EMDR Therapy Chicago: What to Expect During EMDR Therapy and the 8 Phases of EMDR
How Does EMDR Work Through the 8 Phases of EMDR?
As a certified EMDR therapist, I'm often called when someone is looking for therapy to treat trauma, anxiety, stress, burnout, or feeling stuck in situations or patterns that are causing them distress. They may have heard about Eye Movement Desensitization and Reprocessing therapy (EMDR therapy) as a powerful treatment for trauma and other troubling symptoms or they know someone who benefitted from EMDR therapy. They are hopeful about the possibility of EMDR getting them unstuck from past experiences and helping them heal. Yet, they may not know what to expect from EMDR therapy or how EMDR is different from more traditional “talk therapy.” In most cases, they are not familiar with the eight phases of EMDR therapy.
What is EMDR Therapy?
EMDR therapy is a therapy approach that differs from talk therapy because EMDR uses spoken language as only one part of its process. EMDR combines talking with guided movements to explore and change brain connections and body responses. EMDR uses language, neural connections, and physical responses to support healing in a holistic way.
What are the 8 Phases of EMDR therapy?
EMDR consists of eight phases designed to help with the complete processing of challenging experiences that contribute to unhealthy or distressing symptoms in the present. Understanding the eight phases of EMDR will demystify the EMDR therapy process and help you know what to expect during EMDR therapy.
To illustrate how the eight phases of EMDR might look in practice, I’ll use an example of a motivated and high-achieving adult struggling to effectively care for a child who has high support needs. It's important to note that this is a general example. Actual traumatic incidents or experiences can vary greatly. EMDR therapy can support people in addressing their unique challenges, processing trauma, and cultivating adaptive beliefs that empower their personal sense of agency, resilience, and goal attainment.
EMDR Phase 1: History Taking
The first phase of EMDR therapy is the history-taking phase. This phase will look a lot like the initial sessions of traditional talk therapy. History taking involves the therapist asking questions and gathering information about the person's history related to the problem or issue that they've come to therapy to address, as well as a broader history of the individual.
In the example of a motivated and high-achieving parent of a child with special needs or high needs, history-taking might include learning about the parent's own childhood; their educational and work experiences; their journey to becoming a parent; their parenting philosophies and values; their challenges and triumphs parenting their high needs child and any other children; their relationships and sources for support; and significant past and present stressors or traumas such as encountering challenges within the education or healthcare systems while advocating for their child's needs, or being overwhelmed by the demands of advocating for their child.
History-taking helps the therapist notice possible patterns or factors that might contribute to the person's reason for seeking out therapy. It also helps build the therapeutic relationship as the therapist and the individual get to know one another and gain comfort with each other. Because EMDR is often used to process challenging or traumatic experiences, it can be important to develop a connection with the therapist that feels safe and has an element of trust before venturing into the deeper, active phases of EMDR. It is also useful for the therapist to gain a better understanding of the person to help the therapist track and support the individual’s reactions as they go through the later phases of EMDR therapy.
EMDR Phase 2: Preparation
The second phase of EMDR therapy is referred to as the preparation phase.
The history-taking in phase one often includes learning what the person has tried in the past to cope with their symptoms when the problem is more active. These coping strategies are often their best attempts to manage their distress. Sometimes these behaviors are healthy and helpful, but often inadequate to manage the full range of their symptoms. Many times, these strategies include some thoughts or behaviors that contribute to secondary harm to the person, their life, or their relationships. For instance, the parent may at times cope with feelings of overwhelming anxiety or anger by lashing out at their partner, children, or people at work. They may isolate themselves from friends or family or devote excessive time to their job. They may numb their feelings with substances or distractions in ways that have become excessive or dangerous.
Phase two focuses on teaching and practicing a range of skills to help the person notice and identify when and how their body and mind signal to them that they are becoming activated by stress or by traumatic experiences. It supports them in recognizing their level of activation. Phase two helps them know how to respond in healthy ways that are accessible to them, effective for them, and aligned with their values.
Phase two is an essential phase designed to build a solid foundation so that the person can monitor and manage their emotional and behavioral responses. This helps them prepare for the work of the later phases so that they do not become overwhelmed by their responses or motivated to use calming or coping strategies that may be detrimental to them. The skills developed in phase two are used during and between sessions once the active processing begins.
EMDR Phase 3: Assessment
The third phase of EMDR therapy is the assessment phase. In phase three the therapist works with the person to identify an event or experience that they would like to process or a pattern of behaviors that they would like to address with EMDR therapy. In the example, the person might want to address feeling enraged, avoidant, or overwhelmed when faced with the task of advocating for their child’s needs to be understood and supported at school, in the community, with various professionals, or within their circle of family or friends.
Once the target event or behavior is chosen, the therapist guides the person to focus on images, beliefs, feelings, or sensations associated with the experience. The therapist helps them identify and label the root, or core, negative belief that they connect with the incident. In the example of this parent, the core belief may be “I am powerless and incapable of achieving my goals.” Before starting processing, they are asked to rate the level of distress they feel when thinking about the experience and this belief.
In addition to focusing on the negative beliefs associated with the experience, the therapist also helps them identify a more positive thought or feeling that they would like to associate with the experience following processing. In this example, the desired belief may be something like, “I have the power and ability to achieve my goals.” A rating for the strength of that belief is also taken before processing starts.
EMDR Phase 4: Desensitization
The fourth phase of the EMDR is the desensitization phase. This is the start of the active processing in EMDR to explore and rewire connections in the brain and body to support healing.
This phase introduces bilateral stimulation (BLS), or stimulation to the left and right sides of the body. Using eye movements, sounds, or other actions to activate both sides of the body also engages both hemispheres of the brain. Involving the non-verbal, emotionally focused, right hemisphere of the brain and the analytical, verbal, solution-focused, left hemisphere of the brain supports whole-brain and whole-body processing and healing. BLS is also used to calm the amygdala, which is part of the brain that processes fearful and threatening stimuli and other emotions and connects emotions to memories, senses, and learning (1). Calming the amygdala helps the brain feel safe during the therapy session while exploring, reprocessing, and rewiring the neurological connections related to the targeted experience.
Throughout EMDR phase four, the therapist monitors and guides the individual. The therapist moves them back and forth through moments of focusing on the past or future and connecting to a grounded sense of regulation and safety in the present moment. Ratings of distress are taken throughout this phase to track changes. The desensitization phase continues until the entire experience has been processed and neutralized. By the end of phase four, focusing on the identified event or memory no longer causes significant distress when paired with the negative core belief, in this case, “I am powerless and incapable of achieving my goals.”
EMDR Phase 5: Installation
Phase Five of EMDR is the installation phase. Once the negative beliefs and associations with the experience are desensitized, phase five works to strengthen the positive belief that the individual wants to have when they think about the targeted experience. In this example, when the parent is in situations where they are advocating for their child or thinking about their child’s needs being met, they would feel connected to the belief, “I have the power and ability to achieve my goals." Bilateral stimulation is used in phase five for shorter intervals of time. This phase continues until the individual feels a strong association between the event and the positive belief.
EMDR Phase 6: Body Scan
The sixth phase of EMDR is the body scan phase. In this phase, the person thinks about the target memory or event while also focusing on the positive belief. In this example, the person would focus on the thought, “I have the power and ability to achieve my goals.”
The therapist guides them to turn their attention to the physical feelings and reactions within their body as they think about the incident and the newly strengthened positive belief. Brief periods of BLS are used in this phase, alternating with body scans until all lingering physical sensations are neutralized. This phase works to clear any remaining associations with the traumatic thoughts or memory that are held within the body as tension, pain, or other uncomfortable physical sensations.
EMDR Phase 7: Closure
The seventh phase of EMDR. Is the closure phase. This phase happens at the end of every EMDR session, even if an experience or event being targeted hasn't been fully processed within that session. The purpose of the closure phase is to make sure that the person is in a calm and regulated state at the end of each session. This regulation may involve using some of the calming or coping strategies from phase two and reminding them to use these and other self-care strategies as needed between sessions.
Once a targeted event or pattern has been fully processed within a single session or after multiple sessions, the therapist will confirm that the person feels neutral about the processed incident. The therapist will verify that the positive belief feels completely true. They will also verify that the body is completely clear of signs of disturbance related to that event.
EMDR Phase 8: Re-evaluation
The final phase of EMDR phase eight is the re-evaluation phase. This is a check-in and monitoring process that happens in the sessions that follow the complete processing of a memory or event.
The re-evaluation phase focuses on assessing progress by monitoring how the person is feeling in their day-to-day life and how they are responding differently to other events, memories, or experiences related to the incident that was processed or the identified core beliefs. Phase eight monitors their anxiety, stress, trauma, burnout, and other relevant symptoms to see if there are changes in their day-to-day life. In our example, the individual may report that they felt calmer and less panicked when they got a call from their child’s school and were able to clearly explain their thoughts about what was contributing to their child’s struggles and ask for specific supports to be provided.
This reevaluation phase is also an opportunity to see if there are other incidents in connection to the problem area or core belief that may need processing. It is also a chance to consider other areas or experiences in the person’s life that they would like to address with EMDR.
How Long Does EMDR Take?
The eight phases of EMDR are designed to support a person to complete the processing of stuck memories or experiences from the past that are negatively influencing their reactions in the present. The eight phases provide a framework for the EMDR process and an idea of what to expect from EMDR therapy. Because every person is different and their experiences, brain and body connections, stressors, and coping and support resources are different, there is no way to predict the timeline for moving through each of the eight phases.
As a general rule, targeting single incident (acute) traumas such as a specific accident, assault, or natural disaster in the absence of any other significant trauma history will be a faster process than addressing prolonged (complex) traumas such as abusive relationships, neglect, war or combat trauma, or other chronic or prolonged events. Additionally, it may take longer to treat an acute trauma that involved a person who already had a history of other traumatic experiences. Although the eight phases of EMDR take some time to complete, the ability to reprocess and heal trauma that has affected months, years, and even decades of a person’s life is powerful and transformative; opening up endless possibilities for their future.
Get Started with EMDR Therapy Chicago and Online EMDR Therapy
If you are curious about EMDR therapy or ready to start EMDR therapy today, contact me for a free 15-minute phone consultation to discuss your questions and needs and whether I may be able to help. I am a certified EMDR therapist who provides EMDR therapy to people in Chicago and along the North Shore at Shore Therapy Center, as well as virtual EMDR therapy online to individuals all throughout Illinois and to over 35 states across the U.S. through online therapy. I specialize in therapy for trauma and PTSD including online trauma therapy; therapy for parent burnout and caregiver burnout; and treating anxiety, stress, and trauma among marginalized groups including affirmative therapy for the LGBTQIA+ community and neurodivergent folks.
For more information about EMDR therapy, including answers to frequently asked questions, keep reading. If you are ready to start EMDR therapy discover how to find a qualified EMDR therapist and important questions to ask before choosing an EMDR therapist.
professional, Cleveland Clinic medical. “The Amygdala: A Small Part of Your Brain’s Biggest Abilities.” Cleveland Clinic. Accessed 15 July 2023.
