Stages of EMDR Therapy

Stages of EMDR: What to Expect and How to Prepare

As an EMDR therapist, I often find myself explaining not just what EMDR is, but how it actually unfolds in the therapy room. EMDR stands for Eye Movement Desensitization and Reprocessing. It is a structured, evidence-based approach that helps people process traumatic events and stuck negative beliefs. Originally developed to treat post traumatic stress disorder (PTSD), EMDR is now widely used for anxiety, depression, grief, performance anxiety, and relational wounds.

What makes EMDR effective is its structure. It is not simply about talking through what happened. It is about helping the brain reprocess painful experiences so they are no longer stored with the same emotional charge. EMDR follows a clear sequence of stages that allow the work to move at a pace that feels contained and thoughtful.

It is important to say that what follows is a landscape of how EMDR sessions typically unfold. The timing, pacing, and overall duration of EMDR therapy are always determined collaboratively between you and your therapist. For someone with a single-incident trauma, such as a car accident or a traumatic birth, fewer sessions may be needed to significantly reduce symptoms. For someone with more complex trauma across their lifespan, the work is often slower and more layered. In those cases, the goal is gradual desensitization and integration, not moving quickly at the expense of safety. Establishing a grounded and secure therapeutic relationship comes first.

Below is a breakdown of what the process can look like.

What Are the Stages of EMDR

The EMDR process is made up of eight stages, also known as the phases of EMDR therapy. Each one plays a critical role in making sure that EMDR works effectively and safely.

Phase One: History Taking

This is where we begin. During the initial sessions, I learn more about your history, the challenges you’re facing, and any traumatic events or negative beliefs that may be contributing to your distress. We don’t jump into eye movements right away. Instead, we build a foundation and start to identify potential target memories we may work on later. This also includes looking at your current coping skills, relationships, and what support you have in place.

Phase Two: Preparation Phase

In this preparation phase, we focus on building your internal resources. That might include learning relaxation techniques, grounding skills, or visualizations that help you feel safe. This stage is also where we talk about how eye movement desensitization and reprocessing EMDR works, what to expect, and how you can communicate with me during a session. One of the goals here is to ensure you can manage any emotional discomfort that may arise.

Phase Three: Assessment Phase

The assessment phase is where we identify the specific components of a target memory that we’ll be working on. This includes the image associated with the memory, the negative belief you hold about yourself in relation to it, the positive belief you want to believe instead, and the emotions and body sensations that go with it. We also measure two important pieces:

  • Subjective Units of Disturbance (SUD): This measures how distressing the memory feels, on a scale of 0 to 10.

  • Validity of Cognition (VOC): This measures how true the positive belief feels to you, from 1 (not true at all) to 7 (feels completely true).

Phase Four: Desensitization

This is where eye movements come in. You focus on the target memory while following my fingers or a light moving side to side, or sometimes using auditory tones or tactile pulses. The goal is to reduce the emotional charge of the memory. Throughout this process, we check in on your SUD score to see how your level of distress changes. Sometimes your mind will jump to other related memories, which is a normal and welcome part of reprocessing.

Phase Five: Installation

Now that the distress around the memory has decreased, we work to strengthen the positive cognition. The goal here is to get that new belief to feel as real and solid as possible. I’ll ask you how true it feels now, using the VOC scale again. We want your new positive belief to feel completely true.

Phase Six: Body Scan

Even if your SUD is low and your VOC is high, we check the body. The body scan involves bringing the memory to mind and scanning for any body sensations that feel uncomfortable or unresolved. Sometimes the body holds on to stress or fear, even after the mind has shifted. This stage ensures your system is clear.

Phase Seven: Closure

At the end of every session, we make sure you feel grounded and safe. If the memory hasn’t been fully processed, we use techniques learned in the preparation phase to help you return to a calm state. We may revisit the same memory next time or move on to another.

Phase Eight: Reevaluation

In subsequent sessions, we review what we worked on and check whether the changes have stuck. Sometimes we need to revisit a memory or address new memories that surfaced. This helps us track your overall progress and adjust the treatment plan as needed.

How to Prepare for EMDR

Starting EMDR can feel like a big step, but a little preparation can go a long way. Here are a few things you can do to get ready.

Tip One: Reflect on Your Goals

Ask yourself why you are considering EMDR. Is it because of post traumatic stress disorder (PTSD)? Are you carrying around negative beliefs from your childhood? Or maybe you’ve noticed certain patterns in your relationships that you can’t seem to change. Being clear about your goals helps you and your therapist know where to begin.

Tip Two: Learn About the Process

Understanding the phases of EMDR therapy can make the process feel less intimidating. You don’t have to become an expert, but knowing terms like eye movements, SUD, VOC, and body scan can help you feel more confident in sessions. For example, you can read more about how EMDR compares to other therapies like what is cognitive behavioral therapy.

Tip Three: Practice Grounding Skills

Before you even begin EMDR, your therapist may teach you grounding techniques like breathing exercises or visualizations. Practicing these skills ahead of time helps you feel more in control if you become emotionally activated during a session.

Tip Four: Keep a Journal

Some clients find it helpful to track thoughts, dreams, or memories that pop up between sessions. This isn’t mandatory, but it can give you and your therapist insight into what your brain is working on, especially after a powerful reprocessing session.

Tip Five: Prioritize Rest and Self-Care

EMDR engages the nervous system. After sessions, give yourself space. Eat well, sleep, move gently, and limit unnecessary stress when possible.

EMDR can create meaningful change, but it is not rushed work. For some clients, especially those working through a single traumatic event, relief can come relatively quickly. For others with more complex or developmental trauma, the process unfolds gradually. We move at a pace that protects your nervous system and strengthens the therapeutic relationship along the way. The goal is not speed. The goal is lasting integration.

If you are considering EMDR and want to explore whether it is a good fit, we would be honored to support you.

To learn more about our approach, meet our EMDR therapists and read their individual bios here:
Kat Nazaroff, LCSW
Jill Tucker, LPC-S
Lauren Richardson, LMFT-Associate

You do not have to navigate trauma alone.

Jessica HaskellThe Flourishing Way