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The 8 Phases of EMDR

Phase 1: History Taking and Treatment Planning

Phase 1 is the foundational stage of EMDR therapy. During this phase, the therapist establishes a strong therapeutic relationship with the client, gathers comprehensive information about their history and presenting concerns, and develops a tailored treatment plan.

Key components of Phase 1 include: 

  • Building Rapport: The therapist creates a safe and supportive environment to foster trust and open communication with the client.
  • History Taking: The therapist collects detailed information about the client’s life history, including significant traumatic events, current stressors, and any past or present mental health conditions.
  • Identifying Target Memories: The therapist and client collaboratively identify specific traumatic memories that are causing the most distress and negatively impacting the client’s present life.
  • Assessing Readiness: The therapist evaluates the client’s emotional stability, coping skills, and support system to determine their readiness for EMDR therapy.

Treatment Planning: Based on the gathered information, the therapist develops a personalized treatment plan, outlining the number of sessions, the specific target memories to be addressed, and the overall therapeutic goals.

Phase 2 is crucial for preparing the client for the more intense reprocessing phases. During this phase, the therapist focuses on:

  • Psychoeducation: The therapist explains the EMDR therapy process, including the use of bilateral stimulation, and addresses any concerns or questions the client may have.
  • Resource Development: The therapist helps the client identify and strengthen positive coping mechanisms, such as calming techniques, positive self-talk, and grounding exercises. This is essential for managing anxiety and distress that may arise during the reprocessing phases.
  • Stabilization: If the client is experiencing significant emotional distress or instability, the therapist may employ stabilization techniques, such as grounding exercises, deep breathing, or mindfulness meditation, to help them regulate their emotions.

By the end of Phase 2, the client should feel more prepared and confident to move forward with the reprocessing phases of EMDR therapy.

Phase 3 is a crucial step in the EMDR process where the therapist and client work together to identify and assess a specific traumatic memory or negative belief. This involves:

  • Identifying a Target Memory: The therapist and client collaboratively select a specific traumatic memory that is causing significant distress.
  • Assessing the Target Memory: The therapist asks a series of questions to activate the memory, including:
    • Negative Cognition: What negative belief or thought is associated with the memory?
    • Positive Cognition: What is a more positive belief or thought that could replace the negative one?
    • Physiological Sensations: What physical sensations are associated with the memory?
    • Emotions: What emotions are evoked by the memory?

By the end of Phase 3, the therapist and client have a clear understanding of the target memory and its associated negative beliefs, emotions, and physical sensations. This information will be used to guide the reprocessing phases of EMDR therapy.

During this phase, the therapist guides the client through a series of bilateral stimulation (BLS) sets, which can involve eye movements, tapping, or auditory tones. While the client focuses on the target memory, the BLS helps to activate the brain’s natural information processing system. This process allows the client to process the traumatic memory in a new way, reducing its emotional charge and associated distress.

As the client processes the memory, they may experience a range of emotions and sensations. The therapist remains present to provide support and guidance throughout the process.

In this phase, the therapist helps the client to strengthen and internalize the newly formed positive belief or cognition. This is done by focusing on the positive belief while continuing the bilateral stimulation. The goal is to make the positive belief feel more real and believable.

The therapist may ask the client to imagine future scenarios where they can apply the positive belief, further solidifying its integration into their cognitive and emotional framework.

In phase 6, the client systematically scans their body from head to toe, focusing on any residual physical sensations or tension related to the target memory. This process allows the client to release any remaining physical discomfort or emotional charge associated with the trauma.

The therapist may guide the client through the body scan, asking them to notice any sensations, such as tightness, pain, or numbness. As the client focuses on these sensations, the therapist may employ bilateral stimulation to help the client process and release the physical tension.

By the end of this phase, the client should feel a sense of physical and emotional release, with any lingering discomfort or tension significantly reduced or eliminated.

Phase 7 is the final phase of each EMDR session. Closure is designed to bring the session to a calm and grounded end. The therapist helps the client to transition back to the present moment and to stabilize their emotional state. This may involve grounding techniques, such as deep breathing or mindfulness exercises.

The goal of closure is to ensure that the client feels safe, centered, and ready to return to their daily activities. By providing a sense of completion and resolution, closure helps to consolidate the therapeutic gains made during the session.

In phase 8, the therapist and client reassess the target memory that was processed. They revisit the negative and positive cognitions, the associated emotions, and physical sensations. The goal is to determine if the processing has been successful and if the client’s distress levels have significantly decreased.

The therapist may ask the client to rate the Subjective Units of Distress (SUD) and the Validity of Cognition (VOC) again. If the SUD rating is still high, the therapist may decide to return to the desensitization phase for further processing.

If the SUD rating is low and the VOC is high, the client is ready to move on to the next target memory or to explore other areas of concern in their life.