So while you will likely need to identify your traumatic memories as part of the EMDR investigation phase, your therapist will not ask you to vividly recount those memories if doing so would move you outside your tolerance window.

You can discuss with your therapist in advance any concerns you may have about revisiting traumatic or distressing memories, and work with them to plan a treatment approach that feels safe for you.

Is EMDR therapy covered by insurance in Canada?

Therapy, including EMDR, is only covered by public health insurance when it is provided on a doctor’s referral. It’s often very difficult to get EMDR therapy covered under Canadian provincial Health care plans like OHIP or MSP. Occasionally you may get a doctor’s referral for EMDR, but you may have a hard time finding a therapist who is fully funded.

That being said, if you have private health insurance, it will specify which designations or licenses a therapist needs to have in order to be covered, as well as to what extent out-of-network treatment is covered by the plan. In most cases, insurance plans do not specify EMDR therapy as a specific treatment that is covered. Rather, your coverage depends on your therapist’s designation.

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Considering seeing a therapist for the first time? Check out How to Find a Therapist in Canada.