What Is EMDR Therapy? A Step-by-Step Look at the 8 Phases of Treatment
What is EMDR therapy? Learn how the 8 phases work, what a session feels like, and how EMDR fits addiction treatment for trauma in Texas.
TL;DR
EMDR (eye movement desensitization and reprocessing) is a structured trauma therapy that helps your brain store painful memories so they stop feeling like they are happening now.
It has 8 phases. Only some of them involve eye movements or other bilateral stimulation. The first two phases are about history and preparation.
Trauma and addiction often travel together, so treating only the substance use can leave the driver of it untouched.
EMDR can stir up strong feelings. It works best when you have coping skills, stable support, and a clinician who paces the work.
If you are in crisis, call the SAMHSA National Helpline at 1-800-662-HELP (4357) or dial 988.
Table of Contents
Why EMDR matters in addiction and co-occurring disorder treatment
Who can benefit from EMDR (and who may need additional support)
How EMDR fits into a comprehensive treatment plan at Greater Texas Behavioral
Introduction
Some memories do not stay in the past. A smell, a raised voice, or a certain time of night can drop you straight back into the worst moment of your life, and drinking or using may be the only thing that has ever quieted it.
If that sounds familiar, you may have heard about EMDR and wondered what it is. This article explains what EMDR therapy is, what happens in each of its 8 phases, and where it fits when addiction is part of the picture. We are Greater Texas Behavioral, and we want you to know what you would be walking into before you decide anything.
What is EMDR therapy and how does it work?
EMDR stands for eye movement desensitization and reprocessing. It is a talk-based therapy for trauma with one added step: while you briefly hold a distressing memory in mind, you follow a rhythmic left-right input. That input is usually the therapist's moving fingers, but it can also be alternating taps or tones.
The idea is that a traumatic memory can get stuck in a raw, unprocessed form. When it is stuck, your body reacts as if the danger is current. EMDR aims to let your brain file the memory away as something that happened, not something that is happening. You still remember it. It just stops hijacking you.
In practice, EMDR is not hypnosis, and you stay awake and in control the whole time. You do not have to describe every detail of what happened. Many people find that a relief.
Why EMDR matters in addiction and co-occurring disorder treatment
Many people who struggle with alcohol or drugs also carry trauma. When both are present, clinicians call it a co-occurring disorder. NIDA, the National Institute on Drug Abuse, describes its work as supporting science on drug use and addiction, including treatment research.[1] NIAAA does the same for alcohol use disorder and treatment for alcohol problems.[2]
This matters for you because if a substance is how you cope with flashbacks, nightmares, or dread, stopping the substance without addressing the trauma can leave you with the same pain and fewer ways to manage it. The ASAM Criteria, the American Society of Addiction Medicine's treatment guidelines, call for person-centered plans for patients with addiction and co-occurring conditions.[3]
EMDR is one tool for the trauma side of that plan, used alongside addiction care, not instead of it.
The 8 phases of EMDR therapy
EMDR follows a set sequence, and knowing the order can take away much of the fear of the unknown. The table gives the overview, and the next section walks through each phase.
Step by step
Phase 1, history and treatment planning. Your therapist asks about your past, your symptoms, and your substance use. Together you choose which memories to work on and in what order. No processing happens yet.
Phase 2, preparation. You learn how EMDR works and practice calming skills, such as slow breathing or picturing a safe place. This phase can take several sessions, and it matters most if you are early in recovery.
Phase 3, assessment. You pick one memory and name the worst image, a negative belief about yourself ("I am in danger" or "It was my fault"), and the belief you would rather hold. You rate how distressing it feels on a 0 to 10 scale.
Phase 4, desensitization. This is the part people picture. You focus on the memory while following the bilateral stimulation in short sets. Between sets you report whatever came up. The therapist guides, but your mind does the work.
Phase 5, installation. Once the memory feels less charged, you reinforce the healthier belief until it feels true.
Phase 6, body scan. You hold the memory and the new belief together and notice any tightness or discomfort in your body. Leftover tension means the memory is not fully processed.
Phase 7, closure. The therapist helps you return to calm, even if the memory is not finished. You leave with skills for handling anything that surfaces between visits.
Phase 8, reevaluation. The next session begins by checking how the memory feels now. Then you decide whether to continue or move to a new target.
What to expect during an EMDR session
A session usually runs 60 to 90 minutes. Most of the early ones are talking and skill-building, not processing. When processing starts, you may feel emotion, notice body sensations, or see the memory shift or fade.
You can stop at any time. A good EMDR therapist watches your pace and will slow down if you become overwhelmed. Feeling tired afterward is common, and so are vivid dreams for a day or two.
Eat something and drink water beforehand.
Avoid alcohol or other substances before a session.
Plan a quiet hour afterward if you can.
Tell your therapist about any urges that spike between visits.
If you are wondering how this might work remotely, our post on how virtual IOP works in Texas explains the online side of care.
Who can benefit from EMDR (and who may need additional support)
EMDR is designed for trauma-related distress. That includes memories of assault, combat, accidents, abuse, loss, or medical emergencies. Many adults who use substances to blunt those memories can benefit.
It is not right for everyone at every moment. You may need more stability first if any of these are true:
You are in active withdrawal or using heavily.
You are having thoughts of suicide. Call or text 988 now.[4]
You are in an unsafe living situation.
You have severe dissociation, where you often lose time or feel detached from yourself.
In those cases, the first goal is safety and detox, not memory work. Anxiety is also common alongside trauma, and our article on anxiety therapy versus medication covers that side. If you want to compare approaches, see dialectical behavior therapy, which builds the coping skills that make EMDR safer to start.
How EMDR fits into a comprehensive treatment plan at Greater Texas Behavioral
At Greater Texas Behavioral, trauma work is not a separate track. We assess substance use and mental health together, then build one plan. Under the DSM-5-TR, the standard manual clinicians use to define and classify mental disorders, trauma-related conditions and substance use disorders are both diagnosable and treatable.[5]
That plan may combine group therapy, individual counseling, medication when appropriate, and trauma-focused work. If you need structure but live far from a facility, read whether virtual IOP programs can treat alcohol and substance use.
We can talk with you about timing. Some people start trauma processing early. Others spend weeks building stability first. Neither is a failure.
Taking the first step toward trauma-informed care
You do not need to know whether EMDR is right before you call. You only need to be willing to talk. An assessment will show whether trauma is driving your substance use and what order of care makes sense.
If you are not ready to contact us, the SAMHSA Treatment Locator and National Helpline (1-800-662-HELP) are free and confidential.[4] If a family member is the one searching, you can ask the same questions on their behalf.
Frequently Asked Questions
Q: What is EMDR therapy, and how does it help with trauma?
A: EMDR is a structured therapy in which you recall a distressing memory in small doses while following a left-right input such as eye movements or taps. It aims to help your brain reprocess the memory so it feels less intense and less present. You keep the memory but lose much of its charge.
Q: What are the 8 phases of EMDR therapy?
A: They are history and treatment planning, preparation, assessment, desensitization, installation, body scan, closure, and reevaluation. The first two build safety and skills. Phases 3 through 6 process a single memory. Phases 7 and 8 close the session and check progress.
Q: How many EMDR sessions does it usually take to see results?
A: It varies. A single, recent trauma may need fewer sessions than long-standing or repeated trauma. Preparation alone can take a few sessions, so expect the work to span weeks to months. Your therapist can give you an estimate after the history phase.
Q: Is EMDR therapy effective for people in recovery from drug or alcohol addiction?
A: Many people in recovery carry trauma that fuels cravings, so treating it can matter. EMDR is not a substitute for addiction treatment, and timing matters. It is usually added once you have some stability, and alongside relapse-prevention care.
Q: Does EMDR therapy hurt, and are there side effects or risks?
A: It does not cause physical pain, but it can bring up strong emotions, tiredness, headaches, or vivid dreams after a session. These usually pass within a day or two. Tell your therapist if distress or cravings rise, so the pace can change.
Conclusion
EMDR is an eight-phase method for helping your brain stop reliving painful memories, with preparation first and processing second. When trauma and addiction are tangled together, it can be one useful part of a larger plan.
Greater Texas Behavioral can help you work out whether it fits you. Visit greatertexasbehavioral.com to start a conversation, and if you are in danger right now, call 988.
References
National Institute on Drug Abuse. NIDA.NIH.GOV. - https://nida.nih.gov
National Institute on Alcohol Abuse and Alcoholism. NIAAA Home. - https://www.niaaa.nih.gov
American Society of Addiction Medicine. ASAM Home and The ASAM Criteria, 4th Edition. - https://www.asam.org
Substance Abuse and Mental Health Services Administration. SAMHSA Home: National Helpline, 988 Lifeline, and Treatment Locators. - https://www.samhsa.gov
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). - https://www.psychiatry.org/psychiatrists/practice/dsm
