Eye Movement Desensitization and Reprocessing
- EMDR Therapy

The first phase of EMDR therapy is when the therapist learns about the client’s extensive history and then develops a treatment plan based on the information they receive. Often this phase lasts for the first 1-2 sessions and focuses first on the client’s distant past (especially if they had a traumatic childhood), then on more recent traumatic events or the reason they sought EMDR therapy. They will also get to know the client’s present disturbances and things that need addressing in their current life. Once the therapist is well acquainted with the client’s history, they can decide the best and most-effective course of action moving forward and how best to treat their specific set of needs.

The second phase of EMDR therapy is when the therapist offers the client many tools and techniques for calming, relaxation and stress reduction. In this phase, the therapist is aiming to give their client the best possible opportunity to cope with their current stress or anything that inevitably causes them emotional pain or stress in their life. This phase is a good opportunity for the therapist to build a deeper, trusting relationship with the client. Though the client isn’t required to go into detail on their past traumas and memories, the therapy will be most effective if the client fully trusts their therapist. In addition to offering the client coping skills and techniques to deal with stress, in phase 2, the therapist will also explain what the client can expect in EMDR and answer any questions about the process. This is also known as the “preparation phase”. 

The third phase, often referred to as “the assessment” phase. In this portion of the treatment, the client will be guided to target their past traumatic experiences in order to process them. To process these events does not mean the client has to go into great detail or recall the entire memory start to finish, but they will be led to recall specific thoughts, feelings or sensations from the event. They’ll be asked to select a specific image or mental picture from the event that they feel best represents the memory. Then, they will be asked to choose a statement that they feel best summarizes how they feel about the memory. This doesn’t have to be how they think, just how they feel – often the two are distinctly different. For example, a person who was sexually assaulted may know that they are not shameful, but they may feel incredibly shameful about the event. They’ll be asked to verbally convey that statement while recalling the targeted image. Then, they will be asked to choose a positive belief about the event that they would rather believe. Again, the client doesn’t have to think it to be true, but they must have a strong internal desire to possess this feeling. The initial negative statement might be “I am worthless,” and the positive statement that replaces that could be, “I am worthy”. 

In phase 3, the client will also be asked to rate or estimate how true they believe the positive beliefs to be on a scale called Validity of Cognition (VOC), which ranges from 1-7. They will also then rate their level of discomfort and negative emotions using a different scale called the Subjective Units of Disturbance (SUD) scale. This scale rates from 0-10. 

In the fourth stage, the EMDR therapist focuses on desensitization. It is in this phase which the therapist performs the eye movement, sounds or tapping process. The therapist will focus on the targeted trauma and then other associated traumas as they are rated by the SUDs scale, and work to associate those memories with a different focus, repeatedly until the client’s SUD ratings are at a 0, 1 or 2.

The 5th phase of treatment is focused on installation. Its purpose and goal is to increase the strength of the positive beliefs that the client has expressed in phase 3. During this phase, the client’s belief in their new mindset and thoughts regarding the event will be strengthened and practiced. The goal is for the person to believe the positive cognition at a rating of 7 on the VOC scale by the end of this phase. So, they should feel that their positive statement is completely true.

This portion of the process is referred to as the “body scan” phase. During this phase, the EMDR therapist will ask the client to recall the original target event and evaluate if there is any physical response noticed in the body. Trauma has been shown to be carried in the body memory, and so observing the physical sensations when targeting a trauma memory is a really successful way to test if there are any residual negative reactions. If there are, they will be targeted and reprocessed again.

An EMDR therapy is not considered successful until the client can recall their trauma without feeling any body tension.

The seventh phase of the EMDR treatment process is dedicated to closure. Each EMDR therapy session will end this way, as with the entire EMDR therapy process as a whole. It is integral in the process that the therapist ensures that the client feels better upon leaving the session than they felt upon entering. In the cases that the trauma isn’t fully processed in one session, it is the therapist’s role to offer self-calming methods and helpful coping techniques to ensure that they leave in a balanced place. The client and therapist will also discuss what might be expected in between or following each session and how to manage the symptoms, thoughts and mental images that may arise.

In the final phase of EMDR therapy, the individual is reassessed. This phase happens at the beginning of each session as well as after the entire process is complete. It is one of the most important phases, as it gives the therapist a clear idea of where the client is in their healing process, as well as what treatment still needs to be done and how.