The 8 phases of EMDR therapy

There are 8 parts to EMDR therapy known as phases. Below is a brief outline of each phase and what you can expect:

Phase 1 - History taking

AIM: to understand your history and personal life experience

we explore key events in your life (positive ones and those that have been more difficult)
we look at what associated beliefs you hold as a result of your experience and the feelings these create emotionally and somatically (in your body)
we talk about what your existing coping skills look like

This can take a couple of sessions to help build a clear picture together, there is never any pressure to share things before you feel ready to.

Phase 2 - Preparation

AIM: to ensure you understand the full therapy pathway and deep exploration into your self-soothing techniques, coping mechanisms for upset and stress

we look at your existing ‘toolkit’ and resources - healthy and those that are less so
we build on your current tools and add in new techniques to help promote feelings of safety and calm (you will need to practise these outside of our sessions)
I outline the potential side effects some people can experience (see FAQs for more info)

EMDR is intense and can bring up emotions and feelings that are unexpected. Therefore the preparation phase is really important and may also take more than one session to ensure you feel well equipped to manage feelings that are brought up and to maintain as much stability after and in between sessions.

Phases 3-7 are generally completed together in one session

Phase 3 - Assessment

AIM: to identify the specific memory to target with EMDR, the main negative belief associated with it and a positive belief of how you would like to feel about it

we work to create a snapshot that represents the worst part of the event/experience
you will identify a negative belief associated with the event and assign a rating of distress for this e.g. I am unsafe, I am under threat, I am responsible, I am to blame
you will identify a positive belief of how you want to feel and assign a rating of how believable this is e.g. I am safe, I am valuable, I matter, I am in control

In Phase 3, we open up the memory network so this can feel uncomfortable and increase physical and emotional reactions. The point of doing this isn’t to make you relive the event but to activate associated memories so they can all be processed.

Phase 4 - Desensitisation

AIM: this is where the active therapy takes place with the aim of helping you reframe the distressing memory and reduce the emotional charge and associated negative beliefs

you bring the snapshot to mind and I apply bi-lateral stimulation (BLS) whilst you allow your brain to go wherever it wants to in order to process the experience
the BLS is offered in sets and I regularly check in to see what you are noticing as your brain works through things
we track your emotions, thoughts and sensations and monitor the distress level you are experiencing whilst you process the event

As this is the active part of the therapy, it can feel strange and unexpected thoughts, feelings and images can come up. I will ask you to remain with these as much as you can so we can complete this, but we can pause if things feel too distressing and access some of the resources you will have practised as part of phase 2 (preparation).

This part of the therapy can take up to around 40 minutes, sometimes shorter or longer. You will be rating your distress level on the scale we used in phase 3 (assessment) and when you rate it low enough, or you feel neutral or that the emotional charge has significantly lessened towards it, we will move onto the next phase.

Sometimes processing with the BLS takes longer than the time we have available to us. In this case, I would pause the BLS leaving enough time in the session for us to ensure you feel calm and able to manage until the next session. Again, this would be using the resources and tools you have for self-containment and regulation.

Phase 5 - Installation

AIM: this is where we reintroduce the positive belief in order to help you move to more adaptive thoughts about yourself in connection with the target memory

you will already have decided on a positive belief, but after processing, sometimes this changes so I will check in with you if it still fits and it can be changed if not
BLS is applied again, at a slower pace than in phase 4 and with you thinking about the positive belief and what might stop it from being totally real and believable to you
I ask you to allow any feelings, thoughts, physical sensations and other observations to pass through your mind

We do several sets of slow BLS in this phase and you will rate your positive belief on the scale of 1-7. When it is as high as it can go, we pause at that point.

Phase 6 - Body Scan

AIM: this is a simple tool used to ensure there are no residual feelings or sensations within your body connected to the target event

you focus from your toes, up through your body to look and feel for any discomfort, tension or distress
you will connect with the target event as you do this to notice if you have any remaining unwanted reactions to it
If you feel adverse bodily reactions, emotional charge or tension, we reapply BLS for a few short sets

If there are residual experiences and we are running out of time in session, we will make a note of these with a view to addressing them in the next meeting.

Phase 7 - Closure

AIM: at the end of each EMDR session the closure will consist of ensuring you know your self-soothing techniques if they’re needed and ask you to maintain a record of any disturbances until the next session

we may do a relaxation activity together using things we have done in phase 2 (preparation)

Phase 8 - Re-evaluation

AIM: this is the formal check of what impacts the EMDR is having and whether there are other target events that need some attention

we review how your experience has been since completing the protocols
it is important that you are honest and clear about any positive or negative effects that you noticed between sessions
sometimes there are blocking beliefs that prevent EMDR from being successful and a good discussion in re-evaluation can help to identify these

Feeling overwhelmed during a session

EMDR can feel very intense and uncomfortable at times. This is why the preparation phase is so important. However, even when you feel fully ready to move into the active part of EMDR, there can still be moments where things feel very overwhelming. EMDR uses a technique called Pendulation to help support you if this happens. The diagram below explains this a little bit more.

The sessions are always at your pace, so at any point when it feels like you need to pause, this is what we do.

Booking an EMDR session

I can offer you a free 30 minute intro chat via phone or video call so I can get a bit more of an idea of what you’re looking for, you can find out more about me and ask any questions about EMDR.

I offer two other brief interventions that are designed to help people with managing traumatic events (see Flash & Rewind) so this conversation is useful as it may be that I can recommend you try one of these instead.

You can get in touch with me via my website or email me directly at thelisteninglane@gmail.com.

I also have professional profiles on the BACP and Counselling-Directory websites and you can message me from either of these too.

BACP => https://www.bacp.co.uk/profile/fe816d65-3990-e711-80e8-3863bb349ac0

Counselling-directory => https://www.counselling-directory.org.uk/counsellors/natasha-williamson

If you are interested in finding out more but prefer not to use the telephone or have video calls, please email or text me instead.