Introduction: Understanding EMDR’s Structure and Power
Eye Movement Desensitization and Reprocessing (EMDR) therapy is more than eye movements — it’s a structured, eight-phase process that helps clients safely revisit traumatic memories and rewire how those experiences live in the brain.
Developed by Francine Shapiro, EMDR uses bilateral stimulation (BLS) — alternating left-right eye movements, sounds, or tactile sensations — to activate both hemispheres of the brain. This supports emotional processing and reduces distress linked to painful memories.
Whether you’re a therapist integrating EMDR into practice or a client curious about what to expect, this guide breaks down the 8 stages of EMDR therapy with clear explanations, examples, and tools you can use at each step.
Stage 1: History Taking & Treatment Planning
The first phase lays the foundation.
Therapists gather a thorough client history, identifying major themes, target memories, and triggers related to trauma, anxiety, or core beliefs.
Goals:
- Assess readiness and stability
- Identify targets (specific memories or experiences)
- Map out treatment priorities
🧠 Therapist Tip: Use a Case Conceptualization Worksheet to organize client history, triggers, and positive resources.
From Therapy Courses: 📄 EMDR Phases Worksheet – History & Target Planning (included in the EMDR Worksheet Bundle) helps clients describe life events clearly and safely.
Stage 2: Preparation & Stabilization
Before processing begins, clients must build emotional safety and grounding tools.
Therapists teach self-regulation and install positive resources such as the Safe or Calm Place.
Common Techniques:
- Breathing and grounding exercises
- Safe Place visualization
- Dual awareness skills (“I can notice this and still know I’m safe now”)
💬 Therapist Language:
“Before we begin processing trauma, we’ll practice staying grounded — so you can return to calm whenever you need.”
From Therapy Courses: 📄 EMDR Client handouts — includes safe place/ container worksheets, cognitions, infographics, SUDS/VOC + more.
Stage 3: Assessment
This phase defines what will be processed and how distress is measured.
Clients identify:
- The Target Memory (the specific event)
- The Negative Cognition (NC) (“I’m not safe,” “It’s my fault”)
- The Positive Cognition (PC) (“I did the best I could,” “I am safe now”)
- Emotions and Body Sensations linked to the memory
Therapists record:
- SUDs (Subjective Units of Distress) — 0 to 10 scale of distress
- VOC (Validity of Cognition) — 1 to 7 scale of how true the positive belief feels
📊 Example:
- NC: “I’m powerless.”
- PC: “I can protect myself now.”
- SUDs: 8 → VOC: 3
From Therapy Courses: 📄 EMDR Client handouts — includes worksheets, cognitions, infographics, SUDS/VOC + more.
Stage 4: Desensitization
This is the core reprocessing phase — where bilateral stimulation begins.
Clients recall the target memory while focusing on alternating eye movements, tones, or tactile sensations.
The goal is to reduce emotional charge and allow the brain to integrate new information.
Therapist’s Role:
- Maintain dual awareness (“part of you is here in the room, part is remembering”)
- Offer brief sets of BLS
- Pause regularly for feedback (“What do you notice now?”)
Tools for This Stage:
-
EMDR tappers, light bars, or auditory BLS
🧩 Tip: Keep sessions flexible — the process may move through unexpected memories or body sensations.
Stage 5: Installation
Once the distress linked to the memory decreases (SUDs drops near 0–2), the therapist helps strengthen the Positive Cognition (PC).
Clients pair their new belief (e.g., “I am safe now”) with the original memory using bilateral stimulation.
💬 Example:
“As you hold the thought ‘I am strong enough now,’ notice what you feel in your body as we continue the sets.”
📄 Worksheet Link: EMDR Client handouts — includes worksheets, cognitions, infographics, SUDS/VOC + more.
Stage 6: Body Scan
The therapist guides the client to close their eyes and mentally scan their body from head to toe while thinking of the target event and positive belief.
If any residual tension, numbness, or discomfort arises, short BLS sets are used to clear it.
Purpose:
- Ensure all traces of distress are resolved
- Reinforce body–mind integration
🪶 Tip: Encourage journaling immediately after — clients often notice subtle emotional releases here.
Stage 7: Closure
Every session ends with grounding — even if processing isn’t fully complete.
Therapists help clients return to stability and teach self-soothing strategies for between sessions.
Techniques:
- Deep breathing
- Tapping
- Visualization of the safe place
- Quick check-in of current SUDs
From Therapy Courses: 📄 Session Reflection Journal — clients document sensations, emotions, and insights between appointments.
Stage 8: Re-Evaluation
At the start of the next session, the therapist reviews what has changed:
- Does the memory still feel distressing?
- Does the positive belief feel true?
- Have new targets emerged?
This ongoing process ensures the client’s healing is fully integrated — not just symptom relief.
Putting It All Together: The EMDR Cycle
| Phase | Focus | Goal |
|---|---|---|
| 1 | History & Planning | Identify target memories and readiness |
| 2 | Preparation | Build safety and grounding |
| 3 | Assessment | Define target, beliefs, and emotions |
| 4 | Desensitization | Reprocess and reduce distress |
| 5 | Installation | Strengthen positive belief |
| 6 | Body Scan | Clear residual somatic tension |
| 7 | Closure | Re-ground after processing |
| 8 | Re-Evaluation | Review and integrate |
Recommended Tools for EMDR Sessions
Physical Tools:
- Tappers, buzzers, or light bars for BLS
- Audio stimulation systems
- Grounding objects or weighted blankets
Digital Tools:
- RemotEMDR or Easy EMDR (for telehealth)
- EMDR worksheet PDFs (for remote reflection)
Therapy Courses Worksheets Include:
- EMDR Phase Guide
- Safe Place Worksheet
- SUDs & VOC Tracker
- Positive Cognition Sheet
- Session Reflection Journal
All available in the EMDR Worksheet Bundle for Therapists.
Conclusion: Structured Healing That Meets the Nervous System
The eight stages of EMDR form a roadmap — moving from story and safety to release and re-integration.
When supported by the right tools, pacing, and worksheets, each session becomes a bridge between trauma and transformation.
Because EMDR isn’t just about desensitizing distress — it’s about restoring the mind’s natural ability to heal.
✅ Next Step for Therapists:
Explore the EMDR Worksheet Bundle for Therapists — includes phase-by-phase client forms, reflection pages, and therapist tracking sheets for seamless session flow.
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