The 8 Phases of EMDR Therapy

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If you’ve heard of EMDR, you might know it as a trauma therapy or more accurately, “that therapy with the eye movements.” EMDR stands for eye movement desensitization and reprocessing, and is primarily used for the treatment of trauma. But that’s not all!

EMDR is based on the idea that our memories hold the foundation of our core beliefs (what we believe is true about ourselves and the world around us). Often when an adverse event occurs, we store beliefs in our memories that help us to navigate future events. For example, when we are children, we learn not to touch the stove because it is unsafe. That’s adaptive! But sometimes events occur that lead us to unhelpful conclusions.

For example, someone may feel very unsafe driving a car after a major accident. Does that mean this person automatically has PTSD? No. It just means they have a belief that they are inherently unsafe when driving a car because of the information stored during the accident. The memory is not allowing them to move forward with their life because the limiting belief is holding them back.

So how would EMDR sessions work with something like this? Well, there are 8 phases:

1. In the first phase, the therapist takes a history with the individual to understand the memories that underlie the present issues. Then the therapist and client work together to organize what memories will be targeted during the sessions. This is also the part where the therapist checks for any barriers to treatment (for example, eye problems that could make it hard to follow the eye movements).

2. Many clients naturally feel nervous about reprocessing old memories because they have felt burdened by them for so long. The second phase helps to prepare clients for this by teaching calming skills. We guide clients in an assortment of different techniques to breathe easier and redirect their attention from whatever is causing the disturbance. We build these techniques to use later on if reprocessing does become overwhelming.

3. In phase 3, we choose a memory to work on and pinpoint what self-limiting belief has been associated with this memory. We also identify what the client would alternatively like to believe about themself. We also check in for other important factors, like how this memory makes the client feel emotionally and physically, and how much disturbance the memory causes. This is important, because our ultimate goal is to relieve the client of any lingering disturbance.

4. Once we’ve gathered this information, we start the reprocessing phase with eye movements. Picture a dot traveling back and forth horizontally across a screen. While the client follows the dot with their eyes, the therapist asks them to just notice what comes up in relation to the memory. The therapist stops every so often to check in about what the client is noticing and then guides the client back to following the dot.

The seemingly magical part of EMDR therapy happens during this fourth phase, but it’s not magic at all. Externally, the eye movements are there to help the client keep one foot in the present while their brain keeps the other foot in the past. When we expose our brains to information from the past, it will start with default beliefs such as “I am unsafe.”  But the brain is wired for survival and healing. We can only hold on to limiting beliefs for so long before our brains naturally start to connect more adaptive information. For example, the client who is afraid to drive might start by imagining the point of impact. But after successive eye movements, a thought might occur, such as “Is everyone unsafe while driving?” and a follow-up thought might be “If I don’t apply this rule to everyone else, why do I apply it to myself?” These insights naturally occur one after another until eventually the client is no longer disturbed or “desensitized” to the memory, and subsequently does not believe they are inherently unsafe while driving.

*I just want to caveat that the information in the previous paragraph can seem pretty unbelievable. I certainly did not think it would work before I tried it. EMDR is one of those “trust the process” type of therapies, but in my experience, and according to a lot of research, it works.

5. After the disturbance is released from the memory, we make sure the limiting belief no longer feels true. If it does, we can use the eye movements to help work through that. Then we switch to focusing on the belief the client hopes to have about themself. For the client who experienced a major accident, the adaptive belief might be: “I am safe.” In this 5th phase we use the association between the now desensitized memory and the new perspective to support the client’s new belief systems moving forward.

6. In phase 6, the therapist will check in for any lingering physical sensations that the client mentioned to us during the initial assessment. As Bessel Van Der Kolk’s work has taught us: “The Body Keeps The Score” and trauma often gets trapped in our bodies. EMDR therapists check for any remaining disturbance or tension that might have stayed with the memory. Then we use eye movements again to desensitize the body to those physical symptoms until they are completely released.

7. We don’t want you to leave therapy feeling rattled, so no matter what, this 7th phase will always be the last thing before you go! Often times, we do not get through all 8 phases of EMDR in one session, and we use the final minutes of session to help you re-center. This phase is called “closure” and we contain the work you have been doing with the memory so it has a place to go until next time.

8. This last (but also first) phase is called re-evaluation and it’s where we pick up after the sessions that were incomplete. In the following session, we will ask about any new insights you might have experienced related to the previous work. Once we’ve processed through that, we go back to the phase where we last left off.

Phew! It’s a lot, right? But don’t worry, you don’t need to memorize these phases. The therapist will know these steps and will be able to guide you through each one. The point of this is to give a brief overview of what actually happens during an EMDR session, because it can feel so mysterious (and kind of daunting) to so many people.

Do you still have questions about EMDR? Ask away in the comments!

Tune in next week for new insights!