Eye Movement Desensitization and Reprocessing (EMDR) therapy is a powerful, evidence-based treatment for trauma and other distressing experiences. Developed by Dr. Francine Shapiro in the late 1980s, EMDR has helped millions of people process traumatic memories and find relief from psychological distress.
At the heart of EMDR therapy lies a structured eight-phase approach that guides clients through the healing process. Each phase serves a specific purpose, ensuring that treatment is thorough, safe, and effective. Let's explore each phase in detail.
Phase 1: History and Treatment Planning
The first phase lays the foundation for successful EMDR therapy. During this comprehensive assessment phase, your therapist will:
- Gather Complete History: Collect detailed information about your past experiences, current symptoms, and treatment goals
- Identify Target Memories: Pinpoint specific traumatic events or distressing memories that need processing
- Assess Resources: Evaluate your internal strengths and external support systems
- Develop Treatment Plan: Create a roadmap for which memories to address and in what order
This phase ensures that therapy is tailored to your unique needs and that all safety measures are in place before beginning the deeper work.
Phase 2: Preparation
The preparation phase focuses on building the therapeutic relationship and equipping you with essential coping skills. Your therapist will:
- Establish Rapport: Create a safe, trusting environment where you feel comfortable
- Explain EMDR Process: Help you understand how bilateral stimulation works and what to expect
- Teach Coping Techniques: Provide tools for managing emotional distress between and during sessions
- Practice Resource Development: Strengthen your ability to access calm, safe states
This phase is crucial for ensuring you feel stable and supported throughout the therapeutic journey.
Phase 3: Assessment
During the assessment phase, you and your therapist identify the specific components of the target memory that will be processed. This includes:
- Image Selection: Choose the most distressing visual aspect of the memory
- Negative Cognition: Identify the negative belief you hold about yourself related to the event
- Positive Cognition: Determine the positive belief you'd prefer to hold
- Validity of Cognition (VOC): Rate how true the positive belief feels on a scale of 1-7
- Emotions: Name the feelings associated with the memory
- Subjective Units of Distress (SUD): Rate the current distress level on a scale of 0-10
- Body Sensations: Notice where you feel the distress in your body
This detailed assessment creates baseline measurements that track your progress throughout treatment.
Phase 4: Desensitization
The desensitization phase is where the core EMDR processing occurs. While focusing on the target memory, you'll receive bilateral stimulation (typically eye movements, but could also be taps or tones) through sets of approximately 30 seconds each.
During this phase:
- Bilateral Stimulation: Your therapist guides you through eye movements or other forms of dual attention stimulation
- Memory Processing: You allow whatever comes up to surface without judgment
- Distress Reduction: The SUD scale is used to track decreasing distress levels
- Association Processing: New thoughts, images, feelings, and insights naturally emerge
- Multiple Sets: Continue until the distress level reaches 0 or 1
This phase continues until the target memory no longer causes significant distress and feels neutral.
Phase 5: Installation
Once the distress is reduced, the installation phase strengthens the positive cognition you identified in Phase 3. The goal is to increase the validity of this positive belief until it feels completely true.
During installation:
- Focus on Positive Belief: Hold the positive cognition in mind while thinking of the original event
- Bilateral Stimulation: Continue with sets of bilateral stimulation
- VOC Monitoring: Track the increasing validity of the positive belief
- Complete Installation: Continue until the VOC reaches 7 (completely true)
This phase ensures that the positive perspective becomes firmly integrated with the memory.
Phase 6: Body Scan
The body scan phase checks for any remaining physical tension or distress related to the processed memory. This is important because trauma often gets stored in the body even when cognitive and emotional distress has been resolved.
During the body scan:
- Hold Target and Positive Belief: Think of the original event and your new positive belief
- Scan Your Body: Systematically check from head to toe for any residual tension or discomfort
- Process Remaining Disturbance: Use bilateral stimulation on any areas that still hold tension
- Complete Clearing: Continue until the body feels completely calm and clear
This phase ensures that the trauma is fully processed at both cognitive and somatic levels.
Phase 7: Closure
The closure phase brings each session to a safe and stable conclusion, whether the processing is complete or ongoing. Your therapist will:
- Assess Current State: Check how you're feeling at the end of the session
- Ensure Stability: Make sure you feel calm and grounded before leaving
- Provide Coping Tools: Review techniques for managing any emotions that might arise between sessions
- Plan for Next Session: Discuss what to work on in future sessions
Closure is essential for maintaining safety and stability throughout the therapeutic process.
Phase 8: Reevaluation
The final phase occurs at the beginning of each subsequent session. Your therapist will:
- Review Progress: Check how you've been feeling since the last session
- Evaluate Target Memories: Ensure that previously processed memories remain stable
- Assess Treatment Goals: Determine if the positive cognitions are holding strong
- Plan Next Steps: Decide whether to continue with current targets or move to new ones
This ongoing evaluation ensures that the treatment gains are maintained and that therapy continues to address your evolving needs.
The Science Behind EMDR
Research shows that EMDR therapy works by helping the brain process traumatic memories in a way similar to how we process information during REM sleep. The bilateral stimulation appears to facilitate the brain's natural information processing system, allowing traumatic memories to move from being "stuck" in the nervous system to being properly integrated and stored.
Studies demonstrate that EMDR can be as effective as traditional exposure therapy but often works more quickly and with less distress between sessions. The structured eight-phase approach ensures that treatment is both thorough and safe.
Is EMDR Right for You?
EMDR therapy has been shown effective for:
- Post-traumatic stress disorder (PTSD)
- Anxiety and panic attacks
- Depression
- Phobias
- Complex trauma
- Grief and loss
- Performance anxiety
- And many other psychological issues
If you're struggling with the effects of traumatic experiences or distressing memories, EMDR's eight-phase approach offers a structured, evidence-based path to healing. The comprehensive nature of the protocol ensures that all aspects of traumatic experiences are addressed - cognitive, emotional, and physical.
Conclusion
The eight-phase EMDR approach provides a comprehensive framework for healing trauma and processing distressing memories. By following this structured protocol, therapists can help clients safely and effectively transform how traumatic memories are stored in the brain and body, leading to lasting relief and improved quality of life.
If you're considering EMDR therapy, finding a trained and certified EMDR therapist is essential. They will guide you through each phase with expertise and care, ensuring that you receive the full benefits of this powerful therapeutic approach.
Remember, healing is possible, and you don't have to walk this path alone.