EMDR: A Symptom-Based, Eight-Phased Treatment

A troubled man looks at his therapistTen years into being trained in eye movement desensitization and reprocessing (EMDR), I am still amazed by its ability to transform a life filled with trauma, anxiety, and hypervigilance into one of presence, mindfulness, and relief. Clients and clinicians often find themselves confused about EMDR, and I would like to address what is meant by symptom-based and eight-phased trauma treatment.

Symptom-Based Protocol
EMDR is a treatment modality that is research driven and well known for its ability to reduce symptoms associated with posttraumatic stress (PTSD), and your therapist may recommend it to relieve your symptoms associated with PTSD. EMDR clinicians around the world are finding, in clinical practice, that it is also effective for addressing an even wider range of symptoms, especially those rooted in the events of the past.

With this in mind, EMDR is what you could call a symptom-based protocol. This means that EMDR therapists focus on how your present experience is rooted in old stuff, even things that you think that you are over. We look at how the symptoms you have in the present mimic, or cluster, around those events in that past.

Trauma is tricky and can disguise itself as many things. An EMDR therapist will review your symptoms and review how your current thoughts, emotions, beliefs about yourself, and physical sensations may be related to disturbing life events and traumas from the past. Depending on when your EMDR therapist was trained, he or she may have different ways of asking you to prioritize and list what events are still contributing to your symptoms.

Even though you may not believe that those events from the past are really a big deal, they are still locked in your nervous system in what is termed a state-dependent form. Often, they are not completely processed and healed, like a record stuck in a groove. As time progresses, the record turns; it still plays, but the disturbance repeats itself over an over again, until the scratch is healed.

An Eight-Phased Treatment Model
Often mistakenly viewed as an intervention, EMDR is an inclusive treatment modality, one that includes eight comprehensive treatment phases. Each phase is a unique and necessary part of the approach. It is imperative that your EMDR therapist walk you through each of the eight phases. While they can be circular, and you may go back and forth between them, each phase will help you as you complete the therapy. The eight phases include history taking, preparation, assessment, desensitization, installation, body scan, closure, and reevaluation. Unfortunately, EMDR has become known primarily for its desensitization phase, which is what people often confuse as the sole part of the therapy.

With this knowledge, those of you who are seeing an EMDR therapist can inquire where you are in the process, what phase you are in, or how you will prioritize the events from the past to work on them. You can also find out what symptoms you are focusing on and how the past relates to them. I often find that the more my clients know about each phase, the safer they feel and the more they feel they are part of the process.

If you have general questions about EMDR, please post them. Keep in mind that I can’t speak about your clinical work or therapy or provide clinical advice. I will try to cover your questions about the treatment in future blog posts.

© Copyright 2010 by Sarah Jenkins. All Rights Reserved. Permission to publish granted to GoodTherapy.org.

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

  • Leave a Comment
  • Claire Blake

    April 29th, 2010 at 2:15 AM

    I have never heard of EMDR treatment before but it seems way more logical for treating PTSD than the ecstasy treatment that was cited several articles ago. I am anxious to learn more about the methodology of the treatment. Sounds like it could be a very promising thing for those who suffer from this disorder.

  • harry

    April 29th, 2010 at 7:07 AM

    there are things that we may have forgotten because we do not consider them to be important but they may be rooted deep in our minds and our brain may not have actually ‘deleted’ those things.this kind of a situation is a tricky one and if something happens to us that is similar to or related to such a memory,only then do we actually recall that particular incident.because such a recall is not easy and is not under our control,EMDR comes to such a person’s aid in actually getting to know what old memory is having an effect on the person’s present self.

  • Becky K.

    April 29th, 2010 at 11:16 AM

    we are often so involved with the present that we may not even be able to recall what we did last monday!it happens to a lot of us and even though the solution to some of our problems may be in the past,we cannot make use of the solution…simply because we do not remember the particular moment!

  • Sarah Jenkins

    May 18th, 2010 at 4:23 PM

    The comments that you all are making really link to the fact that our bodies remember, and can be “stuck” in the past, even if we are really focusing on the present. Harry, I often give folks computer analogies when discussing trauma treatment, especially via EMDR. We have to “de-fragment” how the body stored the trauma, and reprocess it to reach a more adaptive conclusion. As you mentioned, Becky, we may not recall the past, or we might. But, either way, the present is still impacted by it. The body, the nervous system, is accessed via EMDR, and its eight phases, to help release the past’s hold on us. So, I will certainly make sure to share more about it as I add more entries!

    Thanks for your comments everyone…


  • sharon

    December 29th, 2011 at 10:22 AM

    what does it mean when a therapist is a level two in the emdr method does it mean that the therapist is not finished learning or what

  • Joe Fr

    June 8th, 2013 at 7:02 AM

    I had a professor trained I EMDR. I became a devotee. Fast forward, 2012, I was attending a VA mental health conference and queried the medical director as to why we couldn’t be using this modality for veterans in Minneapolis. He stated the VA hadn’t recognized it as an approved therapy. So, any idea as to when the VA might consider this for our vets?

  • Sarah Jenkins

    July 10th, 2013 at 2:19 PM

    Hi Joe – there is a great article in the Huffington Post on this very topic and about this very question of yours! This may provide you with some more details as well… huffingtonpost.com/mark-c-russell-phd-abpp/veterans-denied-access-to_b_1541442.html


    June 17th, 2021 at 2:24 PM

    How do I find a therapist. How do I know if EMDR is for me?

  • Sara GT

    June 18th, 2021 at 6:16 AM

    Hi Alicia, Here are suggestions for finding a therapist! You can start by entering your city or ZIP code into the search field on this page: https://www.goodtherapy.org/find-therapist.html. Once you enter your information, a list will be provided of therapists and counselors who meet your criteria. You may click to view our members’ full profiles and contact the therapists themselves for more information. If you need help finding a therapist, you are welcome to call us. We are in the office Monday through Friday from 8:00 a.m. to 4:00 p.m. Mountain Time, and our phone number is 888-563-2112 ext 3. Kind regards, The GoodTherapy Team

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