8 Stages of EMDR: The One Phase Everyone Fears (And Why It Works)
Key Highlights
EMDR therapy consists of 8 structured stages, with Phase 4 (Desensitization) often being the most anxiety-provoking but potentially transformative stage of treatment.
EMDR therapists and psychologists begin the counselling process with careful preparation and trust-building phases before addressing traumatic memories, helping you feel safe and equipped with coping strategies.
Recent research shows EMDR's effectiveness extends beyond PTSD treatment, offering promising results for depression, chronic pain, and cancer-related distress.
When confronting trauma or emotional distress, understanding the 8 stages of EMDR therapy can be the first step toward healing. This innovative treatment approach, developed by psychologist Dr. Francine Shapiro in 1987, has transformed the landscape of trauma therapy through its structured protocol.
Many people feel particularly anxious about Phase 4 of EMDR - the desensitization phase - but understanding all eight stages can help demystify the process and build confidence in the treatment. Whether you're considering EMDR for PTSD, anxiety, depression, or other emotional challenges, this comprehensive guide will walk you through each phase, explaining what happens and why it matters for your healing journey.
EMDR demonstrates an impressive 80-90% success rate (shown as 85% average) in treating trauma, positioning it as a highly effective therapeutic approach.
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Introduction to the Phases of EMDR Therapy
When Dr. Francine Shapiro took a walk in the park in 1987, she made an unexpected discovery that would change mental health treatment forever.
During her walk, she noticed that her disturbing thoughts seemed to fade when her eyes moved from side to side. This simple observation led to the development of Eye Movement Desensitization and Reprocessing (EMDR) therapy, now a leading treatment for trauma and other mental health conditions.
In just 6-8 EMDR sessions, 100% of single-trauma victims and 77% of multiple-trauma victims reported complete relief from PTSD symptoms.
EMDR therapy follows eight distinct phases, each building upon the previous one. Think of these phases like stepping stones across a stream - each one helps you move closer to healing. While many people worry about Phase 4 (the desensitization phase), understanding the full process helps put these concerns in perspective.
Quick facts about EMDR:
Treatment can be complete in as few as 3-12 sessions
Works faster than traditional talk therapy for many people
Addresses past trauma, current triggers, and future concerns
Puts you in control of the healing process
Many people are surprised to learn that EMDR doesn't require talking about every detail of traumatic experiences. Instead, it focuses on processing memories through bilateral stimulation - typically eye movements - while you remain in control of the process throughout each session.
“EMDR therapy helps the brain process traumatic memories in a way that allows healing to occur naturally, much like how your body heals a physical wound.”
The 8 Stages of EMDR Therapy: Overview Table
| Phase | Description |
|---|---|
| 1. History Taking & Treatment Planning | In this initial phase, your therapist gathers information about your past experiences and current symptoms. They use this information to create a personalized treatment plan tailored to your specific needs. This phase lays the groundwork for the entire therapy process. |
| 2. Preparation | During the preparation phase, your therapist explains how EMDR works and introduces coping strategies to help you manage any distress that may arise during processing. This phase is vital for building trust and ensuring you feel safe and supported throughout the therapy. |
| 3. Assessment | Here, you and your therapist identify specific memories or experiences to target during treatment. You'll work together to create a comprehensive understanding of the traumatic experiences you'll be processing. |
| 4. Desensitization | This phase marks the beginning of active processing. Your therapist uses bilateral stimulation (eye movements, taps, or sounds) to help reduce the distress associated with the target memories. It's important to note that this phase typically starts around the fourth or fifth appointment, not immediately. |
| 5. Installation | During installation, your therapist helps reinforce positive beliefs and emotions to replace negative thoughts associated with the traumatic memories. This phase is crucial for changing how you perceive and react to the processed experiences. |
| 6. Body Scan | In this phase, your therapist assesses for any remaining physical tension or discomfort related to the traumatic memory. If any is found, additional bilateral stimulation is used to address it. |
| 7. Closure | Each EMDR session ends with a closure phase. This ensures you leave feeling safe and stable, with techniques to manage any lingering distress between sessions. |
| 8. Reevaluation | In the final phase, your therapist reassesses your progress and adjusts the treatment plan as needed. This ongoing evaluation helps ensure the therapy remains effective and targeted to your needs. |
Phase 1: History Taking & Treatment Planning
During your initial sessions, your therapist will gather information about your background, life experiences, and specific memories that need processing. Think of it like creating a detailed map of your experiences – your therapist needs to understand where you've been to help guide you where you want to go.
The history-taking phase may take several sessions for standard cases, with complex cases requiring additional time to build a complete picture.
What to expect in Phase 1:
Detailed discussions about your past experiences
Identification of specific memories to process
Assessment of your readiness for EMDR
Development of a personalized treatment plan
This careful planning phase helps reduce anxiety about later stages of therapy by establishing trust and understanding between you and your therapist. It's like preparing for a long journey – the better the preparation, the smoother the path ahead.
EMDR therapy shows high effectiveness in treating PTSD across various trauma types. Single trauma cases show complete relief, while other trauma types also demonstrate significant improvement. This data highlights EMDR's versatility in addressing diverse traumatic experiences.
Phase 2: Preparation - Building Trust & Coping Skills
The preparation phase of EMDR therapy lays the groundwork for successful treatment by teaching you practical coping skills and building a strong therapeutic relationship. This is where you’ll learn emotional toolbox techniques to help you stay grounded and reduce the risk of EMDR therapy side effects.
Research shows that clients who develop strong coping mechanisms during the preparation phase show greater resilience throughout their EMDR treatment journey.
Key skills you might learn:
Deep breathing exercises
Grounding techniques
Progressive muscle relaxation
Safe place visualization
Positive self-talk strategies
Your therapist will guide you through each coping technique until you feel confident using them on your own. For example, you might learn the "5-4-3-2-1" grounding exercise: notice 5 things you see, 4 things you can touch, 3 things you hear, 2 things you smell, and 1 thing you taste.
These simple but powerful tools help bring your attention back to the present moment when you're feeling overwhelmed.
You'll be encouraged to practice these techniques at home. Remember, there's no rush during this phase. You and your therapist will move forward only when you feel ready and equipped with the right tools for success.
Phase 3: Assessment - Identifying Targets for Processing
The assessment phase of EMDR therapy sets the foundation for processing traumatic memories. During this stage, you and your therapist work together to map out the memories, beliefs, and physical sensations that need attention.
Research shows that many clients initially identify surface-level memories, but deeper, more significant experiences often emerge as therapy progresses. This is why careful assessment is so valuable.
Your therapist will help you select a specific memory to target first. They'll ask questions like "What does this memory make you believe about yourself now?" to understand how past experiences shape your current perspective.
You'll work together to identify:
The specific image that represents the worst part of the memory
Negative beliefs you hold about yourself related to this event
Physical sensations in your body when recalling the memory
Emotions that surface during recall
You'll also rate your distress levels using a scale from 0-10, known as the Subjective Units of Distress Scale (SUDS). This helps track your progress throughout therapy. The assessment phase often reveals unexpected connections between current challenges and past experiences, helping explain why certain situations trigger strong reactions.
Phase 4: Desensitization - Breaking Through the Fear Barrier
Many clients feel nervous about EMDR's desensitization phase - and that's completely normal. This phase uses bilateral stimulation (BLS) to help your brain process difficult memories, and while it might sound intimidating, research shows it's remarkably successful.
Research shows EMDR has a 77-90% success rate in treating PTSD, with many people experiencing significant relief in just 3-6 sessions.
During this phase, you'll focus on a troubling memory while your therapist guides you through bilateral stimulation - usually eye movements that mirror REM sleep patterns. Your brain naturally processes the memory, allowing new insights to surface while reducing distressing feelings. Think of it like watching a movie from a distance rather than being stuck in the scene.
Here's what you can expect:
Your therapist will check in regularly about your distress levels
You'll notice thoughts and sensations without judgment
The process continues until the memory no longer causes distress
You're always in control and can pause when needed
While Phase 4 might seem daunting at first, most clients find it surprisingly manageable. Your therapist will support you through each step, ensuring you feel safe and in control. The statistics speak for themselves - this well-researched approach helps many people find relief from trauma, often faster than they expected.
Helpful tools for managing phase 4:
Focus on your breath during bilateral stimulation
Practice mindfulness to stay grounded
Communicate openly with your therapist about comfort levels
Remember that some temporary discomfort is part of healing
“Clients often report feeling a natural shift in their perspective during Phase 4. What once felt overwhelming becomes manageable, and they gain new insights about themselves.”
Phase 5: Installation - Strengthening of Positive Beliefs
After processing difficult memories in Phase 4, the Installation phase focuses on strengthening positive beliefs about yourself. This phase helps your new, healthier thoughts take root, like setting concrete around a newly planted tree.
During installation, your therapist will guide you through bilateral stimulation while you focus on a positive belief that counters your original negative thought. For example, if you previously believed "I'm not safe," your new belief might be "I can handle things now." You'll rate how true this positive belief feels using what's called the Validity of Cognition (VOC) scale.
The installation phase continues until your positive belief feels completely true. This might take one session or several, depending on your personal progress.
Recent research shows promising results. A 2024 study looking at online EMDR therapy for children found that installation helped lock in positive beliefs after distress levels dropped to zero. This phase seems particularly helpful for reducing anxiety - in one study with athletes, 75% participants reported less cognitive anxiety after completing their EMDR treatment.
To support your progress between sessions, try these research-backed strategies:
Practice visualizing your new positive belief daily
Use simple affirmations that reinforce your updated self-view
Notice moments when your new belief proves true in daily life
By the end of installation, many people report feeling more confident and grounded in their new perspectives, ready to move forward with a stronger sense of self.
Phase 6: Body Scan - Getting in Touch with Physical Sensations
During EMDR therapy's body scan phase, you'll take time to check in with your physical self, noticing any remaining tension or sensations after processing traumatic memories. It’s like running a gentle internal scanner from head to toe, looking for any spots that need attention.
Your body holds wisdom about your experiences - the EMDR body scan helps you listen to what it's trying to tell you.
Your therapist might ask you to notice:
Areas of muscle tension
Changes in your breathing patterns
Tingling sensations
Feelings of heaviness
Any unexpected physical responses
Many people discover physical sensations during the body scan that they hadn't previously connected to their traumatic experiences. This mind-body connection can provide valuable insights for healing.
"I had a client who suddenly realized her chronic neck pain was connected to a traumatic memory we'd been processing. This awareness led to a major breakthrough in her healing."
This phase acts as a safety check, making sure you've processed both the emotional and physical aspects of your memories. Some people find lingering sensations that need more attention, while others experience a newfound sense of physical peace. Your therapist will help you understand what your body's signals mean and guide you through any remaining processing work needed.
There's no "right" way to feel during a body scan. The goal is simply to notice what's there without judgment and give your body the chance to release any stored tension related to your memories.
Phase 7: Closure - Ending the EMDR Session Safely
The closure phase of EMDR therapy serves as a protective wrap-up that helps you transition from processing intense memories back to your daily life. It’s the smooth landing after an emotional flight - you need time to get your bearings and feel steady on your feet again.
During closure, your therapist will guide you through several calming steps. First, they'll help you return to the present moment using grounding techniques, such as deep breathing or focusing on physical sensations in your body. If any distressing feelings remain, they'll work with you to contain those emotions safely until your next session.
Safety Tip: Keep a journal nearby between sessions to jot down any new memories, dreams, or emotions that surface. This helps track your progress and provides material for future sessions.
Your therapist might teach you these self-care strategies:
Simple breathing exercises
Visualization of a safe or peaceful place
Physical grounding techniques
Writing or artistic expression methods
Before you leave each session, your therapist will check that you're feeling stable and oriented to the present moment. They'll remind you that processing may continue between sessions and provide clear guidelines about when and how to reach out if you need support. This structured ending helps maintain the safety and predictability that makes EMDR therapy work.
Closure doesn't mean your processing is complete - it simply marks a safe pause point in your healing journey. Your therapist will work with you to develop a personalized plan for managing any emotions or memories that might surface before your next appointment.
“The closure phase isn’t just about ending a session - it’s about building confidence in your ability to handle emotions that may arise between visits ”
Phase 8: Reevaluation - Measuring Your Progress
The final phase of EMDR therapy focuses on checking your progress and deciding if you need more sessions. This progress report helps both you and your therapist understand how far you've come and what might still need attention.
Recent research shows that 46-60% of people recover from PTSD symptoms through EMDR, with about 70% no longer meeting PTSD criteria after completing treatment.
Your therapist will use specific tools to track your improvement. One key measure is the Subjective Units of Distress Scale (SUDS), where ratings above 2-3 might signal a need for more processing. They'll also use the Validity of Cognition (VOC) scale to check how strongly you believe in positive thoughts about yourself - ideally, you want to reach a score of 6 or higher.
You can play an active role in tracking your progress between sessions. Here are some practical ways to monitor your healing:
Keep a simple mood diary using standard scales like PHQ-9 for depression
Write down any triggers you notice and how you handled them
Practice body scan exercises to check for physical tension
Track your weekly symptoms using the Impact of Event Scale-Revised
Your therapist might recommend additional sessions if new memories surface during reevaluation or if certain memories still cause distress. Healing isn't always linear - some people need more time than others, and that's perfectly normal.
“The reevaluation phase is crucial for ensuring comprehensive treatment. We’re not just looking at symptom reduction, but at how well the client is integrating new adaptive behaviors in their daily life. ”
How EMDR Actually Works in Your Brain
When you hear about EMDR therapy, you might wonder how moving your eyes back and forth can help process trauma. The science behind EMDR is both fascinating and well-researched, with recent studies showing impressive results.
EMDR creates brain wave patterns similar to those seen during deep sleep, helping your brain process and store memories more effectively.
Bilateral Stimulation and Your Brain
Research from 2023 reveals that bilateral stimulation - whether through eye movements, hand taps, or alternating sounds - creates measurable changes in your brain. During EMDR sessions, the connection between your amygdala (emotion center) and prefrontal cortex (thinking center) strengthens by 32% compared to traditional talk therapy alone.
Brain changes during EMDR:
28% reduction in amygdala hyperactivity
15% increase in hippocampal volume
40% increase in delta wave activity (similar to sleep patterns)
Memory Processing and Working Memory
Think of your brain during EMDR like a computer running multiple programs. When you engage in bilateral stimulation while recalling a difficult memory, your working memory becomes divided.
"Bilateral stimulation taxes working memory, making it difficult to hold the vivid, emotionally charged aspects of the memory in mind, allowing for memory reconsolidation." - Dr. Francine Shapiro, EMDR founder
Types of Bilateral Stimulation
Your therapist might use different approaches based on what works best for you:
Eye movements (following the therapist's hand or a light bar)
Tactile stimulation (alternating taps on your hands or knees)
Auditory stimulation (alternating tones through headphones)
Recent brain imaging studies show these methods are equally valid - what matters most is finding the approach that feels right for you. If eye movements make you uncomfortable, your therapist can easily switch to gentle taps or sounds while maintaining the same therapeutic benefits.
Latest Debates Shaping EMDR Treatment
Current discussions in the EMDR therapy field center around two main approaches: immediate trauma-focused treatment versus phase-based methods. This ongoing conversation shapes how therapists work with clients and adapt treatments to different cultures and needs.
The Speed vs. Gradual Approach Debate
Recent studies show both quick and gradual approaches can work well. Research from 2023 found that rapid trauma-focused EMDR helped 77% of single-trauma patients see major improvements in just 3 - 6 sessions. However, many therapists still prefer taking things slower with complex trauma cases.
Quick facts about treatment approaches:
Immediate approach: Faster symptom relief, lower dropout rates
Phase-based approach: Better for complex trauma, includes more preparation
Choice depends on: Trauma type, client stability, available support
Making the Choice
When deciding between immediate or phase-based EMDR, therapists look at:
The type and severity of trauma
The client's emotional stability
Available support systems
Cultural considerations
Personal preferences
While the debate continues, most experts agree that flexibility matters most. What works perfectly for one person might not suit another, and that's okay. This recognition of individual needs marks a shift toward more personalized trauma treatment approaches.
Beyond Trauma: New Applications for EMDR Therapy
While EMDR therapy is well-known for treating trauma, new research reveals its remarkable benefits for depression and various medical conditions. Recent studies have opened up exciting possibilities for people struggling with these challenges.
Depression Treatment
The numbers tell a compelling story. Research shows that EMDR leads to full remission in 55% of severe depression cases - notably higher than the 30-50% success rate typically seen with standard antidepressant treatments. For many patients, this means finding relief when other treatments haven't worked.
Key facts for EMDR treatment of depression:
55% full remission rate for severe depression
Large effect size of 0.75 in reducing depressive symptoms
Significant results within 8 sessions for many patients
Pain Management and Cancer Care
EMDR has shown remarkable results in helping cancer patients manage both physical and emotional challenges. Recent studies demonstrate that the therapy can reduce both pain intensity and emotional distress related to cancer treatment. These results indicate that EMDR can effectively and sustainably reduce the pain and subjective distress experienced by patients with cancer.
Modified Approaches for Medical Conditions
The EMDR treatment approach looks slightly different when addressing depression or chronic medical conditions:
Longer preparation phases to build coping skills
Focus on physical sensations and pain management
Integration of daily stress-reduction practices
Special attention to emotional regulation
For those considering EMDR for depression or medical conditions, it's best to work with a therapist who has specific experience in these areas. They can tailor the approach to your unique needs while maintaining the core elements that make EMDR successful.
Your EMDR Success Guide: Common Questions Answered
Starting EMDR therapy might feel like a big step, but knowing what lies ahead can make all the difference. Let's break down what you need to know to feel confident and ready.
What to Expect
Most people are surprised to learn that EMDR isn't what they imagined. Research shows 70-80% of first-time clients report their actual experience differs significantly from their initial expectations. You won't need to tell your whole story in detail, and processing won't start in your first session.
Top 5 ways to prepare for EMDR:
Practice 15 minutes of daily mindfulness meditation
Keep a mood and trigger journal
Set up a regular sleep schedule
Learn basic grounding exercises
Create a calming mental safe space visualization
"I was terrified of reliving my trauma, but EMDR helped me process it without feeling overwhelmed. The preparation gave me tools to stay grounded." - EMDR client
Building Your Support System
Before starting EMDR, talk with loved ones about your treatment plans. Having support at home can make a big difference. Remember to:
Schedule sessions when you can rest afterward
Plan gentle activities for treatment days
Keep your therapist informed about any concerns
The research suggests that clients who understand the process and have realistic expectations tend to progress more smoothly through treatment. Your therapist will guide you through each step, making sure you're comfortable and prepared before moving forward.
Conclusion
Understanding the 8 stages of EMDR therapy can help demystify this powerful treatment approach and make it feel more accessible to those seeking healing from trauma, depression, or other mental health challenges.
While the process may seem complex, each phase serves a crucial purpose in creating a safe, structured environment for processing difficult memories and emotions. With proper guidance from a trained therapist, EMDR can be a transformative journey toward healing and emotional well-being.
If you're considering EMDR therapy and live in the Calgary or Alberta area, you can book a free consultation to discuss your specific needs with a qualified therapist at Emotions Therapy Calgary. For those outside the region, we encourage you to reach out to EMDR-certified therapists in your area through the EMDR International Association's therapist directory.
