The 8 Phases of EMDR Therapy

Many people who come to EMDR are eager to get started in the processing of difficult memories. However, Eye Movement and Desensitization Reprocessing does not start immediately with the bilateral stimulation and reprocessing. Instead, there is a process known as the Eight Phases of EMDR, or Eight Stages of EMDR that the client and therapist must work through. In my Online EMDR Therapy practice, I work carefully through these 8 stages with each and every client.

This process is designed for the individual to get the most out of EMDR therapy by buildign a relationship with their therapist, allowing the therapist to appropriately understand the underlying experience of the client, and treat it in a way that will be most useful. 

The Eight Phases of EMDR

1. History Taking
2. Preparation
3. Assessment
4. Desensitization
5. Installation
6. Body Scan
7. Closure
8. Reevaluation

Phase One: History Taking

After scheduling a free consultation, clients may receive a set of forms aimed to help the therapist get a completel look at what you are experiencing as far as symptoms, your history with other therapists, and treatment goals. They may also be sent screening tools or questionnaires to more deeply assess the difficulties you are facing. The ACE (Adverse Childhood Experiences) Questionnaire may be used to investigate trauma, neglect, and abuse. 

The history taking phase of EMDR will also include a conversation during your session with your therapist. In the initial conversations, you may be asked to share about your childhood, the people in your life when you were young, and your experience as a kid. The therapist will also likely seek to understand your present experience including your treatment goals, what is important to you in your current life, and more.

Phase Two: Preparation

The second phase after history taking is preparation. Specifically, the preparation phase aims to create safety for the client during the future stages of EMDR. The therapist will help the individual find a window of tolerance or resilience, investigating what feels comfortable and safe for them as they move through the EMDR therapy. 

This often includes establishing some grounding techniques. In EMDR therapy, the client is reflecting on past traumas and difficult memories. The preparation phase aims to make sure you are not sucked into the past, and can remain partially in the present throughout the treatment.

Phase Three: Assessment

After we have prepared and established a plan for comfort and safety, we will move into the assessment phase. During this stage, the therapist and client will work together to develop a treatment plan. Using the intake as a jumping off point, we will make a list of the traumatic or difficult events and memories they have experienced. Without diving deeply in to the memory, we will simply make a list. 

Once we have a list, we will begin to categorize and target specific traumas or memories. By looking at the most difficult part of the memory, the body sensations associated with the experience, the emotions, and negative and positive cognition, the therapist will begin to create a roadmap for the EMDR sessions.

Phase Four: Desensitization

Phase four is desensitization, and generally includes bilateral stimulation. This is the phase of EMDR that most people think of when they imagine EMDR therapy. During bilateral stimulation, you may follow a movement with your eyes, utilize a tapping technique, or be stimulated via auditory cues. Bilateral stimulation lasts under a minute, and the client observes what arises in relation to the memory, emotions, body sensations, or anything else. 

During the breaks between stimulation, the therapist may give direction and feedback to help the individual dive more deeply into an experience. The goal of bilateral stimulation and the desensitization phase is to lower the Subjective Units of Disturbance (SUD) score, a measure of how painful or uncomfortable the memory is. That is, we are working to desensitize or de-charge the experience.

Phase Five: Installation

As the SUD is brought down to lower levels, the trauma will feel less triggering to the individual. At this point, there is an opening to install positive cognition (PC) in relation to the memory. To put it rather simply, PC is a thought pattern that you would like to believe about yourself or this memory in place of the disturbing or painful thoughts you’ve experienced in the past. An example may be that you are safe now or that it’s no longer occurring. 

During the installation phase, you will also use bilateral stimulation. In this case, you are working to install this positive cognition rather than reduce the pain around it. You will reflect on the memory while also holding the PC in your mind, working to put this new thought pattern into your mind and memory.

Phase Six: Body Scan

Once the SUD has reduced and the PC has been installed, it is time to look at the body. The body is often neglected during therapy, and it is important to notice what experience is occuring in the body surrounding the memory. This will be done through a body scan, similar to the practice of a body scan meditation. The individual will investigate the memory and positive cognition as they scan their body to look for any present sensations. If something is found, bilateral stimulation is used to process it out.

Phase Seven: Closure

The closure phase of EMDR therapy is aimed at containing the memory at the end of the session. As you move from the safety of a therapy session back into your daily life, it is important to ground yourself. This helps you prepare to re-enter your everyday life without lingering trauma or bodily sensations hanging around too heavily. 

Phase Eight: Reevaluation

Reevalution happens at the beginning of each new session. During this stage, clients reflect on anything they are noticing regarding the target previously worked on. Things like memories, emotions, bodily sensations, or any big shifts in perspectives or relationships may be reviewd to re-assess where you are at as far as the needs for your EMDR sessions.