Understanding Phase 4 of EMDR: Desensitization
We’ve already explored phases 1-3 of EMDR in our previous blogs. Today we are going to look at phase 4- Desensitization.
What does Phase 4 look like?
Phase 4 is what most people think of when they think about EMDR, because this is where the processing starts. This is also what makes EMDR look and feel quite different compared to most talk therapy sessions. Phase 4 encompasses active reprocessing. Your therapist will help you bring the target memory to mind, and then you will follow where your mind takes you, watching and feeling what comes up as if you’re on a train watching the scenery pass by the window- just noticing thoughts, images, feelings, and sensations as they arise.
While doing this, you will be engaging in some type of bilateral stimulation or “BLS”. Typically, the BLS involves either side-to-side eye movements (the “EM” in “EMDR”), fast-paced taps, or some type of audio tone which alternates between your right and left ears. Your therapist will be there to make sure you continue in your window of tolerance (not feeling overwhelmed or shut down) and that you are not distracted and haven’t veered off course. Unlike other therapies, you do not have to re-tell or describe the traumatic memory. Starting with the target memory, Phase 4 provides the opportunity to explore the memory, gain insights, and make associations with other events or memories until the target memory feels resolved.
The Role of the SUD Scale
This processing continues until the SUDs (subjective units of disturbance/distress) reduce to 0. During EMDR, we use a scale of 0-10 to assess the amount of distress felt when bringing a target memory to mind. Once phase 4 is complete (in most cases, when the client reports a SUDS of 0), many describe being able to feel calm alongside the memory, or feeling like the memory is farther away, and better situated in the past. At this point, the memory no longer holds a painful, disruptive grip in the present.
An Adaptive Healing Process
Phase 4 is not about forgetting what happened. Rather, it aims to change how the memory is stored in your brain (American Psychological Association, n.d.). You will still remember what happened, but the raw, overwhelming emotional charge of it should be significantly decreased or even gone altogether. Healing from trauma is a deeply personal journey, and you don’t have to navigate it alone. If you are curious about how EMDR might help you find relief and want to explore if we would be a good fit, I invite you to reach out today to schedule a free 15-minute consultation.
References and Resources
American Psychological Association. (n.d.). Eye movement desensitization and reprocessing (EMDR) therapy. https://www.apa.org/ptsd-guideline/treatments/eye-movement-reprocessing
Shapiro, F. (2018). Eye Movement Desensitization and Reprocessing Therapy: Basic Principles, Protocols, and Procedures (3rd ed.). New York, NY: The Guilford Press
Kaufman, S. (2021, August 13). The eight phases of EMDR therapy. EMDR International Association. https://www.emdria.org/blog/the-eight-phases-of-emdr-therapy/
Please remember that the information shared in this post is for educational purposes only and isn’t a substitute for professional mental health treatment.
Frequently Asked Questions About EMDR Phase 4
Do I have to detail every part of my trauma out loud?
No. Unlike traditional talk therapies, Phase 4 does not require you to re-tell or describe the traumatic memory in detail.
What if I can't keep my mind on the target memory?
It is completely normal for your mind to veer off course. Phase 4 is an adaptive healing process where your brain naturally makes associations with other events, images, or feelings. Simply follow where your mind takes you, like watching scenery from a train window.
How do we measure if the processing is working?
We use the SUD (Subjective Units of Disturbance/Distress) scale, which rates your distress from 0 to 10. Your therapist tracks this number throughout the session, and Phase 4 is generally complete when your SUD score reduces all the way to 0.
Will Phase 4 make me forget my past?
No. Phase 4 is not about forgetting what happened to you. You will still remember the event, but the therapy changes how the memory is stored in your brain, removing the raw, overwhelming emotional charge so it no longer holds a disruptive grip on your present life.
What happens if I start to feel too overwhelmed?
Your therapist is right there with you. You work together to ensure you stay grounded and do not feel overwhelmed or shut down. If the distress becomes too intense, you will have already learned and practiced regulation skills during phase 2, which you can use to regulate and ground.
