What happens in an EMDR therapy session from the chair

Run the hour as opening check, one target, sets, then close. For the eight-phase completion test across treatment, use the EMDR 8 phase protocol guide. For readiness, measurement, and documentation posture, use EMDR basics for therapists. Stay here when the hour is already a reprocessing session and you need the next cue.

Educational content for licensed clinicians with EMDR training or live consultation for this hour. It is not Shapiro scripts, and not permission to process without training. The leftover-time window, incomplete-close sequence, SUD remainder call, and no take-home bilateral stimulation rule are clinician judgment for this hour, not Institute protocol.

What happens in an EMDR therapy session

The EMDR Institute clinician description names EMDR as an eight-phase treatment. The VA clinician page on EMDR for PTSD describes weekly, up to 90-minute individual sessions. A reprocessing hour usually holds assessment through closure. History and preparation may already be done. Reevaluation opens the next contact. You can loop inside a phase. Closing an unfinished target is still the hour. That close is chair-side, not a reason to skip Phase 7.

Francine Shapiro’s protocol text is the source for phase order. Use that text and EMDR training for the procedures. If you should not be in reprocessing today, stop. Preparation can be the clinical work.

Do not build a past-present-future map in this hour. That job sits on the EMDR target development worksheet. One selected target is enough.

Opening check

What you do: Recheck last week’s target, present window, consent for this method and this target, and the minutes you still have for a real close.

What you say: “When you think of last week’s target, what do you notice now? Where is it in the body? Can we stop if you need to?”

What you watch for: Orientation, a usable stop signal, a resource that still works without you narrating it, and whether they have to drive, pick up a child, or walk into a high-conflict house after the hour.

If last week’s SUD is back up, you are still on that target. Opening a bigger memory so the note looks productive is not the next step. If they arrive flooded, you are in preparation. You are not in sets. What happens in an EMDR therapy session does not change because the booked slot is 50 minutes. You still close.

Target activation

What you do: Activate one already selected target. Image, negative cognition, desired positive cognition, VOC, emotion, SUD, body location. Write the baselines. Bilateral stimulation has not started.

What you say: “What picture represents the worst of it now? What words go with that about yourself? When you pair it with [positive cognition], how true does that feel, 1 to 7? What emotion is here? 0 to 10, how disturbing? Where do you feel it?”

What you watch for: A story that wants to replace the picture, a second memory crowding in, or your own hand starting the stimulus because the image is already vivid.

Those questions are the assessment elements the VA clinician page on EMDR for PTSD lists in public clinical language. They are not a grade. A high SUD at activation is information, not a reason to rush the first set.

Sets

What you do: Dual attention. One set, then a pause. Stay out of the content. Track whether they are in the room.

What you say: “Notice that.” After the set: “What do you get now?” If they are still in a channel and oriented: “Go with that.”

What you watch for: Presence with distress can be processing. A blank face, lost time, or frozen compliance is not a score to chase. If orientation drops, stop the stimulus and restabilize. Do not go faster to finish the channel.

When a channel clears, return to the original picture and recheck SUD. Crying, insight, or one set does not complete desensitization. EMDR Institute puts installation after the client reports no distress related to the targeted memory. The VA clinician page uses body scanning after distress is greatly reduced, then moving on once distress is alleviated and the more adaptive self-appraisal feels true. A SUD of 0 or 1, or an ecological remainder, is how you may call that in the chair. It is not a published VA cutoff. If distress is still high, you do not install.

Close incomplete

What you do: Keep a leftover window. Ten to 15 minutes is chair-side, not an Institute clock. Stop bilateral stimulation. Name that the target is unfinished. Use the resource they already have. Contain leftover material. Orient to the room. Agree the gap. Do not install. Do not add a trauma narrative as homework.

What you say: “We are going to pause. This is not finished, and that is allowed. Put the leftover in the container we already practiced. Look around the room. Tell me three things you can see.”

What you watch for: They are still in the garage in their body. They want to “just finish.” You want a tidy VOC in the note. None of those is a reason to install “I am safe” on a chest that is still at SUD 4.

EMDR Institute names Phase 7 as closure, with a log of related material and the Phase 2 self-calming work. Ending the hour in that close, complete or not, is still the method. An activated exit is not.

Mira’s hour was EMDR because the cues were honest. It would not have been EMDR if you had installed “I can leave” on a SUD 5 chest so the chart would look complete.

Keep the next hour honest

The between-session log is a label, not a replay. Dreams, a spike at the ramp, a new picture, a night they could not sleep. Short. Dated. EMDR Institute asks for related material and a self-calming reminder. The no take-home bilateral stimulation rule is chair-side. Dual attention stays in the room with you. No processing in the garage.

Next contact starts on this target. If the log is a flood, you are in preparation again. If SUD held or dropped, resume sets. If they want “the next memory” because this one was hard, stay with the one you opened.

Carry the phase you actually completed, the SUD you closed on, the feeder you did not finish, and the close you used. Keep this map of what happens in an EMDR therapy session next to the hour, not next to a transcript. The therapist stays with the protocol. Emosapien can hold that line so next week’s hour does not open on a blank chart.

References

• EMDR Institute. What is EMDR?.
• Shapiro, F. (2018). Eye Movement Desensitization and Reprocessing (EMDR) Therapy: Basic Principles, Protocols, and Procedures (3rd ed.). Guilford.
• U.S. Department of Veterans Affairs, National Center for PTSD. Eye Movement Desensitization and Reprocessing (EMDR) for PTSD.