Beyond the Protocol: Relational Perspectives on the Eight Phases of EMDR

Eye Movement Desensitization and Reprocessing (EMDR) therapy is often described as an eight phase, evidence based approach to treating trauma and other distressing experiences. As clinicians, we are taught the structure of the protocol, the sequence of interventions, and the clinical decision making necessary to support adaptive information processing. Yet, after years of practicing EMDR and providing consultation to other clinicians, I have come to believe that while the protocol provides the roadmap, relationship creates the conditions in which healing can occur.

This perspective is particularly relevant when working with clients who have experienced developmental trauma, attachment disruptions, chronic invalidation, or environments where emotional experiences were minimized or ignored. In these cases, EMDR is not simply something we do to clients. It is something we engage in together.

Francine Shapiro (2012) reminded us that, "The past affects the present even without our being aware of it" (p. 3). The work of EMDR involves helping clients access and reprocess these experiences so they are no longer organized around survival.

How we move through the eight phases matters. Equally important is how we show up within them.

History Taking as Witnessing

History taking becomes more than information gathering. It is an opportunity to witness clients' stories and understand the adaptations that once helped them survive. In consultation, I sometimes hear clinicians describe clients as "avoidant," "guarded," or "not ready." Sometimes these observations are accurate. Other times, they reflect our own urgency to move toward reprocessing before sufficient trust has been established.

One consultee brought a case in which the client repeatedly changed the subject whenever childhood experiences were discussed. The clinician wondered whether the client was resistant to treatment. Through consultation, we explored an alternative perspective: What if this was not resistance but protection? What if the client's nervous system had learned that vulnerability came at a cost?

Shifting from pathology to adaptation transformed the treatment approach. Rather than pushing toward targets, the clinician slowed down, deepened attunement, and strengthened the therapeutic alliance. Over time, the client's willingness to engage expanded naturally.

Preparation as Co Regulation

Preparation extends beyond teaching coping skills. Peter Levine (2010) wrote, "Trauma is not what happens to us, but what we hold inside in the absence of an empathetic witness" (p. 233). Through attunement, psychoeducation, and resource development, therapists help clients build the capacity to remain present with difficult experiences.

In consultation, I frequently encounter clinicians who feel frustrated that they "cannot get to Phase Four." Often, however, the work of preparation is exactly where treatment needs to be. One clinician described repeatedly attempting reprocessing with a client who became emotionally flooded within minutes of activating a target memory. Together, we revisited stabilization skills, strengthened Resource Development and Installation, and explored how the therapist's own anxiety about "moving the work forward" may have contributed to pacing that exceeded the client's capacity. Several sessions later, the client successfully engaged in reprocessing. Preparation had not delayed treatment. It had made treatment possible.

While there is tremendous value in dedicating adequate time to Phase 2 preparation, clinicians must also be mindful not to remain there longer than clinically indicated. Over resourcing can inadvertently reinforce clients' beliefs that they are incapable of tolerating distress or that they must be completely symptom free before engaging in reprocessing. The goal of Phase 2 is not perfect regulation, but sufficient stabilization and confidence in the client's ability to navigate the processing experience with appropriate support.

Assessment and Desensitization as Collaborative Presence

Assessment becomes a collaborative process of helping clients put language to experiences that have often existed outside of awareness. Desensitization requires us to trust the client's innate capacity toward healing while remaining attentive to pacing, signs of overwhelm, and the need for additional support.

Shapiro (2018) emphasized that EMDR therapy targets the unprocessed memories that contain the emotions, sensations, and beliefs associated with disturbing experiences.

In consultation groups, clinicians often bring cases involving looping, blocked processing, or uncertainty about when to intervene. While protocol knowledge is essential, so is curiosity.

I frequently ask consultees:

• What is happening between you and the client right now?

• What feelings are emerging in you as the therapist?

• What might the client's nervous system be communicating?

• What would happen if we trusted the pace of the process?

Sometimes the answer lies in a cognitive interweave. Other times, it lies in repairing a subtle rupture, acknowledging fear, or slowing the pace enough for the client to remain present.

Installation and the Body Scan as Reclaiming Self

Installation is not simply about strengthening positive beliefs. It is about helping clients recognize truths that emerge through their own experience. Similarly, the body scan invites clients to reconnect with embodied awareness and approach sensations with curiosity rather than fear. One clinician consulted about a client who struggled to endorse the positive cognition, "I am enough." Rather than challenging the client's difficulty, we explored the historical context in which believing otherwise had been protective.

As the clinician approached the experience with compassion rather than correction, the client's response shifted from self criticism to grief. Processing resumed. What initially appeared to be a cognitive block became an opportunity for deeper understanding.

Closure and Reevaluation as Ongoing Relationship

Closure reflects our responsibility to support stabilization and integration between sessions, while reevaluation reminds us that healing is rarely linear. In consultation, clinicians sometimes express disappointment when previously resolved material resurfaces. Yet reevaluation invites a different perspective. As clients develop greater capacity for awareness and regulation, new layers of experience often emerge. This does not necessarily indicate treatment failure. It may reflect increased readiness.

Healing rarely unfolds in a straight line.

Beyond the Protocol

The protocol matters. Fidelity to the model matters. At the same time, healing unfolds within relationship.

Francine Shapiro (2018) emphasized that EMDR targets the unprocessed memories that contain the emotions, sensations, and beliefs associated with disturbing experiences. Yet these experiences are rarely processed in isolation. Clients encounter them while sitting with another human being who offers steadiness, curiosity, and presence. Peter Levine (2010) reminds us that. "Trauma is not what happens to us, but what we hold inside in the absence of an empathetic witness" (p. 233). this perspective aligns closely with Gestalt therapy's emphasis on authentic contact. Polster and Polster (1973) observed "The therapist's work is to be present, available, and authentic in the encounter" (p. 101).

Within EMDR, therapeutic presence does not replace the protocol. Rather, it provides the relational foundation that allows clients to engage with it. For many individuals, particularly those with developmental trauma or attachment wounds, the experience of remaining connected while approaching painful material may itself be reparative.

Perhaps the question is not whether EMDR is procedural or relational. Rather, it is this:

How do we embody the protocol in ways that foster safety, awareness, and authentic contact?

The most meaningful consultation experiences often involve helping clinicians trust both the structure of EMDR and their own therapeutic presence. We explore not only what intervention to use, but how to understand the person sitting in front of them.

EMDR gives us the map.

Relationship helps clients travel the terrain.

References

Levine, P. A. (2010). Healing trauma: A pioneering program for restoring the wisdom of your body. Sounds True.

Polster, E., & Polster, M. (1973). Gestalt therapy integrated: Contours of theory and practice. Vintage Books.

Shapiro, F. (2012). Getting past your past: Take control of your life with self-help techniques from EMDR therapy. Rodale.

Shapiro, F. (2018). Eye movement desensitization and reprocessing (EMDR) therapy: Basic principles, protocols, and procedures (3rd ed.). Guilford Press.