The 8 Phases of EMDR Therapy: What to Expect at Each Stage
Eye Movement Desensitisation and Reprocessing (EMDR) therapy is a structured, evidence-based psychological therapy that was originally developed to treat post-traumatic stress disorder (PTSD).
One thing that can be confusing when you first hear about EMDR therapy is that it isn't simply a technique involving eye movements. EMDR follows a structured eight-phase process, and the preparation and planning that happens before processing are an important part of the therapy.
The eight phases of EMDR therapy: What to Expect at Each Stage
The eight phases are a framework rather than a fixed timetable. You don't necessarily move through one phase in each session, and some phases may be revisited or overlap depending on what you need.
1. History Taking and Treatment Planning
The first phase involves understanding what has brought you to therapy, your history, what you would like help with and what you hope to achieve.
We look at the experiences and patterns that may be contributing to what you are experiencing now. This helps us develop a treatment plan and identify experiences, memories or current difficulties that may be useful to work with.
We also consider your current circumstances, resources and readiness for EMDR, including how you respond when things become emotionally difficult.
2. Preparation
Before beginning EMDR processing, we spend time making sure you understand how the therapy works and what to expect.
Preparation may include developing grounding and regulation strategies, identifying resources that help you feel more settled, and learning to notice emotions and sensations in your body.
We want you to have enough capacity to approach difficult emotions without becoming overwhelmed or losing your connection with the present. This includes being able to notice changes in your emotions and body.
We also consider what is happening in your life outside therapy, as this can affect how much preparation and support you need.
We want you to have enough support, safety and coping strategies around you that when you leave the therapy room, you have ways of coming back to the present and getting through the rest of your day.
Preparation can therefore involve learning skills that you may never have been taught before.
Preparation is not about making sure you never feel distressed. Difficult emotions are part of therapy. We are looking for enough stability and flexibility that you can approach difficult material while still being able to notice what is happening in the present and return to a steadier state when needed.
For some people, this phase is relatively brief. For others, it may take considerably longer.
3. Assessment
Once we are ready to begin working with a particular target, we identify what we are going to focus on.
This might be a particular memory or image, the negative belief you have about yourself, the emotions and body sensations connected with it, and what you would prefer to believe about yourself instead.
For example, a distressing memory might be connected with a belief such as:
An adaptive belief might be:
“I am good enough as I am.”
We also rate how disturbing the memory feels and how strongly you currently believe the adaptive belief. These ratings give us a way of noticing changes as the processing progresses.
4. Desensitisation
This is the part of EMDR that most people have heard about.
You focus on the target while using bilateral stimulation. This might involve following my fingers with your eyes, listening to alternating sounds, or using tactile stimulation such as buzzers or tapping.
You might remember something you hadn't thought about for a long time, notice a change in how the memory feels, or find that a different thought comes to mind.
You don't have to force anything to happen. I guide the process and help you stay connected to the present while noticing what comes up.
5. Installation
Once the distress associated with the target has reduced, we identify an adaptive belief you would like to hold about yourself in relation to what happened.
This might be something like:
“I am safe now.”
“I have choices.”
“I did the best I could.”
“I am good enough.”
We then strengthen this adaptive belief while holding the target in mind.
The aim isn't to simply replace a negative thought with a positive one. It's about developing a belief that feels more accurate and useful in relation to what you have experienced.
6. Body Scan
After the memory and adaptive belief have been worked with, you are asked to notice what is happening in your body.
You might notice tension, heaviness, discomfort, a change in your breathing, or another physical sensation.
If there is still a sense of physical disturbance connected with the target, we work with this as part of the processing.
Sometimes you may notice physical responses even when you consciously know that something is over.
7. Closure
EMDR processing doesn't always finish neatly within one session.
At the end of a session, we shift our attention back to the present and make sure you are sufficiently settled before leaving.
If processing isn't complete, we don't try to force it to a conclusion just because the session is ending. We talk about what may come up between sessions and what you can do if difficult emotions or memories arise.
8. Reevaluation
At the beginning of the next session, we check what has changed since the previous session and how you are experiencing the material now.
We look at whether the previous target still feels disturbing, whether anything new has emerged, and whether there are other memories, current situations or patterns that need attention.
This helps guide what we work on next.
Reevaluation is therefore not simply a final review at the end of therapy. It is an ongoing part of the EMDR process.
What does EMDR processing actually feel like?
There isn't one typical EMDR experience.
You might notice memories, images, emotions, physical sensations or thoughts changing as you move through a set of bilateral stimulation. Sometimes something unexpected comes to mind. Sometimes the memory becomes less emotionally charged. Sometimes you notice a new perspective on something that happened.
You don't need to make the processing happen or work out what everything means while it is happening.
My role is to guide the process, pay attention to how you are responding and help you stay within a manageable level of emotional activation.
Does EMDR always involve eye movements?
No.
Eye movements are one form of bilateral stimulation, but they are not the only option.
Bilateral stimulation can also involve alternating sounds or tactile stimulation such as buzzers or tapping. The type, speed and length of stimulation can be adjusted depending on what works best for you.
You can also pause or stop at any point.
Considering EMDR therapy?
If you're considering EMDR therapy in Adelaide or online across Australia, you can read more about EMDR therapy with Mel or get in touch to talk about whether it might be a suitable approach for you.
