What to Expect in EMDR Therapy

Eye movement desensitization and reprocessing (EMDR) therapy can be highly effective in relieving distress and negative beliefs related to a traumatic experience. There are eight phases involved in standard EMDR therapy—not all of which occur during a single session, but typically over a period of sessions. How fast or slow one moves through the eight phases depends on several factors including how recently the trauma occurred, pre-trauma functioning, and one’s unique strengths and skills in tolerating distressing emotions, to name a few.

Below is a breakdown of each of the eight phases of EMDR therapy.

Phase 1: History and treatment planning

This typically occurs over the course of the first few sessions and involves your therapist gathering information about your own background and history. They may ask about family relationships, current stressors and symptoms, strengths and coping skills, and some brief information about the trauma(s) you’ve experienced and are hoping to address with EMDR. It also often involves a conversation about where you’re looking to get relief now. Most people have experienced a variety of distressing life experiences and it can be helpful to prioritize what seems to be getting in the way the most and begin there, resulting in some immediate relief and progress.

Phase 2: Preparation

The second phase is when your therapist will prepare you for trauma reprocessing. This involves providing some education and expectations of what EMDR might be like during the reprocessing phase. It also involves exploring your internal strengths and coping skills that you can use during sessions and daily in between session to help contain any distress. Your therapist might guide you through a few different exercises that help to ground, calm, and contain difficult emotions as they arise.

Phase 3: Assessment

This phase involves the therapist briefly asking you some questions about the memory that you will process. You’ll identify negative and positive beliefs associated with the memory as well as emotions and physical sensations. This sets the stage for where to start when it comes time to add in some eye movements or bilateral stimulation (BLS).

Phase 4: Desensitization

During the desensitization phase your therapist will guide you through several “sets” (typically 30 second-1 minute) intervals of eye movements or BLS. After each set you’ll be instructed to take a breath and briefly report to the therapist what you’re noticing. You’ll continue to do this until the original memory is no longer disturbing.

Phase 5: Installation

The installation phase involves connecting the trauma memory to more adaptive information already stored in your brain. This is where transformation around beliefs about the self in relation to the trauma can occur. For example, initially a person may have believed “It was my fault” and hopefully after installation that belief has transformed into something more adaptive or positive such as “I am not responsible for what happened.” The client and therapist work together collaboratively to help identify an adaptive belief that fits best with the traumatic experience.

Phase 6: Body scan

This phase involves scanning to body to observe or notice any body sensations or disturbance and to then engage in eye movements or BLS until there are no longer any physical sensations that are disturbing or uncomfortable. As we know, trauma is often stored in the body and this is a way to help assure that somatic symptoms are also resolved.

Phase 7: Closure 

Closure occurs at the end of every EMDR session, regardless of what phase you may be in when time is up, and the session is nearing the end. Closure can look different depending on what is needed to feel stable before formally ending the session. It can be a brief guided imagery or grounding exercise or one that involves putting the trauma in a “container” or on a “bookshelf” to re-visit at the next session.

Phase 8: Re-evaluation

Each EMDR session will typically start with a re-evaluation or check-in about what has come up since the last session. The therapist may also re-visit the memory that was addressed at the previous session and ask some brief questions about it to determine whether there is more processing to be done or whether it’s time to move to a new memory.