Mastering the 8 Phases of EMDR Therapy

Unlike traditional talk therapy, EMDR engages the brain’s natural healing processes, enabling clients to process and resolve distressing memories rather than just manage symptoms. Using “bilateral stimulation” through the use of guided eye movements, holding tappers, and even audio sounds, EMDR stimulates the mind to bring up memories, thoughts, and feelings that may otherwise be inaccessible. This happens through a structured eight-phase model, including history-taking, preparation, identifying target memories, reprocessing with bilateral stimulation, and installing positive beliefs to support long-term healing. 

This model was developed by Francine Shapiro to ensure that therapists and clients walked through the complex process of processing trauma in a safe, effective, and comprehensive way. Each phase builds on the previous one which allows clients to gradually access, process, and resolve the distressing memories. If any of the phases are rushed or skipped, it can compromise the client’s progress or even retraumatize them. By following the model, EMDR therapists not only maintain client safety, but they also offer the brain support in its natural healing process and promote lasting change. This article will provide you with a roadmap for the eight phases, including clinical considerations and best practices. 

What is processing in EMDR therapy?

The word “processing” is used often not only in therapy, but in everyday conversations. Let’s define it clearly before moving forward:

Processing refers to the human’s natural ability to integrate our emotions, beliefs, and physical sensations in our body regarding an experience, and within EMDR therapy, this is specific to distressing or traumatic memories.

With this in mind, processing becomes more than just a way to understand an experience and come to terms with its reality. In this context of EMDR therapy, processing also focuses on resolving and replacing the hurtful emotions, thoughts, and body sensations attached to those difficult experiences.

The 8 Phases of EMDR Explained

Phase 1: History Taking & Treatment Planning

The goal of Phase 1 in EMDR therapy is to learn who your client is and collect important information about their history. This will allow you to identify their trauma points, symptoms, possible triggers, and current impact on daily life. Here are important notes to consider in this phase:

 - Utilize the Three-Pronged approach to evaluate past events, current triggers, and future concerns.
 - Evaluate the client’s level of stabilization to determine whether additional preparation is needed.

Phase 2: Preparation

In Phase 2, the focus is on building rapport and assessing the client’s readiness for EMDR. This includes evaluating their potential for dissociation, emotional tolerance, and the possible need for additional preparation. Some clients may require more coping skills before processing trauma. You can support them through:

 - Sharing clear expectations about EMDR to help them feel accurately prepared.
 - Teaching grounding techniques like Safe Place, the Container Exercise, and diaphragmatic breathing to build emotional regulation skills.

Phase 3: Assessment

Once you’ve prepared your client for what to expect and equipped them with some emotional regulation tools, you can begin identifying target memories that will be revisited in the EMDR process. This involves the following steps:

 - Select specific traumatic memories, images, and associated negative beliefs.
 - Measure their baseline distress using the Subjective Units of Disturbance (SUD) scale (0 being no distress and 10 being the highest level of distress imaginable).
 - Identify and reinforce positive beliefs using the Validity of Cognition (VOC) scale which encourages clients to rate their positive beliefs about the traumatic memory (1 being completely false and 7 being completely true).

Phase 4: Desensitization

In Phase 4, you begin implementing bilateral stimulation (BLS) to reduce emotional distress linked to the target memory. This can be through eye movements, taps, or auditory stimulation based on client preference. The stimulation helps the brain reprocess the memory, reduces its emotional charge, and opens the mind to integrating more adaptive information. In this phase, you should also:

 - Manage their reactions and help them learn how to recognize and handle any intense emotional responses.
 - Monitor any shifts in their cognition, emotions, and somatic experiences.
 - Use interweaves appropriately when the client gets stuck or begins dissociating. Interweaves include gentle prompts or statements, used sparingly and strategically, to help the client move forward.

Phase 5: Installation

Having begun the bilateral stimulation in the previous phase, Phase 5 continues using it while integrating positive cognitions to replace the negative beliefs. You should also address any blocks or cognitive dissonance that may arise. Some examples of installation beliefs can include the following:

 - Themes of safety: I’m safe now. It’s over, and I survived. I can protect myself.
 - Themes of control: I’m strong. I’m in control now. I can make good choices.
 - Themes of self-worth: I am good enough. I am worthy of love. I deserve respect.

Phase 6: Body Scan

Nearing the end of the experience, you want to identify and clear any residual somatic distress linked to the memory. This is what Phase 6 is for: helping the client scan their body for any lingering tension or discomfort. Here are some ways you can do that:

 - If something feels off, use brief bilateral stimulation, for just a couple of seconds, and ask the client to observe what comes up.
 - Repeat the scan until the client feels their body is clear, calm, or neutral. 
 - If body sensations persist, determine whether their tension may be connected to another memory that should be assessed in a future session.

Phase 7: Closure

Phase 7 is about ensuring emotional stabilization to return to everyday routines. You do this by reviewing the progress made and asking how the client feels. Another central part of this is reinforcing safety protocols and practices such as the following:

 - Grounding techniques to help them if their memory remains partially processed.
 - Strategies such as journaling, tapping, imagery, and other techniques from Phase 2 to help manage emotions between sessions.

Phase 8: Reevaluation

The final phase of EMDR is actually about preparing for the next session. In this step, evaluate how the client feels about their progress, the effectiveness of EMDR, and choose what to focus on next. You should make sure to go over these things:

 - Targets of previous sessions to ensure distress has remained low and positive cognition is holding.
 - Any new targets that have emerged as part of the process.
 - Any adjustments to the treatment plan based on their response in the sessions.

How do I know if EMDR is working?

Evidence of successful EMDR therapy in a client usually looks like lessened emotional distress surrounding the specific traumatic memories, successful change in negative beliefs, healthy changes in behavior and body sensations, and better memory integration. Here is what our EMDRIA Approved Consultant & Trainer, Mariana Caro, LCSW, has to say about it:

“EMDR helps make life lighter. So often, we try to think and problem solve our way out of our traumas and our challenging behaviors. We can be hard on ourselves for not being able to “get over things” faster, or because we can’t just stop doing things we don’t like. But our brains don’t work that way. We need to heal from our pasts in order to be freer in the present, and EMDR is an extremely effective and efficient way to do that. Once you heal your past, you don’t have to work as hard to change behaviors or thought patterns. Yes, of course there’s work to do after EMDR, but it doesn’t feel like such an uphill battle anymore.”

Rushing or skipping any of the phases can compromise a client’s progress and risk retraumatization. Learning about each phase and executing them with integrity will allow you to truly protect your client, facilitate their brain’s natural healing process, and foster deep and lasting change. Whether you’re already trained, in the process of getting trained, or looking to start the journey, we’re here to help you at Coast to Coast! Explore the resources we have for you below.