8 Phases of EMDR Therapy Demystified
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Reaching out to an EMDR therapist can be nerve-wracking!
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Reaching out to a therapist or starting therapy can be an intimidating process. I find that often people are interested in or want to try EMDR therapy but are unsure what to expect. In this article, I break down the Standard Protocol for EMDR therapy and what they typically look like with me as an EMDR therapist. Please be aware that some phases take longer than one session, and some will be repeated. In some cases, some clients benefit from a modified approach to this Standard Protocol, and that’s okay too! Everyone's treatment will vary and can look different, but this gives a general breakdown and idea of what to expect with EMDR therapy with me.
If you are looking for a more general breakdown of what to expect from EMDR therapy, conditions that benefit from EMDR therapy, and the risks and benefits, check out this article.
The Prep Phases (Phase 1 and Phase 2)
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Phase 1 - History Taking
In this phase, I am trying to understand what triggers the client is currently dealing with. Are they feeling anxious in social situations, work situations, or both? Are they having flashbacks or nightmares? What spurs them into bouts of anxiety or depression? I also want to understand what parts of their past have informed how they feel now. Did they experience something big and traumatic or maybe a bunch of "small t" traumas? What was their family like growing up? How did their relationships impact their anxiety or depression levels? And, of course, a vital step to all this is understanding where they want to get to. How do they want to feel after therapy is said and done? What in their lives do they want to see be different? I find that I can get a general history from a client in one to two sessions, but that to truly help the client feel comfortable and get a real sense of their experience, this can take longer.
Phase 2 - Resource Building
I often will blend this phase into the history-taking phase as the client, and I determine what coping skills and resources may be helpful. This phase is about seeing what types of resources the client needs, developing them, and "installing" them with tapping. This helps the body get a felt sense of the resource. For example, if the client is overwhelmed with stress and anxiety, developing a place they can visit to feel calm is helpful. This is like a mini-vacation that taps into the use of mindfulness and visualization. Another resource I love to help clients develop is a container, where they can safely store situations that are creating a sense of anxiety or stress. This is also done with visualization, but the effect is powerful! Depending on what the client needs and how stable they feel coming into therapy, resourcing and history taking can last for a handful of sessions. The goal is that they feel capable of handling distressing situations when we start reprocessing painful memories.
The Trauma Processing Phases (Phases 3 and 4)
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Phase 3 - Memory Activation
After a thorough history taking and building a felt sense of resources, we look at what memory needs to be reprocessed. In this phase, we bring that memory to the surface by looking at the worst image, the negative belief, body sensations, and what the client would rather believe. This is done as the first step to reprocessing.
Phase 4 - Desensitization
After activating the memory, we start phase 4. This is where I guide clients to use eye movements or tapping while thinking of the memory. In this phase, the client is just noticing what comes up while moving their eyes or tapping. It's also good if the client can try and stay away from judging their experience. The brain will bring up what it needs to. After a set of eye movements, I will pause the client and ask what they notice, and the client can share a brief explanation of what came up. If need be, we can redirect back to that initial memory, or I might give a reflection, but for the most part, I am allowing your brain to process how it needs. These pauses mainly ensure the client stays on track, and I can offer help if they feel stuck. This is the second step to reprocessing. As reprocessing occurs, the goal is for the level of distress to go down and for the client to notice new perspectives and possibilities, naturally working their way to an alternative belief. Depending on the target and the client, this can sometimes take several sessions.
Winding Down for the Closing of Session (Phases 5-7)
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Phase 5 - Installation
If the client works their way to a positive belief held over that memory in that session and feels little to no distress, we move into phase 5. In this phase, we work to strengthen the connection with positive belief. This is like resource building but is tapping into the natural positive shifts the client has experienced during that session.
Phase 6 - Body Scan
After focusing on this positive belief, I will ask clients to scan their bodies from the tops of their heads to the tips of their toes and see if there is any sensation, positive or negative. If negative, it can be further processed, and if positive, it can be installed as a felt resource for the body and brain.
Phase 7 - Closure
This phase is done whether or not the client experienced resolution to processing the target memory. Remember that phase 4 can take several sessions. In this phase, I help the client close down that memory and return to their center. In this phase, it's helpful for clients to visit one or more of the resources we already built, so they can leave the session feeling grounded.
What Happens in the Next EMDR Therapy Session?
Phase 8 - Re-evaluation
This phase occurs in the session after the processing and is to help me re-evaluate how life has been since the last session. How did the client feel after processing? Did they feel refreshed and find new insights, or did they feel dysregulated? This helps to tell me if we need to do more work on resourcing or if longer sessions are needed to process a target more fully. This takes a few minutes at the start of the session. At this point, we decide if the best course of action is to continue focusing on the memory that was being processed last session or if we move forward.
And there you have it - the 8 phases of EMDR therapy! I hope this has helped clarify and gain insight into what EMDR therapy can look like and has eased some anxiety. If you are looking for an EMDR therapist in the Tampa area or virtually through Florida, please reach out for a free 15-minute consultation. I'd be happy to discuss if EMDR therapy is the right fit for you.
Kandace Ledergerber, EMDR Therapist Tampa FL
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About the Author
Kandace Ledergerber (she/her) is an Licensed Mental Health Counselor in the state of Florida trained in EMDR therapy and as a Registered Yoga Teacher. She focuses on helping adults who have experienced trauma find relief from constant triggers that send them into overwhelm, anxiety and stress. When she’s not helping clients find healing from trauma, she enjoys being with her family, going on hikes when it’s cool out and practicing yoga.
