Eye Movement Desensitization and Reprocessing

A process of identifying and strengthening positive images, thoughts, feelings, and bodily sensations connected to the client's inner resources — capacities, strengths, supportive memories. The client recalls a moment when they felt competent, safe, or strong, and anchors the image and the bodily feel of that state. The therapist applies bilateral stimulation, increasing the resource's accessibility in memory: after the work, the resource is easier to summon in stressful situations.

• 1. Ask: "Recall a moment when you felt able to cope / safe / strong"
• 2. Have the client describe the image: what they see, hear, sense in the body
• 3. Pick an anchor word or short phrase tied to that state
• 4. Have the client hold the image and the anchor word in mind
• 5. Apply a short set of BLS (6–8 movements or taps)
• 6. Ask: "What is happening now?" — if the resource grows, continue with another 1–2 sets
• 7. Lock in the anchor: "This is your resource. You can call it up anytime with this word"

When to use:

• The Preparation phase (Phase 2) before trauma reprocessing
• A client with complex trauma who needs stabilization
• Dissociative clients before reprocessing
• Strengthening self-efficacy before heavy trauma work
• A client with a resource deficit (does not see their own strengths)

Key phrases:

Follow-up questions:

Warnings:

• ⚠️ With high dissociation — grounding techniques first, RDI only after stabilization
• ⚠️ In an active psychotic state — pharmacological preparation takes priority
• ⚠️ If the client cannot find a single resourceful memory — start from an imagined "ideal" state

Shapiro, 2001, 2018; Fisher, 2007

The client builds a mental image of a place of complete safety — real, imagined, or a mix. The image is filled in with sensory detail: colors, sounds, smells, textures, body sensations. Several sets of bilateral stimulation are then applied to consolidate the image, and an anchor word is chosen (for example, "calm", "I am safe"). In difficult situations the client can use the anchor for a quick return to the calm state.

• 1. "Close your eyes. Picture a place where you feel completely safe"
• 2. Fill in the image: "What do you see? Hear? What smells, textures? What do you feel in the body?"
• 3. Have the client hold the image and the bodily sense of calm
• 4. Apply the Butterfly Hug or another BLS, 6–8 repetitions
• 5. Ask: "What is happening?" — strengthen with another 1–2 sets if the image is stable
• 6. Pick an anchor word: "What will you call this place? What word describes it?"
• 7. Practice: "Say the word and see whether the image returns"

When to use:

• Anxiety and panic at the start of a session
• Preparation for trauma reprocessing (Phase 2)
• Activation during a session — to calm the client quickly
• Closing an incomplete session (Phase 7)
• Work with children and adolescents

Key phrases:

Follow-up questions:

Warnings:

• ⚠️ With high dissociation — grounding first (feet on the floor, objects in the hands)
• ⚠️ If the image cannot form — switch to a sensory anchor: a word, a sensation in the body
• ⚠️ Do not use images with other people — they can become triggers

Shapiro, 2001, 2018

The client visualizes a sturdy, securely sealable container — a safe, a chest, a locked room — and mentally places into it the disturbing thoughts, images, and feelings linked to the trauma. This exercise creates a psychological boundary between therapy work and everyday life. The container image can be reinforced with bilateral stimulation. The client knows that the material does not disappear but is held safely until the next session.

• 1. "Choose a container: a box, a chest, a vault, a room — anything you like"
• 2. "Make sure it is sturdy, safe, and can be securely closed"
• 3. "Place into it the disturbing thoughts, images, and feelings that trouble you"
• 4. Reinforce the container image with several sets of BLS (optional)
• 5. "Close the container. It will stay closed until we continue the work in the next session"
• 6. Practice the instruction for use between sessions

When to use:

• The client fears losing control of emotions between sessions
• Unfinished reprocessing — material needs to be "set aside" until the next meeting
• Complex trauma (the client may be overwhelmed by the material)
• Resistance or fear of reprocessing
• Session closure (Phase 7)

Key phrases:

Follow-up questions:

Warnings:

• ⚠️ With paranoia — the container can amplify control; use carefully
• ⚠️ If there is a risk of avoidance — combine with a clear agreement to continue the work
• ⚠️ The container is not a suppression technique — explain the difference to the client

Shapiro, 2001, 2018

The client crosses their arms on their chest, the tips of the middle fingers placed under the collarbones, fingers pointing up toward the neck. They then alternate taps with their hands, mimicking the wings of a butterfly, while breathing slowly and deeply. This is self-administered bilateral stimulation that can be done discreetly anywhere — at home, at work, in transit. Developed by Lucina Artigas and Ignacio Jarero in 1997 for work with hurricane survivors.

• 1. Cross the arms on the chest, fingers vertical under the collarbones
• 2. Take a slow, deep exhale (abdominal breathing)
• 3. Begin alternating taps of the hands like butterfly wings — slowly and rhythmically
• 4. Observe thoughts, images, sensations without judgment for 1–3 minutes
• 5. Practice at home several times a day, especially in a calm state

When to use:

• Anxiety and panic outside the therapy room
• Self-administered resource installation at home
• Work with children and adolescents
• Closing an incomplete session
• Group work (each participant applies it on their own)

Key phrases:

Follow-up questions:

Warnings:

• ⚠️ If there are problems with the arms or shoulders — replace with tapping on the knees
• ⚠️ With strong bodily defense or unwillingness to touch oneself — switch to auditory stimulation

Artigas, L. & Jarero, I. 1997, updated 2011

A four-step stress management exercise developed by Elan Shapiro. Each element addresses a separate self-regulation parameter: Earth — grounding in the present, Air — breath regulation, Water — switching the parasympathetic nervous system, Fire — a resource image with bilateral stimulation. Takes 1–2 minutes and can be done anywhere.

• 1. EARTH: feel your feet on the floor, your body on the chair. Name the date, the place, what you see around you
• 2. AIR: in for 4 counts, out for 4–6. Abdominal breathing. Repeat 4–6 cycles
• 3. WATER: produce saliva (imagine a lemon, drink some water) — a physiological signal for the body to switch into "rest" mode
• 4. FIRE: recall a moment or place when you felt good. Hold the image, feel the bodily sensation
• 5. Add the Butterfly Hug to the Fire step (6–8 taps) to strengthen the resource

When to use:

• Daily stress management (10 times a day for the first 2 weeks)
• A panic attack or acute activation
• Prevention: practice in a calm state to consolidate the skill
• Work with children and adolescents

Key phrases:

Follow-up questions:

Warnings:

• ⚠️ With high dissociation — start with Earth and Air only, add the rest later
• ⚠️ With swallowing problems — skip the Water step
• ⚠️ If positive memories are absent — first develop resources through RDI

Elan Shapiro

A guided imagery in which the client visualizes a calming colored light (blue, green, white — by choice) that gathers above the head and enters through the crown. The light slowly streams down through the body, dissolving tension and bringing relaxation. A quick way to release bodily activation without any equipment — especially useful when the hands cannot be used for the Butterfly Hug.

• 1. Ask the client to close their eyes and scan the body from head to feet
• 2. Detect tension or discomfort (chest, throat, belly)
• 3. "Choose a color of light that feels calming to you"
• 4. "Picture this light gathering above your head and entering through the crown"
• 5. "The light streams down through the shoulders, chest, belly, legs — wherever the light reaches, the tension lifts"
• 6. Repeat for 2–5 minutes, until the tension lessens

When to use:

• Bodily tension and tightness in the chest, throat, belly
• The client cannot use the hands for the Butterfly Hug
• Stabilization at home between sessions
• Quickly de-escalating activation at the end of a session

Key phrases:

Follow-up questions:

Warnings:

• ⚠️ With nightmares — strengthens imagery, use carefully
• ⚠️ With neurological disorders or photosensitivity — consult a doctor

EMDR tradition, Shapiro

The first phase of EMDR — a full history, identifying the key traumatic events and current triggers, assessing the client's resources and stability. The therapist defines the focus of the work: which specific event lies at the root of the present symptoms, and whether the client is ready for reprocessing. Without this stage it is impossible to build a correct treatment plan and choose a target event.

• 1. Take the history: when the problem began, what the key events were
• 2. Identify specific traumatic moments and their impact on life now
• 3. Assess current triggers: what activates the symptoms
• 4. Assess resources: what helps the client cope with stress
• 5. Assess stability: is the client ready for reprocessing (no active psychosis, no suicidal plans)
• 6. Inform about the EMDR model and the process of the work
• 7. Define the primary target event

When to use:

• The first EMDR meeting with the client
• Defining the entry point into therapy
• When the direction of work changes — re-evaluation of focus

Key phrases:

Follow-up questions:

Warnings:

• ⚠️ Do not move to reprocessing without assessing stability and resources
• ⚠️ Do not rush the choice of target event — specificity matters

Shapiro, 2001, 2018

The selection of one specific moment of the trauma — not a generalization and not the whole story, but a specific "frame" that haunts the client most. The image must be vivid, accessible to recall, and specific enough to focus on. This image becomes the entry point for all subsequent reprocessing: NC, PC, SUD, VoC, and bodily sensation are tied to it.

• 1. "Recall the event that we will work on"
• 2. "Out of the whole situation — which one moment or image is the most painful / the one that haunts you?"
• 3. Have the client describe the image concretely: what they see, hear, where they are
• 4. Check specificity: not "scary in general", but a concrete moment — a frame
• 5. Lock in the image as the entry point for Phases 3–5

When to use:

• The Assessment phase (Phase 3) before each cycle of reprocessing
• Choosing the primary target at the start of work
• When several competing memories are present — one needs to be chosen

Key phrases:

Follow-up questions:

Warnings:

• ⚠️ The image must be specific, not generalized — that is the key to effective reprocessing
• ⚠️ If the client names several images — pick the one most charged emotionally

Shapiro, 2001, 2018

A personal belief about the self that the trauma has left in the client: "I am helpless", "I am to blame", "I am not safe", "I am not good enough". This is not a description of the event and not a fact, but an irrational belief that activates with the recall of the target image. The NC is formulated in the present tense, in the first person. It is important to distinguish the NC from a description of the situation — clients often first describe the event rather than a belief about themselves.

• 1. Have the client recall the target image
• 2. Ask: "As you look at this image — what thought about yourself feels true?"
• 3. If the client describes the event — reframe: "What does this say about you as a person?"
• 4. Check the formulation: the NC must be in the first person ("I am."), in the present tense
• 5. Make sure the client "believes" the NC (at least partly) when recalling the image
• 6. Lock in the NC for the Assessment phase and as a guide for formulating the PC

When to use:

• The Assessment phase (Phase 3), formulation before desensitization
• When you need to understand the deep belief sustaining the symptoms

Key phrases:

Follow-up questions:

Warnings:

• ⚠️ The client's first answer is often a description of the event or a blaming of someone else, not a personal belief — gently reframe
• ⚠️ The NC must be in the first person and the present tense, not "back then I was weak" but "I am weak"

Shapiro, 2001, 2018

An adaptive, healing version of the negative cognition — what the client would like to believe about themselves after reprocessing the trauma: "I am able to cope", "I did what I could in that situation", "I can be safe". The PC is formulated in the present tense, without negation, realistic and concise. In Phase 5 (Installation) the PC is strengthened through BLS until VoC reaches 6–7.

• 1. Offer several PC options as opposites to or healing of the NC
• 2. Have the client choose the one that "sounds" most healing
• 3. Check the formulation: a positive statement, present tense, no negation
• 4. Measure the initial VoC: "From 1 to 7 — how true does this feel right now?"
• 5. Lock in the PC for use in Phase 5 after the SUD has come down

When to use:

• The Assessment phase (Phase 3) — right after the formulation of the NC
• The Installation phase (Phase 5) — after the SUD has dropped to zero

Key phrases:

Follow-up questions:

Warnings:

• ⚠️ The PC must not be in the form of a negation: not "I am not helpless", but "I am able"
• ⚠️ The PC must be realistic — fantastical statements do not yield a VoC of 7
• ⚠️ If the client offers a weak PC — gently suggest a stronger version

Shapiro, 2001, 2018

A numeric scale from 1 to 7 measuring how much the client believes the positive cognition (PC) when recalling the target image. It is measured twice: before reprocessing (usually 2–4) and after installation (target — 6–7). A rising VoC shows that the adaptive belief is consolidating in memory. The scale lets the therapist track progress in real time and recognize when the Installation phase is complete.

• 1. Have the client recall the target image
• 2. Offer the PC and ask for a rating: "How true does [PC] feel right now? From 1 to 7"
• 3. Record the initial VoC (usually 2–4 at the start)
• 4. After desensitization is complete (SUD = 0) repeat the measurement
• 5. Continue BLS until VoC reaches 6–7
• 6. VoC < 6 after several sets — look for a blocking belief

When to use:

• The Assessment phase (Phase 3) — initial measurement
• The Installation phase (Phase 5) — monitoring after each BLS set

Key phrases:

Follow-up questions:

Warnings:

• ⚠️ VoC < 6 after the Installation phase is a signal to continue BLS or look for a blocking belief
• ⚠️ Sometimes "6 — the maximum for this situation" is ecologically realistic and normal

Shapiro, 2001, 2018

A numeric scale from 0 to 10 measuring the emotional distress from the target image in the present moment. 0 — complete calm, 10 — unbearable distress. SUD is checked after each BLS set in the desensitization phase: a drop shows that reprocessing is moving. The aim is to bring SUD down to 0–1 before moving to PC installation. If SUD does not drop for 3+ sets in a row, consider a cognitive interweave.

• 1. Have the client recall the target image and the NC
• 2. "How much does this disturb you right now? From 0 to 10"
• 3. Record the initial SUD (usually 7–10 in the first reprocessing)
• 4. After each BLS set: "What is the SUD now?"
• 5. Continue until SUD = 0–1
• 6. If SUD does not drop for 3+ sets — apply a cognitive interweave

When to use:

• The Assessment phase (Phase 3) — initial measurement
• The Desensitization phase (Phase 4) — after each BLS set

Key phrases:

Follow-up questions:

Warnings:

• ⚠️ If the SUD does not drop after 3+ sets — do not continue mechanically; look for a block
• ⚠️ SUD = 1–2 instead of 0 is often ecologically normal, especially in grief or with realistic threats

Shapiro, 2001, 2018

The standard method of bilateral stimulation in EMDR: the client tracks a moving object (the therapist's finger, a stylus, a light bar) from left to right and back. One set is 24–36 movements at a frequency of about 1.5 Hz (30–60 seconds). The client holds the target image in mind, while the head stays still. This method is the most studied and shows the strongest effect on lowering the vividness of traumatic images.

• 1. Place the finger or stylus 30–40 cm from the client's face
• 2. Have the client hold the target image in mind
• 3. Make smooth movements left-to-right at the level of the client's eyes
• 4. Start slowly, then accelerate to a comfortable speed (1.5 Hz)
• 5. The standard set: 24–36 movements (30–60 seconds)
• 6. After the set: "What is happening?" or "What is the SUD now?"

When to use:

• The primary BLS method in the Desensitization phase (Phase 4) and the Installation phase (Phase 5)
• When there are no contraindications to eye movements

Key phrases:

Follow-up questions:

Warnings:

• ⚠️ Contraindicated in epilepsy, photosensitivity, and serious vision impairments
• ⚠️ With vestibular problems — be careful, dizziness is possible
• ⚠️ With eye trauma or eye surgery — use tapping

Shapiro, F. 1989; Shapiro, 2018

An alternative method of bilateral stimulation: alternating light taps on the knees, shoulders, or hands. It can be performed by the therapist or self-administered by the client through the Butterfly Hug. Vibrating pulsers (devices in each hand) are another option. The alternating activation of left- and right-side sensation supports the same mechanism of bilateral processing as eye movements.

• 1. Choose the method: tapping on the knees, shoulders, or hands
• 2. If the therapist is doing it — ask permission for the touch
• 3. Have the client hold the target image in mind
• 4. Alternate left–right taps at a rate of 1–2 per second
• 5. The pressure is light, not painful
• 6. After the set: "What is happening?" or "What is the SUD?"

When to use:

• Vision impairment or inability to track movements
• Epilepsy, photosensitivity
• Eye trauma or trauma to the visual system (could be a trigger)
• Work with children
• Client preference

Key phrases:

Follow-up questions:

Warnings:

• ⚠️ Always ask permission for touch on the knees or shoulders
• ⚠️ Less studied than eye movements, but clinically effective

Shapiro, 2018

Alternating sound tones or clicks in the left and right earphone in turn. The frequency is about 1–2 Hz, the volume comfortable. Especially convenient in teletherapy and when the eyes or hands cannot be used. The mechanism is the same: alternating activation of the auditory areas of both hemispheres supports bilateral processing of information.

• 1. Put the headphones on the client or set up the app for teletherapy
• 2. Check that the volume is comfortable
• 3. Have the client hold the target image in mind
• 4. Start the alternating left–right tones (1–2 Hz)
• 5. After the set: "What is happening?" or "What is the SUD?"

When to use:

• Teletherapy — the most convenient method for remote work
• Inability to use vision (blindness, eyes closed by choice)
• Inability to use the hands
• Client preference

Key phrases:

Follow-up questions:

Warnings:

• ⚠️ Check the volume — sound that is too loud distracts from the image
• ⚠️ The least researched of the three BLS methods

Shapiro, 2018

A brief, targeted intervention by the therapist when reprocessing has stalled: SUD is not dropping for 3+ sets in a row, or the client cycles back to one image or belief. The therapist asks one question or speaks one or two phrases that build a "bridge" between the traumatic memory and adaptive information (adult-life logic, resources, the reality of the present). BLS is then resumed immediately. This is not cognitive restructuring but a minimal intervention to unblock.

• 1. Note that SUD is not dropping or that the client is "stuck" on one piece of material
• 2. Choose the type of interweave for the situation (logic, adult resource, contrast, blame)
• 3. Speak one or two phrases or one question
• 4. Let the client answer (1–2 sentences)
• 5. Resume BLS immediately with the new information
• 6. Check SUD after the set — usually it begins to drop

When to use:

• SUD does not drop after 3+ BLS sets in a row
• The client is locked into one image, belief, or feeling
• A "bridge" is needed between the traumatic belief and adaptive reality

Key phrases:

Follow-up questions:

Warnings:

• ⚠️ This is a bridge, not cognitive therapy — at most 1–2 phrases, then BLS immediately
• ⚠️ If the interweave does not help after 2–3 attempts — possibly the wrong target image or a hidden block

Shapiro, 2001, 2018; Parnell

After the SUD drops to 0–1, the therapist switches the client's focus from desensitization to strengthening the adaptive belief. The client holds the original target image together with the PC, and BLS is applied. After each set the VoC is measured — it should rise. The aim is VoC 6–7, when the PC feels true. This is the moment when adaptive information consolidates in memory in place of the traumatic one.

• 1. After SUD = 0–1: "Good. Now we work with the positive belief"
• 2. Recall the PC: "Bring the image to mind together with the belief [PC]. How does it sound to you now?"
• 3. Measure the VoC: "From 1 to 7 — how true does it feel?"
• 4. Apply BLS with image + PC
• 5. After the set: "What is the VoC now?"
• 6. Continue until the VoC reaches 6–7

When to use:

• Phase 5 — after desensitization is complete (SUD = 0–1)
• Consolidation of adaptive information in memory

Key phrases:

Follow-up questions:

Warnings:

• ⚠️ In Phase 5 the focus is strictly on the original image + PC, not on new material that may surface
• ⚠️ If new material surfaces — return to it after the installation or in the next session

Shapiro, 2001, 2018

After reaching VoC 6–7 the client holds the target image and the PC simultaneously in mind and slowly scans the body from head to feet. Any residual bodily tension, discomfort, or pain points to incomplete integration — they become a new target for BLS. A session is not considered fully complete until the body is "clear". This step is often skipped — and that is a mistake.

• 1. "Hold the target image and the belief [PC] together in mind"
• 2. "Now slowly scan the body from head to feet"
• 3. "Is there any remaining tension, pain, discomfort?"
• 4. If the body is "clear" — move on to closure (Phase 7)
• 5. If there is residual tension — the sensation becomes the new target
• 6. Apply BLS to the sensation + image, repeat until it is gone

When to use:

• Phase 6 — after VoC 6–7 has been reached
• Before closing every fully reprocessed session

Key phrases:

Follow-up questions:

Warnings:

• ⚠️ Do not skip — residual bodily tension means incomplete integration
• ⚠️ Residual sensations after several BLS sets — may require a separate session

Shapiro, 2001, 2018

A mandatory procedure at the end of every EMDR session, regardless of whether reprocessing is complete. With incomplete work, the client places the remaining material into the container, returns to the safe place, and applies the Butterfly Hug. With completed work — grounding, return to the present, psychoeducation about possible processes between sessions.

• 1. Assess whether the work is complete (SUD = 0, VoC = 6–7, body scan clear)
• 2. With incomplete work: "The images and feelings that remain — let us place them into the container"
• 3. Return to the safe place, apply the Butterfly Hug
• 4. Grounding: "Open your eyes. What day is it? Where are you?"
• 5. Psychoeducation: "You may have dreams or thoughts may surface — that is normal"
• 6. Agreement: "Use the container and the Butterfly Hug if stabilization is needed"

When to use:

• The end of every EMDR session
• When reprocessing is incomplete — especially important
• When activation is present at the end of a session

Key phrases:

Follow-up questions:

Warnings:

• ⚠️ Closure is mandatory after EVERY session — without it the client leaves unstabilized
• ⚠️ Do not end a session in the middle of active reprocessing without stabilization

Shapiro, 2001, 2018

The first step of every following EMDR session — checking the client's state, the result of the previous reprocessing, and identifying the next targets. The therapist asks about dreams, thoughts, and experiences since the last meeting and checks whether the SUD of the target event has dropped. If processing has consolidated well between sessions, move to a new target or check triggers.

• 1. "How have you been since our last meeting?"
• 2. "Have there been dreams, thoughts, images connected to what we worked on?"
• 3. "When you recall the event now — what do you feel? From 0 to 10"
• 4. If SUD has risen or has not changed — return to this event
• 5. If SUD has dropped or = 0 — move to the next target or to triggers
• 6. Check generalization: "Has anything changed in your life as a result of our work?"

When to use:

• The start of every following EMDR session after the initial reprocessing

Key phrases:

Follow-up questions:

Warnings:

• ⚠️ If SUD has returned to high values — there may be a new layer or a connected event
• ⚠️ Do not move to a new target without making sure the previous one is fully consolidated

Shapiro, 2001, 2018

The basic frame of treatment planning in EMDR: one problem is processed across three temporal layers. Past — the original traumatic event or the series of formative incidents that created the present symptoms. Present — the current triggers and situations that activate the same memory network. Future — a positive image of how the client will cope in similar situations. Each layer is processed as a separate target image.

• 1. PAST: identify the original traumatic event, work until SUD = 0
• 2. PRESENT: "What in your life now reminds you of this?" — process each trigger
• 3. FUTURE: "Suppose something similar happens again. How will you handle it?" — build a coping image
• 4. Process the future image with BLS, PC: "I can cope"
• 5. VoC of the future image = 6–7 — the work is complete

When to use:

• Treatment planning for most traumas and PTSD
• The standard frame of EMDR work with any problem

Key phrases:

Follow-up questions:

Warnings:

• ⚠️ Do not move to the present or the future before the SUD of the past event has dropped
• ⚠️ There may be many present-day triggers — process them in sequence, starting with the most charged

Shapiro, 2001, 2018

The third and closing part of the standard three-pronged protocol: the client builds a positive image of themselves in a similar future situation and processes it through BLS. This is not a daydream but a concrete scenario: "What happens first? How do you respond? What do you say or do?". The aim is to consolidate in memory an adaptive pattern of behavior that the client can use in real life.

• 1. "Picture that something similar happens in the future. Not the same, but similar"
• 2. "How do you notice the first signal of danger? What do you do?"
• 3. Build an image of the moment of choice / the first adaptive reaction
• 4. PC: "I can cope" or "I have options"
• 5. Measure the SUD of the image (usually low) and the VoC
• 6. Process with BLS until VoC 6–7

When to use:

• Closing the work with a specific trauma or phobia
• The client expresses worry: "What if it happens again?"
• Relapse prevention

Key phrases:

Follow-up questions:

Warnings:

• ⚠️ Move to this only after processing the past and the present-day triggers — not as a first step
• ⚠️ If the future image evokes high SUD — there may still be unprocessed present triggers

Shapiro, 2001, 2018

An adaptation of standard EMDR for acute, recent traumatic events (days–3 months). The aim is rapid treatment in 2–4 sessions, preventing chronification into PTSD. It differs from the standard protocol in stronger preparation (more time on resources), more conservative desensitization (fewer SUD cycles at a time), and careful closure of every meeting. The event is still alive and vivid — the brain is able to integrate it quickly with the right support.

• 1. Brief history: what happened, when, SUD now
• 2. Strengthened preparation: resources, safe place, container, testing BLS
• 3. Assessment: one primary target image, NC, PC, VoC, SUD, body sensation
• 4. Conservative desensitization: fewer sets at a time, frequent SUD checks
• 5. Installation and Body Scan
• 6. Careful closure with the container and the safe place

When to use:

• Acute trauma (days, weeks — up to 3 months)
• High risk of chronification into PTSD
• Accident, disaster, assault, acute loss

Key phrases:

Follow-up questions:

Warnings:

• ⚠️ More attention to stabilization before reprocessing than in standard EMDR
• ⚠️ Do not force the depth of reprocessing — risk of decompensation with recent trauma

Shapiro, developed for crisis situations

A specialized protocol for processing specific phobias on the basis of the three-pronged protocol. A phobia often has an original traumatic event (sometimes early childhood), current trigger scenarios (many — flying, the airport, takeoff), and a desired future image of calm interaction. Each scenario may require separate processing. High avoidance is a sign that work should move from less intense scenarios to more frightening ones.

• 1. PAST: "What is the earliest memory of this fear?" — process the original event
• 2. If no original event is found — move to current triggers
• 3. PRESENT: identify all trigger scenarios (e.g., booking → airport → boarding → takeoff → turbulence)
• 4. Process each scenario as a separate target image, from less to more intense
• 5. FUTURE: build an image of calm interaction with the object of the phobia
• 6. Process the future image with BLS, PC: "I am safe" or "I can cope"

When to use:

• Specific phobias: heights, flying, animals, injections, medical procedures
• Phobic avoidance that limits the client's life

Key phrases:

Follow-up questions:

Warnings:

• ⚠️ With active panic or dissociation — stabilization first
• ⚠️ With a high SUD on the first scenario — consider the Flash Technique
• ⚠️ Phobias require several sessions — do not force it

Shapiro, 2001, 2018

A specialized EMDR protocol for processing grief and loss. Unlike the standard protocol, it does not aim to "erase" the pain — the goal is to reintegrate it into the client's life so that they can keep living with the memory of the loss without paralyzing distress. Target images include the moment of realizing the death, traumatic scenes, regrets, unfinished conversations. The PC is formulated not as a denial of the reality of the loss but as integration: "I can carry this pain and keep living".

• 1. History: how long the grief has lasted, was the death expected, are there resourceful memories
• 2. Define target images: the moment of realization, traumatic scenes, regrets, the unfinished
• 3. NC: often "It is my fault" or "I should have been there" or "Without him/her there is no meaning"
• 4. PC: "I did what I could" or "I can carry this pain and keep living"
• 5. Process each image in sequence
• 6. Long work: months, not weeks

When to use:

• Grief and loss — the loss of a loved one
• Unresolved grief, "stuck" mourning
• Traumatic death (sudden, violent, suicide)
• Regrets, the feeling of guilt over the loss

Key phrases:

Follow-up questions:

Warnings:

• ⚠️ The protocol is long — 6–20+ sessions, do not force it
• ⚠️ The PC does not deny the reality of the loss — it integrates it
• ⚠️ SUD = 1–2 at the end of mourning is normal — full "0" may not be the goal

Luber, 2005; Shapiro, 2018

A minimally invasive technique for clients who are not ready for full contact with a traumatic image. Instead of holding the image throughout an entire BLS set, the client looks at it for only 1–2 seconds (a "flash") and then switches to a neutral or safe object. BLS is then applied. The cycle repeats many times. The brain gradually processes the traumatic information without the risk of overwhelm.

• 1. Explain: "Instead of holding the image, we will work with very brief flashes"
• 2. Choose a neutral object to switch to (a table, a book, the hands)
• 3. Give the cue: "Look" — the client sees the image for 1–2 seconds
• 4. "Now look at [the object]" — the switch
• 5. BLS (eye movements or tapping)
• 6. Repeat: flash → neutral → BLS → flash → neutral → BLS
• 7. Check the SUD every 5–10 cycles

When to use:

• Dissociation — risk of fragmentation with the full image
• Very high SUD (the client cannot hold the image for 30+ seconds)
• Suicidal ideation or high risk of decompensation
• Reduced concentration or attention
• The client asks for a less intense approach

Key phrases:

Follow-up questions:

Warnings:

• ⚠️ The technique is less studied than standard EMDR — use only on clear indications
• ⚠️ Does not replace the full protocol with stable clients

Manfield, Phil, 2012; Journal of EMDR Practice and Research

The client goes through the standard EMDR process without disclosing the content of the trauma to the therapist. The therapist knows there is a problem but does not know the details — only the SUD and VoC numbers, a body location, a general category (work, relationships). The client processes the image mentally, in full silence. This creates a unique level of privacy and often helps clients with high shame to open up during reprocessing.

• 1. Explain: "I am not asking you to tell me what this situation is"
• 2. "Hold the situation in mind. How much does it disturb you? From 0 to 10"
• 3. NC and PC — the client formulates them on their own; the therapist helps only with structure
• 4. VoC and SUD — only numbers, no explanations
• 5. Body Scan — the client points to a body area without describing the content
• 6. Desensitization: BLS in silence; after the set — only "What is the SUD?"
• 7. Installation and closure — standard

When to use:

• High shame, when the client cannot speak about details
• Professionals (police, doctors, military) facing reputational risk
• Protecting the confidentiality of third parties
• Cultural restrictions on disclosing certain topics

Key phrases:

Follow-up questions:

Warnings:

• ⚠️ Cognitive interweave is harder without knowing the content
• ⚠️ If processing stalls, partial disclosure may become necessary
• ⚠️ Requires therapist experience — orienting only by numbers is harder

Blore, D. 2005; Journal of EMDR Practice and Research

An adaptation of EMDR for group work in conditions of mass trauma: natural disaster, war, catastrophe. Groups of 8–15 people. The emphasis is on stabilization and resources, with minimal reprocessing. The Butterfly Hug is the main BLS method (each participant applies it on their own, preserving privacy). Processing happens internally — people do not speak about their images aloud. The goal is first aid and screening of those who need individual therapy.

• 1. Introduction: explain the method, normalize trauma reactions
• 2. Teach the Butterfly Hug — each person practices on their own
• 3. Resources: the safe place, the group as support
• 4. Target event (shared for the group or individual)
• 5. Butterfly Hug + internal processing in silence (10–15 minutes)
• 6. Closing: what has changed, resources, group support

When to use:

• Natural disaster: hurricane, earthquake, flood
• War, mass violence
• When there are many traumatized people and few resources for individual work

Key phrases:

Follow-up questions:

Warnings:

• ⚠️ The group protocol is first aid, not a replacement for individual therapy
• ⚠️ Do not allow disclosure of traumatic content aloud in the group

Jarero, I. & Artigas, L. 2000+

Holding the target image and the negative cognition in mind, the client scans the body from head to feet, noticing the bodily sensations linked to the trauma: tension, pain, numbness, pressure, heat, cold, a lump in the throat. The sensation that is identified becomes part of the reprocessing "package" — an anchor for the desensitization phase. Skipping this step means an incomplete capture of the traumatic reaction.

• 1. Have the client recall the target image and the NC at the same time
• 2. "Now slowly scan the body from head to feet"
• 3. Ask questions by zone: head, neck, shoulders, chest, belly, legs
• 4. Pay attention to: tension, pain, numbness, heat, cold, pressure, tingling
• 5. Identify one main bodily sensation as the anchor for the work
• 6. Note the location and quality of the sensation

When to use:

• The Assessment phase (Phase 3) — before desensitization
• For full capture of the traumatic response: image + belief + body

Key phrases:

Follow-up questions:

Warnings:

• ⚠️ Do not skip — the bodily component is part of the activation of the problem; without it the reprocessing is incomplete
• ⚠️ Dissociative clients may not feel the body — work with descriptions of "emptiness" or "nothing"

Shapiro, 2001, 2018