EMDR stands for Eye Movement Desensitization and Reprocessing. EMDR therapy is a structured and evidence-based psychotherapy used primarily to treat trauma and post-traumatic stress disorder (PTSD). It helps individuals process distressing memories and reduce their emotional impact.
In this post, we’ll explore how EMDR therapy works and break down its key terminology. To demystify EMDR and its benefits, we’ll answer common questions and explain the terms used in this therapeutic approach.
Who Can Benefit from EMDR?
- Individuals with PTSD, anxiety, depression, and panic disorders
- Those who have experienced abuse, accidents, surgery, violence, or grief
- People with phobias, low self-esteem, and stress-related conditions
How does EMDR therapy work?
EMDR therapy begins with the EMDR therapist gathering information about an individual’s past traumatic experiences and identifying the target memories for treatment. They then take the following steps:
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Preparation: The therapist explains EMDR and helps the individual develop coping strategies.
Desensitisation: The client gradually and sensitively recalls distressing memories while engaging in bilateral stimulation, which helps reprocess the memory.
Reprocessing and Integration: Over multiple sessions, the brain reduces the emotional intensity of the memory, making it feel less disturbing.
Closure and Re-evaluation: The therapist ensures the client feels safe and can use coping techniques outside of sessions.
What is Bilateral Stimulation?
Bilateral stimulation (BLS) involves rhythmic, alternating stimulation of both sides of the body, which helps the brain reprocess traumatic memories and reduce emotional distress.
Types of Bilateral Stimulation in EMDR:
- Eye Movements – The therapist moves their fingers or a light bar from side to side, and the client follows with their eyes.
- Tactile Stimulation (Tapping) – The therapist or client taps alternately on the left and right sides of the body (e.g., knees, shoulders, or hands).
- Auditory Stimulation – Alternating sounds play through headphones, moving from one ear to the other.
What is SUDS?
SUDS (Subjective Units of Disturbance Scale) is a system used to measure the intensity of distress related to a traumatic memory. It helps track emotional changes throughout the reprocessing stage.
How SUDS Works in EMDR:
- Scale: Ranges from 0 (no distress) to 10 (maximum distress)
- Purpose: Used before, during, and after EMDR to assess progress
- Goal: Reduce the distress level associated with a memory to 0 or close to it
Example:
- Before processing: The client rates distress when recalling a traumatic memory (e.g. SUDS = 8).
- During bilateral stimulation, the therapist checks in on changes in SUDS scores.
- After reprocessing: The goal is to bring the intensity and SUDS score down (e.g. from 8 to 1 or 0).
SUDS helps both the therapist and individual track emotional relief and determine when a traumatic memory has been successfully processed.
What is VOC?
VOC (Validity of Cognition Scale) is another key tool in EMDR therapy used to measure how strongly an individual believes a positive statement (or “adaptive cognition”) about themselves in relation to a traumatic memory.
How VOC Works in EMDR:
- Scale: Ranges from 1 (“completely false”) to 7 (“completely true”)
- Purpose: Tracks how much an individual believes a positive cognition before, during, and after reprocessing
- Goal: Increase the belief in a positive, adaptive thought (ideally reaching 7)
Example:
- Identify a negative belief related to trauma (e.g. “I am powerless.”)
- Replace it with a positive belief (e.g. “I am in control now.”)
- Rate the belief’s validity using the VOC scale (e.g. initially, “I am in control now” = 3/7)
- Reprocess the traumatic memory with bilateral stimulation (BLS)
- Re-evaluate VOC – as the memory becomes less distressing, the belief in the positive cognition typically strengthens (e.g. “I am in control now” moves from 3 to 7)
VOC helps track cognitive shifts as an individual replaces negative self-perceptions with healthier, more empowering beliefs. The goal of EMDR is not just reducing distress (via SUDS) but also reinforcing positive self-beliefs (VOC).
What is a body scan in EMDRBody Scan The body scan in EMDR (Eye Movement Desensitisation and Reprocessing) is a vital step in the therapeutic process,... More about this therapy Therapy?
The Body Scan is a crucial final step in an EMDR session, used to detect and clear any remaining physical tension, discomfort, or distress associated with a reprocessed memory.
Purpose of the Body Scan:
- Ensures that no lingering physical sensations related to trauma remain.
- Helps integrate positive beliefs (validated by VOC) into both the mind and body.
- Completes the healing process by addressing body-stored trauma (often linked to the nervous system).
How the Body Scan Works in EMDR:
After reprocessing, when the distress level (SUDS) is low (0-1), and the positive cognition (VOC) is strong (ideally 7), the therapist asks the client to:
- Close their eyes. Bring up the target memory and the new positive belief (e.g. “I am safe now.”). Scan their entire body, from head to toe, noticing any tension, tightness, or discomfort.
- If any discomfort remains, it is processed with more bilateral stimulation until it clears.
- Once the body feels neutral or positive, the session moves to closure.
Why the Body Scan Matters:
Trauma is not just stored in the mind but also in the body. The body scan ensures that healing is fully integrated, preventing physical symptoms (like headaches, stomach tension, or tightness in the chest) from lingering.
What is Systematic Desensitisation?
Systematic desensitisation is a therapeutic technique used to gradually reduce emotional distress associated with traumatic memories, fears, or phobias. While it is commonly used in Cognitive Behavioural Therapy (CBT), aspects of systematic desensitisation are also present in EMDR therapy, particularly in the desensitisation phase.
How Systematic Desensitization Relates to EMDR:
- Gradual Exposure to the Traumatic Memory
- In EMDR, clients recall a distressing memory while engaging in bilateral stimulation.
- The memory is processed in small, manageable doses, allowing the brain to gradually reduce distress (similar to systematic desensitisation).
- Reduction of Emotional Intensity
- SUDS is used to track distress levels.
- With continued processing, the distress linked to the memory decreases until it feels neutral or manageable.
- Strengthening of Adaptive Responses
- Unlike traditional systematic desensitisation, where relaxation techniquesRelaxation Techniques in CBT Cognitive Behavioural Therapy (CBT) offers approaches to support individuals in managing their stress and anxiety. Relaxation... More about this therapy are paired with gradual exposure, EMDR replaces negative beliefs with positive cognitions (measured by VOC).
- This helps the individual reframe the experience in a healthier way.
While systematic desensitisation and EMDR share the goal of reducing distress, EMDR works faster by stimulating the brain’s natural processing abilities rather than relying solely on gradual exposure and relaxation.
How is EMDR Effective?
EMDR is founded on the idea that traumatic memories get “stuck” in the brain in a distressing way. Bilateral stimulation (eye movements or tapping) helps the brain reprocess these memories, making them feel less overwhelming. Many clients experience rapid improvements compared to traditional talk therapy.
We hope this post has helped clarify EMDR therapy and its key terminology. If you believe EMDR could support your healing journey, our trained therapists at Leone Centre are here to help. We offer online sessions, providing a safe and professional space for you to explore this transformative therapy. Get in touch today to learn more or schedule a session.
Find out more about Peter Bryant, the author of this post and one of our experienced EMDR therapists: Visit Peter’s Profile.
Book an EMDR session online by visiting the booking page and selecting option 7 for ONLINE – EMDR Individual Therapy.
- About the Author
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I am a passionate integrative psychotherapist and EMDR practitioner with experience across private practice, companies and the NHS. I enjoy providing solution-focused and practical therapeutic outcomes alongside a person-centred and humanistic approach.