The 8 Phases of EMDR Explained
As you may know firsthand, trauma can have serious impacts on a person’s health, relationships, and overall well being. However, it is possible to heal. EMDR therapy is a highly effective trauma treatment that has helped many people like you. In this post, I’ll explain the 8 phases of EMDR to help you better understand the process.
What is EMDR therapy?
Eye movement desensitization and reprocessing (EMDR) is a form of psychotherapy. It was originally created in the 1980s by Francine Shapiro, PhD to help people who have experienced traumatic events.
In EMDR, therapists use a technique called bilateral stimulation to help clients change the way that their brain and body react to traumatic memories. Each therapist uses different types of techniques, but some include: rapid eye movements, music, and alternating vibrations from handheld devices.
Researchers are still unsure how exactly EMDR works, but one theory is that the brain waves created during EMDR sessions are similar to the waves the brain creates during deep sleep. In deep sleep, your brain processes events from the day and turns them into memories.
Who is EMDR therapy for?
Eye movement desensitization and reprocessing was first designed as a treatment for post traumatic stress disorder (PTSD). It helps people break down the negative beliefs they may have about themselves after experiencing trauma.
While EMDR therapy is still frequently used for survivors of trauma, studies show that it can be helpful for people with a number of other conditions. While more research is needed, there is evidence to suggest that EMDR can help with the following issues:
Substance abuse
Eating disorders
Anxiety disorders
Performance anxiety
Sexual dysfunction
Obsessive compulsive disorder (OCD)
Pain
Sleep issues
How effective is EMDR?
Though EMDR is a relatively new type of therapy developed in the past several decades, it has a significant amount of research showing how effective it can be. In fact, studies show that it can help people feel better faster than if they engage in traditional talk therapy alone.
EMDR may even be more effective than talk therapy since it engages the brain and body to help people heal from trauma.
Many people prefer EMDR since they don’t have to complete “homework” outside of session, like in traditional approaches such as cognitive behavioral therapy (CBT). It also allows people to recover without sharing detailed accounts of their trauma.
What are the 8 phases of EMDR?
Eye movement desensitization and reprocessing therapy is a highly structured approach to treating trauma. While you and your therapist will work together to make a treatment plan that makes sense for you, all of the stages of EMDR will be incorporated. Here’s a breakdown of the eight phases of EMDR so you can get a sense of what to expect.
Phase 1: History taking and treatment planning
The first phases of EMDR therapy involve a discussion of what brings you into therapy. You don’t need to share intimate details of your trauma, but it’s important for your therapist to know how your trauma experience is showing up in your day to day life.
For example, many trauma survivors experience negative beliefs about themselves or the world. You may also experience negative emotions related to the event that impact your current quality of life.
During this phase, you and your therapist will collaborate to make a treatment plan that fits your needs and goals. As part of this phase of EMDR, you and your therapist will also identify the target memory (or memories) that you want to address in therapy.
Remember, you don’t need to share explicit details of your traumatic memory if you aren’t comfortable doing so. You can give your therapist a vague understanding of the memory or event.
For example, you can share that you were bullied without recounting exactly what was said or done to you. The important part is that you identify a memory that makes you feel activated.
Phase 2: Preparation
During preparation, your therapist explains more about the treatment process so you can understand what to expect. Each of the phases of EMDR therapy can vary in length depending on you and your unique situation.
You might spend just one session in the preparation phase, or you may need several sessions to feel ready to move forward. You and your therapist will work together to determine what’s right for you.
As part of the preparation process, your therapist will also teach you self control techniques that you will use throughout your time in EMDR therapy. People with posttraumatic stress disorder often have a hard time regulating their emotions when feeling triggered-having these skills can help you do so.
Each person may learn different skills during EMDR. However, they all typically center around the theme of mindfulness. Some examples of mindfulness skills include breathing exercises, the 5-4-3-2-1- technique, and progressive muscle relaxation.
Using these skills can help you get grounded when unpleasant memories pull you into fight-or-flight mode. You can use these skills when processing trauma in session, and they can also be helpful in your day-to-day life outside of therapy.
Phase 3: Assessment
Assessment is the third phase of EMDR therapy. In the assessment phase, the therapist helps you tap into the targeted memory of the traumatic event. This will help you and your therapist begin to identify negative beliefs or emotional disturbance associated with the memory.
During this process, you and your therapist will also work together to identify a positive cognition to contrast the negative cognition or belief you already have. For example, if your negative belief is “I am a bad person,” a positive belief could be “I am worthy of love.”
Your therapist will use rating scales to get a sense of how you feel. The Validity of Cognition (VOC) scale asks you to rate how true the positive cognition feels to you on a scale of 1-7. It’s okay if the positive belief doesn’t feel entirely true right now-this is just to gain insight and information.
Your therapist will also use the Subjective Units of Disturbance (SUD) scale. This tool asks you to take your negative emotions and somatic response (body sensations) into account. You will rate how you feel on a scale of 1-10.
Phase 4: Desensitization
During the desensitization phase, you will start to combine everything you have learned in EMDR therapy so far. In this step of treatment, you will hold the target image or negative belief in mind while your therapist guides you through bilateral stimulation exercises.
Eye movements are some of the most common forms of bilateral stimulation, though your therapist may also use a variety of other methods.
It can be difficult to maintain focus on doing the eye movements or other techniques while also holding onto the emotional and physical sensations that the negative memory triggers, but your therapist will guide you.
The goal of this phase of treatment is to reduce the distress you feel when thinking of the unpleasant event. Your therapist will continue to use the rating scales to check in with you. The hope is that your SUD ratings will decrease over time.
Phase 5: Installation
Installation is the fifth phase of EMDR treatment. By this time, the intensity of the negative beliefs will have softened. In the installation phase, the focus will shift toward incorporating the positive beliefs.
You and your therapist will repeat the same process from phase four, though you will now hold the positive self beliefs in mind. You will think of the targeted event while introducing the positive cognition.
At the same time, your therapist will lead you through the same bilateral stimulation techniques used during the desensitization phase. This will help you strengthen the positive cognition.
During this part of the EMDR process, you will revisit the VOC scale to rate how true the positive belief feels to you. The goal is for the positive belief to strengthen to the level of 7/7, but you and your therapist will discuss a level that feels appropriate for your unique situation.
Phase 6: Body scan
Once you and your therapist have agreed that your positive beliefs have been strengthened to a realistic level, you will move onto the sixth phase of EMDR therapy.
In this stage, you will hold the target trauma memory in mind while thinking of the positive cognition at the same time. Your therapist will guide you through a body scan, asking you to take note of any body sensation you feel during this time.
Though this is one of the final EMDR stages, don’t worry if you still have a lingering physical response. If you notice lingering body sensations during this stage, you and your therapist will revisit earlier phases of EMDR.
Further sessions can be focused on different parts of the traumatic memory that are left unprocessed. You and your therapist will know it’s time to move onto the last phases of EMDR therapy when you no longer have a physical response to the memory.
Phase 7: Closure
Though closure is one of the last steps listed, it is used at the end of each EMDR therapy session where reprocessing takes place. Since reprocessing can be emotionally and physically overwhelming, your therapist will help you get grounded before leaving the session.
Sometimes, you might be able to fully process a memory in a single session. However, there are many times when you and your therapist will need to close out a session before processing is complete.
Each therapist will use different methods during this part of the process, though mindfulness skills are a common practice. Your therapist will also remind you of grounding skills and stress reduction skills that you can use outside of session if you feel triggered before the next appointment.
Phase 8: Reevaluation
This is the last of the eight phases in EMDR therapy. Like closure, reevaluation is one of the EMDR steps that takes place during each session where you and your therapist engage in reprocessing.
During the reprocessing part of treatment, you and your therapist will start each new session with reevaluation. Here, you’ll check in about how you’re feeling since your last appointment. If you noticed feeling triggered, you’ll revisit the target event and continue the EMDR process until you feel better.
Imagine a better future with the help of EMDR in Tampa
If you’re interested in trying EMDR in Tampa, I’m here to be your guide through all eight phases. Together, we can help you achieve the inner peace you crave. Reach out today to get started.
Meet Ciara, Licensed Clinical Social Worker in Tampa, FL
No matter your journey to get here, I want to assure you that it's okay to not be okay. You deserve time and space to deal with your pain.
While trauma can fundamentally change you as a human being, it doesn't have to be a life sentence. I'm passionate about helping people heal from old wounds: whether that's childhood trauma, significant loss, or any other painful experience that makes it difficult to be the person you want to be.