Reviewed by Aamir Ranjha
If you have heard someone say EMDR helped them process a painful memory, you may wonder what actually happens in the therapy room. EMDR — Eye Movement Desensitization and Reprocessing — is a structured psychotherapy used most often for trauma and post-traumatic stress, and also for anxiety, grief, and other distressing experiences.
What makes EMDR different is its structure: a clear protocol of eight phases, developed by psychologist Francine Shapiro, who created EMDR in the late 1980s. The phases build on one another in order — you cannot skip ahead to the eye movements without doing the groundwork first, and the final phases make sure the work holds between sessions.
What Is EMDR Therapy?
EMDR is based on the idea that distressing memories can become “stuck” in the brain’s processing system. When a traumatic event is not fully processed, reminders of it can trigger the same emotions, body sensations, and beliefs as the original event — sometimes years later. EMDR uses bilateral stimulation, most commonly guided eye movements, while the client focuses briefly on the memory, helping the brain reprocess it so it feels less distressing.
EMDR is not hypnosis, and it does not erase memories — people who complete it generally still remember what happened. What changes is how the memory feels: the emotional charge softens, and negative beliefs such as “I am not safe” can shift toward more balanced ones, such as “I survived.”
The World Health Organization and the American Psychological Association recognize EMDR as an evidence-based treatment for post-traumatic stress disorder, though it is also used for other concerns.
Why EMDR Has 8 Phases
The eight phases work like a roadmap: the first three prepare the client and therapist for reprocessing, phases four through six are where reprocessing happens, and the final two make sure the client leaves sessions safely and progress is reviewed over time.
This structure matters for safety. Processing a traumatic memory can be emotionally intense, and the early phases ensure the client has coping skills and a strong therapeutic relationship before the harder work begins. A trained therapist will not rush this process. A single session may cover more than one phase, or one phase may stretch across several sessions.
Phase 1: History Taking and Treatment Planning
The first phase is an assessment. The therapist takes a thorough history — current concerns, past experiences, relationships, medical background, previous therapy — and together they identify the specific memories to target in treatment.
Not every painful memory becomes a target. The therapist and client prioritize the memories most connected to the client’s current symptoms — the accident itself, for example, for someone with PTSD from a car crash — and map out several targets when the history is longer.
This phase also screens for factors that could affect treatment, such as dissociative symptoms, substance use, or current safety concerns. If someone is in an unsafe situation, the therapist may recommend stabilizing that first. Phase 1 ends with a treatment plan: what will be worked on, and in what order.
Phase 2: Preparation
Phase 2 is where the therapist helps the client build coping resources. It is sometimes the longest phase, especially with complex trauma histories or limited daily support.
During preparation, the therapist explains how EMDR works, what reprocessing feels like, and what to expect between sessions — understanding the process often reduces anxiety. The therapist also teaches stabilization skills: grounding exercises, breathing techniques, and a guided imagery exercise often called the “safe place” — imagining a real or imagined place where the client feels calm, strengthened with sensory detail.
The safe place is a tool for sessions when processing becomes overwhelming, and between sessions when distressing feelings surface. The therapist also practices the bilateral stimulation in a low-stakes way, so the eye movements or tapping feel familiar before they are used with a real target memory. By the end of Phase 2, the client should feel ready — not necessarily unafraid, but equipped.
Phase 3: Assessment
In Phase 3, the therapist and client focus on one target memory, identifying several components:
- The image: the most distressing part of the memory, often a still image or a brief scene.
- The negative belief: the negative thought about oneself tied to the memory, such as “I am in danger.”
- The preferred positive belief: the belief the client would rather hold, such as “I am safe now.”
- The emotions: what feelings come up with the memory.
- The body sensation: where the distress is felt, such as tightness in the chest.
- Baseline ratings: how disturbing the memory feels and how true the positive belief feels, on simple scales used to track change.
Phase 3 is a setup phase: no eye movements yet, and by the end the target memory is clearly defined and ready for Phase 4.
Phase 4: Desensitization
Phase 4 is the phase most people picture when they think of EMDR. The client holds the target memory in mind — the image, the negative belief, the emotions, and the body sensations — while the therapist leads sets of bilateral stimulation, usually side-to-side eye movements following the therapist’s fingers, though some use alternating tones or gentle taps.
After each set, the therapist asks what the client notices — a new thought, a shift in the image, a change in feeling, or a different memory surfacing — and follows these associations, letting the client’s own processing guide the session. A key idea in EMDR: the therapist does not interpret the material or steer the client toward a conclusion. The client’s brain does the reprocessing work; the therapist facilitates it.
Desensitization continues until the memory no longer feels strongly distressing — until the client’s disturbance rating has dropped to a low level. This can happen within one session for a single-incident trauma, or take several sessions for more complex memories. New, related memories often surface here, and the therapist helps the client work through them.
Phase 5: Installation
Once distress around a memory has decreased, Phase 5 strengthens the positive belief from Phase 3. With more sets of bilateral stimulation, the therapist helps the client link the belief — “I am safe now,” for example — to the target memory until it feels as true as possible.
Installation is more than repeating an affirmation: the positive belief should feel genuinely connected to the memory — not just intellectually true but emotionally believable. The client rates how true it feels, and the work continues until that rating is as high as it can go.
Phase 6: Body Scan
Phase 6 is a check. The therapist asks the client to bring the target memory to mind with the positive belief and notice the body. If tension or discomfort remains, more sets of bilateral stimulation process it.
This reflects a core idea in EMDR: trauma is stored not only in thoughts and emotions but also in the body. A memory is not fully processed if the body still reacts strongly to it. If the scan is clear — the client can think of the memory with the positive belief and feel calm — the target is resolved.
Phase 7: Closure
Every EMDR session ends with Phase 7, whether or not the target is fully processed. Closure makes sure the client leaves the session in a stable state.
If reprocessing is incomplete, the therapist uses containment techniques to set the material aside until the next session — the safe place imagery from Phase 2, a grounding exercise, or a visualization of putting the memory into a container. Processing can continue between sessions — dreams, thoughts, or feelings related to the target may surface — so the therapist suggests keeping a brief log. No session ends with a client left in raw distress without support.
Phase 8: Reevaluation
Phase 8 happens at the start of the next session. The therapist checks how the previous target is holding up: has the distress stayed low, the positive belief stayed strong, and anything new come up?
If the target remains resolved, they move to the next target on the plan. If distress has returned or new material has surfaced, they return to the earlier phases. Reevaluation also tracks broader progress — symptoms, functioning, and daily life — repeating throughout treatment in a loop: assess, reprocess, install, check, close, reevaluate, and move forward.
How Long Does EMDR Take?
There is no fixed number of sessions — a responsible therapist will not promise one. A single-incident trauma in an otherwise stable adult may be resolved in relatively few sessions, while complex trauma often takes longer. Phase 2 alone varies widely: some clients need a session or two of preparation, others several weeks of stabilization.
What matters more than the number of sessions is the pace. Rushing through the phases, especially preparation, tends to make the work harder rather than faster. A good therapist checks in regularly and adjusts the plan as needed.
What to Expect in Your First EMDR Sessions
Your first few sessions will likely feel more like a conversation than anything else. Your therapist will ask about your history, explain the approach, and teach you coping skills before any reprocessing begins. You will not be asked to describe your trauma in detail — EMDR does not require lengthy retelling of the event.
Ask questions before you begin: what training your therapist has in EMDR, how they decide when a client is ready for reprocessing, and what they do if a session becomes overwhelming. A trained therapist will welcome these questions. Feeling a mix of hope and nervousness is normal.
If you are in crisis, help is available: in the United States, call or text 988 to reach the Suicide and Crisis Lifeline, free and available 24 hours a day.
Key Takeaways
- EMDR follows a structured eight-phase protocol, developed by Francine Shapiro: assessment and preparation, then reprocessing, then review.
- Phases 1–3 prepare the client and define the target; 4–6 do the reprocessing; 7–8 close sessions safely and reevaluate progress.
- In Phase 4, desensitization, bilateral stimulation is used while the client focuses on a distressing memory, letting the brain reprocess it so it feels less distressing.
- Preparation (Phase 2) is essential for safety, especially with complex trauma histories, and should never be rushed.
- A memory counts as resolved only when distress is low, the positive belief feels true, and the body scan is clear.
- Treatment length varies by person and trauma history, with the pace set collaboratively by client and therapist.
Frequently Asked Questions
How long does each phase of EMDR take?
It varies: assessment may take part of one session, preparation can span several, and a single session may cover more than one phase.
Do I have to describe my trauma in detail during EMDR?
No. EMDR does not require retelling the event in detail. You focus briefly on the memory — the image, the belief tied to it, and the body sensation — while the therapist guides the bilateral stimulation.
What does bilateral stimulation feel like?
Most commonly, you follow the therapist’s fingers with your eyes, moving side to side; some therapists use alternating sounds or gentle taps instead. Some find it relaxing, others mildly distracting at first — it usually becomes familiar quickly.
Is EMDR only for PTSD?
No, although PTSD is its best-established use. Therapists also use it for anxiety, grief, and phobias, with the same eight-phase protocol and a plan tailored to the individual.
What if I feel worse after an EMDR session?
Processing often continues between sessions, and some people notice temporary increases in dreams, thoughts, or emotions related to the target. Your therapist should explain this in advance and give you coping tools. If distress feels unmanageable, contact your therapist promptly — and if you are in crisis in the US, call or text 988.
This article is for informational purposes only and is not a substitute for professional mental health advice, diagnosis, or treatment. If you are considering EMDR, speak with a qualified, trained mental health professional.