Glossary of EMDR Terms
The following glossary of terms defines the core elements of EMDR treatment. The glossary provides definitions for words or phrases that may be unfamiliar or have specialized or technical meaning. EMDRIA™ acknowledges that the terms in this glossary continue to be refined, and future revision will be necessary.
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A
An abreaction occurs when a client accesses overwhelming sensations and emotions during reprocessing. An abreaction is considered a normal, potential part of the processing of any given target. It should not be considered mandatory or unnecessary but accepted as a potential effect of client reprocessing of dysfunctional information. The EMDR treatment is not considered to be the cause of the distress, but a natural response to activated neural networks (Shapiro, 2018).
The psychological impact experienced when adapting to a new culture, often including identity conflict, isolation, and pressure to assimilate.
Trauma resulting from a single incident.
The Adaptive Information Processing (AIP model) is the underlying theoretical model of EMDR therapy. It guides clinical practice, explains psychopathology, and predicts EMDR treatment effects. One of the important premises of the AIP model is that the body has an intrinsic capacity for psychological self-healing. The AIP model hypothesizes that current difficulties are caused by disturbing experiences that are inadequately processed and improperly linked memories that hinder our brain’s ability to process information. The AIP model provides a framework for treatment, understanding development of pathology, making associations, coming to a resolution, and guiding future actions.
The AIP model explains that clients are not biologically broken but rather overwhelmed by past experiences and circumstances. Effective reprocessing of disturbing experiences using EMDR treatment can reduce or eliminate symptoms by accessing neuro-physiological networks that contain adaptive information and allow for a more positive and empowering view of self in relationship to past events. Treatment results and improvement in one’s mental health are posited to be the byproduct of adaptive reprocessing.
When an event has been sufficiently reprocessed, clients remember it but do not experience the old emotions or sensations in the present. Clients are informed by their memories, not controlled by them (Shapiro, 2018).
A self-report tool used to assess exposure to 10 types of traumatic or stressful events during childhood (before age 18), including abuse, neglect, and household dysfunction. The questionnaire helps identify individuals at risk for long-term health and psychological challenges associated with early adversity.
Difficulty managing emotional responses to situations or stress.
The affect scan is used when early memories are not accessible to the client (perhaps they took place at an extremely young age) and/or if clients struggle to verbalize their negative thoughts and feelings. It can also be used during reprocessing when a client is stuck in an emotional state, and bilateral stimulation does not help to shift that state. The client notices emotions and sensations in their body and scans back to an earlier time when they felt this way before.
An EMDRIA Consultant™ or EMDRIA Approved Consultant In Training™ (CIT) provides consultation or assistance during the practicum at an EMDRIA™ Approved Basic Training under the guidance of the EMDR Trainer™.
The emotional bond formed between individuals, particularly between children and caregivers, which can be impacted by trauma.
B
A self-report tool designed to assess positive, protective experiences during childhood, such as supportive relationships and safe environments, that can foster resilience and mitigate the effects of trauma. It helps identify factors that contribute to emotional well-being and mental health despite adversity.
Bilateral Stimulation (BLS) in EMDR Treatment typically means alternating lateral (side-to-side) eye movements and/or alternating auditory or tactile stimulation, which has been shown to enhance information reprocessing (Amano, T., & Toichi, M., 2016; Hase, 2021; Laliotis et al., 2021).
Blocking is when a client has difficulties or obstacles when reprocessing a memory in spite of the use of dual bilateral stimulation (eye movements, tactile or auditory stimuli). Examples of blocking include blocking beliefs, looping, overwhelming sensations, reports of no change despite high disturbance rates, etc.
Blocking beliefs are dysfunctional client perspectives (beliefs) that appear to block reprocessing of traumatic memories effectively. Entrenched blocking beliefs, such as “My needs don’t matter” or “I am permanently damaged,” can interfere with memory reprocessing. They are viewed as maladaptive beliefs that were learned from past life experiences.
Key features of this phase include:
- After the positive cognition has been fully installed, the client is asked to hold in mind both the target event and the positive cognition and to scan her body mentally from top to bottom.
- The client identifies any residual disturbance in the form of body sensation.
- The therapist continues bilateral stimulation when these bodily sensations are present until the client reports only neutral or positive sensations.
- This is an important phase and can reveal areas of tension or resistance that were previously hidden.
C
Channels of association refer to the various pathways through which a target memory connects to related experiences, sensations, emotions, images, and/or beliefs. These connections might be revealed in consciousness during the reprocessing of EMDR therapy. Reprocessing of these channels is evident when the forms of information (such as images, emotions, thoughts, sounds, sensations, or beliefs) change while the client focuses on the target memory. Some clients experience these shifts through the awareness of related events or a series of insights. Many clients experience different associations between sessions. The clinician should provide appropriate reassurances for the client's comfort when needed but should also aim to let the reprocessing proceed without unnecessary interference (Shapiro, 2018).
Trauma resulting from repeated and prolonged exposure to highly stressful events.
Key features of this phase include:
- The client must be returned to a state of emotional equilibrium by the end of each session, whether or not the reprocessing is complete.
- Shifts client's focus of attention away from memory work and reorients to present-day context. The therapist may use a variety of techniques to orient the client fully to the present and facilitate the client's stability after the session and between sessions.
- Clients are prepared for the possibility of continued processing and the use of stabilization strategies as needed.
- The clinician should reassure the client that any disturbing images, thoughts, or emotions that arise between sessions indicate ongoing processing, which is a positive indication.
- The client is advised to maintain a log or journal to record thoughts, situations, dreams, and memories that may arise between sessions. This enables the client to create distance from emotional disturbances through writing. The client takes a “snapshot” that might be used as targets for the upcoming sessions.
Trauma experienced by a group of people, community, or society, often due to war, disaster, or systemic violence.
Collective, culturally grounded processes that address trauma through shared rituals, storytelling, ceremony, and support.
Exposure to multiple, varied traumatic events, often of an invasive, interpersonal nature, typically over a long period.
A lifelong process of self-reflection and learning, acknowledging power imbalances and striving to understand and respect clients’ cultural identities and experiences.
Creating a therapeutic environment where clients feel safe expressing their cultural identity without fear of discrimination or judgment.
The impact of historical and systemic oppression, marginalization, or violence experienced by a group, affecting collective identity and functioning.
D
An approach to healing that centers indigenous, ancestral, and non-Western ways of knowing, being, and healing; often a response to the limitations of traditional Western models.
Key features of this phase include:
- Begin eye movement (or other BLS) sets.
- Focus on the client’s negative affect, as reflected in the SUD scale. This phase of treatment encompasses all responses, including new insights and associations, regardless of whether the client’s distress level is increasing, decreasing, or stationary.
- Initiate processing of the target memory. The therapist asks the patient to focus simultaneously on the image, the negative cognition, and the body sensation.
- Use sets of dual attention Bilateral stimulation to activate the client’s information processing
- During the desensitization phase, the clinician repeats the sets, with appropriate variations and changes of focus, if necessary, until the client’s SUD level is reduced to 0 or 1 (or is otherwise “ecologically appropriate” to the individual given his present circumstances). A zero or 1 SUD indicates that the primary dysfunction involving the targeted event has been cleared. However, reprocessing is still incomplete, and the information will need to be addressed further in the crucial remaining phases.
The memory is activated, and the clinician asks the client to notice his/her experiences while the clinician provides alternating bilateral stimulation. After each set of bilateral stimulation, the client reports their observations. These may include new insights, associations, information, and emotional, sensory, somatic, or behavioral shifts. The clinician uses specific procedures and interweaves if processing is blocked. The desensitization phase continues until the SUD level is reduced to zero (or an ecologically valid rating). It is important during this phase to assist the individual in maintaining an appropriate level of arousal and affect tolerance.
Trauma experienced in childhood that affects physical, emotional, cognitive, and social development.
Dissociation is a mental disconnection from one’s thoughts, emotions, memories, body, sense of self, or sense of identity. It is often a protective mechanism that develops in response to trauma, enabling individuals to distance themselves from overwhelming or traumatic experiences. It is typically the downregulation version of an abreaction. While it can be adaptive in the short term, unresolved dissociation can interfere with trauma reprocessing.
Dual attention refers to maintaining two different states of awareness while performing multiple tasks simultaneously. The dual task of moving one's eyes while focusing on a trauma memory has been shown to enhance information reprocessing (Schubert, Lee, & Drummond, 2011).
Dual attention bilateral stimulation is the process of engaging the client in bilateral eye movements, tactile, and/or auditory stimulation while simultaneously concentrating on a specific targeted memory and related associations. This stimulation is thought to activate and enhance the innate information-processing system.
Terminology for this feature of EMDR has changed over the years. Shapiro's 1995 textbook refers to bilateral stimulation; Shapiro’s 2001 book renames it to dual attention stimulation; and Shapiro’s 2018 textbook combines the terms when describing bilateral stimulation.
E
EMDR therapy consists of eight phases:
- Phase one: History Taking and Treatment Planning
- Phase two: Preparation
- Phase three: Target Assessment
- Phase four: Desensitization
- Phase five: Installation
- Phase six: Body Scan
- Phase seven: Closure
- Phase eight: Reevaluation
The number of sessions and the time of the session dedicated to each phase varies greatly from client to client.
Eye Movement Desensitization (EMD) is the original form of what later became Eye Movement Desensitization and Reprocessing (EMDR) therapy. EMD was developed by Francine Shapiro in the late 1980s. It was initially designed as a structured protocol to reduce the emotional distress associated with traumatic memories. The key difference between EMD and EMDR is that EMD focuses on reducing distress while EMDR is a more comprehensive approach that integrates adaptive memory reprocessing and broader therapeutic goals. Shapiro expanded EMD into the EMDR therapy model after recognizing that clients not only experienced symptom reduction but also changes in their beliefs and emotional responses related to trauma (Shapiro, 2018).
EMDR psychotherapy is a trauma-informed comprehensive application of EMDR treatment that:
- Addresses the complete clinical picture of the whole person, including individual, relational, environmental, and behavioral domains.
- Treats a broad range of presenting symptoms, for example, trauma, low self-esteem, attachment issues, developmental deficits, and/or other personal characteristics that are mutually established as goals for treatment across different diagnostic categories.
- Regards the relational component of the therapeutic alliance is an integral part of the therapy and is a collaborative process between the provider and the client.
- Incorporates EMDR treatment protocols and EMDR derived techniques as part of a comprehensive treatment plan.
- Incorporates the standard application of the Eight Phases and the Three-Pronged Approach to identify and reprocess (a) Memories of past adverse life experiences that underlie present problems, (b) Present-day situations that elicit disturbance and trigger maladaptive responses, and (c) Anticipatory future scenarios that require adaptive responses.
- Optimizes the client’s capacity to respond adaptively to life challenges while building/restoring resilience and promoting personal growth.
- Based on EMDR interventions, theoretical principles, definitions, and methodologies.
- Based on the Adaptive Information Processing (AIP) model.
- Administered by a licensed, registered, and appropriately credentialed clinician* trained by an EMDRIA™-recognized training body in EMDR interventions.
* May vary depending on the country and the practitioners' national regulations.
EMDR treatment is the broad term used to describe the umbrella encompassing EMDR psychotherapy, EMDR treatment protocols, and EMDR derived techniques. They are used in various contexts and treatment settings with diverse populations and are integrative, client-centered, and based on neurobiological principles and established theory. They are rooted in the Adaptive Information Processing model (AIP), which provides the theoretical framework and principles for treatment.
EMDR treatment protocols are structured protocol interventions that include the following:
- Applies to individuals or groups.
- Treatments for specific disorders or symptoms or address special clinical situations or specific populations.
- The goal of partial or complete reprocessing of memories that contribute to the client’s presenting problems.
- Use as a stand-alone brief intervention or supplement to a more comprehensive psychotherapy.
- Incorporation of phase-based interventions.
- Consistency with EMDR intervention theoretical principles, definitions, and methodologies.
- Based on the Adaptive Information Processing (AIP) model.
- Considered evidence-based once the protocol has undergone rigorous research standards and shown consistently positive outcomes.
- Some EMDR treatment protocols also qualify as an EMDR-derived techniques.
- Must be administered by a licensed, registered, and appropriately credentialed clinician* trained by an EMDRIA™-recognized training body in EMDR interventions.
* May vary depending on the country and the practitioners' national regulations.
EMDR-derived techniques are techniques that include elements of EMDR treatment that include the following:
- Applies to individuals or groups.
- Use as either stand-alone brief interventions or as supplements to EMDR psychotherapy or protocols.
- It may have one or more purposes in the desensitization of a disturbing memory or part of a memory to reduce distress.
- It may be used to increase stability, improve capacity for emotional self-regulation, prepare for memory reprocessing, and/or strengthen positive experiences.
- It may be used as part of a clinical assessment to evaluate client motivation and readiness as well as the client’s emotional capacity to respond to memory processing demands.
- Consistent with EMDR intervention’s theoretical principles, definitions, and methodologies.
- Consistent with the Adaptive Information Processing (AIP) model.
- It is only considered evidence-based once the technique has undergone rigorous research standards and shown consistently positive outcomes.
- Some EMDR-derived techniques also qualify as EMDR Treatment Protocols.
- Can be used in the field and in clinical sessions by either a licensed, registered, or appropriately credentialed clinician* or an appropriately trained paraprofessional.**
* May vary depending on the country and the practitioners' national regulations.
** May vary depending on the country, the practitioners' national regulations, and the EMDR-derived technique used.
The EMDR International Association (EMDRIA™) is a 501(c)(6) non-profit professional association dedicated to the highest standards of excellence and integrity in EMDR therapy. EMDRIA™ is the original membership organization for EMDR therapists. To achieve its purposes, EMDRIA™ works to advance the education, practice, and science of EMDR therapy; to establish and uphold standards of practice, training, certification, and research; to provide information, education, and advocacy regarding EMDR therapy; to assist practitioners in fulfilling their responsibilities with to the public.
An EMDRIA™ Approved Basic Training provides clinicians with the knowledge and skills to use EMDR therapy, a comprehensive understanding of case conceptualization and treatment planning, and the ability to integrate EMDR therapy into their clinical practice. An EMDRIA™ Approved Basic Training provides, at a minimum, instruction in the current explanatory model, methodology, and underlying mechanisms of EMDR through instruction, practice, and integrated consultation.
In addition to already being an EMDRIA Certified Therapist™, an EMDRIA Consultant™ has three years of experience with EMDR after completing an EMDRIA™ Approved EMDR Training Program, has conducted at least 300 clinical sessions in which EMDR was used, has received more a minimum of 20 hours of consultation-of-consultation, and has been recommended by one or more EMDRIA Consultant™ to receive this credential. An EMDRIA Consultant™ must complete 12 hours of continuing education in EMDR every two years to continue to hold this credential.
An EMDRIA Certified Therapist™ who has completed the online CIT Declaration Form and begins working towards the EMDRIA Approved Consultant™ credential. A Consultant in Training (CIT) receives consultation-of-consultation by an EMDRIA Consultant™. During this process, the EMDRIA Approved Consultant™ provides direction and input regarding the CITs skills and ability as a consultant.
A mental health clinician who is fully licensed to engage in private, independent practice has completed an EMDRIA Approved EMDR Training in its entirety and has completed the requirements for certification.
EMDRIA™ Approved Workshops meet the goals and objectives outlined by EMDRIA™ for continuing education for EMDR-trained professionals.
An EMDRIA™ Credit Provider oversees and handles all the administrative and organizational aspects of advanced EMDR workshops. EMDRIA™ Credit Providers maintain responsibility for all their programs and agree to adhere to EMDRIA™ policies, requirements, and standards.
A mental health clinician who is either licensed in their profession or working toward licensure in their profession and who has completed an EMDRIA™ Approved EMDR Basic Training.
EMDRIA Approved Consultant™ that EMDRIA™ has approved to teach EMDR therapy Basic Trainings.
EMDRIA™ is organized to promote, foster, and preserve the highest standard of excellence and integrity in Eye Movement Desensitization and Reprocessing (EMDR) practice for the membership, for the mental health professions, and for the community which shall be served by the mental health professions.
EMDRIA’s vision is to foster healing, health, and hope by defining, disseminating, and promoting standards and innovations in EMDR therapy and trauma-informed care.
F
An earlier memory that contributes to a client’s current problem and blocks the reprocessing of other memories. Feeder memories can be identified using direct questioning, floatback, or affect scan, and targeting them can get the processing moving again.
A flashforward refers to a distressing or catastrophic future-oriented thought or image that triggers anxiety, fear, or avoidance. It is an irrational and anticipatory imagined scenario of something bad happening in the future (Logie, R.D.J. & Jongh, A.D., 2014).
An approach used to identify an earlier memory that might be causing current difficulties but is not accessible via direct questioning. The client recalls a recent distressing experience, along with its associated negative beliefs and bodily sensations. Then, they allow their mind to float back to an earlier time when they were in a similar psychological or physiological state. (Young, Zangwill, & Behary, 2002).
The future template is a procedure developed to incorporate client-centered desired and appropriate actions for possible future events. The clinician and client work together to envision how the client would ideally perceive, feel, act, and think as they move forward in a possible future situation. A positive future template for various social situations can be integrated to address any client's deficits or needs, such as assertiveness, boundary setting, etc. Imagining positive outcomes appears to facilitate the learning process.
For instance, after a trigger has been effectively reprocessed and adequate education provided, the clinician instructs the client: “I’d like you to imagine yourself coping effectively with a similar situation in the future. With the new positive belief [ ] and a feeling of [ ] (e.g., calm, confidence), imagine stepping into this scene. Notice how you handle the situation and what you’re thinking, feeling, and experiencing in your body.” After a pause, the clinician asks, “What are you noticing?”
G
Strategies used to help individuals stay connected to the present moment and reduce dissociation or distress.
H
Cumulative emotional and psychological wounds passed down across generations within a specific cultural group, caused by massive group trauma (e.g., genocide, slavery, colonization, displacement).
Key features in this phase include:
- Establish a therapeutic alliance.
- Identify client's reasons for seeking treatment and goals.
- Gather information about disturbing/traumatic and other adverse life experiences with attention to pacing and the client's capacity to disclose.
- Gather information about the client’s resources and positive life experiences.
- Assess the client’s readiness for EMDR reprocessing.
- Assess possible client’s psychological needs during and after the session.
- Formulate an AIP understanding of the client’s problem.
- Develop a treatment plan that is collaborative and focuses on the client’s current needs and situation.
- Develop a collaborative treatment plan that focuses on the client's current needs. Adjust the plan as treatment progresses.
A state of heightened alertness and sensitivity to potential threats.
I
Traditional ways of addressing trauma and restoring balance, which may include ceremonies, connection to land, storytelling, and involvement of elders.
Key features of this phase include:
- Links the newly processed memory to the adaptive belief about the self, using fast dual attention BLS.
- Strengthens connections to adaptive memory networks and optimizes new learning.
- The therapist first asks the client to check for a potential new positive belief related to the target memory.
- The client selects a new belief or the previously established positive cognition.
- The clinician asks the client to hold this in mind, along with the target memory, and to rate the selected positive belief on the VOC scale of 1 to 7.
- The therapist then continues alternating bilateral stimulation until the client's rating of the positive belief reaches the level of 7 (or an ecologically valid rating) on the VOC Scale.
Trauma passed down from one generation to the next, often through behaviors, attachment styles, or epigenetic changes.
A framework for understanding how different aspects of a person’s identity (e.g., race, gender, sexuality, class) intersect and contribute to unique experiences of trauma and oppression.
Initially called Cognitive Interweaves by Francine Shapiro. Interweaves are an EMDR proactive strategy designed to assist clients who appear blocked or unable to access adaptive information during EMDR reprocessing. These clients frequently experience cognitive and emotional loops that do not respond well to simpler EMDR interventions, such as changes of bilateral stimulation or speed. Clinicians might find that clients with complicated presentations require more interweaves. However, any client may run into blocks that could be reprocessed through interweaves.
Interweaves are therapist-initiated interventions used to jump-start reprocessing by introducing specific brief statements, questions, or instructions that elicit adaptive thoughts, actions, emotions, and/or imagery. These structured brief inputs aim to unblock reprocessing and facilitate linkage to adaptive information. They are client-centered, only used when necessary to overcome stuck points, and supportive to guide the client without interrupting the natural flow of adaptive reprocessing.
Unwanted, distressing thoughts, images, or memories related to the trauma.
L
Looping is a common form of blocking. Looping can be observed when a client reports the same distressing negative statements, emotions, sensations, or images repeatedly with little to no change without making progress toward resolution. Sometimes, there is a slight decrease in disturbance. However, when this occurs, instead of progressing adaptively through the information in the memory, the client is blocked in the form of cycling within the same components of the maladaptive memory.
M
A memory network is an interconnected system of related information. Although the exact appearance of memory networks is unknown, we can metaphorically imagine them as a series of channels where related memories, thoughts, images, emotions, and sensations are interconnected (Shapiro, 2018).
Subtle, often unintentional, discriminatory comments or behaviors that can accumulate over time and contribute to trauma, particularly in marginalized communities.
N
A Negative Cognition (NC)/Negative Belief is a self-referencing negative statement the client believes now, at least to some extent, when recalling the disturbing event. It reflects the client's current "interpretation" of themselves, rather than just a description. It answers the question, “What is my self-denigrating belief about myself in relation to the event?” It might include statements like “I am bad/worthless/unable to succeed.” A negative cognition that is actually true will not be changed. Clinical observations consistently show that EMDR reprocessing cannot eliminate a valid negative cognition or insert a false one (Shapiro, 2018).
O
This hypothesis is based on the innate response humans have to draw their attention to a new stimulus. According to this hypothesis, as a person engages in bilateral stimulation, their attention shifts away from the distressing memory, reducing its emotional impact and thus promoting adaptive memory reconsolidation.
P
A Positive Cognition (PC)/Positive Belief is a desirable statement that the client wants to have when thinking about the memory. In many cases, successful EMDR treatment leads to the new, positive cognition spreading throughout the entire memory network (Shapiro, 2018).
A mental health condition triggered by a terrifying event, causing flashbacks, nightmares, and severe anxiety.
Key features in this phase include:
- Strengthen therapeutic alliance to foster the client’s ability to tell the therapist what the client is experiencing throughout reprocessing.
- Educate the client about EMDR therapy processes and address client’s questions and concerns to ensure they can provide adequate informed consent.
- Enhance relaxation and affect regulation skills to appropriately facilitate dual attention during reprocessing and maintain stability between sessions. For clients with complex PTSD, it might be more beneficial to introduce affect regulation skills before proceeding with history-taking.
- Some clients may require more preparation phase for adequate stabilization and for the development of adaptive resources before dealing with disturbing memories.
- Some EMDR-derived techniques can be used to provide stabilization.
Psychotraumatology refers to the study of psychological trauma, which includes treatment, prevention, and research of experiences perceived as traumatic and the responses to those experiences. It is a discipline that includes neurobiological developments, forms of trauma exposure, and its impact across the lifespan, including consequences such as post-traumatic stress disorder (PTSD) and Complex PTSD (Olff et al, 2019).
R
The emotional and psychological harm caused by experiences of racism, discrimination, and microaggressions.
Key features in this phase include:
- Opens each session after the first reprocessing.
- Assess the client’s progress and client’s experience with previously targeted material.
- The client and counselor identify the next steps in the treatment plan.
Stickgold (2002) proposed that bilateral stimulation puts the brain into a mode of memory processing similar to REM sleep, which then helps the brain to integrate episodic traumatic memories into general semantic networks.
The “R” in EMDR refers to reprocessing. Reprocessing refers to the process (phases four to six) facilitating the brain’s ability to link distressing memories and experiences with more adaptive information. The reprocessing component largely relates to the spontaneous, adaptive connections achieved as the target memory is desensitized resulting in symptom relief, positive changes to thought quality and beliefs, and/or a sense of closure from a traumatic event. Reprocessing to an adaptive resolution is the goal of EMDR Treatment.
The ability to recover from or adapt to adversity or trauma.
Resourcing refers to the activities during Phase 2, Preparation, which focuses on building coping skills and strategies to tolerate and manage challenging emotions or memories. The term comes from using the client’s existing resources or developing new resources. These resources, including guided imagery, mindfulness, or simple practices like deep breathing, are used during and outside sessions to promote state change.
Experiencing a new trauma or being reminded of a past trauma in a way that causes renewed emotional distress.
Returning to the target refers to a strategy within EMDR reprocessing whereby the therapist directs the client to return to the original target memory/experience.
S
Safe/Calm Place is a resourcing exercise whereby the client is guided to identify positive imagery and other associated good thoughts, emotions and body sensations which evoke a feeling of safety or calm. This exercise assists the client to strengthen access to this state of mind which can become a positive internal resource for the client when needed. It is recommended as part of Phase two: Preparation to reassure clients they can recover emotional stability during any disturbance.
Symptoms similar to post-traumatic stress disorder (PTSD) that result from indirect exposure to trauma (e.g., hearing detailed trauma accounts).
A Set is the period of time the client is engaged in bilateral stimulation during reprocessing. This includes round trip passes of eye movements or other forms of bilateral stimulation, i.e., tactile and auditory, that lasts for an average of 20 to 60 seconds but may vary.
The expression of psychological distress through physical symptoms.
The standard protocol for EMDR therapy follows a three-pronged approach that targets the past, present, and future. It focuses on past experiences driving current symptoms, addresses unresolved present triggers, and uses a Future Template to prepare for upcoming situations. This protocol is embedded within EMDR's comprehensive eight-phase treatment framework, which includes history-taking, client preparation, target memory assessment, desensitization, installation, body scan, closure, and reevaluation of treatment outcomes.
State Change is a temporary shift in one’s emotional state facilitated by a change in focus of attention. This is achieved through the use of resourcing or coping exercises. For example, using a Safe/Calm Place to shift from a state of relative distress to a state of relative calm.
The Subjective Units of Disturbance scale (SUD) is a self-report measure that evaluates the level of distress associated with a memory where zero is neutral or no disturbance and 10 is the highest level of disturbance imaginable (Wolpe, 1991). The SUD scale measures the client’s level of distress in the present moment as they focus on a target memory. Reprocessing typically continues until SUD reaches zero or as low as appears possible (Shaprio, 2018).
T
Key features of this phase include:
- Engage with target memory before reprocessing begins.
- Identify components of the target memory: Image, Negative Cognition, Positive Cognition, Emotions, and location of disturbance in the body.
- Evaluate components of memory: Validity of the Cognition (VoC), Subjective Units of Disturbance (SUD).
A target memory is any life experience identified during treatment for reprocessing. The client considers these memories disturbing by the client and are identified as contributing to present symptoms. These memories are worked on during assessment and reprocessing phases of EMDR treatment; however, alternative target memories may take priority as treatment progresses, or other associated memories not previously identified may arise.
The Three-Pronged Approach refers to the principle of EMDR psychotherapy that identifies and reprocesses (a) Memories of past adverse life experiences that underlie present problems, (b) Present-day situations that elicit disturbance and trigger maladaptive responses; and (c) Anticipatory future scenarios that require adaptive responses.
A tool to help clients become more aware of their internal experiences and to record disturbance that occurs between sessions, generally on a chart. TICES stands for trigger, image, cognitions, emotions, and sensations.
Trait change refers to a sustained or permanent shift in an individual’s personality, viewpoint, or perception. It occurs when a client reprocesses and reshapes their relationship to a memory or resolves a traumatic experience.
Trauma refers to an emotional and psychological response to an event or a series of events that exceeds an individual’s ability to cope either by direct experience or witnessing (indirect) exposure.
These event(s) impact thought quality, behavior, emotions, neurological fight/flight/freeze/fawn reactivity, or other aspects of functioning and healthy regulation. This can result in lasting symptoms of fear, helplessness, dissociation, confusion, or others and disrupts a person’s belief about themselves or the world around them. Traumatic experiences may be singular events or chronic and persistent environmental states, which include human actions (e.g. rape, accidents, war, oppression, childhood abuse), natural forces (e.g. earthquakes), sudden or unpredictable losses (e.g. death of loved one), and medical experiences (e.g. medical diagnosis, progression of symptoms).
Psychotherapy that specifically addresses the impact of trauma, such as EMDR or Trauma-Focused Cognitive Behavior Therapy (CBT).
An approach that acknowledges the widespread impact of trauma and seeks to avoid re-traumatization.
V
The Validity of Cognition (VOC) scale is a self-report measure that evaluates how strongly a client believes in a positive cognitive statement identified during treatment. This tool assesses the believability of the new positive belief on a scale from 1 (completely false) to 7 (completely true). Higher scores reflect a stronger belief in the positive cognition, allowing the therapist to monitor progress and adjust the session as needed.
Emotional residue from exposure to others’ trauma, often experienced by caregivers or professionals.
W
The optimal zone of arousal where a person can function effectively; outside of it are states of hyperarousal and hypoarousal.
The hypothesis posits that bilateral stimulation overloads working memory capacity, causing the target image to diminish/fade due to the competition for limited resources. The belief is that the brain struggles to retain the vividness of the traumatic memory while also focusing on the bilateral stimulation, which causes it to become less distressing over time (van den Hout, et al., 2012).
