Phases of EMDR Therapy

Katy Kandaris-Weiner, LPC

Nearly every type of therapy is a process—healing isn't meant to happen overnight. For patients learning to work through trauma, this can be difficult process, and each therapy session may be used to accomplish different goals.

EMDR therapy help patients re-process their trauma using scientifically-proven bilateral stimulation. It uses eight different, distinct phases.

What is EMDR Therapy?

Eye Movement Desensitization and Reprocessing (EMDR), was developed in the 80s by American psychologist, Francine Shapiro. Together, with her work on the Adaptive Information Processing Model (AIP) and EMDR, she has been highly influential in the psychotherapy field and has helped many people improve their quality of life through her therapy techniques. 

EMDR therapy helps people heal from traumatic and distressing experiences by changing the way the memory is stored in the brain through the use of bilateral stimulation. It “rewires” the brain to have a different reaction to the same negative memory. Traumatic and “overwhelming” experiences are no longer disturbing.

Trauma and Memory

The brain has a natural healing process that allows it to make sense of an experience, then store it or let it go. 

Sometimes, when someone experiences a traumatic event, the memory of it does not get properly processed and stored. The memories of the trauma get stored in a neural pathway with the sensations and emotions that person felt during the incident. 

Our brains like to link new experiences to already established memory networks. It creates connections that help us learn, and grounds us. When an experience links to the memory network of the trauma, it can trigger all those distressing feelings as though it is happening again. 

How Does EMDR Therapy Work?

During EMDR therapy, the client thinks about that traumatic memory while exposed to some form of bilateral stimulation, which involves some form of stimuli (visual, auditory, or tactile) alternating from side to side of the client’s body. The stimulation happening at the same time as the memory reduces the intensity of the emotions tied to it, creating a calming effect. With repetition, the emotion and vividness tied to the memory is released and the brain is able to begin its natural healing process.

Once the negative emotions, sensations, and thoughts diminish, or even disappear when thinking about the incident, the client is able to begin thinking about the experience with a new, positive response that they choose to associate with it. 

The therapist continues to guide the client in bilateral stimulation while the client focuses their preferred response to the experience until it becomes ingrained.  

The 8 Phases of EMDR

Every individual partaking in EMDR therapy will go through these eight phases. The phases of EMDR are:

  • Planning treatment
  • Preparation
  • Assessment
  • Desensitization and Reprocessing
  • Installation
  • Body Scan
  • Closure and Stabilization
  • Re-evaluation

Each one contributes to the overall effect of the therapy, though not all phases are used in one session. Some are even repeated when necessary.

Phase 1: Planning Treatment 

The therapist will gather information about their client and their past to assess whether EMDR therapy is right for them. Together, the therapist and client develop a treatment plan, discuss targets in terms of past traumas, triggers, and goals for therapy and the future.

Phase 2: Preparation for EMDR   

The therapist explains the process of EMDR by going through it step-by-step. They’ll assess whether the client has the appropriate resources and ability to handle emotional distress, and teach them a few calming techniques. The therapist might have the client even practice elements of EMDR in this stage, such as eye movement or other bilateral stimulation. 

Phase 3: Assessment 

The therapist will guide the client through assessing the memory being addressed. This step will use both the Subjective Units of Disturbance (SUD) and the Validity of Cognition (VOC) scales to evaluate the emotional and cognitive elements associated with the memory before starting the therapy and during. The client will identify a visual image, negative thoughts or beliefs, and the emotions and body sensations associated with the memory.

Additionally, the client is tasked with creating a positive belief they would like to associate with the memory to replace the negative one.

Phase 4: Desensitization and Reprocessing 

In this phase, the therapist guides the client as they focus on the memory, or specific negative images, thoughts, emotions, or physical sensations attached to the trauma, while simultaneously engaging in some form of bilateral stimulation. While doing so, the client will share any new thoughts or feelings that may arise, and these new results will be the focus of the next round.

Phase 5: Installation

Once the client no longer reports distress in the mind or body related to the target memory, installation begins. This phase helps embed and strengthen the chosen positive thought the client wants to tie to the memory by focusing on only that positive thought. 

Phase 6: Body Scan 

In this phase, the client observes their body sensations when thinking of the memory to identify any residual distress that might be stored physically. 

Phase 7: Closure and Stabilization

This phase ends the session. If the target memory wasn’t fully worked through and processed, there are techniques to contain it until the following session to avoid discomfort and ensure safety of the client. The therapist talks the client through the expectations between sessions, and reminds them of the calming techniques. They might instruct the client to record any thoughts or feelings related to the memory that emerge between sessions. 

Phase 8: Re-evaluation and Next Steps

This phase begins at the start of the next session. The therapist will evaluate the mental state of the client, what progress has been made, discover if any new or related memories have emerged since the last session, and re-define the targets and goals.

Different Methods of EMDR

The original stimulus used when engaging in EMDR therapy was rapid eye movement to the left and right. Recently, it was discovered that the stimulus simply needed to be a bilateral stimulus, not necessarily eye movement. 

Eye movement is most commonly used, but auditory or tactile stimuli can be utilized as well. This could look like following someone’s finger left and right, wearing headphones with different tones playing back and forth between each ear, or being tapped (or prompted to tap something) on the right and left side. 

The timeline for EMDR therapy varies between individuals, their experience, and how they respond to the therapy. But typically, sessions are 30-90 minutes long with a total of 6-12 sessions. Results from EMDR therapy are usually significantly shorter than those of other therapy types.

Rewire So You Don’t Have to Relive 

By not processing your traumatic experiences and storing their memory with original sensations and emotions means that you relive the trauma each time the memory is triggered. With the help of in-person or virtual EMDR therapy, you may remember the experience, but your stress response is no longer activated. Remembering will no longer feel like reliving. 

Inner Balance Counseling has trained and certified EMDR and trauma therapists who can help you move on from the pain of your past into the joy of the present. Reach out so we can help guide you through your own personal journey of healing.

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Katy Kandaris-Weiner, LPC

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